Exactly What Is Health Insurance?
Do I really need health insurance or can I live without it?
This is a question which many people ask and it is not always an easy question answer. Indeed, the answer often depends on who you ask.
As with most form of insurance, it could be argued that you don’t really need it until you need it. For example, car insurance doesn't do you any good until you have a car accident and life insurance doesn't do you any good until you are dead. By the same token, health insurance doesn't do you any good until you a sick. However, if like many people you believe in Murphy's Law - that whatever can go wrong, will go wrong - then it would probably be a good idea to think about getting health insurance.
In many countries such as the United Kingdom, Canada, France, Norway and Sweden health insurance is not an issue since medical care is provided free of charge and doctors and hospitals are reimbursed by the government.
In the United States however most health care bills are met from insurance and there are three basic forms of health insurance:
- Self-Insured or Uninsured. Here an individual either has no insurance at all or has health insurance and is responsible for paying his own insurance premiums. It is estimated that at least 30% of the United States population falls into this category.
- Managed Care Plans. Managed care plans, which are networks providing contracted service by specified providers at contracted prices, fall into three categories:
- Health Maintenance Organizations (HMOs) are pre-paid health insurance plans for which members pay a set monthly premium. HMOs provide medical services ranging from visits to the doctor's office to hospitalization and surgery and you are normally required to seek treatment from a designated network of health care providers.
- Preferred Provider Organizations (PPOs) comprise groups of doctors and health care facilities which provide medical services to a specified group. Members of PPOs normally pay for services as they are used and are then reimbursed for the costs of treatment. In most cases services are provided at a price which has been negotiated between the health care provider and the PPO.
- Point Of Service (POS) is a type of managed health care system in which you pay a minimal co-payment and no deductible as long as health care is provided within your network. However, you are free to seek treatment outside of the network but, should you wish to do so, you will have to pay additional charges and possibly a deductible.
- Indemnity Plans. An indemnity health insurance plan allows the plan holder to seek medical treatment whenever and wherever they choose. The major benefit of an indemnity plan lies in the freedom of choice that it gives to plan holder but this freedom also makes indemnity plans the most expensive form of health insurance.
The form of plan that will best suit your needs will depend very much on your personal circumstances and choosing a health insurance plan is a time-consuming task. Nonetheless, health insurance is something which everyone needs to consider sooner or later.
Closed PHO: A type of physician-hospital organization that typically limits the number of participating specialists by type of specialty.
Geographic accessibility: Health plan accessibility, generally determined by drive time or number of primary care providers in a service area.
Provider Manual: A document that contains information concerning a provider's rights and responsibilities as part of a network.
Resource-Based Relative Value Scale (RBRVS): A method used by MCOs of determining provider reimbursement that attempts to take into account, when assigning a weighted value to medical procedures or services, all resources that physicians use in providing care to patients, including physical or procedural, educational, mental (cognitive), and financial resources.
White House continues to slam insurers - CNN
10 Mar 2010 at 4:13pm
Reuters
White House continues to slam insurers
CNN
Obama said the changes in the Democrats' bill would result this year in people with pre-existing conditions being able to buy health insurance, ...
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Obama decries waste, fraud in gov't health system - The Associated Press
10 Mar 2010 at 5:48pm
SDNN
Obama decries waste, fraud in gov't health system
The Associated Press
Waste and fraud are pervasive problems for Medicare and Medicaid, the giant government health insurance programs for seniors and low-income people. ...
President Obama Will Tr...
No compromise seen on health care abortion battle - Washington Examiner
10 Mar 2010 at 5:12pm
FOXNews
No compromise seen on health care abortion battle
Washington Examiner
Those provisions, they said, provide a mechanism for federal funding of abortion through the creation of health insurance exchanges that would be operated ...
Will Stupak an...
"Slaughter Solution?" GOP Uses Lawmaker's Name to Hit Health Care - CBS News
10 Mar 2010 at 1:59pm
New York Times (blog)
"Slaughter Solution?" GOP Uses Lawmaker's Name to Hit Health Care
CBS News
Make health care a consumer driven market in the US In Switzerland, a country with a population comparable to Massachusetts, there are ~84 insurance ...
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