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Types Of Health Insurance Plans


Types Of Health insurance plans
Health insurance is one aspect one has to care for, it is important to have a health insurance care coverage to help you during emergency cases and unfortunate scenarious such as illness etc.

The popular saying “Health is Wealth” is justified. A healthy person is always strong, fit to go about his/her activities inorder to acquire the wealth he/she desires to acquire and be strong enough to enjoy the wealth acquired. In the other way round, an uninsured person is at a great risk of shorfalls during hi/her activites as there maybe cases wereby an emergency pops up and the unsinsured person may not be able to coupe in such situations especially on low budget. So the chances of greather medical outcome favours the insured person more than the uninsured person.

Health insurance plan
It is adviseable to have a health insurance coverage, you can start from a lower plan and as time goes on you can upgrade to a higher plan depending on your budget and desire.
Health insurance has different types which has been discussed in this article.

1. Manged Care Plan
2. The Free For Service Health Plan
3. The Maintanance Organizations Plan
4. Point Of Service Plan
5. Preferred Provider Organizations

1. Managed Care: the term ‘managed care’ alone describe how the plan is, the plan is all about managedment. Managed Care is a type of health insurance plan wereby the insurance company helps the client to control the cost related to the care provied. It is simply a way to control your health care expenses which may influence the way most services provided by the insurer are used by you.
All the sections in this plan has its own management programme to help you reduce the health care cost for instance, in an unfortunate situation wereby you fell ill and the need to go to the hospital arises, a form within the managed care plan will require that you obtain an approval from the health insurance company before you are admitted inorder to get clarification of the need for your hospitalization i.e to know the reason you are going to the hospital. However if you are going to the hospital without obtaining an approval from your health insurance company, your medical care cost or hospital bill may not be covered.

Health insurance plan

2. Fee For Service Health Plan: This is a type of health plan that employs the use of traditional health care policy. in this plan, the health insurance companies are the ones that pay for the services rendered to the people covered in the policy. This type of plan offers the clients the abilty to choose their own type of doctors that will attend to their needs and the type of hospital to attend i.e you can choose any hospital of your choice and it will be approved by your health insurance company. In this plan, your health insurance company pays part of the doctor’s charges and hospital bill. You pay for a premium on monthly basis and a deductible to be paid yearly before the commencement of your care. For example if you are to pay a deductible of $100 each in your home, then the deductible for a family of three is $300. The deductible is to be paid each year in accordance with the health insurance policy and as long as you are still covered by the health plan. Note: not all your healthcare expense are included in the deductible so, you should always consult your health insurance policy for guidance. By paying for the deductibles each year, you share the bill with your health insurance company. Now the bill is like a collective responsibility between you and your insurer e.g you may pay 20-30% Percent while your insurer will pay 70-80% Percent of the deductible and your own payment is known as “COINSURANCE”.
Inorder to recieve your payment as a client, you will be mandated to fill out the necessary details on the form that will be given to you and after the successful completion of the form, you will transfer it to the health insurance company before you can file claims for your benefits.
Note: As a client, you are responsible for you decisions, you have to keep track and record of every activity such as the type of care, drug receipts, care level etc. Some health insurance company has limits towards what you can pay for within a year and if you reach your limit the company pays evrything including items your health insurance policy covers and however it does not include your monthly premium payment. Remenber as client, it is your duty to check on health insurance companies that covers most plan as some does not cover most plan and keep in mind to check if the company covers vital plans such as child care and immunization for children. This Fee For Service plans has two types known as
*Basic: basic plan covers when the client is within the hospital rooms health care. Service covered within the basic includes X-rays and Prescribed Medicine for the client, surgery operatins in orr other hospital.
*Major: The major covers injuries and highcost illnesses. In some cases some health insurance company may combine the two plans together to form a comprehensive plan

3. Health Maintanance Organization Plan (HMOP):

The HMOP is at type of plan that has been prepared or a prepared plan. In HMO, people register to become members of the organization and in the process pay a monthly premium to the organization. The organization in-turn provides you and your family a comprehensive healthcare coverage which includes therapy, lab test, visist to a doctor, surgery, x-rays, emergency care etc. The organization either handles this care directlly or with the use of health care professionals. In this plan you have no right to choose your own doctor except those that have an agreement with the organization but in some cases the organiztions have exception to emergency situatioons.
HMO’s recieve a fixed fee however they also strive hard to provide you with the basic healthcare you desire and at a stage the heathcare problem is still news has not gotten to serious level. One drawback in HMO’s is that you’ll have to wait for sometime before you get an appointment. In HMO, all the doctors have their own offices within the HMO building and the organization pay the salaries of the doctors. In HMO, you are assigned a doctor who monitors your health status and provide care when the need arises

4. Point Of Service Plans: is type of plan wereby your healthcare loss is provied to by the health insurace company.

The doctors in this plan can make referals to outside doctors and the members can seek for health care outside and still be covered in the plan. if in some cases your primary doctors refers you to another doctor, the health insurance company will cover all the cost. However if the clients refers his/her self outside and the plan he/she seeks is a plan within the network, the client will pay a “COINSURANCE” to the company.

5. Preferered Provider Organization (PPO)
PPO Combines the Fee for service and HMO

Together, in this plan there are no limits towards the doctors to choose from and all medical cost are covered.

Visiting a doctor in PPO is more convenient as you are only required to present a card to the doctor instead of a manual form fill. There are co-payments and payment of deductible and coinsurance.


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