The purpose of health insurance is to cover or offset the cost of health expenses, whether medical or surgical, for insured individuals. There are a variety of health insurance plans available. Some types require the individual to pay up-front costs (also referred to as out-of-pocket costs) and be reimbursed later while other plans involve direct payments to the provider. To simplify the process of determining which health insurance plan is best for you, Wirefly offers free online quotes for comparing health insurance options in Argyle, GA.
Typically, health insurance plans in Argyle, GA are offered through private companies or employers. Senior citizens can also receive coverage through a program known as Medicare while low-income individuals can be covered by Medicaid. Medicaid and Medicare are both offered at lower rates than private insurance plans.
It is possible to select varying levels of coverage in health insurance plans. Lower cost plans may only offer coverage for catastrophic events, while more expensive plans would offer more complete coverage. In most cases, individuals attempt to anticipate their upcoming medical needs prior to choosing a specific coverage plan.
Comparing Potential Health Insurance Plans in Argyle, GA
When considering which health insurance plan in Argyle, GA to purchase, it's important to understand that it's impossible to know what will happen in the future, so it's wise not to try and guess what health care requirements might present themselves over the next year. To make a more educated guess as to the best health insurance plan to select, consider looking at past health care needs. This can assist in the identification of the level of care that's required for the next year. Anyone who has been generally healthy over the past few years and is still in good shape will likely only need to purchase a low-cost plan that offers only essential benefits. Individuals with more severe conditions should heavily consider plans that offer an extensive amount of coverage to account for any necessary medications or surgical care.
The catastrophic insurance plans mentioned previously are designed primarily to cover emergency healthcare costs. While no other costs and expenses are covered, this might be enough for healthy individuals in their 20's and early 30's. People who regularly play sports on a competitive level should choose a plan that provides coverage for both doctor visits and trips to the ER. These are just a couple of scenarios that could help determine which plan to purchase.
In order to receive a larger amount of coverage, Argyle, GA individuals will typically be required to pay higher monthly premiums. By paying a higher premium for the coverage, the insurance company will readily pay more for any healthcare needs the individual has in the future. The most important thing to keep in mind when choosing between insurance plans is to always have the basics covered. Once these needs are covered, further coverage can be purchased depending on health history and general lifestyle.
Types of Health Insurance Coverage in Argyle, GA
Those searching for health insurance plans in Argyle, GA have many different types available. Some will have similar levels of coverage, but ease of use could vary significantly from plan to plan. It can be tricky to understand how types of plans work, considering choices include HMO, PPO, POS, HSA, HRA, FSA and MSA plans. The key is knowing the basic differences between all these plans.
With a health maintenance organization (HMO) plan, the policyholder selects one primary care physician to handle all his healthcare needs. The first step in getting any type of healthcare is going to this primary care physician, who evaluates the policy holder’s situation and then refers him to a specialist when necessary. One benefit of HMO plans is that they tend to cost less in terms of monthly premiums and out-of-pocket costs. There also aren’t any deductibles. However, networks are also smaller and not all doctors will accept HMO plans.
A preferred provider organization (PPO) plan allows the policyholder to select any primary care physician in his network, and networks usually have a large number of healthcare providers available. The policy holder doesn’t need to get a referral to see a specialist and can instead make an appointment with a specialist in the network at any time. This flexibility comes at a cost, as PPO plans also include deductibles and copayments. There is an annual limit on how much coverage the policyholder can get per year. While PPO plans provide some financial assistance on health care costs if the policyholder sees an out-of-network doctor, it’s better to stay in network for more financial coverage.
A point of service (POS) plan serves as a balanced mix between an HMO and a PPO plan. The policyholder chooses a primary care physician from a network of a decent size, and there are no deductibles for in-network coverage. Copayments for in-network coverage are low. Out-of-network healthcare will result in much higher deductibles and copayments, though.
While the three plans mentioned above are the most common types, non-traditional health insurance plans in Argyle, GA are also available. These include health savings account (HSA), health reimbursement account (HRA), health flexible spending arrangement (FSA) and medical savings account (MSA) plans, all of which work similarly. The policyholder or his employer put money into a tax-exempt savings account, and he can then use that money to pay medical costs. These plans are very flexible. Some even roll over unused funds from one year to the next.
A Cost Breakdown of Health Insurance in Argyle, GA
The amount of money payable each month for health insurance coverage is known as a premium. Irrespective of whether you use your insurance or not, you will never be reimbursed what you paid as premium. Deductibles are not the same as out of pocket expenses. A deductible refers to the amount of money the insured needs to pay a healthcare provider before the insurer begins paying a claim. On the other hand, out of pocket refers to the amount the insured needs to spend before the insurer pays the entire bill.
Although out of pocket costs and deductibles often start over with every year, the expenses of the previous year usually impact these two payments moving forward. Assume the insured has a deductible of $4,000, spent $2,500 out of pocket in the past year, and keeps the same plan when the insurance renews. In this case, the out of pocket expenses will be reset to zero and the $2,500 spent the past year will not roll over. However, some of the health insurance plans in Argyle, GA are exempted from this rule, allowing the insured to roll over the amount of deductible paid from the previous coverage year to the deductible for the coming year’s first quarter.
Also known as coinsurance, co-payment refers to the financial responsibility of the insured for medical services. If the co-payment to see a primary health care provider is $20, then the insured pays $20 every time he/she sees that health care provider. The insurer will then cover the balance if your plan includes the services rendered. However, a co-payment does not apply to a deductible.
The insurer could also give the insured a maximum lifetime benefit, which is the maximum amount the insurer will pay for your health care in total. The insurance provider will not pay any medical claims once the payments already made add up to this maximum.
Employment status also impacts the health insurance plans available to a person. If you are an employee of a large organization, you might get on the company’s group health insurance plan, which is much more affordable than personal healthcare. However, participation in group health insurance plans is not required by law.
You can purchase private, individual health insurance in Argyle, GA if you are either unemployed or self-employed. Senior citizens who don’t work can receive financial assistance from the government through Medicare. People with low-income can also apply for financial support from the government through Medicaid.
Check with your doctors to find out which of the health insurance plans offered in Argyle, GA is acceptable to them, especially if you intend to keep seeing your current physicians. If your insurance plan changes, make sure you inform your doctor. Also, check with your insurer about any specific question that pertains to your coverage.
Getting a Health Insurance Quote in Argyle, GA
Life is full of uncertainties. One minute you are in good health, and the next minute you may not be. Subscribing to a health insurance plan is one of the best decisions you can make for yourself and for your family. Insurance plans vary depending on certain conditions with many factors affecting the rates you will have to pay for coverage. With Wirefly, getting an insurance quote has never been easy. All you need to do is enter your ZIP code. Although there are many ways of saving the costs you use for health plans in Argyle, GA, you should not compromise on the essential coverage. For example, if you are planning on having children at some point, you need to secure a plan that has maternity coverage now to prevent future complications. Make sure you do not leave out important coverage to save money. When choosing an insurance plan you should factor things such as your medical history, your current health condition, the health condition of your loved ones, future plans, and whether or not you want the freedom to visit doctors outside a set network. You may also need to research on the health practitioners in your area and the kinds of plans they accept. Other considerations you ought to make include the deductibles, out-of-pocket expenses, and co-insurance. You can rely on us to help you find the insurance plan best suited for your needs in Argyle, GA by getting a free quote today.
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