Health Insurance - Affordable Health Insurance

When Health Insurance Doesn't Cover Your Medical Care

While it's true that the costs for health insurance coverage continue to increase, having a health insurance plan will save you more money in the long run. But no health insurance plan will cover every medical treatment an insured individual needs over the course of his or her coverage period. No matter how good your health insurance is, you may occasionally encounter a medical treatment or condition that is not covered by your health insurance policy. Although these situations are normally confined to elective treatments like cosmetic surgery and liposuction, that is not always the case.

]]> If you are in need of a non-elective treatment that your insurance company is unwilling to cover, and it is not specifically listed on the "excluded treatments" section of your health insurance policy, ask your insurance company for a written explanation of their reasons for issuing such a denial. Then show this to your physician. Many times, simply re-coding a procedure or treatment and re-presenting it to your insurance company are all that's needed to get approval for the treatment.

But what happens when the procedure hasn't been miscoded or can't be re-coded and coverage for a medical treatment you already received has been denied by your insurance agency? The hard truth is that by this point in the process, you do not have many options, and you may end up being responsible for paying the full cost out of your own pocket.

One option you do have is the opportunity to appeal a decision if you do not agree with it. Every insurance company has a process to go through to appeal a claim, and you need to follow the steps involved in the appeals process precisely. Insurance companies would rather throw your appeal out on a technicality than invest the resources necessary to investigate the claim. The appeal process is typically outlined in your policy handbook. You can also discuss the situation over with your medical care provider before proceeding with the appeal to get another point of view or advice on how to proceed. If, despite your best efforts, the treatment still is denied, all is not lost. Here are some other options that are worth pursuing that may help you avoid paying full price: 1. See if your doctor will negotiate a lower payment or authorize a payment plan. 2. See if your doctor is a member of a medical discount program that you can join. There are thousands of doctors who participate in these networks. 3. If you've not yet had the procedure, shop around for another doctor who is willing to do the procedure for a lower price. 4. See if you qualify for free treatment at a public hospital or clinic because of your income level, veteran's status, or some other socio-economic reason. With a bit of persistence and some extra effort, it is very likely that you'll end up with the treatment that you need at a price you can afford.

All About Travel Health Insurance

None of us want to think about all the things that can go wrong when we're on that much needed vacation, but the truth is, many things can. You could become ill while away, or you could even get sick right before the long awaited day has arrived and not even board that pre-paid cruise ship at all. Travel health insurance is set up to protect you from all the above-mentioned occurrences and many more but before you purchase this type of health insurance, you need to know what it is and just what coverage to look for.

What Is Travel Health Insurance And When Do I Need It?

]]> Travel health insurance is an insurance policy that you can purchase prior to your departure that covers you for a variety of occurrences, whether medical or not, while you are away. This insurance can be pricy so you should take some things into consideration before you buy it. If you are going on a short trip that only requires one round-trip airline ticket of $250 then travel health insurance may be overkill. If you have booked a $5,000 once-in-a-lifetime cruise well in advance, then travel health insurance begins to makes more sense. You need to decide if the cost of the policy is worth it.

What Should It Cover?

A good travel health insurance policy should offer you coverage for a number of things. First, you should be covered the entire time you are on your trip and at any destination. It should cover personal injury or death to you or anyone else named on the policy. It should cover the costs of all medical-related expenses you incur while on your trip. Travel health insurance policies can also cover you in the event you need to be evacuated due to a medical emergency.

Should you be visiting a third world country where medical experience and supplies are limited, make sure your policy covers any type of transportation to a more adequate country to receive proper medical care. If you travel often, you can purchase a multi-trip travel health insurance policy.

Where Do I Get It?

First, check into the coverage you are entitled to under your regular health insurance plan so you don't end up paying more for coverage you already have. Once you know what you need, you can buy travel health insurance from your cruise line, travel agent, or an independent insurance agent. Although the independent insurance agents can be the most expensive, you don't have to worry about your cruise line going bankrupt and not honoring your travel insurance.

Unfortunately, things do and have happened and when they do happen without travel health insurance, they can be costly. So when that travel agent suggests travel health insurance to you, don't roll your eyes and assume they are just trying to get you to spend yet even more money. Pay attention and think about it. It may just be the best vacation money you ever spend.

Understanding Temporary or Short-Term Health Insurance

There are a variety of reasons that you may find yourself in the market for temporary or short-term health insurance. You may have graduated from college and can no longer be covered on your parent's policy, but don't have a job yet that will provide coverage. You may have lost or left your job and now need health insurance coverage until you find a new one. Or you may have started a new job and have to wait a period of several months before you are covered under their plan. Whatever the reason, going without health insurance coverage, even for a few months, can be a costly gamble. If you find yourself in this predicament, temporary health insurance coverage may just be the key to solving your dilemma.

What Is Temporary Health Insurance Coverage?

]]> It's basically just what the name suggests. Temporary health insurance coverage offers you the opportunity to continue to be covered under a health plan for a limited amount of time, usually one to six months, although there are plans out there that will cover longer periods of time. If you find you will need to be covered for more time than you originally thought, some temporary policies can be extended past their expiration date, but you may want to consider getting a more traditional health insurance plan instead.

What Do These Plans Cover?

Temporary health insurance plans cover most of the same types of medical occurrences that permanent policies do, but there are some very important differences.

For one, these plans are usually strictly indemnity plans. Preventative treatments like check-ups, as well as dental and optical coverage are generally not covered. Pre-existing medical conditions and work-related injuries or illnesses are also not covered.

Your temporary health insurance policy will generally cover any emergency medical care you may need, prescription drugs, hospital and intensive care needs, lab and x-ray needs, ambulance care, and even some in-home medical care.

How Do I Get It?

Your first step should be to find an agent that specializes in temporary health insurance. Decide in advance how many days or months you need the coverage and when you want it to start. Pay attention to the 'exclusion' clauses in the policy and ask questions about any concerns you may have. Review the application and make sure all your personal information is correct before you sign anything. Also, remember to get a copy of all paperwork for your files.

NEED Health Insurance? In addition to featuring the largest selection of major medical health plans from leading companies, also offers a wide selection of quality short term, student, and dental plans. You can obtain FREE instant quotes, side-by-side comparisons, the best available prices, online applications, and a knowledgeable Customer Care team to help you find the plan that is right for you.

The cost of the temporary health insurance plan will depend on the type of coverage you pick. To keep the cost down, you can choose to have a higher deductible with a 50/50 co-insurance option rather than the more common 80/20 ratios. There are some extras that you may want to consider, though. With the high cost of prescription medicines, you may be better off buying the coverage rather than leaving it off.

The important thing is to read through the temporary health insurance policy carefully and make sure you are being offered the coverage you think you are paying for.

The Role of the Health Insurance Broker

A health insurance broker is just like any other type of broker; this one just happens to specialize in the field of health insurance. A broker is somewhat like a matchmaker. His responsibility is to match up those seeking health insurance with health insurance companies that most closely match that person or group's needs.

]]> Health insurance brokers are sought by those individuals who, for various reasons, do not belong to a group insurance policy. These individuals are often the self-employed, or those with pre-existing conditions. However, a health insurance broker will also work with the coordinators of group insurance benefits in much the same way he works with an individual. The broker is given a list of desired benefits, either by an individual or a group coordinator, and the broker shops around to find the best match. The health insurance broker then presents what he feels is the best plan based on the list of needs, and if the person or group benefits coordinator agrees, the broker usually works to get a contract signed by both parties.

Who Does the Health Insurance Broker Work For?

It's important to understand that a health insurance broker does not work for a health insurance company. Instead, a broker makes it his business to know all about the different health insurance companies in the area including their reputations, their frequency of rate increases, and even such things as the way they treat policy holders who submit a lot of medical claims. But even though the health insurance broker is different from a health insurance company, it often does happen that a broker is given an incentive (usually a financial incentive) to recommend one health insurance company over another.

Will it Cost More to Use a Broker?

Does the cost of health insurance differ if it is secured by a broker? That's difficult to answer in general terms. A health insurance broker might be able to get an individual included in a group plan that is offered by the state or a trade union or organization and in such a case, an applicant might find the rates are lower and the coverage better than if he had attempted directly applying via a health insurance company. Most health insurance brokers work on commission and only make money when they've matched up insurer and insured. That means that one party or the other (and in some cases, both parties) typically is responsible for paying the broker's fee.

Because the rates and the rules regarding health insurance are continually changing, health insurance brokers are few and far between. Most states do have licensing requirements that brokers must meet before they're allowed to work as a health insurance broker. And because these requirements are issued at the state level, they differ from state to state. But if you find yourself lost in the tangled web of health insurance red tape, consider working with a health insurance broker. That person might just turn out to be your best ally.

Health Insurance For Pets

For those of us who own animals and have taken them to the vet's office for one reason or another, we know just how quickly the costs of maintaining a pet add up. Not only can the yearly physicals and immunizations be costly, but add in any unexpected injuries or illnesses and the costs can easily run into the hundreds, if not thousands of dollars. Most of us carry health insurance on ourselves and our family members for this very reason, so why not on our pets too?

]]> There are many options available to you for pet insurance. Depending on the coverage you pick, the cost can vary just like in health insurance policies for humans. Let's go over a few of your options and just what they mean for you and your pet.

What Does Pet Insurance Cover?

Like with our health insurance, different policies will cover different things. How much coverage you have will depend on what you want to spend. If you only want to cover injuries and medical emergencies, the coverage will be cheaper than if you wanted the whole package, including all well-pet check-ups and immunizations. There are policies that will only cover what is called catastrophic illnesses, like cancer. These policies can be quite cost effective for those on a budget and still give you some peace of mind knowing that if anything major happened, you would be able to have your pet treated. Some policies even offer you the option of having kennel coverage. If you travel a fair amount and your pet spends that time in the kennel, this may be an option that would work for you.

These policies will also work on the deductible set-up. How much of a deductible you choose will also affect the cost of the policy.

When Do I Need Pet Insurance?

Really, anytime you have a pet. Some may think that older pets that are prone to some of the aging medical issues are the only ones that need coverage, but that would be like covering your child only once they are no longer a toddler. That really doesn't make any sense. Young animals can also get sick and injured. As a matter of fact, some of the more serious and costly illnesses that animals are prone to occur when they are in their infancy.

Even if you keep your pet indoors, this doesn't protect them completely. Although outdoor pets are probably more likely to get injured, indoor pets are more likely to get into household poisons and other chemicals. And illnesses don't care if your pet is kept indoors or not.

Where To Get Pet Insurance

Check out the Internet for a large array of pet insurance companies. These companies offer many different types of coverage for many different animals, not just the traditional dog or cat. Before you purchase one though, check with your veterinarian to make sure the company is reputable, the coverage is adequate and that the vet accepts that particular plan.

One-Size Health Insurance Does Not Fit All

Health insurance coverage and associated costs vary greatly based on whether the insurance is an individual policy (for the self-employed/unemployed), for a small businesses (from 2 to 50 employees), or for a large group. Coverage for group plans is far more comprehensive and considerably less expensive because there are more people paying into the insurance pool making more money available group-wide to cover medical claims.

]]> Those who try to get health insurance on their own, either because their employer does not offer this benefit or because they are self-employed or unemployed often have difficulty obtaining health insurance. Many simply cannot find an insurance company in their state that is willing to offer individual plans. Pre-existing conditions complicate this search and put individuals into a 'high-risk' category. It's often the reason coverage is denied.

Those who are fortunate enough to find individual coverage don't feel so fortunate once they review the policy details. They typically find that the cost is significant and the coverage less than desirable and loaded with out-of-pocket costs. Those who obtain health insurance on their own can usually purchase a family plan, but then the costs are even higher.

Those individuals who are employed by small businesses, defined as having more than 2 but 50 or fewer employees, also find themselves in a difficult situation when it comes to health insurance. If the employer chooses to, it may offer a group type of health insurance to the employees. When applying for coverage, the overall costs will be based on the number and physical condition of all the employees who wish to participate. High risk individuals and those with pre-existing conditions will bump up the costs for everybody. Even so, the costs for this type of coverage will usually be better than if each employee obtained an individual policy. Employers are not required to cover other family members and can choose the percentage of the employee's costs that they will cover.

Group health insurance generally offers the best coverage at the most affordable price. Group insurance is available to all eligible employees of the company offering the health insurance and generally also to the employee's immediate family members, including spouse and/or children. A group plan must accept every eligible employee even if the person has a known pre-existing condition and even if that person or his/her family members fall into a high-risk category.

Whether you need private health insurance if you participate in a group health plan is not an easy question to answer. To adequately assess this situation, you've got to review your group insurance coverage and compare it to what you need. Some group health insurance plans exclude certain medical services such as dental and vision care, experimental treatments, cosmetic surgery, some mental and substance abuse therapies, and more so you may find you need to complement your group plan with a private health insurance plan. In doing so, you'll incur more costs so you'll have to weight the additional benefits against the additional costs to see what makes sense for you.

Understanding Managed Care Plans

Managed Care Plans are the most common form of health care coverage offered in the United States today. Unlike Indemnity Plans, where participants are free to seek medical attention whenever and wherever they feel necessary, Managed Care Plans are much more restrictive.

]]> One of the reasons that managed care plans have become so popular is because employers are the ones footing the bills for most medical coverage. The cost associated with providing medical benefits to employees is one of an employer's highest expenses. So that they are able to continue offering medical benefits, employers need to select the most affordable health plans available and more often than not, it's the managed care plans that are the least expensive.

Managed Care plans work off the basic premise that health care costs can be better controlled by controlling access to health treatments and services. While this may be true and beneficial to the companies offering these plans, from a patient's perspective, it can be difficult to get approval for health care that goes beyond basic preventative care.

There are three main categories of Managed Care Plans: a Health Maintenance Organization (HMO); a Preferred Provider Organization (PPO); and a Point of Service (POS). Of the three, HMOs and PPOs are the most common. A brief summary of each follows:

A Health Maintenance Organization (HMO) plan is less expensive than a PPO and generally includes coverage for preventative care. Participants are required to pay a monthly premium, and a nominal co-payment each time they see a doctor. They must be seen by medical care providers that are part of the HMO network. These medical care providers have an agreement with the insurance company to perform various medical procedures at a previously negotiated and reduced rate. Participants are required to select from this group of providers a Primary Care Physician (PCP) and must always see their PCP first. To be seen by a specialist, the PCP must initiate a referral.

The disadvantage of an HMO is that participants are forced to choose a PCP from the HMOs approved list of providers and sometimes, their 'preferred' doctor is not on the list. The HMO typically won't cover the costs of medical care provided by professionals outside the HMO network. And because an HMO network is limited in size, it often takes a long time to get an appointment with the PCP.

A Preferred Provider Organizations (PPO) is similar to a HMO, except that there is no need to first be seen by a PCP. Participants are advised to choose a medical professional from the PPO's approved 'network' but they don't have to and they don't need a referral to see a specialist. Should a participant choose to go outside the network, their co-payment will generally be higher, the percentage that the PPO pays for the medical care will be lower, and they will likely have to satisfy a deductible.

Although PPOs offer more freedom of choice, there are generally more costs involved in this type of managed care plan. These costs can be significant when participants go outside the network.

A POS or Point of Service managed care plan is somewhat like a hybrid. It offers more freedom of choice like a PPO, and a lower cost like an HMO. Participants must designate a PCP, but even then it is difficult to get a referral to a specialist. When participants stay within the network, paperwork is minimal, and so are co-pays. Plus, there are no deductibles. Although they might sound like the best of both worlds, POS plans aren't very popular.

Selecting the managed care plan that best suits your needs requires a careful analysis of each plan's coverage and should not be based on cost alone. Since coverage and additional costs differs greatly from plan to plan, take your time and don't be afraid to ask questions!

Understanding Indemnity Care Plans

For years, Indemnity Care Plans were the most popular type of health insurance coverage. However, because medical costs have continued to soar, this is not longer the case. Although still the first choice of many, more people these days are switching to managed care plans; not necessarily because they want to, but rather because these plans are the ones being offered by their employers. For clarification, Indemnity Care Plans are frequently referred to as 'fee for service' plans.

]]> The main difference between Indemnity Care Plans and Managed Care Plans is the freedom to choose any medical care provider regardless of whether the patient first receives a referral or regardless of whether the medical care professional is part of the contracted 'network' of providers. Those who choose Indemnity Care Plans can visit the most well-known specialists and the hospitals with the best reputations for their care.

But with that freedom come a price and participants usually end up with higher out of pocket costs. After a participant receives medical care, a bill for his services is forwarded to the insurance company. The insurance company then refers to its list of 'reasonable and customary' charges for the services that were provided to determine the amount it will pay. Of that amount, the insurance company will typically pay 80% while the remaining 20% becomes the responsibility of the patient. In many instances, especially when care is provided by top-notch institutions and/or professionals, the amount billed for the medical services will actually exceed 'reasonable and customary' charges. When this happens, the patient is responsible for paying his percentage PLUS the difference.

NEED Health Insurance? In addition to featuring the largest selection of major medical health plans from leading companies, also offers a wide selection of quality short term, student, and dental plans. You can obtain FREE instant quotes, side-by-side comparisons, the best available prices, online applications, and a knowledgeable Customer Care team to help you find the plan that is right for you.

In addition to paying the above, those who choose Indemnity Care Plans also have to pay a premium and an annual deductible. And even though these costs can be high, this type of health insurance plan is right for many people.

When it comes to managed care plans, a PPO or Preferred Provider Organization is the plan that most closely matches an Indemnity Care Plan. With a PPO, participants have a wider network of providers from which to choose. Their costs will be lower if they choose a medical professional within the PPO network. Participants still do have the option of choosing to go outside the network, but when they do, their out of pocket expenses will be higher. Before the insurance company will contribute towards these costs, the person will have to first satisfy their deductible. And after that amount is met, the insurance company will pay a smaller percentage of the overall costs than it would pay had the participant chosen an 'in network' medical service provider.

So which type of plan is better—an Indemnity Care Plan or a Managed Care Plan? That all depends on the individual. Those who can afford the higher costs and place a high value on the ability to decide from whom they receive their medical care usually choose Indemnity Care Plans. Those who want more freedom of choice, but who also need to closely monitor medical costs are probably better off with a PPO.

Health Insurance Fraud

Don't be Victimized by Health Insurance Fraud

It's unfortunate but true: health insurance fraud is prevalent in our society and it's not always possible to protect yourself from becoming a victim. In fact, most people won't even know they've fallen prey to health insurance fraud until they submit a claim for a medical service that they think is covered under their policy. It's often not until after a claim is denied that most people realize they've been a victim of health insurance fraud.

How to Spot Health Insurance Fraud

]]> Is it possible to keep yourself from becoming a victim of health insurance fraud? Would you even know what to look for? While there probably are as many different fraud scenarios as there are victims, there is one thing that should always throw up a glaring red flag: health insurance coverage that seems too good for a price that seems incredibly low.

Be wary of unsolicited mail that advertises discounted health insurance, especially if you're not familiar with the name of the company making the offer. Before you take any further action, you should do what you can to research the credibility of the company. Health insurance companies are rated at this web site http://www.ambest.com/. You should also check with your State Insurance Commission to see if the company is licensed to do business in your state.

Most importantly, you also need to read the offer in its entirety, especially the fine print. Be very careful of any salesperson that asks you to pay using cash and/or requires you to pay the total amount of your premium in advance.

If you find that you are a victim of health insurance fraud, follow these guidelines immediately:

1. Contact your State Insurance Commissioner. Find out if they have any other complaints about the company from which you purchased your coverage. Also file a health insurance fraud complaint.

2. Contact your bank or credit card company to stop any future automatic payments that may be scheduled.

3. Contact your local law enforcement agency.

Be sure to have all of your cancelled checks or credit card statements and a copy of the health insurance contract that you signed. Also get a copy of your personal credit report from all three major credit reporting agencies as soon as possible. Many times people who perpetrate health insurance fraud also use your personal information to steal your identity and to commit other fraudulent acts.

Be smart and check out the health insurance company before you sign on the dotted line. As a final precaution, call your local hospital or personal physician and ask if they accept the insurance. If not, at least find out if they have ever heard of the insurance. When it comes to protecting yourself from health insurance fraud, an ounce of prevention really is worth a pound of cure.

Health Insurance For Children and Students

Health insurance coverage for children, as well as college students, is critical. Finding a health insurance plan that fits your needs and price range can be difficult, but with some guidance, is possible.

Children's Health Insurance...

]]> In 1997, Congress passed a plan entitled Title XXI, or the State Children's Health Insurance Program (SCHIP). This program was created to help deal with the growing number of children in the U.S. that were living without health insurance. For many families, their annual income was too much to apply for Medicaid, but not nearly enough to afford a private policy. With state coverage, the family is charged no more than 5% of their gross annual income, with some receiving it at no cost to them at all.

What exactly this health insurance plan for children covers will vary a bit from state to state, but all states are required to cover at a minimum well-baby and well-child physicals, all required immunizations and any emergency services these children require.

If your child is already covered under a health insurance policy, whether it's your group insurance plan or any other insurance plan that you have, they will not be eligible for the state's coverage.

If you don't qualify for state coverage, before you apply for health insurance for your child, do a little research. It may be more cost effective to have a family policy with all your children covered than to have an individual policy on each one. Of course, if you have only one child, it may work the other way around.

Student Health Insurance

Although most universities have a health care clinic that the student can go to for routine physical ailments, like sore throats and such, to depend solely on this as your source of health care is not advisable. All students need to have some other type of health insurance plan that will cover unexpected medical problems like visits to the emergency room or surgeries.

There are several options available to students for health insurance coverage. The best possible choice is to have them covered on their parents' policy, even while away at school. Most family group health insurance plans will cover a child at school as long as they are actively enrolled. Check with your insurance agent to see what, if any, stipulations there are that need to be followed.

If you find that the student will need an individual health insurance policy, there are insurance companies out there that cater to this type of need. Don't just go with anybody, though. Do some research. Decide what coverage you will need and ask questions. You need to know what the maximum amount of coverage is and what your deductible will be. Find out what you won't be covered for as well as what you will. If you are going to school out of the country, make sure you don't need additional coverage for expenses that may come up while you are gone. Having proper student health insurance coverage will help make your college experience go much smoother.

Health Insurance Costs Explained

Have you ever taken a moment to have someone explain health insurance costs to you? We know that health insurance costs just keep going up and up, but how do these spiraling costs affect your health insurance coverage? You know the amount you're paying every month for your health insurance premium, so it's easy to know when this cost increases, but what about all the other costs involved with health insurance? Do you know what they mean? Before you're hit with an excessively large medical bill, read the following explanation of health insurance costs.

The Premium...

]]> The premium is the amount you'll pay for the benefits covered under your health insurance plan. The premium is typically broken down into equal monthly payments. If you've got group insurance, your employer or a union is probably sharing some percentage of this cost.

The Deductible

If your health insurance policy includes an annual deductible, it's important to understand the details. A deductible is an amount that you are responsible for paying before the insurance company begins paying out claims. As with car insurance, the higher your deductible the lower your monthly premium and vice versa. A family health insurance plan typically includes multiple deductibles.

The Co-Payment

A co-payment is a fixed amount that the insured has to pay each time they visit the doctor. The co-payment amount differs based on the type of health insurance plan you have and typically an HMO will have the lowest co-payment. The co-payment can however, increase for different types of medical service and/or if you go outside the network.

Co-Insurance

Co-Insurance is the amount of a claim that the insured is responsible for paying, once the deductible has been met. A typical ratio is 80/20 where the insurance company pays 80% of a claim and the insured pays 20%. An insured's percentage will typically increase when he goes outside the network. Also, in situations where the claim exceeds what the insurance company deems 'reasonable and customary' the difference is another form of co-insurance that must be paid by the insured.

If you don't fully understand these health insurance costs have someone explain them to you. These are the things you've got to ask about when requesting quotes, especially online health insurance quotes. When you're comparing quotes from different insurance companies, it's important to know all your costs, not just the premium. Make sure the person preparing your quote clearly defines the deductible amount and whether there is a separate deductible for different types of services, the co-payment amount and the co-insurance amounts. Also ask the person to elaborate on other costs that may not be readily apparent.

To keep costs as low as possible, always stay within your network. If you can choose any medical care professional, be sure that the fees for the services you'll need fall within your insurance company's 'reasonable and customary' guidelines. If not, shop around for a less expensive provider. Other tips for keeping health insurance costs as low as possible include living a healthier lifestyle and seeking medical care only when absolutely necessary.

The Health Insurance Claims Process

Having health insurance is one thing, but what happens when you need to file a health insurance claim? Unfortunately, there's no one straightforward answer to this question. The reason is because every type of health insurance plan generally includes its own way of handling claims. And when you stop and consider the number of companies offering multiple types of health insurance policies, you can begin to understand why answering such a seemingly simple question can be so complex.

]]> If you need help understanding how to file a health insurance claim for a benefit that is covered under your health insurance policy, the best place to begin is with the insurance company itself. Most will offer a toll-free telephone number that is staffed during normal business hours that you can call. You'll typically be first required to provide some basic information about your policy including the policy or group number and the name of the primary insured on the policy. From there, the insurance company representative can access the details of your health insurance policy and advise you how to proceed with your claim.

If you have a Managed Care Plan and you're dealing with a covered benefit, you'll find that the process is surprisingly simple. Most often, those staffing the front offices of the medical facilities you visit take care of processing the necessary paperwork. They input the proper medical codes for the services rendered and send the paperwork to the insurance company. Patients typically make the required co-payment at the time services are rendered and need take no further action until they receive from the insurance company the paperwork that corresponds to the office visit. The paperwork shows the percentage that the insurance company paid, how much was applied towards the deductible, and it will show if there is a balance due by the patient.

In the past, those with Indemnity Plans were required to pay in full for the services rendered at the time they were rendered. They were given lengthy claims forms to complete and submit to the health insurance company. It would take weeks to get reimbursed for the services provided. But today, front office personnel typically will directly bill the insurance company for the services rendered first and then they'll wait to see what percentage the insurance company pays. In situations where there is a balance due afterwards, the patient is billed. Anytime there's a dispute, the medical services provider bills the patient directly and the patient does need to pay. It's then the patient's responsibility to work out an agreement with his or her health insurance company.

With all the computerization involved in the medical billing process today, patients typically don't have any out of pocket costs aside from their co-payment. If they are required to first meet their deductible, the paperwork still gets forwarded to the insurance company first, so that those in charge can keep accurate track of the policy's usage and payment history. Given the enormity of the task, health insurance claims for covered benefits get settled rather quickly.

Health Insurance Benefits

One thing that's important to understand when researching health insurance benefits is that each policy includes its own set. It's easy to make the mistake of assuming that features or health coverage exists when they don't. However, these types of assumptions not only are wrong, but they could one day leave you facing insurmountable medical bills.

]]> The ideal personal or family health plan would pay for every health issue that may arise—pregnancy, blood transfusions, sick and well care, minor and major surgery, hospital stays, etc. But the truth is health insurance benefits typically are limited and they seldom will cover 100% of the costs, which is why it's so important to read the policy's fine print. You've got to know exactly what is and is not actually covered.

While health insurance benefits do vary from policy to policy, one thing that most health insurance companies are offering in their policies nowadays is something called preventative or 'well' care. Administrators realize that their overall medical costs can decrease significantly when those they cover seek routine medical treatment. Staying healthy by getting annual check-ups and regular immunization oftentimes helps prevent illnesses from developing in the first place. And identifying potential health issues early on, before they become difficult and expensive to treat is saving insurers money and saving lives.

Generally, the types of health insurance benefits that most policies cover in full or partially include: annual physical examinations, emergency/urgent care, laboratory work including blood testing and x-rays, prenatal care, well baby visits, an annual routine eye exam, and most care required while admitted into a hospital. Some plans even offer discounts on health club facilities and programs that help individuals stop smoking.

While health insurance benefits are sometimes difficult to determine, those responsible for putting policies together often do a great job delineating the types of medical treatments and services that are not covered. This is typically an alphabetical, detailed listing of everything that is not covered under a policy, from acupuncture to vision correction treatments such as Lasik and radial keratoplasty. When selecting a health plan, don't forget to carefully review this section.

Dental care and vision/eye care beyond an annual eye examination are usually not included in health care plans in the USA. Coverage for these types of services is instead typically offered as separate plans with separate benefits, separate premiums and separate deductibles. They'll typically have different forms to use and different procedures to follow. Because of the soaring costs associated with prescription drugs, many insurers have eliminated this type of coverage from their health insurance benefits package. More and more, prescription drug plans are being offered separately in the same manner as dental and vision plans.

Finally, several states have developed unique state-mandated health insurance requirements for their residents. These are usually designed to be consumer-oriented to protect consumers from predatory practices. The requirements are not transferable from one state to another so when a person moves out of state, they lose them (or they gain them). That's why it's important to use your correct residential address to ensure that you receive the health insurance benefits you're entitled t

Individual vs. Family Health Insurance Plans

With the ever-growing cost of healthcare in the USA, finding the right health insurance plan that fits into your budget isn't always easy. Knowing what you need to accomplish with a health insurance plan and just who and what needs to be covered by it will help you to decide what type works best for you and your family.

Individual Health Insurance Plans

]]> Okay, let's start with the individual health insurance plan and go from there. First, an individual health insurance plan is pretty much just what it says; it's a health plan for one person. For those who only have themselves to worry about, this is going to be your best option in the cost department. Individual plans can still vary a great deal in affordability, depending on what type of coverage you opt for.

A more traditional health insurance plan (called an indemnity plan) covers visits to whatever doctor you want to see and will cover whatever those procedures are that the said doctor prescribes for you. The cost can vary as to how much of a deductible you have and your out-of-pocket limit. Overall though, this is the more expensive type of individual health insurance plans out there but offers you the most freedom of choice.

Individual managed plans, like HMO's, are more cost effective but you do give up some of the freedoms that you have in the indemnity plan. You will need to see doctors on your approved list and any specialists that you need to see will need to be by referral. If your health care is primarily yearly check-ups and the occasional antibiotics, this is a plan that could work for you. It will cover health emergencies, there are just more hoops you have to jump through.

Both of these health insurance plans can include prescription and dental coverage at an additional cost.

Family Health Insurance Plans

Like the name suggests, family health insurance plans are for families and since these health plans are covering more than one person, the cost is going to be higher. As a matter of fact, the bigger the family, the bigger the price tag. Also, the ages, gender, and health choices, like smoking, from each family member will play a big part in just how much a policy like this will cost you. There are indemnity plans that are for families and they offer the same freedoms as the individual plans. This can be a real bonus when dealing with multiple people.

Family health insurance plans also come in the managed health care package and work pretty much the same way as the individual ones. The cost will be higher than the individual plan, but not as high as the family indemnity plan.

Group Insurance Plans

Many companies now offer their employees group insurance coverage, footing the bill for some or most of the premium. Since many of these companies now offer both types of health insurance coverage, how much you end up paying out-of-pocket will depend on which type of policy you choose.

The Difference between Health Insurance and Life Insurance

Health insurance protects the insured against incurring extensive medical expenses by offering full or partial coverage for certain medical treatments and procedures. Life insurance, on the other hand, is an insurance policy that pays out the face value of the policy, in a lump-sum payment, to the person designated as the beneficiary, upon the death of the insured.

]]> There are two basic types of life insurance: whole life and term life. Term life insurance is by far the less expensive of the two because it offers just life insurance. A term life insurance policy can be purchased for as little as one year and for as long as 30 years. In order for the beneficiary to cash in on the policy, the insured must die sometime during the term. This is probably why so many people wait until they are older before purchasing life insurance.

Whole life insurance is a combination of a life insurance policy and an investment plan. The premium associated with the whole life policy is shared between the two with a portion going towards the life insurance premium and the balance being invested into whichever investment vehicle has been chosen: mutual fund, money market, stock and bonds, etc. The benefit of a whole life policy is that it forces the insured to save money for retirement by using a portion of the premium as investment money. In reality however, these policies are typically loaded with fees and commissions, and after taking these costs into consideration, it often is not the best use of an individual's investment dollars.

A life insurance policy is totally different from a health insurance policy and the price for each ultimately depends upon a person's age and physical well-being. In general, individuals who are young and healthy pay less than those who are older, and especially those who are older and in poor health.

It's not possible to advise a person which is better, a health insurance policy or a life insurance policy. Many people obtain health insurance through their employer, and many employers also offer as a benefit the ability to purchase a low face value life insurance policy for a nominal cost. If this is your situation, it's advisable to take advantage of both these benefits.

Otherwise, deciding which insurance policies to purchase becomes more a matter of how much you can afford each month and your personal situation. It's advisable to choose health insurance coverage, even though it probably will be more expensive because it only takes one uninsured medical illness or accident to leave you with insurmountable medical bills. Also consider this. If you don't have health insurance, and your medical bills (and/or other bills) are considerable, it might be a good idea to purchase term life insurance with a face value high enough to pay off your bills and designate your spouse as your beneficiary. That way, your spouse won't have to worry about inheriting your sizeable debt!