An Important Decision: Health Care Insurance

There are quite a few things you have to consider when shopping for a health care insurance plan, especially if a plan has not already been chosen by your employer, union or professional organization. This particular decision is even more worrisome if there is a possibility that you may need long-term health care coverage in the very near future, as the cost of a nursing home or in-home care can stack up quickly.

The Different Kinds of Health Insurance

What kind of health care insurance you need depends on how many family members you need covered, if your family has need of any long-term care, how many options you want in prescriptions and doctors, and whether or not your claims are filed automatically. Network based health care insurance is the type of plan that relies on a group of health care providers banded together to offer affordable services to those covered by a network health plan.

HMOs, POSs, and PPOs all fall under this umbrella, also known as managed care plans. Such health care insurance policies are generally more affordable than other policies that aren’t managed, but more pre-approval rules for specific services and a set list of covered hospitals and doctors often prove too constricting for some.

Non-network health care insurance plans (AKA indemnity health care insurance plans) are created by private insurance companies. These plans provide coverage for services from any eligible health care providers you go to. Although you will still probably have to have a primary care physician (PCP) and get approval from them to see a specialist, you will probably have more options when it comes to choosing a provider, rather than being limited to a shorter list of health care providers from within your network.

Indemnity health care insurance plans generally require you to submit claims personally for reimbursement, but some providers will do it for you. These plans generally are more expensive and come with higher deductibles.

Whichever plan you choose when it comes to health care insurance, always carefully consider what options you want in your plan and always read all the fine print (twice if you have to) before ever signing anything. Check to make sure you know what premiums you are looking at and what sort of benefits and coverage you will have.

You should also look into what sort of access you will have to hospitals, doctors, and specialized providers and ensure that emergency and after-hour care is a part of the plan. Finally, make sure you know what sort of out-of-pocket expenses you’ll be in for (i.e., deductibles and co-pays) and any limitations or exclusions in your health care insurance plan.