Home > Health Insurance Overview This type of insurance serves to pay for any medical, health, physiological or hospital related expenses which affect an injured person. The benefits are used to pay doctors, hospitals, laboratories, and pharmaceutical companies. Despite its importance, a percentage of the population is not covered under any type of health insurance plan. Pricing of Health Insurance Health insurance providers use specific underwriting criteria in order to establish pricing for health insurance Some of these are: -Age of the Applicant -The Number of Insured People to be Covered -Gender -Past Health History -Occupation -Lifestyle The 3 Ways to Obtain Health Insurance Consumers can get health insurance coverage in any of 3 ways. As an individual policy, as part of group plan, or as government benefits. Individual - As an individual, a person can purchase health insurance for themselves and their family from an insurance company, provider, or broker. Individual health insurance policies are generally more expensive than other plans. It also may be more difficult to be approved for coverage if an applicant has any health problems. Group Insurance - Group insurance policies are frequently made available to organizations of people who can be recognized as an identifiable group, including companies, clubs, church groups, unions, trade associations, and other organizations. Generally speaking, a group insurance policy is able to offer coverage for a lower cost per insured person than would normally be permitted by an individual policy. There are other advantages to a group plan: Group insurance often covers preexisting conditions - Many individual policies exclude those medical conditions that existed prior to the beginning of the policy coverage. Often, the only way to gain coverage for an ailment that has been preexistent is to join a group health plan that has negotiated a concession with an insurance company which will cover preexisting conditions. Medical exams are often unnecessary - The medical exams required by insurance companies for individual coverage can often be avoided by joining a group plan. More significant benefits - group includes lower premium prices and lower expense required to be paid by the policy holder. Lower deductibles -as a result of lower premiums. Government Insurance Benefits - The U.S. government provides healthcare benefits to citizens under programs such as Medicare and Medicaid, as well as Veterans Administration benefits. The Types of Health Insurance There are several different types of health insurance, including Traditional, HMOs, PPOs, and Disability insurance. Traditional - this type pays for medical care on a fee-for-service basis, or for each medical service that is required. Traditional health insurance can cover 3 areas of healthcare: Hospitalization - covers the medical expenses that are accumulated during a hospital stay. If the benefit is an indemnity plan, there will be payment in the form of a fixed monetary sum usually below the sum of actual charges made by the hospital. The beneficiary would simply be paid the flat fee by the insurance company and then would pay the hospital themselves. Medical and Surgical - this covers medical expenses other than the hospital bill, such as treatments, and doctor visits. This type of coverage usually requires deductibles and copayments. Catastrophic or major medical - this extends the umbrella of financial protection beyond that of hospitalization and medical/surgical, and protects against the exaggerated medical expenses of acute or prolonged illness or injury. There is often a high maximum benefit level. HMOs or Health Management Organizations - An HMO plan requires policy holders to pay just one premium and then covers their healthcare costs at very little or no addtional expense. This HMO plan of healthcare was developed in order to reduce costs for policyholders, in comparison to the traditional style, which is more expensive and necessitates payments from those insured. The disadvantage is that the insured person has less choice in who performs their health care. PPOs or Preferred Provider Organizations - PPOs attempt to combine the advantages of both traditional and HMO health plans. PPOs offer increased benefits when policyholders use doctors or hospitals that have been specifically designated by the PPO. Disability - Rather than paying for health care, this type of insurance pays the beneficiary for any lost wages due to a disabling injury or illness. Common Exclusions -Preexisting conditions -Substance abuse and any resulting illnesses -Attempted suicide -Mental illness -Illnesses covered by workers compensation claims -Cosmetic surgery (unless required due to injury) -Pregnancy -Eyeglasses and dental work -Prescription drugs (sometimes) -Preventive care such as physicals and tests with no apparent symptoms Renewability Often an important issue is the ability to renew a health insurance policy at the end of its term. A policy can be declared as one of the following: Guaranteed Renewable(by the holder), Conditionally Renewable, Nonrenewable, Cancelable (by the broker), and Noncancelable.