Wednesday, April 27, 2011

what is the difference between HMO & HSA & PPO health insurance plans? and which one is better to have?

My husband and I do not have health insurance and were trying to get pregnant. I really need to purchase a good health insurance plan. I was thinking of choosing Kaiser. And I have no clue about the health insurance lingo. Can someone help me. Sincerely, Jennifer
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The basic differences: With an HMO you must select a primary care doctor, and must get referrals from that doctor to see a specialist. If you want to change primary care doctors you must first notify the insurance company and cannot see the new doctor until the change has been processed. You cannot go outside of the doctor network except in emergencies. In general, the premium will be higher but your cost when you use medical services will be lower. With a PPO you do not have to select a primary care doctor and you do not have to get a referral to see a specialist. You can go outside of the network although your cost may be higher. An HSA is just a PPO that has a higher deductible and allows you to open up a health savings account that works much like an IRA. My advice would be to visit a local agent that works with Kaiser as well as all of the other major companies in your area. The agent can find the best plan for your situation and budget. They can explain what you get and, more importantly, what you don't get with each policy and can answer all of your questions. There is no extra charge using an agent. Be aware that with individual policies there will be a waiting period for maternity coverage. The agent can explain how long this waiting period will be with each different policy.
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Is the fact that everybody has to get health insurance true yet?

Before I could only get insurance thru my parents or job, because I have a pre-existing heart problem. Am I able to get it yet without using my job's or parent's? How?
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Many states currently have high risk pools available. The health care bill will have a national high risk pool that was supposed to be in effect July 1 but which has been delayed. The portion of the bill allowing that all policies are guaranteed issue, which is what you are asking about, will go into effect in 2014.
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In Minnesota How old are u covered for health insurance?

on a Parents work-provided health plan how old does your child have to be to be covered is it after 18 they need to be in school to be covered? or are they covered until 21?
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....under the new health care if it passes your child can be insured up to age 26. Under the current plan.. you are carried under most insurances until 18 but if you are in college that lasts until 21 years of age.
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If Obamacare passes, how long will it take health insurance companies to go bankrupt?

forcing insurance companies to cover preexisting conditions will bankrupt them. how long will it take?
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They will have more business. They won't go bankrupt. plus, pre-existing conditions don't always result in higher costs.
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I'm confused about primary and secondary health insurance?

My daughter is on my policy, where all of the payments come out of a fund set at the beginning of the year, so if it is $1,000 that can be wiped out by one trip to the ER. Also, she is on her father's plan which is a taditional co-pay plan. Would it work out to my advantage to use his at primary and mine as secondary? Can the co-pay requirement from his insurance be paid from my plan?
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Here are the rules of the National Association of Health Insurance Commissioners. These rules are listed in order - the first one to apply to you will be used to process claims. 1. If the Policy Holder is the same for both contracts: a. The plan that covers the policyholder as an active employee is primary. b. If the policyholder has the same employment status (active/retired) under both plans, the plan with the earliest effective date is primary. 2. If the Policy Holder is the spouse or domestic partner: a. The plan that covers the policyholder as an employee is primary. The spouse's is secondary. 3. If children are covered under more than one policy and the parents are married or living together: a. The policy of the parent whose birthday (month and day) is earlier in the year is primary. b. If the parents share the same birthday (month and day), the policy with the earlier effective date is primary. 4. If children are covered under more than one policy and the parents are divorced or living apart: a. The policy of the parent that the court has made responsible for health care insurance is primary. b. The policy of the parent who has custody of the children is primary. c. If the court has not placed responsibility on one parent to insure the children and the parents have joint custody, the policy of the parent whose birthday (month and day) is earlier in the year is primary. If the parents share the same birthday (month and day), the policy with the earlier effective date is primary. d. If the natural parent elects to have coverage under the policy of the step parent, we will consider the policy to be that of the natural parent. These rules do not apply when one policy is Medicare. Your state laws may vary.
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Are insurance companies lobbying to get the contracts to administer the proposed govt. health insurance?

Private insurance companies already administer the Medicare program. People blame the government for problems with Medicare, but the government doesn't administer it.
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Insurance companies can lobby for anything they want but hopefully they are not going to get it this time. I don't actually know why taxpayers are currently subsidizing private insurance companies that run Medicare Advantage programs at a cost nearly 20 percent higher than Medicare but that has to be looked into as part of this health care reform.
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Does anyone know how I can get private health insurance?

I can purchase it through work but I was told to shop around a bit. I need medical insurance and dental would be nice. Anyone know of any websites?
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Contact a local independent agent. If you want maternity, chances are the group plan will be better. However, depending on the average age and medical conditions of the group, you may be able to cut the cost in half by going out on your own. That will vary from state to state and group to group also. A local agent can help you. Get the info on the group plan (outline of coverage) and the cost so they can see what they can do for you on an individual plan that is comparable to the group plan. You are making a wise choice by checking out your options. Keep in mind that the group plan is most likely paid in part by your employer. Compare what your actual costs will be.
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Do health insurance companies charge per prescription?

Im 18 years old and away at school but am still under my parents health insurance. Today I was prescribed aderol from a Psychiatrist my father and I both see. In the past when I have talked to my parents about my potential ADD they laughed at me and told me that ADD was not real. After testing, I have been prescribed Aderol. I still would not like my parents to know. I am wondering if the insurance company will show the names of the prescriptions I fill?
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yea
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Does anyone know of ratings for Long Term Health Insurance?

I have to decide whether or not to join a Long Term Health Plan, but I see the outfit has been sued several times. How do I find out if they're worth the dough?! My HR Dept doesn't seem to know anything about them.
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healthplans.my-age.net - here is my health insurance plan. As I remember they can provide such a service.
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When you join the Army, do they talk to your current health insurance company about bills and stuff?

I got hurt when I was 13 but it doesn't have anything to do with me now I'm 100% healthy. My parents are still making payments on the bills but I'm wondering if they will know about this? Will they talk to the insurance company I'm currently insured under at all?
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Let's be honest, if the military spent time investigating peoples medical history it would be one never ending episode of CSI. The Privacy Act ensures your medical records aren't for the public eyes. The Army does run a credit check to make sure you don't suffer from indebtedness. If your name pops up on a credit check and the bills are from a medical institution it would be a dead give away that you aren't 100% healthy and honest. Don't lie to the recruiters, seriously. The military has it's own health care system called TRICARE. They are an independent agency that deals with active duty soldiers, dependents, retirees etc. They have no business talking with your current health care insurer. ps Just because you think you are healthy doesn't mean you are fit 2 fight. Good luck
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With health insurance, what if the provider does not submit the claim before the window for doing so closes?

For example, on a date the provider provided a service, but failed to properly submit the claim for insurance before the window for doing so closes. Does the person who received the service then have to pay the provider, or does the provider forfeit payment for not properly submitting the claim?
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It depends on the provider's contract with the insurer. Most contracts, with an IN NETWORK provider, say that the provider has to "eat" the bill - and can't charge the patient. But if it's not in network, or that provision isn't in the contract, then the patient is on the hook for the full amount.
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Double up on individual health insurance?

Can you have more than one Health Insurance Plan for your self? I have to buy my own insurance, but even the best individual insurance is crappy and I wanted to now if people ever buy two insurance plans? The insurance i have now only lets me see the doctor twice a year. If I got another insurance plan would it pick up where the other left off?
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Hi, Generally it is not a good idea to have more than one health insurance plan because only one will be your primary coverage. You need to be careful if you want secondary coverage. Many policies will not allow you to get a policy if you already have a policy. Having said that, there are supplemental plans that pay YOU instead of the doctor or hospital. They are with companies such as Aflac and are supplemental plans. They are set up so that you get a certain dollar amount for each doctors visit, emergency room visit, hospital stay, or surgery. While I represent individual insurance companies I don't generally recommend these supplemental type plans unless you go with an HSA where you don't have co payments and you have a high hospital deductible. But you get what you pay for with insurance. If you want low co payments and deductibles then your premium will be high. I would recommend getting a primary plan that is good enough and saving money to pay co payments and deductibles. Try this site http://free-health-quote.blogspot.com/ Here you can get quotes from different health insurance companies in your area, its the best way to find an individual health insurance with a reliable company. Best Wishes,
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Double up on individual health insurance?

Can you have more than one Health Insurance Plan for your self? I have to buy my own insurance, but even the best individual insurance is crappy and I wanted to now if people ever buy two insurance plans? The insurance i have now only lets me see the doctor twice a year. If I got another insurance plan would it pick up where the other left off?
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Hi, Generally it is not a good idea to have more than one health insurance plan because only one will be your primary coverage. You need to be careful if you want secondary coverage. Many policies will not allow you to get a policy if you already have a policy. Having said that, there are supplemental plans that pay YOU instead of the doctor or hospital. They are with companies such as Aflac and are supplemental plans. They are set up so that you get a certain dollar amount for each doctors visit, emergency room visit, hospital stay, or surgery. While I represent individual insurance companies I don't generally recommend these supplemental type plans unless you go with an HSA where you don't have co payments and you have a high hospital deductible. But you get what you pay for with insurance. If you want low co payments and deductibles then your premium will be high. I would recommend getting a primary plan that is good enough and saving money to pay co payments and deductibles. I hope this helps.
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Should overseas student buy health insurance while they're studying or just the 1st yr? Other except medibank?

Should overseas student buy health insurance while they're studying or just necessary for the 1st year? Is there any health insurance company like medibank? any health insurance company cover dental/eye? Thank you!
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Hi there, I'm assuming that you are talking about an Australian student visa because you've referred to Medibank and also the requirement to have private medical insurance. When you apply for your visa you will need to show that you have taken out at least 1 years Overseas Student Medical Coverage. This is usually organised through the institution where you will be studying. Once you get your visa you will have a condition attached to it that states that you must maintain your OSMC throughout your stay as a student in Australia - so, you will need to renew your insurance every year. Medibank private is one of the main providers however you can also check out: MBF NIB HCF Best of luck and feel free to contact me on Jessica.Stooke@Visalogic.net if you need help with your visa application.
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Does Caresource health insurance cover cosmetic dentistry?

I have Caresource health insurance and am in need of a few teeth being pulled due to damage and wanted to know if Caresource would cover dentures or implants as well
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health-quotes.isgreat.org - here is my health insurance plan. As I remember they can provide such a service.
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Why did Dear Leader Øbama speak of eliminating private health insurance in 2007?

employer coverage = private health insurance "I would hope that we could set up a system that allows those who can go through their employer to access a federal system or a state pool of some sort. But I don't think we're going to be able to eliminate employer coverage immediately. There's going to be potentially some transition process." -- Barack Øbama, March 24, 2007
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Obama openly campaigned for Universal Health care for everyone. This would automatically end all private health insurance coverages.
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How do I cure a UTI with not having health insurance to go to the doctor?

My husband and I just got married and I was kicked off my family insurance. I do not have the money to go to the doctor with not having insurance and I was wondering what would be the best over the counter products that I could take to treat this?
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You can easily check your minimal health care rates in internet, for example here - health-quotes.talk4fun.net
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Does a person on Medicaid need to continue with a secondary health insurance like Blue Cross?

I can't get a straight answer from either agency. Naturally Blue Cross wants their monthly payments to continue -- as Medicaid wants their percentage of health costs to be at a minimum. Can someone out there give me a definative answer?
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Medicaid or Medicare? Where I live, you can't get Medicaid if you have insurance. Medicaid is based on income and ability to get medical care. With Medicare, secondary health insurance is really a necessity these days.
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Why do we allow our governing bodies to spend so much time and effort trying to establish health insurance?

We spend very little trying to prevent bad health, actually bad health is sold. People in this country overeat, under exercise, and try to blame someone else.
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I assume you mean the US. In the UK everyone pays an amount from their wages/tax according to their income to the Health Service. When they are ill or taken to hospital they are treated. There is no argument or questioning after this, it is paid for. The same service is given to all regardless of income or status, although there is a private treatment option for those that can afford it. This tends to just be to get treatment quicker for minor operations, or for cosmetic surgery etc. The same system covers dental treatment. What you should be asking is why hasn't the US had a similar system for years. - the answer is that the people who provide medical insurance in the US are making too much money from it to let it happen! .
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Can my employer refuse to provide me information on our new health insurance?

I work in the medical field and recently our facility was sold to an individual who owns 6 other facilities. He had a meeting with all of the staff to "explain" our new health coverage, but will not provide us with any documentation of what it really entails. Can he really hide this information from us?
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just sit tight for now since the company you work for is now owned by another company all the information will come to light right now maybe the only person might have a answer for you might be HR DEPT because its there area to know this stuff, but for now just sit tight and wait.
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Can I get WIC even though I pay for my own Health Insurance?

Can I have WIC even though I am planning to get married and go under "his insurance"?
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I don't think WIC is for health matters. It provides assistance for food. If your income is low enough then you can qualify. My sister had it and she got all her formula, milk, cereal, cheese, bread, etc. BTW, you have to have a child to get WIC as well.
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Does my health insurance pay for vaccinations?

I am an international student in Oz and have worldcare health cover (meant to be same as medicare). I now have to go on a placement in NSW health care places, which requires full vaccinations. Will my worldcare OSHC cover this or will i have to pay? If i have to pay how much will it be?
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Please check up the terms and conditions included in the insurance policy.In some countries vaccinations are free in Govt Hospitals
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Will health insurance cover prescriptions written by out of network doctor?

I founda really good doctor that is out of network. I don't mind paying the visits or the labs, but if he writes prescriptions, can I still take them to walgreens and get them filled under my insurance plan? Or does the doctor writing the prescriptions have to be in the network? Thanks
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Yes, your choice of doctor will not affect your coverage for prescription meds and you can still get them filled at Walgreens.
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I need help finding a health insurance company?

I am graduating, so my parents insurance dropped me and I need to find a new company. I wanted Blue Cross Blue Shield, but I have diabetes, and they said I would have to wait 365 days before they would cover treatment for my diabetes, or any other pre-existing condition. I need to find a good insurance company that won't delay treatment on my pre-existing condition. Does anyone have any suggestions?
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Oh my!! I understand completely about pre-existing conditions!! I will research insurance companies for you. Please send me a reminder email. easyhomebiz@alltel.net. Thanks!!
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