Understanding Health Insurance Coverage: A Primer

by: Peter Lenkefi

Health Insurance Coverage: What are ‘Covered’ Services? Health insurance coverage is a contract used to determine medical benefits that are covered, or not covered, between you and your insurance provider. The insurance company, based on a fee that you provide them on a regular basis, promises to pay health insurance coverage on certain items or benefits listed in that contract. These are called ‘covered’ services. ‘Covered’ services can include a wide variety of things, such as implements, prescriptions, services (such as massage), checkups, tests and/or research. Your contract should also list all of the things NOT covered in your health insurance coverage – these are items or services that you will need to pay for out of your own pocket, should you require them. Health Insurance Coverage: What is a Medical Necessity? How is this Different from Covered Services? Just as it seems, a medical necessity is something that your health professional has deemed a required service/ item that will affect your health negatively should you decide not to purchase it. However, just because your doctor tells you something is a medical necessity does not mean your health insurance actually offers coverage for it. Since insurance companies decide what health coverage they will and will not provide, you really have no leeway in this area. Health Insurance Coverage: What Do I Do? Most doctors try and keep themselves abreast as to what the major insurance companies do, and do not cover when it comes to health coverage. However, there are a LOT of plans out there, so this just isn’t enough. So how can you avoid any nasty surprises during an emergency? Read your health insurance coverage. You’re better off knowing what your health insurance company will, and will not provide coverage for right off the bat. Then, if your doctor decides on a treatment plan that isn’t covered, you can ask for alternatives that may be. If there are questions regarding your health insurance coverage, do not hesitate to contact the insurance company. Questions are good, and they expect them. Health Insurance Coverage: What Do I Do if Something I Need Isn’t Covered? The gross majority of what your doctor orders for you will be covered in your health insurance plan. If you do get a treatment or supply that isn’t covered, you can always challenge the health insurance coverage. You may not be the only one who requires the same type of service, benefit or item – so you’ll end up fighting not just for yourself, but for others in the same situation. Ask your doctor for their side, and use this in your claim. It may not help in the end, but if your doctor is on your side, you may be able to convince the health insurance company that coverage is required. About the author: For more more information about health insurance coverage please visit http://www.1health-center.com/articles/Health-Insurance-Coverage.php

Top Five Health Insurance Plans

by: David Chandler

Since competition in terms of health insurance is on the rise, it is no wonder that more and more forms of health insurance are being designed. Among these, there are few that are popular and they are briefly described below. Individual Insurance: Ensuring a person individually is a common mode of insurance. One may be selective about what s/he wants in a plan through this process. Accordingly, one has required premium is calculated, and the insurance plan takes effect. Group Insurance: Another type of insurance is the group arrangement. Through this type of insurance, one is compelled to abide by what others are going for, and this is dependent on the insurance providers. They are the ones that decide what is feasible to include in a plan, and on that basis, a group insurance can take place. Indemnity Plan: This plan allows one to go to any doctor when one needs to; there are no restrictions on this, and it is believed to be more of a traditional plan. One does not need permission to go to a particular health care provider. However, usually what happens is that the member pays 20% of the total fee for treatment while the insurance provider pays 80%. In addition to this, there is a period through which one pays up in this manner, and then the company takes over paying the whole 100%. HMO: The Health Maintenance Organization is one that allows a member to select a particular doctor off the panel. It is these selected doctors that will deal will with members' problems. The selected doctor is the one that will be approached for checkups of any kind, and if there are problems with a member that cannot be handled by him or her, the member is referred to specialists. About the author: For more information, visit http://www.healthinsuranceinfocenter.com

How to Shop for Individual Health Insurance

by: Keith Thompson

If you find yourself in the position of shopping for an individual health insurance policy, there are certain things you'll want to keep in mind. Whether you are coming out of a job that covered you before, or are at the end of your COBRA benefits, or simply have never had coverage before there are things you can do to get coverage on yourself and your loved ones. The basic thing to know is that if you have a shot a group health insurance, whether through a job or an association you're a member of, that is usually much more affordable than buying individual health insurance on your own. First you need to figure out your health insurance goals; in other words, what are you after? If you're young, healthy as a horse, no dependents and not attempting Mt. Everest next week, you may want to opt for a policy that covers only the catastrophes, and cover the rest out-of-pocket. On the flip side of that, if you're the sole bread winner with a family to support, the scenario is different. The basic choices you'll have are Fee-for-Service, Managed Care Plans, and Association-based health insurance. Fee-for-service is the traditional indemnity plan, harder to acquire, more expensive, but usually great coverage. Managed care plans include most HMO's and PPO's. These offer lower costs but your choices are somewhat limited. Another way to get insured is through a group or association you may already be a member of, such as professional, religious or trade organizations. Often they may offer health insurance. It's worth checking out, as sometimes you can strike gold in this vein. Things to consider when you're looking for any policy are what's covered on this plan, how much are the monthly premiums, what is the yearly out-of-pocket, what is the deductible, how much are office visits, does it cover preventative medicine, vision, dental? And I'm sure you can come up with many of your own. Sit down before you go shopping and make a list of your needs and wants, and decide in advance what you're willing to give to get. Be aware that once you start getting quotes they can vary as much as 50% for the same person! Remember, you're shopping, and nobody's making you do anything. If one insurer isn't cutting it, move on to another. If you're coming at this cold and have no good recommendations it may be wise to use a broker who represents several companies, as he or she wil be more likely to find the best policy for you, as opposed to selling the company they work for. Shopping for individual health insurance can be frustrating and time-consuming, but if you come armed with facts you'll be able to navigate this highly competitive and ever-changing field. About the author: Keith Thompson is the webmaster at http://www.health-insurance.giftsforbiz.com,a site geared toward helping you find great individual health insurance!

How To Get Fit And Slash Your Health Insurance Costs

by: Neil Stelling

Okay, before we start, let me explain the purpose of this article. I want you to get so healthy, you'll never need to make a health insurance claim. You'll save money by increased fitness. You'll save money with a long no-claims insurance history. And you'll look and feel much better. There's three sides to your maximum health and fitness. Diet, and Exercise. But that's only two ! Let me split Exercise into Aerobic exercise and Aneorobic exercise. Get all three right. Get the right balance. And you'll get as fit and healthy as your body and genetics will allow. Whole forests of paper have been filled with advice on each of these fitness factors. Just go into your local bookstore, and see shelves of diet advice. Shelves of exercise advice. Funny how so much contradicts itself, especially for diet e.g right next to each other on the shelf, you'll find a book advocating low carbs & low fat; another saying high fat is okay if you keep the carbs low. Yet another focuses on high protein, and says carbs don't matter... * Diet Let me give you this simple diet advice. Stick to low fat, low carbs and high protein. Many medical and weight loss studies over the last 10-20 years prove this approach. Many other diet myths come from way back in time, and look just plain wrong when analyzed with modern methods. * Aerobic Exercise Couch potatoes don't realize how easily they can start feeling fit and healthy. Just walk somewhere 3-4 times per week, for around 20 minutes each time. Ideally, do some more demanding aerobic exercise. I do a lot of cycling, because it's great low-impact exercise. And I get to see beautiful scenery while I ride. Running provides even more intensive aerobic exercise, but careful of your joints. Maybe you prefer hiking, to see the local countryside ? Or take up a sport like rowing or tennis. You also get to meet new friends by taking up exercise as a sport. * Anaerobic Exercise Many people work on their diet. Many people take aerobic exercise. But many people ignore anaerobic exercise, or weight training. What makes weight training so important ? As you get older, muscle mass decreases. Muscle burns fat. So as you lose muscle, it gets harder to keep the fat off. Equally important, weight training can reshape your body. No matter how much aerobic exercise you do, you'll still be a pear shape (a smaller pear shape) if you started out a pear shape. Using weights you can flatten your stomach, tone your thighs, bulk up your chest and shoulders, and reshape your body any way you want. Weight training is incredibly beneficial to your general skeleton strength and conditioning. Older women can reduce the effects of osteoporosis, and older men can maintain their strength and agility. This short article can do nothing more than provide an introduction to the three keys to your health. Follow these and you shouldn't need to make a health insurance claim. Slash your health insurance costs with a long no-claims bonus. Slash your health insurance costs with any insurer who rates your fitness. About the author: ========================================================== "How To Get Fit And Slash Your Health Insurance Costs" - by Neil Stelling BSc, MBA © DigiLectual Inc. 2004 http://www.healthinsurance--quotes.com/ ===========================================================

How To Choose A Health Insurance Plan

by: Ron King

Are you thinking about buying health insurance? With so many different alternatives, it is difficult to know which to choose. When choosing a health insurance plan, never base your decision solely on the monthly premium. There are many other cost factors -- deductibles, co-payments, and the like -- that will determine the true price tag of your insurance. You'll need to read the fine print of the health insurance plan, including what it does and does not cover, the in-network versus out-of-network coverage and costs, claims processing procedures, and the coverage limits. Know Your Health Care Needs The first step is to review the scope of your needs: coverage just for yourself, for a large family, or something in between? Next assess the health needs for all you intend to include in your health insurance plan. Are there any pre-existing conditions to consider? Does someone need to have access to certain medical specialists or medical institutions? Research and Compare Your Options The answers to the above questions will give you a good starting point in your search for the right health insurance plan. Next, you need to explore your options. If you're getting group insurance through your employer, your options will be limited to what the company offers. Otherwise, you'll need to more research and comparison shopping. At a minimum, you have to understand the difference between the 2 basic types of health insurance plans offered today: the Indemnity Plan, and the Managed Care Plan with its variants. Indemnity Plans and Managed Care An Indemnity Plan offers the freedom to choose when and where you will seek medical assistance. Along with this freedom usually comes higher out-of-pocket costs. For many this is a fair trade-off. Managed Care Plans are more restrictive, and require you to utilize the medical professionals and institutions that are part of the plan's "network." Participants often need pre-approval for medical services that are beyond basic preventive care. The costs for this type of plan are usually lower than Indemnity Plans. For those who are basically healthy, don't mind who provides their medical services, and who need to control medical costs, Managed Care Plans are usually the better choice. This is a very basic comparison of the types of health insurance plans available. It is a first step in your own data gathering and analysis process. Select The Right Company Once you've done your homework and know what you want, you need to choose the right health insurance company. Many companies offer health insurance, from well-known corporate giants to small independent outlets. As with any major purchase, you'll want to research these companies before making a final decision. Also, find out which state or federal agency regulates the type of health insurance you're considering, in case you have questions or experience problems. Each type of health care plan has advantages and disadvantages. It is in your best interest to research thoroughly, so that the health plan you choose will be the right one for you and your family. For today and for years to come. About the author: Ron King is a full-time researcher, writer, and web developer. Visithttp://www.healthinsuring.comto learn more about this subject. Copyright 2005 Ron King. This article may be reprinted only if the resource box is left intact.

Is Pet Health Insurance an Option?

by: Peter Lenkefi

Most pet owners aren’t aware that health insurance for their loved animals has been available for about 15 years now. However, both the availability and restrictions on most plans have made this type of health insurance out of reach for most pet owners. Interestingly enough, pet health insurance has changed in the past couple of years. Now, animal owners are able to afford medical procedures previously prohibitive because of the cost. But many skeptics are concerned that health insurance for pets will see an increase in the red tape us humans already encounter every day. Animal medicine is one of the few health care services that isn’t financially dependent on health insurance. Medical, dental, surgical and pharmaceuticals are all pretty much covered by health insurance in humans, but veterinary patients are responsible for all of that, themselves. Or, at least their owners are. Health insurance for pets is very similar to insurance for humans. The same fees, deductibles, coverage rates and plans are all in place, with different plans based on the age, species, and general health of your pet. Most health insurance policies for animals start around the 6-8 week range, but when the policies end depend on a variety of factors, mostly decided by the health insurance company. Some have age limits, and some don’t. And just like with humans, some health insurance companies will only accept your pet on their plan if they are healthy; others will accept them only if they have had a stable condition for more than six months in a row. Currently, deductibles stand around $100 for pet health insurance. Policy costs vary as much as human health insurance does, unfortunately. Some depend on what types and kind of coverage is desired, and yet others are just blanket coverage catch-alls. Some may only cover accidents and illnesses. And more pets usually means a reduced health insurance rate for subsequent animals. But what if you decide that an health insurance policy is not right for you, and your pet? There are other options, of course! First, discuss your situation with your Veterinarian. Some animal hospitals offer packages that aren’t quite health insurance, but can offer a rate deal of some sorts on more mundane medical procedures (spaying/neutering, vaccinations, etc.), or packages for your aging animal. Secondly, research plans that offer discounts on animal health services. PetAssure is one of these companies, but there are a myriad of not-for-profits that may offer this as a side benefit when you join. Or, these same animal not-for-profits may offer financial assistance for pet owners whose health costs are beyond their means – a sort of emergency fund, if you will. All in all, it depends on you, and your pet(s), whether or not pet health insurance is the right choice. Hopefully, with the help of this article, your choice will be an informed one. About the author: For more more information about pet health insurance please visit http://www.1health-center.com/articles/The-Important-of-Health-Insurance.php

Health Care Costs Are Rising At Epidemic Proportions - Here's How To Protect Yourself

by: Blaine G. Dares

Health care costs are now approaching 15% of our national economy and the economic repercussions have been felt by most American families as employers are unwilling to absorb the bulk of the health care cost burden. In 2004, employer health insurance premiums increased by 11.2% - nearly four times the rate of inflation. The annual premium for an employer health plan covering a family of four averaged nearly $10,000. The annual premium for single coverage averaged $3,695. Health insurance premiums will rise to an average of more than $14,500 for family coverage in 2006. In 2004, health care spending in the United States reached $1.7 trillion, and is projected to reach $1.9 trillion in 2005. Health care spending is 4.3 times the amount spent on national defense. Overall national health care costs will increase further with the implementation of Medicare prescription drug coverage. Too many Americans are uninsured while even a greater percentage have no insurance at all. Uninsured individuals also present a problem for hospitals and other providers who must provide treatment in catastrophic situations without compensation. Many employees receive restricted coverage and insurance plans that are negotiated between employers and insurance providers limit coverage to a single insurance carrier or an HMO. Prescription drugs are the fastest-growing part of the nation's health care expense. Pharmacy bills have become a significant item in the budget of most families. For 37% of Americans without prescription coverage, the problem is critical. Especially for seniors who constitute 12% of the population but use 37% of prescription drugs. The rest especially those without health insurance, is significantly affected by high drug prices. What has caused this cost increase? Much of it is due to a riddled health care system of excessive administrative expenses, inflated prices, poor management, inappropriate care, waste and fraud. These problems significantly increase the cost of medical care and health insurance for employers and workers. On the other side of the cost issue there is the recent development of new effective medications for a variety of illnesses. Such newer "brand name" medications are patent-protected and cost far more than generic medications. The drug industry argues that the higher cost of new medications helps fund research and development of even newer medicines. Many critics argue that much of the research and development of pharmaceutical products is actually government funded. Also contributing to the cost increase is marketing. As this is 30% of a drug manufacturer's budget. Brand-name U.S drug makers were reported to employ 81% more people in marketing than in research and development of much needed drugs. Policymakers and government officials agree that health care costs must be controlled. But they disagree on the best ways to address rapidly escalating health spending. Some favor price controls and imposing strict budgets on health care spending. Others believe free market competition is the best way to solve the problems but if people can't afford it, how will they protect themselves and their family? Well there is something you can do and that's become apart of the solution and not the problem by learning more about our troubled medical industry. Visit http://www.medicalcardsavings.com and sign up to our weekly ezine and receive our Free ebook for complete details and answers to these questions and mo Share this article with others and we will reward you with cash and more subscribers. for your eZine. http://www.medicalcardsavings.com/ezinepublisher.html About the author: Blaine Dares is the President of Medical Card Savings USA Saving over 1 Million Americans over $100 Million on Dental, Medical, Prescriptions, Vision & Chiropractic Care. Instant Nationwide Savings. For complete details visit http://www.medicalcardsavings.com