Health Plan versus Health Insurance
Long gone are the days when family doctors made house calls. With today’s rising cost of just about everything, from diagnostic treatments to prescription drugs, we’re running in circles trying to find some sort of manageable health care network to provide us with workable solutions.
Health plans were previously more frequently known as HMOs. You may also hear of health plans being referred to as subscription-based medical care arrangements which are offered through HMOs, point of service plans, or preferred provider organizations.
Each of these types of plans share similarities to any of the other pre-paid services such as dental, legal and vision plans. Any pre-paid health plan will typically agree to pay for a certain fixed number or amount of services. Examples of this could include an amount of $500 towards preventative care, a fixed number of days in hospice facilities or any other required care which is covered under the plan’s services.
These services are usually deemed necessary or not by a review nurse. Any managed care entity can choose to contract out this particular task to a professional of their choosing. Such decisions can be made either before or after admittance to a hospital.
Many of the health plans fall under the heading of governmentally sponsored health care services, which are often offered to social assistance or low income families and individuals. Many of these recipients are patients over the age of 65.
Private health insurance plans are typically provided through employers and cover not only the employee, but their family as well. The positive light of the plans is how they will automatically accept any dependent or family member of the employee without consideration of previous medical history or existing conditions, nor any other condition which may prove expensive to the insurance company.
Another benefit in this situation is the amount which the employer normally covers in relation to the total cost. For example, the average American worker will pay $1,946 each year for their coverage. For this amount, all members of the employee’s family qualify for medical coverage, usually only needing to pay a small portion of the actual cost as well as yearly deductibles.
An alternative which you may find worth looking into are some of the various health discount programs (HDPs) available. However, these programs are not insurance. Depending on the choices you make when purchasing such an option, they are able to provide you with reduced costs for medical staff, hospitals and prescriptions. You may even choose to have an addition of vision or dental care, or even chiropractic if you so desire.
These too are available without exclusions for pre-existing medical conditions. They can include other services such as laboratory procedures, physical therapy, diagnostic testing as well as many other necessary medical services and supplies. The discount range with this type of health program is between 40% for visits to the doctor’s office, 60% or more on laboratory tests as well as savings of up to 85% for prescription medications.
Many of the HDPs have hospital advocacy programs where you will have someone assigned directly to your case. This person will negotiate the best possible fees for you. There is the issue of using only the provider which agreed to offer their services at reduced rates. When you can cover your entire family’s medical needs for 40$ a month or less, who’s going to argue?
There are options out there for almost every circumstance. With a little bit of researching and comparison-shopping, you can find some sort of coverage to fit the needs of not only yourself, but your family as well.