Health Insurance: Most Popular Articles
The most common types of managed care plans are health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Less common are point-of-service (POS) plans that combine the features of an HMO and a PPO. Learn the differences between HMOs and PPOs.
Learn 6 ways HMO, PPO, EPO & POS health plans differ. Understand how each plan works so you can choose what's best for you. Know what you're buying.
Learn how your out-of-pocket maximum works, what counts towards it, and what you're still required to pay after you've met your out-of-pocket limit.
How much is the penalty for not having health insurance? Learn to calculate your penalty. Don't rely on estimates that can be off by thousands.
Not sure when you pay coinsurance vs copay? Not sure which costs more? Learn the difference between copay and coinsurance and what to watch out for.
Most Americans who have health insurance through their employer (and many who are self-insured) are enrolled in some type of a managed care plan. Managed care plans include health maintenance organizations (HMOs), preferred provider organizations (PPOs), and point of service (POS) plans.
Medicaid is a joint program of the federal and state governments to provide health coverage to the poor and people with disabilities. Each state has different Medicaid eligibility requirements, but as a general rule, children and pregnant women are given priority.
Need to know how much COBRA costs? Learn to calculate your COBRA health insurance premiums and why COBRA costs more than job-based health insurance.
Some health insurance is tax deductible. Learn the ins and outs of using your health insurance as a tax write-off. Find out if you can save on taxes.
Your doctor uses abbreviations (based on Latin words) that tell your pharmacist which medication to give you and directions on how to use that medication. Learning to read a prescription immediately after your doctor writes it will help make sure that you know what medication you are getting. It will also give you a chance to ask questions about your doctor’s instructions.
Have Florida Medicaid Share of Cost? Learn to maximize its benefits without going broke. Use it incorrectly; you'll pay more and miss out on coverage.
Don't know the difference between an EPO and a PPO or HMO health plan? Compare EPO vs HMO and EPO vs PPO health insurance.
Need help paying for health insurance? The premium tax credit health insurance subsidy can help. Learn how it works, how to apply, and how much you'll get.
Supplemental insurance is extra or additional insurance that you can purchase to help you pay for services and out-of-pocket expenses that your regular insurance does not cover. Aside from Medigap policies, three other types of supplemental health insurance are widely sold in the U.S.
A pre-existing condition can affect your health insurance coverage. If you are applying for insurance, some health insurance companies may accept you conditionally by providing a pre-existing condition exclusion period.
Find out how your deductible works, what counts toward it, and when you don't have to pay. Learn the different types of health insurance deductibles.
Learn the meaning of the term “Out-of-Pocket Maximum” from your About.com Guide to Health Insurance.
Explanation of Benefits, insurance claim forms, and medical bills from your doctor or hospital can be difficult to understand because of the use of codes to describe the services performed and your diagnosis. It may be useful for you to learn about these codes, especially if you have a chronic health problem.
Short term disability insurance pays a percentage of your salary if you become temporarily disabled, which means that you are not able to work for a short period of time due to sickness or injury not related to your job.
Can't afford health insurance? Learn about financial aid and subsidies to help pay for health insurance. See if you're eligible; learn how to apply.
Learn what an embedded deductible is and how this type of family health insurance deductible works.
PPOs are more expensive than HMOs, so make sure you know how a PPO works and how it differs from other health plans when you buy health insurance.
The donut hole, or coverage gap, is one of the most controversial and confusing parts of the Medicare Part D prescription drug benefit and of concern to many people who have joined a Part D drug plan. Understanding the donut hole will help you choose a Medicare Part D drug plan.
An Explanation of Benefits (EOB) is a form or document that may be sent to you by your insurance company several months after you had a healthcare service. Your EOB gives you information about how an insurance claim from a health provider (such as a doctor or hospital) was paid on your behalf.
Pregnant? Don't have health insurance? Health plan doesn't include maternity insurance? Get resources for affordable maternity care or maternity insurance.
Learn how your health insurance family deductible works. See examples of the family deductible. Know what you’ll owe when you use your health plan.
HMO or PPO, how do I decide which health plan is best for my family? When you get health insurance from your employer, buy private insurance, join a high-risk plan offered by your state, or enroll in a government-funded program such as Medicaid or Medicare, you may have the opportunity to choose among several health plans.
Learn what health insurance open enrollment is and how it works. Find out why open enrollment periods exist and what happens if you miss yours.
Medicare won't be available to most of us until we turn 65. If you can establish that you suffer from a long-term disability that prevents you from working, you may qualify for monthly Social Security Disability Insurance (SSDI) payments and for Medicare.
Losing dependent coverage under a parent's health plan because you're turning 26? See your young-adult health insurance options. Learn what to do.
Although most people with Medicare get their health benefits from Original Medicare (Parts A and B), you can choose to get coverage from a Medicare Advantage Plan, sometimes called Medicare Part C. These plans are offered by private health insurance companies that are approved by Medicare and have a contract to provide you with Medicare benefits.
If you have been laid off from your job and your former employer has 20 or more employees, the company is required by a 1986 federal law (known as COBRA) to offer you the option to pay for an extension of your health insurance coverage for at least 18 months. COBRA provides you with insurance for you and your family but COBRA can be very expensive.
An open enrollment period for health insurance is typically offered for one or two months a year by many companies to allow employees to make changes to their insurance coverage.
Learn the difference between a health insurance deductible and copayment. See examples of how deductible vs copayment works. Know what you'll owe.
Choosing between COBRA health insurance and an Obamacare health plan on your state’s health insurance exchange? See how they compare.
What's the difference between Medicare and Medicaid? It goes beyond one being for the elderly and the other for the poor. Learn the other differences.
Learn how the bronze, silver, gold & platinum system works and what it really tells about a health plan's value. Find out which tier is best for you.
Learn what a health insurance exchange is. Find resources to help you understand how you can use a health insurance exchange, and how these health insurance marketplaces will affect you.
Learn the meaning of the term “premiums” from your About.com Guide to Health Insurance.
Balance billing may happen when your health plan pays less than what your doctor or hospital charges and want to be paid. Your healthcare provider may demand the balance of the bill from you. Some people do not know that this is inappropriate and pay what is being asked.
Buying health insurance is the only health coverage option for some consumers. Even if you have health insurance from your employer, private insurance may still be an option to save money. With your health insurance premiums increasing every year and some employers passing more of the costs onto their employees, your company's health insurance may not be the best deal.
Learn how to qualify for a health insurance exemption if you're uninsured and don’t want to pay a tax penalty.
Want to lower your income taxes by writing off your medical expenses? Here’s what you need to know about the tax deduction for medical expenses.
Learn what an aggregate deductible is and how this type of family health insurance deductible works.
Learn the difference between deductible and coinsurance so you'll know how much you owe when you use your health insurance.
See open enrollment dates for 2015, 2016 and beyond. Learn when your coverage starts and what to do if you miss open enrollment on your exchange.
There are many things that determine how much your health insurance will cost you each month. How much health insurance will cost you depends on your age, the condition of your health (how healthy or unhealthy you are), where in the country you live, your income, and your job status.
Health Savings Accounts (HSAs) are a type of account that you can put money into to save for health-related expenses on a tax-free basis. If you decide to open an HSA, you must have a high-deductible health plan (HDHP).
Bigger than expected medical bill? Learn what balance billing is and how it works. Learn when balance billing is legal, and when it’s illegal.
Learn what, exactly, EPO health insurance is and how an EPO health plan works.Understand how to use an EPO correctly; don’t make an expensive mistake.
Have to pay a penalty tax because your family doesn’t have health insurance? How much is the family penalty? Simple charts and estimates can be off by hundreds or even thousands of dollars. Learn to accurately calculate your family’s health insurance penalty so you’ll know what you owe.
Find out what federal poverty level is and why it matters in health insurance. Learn 3 things you must know about FPL and health insurance subsidies.
Losing your health insurance? Think you can’t get a health plan on your health insurance exchange because it’s not open enrollment? Think again.
If you are pregnant or thinking about expanding your family in the near future, you may be concerned with how much your pregnancy will cost. Read on to find out how much your insurance is likely to cover.
If you use your health insurance, you might run up against a claim denial. It's usually worth fighting your denial.Fortunately, routes are available for disputing claim denials, including getting help from the government in many states. Sometimes your insurer will surrender and pay your claim to avoid the expense of handling an appeal.
Think you may lose your health insurance? Learn whether you’re eligible for COBRA health insurance so you can stay with your current health plan.
A drug formulary is a list of generic and brand name drugs that are preferred by your health plan. Since your health may limit the medications it will pay for, it is important for you understand your health plan's drug benefit and formulary.
Don't get stuck with bills your health insurance won't pay. Learn 5 common things not covered by health insurance. Know what's covered and what's not.
Medicare Part B, also known as the Medical Insurance program, helps cover the costs of medical services, such as your doctor's care and prevention services for the early diagnosis and treatment of illness. If you are 65 or older, you are automatically eligible for Medicare Part B.
Have a high deductible health plan? Learn how your HDHP family deductible works and how it differs from family deductibles in other health insurance.
Find out how to qualify for a hardship exemption so you won't have to pay the health insurance penalty tax. Get the details, not just the basics.
Learn how an HMO works in order to use it effectively and avoid costly mistakes. If you're choosing a plan, make sure an HMO will fit your needs.
At open enrollment time, look at the plan options your employer offers. You may be able to save money by switching to your spouse's health coverage.
Your Explanation of Benefits is a window into your medical billing history. Many doctors’ offices, hospitals, and medical billing companies make billing errors. Such mistakes can have annoying and potentially serious, long-term financial consequences.
Need health care but can't afford your health insurance deductible? Get ideas on how to pay your deductible when you don't have money but need care.
If you plan to travel to a foreign country, it is important that you provide for your medication needs before leaving. An illness in the middle of your trip can ruin your vacation and cost you money to get needed medications.
If you have lost your job, you may be worried about the loss of your employer-based health insurance. To protect you and your family, it is important to try and find some type of health insurance plan during your period of unemployment. Fortunately, if you are handed a pink slip, you do have options to remain insured.
Medicare is a federal government program that provides health insurance for people age 65 and older,
What is the Affordable Care Act? What reforms does it create? Get a basic understanding of the Act as well as resources for more in-depth information about the Affordable Care Act.
Learn the meaning of the term “Coinsurance” from your About.com Guide to Health Insurance.
What is a silver health plan? Who should buy silver-tier health insurance; who shouldn't? How does a silver plan differ from bronze, gold, or platinum?
Learn more about what happens when a retiree turns 65.
Hospitalized in observation status rather than inpatient? Learn what observation status is, how observation guidelines work, and why you'll pay more.
Learn the meaning of the term “Deductible” from your About.com Guide to Health Insurance.
Learn the meaning of the term “Medical Necessity” from your About.com Guide to Health Insurance.
Missed Obamacare open enrollment? Find ways to avoid being uninsured, what will happen if you are uninsured, and how to avoid the tax penalty.
Learn about out-of-network providers.
Not sure what Obamacare is? Is it private health insurance, a social welfare program, a law? Can people actually “enroll in Obamacare”? Get answers here.
A number of health care benefits are mandated by either state law, federal law—or in some cases—both. Although mandates continue to be added as health insurance requirements, they are controversial and may impact health reform legislation.
Being billed for the balance due on a medical bill after you and your health insurance have already paid? Learn strategies to handle balance billing.
Going to college is one of the most important things you can do to secure your financial future. But what happens if you get sick or injured while you're there? Accidents and sudden illness can happen to anyone at any time. So it's important to make sure you have health insurance coverage.
Buying drugs in Canada and other foreign countries can save money. Due to the high price of prescription drugs, many Americans buy their medications by crossing the border into Canada and Mexico or when they travel to a foreign country.
Waiting to buy health insurance until you need to use it? Think you’ll save money? There are three reasons why waiting to buy health insurance won’t work.
Dental insurance is meant to help cover some of the costs associated with your dental care. Although regular dental services, including regular checkups and preventive services, such as cleaning, is relatively inexpensive, dental procedures such as dental implants and crowns are expensive.
The donut hole, or coverage gap, is one of the most controversial and confusing parts of the Medicare Part D prescription drug benefit. There are ways to save money on medications when you hit the donut hole and ways to actually prevent either getting to the donut hole or delaying when you hit it.
Medicare Part A, also known as the Hospital Insurance program, helps cover the costs of inpatient care in hospitals. Learn more about how to qualify.
The health reform legislation (Patient Protection and Affordable Care Act) signed into law in March 2010 by President Obama creates state-based health insurance exchanges. The purpose of the health insurance exchanges is to make health insurance more affordable and easier to purchase for small business and individuals.
While Original Medicare (Parts A and B) will most likely pay for most of your hospital, skilled nursing facility, and outpatient medical expenses, you still will have out-of-pocket costs. So, you may want to consider a Medigap plan to help pay your out-of-pocket costs such as hospital deductibles, coinsurance charges, and copayments
Learn what case management is and who does it. See examples of how the case management works in hospitals, health insurance companies, and home health care.
Learn what a health insurance provider network is and how it works. Understanding it is essential to choosing and using your health plan wisely.
The purpose of the legislation is to assure that all Americans have access to affordable health insurance. The key reforms in the Affordable Care Act should significantly decrease barriers for obtaining health coverage as well as accessing needed health care services.
Don’t be a babe in the woods. Learn 7 key health insurance concepts crucial to understanding your health plan and using it wisely.
Medicare Part D allows people over age 65 to choose from a number of prescription drug plans (PDPs) that offer a set of basic prescription services. Before joining a Part D drug plan, it is important you understand and are comfortable with your choice.
Need a lower out-of-pocket maximum? Learn how an Affordable Care Act health insurance subsidy can lower it. Find out who's eligible and how it works.
Health insurance deductibles and copays too high? Learn how an Affordable Care Act subsidy lowers them. Learn who's eligible and how it works.
Learn what a shared responsibility payment is, how it might affect you, and how it came about. If you or your business is at risk for a shared responsibility payment tax penalty, get resources to help you learn what to do.
Learn the meaning of the term “Medically Needy” from your About.com Guide to Health Insurance.
Learn the meaning of the term “Prior Authorization” from your About.com Guide to Health Insurance.
What is Medicaid? A huge social welfare program, Medicaid is government health insurance for low income people. Learn who can get it and how it's paid for.
Don’t let your Medicare coverage get lost in the shuffle when you move. Learn what you need to do about your Medicare coverage when moving, how to submit a change of address to Medicare, and whether or not you need to choose a new plan if you have Medicare Advantage,Medicare Select, or a Medicare Part D plan.
Medicare is the federal program that provides health insurance coverage for Americans age 65 and older and younger people with certain types of disabilities, including end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant). If you (or your spouse) have contributed payroll taxes to Medicare throughout your working life you are eligible for Medicare when you reach age 65, regardless of your income or health status.
Learn what the premium tax credit health insurance subsidy is and how it can help you pay for health insurance.
A primary care physician is your main doctor and manages most of your medical issues. Learn what a PCP does, why you need one, and who can be a PCP.
Learn the meaning of the term “Copayment” from your About.com Guide to Health Insurance.
Learn what a health insurance special enrollment period is, who qualifies, and how to sign up for health insurance when it's not open enrollment.
Choosing a health plan? Educate yourself with these resources before you shop for health insurance. Understand exactly what you're buying.
Find out if you’re required to have health insurance and what will happen if you don’t get it. Learn how to enroll in Obamacare and how to get a subsidy to help pay for health insurance.
If you cannot afford to buy private health insurance and your family earns too much to qualify for Medicaid, you may be eligible for CHIP, the Children's Health Insurance Program.
No health insurance? Prepare for being uninsured with this tool kit. Get strategies to deal with problems before they arise. Learn to decrease risks.
Learn more about referrals and when your health insurance may require them.
Learn more about your options when a medical procedure recommended by your doctor isn't covered by insurance. Sometimes, it is possible to negotiate with your doctor and insurance company for the best deal.
Medicaid can take back the money it spent on your healthcare after you die by taking funds meant for your heirs. Find out if your estate might be at risk.
One of the more controversial parts of the health reform legislation is the issue of a health insurance mandate – the requirement that, starting in 2014, all Americans must have healthcare coverage. The vast majority of people in this country have health insurance through work or a public plan such as Medicare and Medicaid.
Think the tax penalty for being uninsured is $95? Think again. It's a percentage of your income. Learn what else you need to know about this penalty.
When choosing a dental insurance plan, it's optimal to look for a plan that covers not only your current needs, but the dental care you and your family may require in the near future.
Learn what cost-sharing is and how it impacts your budget. Find out what’s included in cost-sharing and why health insurers require it. Learn how your cost-sharing can be limited or lowered.
Learn more about open enrollment, and what you can do if you miss your plan's open enrollment period.
: Some health insurers require pre-approval, also known as pre-certification, for certain types of healthcare
Do you reach your out-of-pocket maximum each year? Learn two techniques to save money if you reach your health plan's out-of-pocket limit each year.
What is a bronze health plan? Would a bronze plan be a good choice for you, or not? Who should avoid bronze-tier health plans?
What's platinum health insurance? Who should buy a platinum-tier health plan; who shouldn't? How does a platinum health plan differ from bronze, silver,or gold?
Learn the meaning of the term “Reasonable and Customary Fee” from your About.com Guide to Health Insurance.
When Stupid Mistakes Cause Health Insurance Claim Denials
Find out what the Michael Moore film Sicko is all about, and whether you should see it.
Many situations call for out-of-network care, and some of them won't cost you more than participating providers.
Learn how the Hospice Medicare Benefit, or HMB, works. Find out what it pays for and what it doesn't, who's eligible, and how to get it.
Medicare’s late enrollment penalty is an amount that is added to your Part D monthly premium. You may owe a late enrollment penalty if you did not join a Medicare Part D drug plan when you were first eligible for Medicare
Why is the cost of health care so expensive? Why does the cost of health care increase faster than inflation? There is one single reason that overshadows all the other factors contributing to the rising cost of health care. Read more to learn what's responsible.
To protect you and your family from the financial burden of sudden or chronic health conditions, it is important to have health insurance. There are many factors to consider and questions to ask when choosing a health insurance plan.
One of the significant provisions in the health reform law that is being implemented in 2010 is an extension of dependent coverage to assure that all young adults have affordable health insurance. Many parents and their young adult children who worried about losing health insurance after their children moved away from home or graduated from college no longer need to worry.
Elective surgery -- which often improves quality of life, rather than saves it -- is, by definition, a choice, not a mandate. Some of these procedures are covered by health insurance companies, others are not.
Mail order drugs may be available through your health plan or Medicare Part D. Mail order drug programs are convenient and can save you money.
Are Obamacare rumors true, or are they just fear mongering and urban legends? Learn what's true and what's not regarding the Affordable Care Act.
It pays to take advantage of preventive health benefits like gym memberships and smoking cessation programs included in your health insurance policy.
Think a health care provider is just insurance lingo meaning doctor? Think again. Discover what a provider really is and why it should matter to you.
Finding the right doctor to help you with your healthcare needs is very important. The relationship you develop with your physician greatly influences the health decisions you make and, in due course, your wellbeing.
Eligible for an exemption from health insurance? Learn how to apply for a health insurance exemption and avoid the tax penalty for being uninsured.
What happens when a billion-dollar system is excessively complex and disconnects the shopper from the bill-paying? Upcoding fraud happens. Upcoding takes
To learn how much of an upcoming surgery is covered by health insurance, ask your surgeon for a breakdown of what your procedure normally costs and what preparation, care and supplies will be necessary both before and after surgery. Then, read the health plan summary patients receive upon insurance enrollment. Inside this booklet, insurance companies typically list covered and excluded costs for preventive to emergency care and everything in between.
What is a gold plan? Who should buy a gold-tier health plan, and who shouldn't? How does a gold health plan differ from bronze, silver, and platinum health insurance plans?
Learn the meaning of the term “creditable coverage” from your About.com Guide to Health Insurance.
Whether you have prescription drug coverage or not, if you use generic medications when appropriate for your health condition you can save money – often more than 50% less than the brand name drug. But, are generic drugs safe? According to the U.S. Food and Drug Administration (FDA), generic medications are as safe and effective as the brand name equivalent.
Learn about self-funded health plans and how they differ from fully insured plans
Learn what the Medicaid Share Of Cost program is, who gets it, and how it serves the medically needy.
Help! My Health Plan Says the Care I Need Isnt Necessary
A health insurance exemption excuses you from the requirement to buy health insurance and lets you avoid the tax penalty for being uninsured.
Are you running out of time and ways to spend money you've set aside in an FSA? Here are the 10 best ways to spend your remaining Flexible Saving Account dollars.
Definition and explanation of the term
Major medical defined. Health Insurance.
Learn what a DRG is, how DRGs work, and why Medicare and health insurers use them to pay hospital bills. Learn where to get a list of current DRGs.