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Health Insurance FAQS |
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Frequently Asked Questions about Health Insurance
1) What exactly is Insurance?
Insurance is a contract (policy) in which an individual or group gets financial protection or reimbursement against losses from an insurance company. The specific company pools clients' risks to make payments more reasonable for the insured.
2) What is a Deductible?
It is a predetermined sum of money, which a person commits to pay before the insurance company agrees to the responsibly for any benefit payments. This is done so that people would remember that any problem that an insured may require medical assistance. This is why for insurance companies to keep premium amount down.
3)What is a PPO?
A PPO is a Preferred Provider Organization. As a member of PPO, you would get the benefit to use doctors and hospitals within the PPO network or even go outside the network for care. You do not surely require a referral to see a specialist. If you are joining a PPO, you will find you have more flexibility than with an HMO, but your out-of-pocket expenses probably to be somewhat higher.
4) What is an HMO?
An HMO is a Health Maintenance Organization. As a member of an HMO, you choose a primary care physician from a list of doctors in the HMO's network. Your primary care physician would be the first medical provider you call for medical condition. He or she would make any required referral to a medical specialist. Typically, these specialists would be a part of HMO network. If you join HMO, you would find that you have few out-of-pocket expenses for special medical care, as long as you are using doctors or hospitals that are listed in HMO.
5) What is an MSA?
An MSA is a Medical Savings Account. It is specially designed for tax-advantaged personal savings account that is used in conjunction with a high deductible health policy. Individuals could put in money to this account on a pre-tax basis to set aside money for skilled medical care and expenses, counting annual deductibles and co-payments.
6) What is a POS?
POS is a Point-of-Service Plan A type of managed care plan with features of health maintenance organizations (HMOs) and as well as preferred provider organizations (PPOs). You could determine whether to go to a network provider and pay a flat dollar or go to an out-of-network provider and pay a deductible and/or a coinsurance charge.
7) What is a provider?
A provider is a hospital, healthcare facility, physician or other medical qualified that offers healthcare services.
8) What is a Primary Care Physician (PCP)?
Primary care physician is a physician or other medical professional who serves as a group member's first contact with a health plan system. It is other wise known as a primary care provider, personal care physician or personal care provider.
9) What is Coinsurance?
Coinsurance is the part of medical costs, which are shared by both the Insured (the patient) and the Insurer.
10) Can I buy health insurance for less if I buy directly from the insurance company?
No. Insurance companies charge the same health insurance premium whether the plan is purchased directly from the company or through a broker.
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