As a subcategory in the broader field of insurance, health insurance is the section that covers part of the health expenses incurred by an insured person. Today, there are different kinds of health insurance plans available. Depending on the coverage, there are two possibilities when an insured individual seeks medical services. Either the insurance company pays the medical service provider directly, or the insured person covers the costs with an out-of-pocket payment and is later reimbursed by his or her insurer.
As a health insurance comparison website, Wirefly offers more than free online quotes. It also makes it easy to compare the different types of health insurance plans available in Pittsburgh, PA.
Although employers and private insurance companies are the most common providers of health insurance in Pittsburgh, PA, it is also available to low-income earners through Medicaid and to senior citizens via Medicare. Compared to private insurance companies, Medicaid and Medicare provide health insurance services at a significantly lower cost. There are several levels of coverage included in this type of insurance. While the least expensive plans usually cover catastrophic events only, high-cost plans will most certainly provide full coverage. As a result, people often try to anticipate their medical care needs before deciding the most suitable health insurance plan.
Statisticians and actuaries recognize that an individual’s health care needs in the future are unpredictable. It is challenging to know how much health care coverage you need for the next 12 months. Financial advisers recommend using the past as a future indicator. For instance, if you are healthy and do not visit a primary care physician or specialists on a routine basis, you may get enough coverage from a lower premium cost health insurance policy. However, if you manage a chronic illness and see your doctor on a regular basis, it may be wise to consider insurance that costs more and offers a wider range of coverage.
Catastrophic only insurance is one of the lowest priced health insurance plans in Pittsburgh, %stat. This type of policy is for those who rarely visit the doctor and only desire coverage in the event of a severe health emergency. In comparison, if you often travel or participate in dangerous activities like extreme sports, you need an insurance plan that covers emergency room visitors and regular doctor visits.
Higher health care coverage in Pittsburgh, %stat usually comes with higher monthly premiums. That is, the more you pay in premiums each month to the insurer, the more the insurer pays towards your medical and health care needs. This is one of the reasons it is essential to consider your health history and lifestyle to determine the most financially prudent choice for your needs. Start by ensuring that your basic health care costs are covered. Add additional coverage as necessary and if you can afford it.
When individuals shop for health insurance coverage in Pittsburgh, PA, they have many options. Some of the types of plans include PPO, HMO, POS, HSA, HRA, FSA, and a MSA. People need to find the right one that is best for them. These plans each differ in what they will offer. The terms and flexibility will vary. Selecting an insurance plan can seem complex; therefore, it is important that people understand each type of plan, so they will know what to expect from each one.
A Health Maintenance Organization (HMO) is a plan in which people usually have less out-of-pocket expenses, but they will also have fewer choices in the doctor’s they can see. Normally, with an HMO, people will have coverage for most preventative medical procedures. One of the best things about HMOs is that people will not be required to pay a deductible. Most of the time, the co-payment will be small. Individuals must choose a physician inside the network with proper authorization from the primary doctor, so sometimes the options are limited. This type of coverage is good for people who prefer lower premiums, and want certain preventative coverages for regular check-ups.
A Preferred Provider Organization (PPO) is a plan that offers a larger network of providers. These doctors are contracted to offer services to members at a lower or discounted price. The insured is not required to choose a primary care doctor, but has the option to see a choice of physicians within the network. Individuals normally have a yearly deductible that they must pay before coverage can begin. Many of the services require a copayment that the insured needs to pay. With this option, there are also limits on how much a person can spend annually. If a person chooses a doctor out of the network, the out-of-pocket expenses will be higher. No referral is needed for a PPO. This type of coverage is good for people who like flexibility and the freedom to choose their doctor and do not mind the higher premiums.
A Point of Service (POS) plan is a combination of an HMO and PPO. The insured will choose a primary care doctor in Pittsburgh, PA from the network of providers. Co-payments are minimal, and no deductible is needed. If a person goes to see a doctor out of the network, the prices are much higher. This is good for individuals who prefer flexibility when choosing doctors and enjoy the balance of more choices as opposed to lower premiums.
In Pittsburgh, PA, there are some unconventional options to health insurance. A Health Savings Account (HSA), a Health Reimbursement Account (HRA), a Health Flexible Spending Arrangement (FSA), and a Medical Savings Account (MSA) are options for health insurance in Pittsburgh, PA. With these choices, individuals will set up a tax-exempt savings account and put money aside to pay for anything that people need for medical care. This can include prescriptions, routine doctor’s visits, and surgeries. In some cases, the money can even be used for over the counter medications. This option has lots of flexibility when it comes to how the money is distributed, and any extra funds can be applied to the next year.
The premium is the monthly fee for a health insurance policy in Pittsburgh, PA. The policyholder pays this amount for coverage even if he doesn’t use it that month. The deductible is the amount that the policyholder pays for healthcare coverage first before the insurance provider pays its portion of the bill.
People sometimes confuse deductibles with out-of-pocket costs, but they’re not the same. The deductible is the amount the policyholder must pay for the year before his insurance provider covers anything, while out-of-pocket costs are how much money the policyholder spends before the provider covers all of the bill.
With a typical health insurance plan in Pittsburgh, PA, deductibles and out-of-pocket costs reset to $0 at the start of a new calendar year. For example, if a policyholder's plan has a $3,000 deductible and he spends $2,000 in out-of-pocket costs that year, his out-of-pocket expenses go back to $0 on January 1. This isn’t always the case, as there are a few plans that roll over the paid deductible amount from the end of one year to the next.
The co-payment, also known as co-insurance, is the amount the policyholder needs to pay for a service. The amount can vary depending on the service. If a plan has a primary physician visit co-payment of $10, then the policyholder must pay that $10 every time he visits his primary physician. The insurance provider pays for the remaining balance as long as the policyholder has coverage for those services. Co-payments don’t count towards a plan’s deductible.
A plan could have a maximum lifetime benefit, which is the most that the insurance provider will pay out for the policy holder’s healthcare costs. After hitting that mark, the insurance provider won’t pay any more healthcare costs for the policyholder.
A person’s health care options rely quite a bit on his employment status. Employees of large companies can typically sign up for a group health insurance plan. While no one is legally required to sign up for a group plan, these plans tend to cost less than individual plans.
Those who are unemployed or self-employed will need to get private, individual health insurance plans. There are other options available for senior citizens who don’t work and people with low incomes. Seniors can sign up for a Medicare plan for financial assistance from the government. People with low incomes can get government-provided financial assistance through a Medicaid plan.
If a person already has a doctor he likes, he should ask what health insurance plans in Pittsburgh, PA that doctor can accept. He must also notify the doctor regarding changes to his insurance plan.
You already know how important it is to have a good health insurance plan for yourself and your family. Now you need to find out which plan and company offer the best options that fit your needs. There are many options to consider, and choosing a health insurance plan in Pittsburgh, PA can be an overwhelming experience. That is why Wirefly has made it easy to get a quote quickly, just by entering your ZIP code.
Don’t miss out on the health coverage that you need just because you don’t have time to compare health insurance plans and rates in Pittsburgh, PA. Wirefly can help you find the right plan with the amount of coverage you need at a price that you can afford. It only takes a few minutes for you to get your free health insurance quote, let us help you simplify one of the biggest decisions you will make by helping you compare health insurance rates today here at Wirefly.
