Health Care Benefits

December 27, 2016

Health Care benefits are benefits provided by the employer as a part of your salary to cover health care expenses if any. This is largely prevalent in the United States where there is no national health care that they can depend on for help as is the case in several other countries. Hence employers use this to lure employees to their company. If you are joining a company make sure you find out what are the health care benefits they offer and do a complete analysis about it before deciding. The various types of insurance available are:

Managed Cover Care: Here the insurer is in contract with certain health care providers and suggests that the individuals visit those hospitals or doctors for their services. It also gives them financial or other incentives to use the recommended providers.

Indemnity: In this type of insurance you visit the provider of your choice, pay upfront and claim for a reimbursement later. You will need to fill out a form and submit all the medical receipts, bills that you are claiming for. The amount of reimbursement will depend on the amount you along with your employer pay as premium. Indemnity is not very common.

Preferred Provider Organizations (PPO): In the preferred provider organization you pay a fixed charge every month towards the premium of the insurance. Then you get to choose from their network of doctors and hospitals for your medical needs. You need not specify a primary caregiver and so referrals for specialists are eliminated. You can choose a provider that does not fall under the network but might have to pay higher insurance premium or co payment.

Health Maintenance Organization (HMO): This is similar to the PPO in terms of the network and monthly payments. However you will have to specify a primary caregiver who will then put you onto specialists if required. Your choice of health care providers is restricted to the network of providers and if you require other providers it will not be covered. Exceptions might be made in case of emergencies.

Point of Service Plans: This plan attempts to strike a balance between the HMO and PPO plan in combining the choices available in the PPO with the low cost involved in the HMO. You choose a primary caregiver within the network who refers you to specialists within or outside the network. If within the network all the payments and paperwork are taken care of. If the specialist is outside the network then payment is done partly and you will have to submit bills for reimbursements and keep a track of all your expenses.

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