Sleep-At-Night Coverage With A Private Health Insurance ( Affordable Health Insurance )
Sleep-At-Night Coverage With A Private Health Insurance ( Affordable Health Insurance ) Let us now try to take a microscopic view of the intricacies of the two major types of health insurance: Indemnity vis-à-vis the Managed Care. The Indemnity is the traditional fee-for-service plan allowing more flexibility in terms of choosing your physicians and health care providers in lieu of an annual deductible amount. This is also referred to as the typical private or individual health insurance plan, tailored to the person's situation. Exclusions are defined when you buy your policy for your particular scenario. Due to the personalization nature of the policy and the subsequent risk exposure to the insurer, this comes with a higher price tag. Exploring the intricacies of a Managed Care Plan A Managed Care plan will typically restrict the individual to visiting in-network set of physicians, hospitals and health care providers. This encompasses the Group Health Insurance plan, usually extended as part of an employer benefit. A single policy is designed for a big group of individuals belonging to different age groups and with varied medical conditions. Due to the economies of scale, in terms of risk distribution, these plans have lower premiums and out-of-pocket expenses than the private health insurance plan. There are three variations of the Managed Care plans: PPO (Preferred Provider Organization), HMO (Health Maintenance Organization) and POS (Point-of-Service). The in-line exclusions of these plans are a major concern, which are probably not always evident to the policy holder till the unforeseen happens. The provisions in the policy are decided between the insurer and the policy owner (typically your employer). Due to the restrictions imposed to visit doctors registered with the plan, you may come across a situation where you do not have a doctor to treat your specific illness. Simple surgeries and diagnostic tests can add up to thousands of dollars in medical expenditures due to the exclusions. In the long run, the lower premiums may not actually save your money due to these occasional exclusions/limitations. Thus, it always becomes an annoyance for the consumer to choose a well-rounded managed care plan that covers all or most of the medical diseases and/or illnesses. The bureaucracy and red tape involved in these policies to obtain authorizations and referrals even for the slightest of variations, for cost control measures always lead to a lot of dissatisfaction. Typically, you are also required to go through a primary care physician (PCP) for any of your treatment needs and may not be able to get your treatment done with the doctor of your choice to avoid excessive costs to the insurer. « Previous Page « » Discuss it » Continue Reading »
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