Lay and Williams Health Insurance Team

Lay and Williams Health Insurance Team
Your Health Insurance Team

Wednesday, May 11, 2011

The basic health care services

The most important factor, and the first you need to consider when it comes to determining which health insurance policy to purchase is the type of policy choose. Indemnity, HMO, PPO and POS medical insurance plans all have different priorities when it comes to how your health care is viewed and, therefore, treated. Some important topics that differ from one type of plan to another include your:

  Doctor visits
  Preventative care
  Diagnostic tests
  Hospital
  Extended care
  Emergency Treatment
  Prescription drugs
  Home health care

A really good medical insurance policy will include all these critical areas of coverage. However, a really good medical insurance policy is also really expensive. You will probably need to prioritize your health care to get what you need and want in a health insurance policy, without paying for coverage that is unnecessary for your needs.

An example: A typical fee-for-service (indemnity) plan will be relatively comprehensive except for prescription drugs and preventative care coverage. This is ideal for someone who values the security of extensive coverage over the elimination of routine costs, like doctor visits.

If a plan makes up for its lack of coverage in one area by covering services you find essential to your health care, it may be wise to live with this particular deficiency in the policy. Please contact us we are here to help you find a plan that fits your needs.  

Visit us at www.layandwilliams.com or call 1.800.281.8783

The deductible, co-payment and co-insurance

It is important to understand that the cost of health services is not completely eliminated by paying the monthly premium. There are other costs associated with major medical insurance coverage that you have to meet.

The first cost we'll discuss is the deductible. The deductible is a pre-arranged dollar figure that you'll have to satisfy (pay) before the health insurance company begins to contribute any money to your health care costs.

Your deductible can be a significant out-of-pocket expense, particularly because it must be satisfied each year before the company pays. (So paying $1000 this year for medical services will not decrease your deductible next year.)

Deductibles can range from a few hundred dollars to a several thousand. While some health insurance policies do not involve deductibles, others involve them only in certain cases. Again, the higher the deductible, the lower your monthly premiums.

The other expenses you will encounter are co-payments and your co-insurance. All medical insurance policies will require that you agree to one or both of these types of charges. A co-insurance payment means that you will be required to pay a certain percentage of your health care costs, while a co-payment means you'll be required to pay a certain, pre-set dollar amount for each medical service you receive before your medical insurance kicks in.

These are usually charged in addition to your deductible. In either case, the medical insurance company will pay a substantial amount of your medical costs in comparison to your financial responsibility.

The point of having medical insurance is, after all, to alleviate the financial burden on you and your family in case of medical emergencies and/or a chronic illness.