What are my health insurance choices?
There are essentially two types of health insurance plans: indemnity plans (fee-for services) or managed care plans. The differences include the choice of providers, out-of-pocket costs for covered services and how bills are paid. There is no one “best” plan for everyone. Some plans are better than others for your or your family’s health care needs, but no one plan will pay for all the costs associated with your medical care.
Here is a brief description of the types of available health insurance plans: Indemnity Plans; Managed Care Options; and Government-sponsored Health Insurance
A. Indemnity Plans
Cafeteria/Flexible Spending Plans are employer-sponsored plans that allow the employee to design his or her own employee benefit package, choosing between one or more employee benefits and cash. Several types of Flexible Benefits or Cafeteria Plans are used by employers, including a pre-tax conversion plan, multiple option pre-tax conversion plan, medical plans plus flexible spending accounts, and employer credit cafeteria plans. For more information about these choices, contact your employee benefits department.
Indemnity Health Plans allow you to choose your health care providers. You can go to any doctor, hospital or other provider for a set monthly premium. The plan reimburses you or your health care provider on the basis of services rendered. You may be required to meet a deductible and pay a percentage of each bill. However, there is also often an annual limit on out-of-pocket expenses, so that once an individual or family reaches the limit, the insurance covers the remaining eligible medical expenses in full. Indemnity plans sometimes impose restrictions on covered services and may require prior authorization for hospital care or other expensive services.
“Basic and Essential” Health Plans provide limited health insurance benefits at a considerably lower cost. When buying such a plan, it is extremely important to read the policy description carefully because these plans don’t cover some basic treatments, such as chemotherapy, certain prescriptions and maternity care. Furthermore, rates vary considerably because, unlike indemnity plans or a managed care option, premiums are community rated and are based on age, gender, health status, occupation or geographic location.
Health Savings Accounts (HSA) are a recent alternative to traditional health insurance plans. HSAs are basically a savings product designed to offer individuals a different way to pay for their health care. HSAs enable you to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis. Instead of paying a premium, you establish a tax-free savings account that covers your out-of-pocket medical expenses. This means that you own and control the money in your HSA. You make all decisions about how to spend the money without relying on a third party or a health insurer. You also decide what types of investments to make with the money in the account in order to make it grow. However, if you sign up for an HSA, you are generally required to buy a High Deductible Health Plan as well.
High-Deductible Health Plans (HDHP) are sometimes referred to as catastrophic health insurance coverage. An HDHP is an inexpensive health insurance plan that kicks in only after a high deductible is met of at least $1,000 for an individual or $2,000 for a family.
B. Managed Care Options
Health Maintenance Organizations (HMOs) offer access to an extensive network of participating physicians, hospitals and other health care professionals and facilities. You choose a primary care doctor from a list provided by the HMO and this doctor coordinates your health care. You must contact your primary care doctor to be referred to a specialist. Generally, you pay fewer out-of-pocket expenses with an HMO, but you are often charged a fee or co-payment for services such as doctor visits or prescriptions.
Point-of-Service (POS) plans are an indemnity-type option in which the primary care doctors in the POS plan usually make referrals to other providers within the plan. If a doctor makes a referral out of the plan, the plan pays all or most of the bill. However, if you refer yourself to an outside provider, the service is covered by the plan, but you will be required to pay co-insurance.
Preferred Provider Organizations (PPO) charge on a fee-for-service basis. The participating doctors, hospitals and health care providers are paid by the insurer on a negotiated, discounted fee schedule. Costs are lower if you use in-network healthcare services, but you have the option of going out-of-network. If you choose an out-of-network provider, you are generally required to pay the difference between what the provider charges and what the plan pays.
C. Government-sponsored Health Insurance
Medicaid is a federal/state public assistance program created in 1965. It is administered by the states for people whose income and resources are insufficient to pay for health care or private insurance. All states have Medicaid programs, though eligibility levels and coverage benefits vary.
Medicare is a federal government program for people 65 and older, or those with certain disabilities, that pays part of the costs associated with hospitalization, surgery, doctors’ bills, home health care and skilled-nursing care.
State Children’s Health Insurance Program (SCHIP) is administered at the state level and provides health care to low-income children whose parents do not qualify for Medicaid. SCHIP may be known by different names in different states.
Military Health Care includes TRICARE/CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) and CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) as well as care provided by the Department of Veterans Affairs (VA).
State-specific Plans are available for low-income uninsured individuals. These plans are known by different names in different states.
Indian Health Service (IHS) is a Department of Health and Human Services program offering medical assistance to eligible American Indians at HIS facilities. In addition, the HIS helps pay the cost of selected health care services provided at non-HIS facilities
Tuesday, March 10, 2009
About Health Insurance
Kentucky Department of Insurance
The Kentucky Department of Insurance is responsible for regulating all types of insurance sold in the state of Kentucky - including health insurance policies.
If you are looking for health insurance coverage, the Department of Insurance can help you find an insurance agent or insurance company that is licensed to do business in Kentucky. You can contact them at the phone number listed below, or conduct your own search online.
If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Department of Insurance. Contact the Department of Insurance at the phone number listed below, or fill out the online complaint form.
Kentucky Department of Insurance
215 W. Main St.
Frankfort, KY 40601
Phone: 800.595.6053
http://doi.ppr.ky.gov/kentucky/
U.S. Department of Labor
If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees - for example, your employer cannot single out an individual employee to exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.
If you have concerns about your employer's practices in administering your job-based health coverage - for example, if you think you should have been offered COBRA continuation coverage, but were not, or if you feel that you were wrongly terminated from your health plan - contact your regional EBSA office.
U.S. Department of Labor Employee Benefits Security Administration
Cincinnati Regional Office
1885 Dixie Highway, Suite 210
Ft. Wright, KY 41011-2664
Joseph Menez - Director
Phone: 859.578.4680
Fax: 859.578.4688
http://www.dol.gov/ebsa/
Buying Individual Policies in Kentucky
As a general rule, insurers in Kentucky are allowed to reject your application for coverage based on your health status. However, you may qualify for coverage as a "HIPAA-eligible" individual if you:
* had at least 18 months of continuous creditable coverage, the last day of which was under a group plan AND
* you have exhausted all COBRA continuation coverage which was available to you.
People who are HIPAA-eligible are guaranteed the right to buy insurance through Kentucky Access (described below). If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the Department of Insurance can help you find out.
Kentucky Access - The State High Risk Pool
Kentucky Access offers coverage to individuals who are unable to purchase an individual health insurance policy because they have pre-existing health conditions. It also covers "HIPAA-eligible" individuals as described above. The Kentucky Access website details the eligibility requirements for their program here.
You can also learn more about Kentucky Access's benefits and by visiting their site or contacting them at the phone number listed below.
Kentucky Access
P.O. Box 33707
Indianapolis, IN 46203-0707
Phone: 866.405.6145
Kentucky Children's Health Insurance Program (KCHIP)
KCHIP provides health insurance coverage for children under age 19 whose families earn 200% of the federal poverty level or less.
Kentucky Children's Health Insurance Program
Phone: 877.KCHIP.18 (877.524.4718)
Email: chfs.kchip@ky.gov
http://chfs.ky.gov/dms/KCHIP.htm
Kentucky State Health Insurance Assistance Program(SHIP)
SHIP provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the new Part D prescription drug benefit, or Medigap coverage.
Kentucky State Health Insurance Assistance Program
Phone: 877.293.7447
http://chfs.ky.gov/agencies/os/dail/ship.htm
KyHealth Choices - The State Medicaid Program
Medicaid is a government program designed to help the poor and indigent obtain health care services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals. For more information about KyHealth Choices, including eligibility requirements, contact KyHealth Choices at the number listed below.
The Kentucky Department of Insurance is responsible for regulating all types of insurance sold in the state of Kentucky - including health insurance policies.
If you are looking for health insurance coverage, the Department of Insurance can help you find an insurance agent or insurance company that is licensed to do business in Kentucky. You can contact them at the phone number listed below, or conduct your own search online.
If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Department of Insurance. Contact the Department of Insurance at the phone number listed below, or fill out the online complaint form.
Kentucky Department of Insurance
215 W. Main St.
Frankfort, KY 40601
Phone: 800.595.6053
http://doi.ppr.ky.gov/kentucky/
U.S. Department of Labor
If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees - for example, your employer cannot single out an individual employee to exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.
If you have concerns about your employer's practices in administering your job-based health coverage - for example, if you think you should have been offered COBRA continuation coverage, but were not, or if you feel that you were wrongly terminated from your health plan - contact your regional EBSA office.
U.S. Department of Labor Employee Benefits Security Administration
Cincinnati Regional Office
1885 Dixie Highway, Suite 210
Ft. Wright, KY 41011-2664
Joseph Menez - Director
Phone: 859.578.4680
Fax: 859.578.4688
http://www.dol.gov/ebsa/
Buying Individual Policies in Kentucky
As a general rule, insurers in Kentucky are allowed to reject your application for coverage based on your health status. However, you may qualify for coverage as a "HIPAA-eligible" individual if you:
* had at least 18 months of continuous creditable coverage, the last day of which was under a group plan AND
* you have exhausted all COBRA continuation coverage which was available to you.
People who are HIPAA-eligible are guaranteed the right to buy insurance through Kentucky Access (described below). If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the Department of Insurance can help you find out.
Kentucky Access - The State High Risk Pool
Kentucky Access offers coverage to individuals who are unable to purchase an individual health insurance policy because they have pre-existing health conditions. It also covers "HIPAA-eligible" individuals as described above. The Kentucky Access website details the eligibility requirements for their program here.
You can also learn more about Kentucky Access's benefits and by visiting their site or contacting them at the phone number listed below.
Kentucky Access
P.O. Box 33707
Indianapolis, IN 46203-0707
Phone: 866.405.6145
Kentucky Children's Health Insurance Program (KCHIP)
KCHIP provides health insurance coverage for children under age 19 whose families earn 200% of the federal poverty level or less.
Kentucky Children's Health Insurance Program
Phone: 877.KCHIP.18 (877.524.4718)
Email: chfs.kchip@ky.gov
http://chfs.ky.gov/dms/KCHIP.htm
Kentucky State Health Insurance Assistance Program(SHIP)
SHIP provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the new Part D prescription drug benefit, or Medigap coverage.
Kentucky State Health Insurance Assistance Program
Phone: 877.293.7447
http://chfs.ky.gov/agencies/os/dail/ship.htm
KyHealth Choices - The State Medicaid Program
Medicaid is a government program designed to help the poor and indigent obtain health care services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals. For more information about KyHealth Choices, including eligibility requirements, contact KyHealth Choices at the number listed below.
Health Information Technology
There has recently been much talk among legislators, policymakers, and in the media about the benefits of adopting a nationwide Health Information Technology system. What is it? What does it mean for you?
What Is Health Information Technology?
Health Information Technology is a term that is often used interchangeably with “electronic medical records”. It is a system where medical professionals store the information usually contained in a patient chart on a computer, rather than on paper.
How Can Health Information Technology Be Used?
Health Information Technology, or Health IT, can be used to improve the efficiency and quality of health care that patients receive. Many people have health conditions that require them to visit several different doctors. For example, I have a primary care physician, and also regularly visit an Ear, Nose & Throat specialist for my sinus and allergy concerns. With Health IT, both of my doctors would have access to my complete treatment chart, so each could see what the other was doing and would not duplicate their efforts. The chances of one doctor prescribing a drug that would interact unfavorably with a drug that the other prescribed would be virtually nil. And if I were to get in an accident and end up in an emergency room, the hospital would also be able to access my medical records, so they could treat me more rapidly and effectively.
Because Health IT would be a national database system that is interlinked and regularly backed up, patient records would be safe even in the face of natural disasters like Hurricanes Katrina and Rita. Many crucial medical records were lost in these terrible storms because they were kept on paper that was destroyed in the flooding. Also, people who become ill while traveling would not have to suffer because the hospital in Honolulu cannot reach their primary care physician in Tuscaloosa. Their patient records would be available and instantly transmittable electronically.
Health insurance information could also be linked to Health IT records. Imagine walking into a doctor’s office and not having to fill out 17 gazillion insurance forms. With a swipe of a card, your medical records and health insurance information would be instantly transmitted to the provider. This would make your life easier, and it would help your doctor’s administrative staff – they would immediately know which procedures your insurance policy covers and what your copay would be.
Health IT also has great potential to reduce health care costs. A recent study by the Rand Institute estimates that if 90% of all health care providers adopted Health IT, potential savings could average over $77 billion per year. An effective Health IT system would cut costs by reducing the duration of hospital stays, the amount of time that nurses spend performing administrative tasks, and drug and radiology usage.
What Is Health Information Technology?
Health Information Technology is a term that is often used interchangeably with “electronic medical records”. It is a system where medical professionals store the information usually contained in a patient chart on a computer, rather than on paper.
How Can Health Information Technology Be Used?
Health Information Technology, or Health IT, can be used to improve the efficiency and quality of health care that patients receive. Many people have health conditions that require them to visit several different doctors. For example, I have a primary care physician, and also regularly visit an Ear, Nose & Throat specialist for my sinus and allergy concerns. With Health IT, both of my doctors would have access to my complete treatment chart, so each could see what the other was doing and would not duplicate their efforts. The chances of one doctor prescribing a drug that would interact unfavorably with a drug that the other prescribed would be virtually nil. And if I were to get in an accident and end up in an emergency room, the hospital would also be able to access my medical records, so they could treat me more rapidly and effectively.
Because Health IT would be a national database system that is interlinked and regularly backed up, patient records would be safe even in the face of natural disasters like Hurricanes Katrina and Rita. Many crucial medical records were lost in these terrible storms because they were kept on paper that was destroyed in the flooding. Also, people who become ill while traveling would not have to suffer because the hospital in Honolulu cannot reach their primary care physician in Tuscaloosa. Their patient records would be available and instantly transmittable electronically.
Health insurance information could also be linked to Health IT records. Imagine walking into a doctor’s office and not having to fill out 17 gazillion insurance forms. With a swipe of a card, your medical records and health insurance information would be instantly transmitted to the provider. This would make your life easier, and it would help your doctor’s administrative staff – they would immediately know which procedures your insurance policy covers and what your copay would be.
Health IT also has great potential to reduce health care costs. A recent study by the Rand Institute estimates that if 90% of all health care providers adopted Health IT, potential savings could average over $77 billion per year. An effective Health IT system would cut costs by reducing the duration of hospital stays, the amount of time that nurses spend performing administrative tasks, and drug and radiology usage.
Travel Medical Insurance
HealthQuotes.ca offers online travel medical insurance for Canadians traveling abroad, visitors to Canada as well as international travelers.
We are fully licensed insurance brokers, and as such we can help you shop for the travel medical insurance that best fits your needs (call us at 1-800-474-4474). If you email us a quote request please provide the following: Date of Birth, Travel Destination, Travel Duration and Province or Country of Residence.
We are fully licensed insurance brokers, and as such we can help you shop for the travel medical insurance that best fits your needs (call us at 1-800-474-4474). If you email us a quote request please provide the following: Date of Birth, Travel Destination, Travel Duration and Province or Country of Residence.
Health
Before we start, a word of reassurance. Every one of the insurance companies you reach through this site will issue a health insurance plan to cover every preexisting condition you have so long as none of them require treatment.
So how does this site work?
Well, to reduce the risk of you pulling a muscle and having to make a medical claim, we do all the heavy lifting for you. Just put your zip into the box. There's a simple form to fill out collecting very basic information about you. That information is then sent out to all the most reliable of the insurance companies trading in your state.
There is some filtering done to make sure you won't have a lot of time wasters asking for excessively high premiums.
Only the most reliable and affordable companies will be given your information. That way, you only get quotes that give the best chance of great value.
For those of you who have one of the new touch screens, there'll be a test of pulse and blood pressure. Please be ready to put your hand flat on the screen when the appropriate message comes up. Those of you with older machines may have to have a physician check you out if you're asking for a high value policy or you do have a preexisting condition that could require treatment.
When you get all the quotes, take your time to read through the policy information. Before you buy, make sure the cover on offer is what you need. That way, the policy you buy through this site will always deliver what you need, exactly when you need it. Never take chances with your health.
So how does this site work?
Well, to reduce the risk of you pulling a muscle and having to make a medical claim, we do all the heavy lifting for you. Just put your zip into the box. There's a simple form to fill out collecting very basic information about you. That information is then sent out to all the most reliable of the insurance companies trading in your state.
There is some filtering done to make sure you won't have a lot of time wasters asking for excessively high premiums.
Only the most reliable and affordable companies will be given your information. That way, you only get quotes that give the best chance of great value.
For those of you who have one of the new touch screens, there'll be a test of pulse and blood pressure. Please be ready to put your hand flat on the screen when the appropriate message comes up. Those of you with older machines may have to have a physician check you out if you're asking for a high value policy or you do have a preexisting condition that could require treatment.
When you get all the quotes, take your time to read through the policy information. Before you buy, make sure the cover on offer is what you need. That way, the policy you buy through this site will always deliver what you need, exactly when you need it. Never take chances with your health.
Colorado Insurance Medical
Colorado Health Insurance Brokers Save You Time AND Money
Get an instant quote or fill out a free expert quote recommendation request and Colorado Health Insurance Brokers will personally review plans from Colorado’s competing top rated health insurance carriers. We’ll work to help you find the right plan at the guaranteed best price. Our services are provided at NO COST or mark up to our clients.
Colorado Health Insurance Brokers are authorized agents for Colorado’s leading health insurance companies including: Anthem Blue Cross Blue Shield, Aetna, Assurant Health, Humana, Kaiser Permanente, UnitedHealthOne / Golden Rule, American Medical Security, PacifiCare, Rocky Mountain Health Plans and many more.
Health Insurance Solutions for Individuals, Families & Small Businesses
It is our personal service and understanding of the Colorado health insurance market that our hundreds of satisfied customers value most. Whether you are a small business owner wanting to set up an employer sponsored group health insurance plan or an individual wanting to get coverage for yourself or your family, we want to learn about your personal situation and your likes and dislikes so we can help you find the exact right plan.
Customer Satisfaction is Our Number One Priority
Colorado Health Insurance Brokers is locally owned and operated. We are independent brokers which means that making YOU happy is our only objective.
Get an instant quote or we would be happy to email you a custom personalized quote, so you can review your health insurance quotes at your convenience. Or give us a call for a free Colorado health insurance quote: (303) 948-2244 or toll free at (866) 488-1339.
Keep up to date with the latest national and Colorado Health Insurance News at our blog.
Get an instant quote or fill out a free expert quote recommendation request and Colorado Health Insurance Brokers will personally review plans from Colorado’s competing top rated health insurance carriers. We’ll work to help you find the right plan at the guaranteed best price. Our services are provided at NO COST or mark up to our clients.
Colorado Health Insurance Brokers are authorized agents for Colorado’s leading health insurance companies including: Anthem Blue Cross Blue Shield, Aetna, Assurant Health, Humana, Kaiser Permanente, UnitedHealthOne / Golden Rule, American Medical Security, PacifiCare, Rocky Mountain Health Plans and many more.
Health Insurance Solutions for Individuals, Families & Small Businesses
It is our personal service and understanding of the Colorado health insurance market that our hundreds of satisfied customers value most. Whether you are a small business owner wanting to set up an employer sponsored group health insurance plan or an individual wanting to get coverage for yourself or your family, we want to learn about your personal situation and your likes and dislikes so we can help you find the exact right plan.
Customer Satisfaction is Our Number One Priority
Colorado Health Insurance Brokers is locally owned and operated. We are independent brokers which means that making YOU happy is our only objective.
Get an instant quote or we would be happy to email you a custom personalized quote, so you can review your health insurance quotes at your convenience. Or give us a call for a free Colorado health insurance quote: (303) 948-2244 or toll free at (866) 488-1339.
Keep up to date with the latest national and Colorado Health Insurance News at our blog.
Introduction to Arizona health insurance
Okay...so you've visited countless websites, received instant quotes and colorful benefit descriptions with enough small print to make you scream...WHAT DOES IT ALL MEAN (and who writes this stuff)!!!
Well we didn't write it but after years of reading it, we have boiled down the various plans to 5 key elements...and if you understand just these points...you will be able to walk into the health insurance market with confidence (and a fair amount of sanity left).
So before we get started, let's list the 5 points:
1. Doctor doctor...which doctors you can see and how that access is handled
2 Premium premium premium...are people paying too much to over-insure the small bills?? Let's see.
3. The Big What-if...the real reason you are buying Arizona health insurance...big bills
4. Pennies on the Nickel??...from the doctor visit to the broken leg - getting the real story on the small bills
5. RX dollars...prescription coverage going up up up
Now granted, there are tweaks and twists between the plans, but with the above 5 points, you already have 90% of it...the other 10% you can ask us.
So let's get started. HMO, PPO, EPO...what does it all mean. We will take a good look at what they are but more importantly...how they affect your care. Let's take a closer look..
Well we didn't write it but after years of reading it, we have boiled down the various plans to 5 key elements...and if you understand just these points...you will be able to walk into the health insurance market with confidence (and a fair amount of sanity left).
So before we get started, let's list the 5 points:
1. Doctor doctor...which doctors you can see and how that access is handled
2 Premium premium premium...are people paying too much to over-insure the small bills?? Let's see.
3. The Big What-if...the real reason you are buying Arizona health insurance...big bills
4. Pennies on the Nickel??...from the doctor visit to the broken leg - getting the real story on the small bills
5. RX dollars...prescription coverage going up up up
Now granted, there are tweaks and twists between the plans, but with the above 5 points, you already have 90% of it...the other 10% you can ask us.
So let's get started. HMO, PPO, EPO...what does it all mean. We will take a good look at what they are but more importantly...how they affect your care. Let's take a closer look..
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