Summary:
Discover the differences among the most popular types of health insurance plans:

*Group
*Individual
*Medicare
*Medicaid

This article discusses each of these plans and what they have to offer....

Details or Sample:
Understanding the Differences among Group, Individual, Medicare, and Medicaid Insurance Plans

There are several types of health insurance, and understanding each of these will help you make the right decision when choosing an insurance plan. The most common types of insurance are group, individual, Medicare, and Medicaid insurance.

Group Health Insurance

Group health insurance is provided through an employer, organization, or union. This is made possible through an agreement between your employer and an insurance company that handles group plans. Because the group plan provides insurance for a group of individuals, a discount is usually granted. Employers that provide group insurance usually pay a portion of or all of the premiums. Employees are responsible for paying the remainder of their premium and the premium amount due is usually taken off the top of their payroll check each pay period.

Employers may offer employees a choice among several plans such as managed care or indemnity, or they may offer only one type of plan. Many group plans include dental and vision benefits as well.

Group plans that are offered through unions, clubs, and organizations are similar to employer plans in that a discount may be granted for the group. They differ, however, because each individual pays their own premiums in full.

Group plans can be beneficial to both employers and employees. Employers can claim premiums paid as a tax expense. Employees receive a discount and/or payment of part of their premiums, which results in very affordable health insurance. Also, these plans may offer more coverage for the money than some individual plans.

Individual Insurance

If your employer doesn´t provide medical benefits, you can purchase individual insurance. With individual insurance, you can choose the company you would like to use and the type of plan that will best meet your needs. You can shop around and compare rates, benefits, deductibles, and co-pay arrangements to find the right plan for you. Unfortunately, you will be required to pay the entire premium and you will not receive group discounts.

If you are self-employed, you can deduct your health insurance premiums from your taxable federal income. This will help reduce the burden somewhat and allow you to have affordable health insurance as a business owner. You may also be able to deduct insurance premiums for your entire family. Check with your accountant to see how this works.

Indemnity or Managed Care Plans

Whether you have a group plan or individual insurance, you still have options within these two types of plans. You may have a choice between indemnity and managed care plans. These are similar in some ways, but very different in others. Both plans cover a vast array of medical, hospital, and surgical services. Many of these plans offer some type of prescription drug coverage and partial dental and/or vision coverage.

With indemnity insurance, you can choose any doctor for medical care and even change doctors when you want. You may have to pay a deductible with this type of plan. Also, your out-of-pocket expenses may be higher. With managed care, you can save money by choosing certain doctors that are part of the network, called network providers. You will likely have a set co-pay amount such as $10 or $20 for each office visit. Prescription drugs are categorized as formulary and non-formulary, with formulary drugs being covered by the plan at lower costs. Three types of managed care plans are health maintenance organization (HMO), preferred provider organization (PPO), and point-of-service plans (POS).

Medicare Insurance

Medicare insurance is a program provided by the federal government to seniors age 65 and older. Qualified individuals who are disabled or have end-stage renal disease (ESRD) may also obtain Medicare....

by Candice Pardue

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