Are you shopping for a health plan that meets your needs?
There are many out there, and no two are the same. With so many options available to you, do a little homework. Use a health magazine or health articles to help you determine what will best treat your medical needs and those of your loved ones.
What is a Health Plan?
A health plan is an organized system for providing health care services to an individual or to a family. Not all health plans are created equal. They vary in price, coverage, care facility locations, preventative medicine, education, post-treatment, and treatment of illness, injury and disease.
Types of Health Care Plans
There two kinds of health plans: ‘fee-for-service’ and ‘managed care.’ Fee-for-service is a pay-as-you-go process. When you need a consultation, you pay. When you need medication, you pay.
Managed care is offered through an organization or association. Fees tend to be monthly. Managed care can be in the form of the following:
Health Maintenance Organization (HMO)
Individual Practice Association (IPA)
Point of Service (POS)
Preferred Provider Organization (PPO)
As you decide which health care plan best suits your needs, check with a medical accreditation group. Many health plan companies elect to undergo an accreditation process. The National Committee for Quality Assurance (NCQA), The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and The American Accreditation HealthCare Commission/Utilization Review Accreditation Commission (URAC) are known for their evaluation standards. These groups look at the health plan’s members rights, medical staff credentials, ongoing quality improvement ratio, ethics and standards, health information, preventative training, and services rendered. You can read their finding in a health magazine or in national health articles.
Questions to Ask When Selecting a Health Plan
Do not let the name of the plan sway you. Ask yourself these questions when comparing health plan services:
- Which plan offers the benefits that you need?
- Which plan provides the services when and where you need them? Do you have access to state-of-the-art facilities with each one?
- Is the medical staff caring and attentive? Do they explain information in a clear, concise way? Are you able to see a specialist when needed?
- Are all choices affordable for your budget?
- What do current members have to say about the care they receive with each plan? Are they able to see their doctor of choice?
- How many of these plans are accredited?
The following is a list of services that many health plans offer their members:
Adult day care. After hours emergency care. Alternative treatments (including acupuncture, massage, and chiropractic treatments).Cancer screening. Care for pre-existing conditions.
Cholesterol screening.
Continuing education with health articles.
Counseling to stop smoking.
Dental exams, treatments, and surgeries.
Diabetes consults and supplies.
Drug and alcohol substance abuse counseling.
Eye care exams and glasses or contact lenses.
Hearing exams and hearing aids.
Home health care.
Hospice care.
Immunizations.
Medical equipment for use at home.
Mental health services.
Monthly health magazine or newsletter.
Nursing home care.
Outpatient prescription medicines.
Pharmacy.
Physical therapy.
Prenatal care.
The Cost of Health Care
When determining if a health care plan fits into your budget, be sure that you consider the monthly cost of your premiums and deductibles. Find out how many doctors and hospital visits cost as well as co-pays for prescription drugs. This could be the deciding factor when selecting a health plan that is right for you.
