Wednesday, February 18, 2009

About Health Insurance Coverage

For sure, finding health coverage can be a difficult challenge especially When employed by a business, you just go with whatever insurance coverage is offered if you can afford it at the time. When you go into business for yourself it opens up the world of insurance. Atmost, you have to be the one to search through the different coverages available and see if any of the offered insurances is right for you. But the question is, how do you decide what you need or want? Here is some information on health coverage that may make you more knowledgeable and better capable of choosing your insurance provider.

Indeed, health care coverage is separated into two forms of private health care coverage in the United States. First offered is health insurance policies and the second are managed care plans, which predominate over health insurance policies. The federal and state government heavily regulates each of these insurances. Some people can view health insurance policies as a negative choice since they will often only cover what is medically necessary. Illness, injury and other medical conditions are truly considered to be medically necessary.

However,if you are to be hospitalized for evaluation or observation this is not covered. There are also a lot of clauses and limitations and the examples of this would be pre existing condition provisions. Federal law states that a pre existing condition is only valid if it relates to a condition that was formerly recommended by insured care within the last six months before enrollment. Issues like this can really make it difficult for people to choose health insurance policies.

Nevertheless, managed care programs include HMO, PPO and POS. HMO stands for Health maintenance organization. An HMO often owns and operates its own hospitals and medical facilities. They hire their own doctors, nurses and medical staff. Independent practices are models of HMO that contract out independent physicians in private practices. A PPO is a preferred provider organization and a hybrid of the HMO and PPO is POS that stands for Point of service plans. Managed care plans often have a fixed monthly fee.

In fact, the purpose of these organizations are basically to transfer the financial risk of health care from the patient to the care organization. If the cost of illness care is over the portion paid by the patient the care organization covers the fee. Actually, the PPO usually offers two or more tiers of coverage with varying benefit levels and co pay options. Some issues arise, such as females being forced to seek out a general practice physician for gynecological care. Some care plans are willing to work with female patients if their family doctor can refer them.

Indeed, no matter the health insurance option you choose you will face ups and downs with both forms. Your best bet is to do thorough research by going online or offline to find which provider best suits your personal needs so that you will be better satisfied with your health insurance coverage.

Obinna Heche is an acknowledged expert in his field and resides in California USA. For more details visit his site at


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