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Diversification in employment and life circumstance means that not everyone is covered by a medical insurance plan provided by an employer. This, of course, does not mean that these people should be without coverage.
While most people view medical coverage as a necessity for medical emergencies, it should also be considered necessary as part of the wellness plan for you and your family.
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So how do you decide which company offers the best plan for you?
A good place to start is by evaluating your needs, including the age and general health of all family members including:
- Frequency of well patient and sick patient visits.
- Need for prescription drugs.
- Do you or any family members wear eyeglasses?
- Do you or a family member see an allergist?
- Do you or a family member require physical therapy or chiropractic care?
- What is the anticipated duration period that you will need coverage?
- What is your available budget to subscribe to a health insurance plan?
Finding medical insurance coverage for your family presents a maze of options and companies to choose from. Finding a health insurance company may also mean becoming familiar with terms like premium, deductible, co-payment and co-insurance.
An independent insurance agent who is familiar with the terminology and all of the available insurance plans can help to make the search for medical coverage easier to manage.
Three of the most common types of insurance plans are available from a variety of companies.
A Health Maintenance Organization (HMO) is a medical plan that utilizes a network of doctors. These doctors agree to work with the insurance provider based on negotiated rates and predetermined service protocol. When seeking medical treatment, you are limited to visiting health care providers within the network, and usually have to pay a co-pay for each office visit.
Indemnity plans are a type of medical coverage that gives you the freedom to select the health care provider of your choice, meaning that you may not need to leave your current primary care physician or paediatrician.
Although a co-pay is typically not required for such a plan, you are required to pay a deductible for the services that the health care provider performs. Indemnity insurance will not start contributing to your medical expenses until you have paid your annual deductible amount, which varies by plan, and then they will only pay what they consider customary charges at pre-determined rates. Anything over and above what the insurance company feels are customary charges will also become your responsibility to pay.
A Preferred Provider Organization (PPO) is a mix between an HMO and indemnity plan. Like an HMO, a PPO creates a network of doctors for you to choose from, and you are only required to make a co-payment for the visit.
An advantage of a PPO is that a doctor in the network can refer you to a doctor out of the network and the PPO will pay for the visit less the co-payment. If you refer yourself to a doctor outside of the network, you will be responsible for a greater portion and possibly all of the expense.
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