Medical Insurance and What You Will Have to Pay

It's no wonder there are so many billing issues with medical treatments. There are different types of insurance each with their nuances. Below are four common ones:

Health Maintenance Organizations (HMO): With HMOs you pay one amount (maybe $25 or $30) for each doctor visit. You are not billed for anything else and there is no need to submit a claim.

You must use what is called a primary care physician (PCP) who helps you manage your health care. S/he will be the first one you call for any treatment you need. This doctor must be a member of the HMO medical group.

You will need your PCP to provide a referral to see a specialist that also contracts with the HMO.

Preferred Provider Organizations (PPO): With a PPO, you receive the majority of your health care from a provider network like an HMO. But, if you are willing to pay more you can go outside of the network. You can choose to select your primary care doctor from the PPO network.

Health Savings Plans (HSPs): There are two parts you can access with HSA coverage. One is a high-deductible plan and the other is a health savings account. The deductible plan provides basic catastrophic coverage. The HSA operates as a tax-free savings account. You pay for routine medical expenses from this account.

Fee for Service (FFS) or Point of Service (POS) plans: This is a simple plan. You pay for and receive the care you need. Then you are reimbursed for a percentage of the cost.

If selecting from any of these plans, ask the following questions:

• What are the covered health care services?

• What is the yearly premium?

• How are referrals managed?

• How much will it cost for non-network treatment?

• How many in-network doctors are there?

• Where are the network doctors and hospitals located?

• What preventive services are covered?

There are many other factors to consider when you are researching one of these plans.

Deductibles: You will pay a deductible which is part of the insurance coverage that you must pay before the insurance company kicks in their portion. As an example, you might have a family deductible of $5,000 that you will have to satisfy. You insurance company will pay their portion after that.

Copayments: A copayment is an amount you pay at the point of service. You might pay $30 for each doctor's visit but will not be billed for anything else while you are at the doctor's office.

Coinsurance: Coinsurance is expressed as a percentage of the medical bill after you have paid your deductible. For example, if you have a coinsurance rate of 80/20, you will have to pay for 20% of the medical bill while the insurance plan will pay 80%. So, if you have satisfied your deductible and your medical bills over that is $5,000, you will pay $1,000 (20%) and your insurance plan will pay the other $4,000.

Medical billing and claim resolution can get confusing with all of the co-pays, out-of-network providers, deductibles and co-insurance requirements so make sure you understand any medical bills.

Sunni Patterson is an accomplished marketing professional and entrepreneur. She is an expert at developing on and offline marketing strategies.

Expensive City Life: Should You Fork Out for Insurance?

We all know how expensive it is to live in Australia's largest cities. A recent survey by Demographia International found that Sydney, Perth, Melbourne and Adelaide housing is the most unaffordable in the English-speaking world. Amidst all this financial pressure for the average Australian family, one very important expense is often overlooked... insurance. Should you be forking out for the security that life insurance, income protection insurance and mortgage insurance bring? Or will that leave you with nothing to eat but Vegemite, bread and two minute noodles? We examine both sides of the issue today.

Cost of Living Pressures

It isn't difficult to see the cost of living pressures faced in Australia. Expensive land flows onto other purchases, and since employers also face price rises, wages are less likely to go up. The obvious and sensible option is to limit your outgoings, cutting back on unnecessary spending to make the most of what you have.

Are Income Protection and Life Insurance Unnecessary Spending?

These cost of living pressures create an unfortunate catch-22 situation. People 'have' to spend more money on various household expenses, and so choose not to insure their ability to earn an income (either in sickness or in death).

However, the cost of living pressure faced by the average family often mean that 'Plan B', for when one adult cannot work, is radically different to your ordinary life. Kids must change schools. Housing has to shift to the outer suburbs. Sports cannot be played, pets cannot be kept, and various other little luxuries disappear.

Income protection insurance and life insurance are more necessary than ever in a life situation with high financial pressure... if you have little spare cash now, just imagine what would happen if your weekly wage suddenly disappeared!

It becomes clear that cutting spending other than insurance is a smarter option.

What Unnecessary Spending Can Be Cut?

Many of us become trapped in the belief that every cent of our spending is necessary - that we must put petrol in the car, we must eat, we must send the children to school and we must dress ourselves for work.

However, the level of expense that each individual family experiences often has an incredible amount of room for movement! Within 'necessary' expenses are often hidden unnecessary preferences. Consider the following:

    Do you need all the packaged food in your weekly supermarket shop?
    Do you waste food at home?
    Can you combine car trips to cut down petrol costs?
    Can the kids take the bus to school instead of being driven?
    Do you have more pets than you need?
    Do you look first at opportunity shops for clothing... especially kids' clothing?
    Do you always shop around for different quotes on your products and services... even on income protection insurance and life insurance?
    Do you really need your home phone line?
    Do you need to have a post paid mobile, or could you use a prepaid mobile instead?
    Do you sell things you don't need on eBay, instead of just giving them away?
    Do you utilise your network to have your household appliances repaired and serviced?
    Do you smoke cigarettes, or regularly drink alcohol? These increase both your weekly bills and your eventual healthcare bills, as well as causing more time off work.
    Do you utilise your library to its full extent?

There are plenty of ways to save money on your everyday expenses without cutting into the true essentials like income protection insurance and life insurance!