Basic Information Regarding Medical Insurance Quotes and Policies

What is Medical Insurance?

Who Provides Medical Insurance?

Types of Medical Insurance Policies and How They Operate

Reimbursement Insurance Plans

Prepaid Health Contracts

Government Sponsored Health Programs

Question: What is Medical Insurance?

Health Insurance Quotes Wiz Answer: Medical insurance covers individuals and their families against unforeseen expenses arising from illness, injury or accidents. Many consumers purchase auto insurance to protect their vehicle, others purchase homeowners insurance to protect their property. Medical insurance is just another type of protection that is always a smart investment.

Today, with medical insurance costs rising dramatically each year, even relatively simple medical procedures can run into the thousands of dollars. In addition, the type of care available and various policy options are also becoming more complex.

In order to reduce the risk of unexpected medical insurance costs, private health insurance companies now offer a vast array of medical insurance plans. These plans vary widely in terms of coverage, costs and benefits. It’s important to know the difference.

At first glance, different medical insurance quotes, plans and policies may seem the same. However, after reviewing the entire thing and breaking through the technical jargon, you may discover they are quite different. Buying medical insurance is one of the most confusing things consumers purchase because of the often difficult-to-understand terminology, exclusions, and limitations, contained in these medical insurance polices.

Question: Who Provides Medical Insurance?

Health Insurance Quotes Wiz Answer: Medical insurance coverage is available from commercial medical insurance companies; hospital and medical service plan providers, like Blue Cross and Blue Shield; and health maintenance organizations (HMOs) like HealthNet, PacifiCare and Kaiser, etc.

Other forms of medical insurance are provided specifically for members of the military, elderly (Medicare), federal civilian employees, veterans of military service, and other special interest groups like American Indians and Alaskan natives.

Medical insurance can be purchased on an individual or group basis. Group health insurance, generally available through an employer, may also be offered by other various organizations such as federal societies, labor unions, college health departments, and rural and consumer health cooperatives. The employer usually pays part or all of the costs for the group health insurance available to employees. However, since the protection provided by group health insurance varies from plan to plan, it is wise to check with your employer’s human resource department or your union office, to find out exactly what medical insurance coverage and benefits are available to you.

If your group health insurance does not fully cover all of your health needs or you are self-employed, then you may need to supplement your coverage with an individual medical insurance plan. Individual medical insurance can be tailored to your particular needs and provided by the medical insurance company or agent of your choice. Because medical insurance coverage and costs of such policies vary from company to company you should shop around and compare the prices as well as benefits offered before making a decision to purchase medical insurance.

Question: What are the Types of Medical Insurance Quotes and Policies and How do They Operate?

Health Insurance Quotes Wiz Answer: Medical Expense Plans— pay expenses incurred for diagnosis and treatment of medical conditions

Payments may be made to either YOU or your medical provider directly. If it’s your provider, you must “assign” your benefits to them. The policy or employer benefit booklet will detail the terms and conditions of what is covered and what is not covered under the medical insurance plan. It’s important to read this contract BEFORE you need to use your medical insurance plan and ask your agent or employer to explain anything that may be confusing.

Question: What are the Reimbursement Medical Insurance Plans?

Health Insurance Quotes Wiz Answer: Full “freedom-of-choice” plans allow you to choose any doctor and hospital. These policies call for a “deductible.” This means that you must pay a stated amount first, before the medical insurance company begins paying benefits. The deductible can be anywhere from $100 to several thousand dollars. The general rule here is: the higher the deductible you are willing to accept, the lower the cost of your overall medical insurance premium. “Co-insurance”- the medical costs you are obligated to pay with your insurer, is also involved.

For example, most freedom of choice medical insurance plans will pay 75% to 85% of all eligible medical costs above the deductible. You would pay the remainder. In other words, a medical care bill totaling $10,000 of eligible expenses would require you to pay $1,500 to $2,500 above the deductible. Medical insurance policies that require you to pay a portion of the costs above the deductible, usually feature a “stop loss” provision. This is the point where you stop sharing the costs with the medical insurance company and they pay all the bills at 100% for the balance of the current calendar year.

Preferred Provider Organizations (PPO) Plans allow you to choose a doctor or hospital from a list of “preferred” providers in order to receive maximum benefits. If you go to a doctor or hospital that is not a member of the preferred list, the medical insurance plan will cover a lesser percentage of the costs. PPO plans have many of the same features as freedom-of-choice plans including coinsurance and stop loss provisions. It’s a good idea to check with the medical insurance carrier BEFORE you use the plan to determine if your physician or hospital is a contracting provider with your plan. Also, it is your responsibility under these types of medical insurance plans to make sure your doctor refers you to other “preferred” providers.

Question: What are Prepaid Health Contracts?

Health Insurance Quotes Wiz Answer: Health Maintenance Organizations (HMOs) were formed with the idea that health costs could be controlled and they could provide preventive health care before members become ill. HMOs are comprised of hospitals, doctors and allied medical personnel who have contracted to provide health care to members in return for a pre-paid monthly medical insurance charge.

When joining an HMO medical insurance plan, members select a doctor, their “primary care physician,” from a list provided by the HMO. Typically family practitioners, internists, and pediatricians manage all medical care including referrals to specialists and determining whether further lab tests or x-rays are needed. The system is designed to eliminate any unnecessary care, which would ultimately increase total health care costs.

HMO’s provide incentives for individuals to seek medical care. In order to see a doctor for an office visit, you would pay a small copay- usually $10 or $15. In addition, prescriptions are available for a small copay. In terms of hospital expenses, they are usually covered at 100% for little or no copay. With an HMO, you do not have the option of going to a medical provider who is NOT part of the HMO network. HMO’s are available on both a group and individual basis.

Question: What are Government Sponsored Health Programs?

Health Insurance Quotes Wiz Answer: Medicare— A federal program which provides medical coverage for people over the age of 65 and for those who are permanently disabled. Contact your local Social Security office for more information and enrollment instructions.

For Information on Medical Insurance Quotes and Policies, visit the following sites:
Government Site for People on Medicare

Information on Medical Insurance Quotes and Policies