An Introduction to Health Insurance

Henderson Insurance Agency of Harrisburg, PA understands how confusing health insurance can seem. We’re here to explain the basic though, so you can make an informed decision.

Health insurance comes in two main forms – private and public. An individual normally obtains a private health insurance policy from their employer or school or by purchasing it directly. A public health insurance policy comes from the government through a program such as Medicare or Medicaid or an agency including the Veteran’s Health Administration and the Indian Health Service.

While both types generally require a premium payment, usually on a monthly basis. This keeps the policy open and active.

While every health insurance plan differs in coverage, in general, they pay for or defray the cost of visiting a health care provider. This can refer to a doctor, hospital, physical therapist, etc.

Some insurance plans offer fully covered wellness visits, while others require a co-pay for a simple annual checkup. The co-pay, or portion the insured pay out of pocket for each visit, varies by plan and insurer.

Even among private insurance plans, there’s no single type. You can choose from five major types of plans:

  • managed care plans provide the insured with a network of lower-cost healthcare providers from which to choose. This plan type charges a penalty or fee for treatment by an out-of-network provider.
  • indemnity plans also called fee-for-service plans, provide a greater choice of providers since the insured can choose nearly any place of treatment. The insurer generally pays about 80 percent of the treatment cost, while the patient pays the rest.
  • health maintenance organizations (HMOs) directly provide medical care to the insured. They have negotiated fees with each healthcare provider. The policy usually assigns a primary care physician to the patient to coordinate all necessary care.
  • preferred provider organizations (PPOs) resemble indemnity plans because they let the insured visit any doctor. Like an HMO, the PPO has negotiated fees with each healthcare provider. It pays for part of an out-of-network provider visit and patients can go to a specialist without a referral.
  • point-of-service (POS) plans let the insured mix and match the best from an HMO and PPO. It lets the insured pick between having a primary care physician coordinate treatment, getting treatment within the provider network and visiting non-network providers.

Picking a health insurance plan helps you pay for wellness care and emergency care. It is important to choose the right plan though so you do not trap yourself for a year or more since in the US, you must wait until open enrollment to switch coverage unless you meet a legal exception.

Call us at Henderson Insurance Agency of Harrisburg, PA for other questions about health insurance. We’re here to help you get the coverage you need.

High risk life insurance

Life insurance is very cheap if you are young and healthy, but sometimes people are in dangerous situations and that increases the risk a person faces. This may make life insurance companies hesitant to cover certain situations. Military personnel in a war zone are covered by a program with the Dept. of Veterans Affairs.  Life insurance can get complicated, so contact the Henderson Insurance Agency in Harrisburg, PA to get help in understanding the details of life insurance.

Soldiers are automatically covered with a $400,000 death benefit. Most life insurance policies have a war-zone exclusion for general citizens in their policies. 

Things like smoking, or any kind of tobacco use, is also considered a risk for insurance companies. You may have to pay higher premiums as a smoker, and in some cases, you may not be able to get insurance. If you have a pre-existing condition you may also have trouble getting life insurance, but it depends on what the pre-existing condition is and how far advanced it is. If you have cancer, for instance, you may not be able to get life insurance, but if you have something like diabetes you may be able to get overage at a higher price.

Race car drivers were once considered high risk, but not so much in recent years. High-risk professions and hobbies can cause your rates to go up, but there are guidelines that assess you much of a risk you face. Stop by the Henderson Insurance Agency in Harrisburg, PA to learn more about life insurance. You may also visit us online and get more information about high-risk situations you may face.  Usually, we take a case-by-case approach and determine how much risk an individual is facing as opposed to just using a formula to set rates.