Sleep-at-night coverage with a Private Health Insurance
Health Insurance: a sense of dissatisfaction The three C’s,
customization, consumerization and customer-satisfaction, seem
to be at the core of the business mantra for every service
provider. The health insurance
provider industry is no exception to this rule. With an
increasing concern among the tax payers of US regarding the
number of people uninsured in the country, there is a burgeoning
market for the providers. Even though, this seems to be a
buyer’s market, there seems to be a lot of dissatisfaction among
the people with the red tape and bureaucracy involved in claims
processing, exclusions and limitations. Based on a survey
conducted a couple of years ago, only 1 in 4 Americans said,
they are “very satisfied” with their medical coverage. In
general, the consent was that the people were dissatisfied with
the bureaucracy of the provider, rather than the health plan
itself.
Taking a closer look at the Indemnity Plans Let us now try to
take a microscopic view of the intricacies of the two major
types of health
insurance: Indemnity vis–vis the Managed Care. The
Indemnity is the traditional fee-for-service plan allowing more
flexibility in terms of choosing your physicians and health care
providers in lieu of an annual deductible amount. This is also
referred to as the typical private or individual health
insurance plan, tailored to the person’s situation. Exclusions
are defined when you buy your policy for your particular
scenario. Due to the personalization nature of the policy and
the subsequent risk exposure to the insurer, this comes with a
higher price tag.
Exploring the intricacies of a Managed Care Plan A Managed Care
plan will typically restrict the individual to visiting
in-network set of physicians, hospitals and health care
providers. This encompasses the Group Health
Insurance plan, usually extended as part of an employer
benefit. A single policy is designed for a big group of
individuals belonging to different age groups and with varied
medical conditions. Due to the economies of scale, in terms of
risk distribution, these plans have lower premiums and
out-of-pocket expenses than the private health
insurance plan.There are three variations of the Managed
Care plans: PPO (Preferred Provider Organization), HMO (Health
Maintenance Organization) and POS (Point-of-Service). The
in-line exclusions of these plans are a major concern, which are
probably not always evident to the policy holder till the
unforeseen happens. The provisions in the policy are decided
between the insurer and the policy owner (typically your
employer). Due to the restrictions imposed to visit doctors
registered with the plan, you may come across a situation where
you do not have a doctor to treat your specific illness. Simple
surgeries and diagnostic tests can add up to thousands of
dollars in medical expenditures due to the exclusions. In the
long run, the lower premiums may not actually save your money
due to these occasional exclusions/limitations. Thus, it always
becomes an annoyance for the consumer to choose a well-rounded
managed care plan that covers all or most of the medical
diseases and/or illnesses. The bureaucracy and red tape involved
in these policies to obtain authorizations and referrals even
for the slightest of variations, for cost control measures
always lead to a lot of dissatisfaction. Typically, you are also
required to go through a primary care physician (PCP) for any of
your treatment needs and may not be able to get your treatment
done with the doctor of your choice to avoid excessive costs to
the insurer.
Private Affordable Health
Insurance gives you the freedom of choice! Comparing the two
major variations, private health insurance seems to be the
option to get the peace of mind for your healthcare needs. With
the rising discontent among policy holders, this seems to be a
more economically viable option for the long run depending on
your health conditions. It is all about the “freedom of choice”
and the flexibility to guarantee you the best medical care. The
exclusions are defined at the onset of the contract based on
your specific requirements and if you can afford the extra
dollars, you actually get the perfect “sleep-at-night” coverage!
Unlike group coverage, the provisions are negotiated by the
policy holder and depending on the financial ability the policy
can be designed as comprehensive as possible. In addition to the
customized health care, the next most important advantage is the
flexibility to choose your own doctor or specialist and the
hospital of your choice. Private health insurance is a surging
business in the United States because of the freedom that policy
holders have in choosing what they want and how they want to be
insured. You can secure yourself against any financial
devastation for any and every imaginable health condition.
Consider your priorities for a secured health insurance, make an
informed decision! In order for a person to have a secured life,
the right health insurance will give the shield for any medical
emergency. The comparative analysis is very much subjective and
varies from one individual to another. Considering the issues
highlighted in this article, here are some other pointers to
keep in mind in choosing the side between a managed care
vis–vis private health insurance plan. Consider the quality of
care with the doctors in your policy. In times of distress,
mental peace is probably the most important thing you are
looking for and with a private health insurance plan; you can
easily switch physicians, if you are not satisfied with the
service. With the restrictions imposed in a managed care policy,
you should give it a second thought by considering the list of
in-network doctors and health care providers. Consider the
lifetime payout on the policy, which is the maximum
reimbursement offered by the policy for your whole life. Lower
premiums are not the end of the world, it is a decision you need
to make for your life, so you actually maybe better off paying
the higher premiums of a private health insurance plan as
opposed to rapid depletion of a managed care lifetime payout.
Consider the delicate balance between the paying out too much on
your out-of-pocket expenses vis–vis the risk of your exposure
to a serious illness. If you feel, you are more prone to getting
infected, you might be better off taking up the more expensive
individual
affordable health insurance option to save you money in the
long-term. Provisions for emergency care, is another major
factor to be considered in choosing your health insurance.
Typically, some of the managed care plans have been occasionally
criticized due to the requirement of primary care physician’s
approval for an emergency care. You must definitely put your
step down on this one, as emergency care is something you do not
want to jeopardize due to higher premiums on the policy. Last
but not the least, are the pre-requisites defined in the policy
before you are eligible for getting medical attention. Keep in
mind; if you are not feeling well, you deserve the right to
visit your doctor, do not let the limitations in your affordable health
insurance policy scare you away from getting your treatment.
Occasionally, people have compared buying a private health
insurance policy to buying a Rolls Royce, but wouldn’t you
rather enjoy the tranquility of a peaceful ride rather than
traversing the rough terrains with the restrictions put in by
the managed care policies? It is a rhetorical question!