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New York Health Insurance
Author: Maria
Health insurance is insurance that pays for all or part
of a person's health care bills. A health insurance
policy is an annually renewable contract between an
insurance company and an individual. With health
insurance claims, the individual policy-holder pays a
deductible plus co-payment (for instance, a hospital
stay might require the first 1000 dollar of fees to be
paid by the policy-holder plus 100 dollar per night
stayed in hospital). Usually there is a maximum
out-of-pocket payment for any single year, and there can
be a lifetime maximum.
The purpose of health insurance is to help people cover
their health care costs which usually include doctor
visits, hospital stays, surgery, procedures, tests, home
care, and other treatments and services.
According to the latest United States Census Bureau
figures, around 85% of citizens have health insurance.
59.5% of these people receive their health insurance
coverage through an employer, and about 9% purchase it
directly from the market. Government sources cover 27.3%
of the population. Those without health insurance
coverage are expected to pay privately for medical
services.
Types of New York Health Insurance (http://new-york.ixs.net/General/New-York-Health-Insurance/index.aspx
) The types of health insurance in New York are group
health plans, individual plans, and government health
plans such as Medicare and Medicaid. In the United
States, government-funded Medicare programs help to
insure the elderly and end stage renal disease patients.
Group Health Plans
A group health plan offers health care coverage for
employers, student organizations, professional
associations, religious organizations, and other groups.
The employer may pay for part or all of the insurance
cost (premium).
Individual and Family Health Insurance
Individual and family health insurance is a type of
health insurance coverage that is made available to
individuals and families, rather than to employer groups
or organizations. These types of health care plans are
sold directly to individuals. For those of you who are
unemployed or self-employed, an individual health
insurance policy is always an option. Unfortunately
rates for these policies are high and the coverage is
usually less comprehensive than a managed care plan. The
good news is that, in many cases, your insurance premium
will be tax deductible. Of course, if you’re married,
you can always try to catch a ride on your spouse’s
group health insurance benefits plan.
Health insurance can be further classified into
fee-for-service or indemnity (traditional insurance) and
managed care. Both group and individual insurance plans
can be either fee-for-service or managed care plans.
Managed Care Health Insurance
These include HMO, PPO, and POS plans. Managed-care
plans typically make use of healthcare provider
networks. Healthcare providers within a network agree to
perform services for managed-care plan patients at
pre-negotiated rates and will usually submit the claim
to the insurance company for you. In general, you'll
have less paperwork and lower out-of-pocket costs with a
managed care health insurance plan and a broader choice
of healthcare providers with an indemnity plan.
There are three main types of managed care plans:
• Health Maintenance Organizations (HMO)
• Point-of-Service (POS)
• Preferred Provider Organizations (PPO)
All of these plans offer substantial health insurance
benefits to members and their families. If you’re
fortunate enough to have a choice of plan, consider the
advantages, and disadvantages, of each. Compare the cost
of care, the difference in premiums, deductible amounts
and your freedom to choose a doctor outside the plan.
There are numerous other coverages to compare as well --
from prescription drugs to dental to alternative
therapies. Be sure you understand the fine points of
each.
Indemnity or Fee-For-Service Plan
Normally it covers the same expenses as managed care.
The difference is your doctor is paid for each visit
with the claim filed by either the patient or the
medical provider. A big advantage-- unlike some managed
care plans, Fee-for-Service allows the patient a great
deal of freedom in choosing which doctors and hospitals
to use, but will probably involve higher out-of-pocket
costs and more paperwork.
However, you'll likely be required to pay an annual
deductible before the insurance company begins to pay on
your claims. An Indemnity plan may also require that you
pay up front for services and then submit a claim to the
insurance company for reimbursement.
Short-Term Health Insurance
Short-term health insurance plans are designed to
protect against unforeseen accidents or illnesses,
rather than to provide comprehensive coverage, and, as
such, typically do not include coverage for preventive
care, physicals, immunizations, dental or vision care.
It covers for a limited period of time, and may be an
ideal solution for those between jobs or those waiting
for other health insurance to start. Typically,
short-term plans offer coverage up to six months,
although some plans may offer coverage up to 12 months.
Purchasing a short-term medical insurance plan will make
you ineligible for any guaranteed issue individual
health plans commonly referred to as HIPAA (Health
Insurance Portability and Accountability Act) Plans.
HIPAA plans are usually very expensive and are generally
intended for people with pre-existing medical conditions
who would have trouble getting health insurance
otherwise.
Medical Savings Account (MSA)
Medical savings account (MSA) is the most recent
development in the area of health insurance. The
principle behind the MSA is to take the bulk of the
financial risk, and premium payments, away from the
managed care and indemnity insurers, and allow
individuals to save money, tax free, in a savings
account for use for medical expenses. Individuals or
their employers purchase major-medical policies, medical
insurance policies with no coverage for medical expenses
until the amount paid by the patient exceeds a
predetermined maximum amount, such as 2500 dollar per
year. These policies have extremely high deductibles and
correspondingly low monthly premiums and the
participants take the money that they would have spent
on higher premiums and deposit it in an MSA. This money
accrues through monthly deposits and also earns
interest, and can be spent only to pay for medical care
What's The Best Health Insurance Plan?
There is no one "best" plan for everyone. The best match
for you and your family may be different than the best
match for someone else. In order to help you answer this
question, here are a few things to consider:
1. Are you going to need long-term coverage or just
something for the short-term?
If you're between jobs for 1-6 months, you may want to
go for short-term coverage options. Alternatively, if
you have no prospects of receiving group health
insurance coverage through an employer, you may value
the stability and increased benefits offered through an
individual and family health insurance plan which will
provide longer term coverage.
2. Are you looking for basic coverage or more
comprehensive coverage?
Some insurance plans offer basic coverage (i.e.,
primarily inpatient hospitalization and outpatient
surgery coverage) to cover you in case of a major
accident or illness. These insurance plans typically
have a lower monthly premium than plans with more
comprehensive coverage, and may be appropriate for
people who intend to use their insurance primarily in
the event of a serious accident or illness. Other
insurance plans that offer more comprehensive coverage
may include benefits such as preventative care,
physician services, prescription drug benefits and
routine office visits. These insurance plans typically
have a higher monthly premium than plans that only offer
basic coverage, and may be appropriate for people who
intend to use their insurance on a regular basis.
3. Would you pay for your services before you use them
or when you use them?
If you choose a health insurance plan with a low monthly
premium, you're likely to have a higher co-payment or
deductible. If you don't anticipate making frequent use
of your health insurance coverage, a higher-deductible
plan with a lower monthly premium may suit you best.
4. How important to you is easy access to specialists?
Health insurance plans that require you to coordinate
your care through a primary care physician typically
require that you obtain a referral before seeing a
specialist. So, if you prefer easier access to
specialists, you may wish to consider a different type
of plan.
5. Do you have a specific doctor or hospital that you
would like to visit for healthcare?
Some insurance plans utilize provider networks. Pay
special attention to the network of doctors or
facilities that each health insurance plan utilizes.
Also note that networks utilized by health insurance
plans can change, so there is no guarantee that your
doctor will always be contracted with your chosen health
insurance plan.
6. What is the most you could pay out in case of a
serious illness or injury?
Health insurance plans typically place limits on how
much a member is required to pay out per year for his or
her healthcare. This limit is often referred to as an
out-of-pocket maximum. Once you've contributed this
maximum amount toward your healthcare, the health
insurance company typically covers all other costs for
the remainder of the benefit year. If you're concerned
about what may happen to you in case of a serious
illness or injury, you may wish to pay special attention
to the out-of-pocket maximums for the health insurance
plans you're considering.
No matter what insurance plan you may choose, educate
yourself and understand all the basics of the health
insurance before finalizing anything.
For more information about New York Health Insurance
visit: http://new-york.ixs.net
Article Source: http://www.articlesbase.com/health-articles/new-york-health-insurance-243609.html
About the Author:
Maria hosts http://events.ixs.net and expresses her
passion for events through writing and discussion. She
works for Less Corporation at http://www.ticketnest.com
Copyright Heidi Grumm
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