The Internet & Technology Blog http://kremtronicz.posterous.com The Internet & Technology On the Go! posterous.com Fri, 23 Mar 2012 12:29:00 -0700 Health Coverage Individual Terminology Everybody Should Know http://kremtronicz.posterous.com/health-coverage-individual-terminology-everyb http://kremtronicz.posterous.com/health-coverage-individual-terminology-everyb

Have you ever tried to read the fine lines of your insurance policy and found yourself more confused than before? This is since an insurance contract is a contract of adhesion, this means the terms are unmodifiable and you are not in a position to change the terms through the insurance agent. The terms of health insurance personal or not are actually given to you on a “take it or leave it” situation.

While this is not against the law per se, you should expect that certain sections will be unconscionable to you. To avoid being duped into signing a document that appears alien to you or which unknowingly will not be good for you in the future, it is paramount that you ensure you at least know the health insurance personal terminology that are used in the contract. Primary Care Physician.

This phrase refers precisely to your own physician, the very same one whom you visit for general check-ups and when you are sick. You will often hear your insurance agent refer to this physician as your PCP, so make sure to understand this phrase. Since the Primary Care Physician is your main doctor, he or she also has the responsibility to refer you to specialists if your health condition requires it. If your health insurance personal requires you to designate a PCP, then you are more or less stuck with this physician and you will only be given the chance to see other doctors under the conditions of your coverage subject to the referral of your PCP.

Health Maintenance Organization

You often hear the phrase HMO or Health Maintenance Organization even from the service center of the hospital. This term is also often observed in various healthcare forms.Under the cheap HMO plan, you will be able to get health coverage from physicians who are in a specific network approved by the insurance provider. This is a common plan opted for by the majority of people considering it is one of the cheapest choices. The HMO plan requires you to name a Primary Care Physician and you can bet that his or her referrals will be in to the network of doctors under the HMO. This is inconvenient for those who have been used to being seen by specialty doctors who are not included in the list. If you insist, then your doctor’s fee and other costs will not be covered by the plan.

PPO

The Preferred Provider Organization or PPO works similarly as the HMO only that it is a network of physicians that have a contract with the insurance company. The only difference possibly is that you do not need a Primary Care Physician when your plan has a PPO, making this option more adaptable because it lets you to schedule a health check-up or appointment with any physician belonging to the network at any time. Unlike the PCP and the HMO choices, you still get up to seventy-percent coverage if you prefer to receive care from other doctors out of the network.

Point of Service

Point of Service or POS is a policy that lets you visit a doctor outside of the network.

Basically, the POS requires a Primary Care Physician that will refer you to an in-network physician. But if you choose to see doctors outside of the network, you will still get a little coverage even though not as high as the coverage provided through the Preferred Provider Organization. This is best for people who cannot afford the services of a doctor on a normal basis but who would like health insurance personal protection in case of emergency.

There are many medical terms you need to become comfortably with if you would like to receive the best viable health insurance personal. When you see the term pre-existing condition, it simply means an existing condition that was diagnosed within six months previous to the effective date of coverage. Understanding these principal terms will effectively help you come up with an intelligent decision when choosing a health insurance personal plan.

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