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Health Insurance

It would be nice if someone could insure that you will remain healthy, as the terminology "health insurance" implies. However, with new epidemics popping up all over the globe, and injuries lurking around the corner of our daily lives, someone came up with the next best thing, a way to help people pay for the treatments necessary to restore one's health.

It might surprise you how many people are without health insurance. The question is, are you one of them? And, should you be one? Take a look at some of the issues surrounding health insurance as well as the benefits and how it works.

Should You have Health Insurance?

Many factors usually go into a person deciding if they need health insurance. Unless you are one of the few people to have an over abundance of money, then it is recommended that you have some form of health insurance. Because the day of disaster is known to no man, one should always be prepared for some things.

Physical maladies should be at the top of the list. Being ill can affect your income and can lead to permanent damage. If you spend money on maintaining your car, you should invest in your own body. Health insurance should not just be used as an emergency ticket but also as a maintenance plan.

You should see doctors regularly to detect early signs of illness so you can take the necessary precautions to preserve your health. Keeping this in mind the monthly investment required for health insurance will pay for itself with your good health.


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How does Health Insurance Work?

Health insurance comes in different forms but they all basically have the same motive; to help people save money long term on healthcare and make a profit doing it. There is a common misunderstanding with the way insurance companies actually work. Some people believe that the money they pay goes into a pot that can pull out when they need it.

While this basic concept holds some truth, there is more to it. Think of an insurance company as more of a mutual fund. From the members perspective they are putting money in for a rainy day and discounted medical treatment.

From the insurance company's point of view, members are investors. They take the accumulated member dues and invest them in investments funds of their choice. Here is where it is different from a mutual fund; only the insurance company earns money from the investments.

The good news is, the more money an insurance company has, the better it is able to assist its members in saving on premiums, deductibles, co-pays and paying out claims. It is a numbers game that requires a lot of careful financial planning.

These insurance companies use averages to determine the number of their members that will actually make claims and spend more than they invest. Over a large sum of members, it averages out that their income will out-weigh their claims. But this should not affect your choice to get heath insurance.

Popular Health Insurance types

Preferred Provider Organizations (PPO) and Health Maintenance Organization (HMO) are the most common insurance types available. These two types programs have very different approaches to health care insurance and should be selected based on your needs.

HMO VS PPO
There are several differences between HMO and PPO insurance programs. The way the programs are structured is one of these differences. HMO insurance programs are run by private insurance companies that have a group of doctors in their network.

PPO insurance programs on the other hand are usually a group of doctors and hospitals under an umbrella that work together to offer its members discounted medical treatment. Another major difference between these two programs is the cost of protection.

Generally speaking, HMO insurance programs are less expensive than PPO programs. The primary reason is because HMO insurance programs have fixed costs for most procedures, in comparison to the percentage structure of most PPO programs.

There are however certain instances, where if not used correctly, an HMO plan can become very costly. It very important that you become familiar with the rules of your HMO. Another difference that factors into your choice of protection is the method in which payments are made for your medical care.

HMO insurance programs usually require a co-payment for general preventative care and doctor visits. These services usually cost anywhere from $0-$25 in most cases. Many PPO insurance programs offer this to its participants but many require full payment of services up front.

If payments are made up front the PPO member is reimbursed the pre-determined percentage of the charges incurred. So in general a PPO member needs to fanancially capable of paying for their services up front.


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Specialty coverage

Some health insurance companies offer specialty coverage. Getting covered is strictly at your discretion. Specialty coverage programs are designed to assist people who are afflicted with debilitating illnesses like Cancer.

These types of illnesses usually are a large financial burden on families and can lead loss of income and property. Most of these specialty coverage programs are designed to cover the losses resulting from such an illness.

Should you get a specialty coverage?
The reasoning behind this should be based on calculated risks. If there is a high possibilty of you being diagnosed with a debilitating illness based on your family's medical history or other outside factors, then maybe it is a good choice.

The truth of the matter is, you never know what the future holds for you. If the piece of mind you receive from attaining such protection is valuable enough to justify the premiums, then this type of program is for you.

So use your discretion, do your research, and make the choice you feel the most comfortable with.

Read the fine print

Be sure to discuss the terms of your premium. It is important to know what factors affect your rates. Some HMO insurance providers rates go up with a person's age or if a person is stricken with an illness that requires a lot of costly treatment. These are things you should know before it is too late.

Use Your Health Insurance

The most important thing to remember, is to use your program. Don't wait for symptoms to become evident before you see a doctor. Visit a specialist of each type at least once a year. The truth is most general practitioners are not always thorough in their examinations.

A specialist is trained to look for certain symptoms that are treated in their field of medicine. An example of a good specialist to see is a dermatologist. With the increasing effects of the sun's damaging rays, it is important that you have a dermatologist inspect your skin for signs of melanoma and other potential problems.


Health Insurance type requirements

HMO Requirements
PPO Requirements

State Health Insurance Regulations

The government has set in place certain restrictions to protect consumer rights. To find out what state regulations are in place to help protect you from insurance fraud and what you should be aware of when choosing a health insurance provider, click your state link.

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