1. What is the difference between primary and secondary coverages?
Primary health coverage is the first plan for payments to be made. Secondary health coverage usuall covers what the primary health coverage could not. Because many people have available health insurance through more than one plan, particularly employed couples who are covered under group health insurance plans, your primary coverage will usually come from your employer or whatever plan you've had the longest.
Secondary coverage applies to those who are listed as a dependent under another persons health plan.
2. Is there an advantage to having group health insurance plan over an individual insurance plan?
Group health insurance generally has some built-in advantages over individual health insurance, while many of the coverages are similiar. As with anything, buying in bulk normally leads to price reductions or additional benefits. Group health insurance is no exception, as group plans result in reduced acquisition costs for insurers and normally better overall coverage for the "group".
3. What are some of the different types of group health insurance plans?
There are many different kinds of group health insurance plans available for both small and large business. Some of the coverages available include:
- Health Maintenance Organization (HMO)- A common type of group program where the organization provides a full breadth of medical coverage to participants. Individual participants are referred to as "enrollees". This basic system is good for providing medical care distinguished by reduction in selection by the individual participant of the provider whom distributes services.
- Fully Insured Employer Group- Most arrangments are for HMO or major medical coverages. Employees typically contract directly with Insurance companies who provide certificates. Large Employer Groups are basically the same thing.
- Self-Funded ERISA- This is an "in-house" health coverage available for large groups. Outside 3rd party sources handle paperwork documentation. The insurance plans along with thes costs for outside sources are all dealt with and paid by the group.
- Small Employer Group- Health insurance for smaller employer groups are typically consolidated with other small company groups. This forms a larger conglomerate of groups getting the same coverage of greater value than my be typically found with individual insurance.
- Associated Group- This insurance coverage is for those who get insurance through a club or group and not a business. Common group that fall in this category are church groups or those who join a service that includes insurance as an marketing campain.
- Preferred Provider Organization (PPO)- Comprised by a network of health care professionals who contract with health insurance companies, often resulting in saving for the patient.
- Group Managed Care- Offers health insurance to groups on an extended basis.
4. What individual health insurance policies are best for me?
Many options are available relating to inividual health insurance and choosing one over another can get tricky. Whether you are in search of long-term care, short-term care, dental, vision, or any number of different types of coverage, the advantage of individul health insurance is you can implement what works best you. Some of the more common types include:
1. Majory Medical- Covers prolonged injuries and illnesses and all or most hospital fees that come with that.
2. Short Term- Similiar to major medical coverage except it only last for an alloted amount of time.
3. Dental- Dental Insurance coverage extends to orthodontists and dentists
4. Long Term Care- This is for people who who require special attention for an extended period of time. This most often deals with the elderly or those with long-term illnesses. Some example of long-term care recipients include those who suffer paralysis, Alzheimer's and Parkinson's.
5. Vision- Covers visits to eye care specilists for things the eye examinations. This usually entails some compensation for eye glasses, contact lenses, and other hardware concerning eye care.
6. Home Health Care- This coverage provides personal care in ones home. Included can be a 24 nurse care and assisted living to help maintain a patients home.
7. Hospital and Surgery- Coverage for hospital stays and surgery and all expenses that are included with these procedures.
8. Health Maintenance Organizations (HMOs)- Comprised of a network of medical professionals that covers basic things like doctor visits and surgery. HMOs normally don't rely on deductibles and co-payments, rather many of the providers withing their network share in financial risk.
9. Accident Only- Covers hospital fees that originated from an accident.
10. Hospital Confinement Indemnity- Sets aside a given monetary value for everyday you are hospitalized.
5. What types of insurance do employers usually offer?
Many Employers offer health insurance to compliment an employees annual income or hourly wage. Just as individual insurance plans can vary, so can group health plans.
Typically, those employed should expect protection in the event of a catastrophic loss through accidents or illnesses. Some bigger corporations even offer varying health programs for an employee to choose.
6. What is an insurance premium and what dictates total cost?
Insurance premiums represent the amount charged by insurance companies for active account coverage. Premiums can vary for every insurance company depending on past and present health, location, and many other factors. Normally an insurance agent or broker will factor in all the variables and let a prospect know a specific premium will cost.
Group plans typically cost less because it is assumed a certain percentage of people will be in good health. For individual insurance, it is assumed someone is applying because they have increased health risks, thus driving the overall cost.
