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How Are the Costs Of A Health Insurance Plan Made Up?

Sunday, December 2, 2007

If you are unfamiliar with health insurance then the costs of a health insurance plan may appear to be a little complicated and many people are surprised that, having shelled out what seems like a small fortune, they find themselves landed with a bill the first time they make a claim. So before you are landed with an enormous medical bill therefore, it would be a good idea to take a moment to understand just what type of costs you should expect to incur on your health insurance policy. [ life , insurance , quotes ]

The first and most obvious cost is the monthly premium or, in some cases, the quarterly premium or annual premium. If you are enrolled in a union or employer's group insurance plan then you will normally be required to meet only a percentage of the premium and this will often be taken directly from your pay check. The majority of health insurance policies also include an annual deductible which is a sum of money that you will be required to pay before your insurer begins paying out on any claims. So, with a yearly deductible of $1,000 you will need to meet the first $1,000 of your medical bills every year before your insurer will begin paying out. You may be familiar with paying a deductible from your experience with motor insurance policies and, if so, will also know that the higher the deductible on your policy the lower your premiums will be. In addition, if you have a family plan then this will often include multiple deductibles for the individual members covered under the plan.The majority of policies will also include a co-payment which is a fixed amount of money that you will need to pay towards every medical bill. Precisely how much you will need to pay in co-payments will depend very much on the type of plan you have. For instance, co-payments on HMO plans are normally less than those on indemnity plans. Additionally, the co-payment can also vary between different forms of medical service and, if you are enrolled in an HMO plan, will normally rise if you seek treatment outside of the HMO network.In cases where no co-payment is required you will usually find that this is replaced by co-insurance which is similar and is a sum of money, this time expressed as a percentage, that you will need to pay towards every medical bill. A typical co-insurance ratio is 80/20 which means that your insurer will meet 80% of each medical bill while you pay 20%. As in the case of co-payments, co-insurance will often rise if, as a member of an HMO plan, you seek treatment outside of the HMO's network. In this event you may also find that, whenever a claim exceeds what the insurance company considers to be 'reasonable and customary', you might be required to meet the additional cost.By this time you will see that comparing different health insurance plans is about much more than simply comparing plan premiums. Accordingly, it is extremely important for you to read the details of any quote very carefully and avoid the common temptation to just pick the plan with the lowest monthly premium.If you want to keep your costs low and are a member of an HMO plan then you should attempt to remain inside the HMO's network and, when you do feel the need to go outside the HMO's network, then compare actual treatment costs to what your insurer considers 'reasonable and customary' before undergoing treatment.It is also possible to keep your costs down on many plans by raising or lowering your deductible and by selecting higher or lower co-insurance. Just how this can be achieved is beyond the scope of this particular article but is a question of balancing the various different costs against the likelihood of needing to claim on your policy. [ life , insurance , quotes ]
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