This post isn’t focused particularly for people in the medical billing space, or even healthcare providers specifically. I figured, since we are talking about medical billing (and health insurance plays a big role), I should make a post that provides a plethora of information on health insurance. And since everyone has/needs it, then you being a healthcare professional can benefit from this post too.
First off let me say, that whenever you are dealing with insurance, it will be complicated no matter what. In any given industry, insurance plans can be a pain. Doesn’t matter if you are talking about health insurance, property insurance, pet insurance, political insurance or any other. I know for a fact that insurance in the limousine industry, is full of loopholes and chaotic situations.
Where do we start? What do we do? The health insurance market is chaotic!
These are some of the things we hear daily, especially from people looking to get into new insurance plans or replace an older one. The search of health insurance is going to overwhelm many people and it may seem like a very daunting process. From that great variety of insurance plans, there is a very good way to narrow down some better selections. And we can really narrow this part of the search down to several general categories:
- HMO plans (Health Maintenance Organization)
- PPO plans (Medicare Plan)
- HSA accounts (Health Savings Account)
These are the main dividing categories from which to select. So let’s get right to it.
HMO Plans: These plans give you access to a series of medical doctors, healthcare providers, hospitals, other medical professionals, medical centers etc. These kind of plans are arranged based on location (geographically) and it is most beneficial for people living in large metropolitan areas and in populated locations. If you or any other maintains a specific relationship with a medical professional, then we recommend you select from the list of HMO plans. Please note that it’s extremely important your doctor (or medical professional) is in fact under an HMO plan. Also please note that these plans will basically help you when you want to see a Primary Care Physician (PCP)
PPO Plans: These plans don’t restrict you to a specific network of healthcare providers. It’s the plan that gives you more choice or “freedom.” Most of the times business people (or people that travel a lot) are the ones that prefer it. Also if you are someone that doesn’t want to go to a family/general doctor first before seeing a specialist, then you would prefer this category of insurance.
HSA Accounts: People who prefer these plans, usually don’t have chronic illnesses to deal with and they are more in control of their money. Usually the people preferring such accounts are business owners and they fund these accounts with the needed funds to cover their medical expenses. The good thing about HSA Accounts is the fact that it’s not a “flexible plan” or account. In other words, even if you don’t use up all the funds set aside, you can get that back or let it roll for the following year. So that money is not withdrawn by anyone, if any is left over. It’s your money and you get to do what you want with it.
Getting down to decision time. Not all plans are for everyone. Which is why we got such a great variety. You need to look at yourself individually and see what fits your needs. So for example if you are someone with chronic illnesses or multiple visits to the doctor per week, then you wouldn’t like an HSA Account. But if you are fortunate enough to be healthy and lead a healthy life, then you may want to consider such an account. In any case, you need to be honest with yourself and family. You also need to make sure the professional you are consulting is helpful and informative so that you make the best decision possible. Feel free to even consult us.