New York Health Insurance
- By:Maria Maria
New York Health Insurance
Health insurance is insurance that pays for all or part of a person's health care bills. A health insurance policy is an annually renewable contract between an insurance company and an individual. With health insurance claims, the individual policy-holder pays a deductible plus co-payment (for instance, a hospital stay might require the first 1000 dollar of fees to be paid by the policy-holder plus 100 dollar per night stayed in hospital). Usually there is a maximum out-of-pocket payment for any single year, and there can be a lifetime maximum.
The purpose of health insurance is to help people cover their health care costs which usually include doctor visits, hospital stays, surgery, procedures, tests, home care, and other treatments and services.
According to the latest United States Census Bureau figures, around 85% of citizens have health insurance. 59.5% of these people receive their health insurance coverage through an employer, and about 9% purchase it directly from the market. Government sources cover 27.3% of the population. Those without health insurance coverage are expected to pay privately for medical services.
Types of New York Health Insurance (http://new-york.ixs.net/General/New-York-Health-Insurance/index.aspx ) The types of health insurance in New York are group health plans, individual plans, and government health plans such as Medicare and Medicaid. In the United States, government-funded Medicare programs help to insure the elderly and end stage renal disease patients.
Group Health Plans
A group health plan offers health care coverage for employers, student organizations, professional associations, religious organizations, and other groups. The employer may pay for part or all of the insurance cost (premium).
Individual and Family Health Insurance
Individual and family health insurance is a type of health insurance coverage that is made available to individuals and families, rather than to employer groups or organizations. These types of health care plans are sold directly to individuals. For those of you who are unemployed or self-employed, an individual health insurance policy is always an option. Unfortunately rates for these policies are high and the coverage is usually less comprehensive than a managed care plan. The good news is that, in many cases, your insurance premium will be tax deductible. Of course, if you’re married, you can always try to catch a ride on your spouse’s group health insurance benefits plan.
Health insurance can be further classified into fee-for-service or indemnity (traditional insurance) and managed care. Both group and individual insurance plans can be either fee-for-service or managed care plans.
Managed Care Health Insurance
These include HMO, PPO, and POS plans. Managed-care plans typically make use of healthcare provider networks. Healthcare providers within a network agree to perform services for managed-care plan patients at pre-negotiated rates and will usually submit the claim to the insurance company for you. In general, you'll have less paperwork and lower out-of-pocket costs with a managed care health insurance plan and a broader choice of healthcare providers with an indemnity plan.
There are three main types of managed care plans:
• Health Maintenance Organizations (HMO)
• Point-of-Service (POS)
• Preferred Provider Organizations (PPO)
All of these plans offer substantial health insurance benefits to members and their families. If you’re fortunate enough to have a choice of plan, consider the advantages, and disadvantages, of each. Compare the cost of care, the difference in premiums, deductible amounts and your freedom to choose a doctor outside the plan. There are numerous other coverages to compare as well -- from prescription drugs to dental to alternative therapies. Be sure you understand the fine points of each.
Indemnity or Fee-For-Service Plan
Normally it covers the same expenses as managed care. The difference is your doctor is paid for each visit with the claim filed by either the patient or the medical provider. A big advantage-- unlike some managed care plans, Fee-for-Service allows the patient a great deal of freedom in choosing which doctors and hospitals to use, but will probably involve higher out-of-pocket costs and more paperwork.
However, you'll likely be required to pay an annual deductible before the insurance company begins to pay on your claims. An Indemnity plan may also require that you pay up front for services and then submit a claim to the insurance company for reimbursement.
Short-Term Health Insurance
Short-term health insurance plans are designed to protect against unforeseen accidents or illnesses, rather than to provide comprehensive coverage, and, as such, typically do not include coverage for preventive care, physicals, immunizations, dental or vision care. It covers for a limited period of time, and may be an ideal solution for those between jobs or those waiting for other health insurance to start. Typically, short-term plans offer coverage up to six months, although some plans may offer coverage up to 12 months. Purchasing a short-term medical insurance plan will make you ineligible for any guaranteed issue individual health plans commonly referred to as HIPAA (Health Insurance Portability and Accountability Act) Plans. HIPAA plans are usually very expensive and are generally intended for people with pre-existing medical conditions who would have trouble getting health insurance otherwise.