Health Insurance Fresno
Individual and family health insurance
is a type of health insurance coverage that is made available to individuals
and families, rather than to employer groups or organizations. Given
the option, most people would prefer to have their employer provide
group health insurance coverage. But, if this is not an option for you,
it is still important for you to seek coverage. You may be pleasantly
surprised with the variety and affordability of the individual and family
health insurance options available.
Below is a list of the major categories
of health insurance available to you with definition for some common
terms.
Preferred Provider Organizations (PPO)
A Preferred Provider
Organization (PPO) is an alternative type of health plan that has quickly
become the most commonly recognized and available type of plan offered
by insurance companies. A PPO plan has similarities to both an HMO and
indemnity plan. Similar to an HMO plan, there is a specific group of
doctors and hospitals selected by the insurance provider, referred to
as "preferred providers," because these doctors and hospitals
have contracted with your insurance company to provide services to their
plan members at predetermined and discounted rates.
Also like an HMO plan,
there is no claim form that must be submitted by the insured member.
When you receive services from a preferred provider, all claims are
handled between that health care provider and the insurance carrier.
However, unlike and HMO plan, you can choose to visit any physician
within their network of doctors and do not need to select a primary
care physician. This greater freedom of choice more closely resembles
that provided under an indemnity plan. Many PPO plans provide you with
the ability to visit any doctor or hospital that you wish, just as you
can under an indemnity plan, and typically there is no limit to the
geographical area within the state. However, if you choose to visit
a physician or medical facility that is not part of the PPO's list of
preferred providers, you will be required to pay a higher coinsurance
percentage and may need to file you own claim form to receive reimbursement
from the insurance company. Accessing a non-participating physician
is referred to as going "out-of-network" and many PPO plans
will place greater limitations and lower maximum benefit levels for
this expanded availability.
When you enroll in a
PPO plan, you will be asked to select your plan deductible and coinsurance
limit. Many companies that offer PPO plans will have a unique name or
brand for the different levels of PPO plans that they offer. Some have
low deductible with high coinsurance percentages, while others may have
high deductibles with lower coinsurance percentages. Just about every
possible combination of coverage limits you could imagine is available
from most insurance carriers offering this type of health plan. In many
cases, you can customize a PPO plan to best meet your budget and your
medical care expectations. Once you are enrolled in a PPO plan, it works
similar to an indemnity plan. You must first meet your annual deductible
(when applicable) and then you will pay your coinsurance percentage
for covered benefits for the remainder of the calendar year. All PPO
plans provide a maximum annual co-insurance maximum, which tells you
what the maximum is that you could possibly pay for covered services
during the year. This is also commonly known as the annual "out-of-pocket"
maximum. Not all covered services may apply to this maximum, and "out-of-network"
services may have a separate maximum. Always refer to the plan details
of any PPO closely for the details on coverage limits and maximums.
Health Maintenance Organizations (HMO)
This type of health plan
provides the most comprehensive level of coverage with the lowest share
of cost passed on to the insured. Health Maintenance Organizations (HMO)
are considered "pre-paid," meaning that you pay for your health
care in advance in the form of a monthly premium. There may be small
co-payments required for some covered services, such as office visits
and prescription drugs, which must be paid to the health care provider
at the time service is provided. The monthly fees remain the same, regardless
of types or levels of services provided and doctor's visits are the
same co-payment regardless of most of the medical treatments provided.
Greater varieties of HMO plans are appearing, many of which require
an annual deductible be met for some covered services, as a result of
rising health care costs. The HMO plan with a $10 office visit and 100%
hospital services still exist, but it is becoming scarce in relation
to HMO plans that require higher co-payments and deductibles.
Any medical treatment
under an HMO plan must be received within the network of physicians
that is operate by the insurance carrier, or from a medical group that
has a contract to provide health care for that insurance company. These
medical professionals are paid a monthly capitation fee by the insurance
company for accepting new members under the HMO plan and must provide
you with the required care that is outlined in your HMO plan contract.
Except for some medical expenses, such as emergency medical treatment,
services you receive outside of this specified network of physicians
and medical facilities will not be covered. With an HMO plan, you choose
a primary care physician that oversees all of your health care needs
and make any necessary referrals to specialists within his medical group.
Since these physicians
that are under contract with the insurance company receive a fixed monthly
capitation fee from the insurance company, it is in their best interest
to keep your health care costs down. The health care costs and repeat
regular visits from plan members are absorbed by the physician or his
medical group, even if the cost of treatment exceeds his compensation
from the insurance company. For these reason, many HMO plans focus on
preventive health care and regular screenings in order to catch a treat
an illness quickly. It is important to understand the limitations of
your HMO plan on what medical expenses are not covered. There may be
exclusions or limitations on such things as chiropractic care, mental
health disorders and maternity coverage. It is also important to select
a primary care physician with whom you are comfortable in allowing him
to make decisions regarding your health.
Point-Of-Service Plans (POS)
The Point-of-Service
(POS) plan is considered the "Cadillac" of health plans and
is by far the most expensive of all the types of health insurance. Due
to the rising costs of health insurance, many companies have stopped
offering POS plans because the number of people enrolling in this type
of coverage was decreasing steadily. A POS plan combines the best parts
of the other types of health insurance and provides three levels of
health care to choose form. It combines access to comprehensive coverage
and low co-payments and coinsurance through the HMO side of the plan.
At the same time, it provides access to the preferred provider network
through the PPO side of the plan, and even gives access to out-of-network
providers.
With a POS plan, you
are required to select a primary care physician, just as you do with
an HMO plan. However, you are not obligated to use the services of this
primary care physician. The incentive to seek treatment first from your
primary care physician is that your coverage will be more comprehensive
if you go through the HMO network of your primary doctor. Also, your
out-of-pocket expenses will be lower because usually there is no deductible
associated with treatment received through the HMO network.
The second level of coverage
under a POS plan is through the PPO network. This benefit works just
like a separate PPO plan would work, and you may have to meet an annual
deductible and pay a coinsurance for most covered services. Some POS
plans offer set office visit co-payments when using a PPO provider,
but these are typically higher than those available through the primary
care physician. Under the PPO network, you may self-refer to specialists
and claims will be handled by the physician or medical group on your
behalf.
The third level of benefits
under a POS is the access to "out-of-network" providers. Like
an indemnity plan, you have the freedom under this level to go to any
physician or hospital anywhere in the country. Your out-of-pocket costs
will be considerably higher if you seek medical treatment under this
level of the POS plan. The deductible and coinsurance are higher than
the PPO level, and you may also be responsible for filing your own claims
for reimbursement.
The primary purpose for
choosing a POS plan is to have the comprehensive coverage through the
HMO network of your primary care physician, while also having the freedom
to use any health care professional of your choosing. Therefore, it
is important to make sure that the HMO network has physicians and hospitals
that are conveniently located to your home or place of work. If the
network is limited, or non-existent, paying the extra premium for a
POS plan would not make sense. For the same reason, you will also want
to make certain the PPO network also utilizes the majority of doctors
and health care facilities in your area. Although a POS plan may seem
like the ideal health care coverage, the monthly premium may not make
financial sense.
Health Savings Accounts (HSA)
An HSA health plan is
a health insurance policy that meets the guidelines for qualifying for
a Health Savings Accounts (HSA). An HSA is an account to which individuals,
family members and employers can make tax-deductible cash contributions,
similar to an IRA. These funds can then be used to reimburse the individual
(tax-free) for qualifying medical expenses such as deductibles, co-payments,
dental and vision care. Withdrawals from the account are exclusively
for the purpose of paying qualified medical expenses of the account
beneficiary.
HSA accounts, and the
tax laws that accompany them, were established by the Medicare Prescription
Drug Improvement and Modernization Act of 2003. In order to open and
HSA, you must first been enrolled in a health plan that meets the federal
guidelines. If you purchase and HSA qualified health plan, you are not
required to open, or make deposits, into an HSA account.
Money that you contribute
to a Health Savings Account belongs to your (the depositor) or the beneficiary
on the account and you have access to the money at any time. There are
penalties for early withdrawal if the money is not used for eligible
health care expenses. You can make an additional deposit into this account
every year and if you are insured under an HSA plan through your employer,
the employer is permitted to make the annual contribution and they will
receive the tax-deduction benefit. If your employer has a "cafeteria
plans" you can make indirect deposits into your HSA through a salary
reduction plan.
Many insurance companies
offer health plans that meet HSA eligibility, and they are become more
common as the cost of health insurance rises nationwide. These are high
deductible health plans (HDHP) that have a set deductible amount, ranging
from $1,050 to $5,250 for individuals. The availability of deductible
options depends on your state of residence and the access to insurance
companies offering this type of coverage. The annual out-pocket-maximum
(coinsurance limit), must also not exceed a specific dollar amount in
order to qualify as and HSA health plan. This limit may be low compared
to the maximum limit on many PPO plans. Once this maximum has been met,
the insured member is covered in full for the remainder of the calendar
year for all medical expenses covered under the plan. One unique feature
of an HSA plan is that prescription drug coverage is treated like any
other covered medical expense. You must first meet the annual deductible,
and then a set coinsurance until you reach the maximum.
An HDHP plan will often
work with a network or preferred providers, much like a PPO plan. Using
this network for health care will provide you access to services at
lower negotiated rates. However, you will have the freedom to use physicians
outside of the network, but at a higher share of cost to you, at rates
that are not monitored by your insurance company. Some HDHP plans may
place emphasis on preventive health care by allowing you annual physical
exams and well-care checkups without having to meet your deductible
first. The availability of this benefit varies from one insurance company
to another and may not be available in all states.
Wondering about some of the terms used in health insurance?
Here are some
common terms and definitions.
Pre-existing condition:
An illness, disease or condition an individual has at the time of enrollment
in a health care plan. Pregnancy is not a pre-existing condition.
Catastrophic coverage:
This plan pays hospital and medical expenses above a certain (usually
high) deductible. The maximum lifetime limit may be high enough to cover
the cost of a catastrophic illness.
Long-term care policies:
These cover medical care, nursing care and certain in-home care if you
ever become unable to care for yourself due to an extended illness or
disability.
Disability income insurance:
This plan will provide you with an income if you become unable to work
due to an injury or illness. Benefits are usually 60% of your income
at the time of disability.
Premium:
The amount the policy-holder pays to the health plan each month to purchase
health coverage.
Deductible:
The amount that the policy-holder must pay out-of-pocket before the
health plan pays its share. For example, a policy-holder might have
to pay a $500 deductible per year, before any of their health care is
covered by the health plan. It may take several doctor's visits or prescription
refills before the policy-holder reaches the deductible and the health
plan starts to pay for care.
Copayment:
The amount that the policy-holder must pay out of pocket before the
health plan pays for a particular visit or service. For example, a policy-holder
might pay a $45 copayment for a doctor's visit, or to obtain a prescription.
A copayment must be paid each time a particular service is obtained.
Coinsurance:
Instead of paying a fixed amount up front (a copayment), the policy-holder
must pay a percentage of the total cost. For example, the member might
have to pay 20% of the cost of a surgery, while the health plan pays
the other 80%. Because there is no upper limit on coinsurance, the policy-holder
can end up owing very little, or a significant amount, depending on
the actual costs of the services they obtain.
Exclusions:
Not all services are covered. The policy-holder is generally expected
to pay the full cost of non-covered services out of their own pocket.
Coverage limits:
Some health plans only pay for health care up to a certain dollar amount.
The policy-holder may be expected to pay any charges in excess of the
health plan's maximum payment for a specific service. In addition, some
plans have annual or lifetime coverage maximums. In these cases, the
health plan will stop payment when they reach the benefit maximum, and
the policy-holder must pay all remaining costs.
Out-of-pocket maximums: Similar to coverage limits, except that in this case,
the member's payment obligation ends when they reach the out-of-pocket
maximum, and the health plan pays all further covered costs. Out-of-pocket
maximums can be limited to a specific benefit category (such as prescription
drugs) or can apply to all coverage provided during a specific benefit
year.