| Health care insurance can be confusing even for | | | | only illness or accidents, and does not pay for |
| those who have some experience with it. For | | | | preventive care such as flu shots or birth control |
| those who are new to it, it can be downright | | | | medication or devices. Depending on your policy, it |
| unfathomable. A good place to begin learning more | | | | may or may not pay for prescription drugs or |
| about the issues behind health care insurance is | | | | psychotherapy. |
| with the basics. | | | | Managed care can be thought of as the opposite |
| There are, generally, two types of health care | | | | of indemnity care. With a health maintenance |
| insurance: indemnity and managed care which is | | | | organization (HMO), your deductibles are often |
| often referred to as HMO. | | | | smaller than with other plans. In some cases, |
| Indemnity health care insurance is also known as | | | | there may not be any deductibles at all. |
| "fee-for-service". This type of insurance will offer | | | | Co-payments are almost always fixed and kept |
| the most flexibility because it allows you to pick | | | | low. Most preventive care, drugs, and mental |
| your own doctor, clinics, hospitals, etc. The | | | | health treatments are covered but you should |
| downside is that it will cost a good deal more than | | | | always check on this. |
| the managed types of health care plans. These | | | | The downside to managed care health insurance is |
| added costs may be reflected in the premiums | | | | that you must choose from doctors, hospitals, |
| that you pay, but they will certainly be reflected | | | | and other health care providers who have |
| in the out of pocket costs that you have to pay | | | | contracts with your HMO. In other words, you |
| when you go for care. For many people, the out | | | | cannot simply go to whomever you want. Also, |
| of pocket costs can make indemnity health | | | | you are limited to receive only those medical |
| insurance a non-option. | | | | services authorized by the plan that you have. If |
| In addition to much higher out of pocket cost you | | | | you use non-authorized providers or receive |
| will also be required to pay an annual deductible, | | | | non-authorized care, your insurance will not pay |
| which can range from a few hundred dollars to a | | | | any portion of the bills. |
| few thousand dollars. This amount must be paid | | | | Because many people did not like these |
| before the insurance will even begin to pay. | | | | restrictions, managed care has begun to evolve |
| Once the annual deductible has been paid into | | | | to include hybrid plans that blend HMOs with some |
| your account, the insurance company will then | | | | of the features of indemnity health care |
| pay a portion of what is owed. You will normally | | | | coverage. |
| have to make a co-payment of around twenty | | | | One example is the Point-of-Service plan. If you |
| percent or so, and the insurance company will | | | | are under a point-of-service plan (POS), you can |
| then pay its eighty percent. If the doctor or other | | | | keep your overall costs low by using a network |
| health professional charges high rates to begin | | | | of doctors and hospitals that have contracts with |
| with, you may end up paying a higher rate | | | | your insurer. If you decide to go outside the |
| because the insurance company will normally pay | | | | network that has been set up for the plan, you |
| only what it considers to be "usual and | | | | will have to pay an added deductible as well as |
| customary" fees for the service. | | | | higher co-payments for the services rendered. |
| Generally, indemnity health care insurance covers | | | | |