As a subcategory in the broader field of insurance, health insurance is the section that covers part of the health expenses incurred by an insured person. Today, there are different kinds of health insurance plans available. Depending on the coverage, there are two possibilities when an insured individual seeks medical services. Either the insurance company pays the medical service provider directly, or the insured person covers the costs with an out-of-pocket payment and is later reimbursed by his or her insurer.
As a health insurance comparison website, Wirefly offers more than free online quotes. It also makes it easy to compare the different types of health insurance plans available in Pinehurst, MA.
Although employers and private insurance companies are the most common providers of health insurance in Pinehurst, MA, it is also available to low-income earners through Medicaid and to senior citizens via Medicare. Compared to private insurance companies, Medicaid and Medicare provide health insurance services at a significantly lower cost. There are several levels of coverage included in this type of insurance. While the least expensive plans usually cover catastrophic events only, high-cost plans will most certainly provide full coverage. As a result, people often try to anticipate their medical care needs before deciding the most suitable health insurance plan.
Pinehurst, MA Health Insurance Plan Comparison
Choosing the right coverage for your health care needs can be extremely hard since the future can be unpredictable. The best way to properly predict how much coverage you’ll need is to use the amount from the past year.
The first type of coverage health insurance plans offer in Pinehurst, MA is known as catastrophic insurance. This is the lowest cost insurance and is primarily designed for people who rarely visit their healthcare professionals. Of course, if you plan to visit your doctor on a regular basis and participate in dangerous activities, you will need a healthcare plan that can cover you more. This will usually cost you more in the end.
Most plans that provide more coverage require higher monthly payments. However, this also means that the more you put down, the more your insurance provider will give you when you run into a medical emergency. This, in turn, is why it’s so important to decide on the best plan to cover your health care needs. The last thing you want to do is purchase coverage that will offer less protection or coverage that costs too much to afford.
Common Types of Health Insurance Plans in Pinehurst, MA
There are many types of health insurance covers to choose from in Pinehurst, MA. These plans may look like they offer the same coverage; however, their convenience and flexibility is very different. The main types include HMO, PPO, POS, HSA, HRA, FSA, and MSA. Determining the differences between these choices will help you choose an appropriate plan.
Health Maintenance Organization, or HMO. An HMO is a plan that restricts you to a particular healthcare provider. This means, whenever you have a health concern, you will only visit a particular physician for assistance. In cases where you need additional attention, this primary care doctor will be the one to refer you to a specialist. Health maintenance organization plans in Pinehurst, MA are cheap compared to other plans. The major downside of HMO plans is that the network of doctors you can choose from is limited because some physicians do not offer HMO plans. The upside of HMO is that out-of-pocket expenses are relatively low and reasonable. Furthermore, you do not have to pay any deductibles.
Preferred Provider Organization, or PPO. A PPO plan involves a large network of physicians. This means that you have a bigger circle of doctors to choose from. With this coverage, you are not limited to the referrals given by your primary care doctor. You can visit a specialist without consulting your primary physician. When you are treated by doctors who are within the circle of health care providers contracted by your insurance carrier, you get to pay low medical costs. However, if you are treated by doctors who are outside the network, your insurance carrier will only pay a small fraction of the costs. With PPOs, you are subject to copayments and deductibles. There is also a limit to the amount of out-of-pocket expenses you can incur annually.
Point of Service, or POS. A POS plan combines the features of HMOs and PPOs. With POS coverage, you have a reasonable circle of medical practitioners from which you can choose a primary care doctor. Provided you remain within the circle of doctors in Pinehurst, MA, you will pay low copayments. There are also no deductibles in this plan. However, if you insist on seeing a physician outside the network of doctors, the deductibles and copayments are high.
Non-Conventional Health Insurance Plans. Some of the non-conventional health insurance plans in Pinehurst, MA, include "Medical Savings Account" (MSA), "Health Reimbursement Account" (HRA), "Health Savings Account" (HSA), and "Health Flexible Spending Arrangement" (FSA). All these plans work on the grounds that you or your employer has set aside some money in a savings account for all your medical expenses. The funds that have been set aside are used for paying doctor prescriptions, surgical treatments, doctor visits, and over-the-counter medicine. These plans provide a lot of freedom with regards to how you can use the money. Some plans even give you the option of rolling unused funds to the next year.
Explanation of Health Insurance Costs in Pinehurst, MA
The amount of money you are required to pay each month to maintain your health insurance coverage in Pinehurst, MA is referred to as the premium. The premium will not be returned to you under any circumstances, even if you do not use your insurance. Any additional money you are responsible for paying prior to your insurance company covering their agreed portion is known as the deductible.
Deductibles differ from out-of-pocket expenses. The deductible describes the annual amount you are responsible for paying before your insurance start to cover costs. The term 'out-of-pocket' refers to the amount of money you need to pay before your insurance company will cover 100 percent of your bill.
With each new year, deductibles and out of pocket usually start fresh. Any expenses from the prior year can have an impact on these costs moving forward. This means that if you have a $4,000 deductible and you spent $2,500 out-of-pocket in the previous year, your out-of-pocket expenses will reset to $0 and the $2,500 will not roll over if you keep the same plan. Certain plans in Pinehurst, MA allow exceptions to this rule and allow you to transfer your paid deductible amount from the prior year towards the first portion of the new year.
Co-payments refers to your financial requirements in terms of medical visits and services. If you have a copayment of $20 to see your primary care doctor, then you will be required to pay $20 each time you visit your physician. After you cover the co-pay, the insurance pays the remaining balance as long as the services are covered under your plan. Copayments do not count towards your deductible.
You may also be offered a maximum lifetime benefit by your insurance provider. This term refers to the highest amount of money that your provider will pay in total for your medical expenses. Upon reaching the maximum limit, your insurance company will stop paying for any medical claims.
The health insurance options that are open to you in Pinehurst, MA are affected by your current employment situation. If you are employed at a larger company, it is likely that you will qualify for their group health insurance plan. Generally, this is a more affordable option than choosing individual health care. However, no one is required to participate in these specific plans.
If you are currently unemployed or are self-employed, you are eligible to purchase private health insurance. If you are an unemployed senior citizen, you are eligible to obtain financial assistance provided by the government known as Medicare. Individuals with an income that falls below average have the option to apply for a government funded program known as Medicaid.
It is crucial to double check with your physician to see which health insurance policies are covered in Pinehurst, MA. If you wish to see a particular doctor, it is important to verify that they are covered under your plan. Additionally, let your physician know if your plan is altered. Check with your health insurance provider about any questions or concerns you have in regards to your coverage.
Get a Health Insurance Quote in Pinehurst, MA Today
Buying health insurance is one of the best ways to care for yourself and your family. There are many different factors that may affect insurance plan coverage and rates. Wirefly simplifies the task of comparing health insurance plans and getting health insurance quotes in Pinehurst, MA. Just enter your ZIP code to start.
While it is possible to save money on health insurance in several ways, do not pass on the coverage you may need. For instance, if you plan to have a child in the future, choose a plan that includes maternity coverage to avoid the trouble of obtaining coverage later. Make sure that you do not eliminate coverage you need to save money on premiums. Although insurance premiums are not cheap, out-of-pocket costs for future medical care are potentially many times more costly. Let Wirefly help you find the best insurance plan in Pinehurst, MA. Save on health insurance by getting free quotes now.
Wirefly Is America's Most Trusted Source For All Cell Phones, Plans, TV, and Internet Deals
Wirefly offers great deals on a large selection of smartphones, cell phones, tablets, mobile hotspots, and other wireless devices for the nation's most popular carriers. Use Wirefly’s innovative cell phone and plan comparison tools to ensure you are getting the best deal on the market. Shop with confidence knowing that Wirefly wants to help you find the best prices on cell phones, cell phone plans, TV, and Internet service.