Entries Tagged 'Health Insurance' ↓

When it comes to health coverage these days, we sure have a lot of various options to choose from. One of such options, which has become quite popular lately are Point Of Service (POS) plans that can be viewed as a mix of traditional indemnity and modern managed coverage options. And what such a combination provides you with are money saving potential and flexibility, all in a single package.

Health coverage on two levels at once

People familiar with HMO plans can easily see the similarity between HMOs and PPOs when it comes to organizing the services. Here you are also required to choose a PCP (Primary Care Physician), who will coordinate your services and provide referrals to other specialists within the network when required. But you are also free to choose any facility or physician that doesn’t make a part of the specified network. And a POS plan will pay for such services out of the network, however to a narrower extent than with in-network services. So it will still cost you less to get your services within the POS network.

This is what is meant by two levels of insurance coverage, which are called “in plan” and “out of plan” health insurance. In plan coverage is usually more advantageous but it also has tighter restrictions imposed on the user. Like in case of HMO plans, in order to get full coverage at the “in plan” level you will have to provide a referral from your PCP and get your services within the network. You will also sometimes be required to get additional approval from your insurance administrator beforehand.

This all means that even sticking to the specialists and facilities of your POS network won’t give you full coverage unless you provide a referral from your PCP. This is the so called “red tape”, which is one of the biggest complaints about managed insurance plans and the formalities within them. However, when compared to indemnity plans, managed health care provides substantial money saving possibilities that can’t be beaten. Continue reading →

The world of politics is never supposed to make any real sense. After all, once you pit people’s cherished beliefs against each other, passions are roused and the arguments soon become bitter. It would be better if everyone was just allowed to do what they wanted. But, when it comes to organising medical care for the population, it takes a government to put the right kind of infrastructure in place. People have to be trained as care givers. This takes years and costs a small fortune. Hospitals and clinics have to be built. And then we come to all the support staff who drive the ambulances, keep the places clean and keep the accounts. Ah, yes, the money. All of this work over years has to be paid for. So the $64,000 question is who should foot the bill? It’s at this point that emotions get in the way of common sense.

Talk to one side of the argument and they will tell you people who want access to medical care should carry private insurance. Talk to the other side and they will tell you the state should pay for the service out of the tax revenue. It’s never really clear why people disagree. Only people who are in work pay tax. Only people who earn can afford to pay the premiums on insurance. It’s the same money. The only difference is the way it’s collected – one as tax and the other as premiums paid to an insurance company. But wait! There is a difference! If the state collects in the money, it can use it more efficiently because, unlike the insurance industry, it does not intend to make a profit. So the only reason to support the current system is to allow the insurance industry to continue making an ever larger profit.

As the Senate is currently set up, forty-one senators can stop any reform. That’s forty Republicans plus one other. Yet when you look at the number of people these Republican senators represent, it’s only 36% of the US population. This is somewhat unfair. The party with the majority of representatives was voted in by 64% of the population. The Democratic platform could not have been more clear. It was to be reform of healthcare provision. Yet when you look at the media, all you see reported is the opposition to reform. The “tea party” movement captures all the headlines. But in all this, there is one really big irony that gets very little coverage. Continue reading →