Even if you have many options when choosing their health insurance, the right plan can be difficult. In general, individual health insurance is a form of contract between you and the insurer (insurance) for all or a substantial part of their medical expenses, which include hospitalization, can pay for medications, dental care, according to specialists, and some treatments (radiotherapy, chemotherapy, etc.). Whatever you need, you will probably choose one of these plans, fee-for-service, HMO (Health Maintenance Organizations), or (PPO) participation of organizations and suppliers.

Fee for service – also known compensation schemes, is a type of insurance you need in the patients, all medical expenses paid out of pocket and then the reimbursement by your insurance. These types of systems have advantages and disadvantages.

Advantages: more flexibility in choosing your doctor. You can decide how much time to the providers of health care, and what kind of treatment that you want to see if it stays within the limits of your insurance

Require Disadvantages: compensation schemes, the majority of doctors to pay in advance, so you need to submit claim forms to the insurance company for reimbursement. This requires paperwork and sometimes many phone calls. Plans, payment services, limited benefits do not cover the annual programs and physical education.

HMO (Health Maintenance Organizations) – Maintenance Organizations (HMO) are plans that provide health healthcare health care coverage to their members in hospitals, doctors and other healthcare providers that are in their network. In other words, have limited its service to members of the network.

Advantages: Unlike pay service offerings, you have to pay in advance, although some require a copay. There is no need for forms, which are formed after the voucher to be applied. In addition, HMOs generally free to use a lower cost.

Disadvantages: You can only providers of health services associated with the organization. (Most HMO health maintenance organizations) usually refuse certain treatments. While accepting some members of the HMO to a physician or specialist, do not see in their network, they are often additional fees.

(PPO) of the participating provider agency – also known as Preferred Provider Organizations, is an organized form of managed care physicians, hospitals, clinics and other providers of health services to sign a contract with an insurance to healthcare to its members at discounted rates . In general, PPO costs more than traditional HMOs but offer more options for their members.

Advantages: Preferred Provider Organizations more flexibility for their members to have a larger network of doctors and hospitals. You can use the service provider of health services, (not the taking part of their network, they are) often the victims of certain fees. You pay a lower co-payments for the supply of family doctors. Finally, you do not need a referral to see a specialist.

Disadvantages: PPO cost more than traditional HMOs. You are more likely make additional investments (usually $ 10 to $ 30) during a visit to a health professional.

Many people in the United States are in some form of managed care health plan are registered. This is to offer an organized way and pay for it. Different types of managed care plans and preferred provider differently (PPO), the Maintenance Organization (HMO), Point-of-service (POS) and payment appropriations plans for service plans. Persons enrolled in the plans for health care pay a monthly or quarterly, as for the insurance when they need medical care. If a service is offered, takes over the organization of the insurance in whole or in part, the prices that the amount you pay when you receive the service, is reduced. The information contained here will help you choose a health insurance that suits you. If you’re single or married, with children or without children, this information will help you learn how to choose a health plan that best suits your needs and your financial situation. The definitions of health insurance are included in the section called Understanding Health Insurance Terms.

Basic insurance

Insurance
The amount due for the payment of the health plan of the service after your deductible. The coinsurance is expressed as a percentage defined. For example, if the insurer
pays 80 percent of demand, pay 20 percent. The coordination of benefits a system to avoid duplication and to benefit when it comes to more than one group plan. Benefits under the two plans are generally limited to a maximum of 100 percent of demand.

Co-payment
Another way of sharing medical costs. You pay a lump sum when you receive a medical service (eg $ 5) per doctor visit. The health insurance pays the rest.

Costs
Most health insurance companies, where the cost of the service, HMO, PPO or not to pay for all services. Some can not afford prescription drugs. Others can not afford mental health care. The services covered are the medical procedures the insurer agrees to pay. They are listed in the bill of health insurance.

Current Fee
Most health insurance companies only pay for what they make reasonable and customary charges call for a specific service. When repairing your doctor charges $ 1,000 for a hernia, while most doctors in your area, just $ 600, you must pay the difference of $ 400. This is in addition to the deductible and coinsurance are required to pay. To avoid this additional cost, ask your doctor for payment by your insurance company to receive full payment. Or do shop around to find a doctor to. Otherwise, you will pay the rest yourself.

Franchising
The amount of money you pay each year to cover medical expenses before your insurance begins to pay.

Exclusions
The conditions or circumstances on which the policy does not generate the profits.

HMO (Health Maintenance Organization)
Prepaid health plans. You pay a monthly premium and the insurance company covers your doctor “visits, hospitalizations, emergency medicine, surgery, tests, tests in the laboratory, radiology, and therapy. You need doctors and hospitals designated by the HMO.

Managed Care
Options for dealing costs, use and quality of health care. All HMOs and PPO, plans of service and pay a lot, managed care.

Personal spending limit
The largest amount that you need to pay one years to deductibles and coinsurance. It is a stated dollar amount set by the HMO, in addition to the regular premiums.

Policy of non-erasable
A policy which ensures that you can get health insurance until they pay for the premium. Also as a guaranteed renewable policy.

PPO (Preferred Provider Organization)
A combination of traditional fee for service and HMO. If you doctors and hospitals that are part of the PPO, you can have a larger share of their medical expenses taken into account. You can also use other doctors, but at higher cost.

Preexisting conditions
A health problem that prior to the date of the health insurance there was in force.

Premium
The amount or your employer in return for health insurance. Primary care
Usually the first contact for medical care. Often it a family doctor or internist, but some women use their gynecologist. A doctor on your health and the diagnosis and treatment of disease control in children, and refers to specialists if another level of care required. Many health insurance, care by specialists is only paid if they are referred by your GP. HMO or POS plan is a list of doctors, a primary care physician (usually a family doctor, internist, and obstetrician-gynecologists can choose pedicatrician). This could mean that you must choose a new doctor, if this is not part of the plan. PPO members to use the family doctor outside the PPO network () at higher cost. Insurance plans can be used by any doctor. Supplier
Any person (doctor, dentist) or institution (hospital or clinic), provides the medical care available.