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Health Insurance: The Basics
Up until now, you've probably been covered under your parents' health insurance. Keep in mind that once you are no longer a full time student (or once you are 23) it is probable that you will no longer be covered under your parents' insurance plan.
Health insurance is an important benefit. If you should become ill and treatment is needed while you are not covered by health insurance, you could have a significant financial set back. Here is a general guide to health insurance basics, and different plans that may be available to you either through an employer, or independent insurance company.
First things first - Become familiar with the vocabulary.
Deductible: The dollar amount you need to pay for medical expenses before insurance kicks in. This typically would be per calendar year.
Co-Payment: A fee you pay every time you visit the doctor. Not all plans have co-payments, but if your plan does it is usually between $5 - $20.
PCP: This stands for a primary care physician. Usually this is a family doctor that you would need to see before you see a specialist.
Out-of-pocket maximum: This term refers to the most you would have to pay during a calendar year for services. Insurance covers the costs above this amount.
Plan types:
Standard HMO (Health Maintenance Organization): This plan is typically the least expensive and least flexible. Under an HMO, your insurance company provides you with a list of doctors approved for you to see. These are called in-network doctors. When visiting doctors outside the network, you would be responsible for expenses incurred. If you would get sick, you would see your PCP (who you would choose from the list). If you had to see a specialist, you would still need to see your PCP first and get a referral.
Standard PPO (Preferred Provider Organization): This plan is usually more flexible, but more expensive. Under a PPO, you are not required to choose one main doctor. You will still be provided with a list of doctors, but if you see a doctor who is not on the list, your insurance company will help you pay for some of the bill. You will basically pay less by seeking treatment with a doctor on the list.
Standard POS (Point of Service Plan): This plans falls right in between and HMO and PPO. You can go to any doctor you want, but if you want to pay less, you would need to contact your PCP in network.
Which plan is for you?
Usually your employer will offer a designated plan, but you may have the option to upgrade your plan. For example, if you were prone to sickness, a more comprehensive plan such as a PPO would be more appropriate. If you are concerned about budget and are not as concerned with your coverage, than and HMO is probably right for you.
For more information, visit:
http://www.allaboutthebenefits.com/ |
