Types of Plans

The rates are negotiated at the time of sign up. A primary care doctor must be chosen by the member. This doctor is expected to plan all medical care and treatment for the member as well as make referrals to the necessary specialists. All expenses for medical services provided to the member outside of the officially approved network or hospitals and providers will are incurred by the member. The idea behind an HMO is that to keep costs low, it is necessary to provide preventative health care before a member falls ill. HMOs are built upon a network of hospitals and physicians who are interested in providing health care to members in exchange for a monthly charge paid by the HMO. Members may see their primary care doctor as often as necessary, paying the HMO monthly premium plus a small additional fee per visit or prescription. Most health and wellness services are covered. Members may not go to a medical provider outside of the HMO network. HMOs only take on employer groups, but occasionally a few will accept individuals as members.

These doctors and hospitals are generally made available to members of a health plan by lists issued by their health care provider indicating that should a member receive health care through these listed care givers then their expenses will be covered by full benefits. Members of a PPO make their own health care choices as opposed to HMO members, who receive medical services through a primary care physician. Using a provider outside of the PPO network is more expensive than choosing one recommended by your PPO. However, should a PPO member choose a physician or hospital outside of the network, the health provider may still cover a percentage of the costs, though, in some cases, no claims made outside of the network will be covered at all. Be sure to verify that your chosen doctor or hospital is contracted as a provider with your PPO before undertaking any procedures or appointments. If your physician is not a network member, ask for a referral to one who is or for a hospital for which the provider agrees to pay claims at a 'preferred' rate.

Should an emergency arise, these policies will cover you while allowing you to choose your own physicians and health care facilities for treatment as well as pay all the expenses that are covered by the plan once you have paid your deductible and coinsurance. Incidents that are covered by most short term health insurance plans include:

• daily hospital room and board
• major hospital, medical, and surgical expenses
• various hospital services
• surgical services
• anesthesia
• outpatient care

Short Term Policies generally offer coverage lasting between 30 days and 1 year.

Tax-deductible
Contributions to the HSA are 100% deductible (up to the legal limit) — just like an IRA.

Tax-free
Withdrawals to pay qualified medical expenses are never taxed.

Tax-deferred
Interest earnings accumulate tax-deferred, and if used to pay qualified medical expenses, are tax-free.

HSA money is yours to keep
Unlike a Flexible Spending Account, unused money in your HSA isn’t forfeited at the end of the year; it continues to grow, tax-deferred.

Medicare Supplemental insurance or Medigap comes in 10 standardized Medigap plans. The plans are referred to by letter (Plan A, B, C, D, E, F, G, H, I, J) and vary in both price and coverage. Plan J has the most coverage, and Plan A the least.

Each plan is standardized across the nation. This system makes it very easy to compare policies, because every plan must carry the same coverage, no matter who is selling it. Plan J from one insurer offers identical coverage to Plan J from another insurer, plan A from one is equal to A from another, and so forth. Not every plan is offered in every state.

Coverage includes approved medical expenses for physician services, medical and surgical services and supplies diagnostic tests, and much more. In addition, our C and F plans also cover your Medicare deductibles, co-payments for hospitalization, emergencies while traveling, and skilled nursing care.

People on Medicare, Part A or B, who would like to receive prescription drug coverage under Part D have to enroll in a private insurance policy that offers Part D coverage and is approved by Medicare. These plans are called Medicare Prescription Drug Plans (PDPs). You can sign up for the drug benefit from time to time based on needs and Medicare coverage.

Signing up for Basic Medicare Part D
Medicare Part D offers prescription drug coverage. If you already have an insurance policy that covers prescription drugs when you sign up, you will have to choose between your current policy or a new policy and basic Medicare Part D. You will receive notification of whether or not your existing coverage is "creditable" (equal to or better than Medicare Part D).

Signing up for Medicare Prescription Drug Plans (PDP)
Medicare Prescription Drug Plans (PDPs) offer prescription drug benefits. Drug plans vary in what prescription drugs are covered, how much you have to pay and which pharmacies you can use. Like any other insurance, if you join you pay a monthly premium and pay a share of the cost of your prescriptions.

Advantages of a PDP vs. Basic Medicare Part D
PDP plans offer possible advantages in cost value, types of drugs and combinations of services, such as preventive care. Premiums might be equal to or more than those of the basic Medicare Part D Program. In any case, they must at least offer the same basic coverage as Medicare Part D.

About Medicare Advantage Plans
In Medicare Advantage plans, the government contracts with private insurance companies to add Medicare beneficiaries to the rolls of those covered under the insurance company's plan. Payments to the plan are from Medicare (diverting the Part B premium payments), and potentially from the enrollee if the plan costs more than the Part B premium. Enrollees in Medicare Advantage plans are still part of Medicare.

County and Regional Medicare Advantage Plans
Not every Medicare Advantage plan is available in every county, and not every plan is right for every person. However, these plans are growing in popularity and availability, making them a very strong option for most people.