Protecting Your Health
Very little should come before protecting your health or your family’s health. Choosing the right type of health benefits as you start or continue your career with your Las Vegas company can be the deciding factor as to whether your loved ones are admitted to the hospital for treatment or whether they are turned away.
It’s important to understand the extent of the coverage within any health insurance plan. You always want to choose the highest coverage based on what you can afford to pay. Generally speaking, you can shift payment from one end of the coverage to the other, depending on when you want to pay. High premiums result in lower deductibles and vice versa.
And while cost is what most people consider first, you will want to think about other things, as well. Here are
Five Simple And Easily Answered Questions
that you should ask about each plan or policy that you’re faced with:
- Does this plan allow for your choice of doctor or hospital?
- Does it limit prescriptions, visits to specialists, or types of treatment?
- Are there benefit limits per person, family, illness, treatment and/or hospital stay?
- What is the procedure for out-of-network emergency care?
- Does the plan have yearly or lifetime maximums?
Health care plans pay for most, and sometimes all, of the treatment costs for illnesses and injuries. Many people obtain health coverage from an employer, professional association or other organization.
Your employer or association may give you options as to which type of coverage you want, or you may have to purchase your own. Below, you will find details about the main types: PPO, POS, HMO, HSA, and SDHP.
Preferred Provider Plans (PPO)
With this coverage, the insurance company is going to give you a list of doctors and hospitals that they “prefer”. Typically there is a low out-of-pocket fee (typically $15-$20 per visit) for the services because the insurance company will pay a contracting fee to the medical institution.
There is a higher charge for going outside of your network, so make sure that you understand how far that network reaches. If you choose to visit a doctor, specialist, or clinic outside the network, the plan may pay some of your expenses, but there is no guarantee.
Point of Service Plans (POS):
As with Preferred Provider (PPO) plans, you are directed toward a network of contracted doctors, hospitals and clinics for your healthcare, but you can pay a larger out-of-pocket fee to visit an out-of-network provider. With a POS plan your primary doctor oversees your medical care and refers you to contracted specialists when the need arises. POS plans promote health and wellness through prevention and education, in addition to treatment.
The upside to a POS plan is the freedom to go out on your own and chose your own providers, even specialists, outside the network. You are never limited to medical providers your primary care physician refers. However, be aware, the dollar amount the plan will pay decreases when you go outside the network.
If the freedom to self-refer to any healthcare practitioner or hospital you want is important to you, a POS plan may be your ideal fit.
Health Maintenance Organization (HMO)
An HMO is a one-stop shop for all your healthcare needs. Your healthcare is “managed” by your primary care physician, usually a general practitioner. An HMO provides “managed care” in return for a monthly or quarterly premium. You will pay a fee depending on your coverage, and you are offered a wide spectrum of medical care.
Typically, you must receive a referral from your physician before visiting a specialist outside the provider network. With rare exceptions, such as when you are away traveling, you are limited to seeking care completely within the network of providers, doctors, hospitals and labs with whom your HMO has negotiated a fee schedule.
Cost to the consumer is kept down because the insurance company contracts only a certain network of physicians. This would be a “no hassle” option if you feel no strong connections with your current physician.
Health Savings Account (HSA)
An HSA is exactly what it sounds like. It is an account into which you can divert money to help assist with your health insurance costs. Should your plan have a high-deductible, you can use the HSA to cover those expenses. A high deductible will lower your premium, and you’ll pay less for health insurance right now. It can delay your expense.
Another benefit of the HSA is that YOU own your account. It’s your money, and you are paying to an insurance company or medical institution only if you need medical attention. You contribute and control money. The account remains unchanged even if you happen to relocate to Las Vegas. If you’re the type of person that needs a safety net, then you might want to begin putting money into an HSA. You will probably still need a insurance policy, but the HSA will protect you even further. Also, if you are a consumer who desires security and values freedom, an HSA is an option you should research.
Self-Directed Health Plans (SDHP)
With a Self-Directed Plan, you are in almost complete control of your health care insurance. You are given methods by which you can design and use your own health plan, philosophies and circumstances. Patients and their doctors decide how insurance funds should be spent.
Insurance providers have begun offering types of plans utilizing new technologies that allow you to keep your medical records on special software and research medical services, medical providers and fees using the internet. Self-directed plans may be a new, exciting solution for those with the time and desire to manage their own healthcare, tailored to their own healthcare needs and philosophies.
