Other Free Encyclopedias » Online Encyclopedia » Encyclopedia - Featured Articles » Featured Articles: American Idols Tickets - How to Score American Idols Tickets (and How Not To!) - Where to Find American Idol Tickets to Meet Singles Free - How to Meet Singles Free

Medical Insurance Private - Types of Medical Insurance: Private Plans

coverage major services service

If there is one thing in the world today that has become an issue, it is that of health insurance and, more specifically, private medical insurance. Medical insurance, private coverage offered by employers known as group insurance or purchased by individuals and families, is the largest group of insurance coverage in the United States today, covering more than 69 percent of the total population. According to the Census Bureau, 60 percent of those with private medical insurance buy into a plan from their employer and the other nine percent purchase individual policies direct form one of the many private health insurance companies such as Aetna, Cigna, Keystone and others.

Major Medical
Of the nine percent of people who buy their medical coverage direct form the insurers, Major Medical is the most commonly purchased. Major Medical private medical insurance offers coverage for catastrophic illnesses, surgeries and other such major medical issues. For example, those who are in a car accident will typically be covered by a major medical policy to some extent. What this coverage pays out is the majority of the cost of services performed by a doctor, hospital, private nursing, follow-up medical care and medical living aids in addition to some prescription costs as well.

While major medical pays for most costs incurred by catastrophic injury and illness, the catch is that most people with major medical private coverage will pay a deductible an in many cases, the deductible is quite large. Sometimes, a deductible can be as large as $5,000 of which comes out of the insured’s pocket before any expenses are paid by the insurance company. On the other hand, the amount of the deductible directly corresponds with the monthly or yearly out-of-pocket premium as well. The typical scenario is that an insured paying a larger deductible will pay less in premiums and vice versa.

The benefits to purchasing any private medical insurance is that the self–employed can usually deduct their medical premiums and deductibles paid out-of-pocket from their taxes, which is also why more self-employed opt for insurance coverage than those people who work for a small business or other employer that does not offer private group insurance to their employees.

Private Group Medical Insurance
Group insurance is private insurance offered to corporations and other businesses or groups of people at a discount of which everyone who opts to purchase the insurance benefits from the discount. Employers who offer this type of private medical insurance generally cover part of the cost for premiums for as long as the employee remains employed with the company. Several packages are offered of which include coverage for major medical, dental, vision and prescription benefits. Employees are given the choice of whether they want only one type of coverage, or a package that includes all forms of coverage.

After choosing, employees typically pay for the premiums by having a small amount deducted from each paycheck equal to the amount of the yearly premium divided by the number of weeks in a year. Corporations and other businesses typically offer group insurance to their employees as part of a complete benefits package. This type of coverage is typically less expensive for the employee because the entire group receives a discount based on all of the members participating.

Main Insurance Options
When purchasing medical insurance, private policies offered are categorized into two main options including fee-for-service and managed care. Fee-For-Service medical coverage in the past offered all services based on a fixed amount paid for each service offered or disease treated by the provider. They could also pay a specific percentage of the amount of the services as well. However, fee-for-service policies of late typically provide reimbursements of monies already paid by the insured.

Managed care organizations include PPOs, HMOs and others. They typically provide a network of doctors and hospitals to the insured. The insured selects a primary care physician who will be responsible for all services provided to the insured. The insured then pay a co-payment to the service provider for the services rendered in addition to the premium for the coverage. Some managed care networks offer out of network services as well. These will typically charge extra for suing the out of service provider and the amount is reflected in the co-payment paid to that service provider. An out of network provider is classified as such because he does not have an ongoing contract with the insurance company for his services.

Medical Rep Jobs - How to Find the Best Medical Rep Jobs [next] [back] Medical Insurance Jobs - Careers in Medical Insurance

User Comments

Your email address will be altered so spam harvesting bots can't read it easily.
Hide my email completely instead?

Cancel or