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Health Insurance

Health Insurance Explained

What is it?

Health insurance is a kind of coverage that compensates for much of one’s medical expenses resulting from illnesses, disorders and diseases of every stripe. It protects the policyholder from paying full out-of-pocket costs for medical services and medications.

Who Benefits?

This coverage is designed for all people regardless of marital status, health and age as all will need help at some time or another for an illness, injury or other covered issue.

How it works?

Health insurance is an agreement between the policyholder and the insurance company. This contract outlines covered medical services and, depending on the insurance provider, can allow for payments that compensate up to and beyond 80% of expenses. The rest is then handled by out-of-pocket payments on the part of the policyholder.

Kinds of Coverage Available:

PPO (Preferred Provider Organization)

With this plan one can see any doctor or specialist in the provider network without one’s primary care physician’s permission.

EPO (Exclusive Provider Organization)

This plan only allows for doctors and specialists within the company network to be seen, which means there are no out-of-network benefits.

POS (Points of Service)

This plan is a sort of hybrid of an HMO (Health Maintenance Organization) and a PPO. Enrollees are required to choose a primary care physician for their check-up visits and for any referrals. Using this plan, once can also use out-of-network providers.

HDHP (High Deductible Health Plan)

This kind of plan can be attractive to some due to its lower premiums as it comes with a high deductible that has to be paid prior to any medical expenses being covered.

Big Benefits

Carrying good health insurance helps to keep you from paying very high out-of-pocket costs for doctors and hospitals. The insurance provider negotiates with doctors and hospitals, which helps keep costs from skyrocketing.

Another important aspect is that this coverage provides for preventive check-ups that help keep you in good health.  And, fortunately for the consumer, all of these various kinds of coverage have caps on the amount that one can pay annually on their medical costs.






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