paging dr. grey… dr. meredith grey…
HMOs are health maintenance organizations, and though they might be the least expensive, they can also be the least flexible. HMOs might limit you to certain doctors or require referrals for specialized care. They offer lower co-pays and less paperwork than other types of plans.
PPOs are preferred provider organizations, and like HMOs, are a form of managed care. You might have access to more doctors under a PPO plan, and if for some reason you get medical care from a provider outside the plan, you'll get partially reimbursed for the cost.
In a fee-for-service plan, you can get your medical care from a doctor of your choice, and then you (or, your doctor’s office) submit a claim for reimbursement from your insurer. Your policy will specify how much the reimbursement will be – depending on your co-pay or deductible, you may still have to pay some part of the cost.
If your employer doesn’t offer a health insurance benefit (or if you’re not married, or can’t get coverage from your spouse), you might still be able to get coverage on your own, but it could be expensive. Look for a group plan (perhaps through a church or professional association) or a temporary plan that at least includes medical catastrophe coverage.
In addition to plans that cover basic and major medical expenses, hospitalization, or surgery, you might also be able to participate in dental or vision care programs. These plans also have premiums, deductibles, and reimbursement levels.
we're young but we still need it...
Okay, I know what you're thinking. If health insurance is expensive, and I don't have it... I'll deal with the sniffles, aches and pains, and tummy aches until I get older. The reality is that those little health issues aren't the most costly concerns.
What could really put you in a financial mess are the major unexpected accidents that happen to people every day. What're you gonna do when you crack your shin in two as you run to the bathroom in the middle of the night? No box of bandages or over the counter cold meds will help you there. A broken shin need serious medical attention, and serious medical bills will follow.
I’m not going to lie – health insurance is complicated – but understanding your own health plan is the best insurance!