| What can supersede the importance of health? | | | | HMO members pay a monthly premium in return |
| Good health is one of the most precious | | | | of which the HMOs provide complete care to |
| assets of a human being. Thus it is not just | | | | you and your family. This also includes the |
| important but mandatory to insure and thus | | | | visits of doctors, hospital stays, emergency |
| secure your biggest asset against all kinds | | | | care, surgery, lab tests, x-rays and other |
| of threats. | | | | therapies. |
| | | | |
| Health insurance can be defined as a policy | | | | • POS plan- many HMOs offer an |
| that will pay a fixed amount of money for | | | | indemnity-type of option known as a POS plan. |
| medical expenses and treatments. Health | | | | Those who opt for POS plan can refer to |
| insurance is basically a way to ensure | | | | doctors and medical assistance outside the |
| protection against any sickness or injury. | | | | plan and still get some coverage. If a doctor |
| Health insurance includes various types of | | | | makes a referral out of the network, the plan |
| insurance such as accident insurance, | | | | pays all or most of the bill. |
| disability income insurance, medical expense | | | | |
| insurance, and accidental death and | | | | • PPO- Preferred Provider |
| dismemberment insurance. | | | | Organization- is basically a combination of |
| | | | fee-for-service and an HMO. As in HMO plan, |
| Health insurance is your best friend in the | | | | in PPO too the options are confined to a set |
| hours of need. It is a great support to your | | | | of doctors and hospitals. Medical expenses |
| family when hefty medical bills fall over | | | | are covered by the PPO only when the insured |
| their heads and there is immense expenditure | | | | person resorts to the preferred or network |
| on recovery of the person concerned. | | | | providers. |
| | | | |
| Based on the needs and requirements of people | | | | • EPO- Exclusive Provider |
| there are different kinds of health insurance | | | | Organization- is akin to HMO except that it |
| policies available- | | | | is regulated by the California Department of |
| | | | Insurance and generally pays physicians and |
| • Fee-for-Service Plans- is that | | | | other health care providers differently. EPOs |
| where the insurance companies pay fees for | | | | will meet your expenditure only if the |
| the services offered to the insured people. | | | | physician you opt for is within EPO's |
| The insurer only pays for part of your doctor | | | | network. However exigency situations can be |
| and hospital bills and pays monthly fee | | | | considered as exceptions. |
| called premium. Before the insurance payments | | | | |
| begin, a specified amount of money in the | | | | Prior to opting for a plan it is better to |
| form of deductibles is to be paid. After | | | | ponder over your needs and family |
| paying the deductible for the year you share | | | | requirements. You may even want to use the |
| the bill with the insurance company and then | | | | checklist of the agency through which you are |
| your part is known as 'coinsurance'. | | | | purchasing the policy and ask for more |
| Fee-for-service comes in two ways- Basic | | | | information from the health benefits manager |
| protection and Major medical. | | | | at your workplace or a health plan |
| | | | representative. You can also seek advice from |
| • Health Maintenance Organizations- | | | | your physician who is already familiar with |
| these organizations are prepaid health plans. | | | | all health plans and your medical history. |