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Understanding Health Insurance in America

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Internet Pharmacies [Apr. 18th, 2007|07:16 pm]
Understanding Health Insurance in America

sundre
anax has kindly allowed me to write here about safely ordering medications online. Please note that the information I am providing relates specifically to the United States. It is by no means complete, but I hope it will give you a starting point.

There are many reasons for ordering your prescription drugs from the internet. Perhaps the idea of having your medication arrive in your mailbox is really convenient. Maybe the drug you need isn't available at your local pharmacy, or maybe it's too expensive there. But it is very important to do your research first.

1. Find a reputable pharmacy.Collapse )

2. Have a prescription.Collapse )

3. Be prepared to wait.Collapse )

4. But what about international pharmacies?Collapse )
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The fine art of communication [Feb. 26th, 2007|07:09 pm]
Understanding Health Insurance in America

anax
So you need to call your insurance about something. How can you get the most out of your time and effort?

This post will be a guideline on how to deal with the customer service department. A lot of these rules also apply to all calls to any company's customer service. Be kind to your CSRs and they will be kind to you.

yes, it"s a hassle, but it"s up to you whether you want to be productive, or just want to complainCollapse )

Is all of this common-sense? Of course it is. Did I insult your intelligence? It wasn't intentional, but you might be surprised by how many people get to be 50+ years old, and still they don't know how to make a phone call to a company with which they do business. o.O
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Order of Benefit Determination [Feb. 23rd, 2007|08:37 pm]
Understanding Health Insurance in America

anax
With so many people in the United States going without any insurance coverage at all, you might not expect many people to have dual coverage. But lots do. Lots.

Often, the dual coverage happens when both halves of a married couple work, and each picks up insurance through his/her employer. Each spouse covers the other, and any kids also end up covered under two policies.

People with Medicare who are still working, or who have a spouse who is working, often end up with dual coverage. A Medicare supplement policy is technically not dual coverage.

Children on Medicaid who have working parents also frequently end up with dual coverage.

Is dual coverage good for you? You'd think it always would be - two is better than one, right? Except when it isn't. The first step to determining whether or not dual coverage is a good deal for you is to determine which policy will be primary.

Coordination of benefits - not just for geeks anymoreCollapse )
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(no subject) [Feb. 22nd, 2007|09:04 pm]
Understanding Health Insurance in America

anax
For youkofujima

more on individual coverageCollapse )
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(no subject) [Feb. 22nd, 2007|08:32 pm]
Understanding Health Insurance in America

anax
Yep, I'm back. I had some personal issues to work out and that's why I dropped the community. I apologize for that; hopefully I'll be able to get some more essays up soon.

Anyway, this is for scorpio11681

Filled out a form wrong? Not necessarily the end of the worldCollapse )
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(no subject) [Aug. 15th, 2006|07:53 pm]
Understanding Health Insurance in America

anax
For Jeff:

Applying for individual coverageCollapse )
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(no subject) [Aug. 6th, 2006|08:21 pm]
Understanding Health Insurance in America

anax
Last time, I went over the indemnity plan and the HMO. Indemnity plans came first, but they are unsatisfactory in many ways (the high cost before any benefit is paid out is a big factor). HMOs were invented as an answer to indemnities, but while HMOs have a much lower out-of-pocket cost to the patient, they have strict rules and harshly punish the patient for breaking those rules.

The other two major categories are the PPO and the POS.

No, POS does not mean anything vulgarCollapse )

There are other types of plans, filling almost every shade in the spectrum between the extremes of the indemnity vs. the HMO. Too numerous for me to list (too numerous for me to claim that I even have heard of them all). These four are the major ones.

In the end, there is no perfect plan. Each type has advantages and disadvantages.

When you get insurance through your employer, you often have pretty much no choice - a lot of employers offer one policy and if you don't like it, your only other option is not to sign up for it at all. Some larger employers offer a small choice (they may give the option of an HMO or an indemnity, for instance). And, of course, if you are buying an individual policy, not through an employer, you have all the world open to you.

If you are offered a choice, however, you should take into consideration more than just how much the copayments or deductibles are. You also need to judge how healthy you are - and how much you can anticipate actually needing to use the insurance - versus the difference in premiums. It is sometimes a far better deal for you to get an indemnity plan instead of a PPO ... for a fairly healthy person with no children, what you pay out for office visits which apply entirely to your deductible may be easily offset by your savings in how much you are paying in premiums.

There is no perfect plan, and really nobody can tell you what the "best" plan for you will be.
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(no subject) [Jul. 23rd, 2006|05:56 pm]
Understanding Health Insurance in America

anax
A lot of people don't even know what kind of insurance Plan they have. Well, you should know. So I'm going to explain the different types for you.

I'm going to break all of this up by type of Plan. The first two types, in this post, will be the extremes of the spectrum, the indemnity and the HMO.

deductibles, copayments and benefits ... oh my!Collapse )

Next up - the hybrid Plans: the PPO and the POS.
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COBRA [Jul. 16th, 2006|09:46 am]
Understanding Health Insurance in America

anax
If you've ever lost your job or gotten too old and gone off your parents' insurance, you've probably seen a COBRA election form and rate sheet and gone O.O. COBRA is ... pretty pricey! So when do you want COBRA coverage and when do you not?

COBRA ... it really has nothing to do with GI JoeCollapse )
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(no subject) [Jul. 7th, 2006|08:43 pm]
Understanding Health Insurance in America

anax
Pre-certification is a requirement of many Plans. If you don't have certain services pre-certified, there may be a penalty that applies. This penalty may apply to you, or it may be applied to your doctor, depending on the time of policy you have.

Whether or not you need pre-certification for something will be in your Plan Document. You DO have a copy of this, yes? :)

Pre means beforeCollapse )
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