The purpose of health insurance is to cover or offset the cost of health expenses, whether medical or surgical, for insured individuals. There are a variety of health insurance plans available. Some types require the individual to pay up-front costs (also referred to as out-of-pocket costs) and be reimbursed later while other plans involve direct payments to the provider. To simplify the process of determining which health insurance plan is best for you, Wirefly offers free online quotes for comparing health insurance options in Tamassee, SC.
Typically, health insurance plans in Tamassee, SC are offered through private companies or employers. Senior citizens can also receive coverage through a program known as Medicare while low-income individuals can be covered by Medicaid. Medicaid and Medicare are both offered at lower rates than private insurance plans.
It is possible to select varying levels of coverage in health insurance plans. Lower cost plans may only offer coverage for catastrophic events, while more expensive plans would offer more complete coverage. In most cases, individuals attempt to anticipate their upcoming medical needs prior to choosing a specific coverage plan.
When considering which health insurance plan in Tamassee, SC to purchase, it's important to understand that it's impossible to know what will happen in the future, so it's wise not to try and guess what health care requirements might present themselves over the next year. To make a more educated guess as to the best health insurance plan to select, consider looking at past health care needs. This can assist in the identification of the level of care that's required for the next year. Anyone who has been generally healthy over the past few years and is still in good shape will likely only need to purchase a low-cost plan that offers only essential benefits. Individuals with more severe conditions should heavily consider plans that offer an extensive amount of coverage to account for any necessary medications or surgical care.
The catastrophic insurance plans mentioned previously are designed primarily to cover emergency healthcare costs. While no other costs and expenses are covered, this might be enough for healthy individuals in their 20's and early 30's. People who regularly play sports on a competitive level should choose a plan that provides coverage for both doctor visits and trips to the ER. These are just a couple of scenarios that could help determine which plan to purchase.
In order to receive a larger amount of coverage, Tamassee, SC individuals will typically be required to pay higher monthly premiums. By paying a higher premium for the coverage, the insurance company will readily pay more for any healthcare needs the individual has in the future. The most important thing to keep in mind when choosing between insurance plans is to always have the basics covered. Once these needs are covered, further coverage can be purchased depending on health history and general lifestyle.
As in other areas of the country, there are many types of health plans available in Tamassee, SC. Each plan can offer a similar level of coverage for subscribers but with varying levels of flexibility and practicality. HMO, PPO, POS, HSA, HRA, FSA, and MSA are some of the major types of plans available today. In order to choose the best option, the subscriber will want to understand the basics of each type of plan.
The first type of plan to mention is the HMO, or Health Maintenance Organization. HMO plans are made up of a network of physicians and requires you to have a primary care physician, or PCP. The PCP acts as gatekeeper to all your healthcare needs. If one needs the care of a specialist, he or she will have to see the PCP on file first to obtain a referral to the specialist. HMO plans will generally have lower premiums than other health insurance plans. Options on healthcare providers may be limited if physicians in the area don’t accept HMO plans. Costs on this type of plan are usually reasonable and predictable.
PPO, or Preferred Provider Organization, is another popular type of plan in Tamassee, SC. PPO plans have a large network of providers and doesn’t require a PCP. Specialists can be seen without referral and, as long as they are within the network of preferred providers, the subscriber will pay the preferred co-pay for services rendered. Most PPO plans have deductibles that must be met and limits for yearly out of pocket expenses.
Point of Service Plans, or POS, is a combination of an HMO and PPO plan. As long as the subscriber visits providers participating in the network, then the co-payments are low and there are no deductibles to be met. On the other hand, if a provider must be seen who is not in the provider network, then deductibles and high copayments will apply.
The other types of plans available to subscribers in Tamassee, SC are not traditional but can be just as effective. These alternatives include the HSA (Health Savings Account), FSA (Flexible Spending Arrangement), and the MSA (Medical Savings Account). These accounts run on money set aside by the subscriber or their employer, usually from pre-tax wages, and is meant to be used to pay medical related expenses. These expenses include prescriptions, co-pays, and some accounts will even cover OTC medications. Unused money in these accounts at the end of the year may be able to roll over to the next year.
Your health insurance premium is the amount of money you pay monthly in order to keep your health insurance coverage active. This money will not be returned to you no matter if you use your insurance or not. Your deductible is the amount of money you are required to pay up front at the time of a medical appointment. Any money that is still owed to the health care provider after the deductible is paid will be covered by your insurance company.
Deductibles and out of pocket costs are two different things. Your deductible is the amount you are responsible for paying before you insurance starts to pay. Your out of pocket costs are the amount you will pay before your insurance company reimburses you for your bill. Both deductibles and out of pocket costs start over at the beginning of the year. The expenses of the year prior do have an affect on your future costs.
For example, let’s say you have a deductible of $3,000 and you only spend $1,000 out of pocket. If you keep the same insurance plan, your out of pocket costs reset to $0 and the amount you spent previously does not roll over. However, there are some plans that let you roll over your deductible toward the first quarter of the next year. This is not standard and will be clearly stated if this is the case.
Your copayment is the amount you are responsible for paying for a regular medical visit or service. This is also called a coinsurance payment. So, if your copayment is $25, you will be required to pay that $25 every time you go to visit your primary care provider. Your insurance will cover any balance left over, as long as the service is covered by your insurance plan. Copayments do not apply to deductibles.
Your insurance company might also give you something called a maximum lifetime benefit. A maximum lifetime benefit is the total amount of money that your health insurance provider will provide for health care. After this amount is reached, your insurance company will not pay any more medical claims.
The health insurance plans that are open to you in Tamassee, SC depend a lot on your employment status. If you work full time for a large company, you may be able to get insurance through your business. This is typically a group insurance plan that is more affordable than individual health care. However, you are not required to purchase insurance through your place of work.
If you are unemployed or self-employed, you will most likely need to purchase an individual health insurance plan. This is provided by a private company. If you are a retired senior, you may be eligible to receive government assistance with the Medicare program. If you have a low income, you may have the option of applying for government assistance in the form of Medicaid.
You may choose to discuss your insurance options with your regular health care provider, especially if you wish to continue seeing them. Also, you should inform your doctor in Tamassee, SC if your health insurance plan changes. Speak with a representative from your insurance provider if you have any further questions.
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 Tamassee, SC 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 Tamassee, SC. 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.
