General Description about Health Insurance

1. www.lookinghelp.com OVERVIEW HEALTH INSURANCE by ramon de jesushernandez 2010

4. www.lookinghelp.com Policies to Provide Managed Care Services The system combines managed care delivery and financing of health care services. This limits the choice of doctors and hospitals. In return for this limited choice, you'll usually pay less for medical care (eg doctor visits, prescriptions, surgery and other covered benefits) than we would pay with traditional health insurance. The network of managed care controls health care services.

6. Maintenance Organization (HMO)

7. Plans under Point of Service (POS)

9. www.lookinghelp.com Maintenance Organization (HMO) HMO members pay a monthly fixed dollar amount (similar to an insurance premium), which gives them access to a wide range of health care services. In many cases, members also pay a predetermined amount or copay for each doctor visit or emergency room and for prescription drugs instead of paying all the supplier and get some money back later. Members must use the network of HMO providers may include physicians, pharmacies and hospitals contracted by the specific HMO.

10. www.lookinghelp.com Plans under Point of Service (POS) In a Point of Service plan (POS, by its initials in English), the insured members can choose, at the point of service, and receive care from a doctor that is within the plan network or leave the network to receive the services. The POS plan provides less coverage of medical expenses that is provided outside the network for costs incurred within the network. In addition, the POS plan will generally require you to pay deductibles and coinsurance costs for medical care received outside the network

11. www.lookinghelp.com Exclusive Provider Organizations (EPO) In an array of type EPO, an insurance company contracts with hospitals or specific suppliers. The insured members must use contracted providers or hospitals to receive the benefits of these plans.

13. Basic Surgical Expense

14. Specific diseases such as cancer

16. www.lookinghelp.com HealthInsuranceTips List of InsuranceforPrivatePersons A list of companies marketing health insurance policies with guaranteed issue for eligible individuals as defined in Section 627.6487 (3) of the Florida Statutes. Cover Florida provides access to affordable health service and quality. Plans are available for all applicants from 19 to 64 years, who have not had health insurance for at least six months and who are not eligible for a program of public health insurance. Read your policy carefully Know your deductible and coinsurance provisions understands. Know your liability in case you need a referral to see a specialist. Also, learn about their rights to file an appeal or grievance if a complaint which you believe should be paid, is rejected.

17. www.lookinghelp.com HealthInsuranceTips Individual plans have a provision for review period of 10 days. This allows you to return the policy and receive a full refund if you do not agree with the policy. An individual policy should include provision of grace period. The grace period is 7 to 31 days, depending on how much you pay in insurance premium. Individual HMOs must grant a grace period of 10 days.

18. www.lookinghelp.com There are other types of health-related services that are NOT health insurance plans These are: Plans Sale Medical Discount Plans, Discount Plans, Prescription Discount Plans Dental Discount Plans and Eye are plans in which consumers pay a fee to join a plan and in return, the plan offers discounts on products and certain services through participating providers. Often, members who adhere to this plan are issued a card similar to an insurance card that identifies them as members. However, these plans do not work as safe.

20. The cancellation of the plan and reimbursement policies may be restrictive, be careful to pay all costs upfront rather than monthly.

22. www.lookinghelp.com T h e e n d