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 Summerfield, NC.
Typically, health insurance plans in Summerfield, NC 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 Summerfield, NC
When considering which health insurance plan in Summerfield, NC 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, Summerfield, NC 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.
Different Types of Health Insurance Coverage in Summerfield, NC
Several types of health insurance plans are available in Summerfield, NC. Although these health insurance plans may offer similar coverage levels, their convenience of use and flexibility may vary. Choices include a Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Point of Service Plan (POS), Health Savings Account (HSA), Health Reimbursement Agreement (HRA), Flexible Spending Account (FSA), and Medical Savings Account (MSA). There are many options, and comparing them may seem confusing. Before selecting a health insurance plan, however, it is important to recognize the basic differences between them.
An HMO, or Health Maintenance Organization in Summerfield, NC, is a network that requires the insured to select a primary care physician (PCP) to act as the gatekeeper for your health care and related needs. If you need to visit a specialist, the primary care doctor must refer you to the specialist. He or she decides if it is necessary for you to see a specialist. HMOs typically have lower premiums than other plans, but the network of doctors available to the insured may be limited. If the insured wants to see a doctor outside of the HMO network, these doctors might not accept the HMO insurance plan. On the plus side, many HMO plans have no deductibles and out-of-pocket costs are usually reasonable.
A PPO plan, or Preferred Provider Organization, usually offers a large network of health care providers to the insured. He or she may choose any primary care doctor within the PPO network and see specialists without a referral from the primary care physician. Although the insured receives the best financial deal from in-network doctors and hospitals, he or she receives partial financial assistance for out-of-network doctors, specialists, and hospitals as well. PPO participants usually pay deductibles and copayments. Limits may apply concerning annual out-of-pocket costs.
A variety of non-traditional health insurance plans are available in Summerfield, NC, such as a Health Savings Account (HSA), a Health Reimbursement Account (HRA), a Flexible Spending Arrangement (FSA), and a Medical Savings Account (MSA). These approaches operate on the idea that you and/or your employer set money aside in a tax-free savings account for any medical-related expenses. Money in the plan may be used to pay for doctor visits, surgeries, prescriptions, and some over-the-counter medicines. These health care plans offer a great deal of flexibility concerning how the money is used. Some plans allow users to rollover money from year-to-year.
Breaking Down Health Insurance Costs in Summerfield, NC
The premium is the monthly fee for a health insurance policy in Summerfield, NC. The policyholder pays this amount for coverage even if he doesn’t use it that month. The deductible is the amount that the policyholder pays for healthcare coverage first before the insurance provider pays its portion of the bill.
People sometimes confuse deductibles with out-of-pocket costs, but they’re not the same. The deductible is the amount the policyholder must pay for the year before his insurance provider covers anything, while out-of-pocket costs are how much money the policyholder spends before the provider covers all of the bill.
With a typical health insurance plan in Summerfield, NC, deductibles and out-of-pocket costs reset to $0 at the start of a new calendar year. For example, if a policyholder's plan has a $3,000 deductible and he spends $2,000 in out-of-pocket costs that year, his out-of-pocket expenses go back to $0 on January 1. This isn’t always the case, as there are a few plans that roll over the paid deductible amount from the end of one year to the next.
The co-payment, also known as co-insurance, is the amount the policyholder needs to pay for a service. The amount can vary depending on the service. If a plan has a primary physician visit co-payment of $10, then the policyholder must pay that $10 every time he visits his primary physician. The insurance provider pays for the remaining balance as long as the policyholder has coverage for those services. Co-payments don’t count towards a plan’s deductible.
A plan could have a maximum lifetime benefit, which is the most that the insurance provider will pay out for the policy holder’s healthcare costs. After hitting that mark, the insurance provider won’t pay any more healthcare costs for the policyholder.
A person’s health care options rely quite a bit on his employment status. Employees of large companies can typically sign up for a group health insurance plan. While no one is legally required to sign up for a group plan, these plans tend to cost less than individual plans.
Those who are unemployed or self-employed will need to get private, individual health insurance plans. There are other options available for senior citizens who don’t work and people with low incomes. Seniors can sign up for a Medicare plan for financial assistance from the government. People with low incomes can get government-provided financial assistance through a Medicaid plan.
If a person already has a doctor he likes, he should ask what health insurance plans in Summerfield, NC that doctor can accept. He must also notify the doctor regarding changes to his insurance plan.
Get Health Insurance Quotes in Summerfield, NC Today
While health insurance is one the most beneficial things you can do for your family as a whole, so many factors can impact health insurance plans and rates. Fortunately, the task of acquiring health insurance quotes in Summerfield, NC has been made easier by Wirefly. You only need to enter your ZIP code.
Although there are many ways to save money on health insurance, do not eliminate needed coverage just to save some money. For instance, if you intend to have children, choosing a plan that includes maternity coverage now ensures you won’t have trouble getting covered in future. Even though insurance premiums are not cheap, the out-of-pocket cost of health care is exponentially greater. We can ensure you find the best insurance plan based on your needs and financial situation. All you need to do is get your free quotes today.
Health Insurance Plans in Summerfield, NC ZIP Codes
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