Medical Insurance - Health Insurance Coverage & Plans Explained

If you're trying to decide between health insurance plans, you'll find that there are several different kinds from which to choose. It's important that you weigh all your options carefully. Your health insurance, even with an employer contribution to the cost, is very likely to be your largest regular monthly expense other than your rent or mortgage. The plan you choose needs to be more than affordable. It will affect your family's choices in doctors and health care as long as you are a member of that health insurance plan.

Health insurance is like any other kind of insurance. You pay a monthly amount, called a premium, to an insurance company in return for 'benefits', to be paid out as needed. Depending on the kind of plan that you choose, those benefits might include regular doctor's office visits, checkups, emergency room services and hospitalizations, and treatment by specialists. Some health insurance plans also offer benefits that are called 'wellness benefits.' like discounts on health club memberships, stop-smoking classes, and nutritional consultations.

The main types of health insurance plans are:

HMO - Health Maintenance Organizations

HMO benefits are geared toward keeping you healthy. They aim for affordable health care costs by reducing the cost of annual physicals, well-child visits and other routine care by requiring you to pay a 'co-pay' - a small portion of the actual bill - for every visit to your doctor, and the health insurance company pays the rest. Most require that you choose a primary care physician, who takes the place of an old fashioned General Practitioner - the family doctor who knew your medical history and prescribed visits to specialists if needed. HMOs are generally more affordable than traditional health insurance, but they'll still cost you several hundred dollars a month.

All your medical care under an HMO will be arranged through your primary care physician. If you need to consult with a specialist, you simply call your primary care physician and request a referral.

Preferred Provider Health Insurance Plans

PPH health insurance plans are very similar to HMOs. They also attempt to keep overall medical costs affordable by providing both preventive and catastrophic health care coverage. Unlike most HMO's, though, you can usually choose to visit any physician or other provider registered with the preferred provider network. You'll pay a co-payment, and your health insurance will cover the rest.

Catastrophic Health Insurance Plans

Catastrophic health insurance plans are also sometimes called 'fee for service' plans. They generally will pay out to any provider, but they strictly limit the kind of health care that they'll cover. In most cases, you're only covered for illness or injury. There's no coverage provided for regular checkups and other office visits. Catastrophic health insurance plans are often the most affordable option, since they only pay off if you become ill or are injured.

To view our list of recommended health insurance providers, visit: Recommended Medical Health Insurance Providers.

Carrie Reeder is the owner of http://www.eZerk.com, an informational website with articles and latest news about various topics.

In The News:

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President-elect Barack Obama speaks about the economy, Thursday, Jan. 8, 2009, at George Mason University in Fairfax, Va. (AP Photo/Charles Dharapak)AP - Pushed by fellow Democrats, President-elect Barack Obama agreed to modest changes in his proposed tax cuts on Friday after inviting lawmakers to "just show me" ideas for fixing an economy shedding jobs at an alarming rate.



Illinois Gov. Rod Blagojevich makes a statement Friday, Jan. 9, 2009 in Chicago, after he was impeached by the Illinois House on a wide array of offenses including criminal corruption and wasting taxpayers money. The two term Democrat becomes the first governor in the history of Illinois to be impeached. (AP Photo/M. Spencer Green)AP - Gov. Rod Blagojevich was impeached Friday by Illinois lawmakers furious that he turned state government into a "freak show," setting the stage for an unprecedented trial in the state Senate that could get him thrown out of office.



An Israeli border police officer in the West Bank city of Hebron, throws a stun grenade during minor clashes with Palestinians following a protest against Israel's military operations in the Gaza Strip, Friday Jan. 9, 2009. Israeli jets and helicopters bombarded Gaza Friday and Hamas responded with a barrage of rockets on two cities as both sides defied a U.N. call for an immediate cease-fire. (AP Photo/Nasser Shiyoukhi)AP - Israeli jets and ground troops hammered at Hamas targets in the Gaza Strip and Islamic militants fired barrages of rockets at southern Israeli cities Friday, ignoring a U.N. resolution calling for an immediate cease-fire after two weeks of combat.



AP - Speaking out two years after being embroiled in a gay sex scandal, former evangelical pastor Ted Haggard said Friday his sexual identity is complex and can't be put into "stereotypical boxes," but that his relationship with his wife is stronger than ever.

In this Nov. 4, 2008 file photo, Gov. Sarah Palin, R-Alaska, is seen on stage during an election night rally in Phoenix.  In an interview with conservative radio talk-show host and filmmaker John Ziegler, Palin questioned whether Caroline Kennedy was getting better treatment than Palin did as Republican presidential candidate John McCain's running mate. (AP Photo/Elise Amendola, File)AP - She messed up her first interviews, didn't show much of a grasp of the issues and, dontcha know, had a speech pattern that was widely mimicked.



Texas death row inmate Andre Thomas is shown in this undated handout file photo released Friday, Jan. 9, 2009 in Huntsville, Texas. Thomas, who has a history of mental problems is being treated at a prison psychiatric unit after authorities said he pulled out his only good eye and ate it.  He similarly had plucked out his right eye before his trial in 2004. (AP Photo/Texas Department of Criminal Justice, FILE)AP - A Texas death row inmate with a history of mental problems pulled out his only good eye and told authorities he ate it. Andre Thomas, 25, was arrested for the fatal stabbings of his estranged wife, their young son and her 13-month-old daughter in March 2004. Their hearts also had been ripped out. He was convicted and condemned for the infant's death.



This photo released by Dr. David McDonald of Friendswood, Texas, shows a pine flycatcher bird he photographed on Jan. 4, 2009 in Choke Canyon State Park, Texas. (AP Photo/David McDonald)AP - Birders with binoculars and cameras are flocking to a remote state park in search of a small yellow-chested bird that apparently crossed the U.S. border for the first time from its high-mountain habitat to the south.



In these 2008 file photos, actress Jennifer Carpenter, left, arrives at the 60th Primetime Emmy Awards in Los Angeles, and actor Michael C. Hall arrives at the CBS, CW and Showtime Press Tour Party in Los Angeles. Hall's spokesman, Craig Bankey, said Friday, Jan. 9, 2009, that the couple eloped in California on New Year's Eve. They'll walk the red carpet together at the Golden Globe Awards on Sunday, the first time publicly acknowledging their relationship. (AP Photo/Chris Pizzello, file)AP - They play brother and sister on "Dexter." Now in real life, Michael C. Hall and Jennifer Carpenter are husband and wife. Hall's spokesman, Craig Bankey, said on Friday that the couple eloped in California on New Year's Eve. They'll walk the red carpet together at the Golden Globe Awards on Sunday — the first time publicly acknowledging their relationship.



In this photo released by the People for the Ethical Treatment of Animals, 'George,' a live 20 pound lobster rests on a plate at City Crab and Seafood in New York, Friday, Jan. 9, 2009. City Crab and Seafood has spared the lobster, which is expected to be released Saturday, Jan. 10, near Kennebunkport, Maine, in an area where lobster trapping is forbidden. PETA and the restaurant gauged George's age at about 140, using a rule of thumb based on the creature's weight. (AP Photo/P.E.T.A.)AP - A new lease on life — at 140? That's what a Manhattan lobster got Friday, when the 20-pound crustacean named George was released from a swanky Park Avenue restaurant's tank. City Crab and Seafood agreed to a request from People for the Ethical Treatment of Animals to let the lobster return to the Atlantic Ocean.



AP - Baseball authorized nearly 8 percent of its players to use drugs for ADHD last season, which allowed them to take otherwise banned stimulants. A total of 106 exemptions for banned drugs were given to major leaguers claiming attention deficit hyperactivity disorder from the end of the 2007 season until the end of the 2008 season, according to a report released Friday by the sport's independent drug-testing administrator.

Former Treasury Secretary Robert Rubin participates in a panel discussion about Poverty Alleviation at the Clinton Global Initiative, in New York, September 20, 2006. (Chip East/Reuters)Reuters - Citigroup Inc is in advanced talks to sell its Smith Barney brokerage unit to Morgan Stanley, a person familiar with the matter said on Friday, in a move that would further dismantle the financial supermarket that has been bailed out by the U.S. government.



Illinois Gov. Rod Blagojevich speaks during a news conference in Chicago, Illinois January 9, 2009, as he points to Illinois residents that he clamed have been helped by the issues that are now being used as the Illinois House voted to impeachment him. (Stephen J. Carrera/Reuters)Reuters - The Illinois House of Representatives impeached Gov. Rod Blagojevich on Friday for abuse of power, including a charge that he tried to sell President-elect Barack Obama's former U.S. Senate seat.



An Israeli soldier covers his ears after firing a mortar mounted on an armored personnel carrier (APC) towards Gaza from its position outside the northern Gaza Strip January 9, 2009. (Yannis Behrakis/Reuters)Reuters - Israel pressed on with a punishing Gaza offensive and Hamas sent more rocket salvoes into southern Israeli towns in a two-week-old war that continued to defy international efforts to stop it.



House Financial Services Committee Chairman Rep. Barney Frank speaks at the Office of Thrift Supervision National Housing Forum in Washington, December 8, 2008. (Jim Young/Reuters)Reuters - President-elect Barack Obama and a key Democratic lawmaker revealed plans on Friday to overhaul the government's $700 billion financial rescue fund as a way to aid struggling homeowners and speed the flow of credit.



Employers slashed payrolls by 524,000 in December, driving the unemployment rate to its highest level in almost 16 years, a government report showed on Friday, suggesting that the year-long recession was deepening. (Graphic/Reuters)Reuters - The unemployment rate surged to the highest in nearly 16 years last month as a deepening year-long recession forced companies to axe more than half a million jobs, government data showed on Friday.



Voters fill their ballots during the U.S. presidential election in West Hollywood, California November 4, 2008. (Mario Anzuoni/Reuters)Reuters - The U.S. Supreme Court said on Friday it would consider a challenge to a central provision of the 44-year-old voting rights law aimed at preventing states and local governments from making it harder for minorities to vote.



A foreclosed home is seen in Stockton, California in this May 13, 2008 file photo. A top bank industry group said on Friday that it opposes an agreement between financial giant Citigroup Inc  (Robert Galbraith/Files/Reuters)Reuters - A top bank industry group said on Friday that it opposes an agreement between Citigroup Inc and Democratic senators that would rewrite U.S. bankruptcy law to help troubled mortgage borrowers avoid foreclosure, saying it could make home loans more expensive.



A man works near a pressure gauge at a district heating plant in Skopje January 8, 2009. (Ognen Teofilovski/Reuters)Reuters - The European Union sought to finalize details on Friday of a gas monitoring deal to allow the resumption of gas supplies to Europe via Ukraine, which have been cut off for days over a pricing row.



A relative of Palestinian journalist Ihab al-Wihedi and his wife mourns prior to their funeral in Gaza City. Tanks and warplanes pounded Gaza on Friday after Israel defied a truce order from the UN Security Council as the death toll from the two-week-old conflict against Hamas passed 800.(AFP/Mahmud Hams)AFP - Tanks and warplanes pounded Gaza on Friday after Israel defied a truce order from the UN Security Council as the death toll from the two-week-old conflict against Hamas passed 800.



This US Navy photo shows the MV Sirius Star as it is observed at anchor by the US Navy. Somali pirates said Friday they had freed a Saudi-owned supertanker, whose capture nearly two months ago caused panic in international shipping and spurred the world into tougher anti-piracy action.(AFP/NVNS/David B. Hudson)AFP - Somali pirates said Friday they had freed a Saudi-owned supertanker, whose capture nearly two months ago caused panic in international shipping and spurred the world into tougher anti-piracy action.




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