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Health Insuranceby Rajeev ShrivstavaMedical Insurance You must have a medical insurance, if you are going to be in USA, as medical insurance is a basic necessity here. Without it you cannot survive, even a simple blood test may cost you 100's of dollars. If you are going to be employed in USA, your employer should provide you a medical insurance. Some companies provide it for your spouse and children too, otherwise you should buy a insurance for them.
There are three kinds of medical insurance you can get viz. HMO, PPO and POS plan. The basic difference between these plans is the cost, and the flexibility in choosing a physician. 1. What is HMO?HMO stands for Health Maintenance Organization. HMO is a company that offers health plans, which provides medical care from an approved network of doctors, hospitals, and pharmacies. The patient needs to pay some set minimum fee per visit. These fees are usually much lower than PPO (Preferred Provider Organizations). Advantages of HMO:
Disadvantages of HMO:
PPO stands for Preferred Provider Organization. PPO allows patients to see a specialist without a referral from a Primary Care Physician. They have a wider range of doctors to choose from. The direct access to specialists is good for people who have chronic illness, or in case of urgent care and emergencies. Patients can get appointments with their preferred specialists as and when required. Usually, a PPO will pay a greater percentage of the cost for a preferred provider, and less for a non-preferred provider. Advantages of PPO:
Disadvantages of PPO:
POS stands for a Point of Service plan, which combines the cost savings of a HMO with the flexibility of a PPO. Find out the details and rules from your medical insurance company. What to do after you get a HMO plan?Once you've signed up and received your HMO plan, be sure to read your policy thoroughly and carefully. You should know answers to questions like:
A primary care physician manages your entire health care program. One has to first visit his/her primary care physician for any kind of medical problem. In case you require a specialist, then your physician should refer you to a concerned specialist. Can I change my primary care physician?Yes, one can change his/her primary care physician maximum once a month. But it is always better to stick to one physician. Find out the rules form your insurance company. Normally to change, you will just have to call up the new physician you want to be your primary care doctor, and then inform your insurance company about the change. What is a Chart Number?This number is given to each patient, and it refers to a file which has all the records of your prior tests, ailments, etc. This number makes it easy for the person at the reception to make your future appointments and is also a reference for your doctor. You will be required to provide your chart number whenever you call or visit a doctor. What is difference between Urgent Care and Emergency Services?Taking appointment for any ailment is a time taking process, hence every hospital provides urgent care and emergency care services. These are the quick medical care services provided by almost all medical centers. Emergency services are those services required as a result of unforeseen injuries or acute illness, for which a delay in treatment would result in a permanent physical impairment, or loss of life. Such as heart attacks, strokes, poisonings, sudden inability to breathe etc. On the other hand, urgent care includes less serious medical conditions which require immediate attention. Such as fever, fractured bone, any cuts which require immediate attention, etc. ** Note: Always make sure from your insurance company as to what situations are treated as urgent and emergency. If possible, it is better to contact your primary care physician in an urgent situation and arrange for your immediate care. What are Preferred and Non Preferred providers for a PPO plan?PPO is a network of physicians that have agreed, by contract, to discount their rates for the respective PPO members. These physicians, specialists are known as preferred providers, and PPO members are free to see any of them, without any reference from their primary physicians. PPO members may also see non-contracted providers, these are known as non preferred providers. The co-payment fee for seeing a non preferred provider is generally higher than the preferred providers. How to get medicines from a pharmacy?Read your insurance company's manual to find out which are the pharmacies included in your plan. Select the nearest pharmacy to your place. For all prescribed medicines, you will have to pay the minimum fee, and rest will be covered by your insurance. But your insurance won't cover other medicines, which can be picked directly off the shelf from the stores. Note: Information provided here is collected from individual experiences and other sources. It may not be accurate. Please verify it before using. Reproduced with permission. Copyrighted by Path2usa.com.
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