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 Article
 Good Healthcare Isn’t Always About the Money

Money does not buy everything.  For many people, the assumption is that the "better" your insurance is, the better healthcare services you will receive.  That is a misconception.

 

While it is understood that to a certain extent, the healthcare treatments you receive from a doctors is dictated by what your insurance will cover, there are still many options that can be exercised regardless of coverage.  Also, to assume that more expensive treatments are better is not necessarily accurate.

 

For some cases, an HMO policy might actually be better than a PPO; in other cases, the reverse is true.  Nonetheless, people need to appreciate the policy that they have and fully understand what their coverages are in order to receive the best medical treatment available to them.  Among the items you should make yourself well-versed on is deductible, co-insurance, out of pocket expenses, pre-existing conditions, and the lifetime maximum coverage.

The deductible refers to the amount of money that the insured would need to pay before any benefits from the health insurance policy can be used. This is usually a yearly amount so after a year, the deductible would be in effect again. Some services, like doctor visits, may be available without meeting the deductible first. Usually there are separate individual deductible amounts and total family deductible amounts. Coinsurance is the amount that would need to be paid by the insured before the insurance pays and in addition to the deductible. Some health insurance plans will let the insured use some services with just the coinsurance payment, like visiting the doctor, even before the deductible is met.

Out of pocket expenses are the cost one would pay out of their own pocket. An out of pocket expense can refer to how much the co-payment, coinsurance, or deductible is. Also, when the term annual out-of-pocket maximum is used, that is referring to how much the insured would have to pay for the whole year out of their pocket, excluding premiums. Some plans will cover pre-existing conditions while others may completely exclude them and, in addition, some health insurance plans will cover pre-existing conditions after a certain time period. Lifetime maximum is the most amount of money the health insurance policy will pay for the entire life. Pay attention to individual lifetime maximums and family lifetime maximums as they can be different.

Read your coverage thoroughly before pursuing any healthcare options.

Category Medical Insurance Author Admin
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