Saturday, July 16, 2011

Finding Out How To Compare Private Health Insurance Coverage

By Jamey Niese


At some point in your life, chances are good that you're going to have to compare private health insurance. Even if you have coverage through an employer, you might need to make a decision between two or more options available to you. In order to make this decision, you need to understand a little bit about the terminology and options that exist in the field.

Understanding what you're looking at is very important when making decisions. If you are having trouble comprehending a policy that you are looking at, go to your favorite search engine and look up the terminology. Just make sure to only use reputable sources, and double-check with another source if you aren't sure.

Choosing a deductible is important for several reasons. First, it is the largest contributor aside from your age to how much your monthly premium costs. Also, it can vary extremely widely from nothing at all to several thousand dollars. Choose a deductible that you can afford to pay if you have to, because in the event of an emergency, you will be required to come up with that money.

The percentage of covered expenses that you are responsible for, after having paid the deductible, is called co-insurance. It also varies widely, from nothing to 50% or more. However, there will be an out-of-pocket limit on your plan, which determines the total amount of this type of expense you can be liable for. Be sure to read carefully as to whether the out-of-pocket limit includes the deductible or not.

Co-pays are a set amount that you are responsible for in a given circumstance, such as a general health check. They are more common in HMOs, where there is usually a set co-pay for almost any type of covered care. But they also exist in certain circumstances for PPOs and indemnities. Usually, these are things like yearly well-checks where you pay a co-pay instead of the deductible and co-insurance.

Three different types of basic plans exist - indemnity, PPO, and HMOs. Indemnities offer the same coverage no matter where you choose to get your care, provided of course, that the physician and facility are licensed. PPOs cover a given percentage of care at any licensed facility, and a higher percentage of care at preferred provider locations. HMOs limit patients to their network and all emergency rooms, but pay 100% of all covered expenses, minus the co-pays.

HMOs are usually the most expensive option when you compare private health insurance, though they may be a cheaper option if provided by your employer. Indemnities are the middle ground, and PPOs are usually cheapest. However, these positions are reversed when discussing percentage of care covered, so it is again a question of higher monthly payments versus more out of pocket costs.

No one really enjoys dealing with their health care before they need it. But everyone is glad they have the necessary coverage when they do need it. A little bit of work now can save you a lot of headaches later, and is likely to be worth the temporary exasperation.




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