Health Insurance Basics (College Health Guru)



you thought final exams were hard but understanding your health insurance options that feels impossible although there are many different types of health insurance plans the two most common types of health insurances are an HMO and a PPO a health maintenance organization or HMO is less expensive but it is also a more restrictive option of the two there are two aspects to an HMO that are important to understand first each HMO has a network of doctors this is a list of physicians whose services are covered by your insurance when you receive medical care from one of these in network doctors your HMO will pay for it although you'll still be responsible for a small fixed fee called a co-payment or copay for each doctor's visit on the other hand if you go out of network and visit a doctor who is not on the HMOs approved list you'll need to pay those medical bills yourself in addition most HMOs require you to select a primary care physician from their list of approved doctors this primary care physician will provide you with basic health services like your annual checkup more importantly though an HMO will only pay for visits to other doctors like a dermatologist or a surgeon if your primary care physician approves it first the benefit of an HMO is that it cost significantly less than a PPO and it's often offered free of charge by an employer if an HMO seems too restrictive you may also consider a preferred provider organization or PPO generally speaking a PPO will cover medical services from a much broader range of providers than an HMO as well with a PPO you do not need a referral to see a specialist in addition most PP o–'s allow you to see someone out of network who is not on the list and still received some reimbursement usually 50 to 70% of your outlay because of these benefits PP o–'s are more expensive and your employer may require you to put a larger part of your paycheck toward coverage still this type of plan is excellent if you're already attached to your primary care doctor and do not want to switch to a new one it is also a good bet if you need to see specialists on a regular basis whichever type of coverage you choose pay careful attention to the information provided by your insurer even though you're covered there are co-pays and other fees that you are still responsible for so choose the best plan for you

8 Comments

  1. Socialized single payer systems only ride on the accomplishments and innovation of capitalist free markets. The American system is farrrr from a free market as 3/4 of the market is owned by government and employers. Only 1/4 of healthcare is actually in control of the consumer which is why costs are spiraling out of control. A 3rd party system creates the same moral hazards as government student loans and grants and inherently cause changes to normal rational behavior. They are all linked.

  2. It is ridiculous how much healthcare costs in the USA and how the health personnel treat a person who has no insurance.It is true it costs far less to get treatment outside the USA with the same level of efficiency if you have the finances to get out of here.

  3. why such concern for my ass? maybe you like it, no?

  4. Don't let the door hit your ass on the way out. Or maybe it should; let France pay for surgery on your ass.

  5. Thank you for your intellectual comment. I will move to France and I will surely miss you.

  6. "Annual checkup" … ha! That's a good one.

    A new pacer is at least a $100,000 operation (probably more). Just to -live-. No insurance companies cover this, as a pre-existing. To pay for it oneself is to enslave oneself to a loan payoff.

    So basically, unless I opt for this state of semi-slavery, or move out of the USA, I'm fucked. Thanks USA.

  7. Then move! Universal Health Care is socialism and we won't miss you one bit. Believing what Michael Moore says in his mock-umentaries doesn't really give you a lot of clout at the intellectual table.

  8. Watch Sicko, that is the real state of health insurance in the US. I'd rather be in France, UK or Canada where I won't be paying anything, even for a visit to a doctor.

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