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Most Americans either receive health insurance coverage through their employers or are covered by a family member’s policy.
If you leave your job you will lose your employer-supported group coverage.
Not every employer offers health insurance, especially small businesses.
You may not be eligible for health insurance through your company if you work part-time.
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COBRA (Consolidated Omnibus BudgetReconciliation Act) allows for an extension ofcoverage through the group health plan for aspecified length of time, although the premiumis usually higher.
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Indemnity health care plans offer a greater choice of care providers. You are not restricted to a specific group of physicians, hospitals, specialists or other health care providers.
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Managed care plans work within a network of doctors and hospitals or “providers.” To receive the benefits of the discounts negotiated with specific doctors, hospitals and health care providers, you must use services from providers in the health plan’s network.
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You’ll find some indemnity plans that offer managed care-type options, and some managed care plans that allow for members to use providers who are "outside" the plan’s specific network.
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Three common types of managed health care plansPPO plansHMO plansPOS plans
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Health plans negotiate discount agreements with doctors, hospitals and other providers, and pass along the negotiated or discounted prices to plan members.
HMOs use restrictions to control costs.
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You may need to select a primary care physician from a register of area physicians. Use as a gateway for all your health care needs and decisions, including referrals to obtain specialized medical treatment so costs can be managed easily.
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Health Maintenance Organizations (HMOs) often require you to see a provider within the network and to obtain referrals from a primary care physician.
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Questions to compare plans: How do I determine which doctors are accepting
new patients? Can I change doctors? How are referrals handled if I need care from a
specialist? How is emergency care handled? What services are covered, including preventive
care? What if I need services not provided by the HMO
network? Are there additional fees or co-payments required
for office visits, emergency care or other services and, if so, how much are they?
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Preferred Provider Organizations (PPO) are a form of managed care plan. PPO does not necessarily require
that you choose a primary care physician to supervise and make decisions for your health care.
In addition, with a PPO, you may be able to access providers and services outside of the “preferred” provider network.
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It is important to note that PPO plans will likely involve more out of pocket costs than an HMO. PPOs typically involve deductibles, co-payments,
and coinsurance amounts. The increased financial responsibility with a PPO is
a trade-off for the higher level or flexibility that you have in choosing a provider and accessing care.
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Selecting your Doctors: • How many are in the network? • Who are they and where are they located? • What are the processes and restrictions for
referral to specialists?
Review hospitals: • What hospitals are available through the plan? • Where is the nearest one in the network? • How is emergency care handled?
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What services are covered? What are the deductible, copay and coinsurance amounts?What is the out-of-pocket maximum. What are the coinsurance amounts for non-preferred or out of network providers? Are there per-visit fees or other types of co-pays for in-network services? What is the cost difference between using in-network and out-of-network doctors, and what costs are associated with care outside of the PPO?
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Short-term major medical insurance is temporary health insurance that offers gap coverage to guard against high costs of emergency medical bills.
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Short-term major medical insurance is appropriate for: Recent graduates who are between parental
and employer coverage. Employees who are on extended leaves of
absence. Employees who have been laid off or former
employees between jobs. New employees who are not yet eligible for the
employer’s group coverage. Early retirees. People who leave a group policy and want an
alternative to COBRA.
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High deductible health plans (HDHP) are policies that require a higher deductible than most health plans, typically at least $1,000 for single insurance coverage and $2,000 for family coverage.
High deductible plans generally have lower monthly premiums than more comprehensive health plans.
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When comparing HDHP costs with the costs of other plans, consider the potential premium costs relative to your potential health spending for the coming year to determine which plan works best for you and your family.
What are High Deductible Health Plans?
Who is HealthCompare: HealthCompare is your online one-stop-shop for health insurance
where you can research and compare plans online from over 150 national carriers.
We Promise: To give you the best results for YOU, we never promote one carrier
over the other. We just assess your needs and show you the best options from national carriers with plans in your area.
Our Commitment is to YOU: As a division of The Word & Brown Company who has been the
leading source for small group health insurance for over 20 years, we have leveraged technology to build an easy-to-use research tool, supported by a world class customer service team.
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OurPromise
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1. You can enter your information
anonymously
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2. You can review your plan options
online in seconds
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3. You can even compare
plans side-by-side
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4. Then, you can apply online or call one of our
trained Benefits Advisors for help!
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Call toll free 877-641-1101
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