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New Book Reveals Secrets about the Health Insurance Industry
Date:2/8/2010

s off – some day! In the mean time, you and I still have to secure our own health insurance coverage” said Mr. Thomas. “People need to be informed and need to ask questions when considering health care coverage. Here are just a few to consider.”

1.   When considering an HMO (Health Maintenance Organization) find out if the plan is limited by geography? For instance, how does the plan cover a family member if he or she is injured outside of the coverage area? Will the plan limit coverage to emergency care and require the patient to return home for further treatment?

2.   A PPO (Preferred Provider Organization) has both in-network and out-of-network providers. Coverage options may vary dramatically depending on the status of the provider. Check the PPO provider lists to see what doctors and hospitals are included in the PPO network? Also, determine how the plan covers providers who are not in the plan’s network?

3.   If prescription coverage is included in the plan, does that coverage have an annual ceiling? If it does, how does the plan cover prescription costs that exceed that ceiling? Does the plan even cover those costs or do they become the full responsibility of the insured?

4.   How are children covered while at college or when visiting the grandparents in another state?

5.   If coverage is included as part of a trade organization or trade group membership, what happens if a member moves, change careers or leaves the group? Is the plan portable or will the coverage end? What happens if the insured or a member of his family developed a health condition which might render that person un-insurable when shopping for a new plan?

6.   What is the health of the Health Insurance Company? In today’s economic uncertain times, insurance companies are just as vulnerable as Wall Street
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