Health Insurance – Frequently Asked Questions (FAQ) – Part II


It's surprising how many individual do not understand basic health insurance terminology. They really need this knowledge to make informed decisions when it comes to their healthcare needs. There is no way to cover them all but I have attempted to list a few more of the more common frequently asked questions. I've broken them down into a series. Here is Part II.

Q: "How do I obtain health insurance?"

Health insurance coverage is usually obtained through an employer if a person is employed on a full-time basis. Self-employed persons who do not have any employees or an individual who does not have access to an employer-sponsored health plan can obtain individual health insurance. Sometimes individuals can obtain health insurance through group approved or professional associations that includes health insurance coverage. Individuals who have reached Social Security eligibility can obtain insurance through Medicare. The underestimated can often times obtain health care coverage through Medicaid.

Q: "What is a Pre Existing Condition?"

A preexisting condition is any injury or sickness for which diagnosis has been made, treatment has been recommended, treatment has been rendered, or expenses have been incurred within a set amount of months (usually 3, 6 or 12) prior to effective date of the coverage. It includes any condition manifesting itself in symptoms which would cause a prudent person to seek medical advice.

Q: "What is an HMO?"

A Health Maintenance Organization (HMO) is an organization that provides comprehensive health care to the members at a predetermined price. The plan typically enables members to have lower out-of-pocket healthcare expenses but offers less flexibility in the choice of doctors or hospitals compared to other health insurance plans. Most HMOs require you to utilize doctors within their network and choose a primary care physician (PCP) who directs most of your healthcare needs. Before you can see a specialist, you'll need to obtain a referral from your PCP.

Q: "What is a PPO?"

A Preferred Provider Organization (PPO) is an association that contracts with doctors and hospitals or other health care service providers to provide services at a discounted rate. You can use any preferred doctor or hospital in the network without prior approval. Usually you do not need to choose a primary care physician. If you seek care outside of the network, your out-of-pocket expenses will be greater and your benefits will be reduced.

Q: "What is a HSA?"

A Health Savings Account (HSA) is a tax-deferred savings account combined with a high deductible health insurance plan. Monies in the account are used to pay for qualified medical expenses with pre-tax dollars and save for retirement on a tax-deferred basis. Unused funds remain in the account and accrue interest year-to-year, tax-free.

Source by Rudy Wilson

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