Health Insurance Quotes in Durham, PA

Compare Health Insurance Plans in Durham, PA

What is health insurance? Health insurance covers a person's medical expenses, including everything from surgery to other health related costs. In the United States, a number of different healthcare coverage options are available. Some options charge the individual an out of pocket expense, later reimbursing them through the insurance company, while others involve the insurance company paying the provider directly. With MyRatePlan, one can compare health insurance rates and coverage in the Durham, PA area, and even get a free quote online.

Most health insurance in Durham, PA comes from either employers or private companies. Senior citizens also have access to Medicare, and low-income individuals are covered through Medicaid. Medicare and Medicaid offer health insurance coverage at a reduced rate, making it more affordable than private plans.

Private insurance plans offer many different levels of coverage. Less expensive plans might only cover catastrophic emergencies, providing people with minimal coverage. More expensive plans, by contrast, often offer complete health coverage. When seeking a healthcare plan, individuals must anticipate their future healthcare needs and choose their plan accordingly.

Types of Health Insurance Policies in Durham, PA

As has been stressed already, there are many different types of medical insurance policies that need to be compared in order to choose the best fit. All such policies do have the tendency to provide similar amounts of coverage. The biggest difference to be analyzed is the wide range of flexibility and accessibility of the policies available in Durham, PA.

HMO (Health Maintenance Organization) policies come with the mandate that the insured party has a primary care provider. A primary care provider is the physician who is in charge of the patient's overall healthcare. For example, if a specialist is needed, the patient must first go his or her primary care provider to get a referral if the primary care provider agrees that such a specialist is good for the patient. These plans tend to have lower premiums than other medical insurance plans, but there is also quite often a limitation regarding the network of doctors that HMO insured patients can see. However, HMOs never have deductibles, and the out-of-pocket costs tend to be significantly less than those of other health insurance plans in Durham, PA.

PPO (Preferred Provider Organization) plans tend to have exceedingly large networks of doctors available to patients. The insurance holder chooses any one of those doctors in the network as his or her primary care provider. Specialists can also be found within this network, meaning that no referral is required as is the case with HMO plans. As long as the patient chooses doctors and specialists within the network, the coverage will be very inclusive. On the other hand, coverage may be more limited, although not usually withheld, if it is necessary to seek medical care outside of the network of providers. Most PPO policies include deductibles, copayments, and annual limits to out-of-pocket spending.

POS (Point of Service) policies in Durham, PA combine the benefits of both HMO and PPO plans. The network of doctors to choose from is sizable but not to the degree of PPOs. There are no deductibles, and copayments remain low so long as the care provider is within the network. On the other hand, deductibles and copayments are quite high if the insurance holder seeks care from a provider outside the network.

These first three types of medical insurance policies are the most common types of health insurance plans found in Durham, PA. There are also some newer approaches to medical insurance that are now available and worth looking into. Among these are the HSA (Health Savings Account), the HRA (Health Reimbursement Arrangement), the FSA (Flexible Spending Account), and the MSA (Medical Savings Account). These are all accounts that rely on funds that the insured individual or employer has reserved in a tax-exempt savings account. All medical expenses, then, are taken out of such an account. It can be used for medical appointments, surgeries, prescription medications, and other treatments occasionally including over the counter medicines. Such plans tend to be highly flexible with regard to ways in which the money can be used. Some even allow for funds to roll over into the next year.

Breakdown of Health Insurance Costs in Durham, PA

You may have heard the term "premium" when it comes to health insurance. A premium is the amount of money you pay monthly to have health insurance coverage. Whether you use your insurance or not, this money is never returned to you. Another familiar term is "deductible." This is the additional money you are required to pay to any healthcare providers before your insurance company starts to make their promised contributions for any medical costs.

Keep in mind that deductibles are different from out-of-pocket costs. A deductible is an annual financial responsibility but out-of-pocket refers to how much you have to spend before your insurance company will pay 100% of your bill.

Deductibles and out-of-pocket costs typically reset each year, with the previous year's expenses having no impact moving forward. So if you have a deductible of $5,000, for example, and you spent $3,000 out-of-pocket last year and your insurance renews with the sample plan in place, your out-of-pocket expenses are reset to $0 and that $3,000 from last year does not roll over. However, some plans in Durham, PA offer an exception to this rule and allow a rollover of your paid deductible amount from the previous year into the first quarter of the new insurance year.

Co-payments, also known as co-insurance, refers to your financial obligation of a medical visit or service. If your co-payment for visiting a primary care physician is $25, then every time you see your primary care physician, you pay $25. From there the insurance covers the balance if the services rendered are within coverage on your plan. Co-payments are not applied toward deductibles.

You may also receive a lifetime benefit from your insurance company. This refers to the maximum amount of money that your insurance company will pay in total for your healthcare. Medical claims will no longer be paid by the insurance company once this maximum amount is reached.

Your employment has a significant impact on the health insurance plans that are available to you in Durham, PA. Working for a large company will likely qualify you for their group health insurance plan. This is usually more affordable than getting individual healthcare, but no one is required by law to participate in these group health insurance plans.

Being self-employed or unemployed presents the option of purchasing private, individual health insurance. If you are a senior and do not work, you are eligible for government financial assistance through Medicare. Low income individuals can apply for government assistance as well, which is called Medicaid.

It is important to check with your doctor to see which health insurance plans they accept in Durham, PA if you want to continue visiting a specific physician. Notify your doctors if your insurance plan changes, and be sure to check with your insurance company regarding any specific questions or concerns about your coverage.

Get a Quote for Health Insurance in Durham, PA

One of the best things a person can do for themselves or their family is to make certain they have access to a health insurance plan in Durham, PA. Life brings on so many ups and downs in regards to health, and these items can affect not only the plan options available but what rates are being applied. Looking forward to all of the aspects of life that can make certain that the right plan is chosen. For example, if a woman plans on having a baby in the future, she needs to make certain that her plan offers maternity coverage and that a new family member can be added to the plan. It is important to note that eliminating coverage to save up-front costs is not the wisest idea in case disaster does strike. Here at MyRatePlan, we want to help people find the right plan for them, so enter your ZIP code for a free quote today.