An employer selects a group health insurance plan and invites the employees to enroll. Generally, the employer covers at least 50% of each employee’s monthly premium. Some employers also contribute to dependent premiums. The individual employee pays for the rest of the cost.

Types of group health insurance plans
Group health insurance plans are categorized into two major classes. One type is indemnity plans (known as “traditional indemnity,” “fee-for-service,” or “FFS” plans) and the other managed care plans. These two types of plans differ in their basic approach. The major differences are on choice of providers, quantum of out-of-pocket costs for the services offered, and method of paying the bills. Indemnity plans offer you a wider choice of doctors (including specialists and surgeons), hospitals, and other health care providers. A managed care plan involves less out-of-pocket costs and lower level of paperwork.

Indemnity plans were very popular all over the US once but are not as popular today. They are still common on the east coast. Managed care plans now dominate the general health insurance market. They are more dominant in the western parts of the country. The managed care plans are primarily of three types: PPOs, HMOs, and POS plans.

Advantages
If you want to provide health insurance benefits to your employees, group health insurance is the right way to do it. It benefits the owner of the company as well as the employees. Offering a group health insurance plan can help you hire and retain the best workers. The premium you pay is normally tax-deductible. Since continued non-break medical insurance is necessary for all, group coverage also protects workers or they family members.

What are “benefit riders?”
Benefit riders are add-on insurance policies that are not typically covered by the standard health insurance plan. These are additional health-related services like Dental services which is typically not covered under a health insurance plan. Usually, benefit riders are available only when you buy a group health insurance plan.

ZIP codes and health insurance rates
Cost of medical care varies from state to state and area to area. Hence health insurance rates also vary. This cost variation is due to the general cost level of the area, differences in regulations regarding medical practices, the level of specialization of services and the level of competition in an area. Most small group health insurance plans vary their rates depending on the ZIP code. The employer’s business address normally determines the ZIP Code to apply.

How to determine if a company qualifies for group health insurance
A company becomes eligible for a small business health insurance plan if it meets the following criteria:

1. The company has two or more full-time owners, partners, officers, and/or employees. This must be verifiable by officially-filed state quarterly wage and tax statements or by the annual federal tax return documents;
2. The company must be a legitimate business entity. This is to be verifiable one of the following: A business license; Articles of incorporation; or Articles of organization.
3. The company must meet the minimum employer contribution percentage expected by the insurance company.

Benefits of group health insurance
Surveys have demonstrated that workers consider health insurance coverage very important, second only to monetary compensation. Offering group health insurance benefits becomes a basic necessity for an employer and this will make it easier to hire and retain the best workers. Even the business owner can insure the owner and family through a group insurance provided by the company.

Additionally, group health insurance plan provides various tax incentives to the employer and employees. Businesses can deduct 100% of the premiums for group health plans. By offering group health insurance as part of a total compensation package, there will be reduction in payroll taxes. The employees can deduct their contribution to the insurance premium as expenses.

Affordable group health insurance
It is not always necessary to be employed to get the benefits of group health insurance. This is an overlooked source of low cost group health insurance. You may be a member of specific organizations offering health insurance coverage. Although these organizations do not pay the health insurance premiums like an employer does, the cost of insurance would be lower than individual insurance because of the group discount. So, it is worthwhile figuring out the organizations you are a member of to consider any group health insurance they may offer. You can also do research and find out organizations that provide group health insurance and become member of such groups. You could also ask current organizations in which you are already a member to organize and obtain group health insurance quote and offer the group insurance plan to its members.

Types of plans
Medicare Advantage Plans are offered by private companies and they come in different types that may be classified as:

• HMOs (health maintenance organizations)
• PPOs (preferred provider organizations)
• Private Fee-for-Service Plans
• Medical Savings Account Plans (MSAs)
• Medicare Special Needs Plans

HMO Plans
Under HMO plan, you will generally get your health care and services only from the doctors or hospitals in the plan’s network (except for exceptions like emergency care, out-of-area urgent care, or out-of-area dialysis). In a few plans, you can go out-of-network for certain services generally for a higher cost. Generally, HMO plans cover prescription drugs. However just ask and ensure that your plan does. In most cases, you need to get a referral to see a specialist.

PPO Plans
In PPO plans, you will have to use a network of doctors and hospitals, but you can also use out-of-network providers for covered services, usually for a higher cost. Prescription drugs are generally allowed. You are not required to get a referral to see a specialist.

PPFS Plans
You can use any approved doctor or hospital that would accept the plan’s payment terms and who agrees to treat you. Not all providers may. If you join a PFFS Plan that has a network, you will usually have to pay more to see out-of-network doctors. If your PFFS Plan does not offer drug coverage, join a Medicare Prescription Drug Plan to get coverage. You do not require a referral to see specialist. Doctors, hospitals, and others may decide on a case-by-case basis not to treat you even if you’ve used them before.

MSA Plans
You can go to any doctor of your choice. Some plans do provide preferred doctors who would be cheaper. Prescription drugs are not generally covered. Medicare MSA Plans have two parts. They are: a high deductible health plan and a specific bank account. Medicare allots the plan a prefixed amount each year for your health care, and the plan deposits a part of this money into your account. The amount deposited will be less than your deductible amount, so that you will have to pay out-of-pocket before your coverage begins.

Special needs plan
You generally must get your care and services from doctors or hospitals in the plan’s network. All special needs plans cover prescription drugs. You need a referral to see a specialist. A plan must limit plan membership to people in one of the following groups a) people who live in certain institutions like a nursing home or those who require nursing care at home, or b) people who are normally eligible for both Medicare and Medicaid, or 3) people who have one or more chronic or disabling conditions like diabetes, congestive heart failure, a mental health condition, or HIV/AIDS.

Who Can Enroll in a Medicare Advantage Plan?
You can generally join a Medicare Advantage Plan if you meet the following conditions: a) You have Part A and Part B, b) you live in the service area of the plan and c) you do not have End-Stage Renal Disease (ESRD) – permanent kidney failure requiring periodic dialysis or a kidney transplant.

Individual dental insurance is possibly the most widely adopted type of private. Obtaining an individual dental insurance is very affordable, and hence many people take responsibility for that coverage as a stand-alone policy or as a supplemental policy to their group dental coverage.

If you are a self-employed person and have had to visit a dentist, you will realize the need for buying individual dental insurance coverage. Most individual best dental insurance plans emphasize preventive dental care, because in the long run, it lowers costs due to poor dental hygiene and lack of periodic dental check-ups and cleanings.

How Dental Insurance Works
For a specific monthly rate, you are entitled to the full dental benefits. This generally would include x-rays, cleanings and regular checkups. Other services that help promote general dental health are also included. While some plans provide a wider coverage, others may require a larger financial contribution at the time when services are utilized. Some dental insurance for individuals provide for coverage during dental implants, specific oral surgeries, or orthodontia.

Types of Dental Insurance Plans
Similar to medical insurance, dental insurance for individuals plans are often categorized as Indemnity or managed-care plans. Specifically, the types of dental insurance plans are:

• Indemnity plan, a fee-for-service which allows members to see any dental provider. In this plan, you pay up front and get reimbursement after submitting the claims.
• Dental Maintenance Organizations (DMO) plans offer a network of doctors and hospitals and the plan requires referrals to see a specialist.
• Preferred Provider Organizations (PPO) Dental insurance plans permit you see in- and out-of-network dental providers and does not require a referral.
• Combination Plans that combine PPO plans others like DMO or indemnity. These allow a wider coverage.

Unlike managed-care plans, Indemnity plans offer a broader choice of dental care providers. In indemnity plan, you pay up front and get reimbursement later from your insurance carrier. Managed-care plans usually maintain a large dental provider network. Dentists who are part of the network normally provide services at pre-negotiated rates. They submit the claims to the insurance company on your behalf. This means managed care plans involve less paperwork and less out-of-pocket costs. On the other hand, a broader choice of dentists is available for you in the indemnity plan.

Supplemental dental insurance
Supplemental dental insurance really has grown from a changing workplace. In the past, when employees stayed long in work places, employers offered generous insurance options. This was done as a part of a group plan. This meant every one was insured with same insurance provider, and it ensured a good coverage and low costs.

Today, the workplace is very different. Many employees do not stay long with their employers. The costs of insurance have gone up significantly over the past decade or so, making dental coverage expensive for employers. Some employers have reduced their insurance plans or cut out dental coverage entirely.

For many employees, the lack of dental coverage is truly a problem. They now need to pay more to take care of their dental health. Also, nowadays, many employees work part-time, in temporary or freelance positions. These offer fewer benefits. In these cases, workers find their own health plans. They often pay for these through a supplemental or voluntary dental plan.

Supplemental dental insurance means that the dental insurance is provided to the beneficiary directly by a supplemental dental insurance provider. Instead of being part of a larger group plan organized by your employer or by your state, you can get the insurance directly from an insurance provider.

Like many other plans, Medicare health insurance does not pay the complete cost of your medical bills. The coverage is broken down into four parts identified as Part A, B, C and D. To get the Original Medicare benefits you would be provided with Part A which is the basic coverage for hospital expenses. You would also be covered under Part B that includes visits to physicians and hospital services on an outpatient basis. The medical services that you receive may be to you by any doctor and/or hospital that is willing to accept Medicare and who belong to a medicare provider system.

Medicare Advantage Plans – This plan is available in practically all the states. If you have a medicare advantage plan, you do not need a Medigap policy. These plans include:

• Health Maintenance Organizations (HMO) or Medicare HMO
• Preferred Provider Organizations (PPO) served by a medicare provider network
• Private Fee-for-Service Plans
• Medicare Special Needs Plans
• Medicare Medical Savings Account Plans (MSA)

These plans typically cover more services and they have lower out-of-pocket costs compared to the Original Medicare Plan. Some of the plans provide prescription drugs coverage. In HMO plans you may only be able to see only specified doctors or be able to visit only specified hospitals to get covered services.

Medicare Drug Plans
On January 1, 2006, Medicare prescription drug coverage was made available to everyone with Medicare. The beneficiaries of Medicare can get this coverage, which can help lower the prescription drug costs. Medicare Drug plans are insurance. You choose from a number of medicare drug plans and pay a monthly premium. There are two types of Medicare drug plans that provide insurance coverage for prescription drugs. Medicare prescription drug coverage is an integral part of Medicare Advantage Plans and other Medicare Health Plans. The entire Medicare health care can be availed through these plans. Insurance companies that are approved by Medicare generally offer these plans.

Medicare Medicaid
Medicaid is available to certain low-income individuals and families who belong to an eligibility group recognized by federal and state law. Medicare Medicaid does not pay cash to you directly; instead, it sends payments to your health care provider. In some states, you may be asked to pay a small part of the cost as co-payment for some of the medical services. Medicare Medicaid is a state administered program subject to guidelines set by each state regarding eligibility and services.

Medicare Costs
The following is a list of the various medicare costs in terms of Medicare premium, deductible, and coinsurance rates that are in effect in 2010:

Medicare Premiums for 2010:

Medicare Part A: Hospital Insurance Premium

• If a person or the his/her spouse has 40 or more quarters of medicare covered employment, there is no need to pay monthly Part A premium.
• The Part A premium of $254 per month is payable by people having 30-39 quarters of Medicare-covered employment.
• The Part A premium of $461 per month is payable by people who are not otherwise eligible for premium-free hospital insurance and who have less than 30 quarters of Medicare-covered employment.

Medicare Part B: Medical Insurance Premium
Most beneficiaries will be continuing to pay $96.40 premium in 2010. Beneficiaries currently having the Social Security Administration (SSA) withhold their Part B premium and who have incomes of $85,000 or less (or $170,000 or less for joint filers) will not be having an increase in their Part B premium in 2010.

Medicare Deductible and Coinsurance Amounts for 2010:

Medicare Part A: This pays for inpatient hospital care, skilled nursing facility care, and some home health care services. For each benefit period, Medicare pays all the covered costs except the Medicare Part A deductible of $1,100 in 2010 during the first 60 days. It also pays the coinsurance amounts for hospital stays that last more than 60 days and but not more than 150 days.

For each benefit period you are expected to pay:

• A total of $1,100 for hospital stay services of 1 to 60 days.
• $275 per day for days for hospital stay services of 61 to 90 days
• $550 per day for days for hospital stay services of 91-150
• All costs for each of the days beyond 150 days

Skilled Nursing Facility Coinsurance

• $137.50 per day for days 21 to 100 in each benefit period.

Medicare Part B: This covers Medicare eligible physician services and outpatient hospital services. Certain home health services and durable medical equipment expenses are also included in this.

• $155.00 per year. You pay 20% of the Medicare-approved amount for the services after meeting the $155.00 deductible.

Medicare Billing Guidelines:

1. The service (s) used must be medically considered necessary. This is by Medicare’s definition, not yours.
2. The service (s) must have been performed: If you bill for a service and did not have the service performed or some other service different from the one billed for was utilized, you will be ineligible for the benefits.
3. The service (s) performed must be sufficiently well documented to demonstrate medical necessity.

The last one is the most important for billing for the services rendered. Medicare billing is all about right documentation.

Types of family medical insurance plans
Individual and family health insurance plan are normally classified as “indemnity” or “managed-care” plans. The major differences include choice of healthcare providers, out-of-pocket costs and how bills are paid. In Indemnity plans you typically pay up front and obtain reimbursement from the insurance company. Indemnity Insurance plans generally provide a wider choice of health care providers than managed care. Managed-care plans make use of a network of healthcare providers. Healthcare providers within a network provide services at pre-negotiated rates and will usually submit the claim on your behalf to the insurance company. It is less paperwork and lower out-of-pocket costs. This helps keep family medical insurance rate under check.

Types of Managed care plans
Managed Family medical insurance plan may be broadly classified as HMO, PPO, and POS plans.

If your family health plan is a PPO (Preferred Provider Organization) plan, you are expected to use a network of preferred doctors and hospitals. They provide services at a discounted rate. If you use services from an out-of-network physician, it is typically covered at a lower percentage than services rendered by a network physician.

HMO (Health Maintenance Organizations) plans typically offer less flexibility in the choice of physicians or hospitals. You will have to choose a primary care physician (PCP) and your PCP will attend to most of your healthcare needs. Specialists will have to be referred by your PCP.

POS (Point of Service) plans combine the features offered by HMO and PPO plans. Like in the case of an HMO, you will be required to choose a primary care physician (PCP) from the plan’s network. PCP’s services are normally not subject to a deductible. Also, like HMOs, POS plans offer coverage for preventive care.

However, you will receive a higher level of coverage for services rendered or referred by your PCP. Services rendered by a non-network provider will generally be subject to a deductible and covered at a lower level. If services are rendered outside of the network, you may have to pay up-front and get it reimbursed.

Indemnity plans
A typical Indemnity plan offers a more freedom in choice of doctors and hospitals at a higher out-of-pocket cost and more paperwork. Under an Indemnity plan, you can consult whatever doctors or specialists you like, without any need for referrals. However, this freedom comes at a cost. You may be required to pay an annual deductible before the insurance company begins to pay on your claims. The insurance company typically uses a “usual, customary and reasonable (UCR) rate” for the service. It is the amount that healthcare providers in your area typically charge. You may have to pay up front and get it reimbursed.

Health Savings Account
Health Savings Accounts (or “HSAs”) is a tax-friendly savings account. HSA in conjunction with an HSA-compatible high deductible health insurance plan can be used to pay for qualifying medical expenses.
An HSA-compatible health insurance plan can help save money. Typically, the monthly premium on an HSA-compatible high deductible plan is less expensive than others. Contributions can be made pre-tax, up to certain annual limits. HSA funds can be invested at your discretion. Interest earned in HAS account is tax-free.

Co-pay
A “co-payment” or “co-pay” is a specific charge some family health insurance plans may expect you to pay for certain medical service or purchase. For example, you may be required to make a $15 co-payment for a visit to a physician or a specified prescription drug, after which the insurance company will make good the rest of the charges. While considering the family health insurance rate, it is important to keep co-pay in mind.

Deductible
A “deductible” is a specific amount that your family medical insuranceplanprovider may require that you pay out-of-pocket each year before your health insurance plan begins to make payments for claims. Deductibles are required by all health insurance plans. Generally, HMO plans do not require a deductible, while most Indemnity and PPO plans do.

Coinsurance
Coinsurance is a term used to refer to the amount that you are expected to pay for a medical claim. This is in addition to any co-payments or deductible. For example, if your health insurance plan involves a 20% coinsurance requirement and if there is no CO-Payment or deductible requirements, then a medical bill of $100 would cost you $20, the insurance company paying $80.

Some considerations while choosing individual and family health insurance plan
There is no single “best” plan for everyone. The best plan for you and your family may be different than the best match for someone else. While considering a family health insurance quote, it is useful to keep in mind the following factors

1. Long term Vs short term: If you are unlikely to get into a job and hence a group plan, choose a long term plan.
2. Basic coverage Vs comprehensive coverage: The plans offer basic services like inpatient hospitalization and outpatient surgery to comprehensive benefits including preventive care, physician service, prescription drugs.
3. Pay for service before using them or when you use them: The higher the monthly premium, the less you pay per doctor’s visit in copayment and deductibles.
4. Access to specialists: Some plans provide easier access to specialists than others.
5. How much you can pay “out of packet”: Health insurance plans typically place limits to how much you are required to pay as maximum out-of-packet.

With increasing complexity while deciphering your family health insurance quotes, obtain all details from your agent to get the best health insurance for family.

Generally, when you buy a Medicare Supplemental insurance policy you must already have Medicare Part A and Part B. It is necessary that you and your spouse must each buy separate Medicare Supplemental insurance policies. Your Medicare Supplemental insurance won’t cover any health care costs for your spouse.

Types of Medicare Supplemental Insurance Plans
Insurance companies must sell you only “standardized” Medicare Supplement policies. These Medicare Supplemental health insurance plans must all have specific benefits so that they can be compared easily.

Depending on the time of your enrollment, you may be able to choose 10 to 12 different standardized Medicare Supplemental health plans(Medicare Supplement Plans A through N). They must follow Federal and State laws which are meant to protect you.

The benefits from any Medicare Supplement Plan A through N are the same for any insurance company. An insurance company is free to decide which Medicare Supplement policies it will sell. Not all types of Medicare Supplemental health plans may be available in your state. If you need more information, call your State Insurance Department or State Health Insurance Assistance Program.

Medicare Supplemental Insurance Plan Benefits

Med Supp Benefits	A	B	C	D	E	F	G	H	I	J	K	L
Part A Hospital Coinsurance
Part B Coinsurance											50%	75%
Blood											50%	75%
Hospice Care											50%	75%
Skilled Nursing											50%	75%
Part A Deductible											50%	75%
Part B Deductible
Part B Excess Charges							80%
Foreign Travel Emergency
At-Home Recovery
Preventive Care
Preventive Care not Covered by Medicare

The Cost of Medicare Supplement Plans

Though policies from different companies with the same name offer the same benefits, the prices differ from company to company. Insurance companies offering Medicare Supplemental plans set their own premiums depending upon your community, the age at which you purchased the policy or the age you are during the currency of your policy.

You need to have Medicare Part A and Part B to get a Medicare Supplemental policy, and hence you have to pay both the monthly Medicare Part B premium and the premium for the Medicare Supplemental insurance company.

Each insurance company is free to decide how it will set the premium for its Medicare Supplemental policies. You must ask how an insurance company prices its policies. It will affect how much you pay now and how much in the future. Medicare Supplemental policies can be priced (rated) in three ways. They are:

a) Community-rated (also known as “no-age-rated”)
b) Issue-age-rated
c) Attained-age-rated

When to enroll in and switch Medicare Supplement plans

You can enroll in a Medicare Supplemental plan during the six month period starting on the first day of the month in which you became 65 years or older and you are already enrolled in Medicare Part B. This is called the “open enrollment” period.

If your open enrollment period has passed, insurance companies can decline your Medicare Supplement application. So it is important to apply for a Medicare Supplemental plan within six months of you first becoming eligible. Once you are accepted for a policy, the renewal is automatic as long as you pay your premiums.

If you apply for a Medicare Supplement plan, you have a free period of 30 days to decide if you like your new policy. The 30-day period begins on the first day the policy becomes active. If you cancel your policy during the “free look” period, and if you are within your open enrollment period, you can apply for a new Medicare Supplemental plan. However, if you are outside your open enrollment period, your application can be rejected. Hence, it is important that a new Medicare Supplemental plan should not cancel any current plan until they are approved for the new plan.

How Dental Insurance Works
Dental insurance plans work similar to how health insurance plans work in general. For a specific monthly rate or “premium”, you are entitled to full dental benefits. This generally includes x-rays, cleanings and regular checkups. Also included are other services that promote general dental health. Some plans provide a wider coverage. Others may require a larger financial contribution from you at the time when services are utilized. There are some plans that also provide for coverage during dental implants, specific types of oral surgery, or orthodontia.

Types of Dental Insurance Plans
Similar to medical insurance, dental insurance plans are often categorized as broadly classified as Indemnity or managed-care plans. Specifically, the types of dental insurance plans are as follow:

1. Indemnity plan, a fee-for-service that allows members to see any dental provider. The plan also expects you to pay up front and receive reimbursement once claims are submitted.
2. DMO (Dental Maintenance Organizations) plans offer in-network only benefits that require referrals to see a specialist.
3. PPO Dental insurance (Preferred Provider Organizations) plans allow you see in- and out-of-network dental providers without a referral.
4. Combination Plans combine PPO products with others like indemnity or DMO. This allows achieve a wider coverage.

Compared to managed-care plans, Indemnity dental ins plans generally offer a broader choice of dental care providers. In the case of indemnity plan, the carrier generally pays for the covered services after it receives a bill. This means that you will have to pay up front and later obtain reimbursement from your insurance carrier.

Managed-care plans generally maintain dental extensive provider networks. Dentists who are part of a network generally agree to perform services for patients at pre-negotiated rates. They usually submit the claim to the dental insurance company on your behalf. Thus managed care plans mean less paperwork and lower out-of-pocket costs for you. On the other hand, a managed-care dental plan will offer you a broader choice of dentists.

Discount dental plan: The discount dental plan negotiates a discounted rate for typical services. These services include hygiene visits, check ups, fillings, cleanings, root canals treatment, orthodontics, fixing of crowns etc. The dentists provides these services to you at a pre-arranged discount rates. These rates are often shared with you prior to purchasing the reduced fee plan. These are best suited for individuals and their families who are unable to qualify or get for dental insurance coverage through their employer. The typical savings that can be obtained through the provider networks is in the range of 10 – 60 %. The only drawback is the choice dentist being to limited to the one provided by the carrier. However, traditional dental insurance plans too can have similar limitations.

Comprehensive dental coverage: When you have your family covered under family dental insurance plans or individual plans, you expect to save significant part of dental care expenditure. Before deciding to purchase dental insurance, it is desirable to talk with your dentist regarding the extent of coverage provided by your treatment plan. A very important factor to remember is dental insurance differs widely from medical insurance. Even the best dental insurance plans have been designed for covering only the basic dental care of around $1,000 to $1,500 (this is the same amount that was covered 30 years ago) per year and are not intended to provide increased comprehensive coverage like that of medical insurance.

PPO health insurance: In Preferred Provider Organization plan, you are expected to use a network of preferred doctors and hospitals. They provide services at a discounted rate. If you use services from an out-of-network physician, it generally gets covered at percentage that is lower than the services rendered by a network physician. These are private medical insurance plans.

HMO: HMO health insurance is a health insurance product which is offered by a health maintenance organization (HMO), a type of managed care provider. HMO health insurance is widely used, and is popular for group insurance plans that cover the employees of a particular company, or members of a particular organization. There are advantages and disadvantages to HMO health insurance. These can be considered when deciding to buy an insurance product.

Supplemental Medical insurance: It is a type of insurance policy which is designed to cover the gaps in your regular health insurance due to deductibles and co-payments. Supplemental medical insurance covers additional expenses that your primary insurance doesn’t cover, such as lost income and living expenses. Those who should consider supplemental medical insurance are people who are self employed, and those with families and children. Others who find it stretched financially to handle large medical bills or those who have taken time off from work due to illness or injury, and those on Medicare also must consider this plan.

POS: Point of Service plans combine the features offered by HMO insurance and PPO insurance plans. Like in the case of an HMO insurance, you will be required to choose a primary care physician (PCP) from the plan’s network. PCP’s services are normally not subject to a deductible. Also, like HMOs, POS plans offer coverage for preventive care. However, you will receive a higher level of coverage for services rendered or referred by your PCP. Services rendered by a non-network provider will generally be subject to a deductible and covered at a lower level. If services are rendered outside of the network, you may have to pay up-front and get it reimbursed.

Indemnity plans: A typical Indemnity plan offers a more freedom in choice of doctors and hospitals at a higher out-of-pocket cost and more paperwork. Under an Indemnity plan, you can consult whatever doctors or specialists you like, without any need for referrals. However this freedom has a price attached. You may be required to pay an annual deductible before the insurance company begins to pay on your claims. The insurance company typically uses a “usual, customary and reasonable (UCR) rate” for the service. It is the amount health care providers typically charge. You may have to pay up front and get it reimbursed. These are private medical insurance plans.

Medicare Advantage Plans: Private medical insurance plans offered by an insurance company that have a contract with Medicare. They provide you with all the Medicare Part A and Part B benefits. Medicare Advantage Plans are HMO health insurance plans, PPO Insurance plans, or Private Fee-for-Service Plans. If you have joined a Medicare Advantage Plan, Medicare services are covered by the plan. They are not paid by the Original Medicare.

MEDICARE ADVANTAGE PRESCRIPTION DRUG (MA-PD) PLAN: This is a Private medical insurance plans which offers Medicare Prescription Drug coverage. It also covers Medicare Part A and Part B benefits.

MEDICARE COORDINATED CARE PLAN: This is a Medicare Advantage plan combined with HMO or PPO Plan.

MEDICARE COST PLANS: These plans are a type of HMO that acts as a Medicare Health Plan. As with other HMO plans, this plan pays only for services outside its service area when there is an emergency. But, when you are enrolled in a Medicare Cost Plan, if a routine services is required outside of the plan’s network without a referral, the Medicare-covered services are paid for by the Original Medicare plan. You will be responsible for the Original Medicare deductibles as well as coinsurance.

MEDICARE COVERAGE
Made up of two parts: Part A: Hospital Insurance and Part B: Medical Insurance.

MEDICARE HEALTH PLAN
A plan offered by private medical insurance companies that contract with Medicare. These plans provide you with your Medicare Part A and/or Part B benefits .Medicare Health Plans include Medicare Advantage plans (including HMO Insurance, PPO health insurance, or Private Fee-for-Service Plans); Medicare Cost Plans; PACE plans; and special needs plans.

MEDICARE MANAGED CARE PLAN
This is a type of Medicare Advantage Plan which is available in many areas of the country. In most managed care plans, you can choose doctors, specialists, or hospitals which are in the approved list of the plan. The plan is expected to cover the Medicare Part A and Part B benefits. Some managed care plans additionally cover prescription drugs. It is possible that the costs are lower than in Original Medicare.

MEDICARE PRESCRIPTION DRUG COVERAGE
Optional coverage is available to all the people who have Medicare plans through insurance companies and other private companies.

MEDICARE PRESCRIPTION DRUG PLAN
A stand-alone drug plan, that are offered by insurers to beneficiaries who receive their Medicare Part A / B benefits through their Original Medicare plans; Medicare Private Fee-for-Service Plans that do not cover prescription drugs; and Medicare Cost Plans offering Medicare prescription drug coverage.

GROUP HEALTH PLANS
Medical insurance plans that provide health coverage to current employees, former employees and their families. These plans are supported by the employer organization.

Employee (or retiree) benefit plans established or maintained by an employer, an employee organization (such as a union), or a church group that provides medical care to employees and their dependents directly or through insurance (including and HMO), reimbursement or otherwise.

The above constitute all major medical insurance plans available today. All major medical insurance companies provide a wide variants of these plans. Your agent will be able to explain in more detail.

Humana health insurance plans are some of the most popular ones for insurance coverage in the United States. Humana Insurance covers individuals, groups and the senior citizens, making it a complete offering. It includes a large number of hospitals, doctors, dentists, pharmacies and specialists.

When buying a Humana health insurance plans expect them to provide Medicare supplement, dental coverage and term life coverage. If you want to buy medical insurance plan from Humana, you can either buy them via the Internet or through your local dealers. In any case, you will be paying the same amount of premium for a specific proposal.

Humana Health Insurance plans include:

• Humana One Individual Health Insurance
• Humana Medicare Advantage
• Humana Military Health care services
• Humana Dental Insurance
• Humana Military

Humana Insurance – Medicare coverage plans
Humana provides the following Medicare coverage plans:

• Humana Medicare Advantage plans with more benefits than Original Medicare, an affordable premium, an extensive list of doctors in many areas, and predictable costs that are easy to budget.
• Humana Medicare prescription drug plans that can offer you relief from the high costs of medications. In most areas, Humana offers three stand-alone drug plans – so you can choose the one that best fits your needs and budget.
• Humana Medicare supplement plans that can work seamlessly with Original Medicare to cover “gaps” in coverage like deductibles and coinsurance.

Humana Medicare Advantage plans

You can combine Medicare health coverage with prescription drug coverage – in one simple plan, at one affordable price.

• Humana Medicare Advantage plans offer more benefits than Original Medicare.
• Humana Medicare Advantage plans may include coverage for prescription drugs that’s same or greater than Medicare’s standard requirement.
• Humana Medicare Advantage plans can help you get more for your health care dollar.

Original Medicare Plan	Humana's Medicare Advantage Plans
May not cover some of your healthcare costs	Additional benefits beyond Original Medicare
Deductibles and coinsurance when you use healthcare services	Predictable costs that are easy to budget no matter which healthcare services you use
May need supplement plan	No supplement plan needed
No coverage outside the United States	Worldwide coverage for emergency and urgently needed care

Humana Medicare offerings range from Medicare Advantage and Medicare Part D to Medicare supplement (Medigap) policies. The nation’s senior population has more `benefit options than ever before. To get the best value, they must be well-informed consumers. Humana tries to achieve this by various ways. For example, every month Medicare prescription drug plan members will receive a personalized statement called Smart Summary RxSM

Humana Insurance–Humana Medicare Supplement plans
All of Humana Medicare Supplement plans meet regulations of US state and federal Governments and allow members to take advantage of these features and benefits:

• Freedom to choose doctors and specialists with no referrals, anywhere in the U.S.
• Ability to choose any Medicare-certified hospital, anywhere in the U.S.
• Peace of mind with a guaranteed renewable policy.

Humana Medicare Supplement plans cover all or part of Medicare’s deductibles and coinsurance, or additional care that Original Medicare doesn’t cover.

Here are some simple guidelines for Medicare eligibility. You can get Medicare Part A benefits at age 65 without having to pay premiums if:

• You are already getting retirement benefits from Social Security or the Railroad Retirement Board.
• You have eligibility to get Social Security or Railroad benefits but you have not filed for them yet.
• You or your spouse were in government employment that had Medicare coverage

If you are under 65, and if you meet one of the following, your Medicare eligibility allows you to get Medicare Part A without having to pay premiums:

• You received Social Security or you enjoyed Railroad Retirement Board disability benefits for a period of 24 months
• You have End-Stage Renal Disease and meet certain other requirements.

If you meet the above conditions and are eligible for Medicare, you don’t have to pay a premium for Part A.

However, you must pay for Part B premium if you want it. Most Medicare beneficiaries will continue to pay the same $96.40 Part B premium amount in 2010. If you currently have the Social Security Administration (SSA) withhold your Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium for 2010. For all others, the Medicare Part B monthly premium will be $110.50. This premium will be deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you don’t get any of the above payments, Medicare will send you a bill for your Part B premium once every three months.

Those who are not eligible for Social Security retirement benefits, will be eligible for Medicare when they turn 65

Medicare Enrollment
Medicare benefits have two parts:

• Medicare Part A (Hospital Insurance), which helps pay for care in a hospital and skilled nursing facility, home health care, and hospice care; and
• Medicare Part B (Medical Insurance), which helps pay for doctors, outpatient hospital care, and other medical services.

Most people don’t have to pay for Medicare Part A. Most people pay for Medicare Part B.

General Medicare Enrollment Period
If you didn’t sign up for Medicare Part B when you first became eligible, you may still be able to sign up during the General Enrollment Period, which is from January 1 through March 31 of each year. During this time, you can enroll for Medicare Part B at your local Social Security office. If you get benefits from the Railroad Retirement Board (RRB), contact your local RRB office. Your Medicare Part B coverage will start from July 1 of the year you sign up.

Except in special cases, the cost of Medicare Part B will go up 10% for each full 12-month period that you could have had Medicare Part B but didn’t enroll for it. This penalty will be levied as long as you have Medicare Part B.

If you already have Medicare Part A and need Part B you can enroll for Part B at your local Social Security office.