Various types of health and disability income insurance coverage are available to meet your needs. Do not assume you can do without these insurance coverages, even if you are healthy. An accident or illness could quickly deplete your savings, limit your access to care and result in long-term debt.

Health insurance plans may be structured in one of the following ways.
Fee-for-service	Offers the flexibility to see any physician or receive medical services without a primary care physician’s referral. You, or you and your employer pay a monthly premium. Providers bill separately for each medical visit. The insurance company pays all or a set percentage of the fee, usually after you have paid an annual deductible. If applicable, you pay coinsurance, the portion of covered health-care expenses for which you are responsible, usually a fixed percentage.
High-deductible	Can work in conjunction with a health savings account or health reimbursement account. May qualify you to open a Health Savings Account, fund the account with pre-tax dollars and then withdraw funds from the account tax free for federal income tax purposes to pay eligible health-care expenses. Generally have higher annual out-of-pocket maximums than traditional health plans. Preventive care services may be paid after a co-payment. A maximum preventive care amount may apply.
Managed care	Insurance companies contract with physicians and medical service providers, forming a service network in an effort to control costs. You receive financial incentives for using network physicians and other health-care providers. You may be required to choose or be assigned a primary care provider (PCP). You, or you and your employer pay a monthly premium. You generally pay a co-payment for each office visit, prescription and other routine medical expenses. You choose the managed care arrangement right for you. A health maintenance organization (HMO) provides comprehensive medical services for a fixed, prepaid premium. A preferred provider organization (PPO) combines managed care with a traditional fee-for-service arrangement. A point-of-service plan (POS) allows patients to choose from different providers at the time service is rendered.

Before choosing a specific health insurance plan, review the plan’s benefits as outlined in the Summary Plan Description (SPD). Consider the following.

Does the plan cover a chronic illness or pre-existing condition?
Can coverage be easily changed?
What are the plan exclusions?
Can I choose my physicians or hospitals?
Are my physicians in the plan’s network?
Does the plan cover physician visits and hospitalization?

About Premiums

Depending on your situation, one or more of the following health insurance plans may be available to you. Premiums vary with plans.

Plan	Description
Employer-sponsored/Group	Employers generally pay part or all of the premiums for employees, even though they are not required to do so by state or federal law.
Individual	Available if you are in school, between jobs, self-employed or work for an employer that does not provide health insurance. Premiums and benefits can vary widely by plan. You can select coverage that best fits your needs from the company of your choice.
Military	The TRICARE health-care system provides health insurance for active duty, guard and reserve servicemembers, retirees, their families, survivors and certain former spouses. Visit www.tricare.mil for more details.
Federal government	Medicare helps senior citizens and some disabled individuals pay for health care. Call the Medicare Choices Helpline at (800) 633-4227 for details. Medicaid is a joint federal/state public assistance program that pays for health care for individuals with limited income and resources. Check with your state Medicaid office to learn about the coverage rules for your state.

To Lower Costs

Take a higher deductible, especially if you and family members are generally in good health. Save enough money to cover the deductible when you need it.
Participate in your employer’s group medical plan, if available.
Take advantage of preventive care benefits, such as annual physical exams or flu shots.

Next: Disability Income Insurance

Updated Thursday, November 13, 2008

HELPFUL FORMS & LISTS

Tips For Choosing An Insurance Company

Resources For More Information