Why Do You Need Health Insurance?

If you've ever been sick or injured, you've probably recognized the importance of Health insurance. Health insurance helps to ensure that you and your family are protected against the financial hardships that may result from health care expenses.
 

• Are you covered while at work? Many individual policies do NOT cover you while you are working. They expect workman's comp to cover you. But if you are a small business or self-employed do you have workman's comp?
   
• Are you covered while you travel? Many times when you travel you would be out of network, what does that do to the amount you are responsible for?
   
• Do you pay usual and customary or usual, customary and reasonable charges? The American Medical Association sets the usual and customary charges. If your insurance uses the words reasonable, normal, or ??? you might find your portion of the bill to be a lot higher than you anticipated.
   
• Who determines what is medically necessary? Does your doctor make it or is that most critical decision made behind the scenes by your insurance company?
   
• For years we have relied on our employers to provide us with the proper coverage and information. As more and more Americans join the "free agent" market we have to take a much more active role in first selecting our coverage and then managing our overall health care expenses.

• How important is it that I keep the doctor I have now?
  If you have a particular physician in mind, that might dictate whether a PPO or an HMO is right for you, depending on whether he or she belongs to that insurance company's network.
   
• Do I prefer certain specialists?
  Keep in mind that some plans limit not only your visits but also who you can see. If you want to see an acupuncturist or chiropractor, be sure to ask your insurance agent or broker about coverage for these services. Psychotherapy and other mental-health services will probably have specific guidelines and limitations as well.
   
• What are my health insurance goals?
  If you want a comprehensive plan — and don't want a lot of out-of-pocket expenses — an HMO provides a very cost-effective way to cover you from womb to tomb. But if you're in your 20s or 30s, have no children and some extra savings, you can save by buying a policy that covers only catastrophic illnesses. Remember, though, you'll have to pay out of your own pocket for every routine doctor's visit or laboratory test.

(MMP) Major Medical Plan
This plan is favored by those who prefer to choose any doctor or hospital. Major Medical is one of the most unrestricted types of plans. In some plans insureds are responsible to pay in full, and/or in advance for medical services they receive and file their own claims for reimbursement. This is typically the most expensive medical program.

(PPO) Preferred Provider Organization
A delivery system where doctors / hospitals / medical facilities are under contract to an insurance company or health plan to provide care at a negotiated rate. There is freedom of choice among In-Network providers, including specialists. When In-Network providers are used, out-of-pocket expenses are lower and no claim forms are required. This plan affords you the ability to choose any doctor or hospital from the PPO's directory or to use a doctor outside the plan, at a higher expense.

(POS) Point Of Service
Point-of-Service Plan (POS) delivers health care services using both an PPO network and more traditional Major Medical coverage where individuals can utilize health care services outside the network. Out of network coverage requires you to pay more out of pocket expenses than in network coverage.

Dental Coverage
Inexpensive coverage to assist in the cost of cleaning and maintaining teeth.

Maternity Coverage
Covers Maternity under the same benefits as an illness.

Prescription Benefit
Covers Prescription Drugs with a co-payment.

Vision Care Benefit
Covers some costs associated with vision care and correction.