YOUR
BOTTOM
LINE ON YOUR
HEALTH INSURANCE

Most plans differ in the way they work and how much you pay as a premium and co-pay. You will find that some plans will pay for some services more than others and need to look at what your individual needs are. Most plans today focus most of their benefits to preventing illness and reducing the need of medical attention by providing most of their coverage on preventative visits and treatments.

Many companies also require a health screening and won’t pick you up if you have pre-existing conditions. Check to see if premiums are higher for people with chronic illnesses, such as diabetes or hepatitis, or for smokers. There are two different types of coverage available, indemnity or fee-for-service, and managed care.

These deductibles can range -- depending on the plan you need -- between $200 and $1000 per year. The company will then start to pay a portion of the bill; usually 80% is the standard. You would then be responsible for the other 20%.

Depending on your doctor you might be responsible for this payment at the time of treatment – or it may be payable AFTER the insurance company actually pays its share. Usually these types of plans will pay for treatment and prescriptions but are not very preventative friendly. You will probably find you have to pay for routine physicals and the like with this type of plan.

Managed care is the plans most people are used to seeing and hear most about. There usually are the choices of a Preferred Provider Organization (PPO), a Health Maintenance Organization (HMO), or a Point-of-Service Plan (POS).

These have some very similar benefits and you should read carefully through each one to see the differences and figure out which one would be best for you and your family.

Preferred Provider Organization (PPO)

A PPO is very similar to an indemnity plan. It has made arrangements with doctors, hospitals, and other providers who have agreed to accept lower fees from the insurer for their services. As a result, by going to any of the doctors listed because they are accepting this type of insurance, you lower your cost.

With PPO if you want to see a doctor outside the network then you will need to get a referral from a doctor within the network first. That is where PPO differs from indemnity plans. You will pay small co-pay whenever you go to the doctor -- and for prescriptions. But you are covered when it comes to physicals.

When you do go outside the network you will be responsible for the co-pay and extra money that doctor charges, so your portion will be higher.

Remember Grandpa:  Nearly 17 years later, I can still hear grandpa's laughter, still smell grandma's coffee, still shiver at the memory of how cold those rivers were.

The Law of Tooth and Claw:  You have to make allowances for puppies, or kill them.