Health Insurance

What kinds of health insurance are there?

There are essentially two kinds of heath insurance: Fee-for-Service and Managed Care. Although these plans differ, they both cover an array of medical, surgical and hospital expenses. Most cover prescription drugs and some also offer dental coverage.

  1. Fee-for-Service
    These plans generally assume that the medical professional will be paid a fee for each service provided to the patient. Patients are seen by a doctor of their choice and the claim is filed by either the medical provider or the patient.
  2. Managed Care
    More than half of all Americans have some kind of managed-care plan. Various plans work differently and can include: health maintenance organizations (HM0s), preferred provider organizations (PPOs) and point-of-service (POS) plans. These plans provide comprehensive health services...

    more...

How do I pick a health plan?

If your employer gives you a choice of plans or you need to purchase your own coverage, it is crucial that you understand your health insurance choices and pick the insurance that is best for you and your family.

Here are some questions you should ask yourself when choosing a health insurance plan:


How affordable is the cost of care?

  • What is the monthly premium I will have to pay?
  • Should I try to insure most of my medical expenses or just the large ones?
  • What deductibles will I have to pay out-of-pocket before insurance starts to reimburse me?
  • After I’ve met my deductible, what percentage of my medical expenses are reimbursed?
  • How much less am I reimbursed if I...

    more...

Can I buy an individual policy?

Yes. If you are unemployed, self-employed, or decide to return to school you may want to buy an individual health insurance policy.  Here are a number of options that you may consider:

  1. Ask your insurance company if you can convert its group policy to an individual policy. You will pay a higher rate than you did before and your benefits may be limited, but the terms will still probably be better than if you buy your own policy.
  2. If you are married, see if your spouse’s employer will add you to its group plan.
  3. Try to join a group health plan through a trade association or alumni group or professional association may offer reasonable rates. If you are over age 50, you can join the American Association of Retired Persons (AARP), which offers an extensive plan. Even some credit card companies offer health insurance...

    more...

If I change jobs or become unemployed, can I bring my coverage with me?

If you switch employers, you have the right to carry your group health insurance coverage with you to a new job for up to 18 months under the Consolidated Omnibus Budget Reconciliation Act (COBRA).

You must pay the full premium, but at group rates that are far cheaper than the individual rates you would pay for similar coverage. Health insurance under COBRA is available if you are in the following situations:

  1. You leave a company and become unemployed or self-employed for up to 18 months.
  2. You are a widow or widower or child of an employee who dies while working for the same company for three years or more.
  3. You are the divorced spouse or child of an employee who has left the company he or she was employed at for at least three years.
  4. You are the child of an employee who left...

    more...

Where can I get more information regarding health insurance?

If you have specific questions regarding your insurance coverage, contact your health plan directly or speak to the benefits administrator where you work. For information on Medicare, call the agency at 800-638-6833 .

Consumer information on the various health insurance plans that exist today is available from two leading insurance trade associations. They are:

  • America’s Health Insurance Plans
    601 Pennsylvania Avenue, NW
    South Building
    Suite 500
    Washington, DC 20004

  • Life and Health Foundation for Education
    2175 K Street, NW – Suite 250
    Washington, DC 20037