Health Insurance: A Comprehensive Guide

Health insurance can provide critical assistance as insureds manage costs for medical care and preventive services. However, coverage can also be a complex subject to understand fully, making it often necessary to enlist the assistance of a qualified professional. With this in mind, the team at Ramos Insurance is proud to offer this in-depth overview of health insurance.

What Types of Services Can Health Insurance Cover?

Health insurance plans’ capabilities can vary significantly depending on your coverage selections, but in many cases, a health policy can cover a variety of services and treatments, such as the following:

• Preventive and wellness services—This often includes routine checkups, vaccinations and screenings.

• Emergency services—Your policy may help cover the cost of emergency room visits.

• Hospitalization—Health insurance can help cover the cost of your hospital stay and treatments.

• Prescription drugs—Insurance can help reduce your out-of-pocket costs for prescription medications.

• Laboratory services—Tests necessary to diagnose or monitor conditions can be covered by many health insurance policies.

• Pediatric services—This may include checkups, vaccines and dental and vision care for children.

• Maternity and newborn care—Prenatal care, childbirth services and care for newborn babies can be covered.

Most insurance plans include cost-sharing aspects, such as deductibles, copays and coinsurance. Be sure you understand these terms and how they may apply to your unique health plan.

What Are the Common Types of Health Insurance Plans?

There are several types of health insurance plans, each with its own rules and restrictions. Here are some standard coverage options from which you may be able to select:

• Health maintenance organization (HMO)—These plans often limit coverage to care from doctors who work for or contract with the HMO and require you to select a primary care provider who oversees your health and makes referrals for specialist care. Plans generally won’t cover out-of-network care except in an emergency.

• Preferred provider organization (PPO)—Under these plans, you do not need to pick a primary care provider and may have greater flexibility for seeking out-of-network care, albeit with typically higher premiums.

• Exclusive provider organization (EPO)—This type of health insurance policy may resemble HMOs by requiring the selection of a primary care provider; however, you are typically free to visit specialists without needing a referral.

• Point of service (POS)—These arrangements can generally be seen as hybrids of HMOs and PPOs. You’re required to designate an in-network physician for primary care but may have greater flexibility to seek out-of-network services, albeit at greater cost.

Learn More

Contact the team at Ramos Insurance today to learn more about health insurance options and to secure the right plan.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.