Medical Insurance Plans

Many Americans have their healthcare paid for by their employer, but if you don't have cover, you can buy your own health insurance. 

Why Have Medical Insurance?

Health insurance offers a way to reduce costs to more reasonable amounts, helping you to pay for medical bills and sometimes prescription drugs. Depending on which policy you choose, you agree on a percentage amount that the insurer has to pay on what you spend, and you will have to pay the balance. 

Which Insurance Is Right for You?

When searching for the right health insurance, you will find that there are two basic types of cover, managed care and indemnity.

Managed Care 

With a Managed Care Plan, your insurance company will have contracts with set medical facilities and health care providers to provide care for members at reduced costs. These providers make up the plan's network. Health Maintenance Organisations (HMO) usually only pay for care within the network. A downside to this is that patients in certain plans might not be able to easily see their preferred health provider if that health provider works outside of the patient's approved coverage network.

Indemnity Health Insurance Plan

An Indemnity Health Insurance plan, also known as "fee-for-service" plans, gives you more choice as it allows you to choose a hospital, doctor, healthcare professional, or service provider. You can take charge of your own health care and visit almost any doctor or hospital you like. The insurance company then pays a set portion of your total charges.

How do insurance companies set health premiums? 

There are various factors that can affect a plan's monthly premium, these are the location, your age, tobacco use, plan category, and whether your requirements are for an individual plan or to cover both yourself and your family. Your health, medical history, or gender can't affect your premium.

Tips to Make Sure You Are Getting the Most Out of Your Insurance

1. Choosing the right plan - this may sound obvious, but many people will stay with the same plan they have had for years instead of shopping around. When your policy is up for renewal, make sure that you look at what kind of medical and dental needs your family currently has and choose the plan that covers those best.

2. Understanding your plan - understanding the rules of your insurance plan will help you ensure that you get quality care at significant savings.

3. Stick with in-network providers. If doctors and hospitals participate in the insurance network, the charges will be lower.

4. Get your prescriptions via mail order. To make things more convenient and to reduce cost, you can order pills on a subscription service through your insurer. If you are using long term medication, it is advisable to utilize 90-day supplies and mail order, to save on dispensing fees.

5. Ask an advocate to work for you. If you're unsure of a bill you receive and don't understand the charges it may save you money by hiring a medical billing advocate to assist you. You will not be charged if everything is in order, however, if errors or a questionable charge are found the typical billing advocate may charge you one-third to one-half of the amount you save. If you are dealing with a complex medical issue, the savings could mount up to thousands of dollars.

6. Max out any discounts, programs, and benefits. Insurance companies sometimes offer discounts, for example on fitness classes or apps to help you track medications and health records.  Make sure you check out any perks that may be available to you.