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DEDUCTIBLE IS NOT A DIRTY WORD
INSURANCE WAIVERS/RIDERS, RATE-UPS, & CAPPED COVERAGE
WHAT'S A “RIDER”? WHAT'S A “WAIVER”?
PRE-EXISTING CONDITIONS
WHAT'S
A “PRE-EXISTING CONDITION”?
EXCLUSIONS
WEIGHT, WEIGHT CHARTS AND HEALTH INSURANCE
AGE AND INSURANCE PREMIUM
UNDERWRITING
- WHAT IS IT?
TRIP OR HEALTH INSURANCE -- WHAT'S THE
DIFFERENCE?
AMERICAN PPOs & HMOs - WHAT'S THE
DIFFERENCE?
HIPAA / PORTABILITY INSURANCE
THE DIFFERENCE BETWEEN AN INSURANCE BROKERAGE & AGENCY
WHAT IS A “CERTIFICATE OF INSURANCE”
THE “PRE-EXISTING CONDITION” PROBLEM?
WHAT IS CO-INSURANCE?
UNDERWRITING
AT THE POINT OF APPLICATION
HOW DOES AN INSURANCE COMPANY DETERMINE
PREEXISTING CONDITIONS?
WHAT TO DO WHEN THE WEIGHT CHART SAYS YOU AREN’T TALL
ENOUGH?
AMERICAN PPOs & HMOs - WHAT'S THE DIFFERENCE?
In
an HMO (Health Management Organization) you must choose a PCP (Primary
Care Physician). This physician will be your "Care Manager"
in the health care system. Your PCP, if he finds it necessary, will
generally refer you to a specialist working within the HMO. He directs
all of your medical care, making sure you don't receive unnecessary services.
Sometimes the PCP is referred to as the "Gate Keeper" because he
opens the gate and directs you to other providers within your HMO system.
A PPO (Preferred Provider Organization) is a network of medical and health care providers who agree to provide services for a specific amount and adhere to medical utilization guidelines. In a PPO you do not have a Primary Care Physician (although you may choose to have a physician function in that way). Instead you are given a list of physicians that work within a network. You can choose any physician you like and a different physician every time you have a medical need as long as you choose them from the list of doctors provided by the PPO, that is, as long as the physician is in the PPO network. Some PPOs have thousands of physicians in their network.
Some people feel HMOs are better than PPOs because they generally hold down the cost of premiums. They do this because the physician controls the extent of the care given. Others feel PPOs are better because the patient has more freedom and say in the choice of physicians and treatment.
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