Affordable Healthcare: Can It Happen To You? by Irina

Affordable Healthcare: Can It Happen To You?

By Irina

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The author grants permission to publish this article, in

its entirety, electronically or in print, as long as the

bylines are included. A courtesy copy of your publication

(or, at least, an e-mail notification) sent to

irbonness@ureach.com will be appreciated.

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Let's face it - an apple a day is no longer an adequate

substitute for the professional healthcare services. And

after the 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 by the 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

the only one paying (individually!) for the coverage. So,

what's the difference? From a consumer's point of view, the

big advantage of group health insurance plans over

individual is that they can't turn you down because of

health problems.

Of course, the 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 in the health insurance industry.

Here are major plans with unique features to consider while

making your choice:

HMO - Health Maintenance Organizations

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The least expensive, but also the least flexible of all the

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

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More flexible than HMOs, but they also require you to

select a PCP.

Advantages:

- You may visit a doctor outside the 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 submitting the bills yourself and

receiving only a nominal reimbursement - if any.

PPO - Preferred Provider Organizations

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Give policyholders a financial incentive - reasonable co-

payments (also called co-pays) - to stay within the 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

as the doctor participates in the network.

Disadvantages:

- If you see an out-of-network doctor, you may have to pay

the entire bill yourself, then submit it for

reimbursement.

- You may have to pay a deductible if you choose to go

outside the network, or pay the difference between what

network doctors charge vs. out-of-network doctor's

charge.

FFS - Fee-For-Service plans, also called Traditional

Indemnity

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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) before the

insurance company starts paying claims, and then doctors

are reimbursed about 80 percent of the bill while you

pick up the remaining 20 percent.

Go to Page 2

BIO:

Irina runs home-based business helping people save on
healthcare and create steady stream of residual income
working from home
http://www.megaone.com/hbb/savemoney/
mailto:imakemoney@freeautobot.com

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