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Health
Insurance
Types of Health
Insurance
There are many different types of health insurance
programs, but they can be divided into basically three
types of medical expense protection. The first type of
protection is called conventional health insurance and
generally provides for hospital, surgical, medical,
major medical, comprehensive, catastrophic and dental
plans. This insurance is provided by commercial
insurance companies, independent organizations, Blue
Cross and Blue Shield. Rates depend on which plan you
buy into, the level of coverage you and your employer
chooses, and whether you purchase individual or family
protection. The second basic type of health protection
is the prepaid health care plans. The major providers
consist of HMOs or Health Maintenance Organizations,
and PPOs or Preferred Provider Organizations. These
are groups of doctors, hospitals and other health care
professionals who have joined together to provide
members with prepaid medical care. Instead of paying a
premium, each member pays a flat monthly or quarterly
fee. The last type of health insurance available is
government health plans. These include Medicare and
Medicaid. They are both federally funded, while the
latter is administered by the state. Check with your
local offices to see if you qualify. Remember,
consideration of your insurance needs is not a subject
to be taken lightly. Accordingly, this information is
not a substitute for the advice of an insurance
professional.
Employer
Requirements
Most families don't have much choice in the medical
plan they purchase. Many subscribe to whatever plan is
offered by the wage earner's company. This is usually
the easiest and least expensive form of protection.
Where both spouses work, it's to your benefit to
examine both plans before making a decision. Your
employer, however, may choose the level of coverage
you may receive. Several advantages to this type of
coverage are that the premiums are often deducted
directly from your paycheck, and your coverage can not
be terminated regardless of the number of claims you
file. Remember, consideration of your insurance needs
is not a subject to be taken lightly. Accordingly,
this information is not a substitute for the advice of
an insurance professional.
How to Check Your Coverage
There are several questions which you must answer
when checking your health insurance coverage: Does
your insurance provide coverage for only a specified
amount per day, or does it cover usual customary
costs? Does the plan cover pregnancy? For the
unmarried, or only insured and/or spouse? Does it
cover newborns from birth? Does it cover hospital
costs for as long as the injured needs treatment? Does
it exclude coverage for specified illness or
accidents? How long does it cover the insured's
children? Does it pay for outpatient treatment and/or
emergency treatment? Is there a time limit on
submitting claims? There are many other questions in
addition to these basic ones that you should check
into when evaluating your insurance coverage. Check
with your insurance agent or company office if you
need any of these or other questions answered.
Remember, consideration of your insurance needs is not
a subject to be taken lightly. Accordingly, this
information is not a substitute for the advice of an
insurance professional.
Social Security and Disability
Social Security Health coverage consists of several
parts of the Medicare Health Insurance program. Part A
is for the hospital insurance and is financed through
social security taxes. It's available at no cost to
those eligible for social security. Part B is
voluntary supplemental medical insurance. It is
deducted in monthly premiums from your social security
check, and all social security recipients are
automatically enrolled until such time as they
officially withdraw from the program. For additional
information on Medicare coverage, contact your local
social security office. A good rule is to contact your
local office at least two or three months before you
turn age 65 to apply for Part A. For most individuals,
the loss of a paycheck either permanently, or for an
extended period of time, would be financially
devastating. In addition to this, when you become
unable to work because of an injury or illness, very
often you will require expensive medical care. It
becomes very important that you have disability income
insurance. There are several things to look for in a
good disability insurance policy. The monthly benefit
should equal approximately 60 to 70 percent of your
gross pay. Choose a waiting period as long as you can
afford to wait for the benefits to begin. This will
substantially cut your premiums, and a good plan will
pay when you are unable to work at your regular
occupation, as opposed to any occupation. Make sure
that you are covered for both accident and sickness.
Choose non-cancelable renewal. There are other
questions on types of disability insurance that you
will find helpful to discuss with your insurance
agent. Remember, this information is not a substitute
for the advice of an insurance professional.
Supplemental Insurance
Part B of Medicare provides for supplemental
medical insurance. It provides for doctor services,
inpatient and outpatient services and supplies, home
health care, physical and speech therapy, ambulance
services, and unlimited home visits by skills nurses.
You are automatically enrolled in the program unless
you officially withdraw and the monthly premiums are
deducted from your social security check. Although you
must pay the difference between the 80 percent of
Medicare Supplemental Insurance coverage and what you
are charged, many doctors agree to accept the amount
approved as paid in full. You may also be able to
purchase supplemental insurance from your own
insurance company depending on your age and physical
health. For details, check with your insurance agent
about your company and what it has to offer.
Accordingly, this information is not a substitute for
the advice of an insurance professional.
Do You Need Long-Term Health
Insurance?
Long-term health insurance provides coverage for
nursing home care and in-home care. There are
currently around 100 companies nationally that offer
this type of insurance. Premiums and benefits vary
widely. Some policies only pay for care that is
medically necessary. A good policy will not only cover
nursing home care, but also home care and community
services. Some policies will only pay if the patient
comes directly out of the hospital to the nursing home
or home care. In this case, Alzheimer's and dementia
persons might not be covered. Since these disabilities
also leave people unable to care for themselves, it's
important that the policy cover their needs without an
immediately preceding hospital stay. The policy should
also provide for inflation protection. These policies
are not inexpensive, however, the earlier you start,
the lower your rate will be. According to the Health
Insurance Association of America, the average age that
the most people buy long-term insurance is 69. The
average annual premium for a policy is $1,500. Before
your purchase a policy, check with your attorney or
financial advisor. You might also check with AARP to
see what they offer. And, you can also consult the
United Seniors Health Cooperative, 1311 "H" Street NW,
Washington, D.C. 20005-4706. |