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Understanding Health Insurance

In a nutshell, health insurance is typically based around four options; managed care, health maintenance organizations (known as HMO), preferred provider organizations (PPO), and lastly a point of service provider (or POS).

A managed care health insurance program is typically not very popular amongst the average consumer, as it in essence just makes it possible to make visits to doctors or (rarely) a hospital under whichever circumstances and just pay a smaller out of pocket fee in comparison to without the coverage - which might wind up being more costly than having no coverage at all. For those that can't afford any other option, sometimes this is worth the investment - while others might seek state-appointed 'free healthcare' or explore ObamaCare based options.

An HMO program is based around receiving services from approved - only physicians or medical care specialists, and typically paying about 20% out of pocket and having 80% covered by your HMO - upon approval, either in the form of them being billed, or you being reimbursed for the 80% (total amount paid in some instances) at a later date. These plans typically have fairly stringent rules, and going outside of its recommended healthcare professionals will cost you extra and can fetch as high as even double or triple what you would have paid should you sought out an approved healthcare provider via your HMO.

A PPO plan is based on you having the ability to select whichever healthcare professionals or institutions you seek, and having it covered directly without having to pay up front - with some plans covering as much as 100% of any charges accrued for treatment, follow up, and some premium plans even covering some or all of your medications for a certain period of time.


Lastly, a POS healthcare insurance plan is designed to cater to your healthcare needs by providing you preapproved healthcare specialists, approved or recommended by your (preapproved) primary-care physician.

Unfortunately, this type of healthcare plan can be quite costly, both on a monthly or annually rate, dependent upon your circumstances, health, and other various variables.

Taking into consideration all of the “'ore' elements of the healthcare system, it's worth considering some of the following restrictions or additional variables in which might otherwise disqualify you for programs or increase your monthly or annual premium - and even deductible!

  • Predisposition to genetic illness or health - related illnesses
  • Impatient healthcare services or institutionalization (including mental health)
  • In most healthcare plans you are responsible for some, if not all costs of prescription - drugs, although in the instance of state approved health insurance they are typically covered upwards of 80%.
  • Age
  • Smoker 'status'
  • Any current or previous health - conditions
  • 6 month no-coverage or claim(s) capabilities (this is not ideal for someone already sick or wishing to obtain immediate care, treatment, or healthcare options in the near future)


  • Selecting a healthcare program most beneficial and practical for you can be difficult, so it weighs in your favor to look at prospective plans with a trusted friend or loved one to get the best and 'neutral' advice or guidance. If not, there are other options such as selecting and speaking with a more recognized or reputable, nationally known healthcare provider such as Blue Cross Blue Shield - just to get started, not necessarily signup, as this happens to be one of the most costly plans available.

    Additionally there are (some) genuine websites that can give your health insurance quotes based on your circumstances, and then direct you to the best health-care plan or provider tailored to fit your needs!






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