Health Insurance is to insure against the risk of incurring medical expenses among individuals. Designed to assist in the event of minor and major medical needs. Ranging from doctor visits for minor needs such as a cold, sprains to major needs such as heart transplants, cancer or many other traumatic health issues. Not being properly insured can have a devastating affect financially. Make sure when shopping for coverage you get the best you can afford in the event of an unforeseen need.
The most popular medical plan is known as a PPO. A group of doctors, care providers within a network. Before selecting a carrier check to see if your preferred doctor or healthcare provider is within the PPO of the carrier.A PPO is a Preferred Provider Organization within the framework of the managed care health industry. A PPO is a group of doctors, hospitals, and other healthcare providers who create a network and negotiate predetermined fees with a given carrier. The largest (and oldest) PPO network in the United States is Multi-Plan. Founded in 1980, Multi-Plan has over a half million health care providers under contract and processes over 65 million claims per year.
The PPO is the most common type of Health Insurance coverage in place today.
•The function of a PPO is to allow patients to see specialists without a referral from their primary care physician, to control medical costs through oversight, and to streamline the claims process by agreeing to doctor's charges in advance. A Preferred Provider Organization will usually renew their contract with a carrier annually or bi-annually, adjusting fees to reflect the prevailing market costs of medical care.
•Health Insurance companies offer many different PPO plans.
When considering enrolling in a PPO you should do a personal cost analysis by determining how many doctor visits you need rather than paying for unlimited select the number of visits you feel certain you will need and rely on the negotiated rate for those unforeseen visits in the end you should save substantially.
Perhaps a higher deductible with an accident plan to use as a GAP insurance.
GAP ER/Urgent Care plan pays up to $1000. per visit/per person up to 5 ER/Urgent Care visits per year. Great Plan if you have kids that play sports.
Obviously, the better coverage, lower deductibles, and multiple doctor visits with lower co-pays will mean higher monthly premiums. Insurance is a necessity, but to spend more than you can afford for coverage will often leave you cancelling your coverage and nothing good could come from that.
•Just because a PPO is not an HMO doesn't mean the PPO doesn't contain some aspects of an HMO. There is still a good deal of cost oversight, and many procedures need to be pre-authorized. Also, prescription benefits vary greatly from plan to plan and some prescriptions may require secondary approval from the carrier before they can be filled.
•PPO benefits change drastically when the member goes "out of network." While a given procedure may be covered 90 percent in network, the same procedure may only be covered 50 percent out of network. Also, it is important to verify that all your healthcare providers are in network before major surgery. It is all too common for a patient's doctor and hospital to be in network, but the anesthesiologist is not, resulting in costly and unexpected charges. Understanding Preventive/Wellness Benefits of the new healthcare reform law is crucial.
Limited Benefit Plan- National General Foundation Health plans are fixed-indemnity insurance plans that pay limited benefits to provider. This plan is different than other health insurance plans. It pays pre-set dollar amounts for specific health care services. The benefit you receive for a certain health care service is the same regardless of where you receive your care or how much your provider charges
Presently in Texas Major Medical Carriers are only writing Group except for Blue Cross Blue Shield with a high deductible HMO and a limited network. (see above copy)
Medical Coverage providing preventive, episodic and urgent care services alongside a 24/7 telemedicine feature, supported by labs, x-rays & ancillary services.
A tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a high-deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit. DETAILS
Short-term health, also known as temporary health insurance, is a product that provides health coverage for 12 months or less.
This type of health insurance is typically purchased by recent college graduates or individuals in between jobs. Short-term health
typically does not include coverage that is found in a comprehensive health insurance plan. As a result this insurance should only
be used as an option to fill a temporary gap in coverage. DETAILS
Providing Group Insurance options for small to medium sized groups.2-500 Employees; Major Medical-Short Term Medical - Group/Organization Medical - Self Funded Insurance - HSA-Short Term Medical DETAILS
We realize that traveling abroad can be an exciting experience. We also know that anything can happen while you're away from home - whether visiting short term or living abroad indefinitely or visiting the United States. It's important to be prepared for any unexpected illness, injury or medical emergency. Many traditional health insurance medical plans simply are not designed for international travel. DETAILS