Health Insurance Quotes in Fajardo, PR

Compare Health Insurance Plans in Fajardo, PR

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 Fajardo, PR area, and even get a free quote online.

Most health insurance in Fajardo, PR 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 Plans in Fajardo, PR

Many types of insurance plans are currently available in Fajardo, PR. However, they vary based on convenience and flexibility. Among the most popular plans are PPO, HMO, POS, HRA, MSA, HSA and FSA.

A Health Maintenance Organization, also called an HMO, is a network that requires the customer to choose a primary doctor who acts as gatekeeper. When the customer needs to see another doctor or any type of specialist, that customer must go through the primary care doctor first. The primary care doctor must assess the patient and determine if he or she needs to see a specialist. If so, the primary care doctor makes the referral to the specialist. A benefit of HMOs is that they are more affordable in that they require low monthly premiums, no deductibles and out-of-pocket expenses are reasonably priced. One drawback is that the patient is generally only seen by a small network of doctors, and this is because many healthcare facilities do not accept HMO plans.

Another popular health insurance plan in Fajardo, PR is the Preferred Provider Organization, also called a PPO. Unlike HMO plans, PPOs generally have a large network of participating providers. The insured person may choose whichever in-network doctor they desire, and specialists can be seen with no referral requirement. Choosing an in-network provider rewards the insured by giving them more coverage to see the in-network doctor. However, going out of network is not a complete loss to the customer, as PPO plans also offer partial assistance for expenses paid to out of network healthcare providers. PPO plans also have drawbacks. While they do limit the yearly out of pocket expenses to the insured, they also require deductibles and co-payments.

A POS, also called a Point of Service plan, utilizes a combination of PPO and HMO services. A POS plan offers a moderately-sized network of physicians as options for primary care doctors. The insured pays no deductibles and pays low co-payments, but only if the insured stays in network. However, the insured must pay a much higher price for co-payments and deductibles whenever treated by an out of network doctor.

In addition to the above options, consumers in Fajardo, PR, also have the option of purchasing a less traditional insurance plan, such as a Health Reimbursement Account (HRA), a Health Flexible Spending Account (FSA), a Health Savings Account (HSA) or a Medical Savings Account (MSA). These four options all require the insured or the insured's employer to set money aside for medical expenses in a tax-exempt savings account. The money is then used to pay for doctors, surgical procedures, prescriptions and other medical expenses. One benefit these plans all have in common is the flexible of how they can be used. Some of the plans even permit the insured to roll the money over and use it the following year.

A person's employment status is a huge factor in determining the type of health coverage offered. Large companies can typically offer a group plan, which is less expensive than a single health insurance plan. However employees are not bound by law to enroll in a group plan.

Unemployed and self-employed people in Fajardo, PR may choose to buy an individual or private plan. Unemployed senior citizens can get Medicare from the federal government, which provides financial assistance. Some people qualify for Medicaid if they have a very low income. Medicaid is a type of government assistance designed to benefit the poor.

Breaking Down Health Insurance Costs in Fajardo, PR

There are several potential costs with health insurance plans in Fajardo, PR. The first is the premium, which is how much the individual pays every month for his coverage. It's essentially a monthly service fee, as the individual never gets this money back.

The deductible is the amount that the individual needs to pay for medical expenses first each year before the insurance provider starts paying its portion. There are also out-of-pocket costs, which are different than deductibles in that out-of-pocket costs are the amount an individual needs to spend each time before the provider pays 100-percent of the bill.

With most plans, the deductible and out-of-pocket costs reset at the beginning of the year, and expenses from the previous year don't factor in moving forward. For example, if an individual's plan has a $5,000 deductible and he paid $3,000 out of pocket one year, his out-of-pocket expenses will go back to $0 at the start of the year. There are plans in Fajardo, PR that allow policyholders to roll over what they paid for their deductibles to the first quarter of a new year.

The co-pay is the amount the individual must pay each time he visits a healthcare facility. If his primary care physician co-pay is $20, he'll pay that every time he visits his doctor. His insurance provider covers the rest of the costs from the visit, provided any services he receives are covered on his plan. Co-pays don't count towards a plan's deductible.

Some insurance plans have maximum lifetime benefits, which are the maximum amount that the provider will pay for the individual's healthcare. If the provider reaches this maximum, it won't pay any further for the policyholder's claims.

A major factor in health insurance plan options in Fajardo, PR is the individual's employment status. Large companies usually have group health insurance plans with lower rates than employees would get purchasing individual healthcare. However, the law doesn't require employees to participate in these plans.

Individuals who are self-employed, such as freelancers and business owners, and those who are unemployed can purchase private, individual insurance coverage. Senior citizens are eligible for financial assistance from the government by getting Medicare. Those who are in low-income brackets can also apply for government assistance through the Medicaid program.

If an individual has a specific doctor he likes, he needs to check the health insurance policies in Fajardo, PR that will allow him to keep seeing that doctor. It's also important that he informs his doctor if his plan changes, and that he contacts his provider if he has specific coverage questions.

Get A Health Insurance Quote In Fajardo, PR Today

Health insurance is one of the most important things you can have for you and your family. A lot of factors can affect health insurance plans and rates, but MyRatePlan makes it simple to get a quote in Fajardo, PR just by entering your zip code. There's a variety of ways you can save money on a health insurance plan, but don't cut out parts of coverage that you actually need. Insurance premiums aren't cheap, but out-of-pocket costs for medical care can be exponentially greater. Let MyRatePlan help you find the best insurance plans so you can save on your health insurance. Get a free quote today.