What is a PPO?
What is an HMO?
What is an HSA?
What is a POS?
What is an Indemnity Plan?
What is provider?
What is a Primary Care Physician (PCP)?
What is an office visit co-payment?
What is a deductible?
What is the difference between and in-network and an out-of-network medical
provider?
What are my options for making my first payment?
Can I buy health insurance for less if I go directly to the insurance company?
What does "approval" or "declined" mean?
I noticed that you do not offer health insurance in my state. When will it be
available in my state?
How can I be sure that my data is kept secure and private?
Q) What is a PPO?
A PPO is a Preferred Provider Organization. As a member of a PPO, you can use
the doctors and hospitals within the PPO network or go outside of the network
for care. You do not need a referral to see a specialist.
If you obtain care from a medical provider outside of the PPO network, you will
pay more for the service. For example, a PPO might pay 90 percent of the cost
for a visit with an in-network doctor but only 70 percent of the cost for a
visit to a non-network doctor.
You will typically pay a co-payment for each visit/service. These co-payments are
typically higher than an HMO co-payment but not always.
You will usually be responsible for paying an annual deductible.
If you join a PPO, you should find you have more flexibility than with an HMO,
but your total out of pocket costs are likely to be somewhat higher.
Q) What is an HMO?
An HMO is a Health Maintenance Organization. As a member of an HMO, you select a
primary care physician from a list of doctors in that HMO's network. Your
primary care physician will be the first medical provider you call or see for a
medical condition. He or she will make any needed referrals to a medical
specialist. Typically, these specialists will be part of the HMO network.
If you obtain care without your primary care physician's referral or obtain care
from a non-network member, you may be responsible for paying the entire bill.
(with exceptions for emergency care)
With some HMOs, you pay nothing when you visit in-network doctors. With other
HMOs there may be a small co-payment for the visit or service.
With most HMOs you will not be responsible for paying a deductible.
If you join an HMO, you should find that you have few out-of-pocket expenses for
medical care -- as long as you use doctors or hospitals that are part of the
HMO.
Q) What is an HSA?
An HSA is a Health Savings Account. It is a tax-advantaged personal savings
account used in conjunction with a high deductible health policy. Individuals
can contribute money to this account on a pre-tax basis to set aside money for
qualified medical care and expenses, including annual deductibles and
co-payments.
Q) What is a POS?
POS is a Point-of-Service Plan A type of managed care plan combining features of
health maintenance organizations (HMOs) and preferred provider organizations (PPO's).
You can decide whether to go to a network provider and pay a flat dollar or to
an out-of-network provider and pay a deductible and/or a coinsurance charge.
Q) What is an Indemnity Plan?
An indemnity plan is commonly known as a fee for service or traditional plan. If
you select an Indemnity plan you have the freedom to visit any medical provider.
You do not need referrals or authorizations; however, some plans may require you
to pre-certify for certain procedures. Most indemnity plans require you to pay a
deductible. After you have paid your deductible, indemnity policies typically
pay a percentage of "usual and customary" charges for covered services; often
the insurance company pays 80% and you pay 20%. Most plans have an annual out of
pocket maximum and once you've reached this they will pay 100% of all "usual and
customary" charges for covered services.
Many health insurance companies have moved away from indemnity plans and are
instead offering managed care plans such as HMOs and PPO's. You may have few or
no indemnity plan choices in your area.
Q) What is a provider?
A provider is a hospital, health care facility, physician or other medical
professional that provides health care services.
Q) What is a Primary Care Physician (PCP)?
A physician or other medical professional who serves as a group member's first
contact with a plan's health care system. Also known as a primary care provider,
personal care physician, or personal care provider.
Q) What is an office visit co-payment?
An office visit co-payment is a fixed dollar amount or a percentage that you pay
for each doctor visit. For example, with some plans you may pay a fixed amount
such as $5 or $10 per visit. Other plans will charge you a percentage of the
total fee for the visit. So if your co-payment is 10% and the doctor visit was
$200, you would pay 10% which, in this case, would be $20.
Q) What is a deductible?
A deductible is the amount of annual medical expenses that a health plan member
must pay before the plan will begin to cover expenses. For example, if your plan
has a $500 deductible, you will pay the first $500 of your medical expenses
before your health plan begins paying the expenses. Only expenses for covered
services apply towards the deductible. For example, if you paid $100 for a visit
to a chiropractor but the plan does not consider chiropractic care a covered
expense, then the $100 will not apply toward your annual deductible.
Q) What is the difference between an in-network and an out-of-network medical
provider?
An in-network medical provider is within the approved network of providers for a
particular health plan. Out-of-network providers are not on the list. If you
visit a doctor within the network, the amount you will be responsible for paying
will be less than if you go to an out-of-network doctor. In many cases, the
insurance company will not pay anything for services your receive from outside
their network; however, there are exception to this.
As a general rule, HMOs tend to have smaller provider networks than PPO's. In HMO
and PPO plans, referrals to specialists will be to doctors within the network.
Indemnity plans typically do not have networks; you go to whatever doctor you
want. Please note that all instant quotes only show in-network providers, unless
you view the benefits link.
Q) What are my options for making my first payment?
You can usually make your initial payment by credit card or check. The payment
must be made out in the name of the insurance company. However, some insurance
companies may require a check for the initial payment. Normally, your credit
card will not be charged nor will your check be deposited until you have been
approved. If you are not approved for coverage by the insurance company, your
money will be refunded by the insurance company. Any financial information
submitted over the web is kept private and secure. Once accepted as a plan
member, all bills will be sent from the health insurance company and you will
pay them via the choices offered by that company
Q) Can I buy health insurance for less if I buy directly from the insurance
company?
No. Insurance companies charge the same premium whether the plan is purchased
directly from the company, through a broker, or online through us. But remember
we are here to provide the best plan for your situation, so you will an
opinion for many companies not just one company.
Q) What does "approval" or "declined" mean?
Insurance companies approve or decline an application after evaluating the
applying family's health history. This process is called medical underwriting,
and it often requires review of medical records, health history, and health
insurance history. We are very skilled at helping our customers through
the underwriting process.
An approval means that the insurance company is willing to insure those
applying. So approval packets often contain the insurance policy/certificate and
insurance ID cards. Sometimes, approvals have conditions attached, such as, rate
adjustments, not covering all family members, or excluding coverage for a
pre-existing health condition for up to 12 months.
A decline means that the insurance company is not willing to insure those who
applied. If declined, then the insurance company will refund all payments,
except for any non-refundable fees. Anyone who is declined should not lose hope.
Often, a different insurance company will gladly cover a family who has
been declined. Underwriting practices vary greatly between different
insurance companies.
Q) I noticed that you do not offer health insurance in my state. When will it be
available in my state?
We are currently rolling out the service throughout the US. Please send us your
email address so we can notify you as soon as our service is available in your
area.
Q) How can I be sure that my data is kept secure and private?
At eWebInsurance, we are committed to protecting your privacy. eWebInsurance will not sell your personal information to
anyone, except those specifically involved in the referral or processing of your
health insurance quote or application. Additionally, we use industry leading
technologies to ensure the SECURITY of the information is under our control and used appropriately.
If you have any questions about our privacy statement, our company policies and
procedures or your experience with our site, you can contact us
.
|
Get a Quote
Compare Plans
Apply Online
