Understanding Health & Dental Insurance
- Most people start their relationship with health insurance in college or work when they sign up for that first policy. However, there's a lot to know about insurance, or it may get confusing quickly.
According to the American Speech Hearing and Language Association, there are three main categories of health insurance: private (the sort most have from their job), Medicaid and Medicare. The last two programs are government-run, and are meant for those with low incomes or advanced age.
From there, different classes of coverage exist. Many with older relatives have dealt with Medicare Part B prescription plans run by the government. In private insurance, there are HMOs (Health Management Organizations), which "usually have flat co-payments rather than deductibles and co-insurance and no lifetime limits on coverage," according to the U.S. Health and Human Services insurance information site. There are also the more flexible indemnity plans that allow patients to use a wider range of doctors. See Resources for links to more information. - The deductible is a minimum amount that a patient may pay before the insurance company will cover treatment. This amount varies, depending on the policy. Usually, policies with lower monthly premiums have higher deductibles. This deductible may also be applied to lab work. The deductible usually comes into play with hospital visits or emergency care.
A co-pay, on the other hand, is the amount paid by the patient for an office visit with a doctor. The amount of the co-pay may vary, depending on whether the doctor is "in or out of network." If the doctor is in network, meaning that he accepts the company's coverage, the co-pay will be lower (many average around $20 per visit). Out of network, on the other hand, may be a percentage of the base cost or a set fee. - Dental insurance is sold as an add-on to general health insurance. Most policies will allow for several yearly cleanings for free as maintenance care. Further procedures have a deductible or co-pay applied. Usually, a dental premium is very low in cost compared to a health insurance premium.
Dental emergencies may or may not be covered under general health insurance. When purchasing a plan, be careful to read the fine print. Many leading insurance companies have dental plans that can be attached to an already existing policy.
Kinds of Health Insurance
What is a Deductible and Co-pay?
Dental Insurance Basics
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