Affordable Healthcare: Can It Happen To You?

Written by Irina


Affordable Healthcare: Can It Happen To You?

By Irina

========================================================== The author grants permission to publish this article, in its entirety, electronically or in print, as long asrepparttar bylines are included. A courtesy copy of your publication (or, at least, an e-mail notification) sent to irbonness@ureach.com will be appreciated. ==========================================================

Let's face it - an apple a day is no longer an adequate substitute forrepparttar 115545 professional healthcare services. And afterrepparttar 115546 doctor leaves, someone has to reach for a wallet. Accept this undeniable fact of life and make necessary arrangements BEFORE you get into a car accident, suffer intolerable toothache, or become pregnant.

The cold reality of healthcare in this country is that you do not have any legal right to it. There are no state or federal laws mandating employer-paid or -subsidized health benefits. So if you (or your spouse) have a complete and reasonably priced health coverage through your employer - BE GRATEFUL... and find some better use for your time than reading this article. (I would still suggest saving it - just in case...)

For those who keep on reading, health insurance is available on an individual or group basis, but don't be fooled byrepparttar 115547 terms! INDIVIDUAL insurance usually covers A GROUP of people (entire family), and many GROUP health plans will cover "a group" of ONE. In both cases you are repparttar 115548 only one paying (individually!) forrepparttar 115549 coverage. So, what'srepparttar 115550 difference? From a consumer's point of view,repparttar 115551 big advantage of group health insurance plans over individual is that they can't turn you down because of health problems.

Of course,repparttar 115552 ABILITY to get into a health insurance plan is one thing. The AFFORDABILITY is quite another! Let's begin with some basic terminology (or should we call it deceptive lingo?) used inrepparttar 115553 health insurance industry. Here are major plans with unique features to consider while making your choice:

HMO - Health Maintenance Organizations ============================================= The least expensive, but alsorepparttar 115554 least flexible of allrepparttar 115555 health insurance plans. Advantage: - Low co-payments, minimal paperwork, and coverage for some preventive-care and health-improvement programs. Disadvantages: - You must choose a primary care physician, also known as a PCP. - HMO requires that you see only network doctors, or they won't pay. - You must get a referral from your PCP to see a specialist.

POS - Point Of Service plans ============================================= More flexible than HMOs, but they also require you to select a PCP. Advantages: - You may visit a doctor outsiderepparttar 115556 network and still receive coverage; but substantially less than if you stayed within your network. - Offer more preventive care and well-being services, such as workshops on smoking cessation and discounts to health clubs. Disadvantages: - You must choose a PCP. - If you don't receive permission from your PCP, you're likely to wind up submittingrepparttar 115557 bills yourself and receiving only a nominal reimbursement - if any.

PPO - Preferred Provider Organizations ============================================= Give policyholders a financial incentive - reasonable co- payments (also called co-pays) - to stay withinrepparttar 115558 group's network of practitioners. Advantages: - The standard co-payment is $10 for a routine office visit during regular hours. - You may go to any specialist without permission, as long asrepparttar 115559 doctor participates inrepparttar 115560 network. Disadvantages: - If you see an out-of-network doctor, you may have to pay repparttar 115561 entire bill yourself, then submit it for reimbursement. - You may have to pay a deductible if you choose to go outsiderepparttar 115562 network, or payrepparttar 115563 difference between what network doctors charge vs. out-of-network doctor's charge.

FFS - Fee-For-Service plans, also called Traditional Indemnity ============================================= Offers flexibility in exchange for higher out-of-pocket expenses, more paperwork, and higher premiums. Advantages: - You may choose your own doctors and hospitals. - You may visit any specialist without getting permission from a primary care physician. Disadvantages: - There's a deductible (from $500 to $1,500) beforerepparttar 115564 insurance company starts paying claims, and then doctors are reimbursed about 80 percent ofrepparttar 115565 bill while you pick uprepparttar 115566 remaining 20 percent. - You may have to pay up front for medical services, then submitrepparttar 115567 bill for reimbursement. - FFS plans pay only for "reasonable and customary" medical expenses. If your doctor charges more thanrepparttar 115568 average for your area, you will have to payrepparttar 115569 difference.

Health Insurance: The-More-The-Better, Or No-More-HMO?

Written by Irina


---------------------------------------------------------- TITLE: Health Insurance: The-More-The-Better, Or No- More-HMO? AUTHOR: Irina LENGTH: 571 words FORMAT: 58 characters per line CONTACT: irbonness@ureach.com --------------------------CUT HERE------------------------

Health Insurance: The-More-The-Better, Or No-More-HMO?

By Irina

========================================================== The author grants permission to publish this article, in its entirety, electronically or in print, as long asrepparttar bylines are included. Other articles by Irina are available from http://www.megaone.com/hbb/savemoney/articles.html ==========================================================

Inrepparttar 115544 movie "John Q," Academy award winner Denzel Washington fightsrepparttar 115545 HMO restrictions to providerepparttar 115546 necessary cure for his dying son. When such a lackluster topic like health insurance generates enough drama for a Hollywood movie, you know that something must be seriously wrong...

The problem indeed is severe. Almost 45 million Americans are uninsured andrepparttar 115547 number continues to rise. Those still insured are frustrated byrepparttar 115548 double-digit premium increases outpacing all other sectors ofrepparttar 115549 economy. High costs and HMO limitations discourage seeking an immediate medical help. As a result, "little aches" often develop intorepparttar 115550 life-threatening illnesses and financial disasters for some unfortunate individuals and further escalate already intolerably high health care costs for repparttar 115551 rest of us.

To endurerepparttar 115552 existing health care crisis, we all must recognize one simple fact. There are TWO DIFFERENT LEVELS of health care needs that must be covered with two separate tiers of payment. One level is catastrophic illness - and for that, insurance may still berepparttar 115553 answer. Policies that carry a high deductible (say $5,000 a year) are relatively inexpensive, even whenrepparttar 115554 coverage is very high ($1 million or more) or unlimited. That is because most people do not get catastrophic illnesses or injuries.

In fact, most of us only need health maintenance and routine medical procedures that comprise a totally different level of health care needs. For these,repparttar 115555 present INSURANCE-based model is notrepparttar 115556 answer because it is financially incompatible with any efficient HEALTH CARE system.

Cont'd on page 2 ==>
 
ImproveHomeLife.com © 2005
Terms of Use