If you are many self-employed or working for an employer that does not offer any insurance benefits, then you have to shop for a health and dental policy on your own or with the help of an insurance agent. For some it may seem overwhelming but only a few researches are actually resorted to to get a better understanding of how to structure insurance plans.
You will face insurance specific conditions while reading a health insurance policy. These conditions tell you what you are responsible for paying and what the insurance company will pay.
Copay – This is a cost sharing agreement in which the insured pays a predetermined amount and the insurance company pays the rest. Example: You have a $ 50 copy for a doctor’s visit where the cost is $ 80. You pay $ 50 and insurance pays $ 30.
Deductible – This is how much the insured wants to pay to the insurance holder before making the payment. The higher the deduction, the lower the monthly cost.
Coinsurance – This is another cost sharing agreement, but in this you pay a fixed percentage and the insurance company pays another percentage. Example: The cost of your office visit is $ 80 and you are responsible for 30% which is $ 24 so the insurer will pay 70% which in this case is $ 56.
Waiting Period – This is a way for insurance companies to cut costs and avoid paying for pre-existing conditions. Waiting periods vary, but you may face a waiting period of 1 to 12 months for services that will be covered later.
Dental insurance companies offer many schemes but most fall under the category of savings plan, network plan or fixed benefit plan. Each plan will address preventive, basic and key services. There is a need to educate consumers about what all means because the three basic types of schemes are very different.
Dental saving plan is cheaper and only offers network discounts. Depending on which provider you choose, the advertising ranges from 20% to 65% discount. Some people think these schemes are worthless and don’t offer much benefit, but they are perfect for those people Are those that do not require only cleaning, some basic services and larger services. The second thing is that the network and fixed benefit plan have maximum benefits per year. This scheme is not so, so it can also enhance a network plan.
A network plan consists of coops and deductibles. It provides more coverage with an emphasis on preventive services and is the most expensive option. This plan will typically pay 100% of your preventive services and a percentage of your parent and large companies. Some will have a waiting period on these services and some will not include major services. You should determine if you have the risk of needing key services or if you can augment the plan with a savings plan.
Fixed benefit plans pay pre-determined cash for covered services. If your family cannot make a network plan, this is your next best option. This person has no deductions, but you have to pay the difference between the fixed benefit and the dental bill. The best thing is that there is no network so that you can choose any dentist. You can also become a better consumer because you can ask the dentist what their prices are to maximize your set profit. This plan can also be extended with a dental saving plan because the money is sent to you, not to the dentist.
Understanding the specific terms of insurance can be difficult in view of a contract that may exceed 30 pages in length. Consumers should do their research, but I recommend talking with a professional. I have trained a licensed insurance agent and understands the nuances in contracts. They are ready to explain the nuances you can skip.