Whether you buy group or individual health Insurance Policy in California, the options you have regarding the different types of  health  Insurance are generally the same.   In some groups you can even choose from available plans. These different types  are  traditional health Insurance Policy, health maintenance organizations (HMOs), and preferred provider organizations  (PPOs).

California goes beyond the Federal requirements for offering health Insurance Policy to its residents.  Examples of this include  Industry  Advantage plans (IAHP), short-term health policies, Insurance Policy for high risk Individuals and special plans for  children and teens.

Additional Health Insurance in California

The traditional health care delivery system is based on a fee-for-service type of arrangement. In a fee-for-service system,  you give  or each itemized medical service you receive. In the days of the frontier, “Doc” often received a chicken as  payment. Today,  physicians are paid with money, lots and lots of it. Fee-for-service health Insurance Policy recognizes this  practice and is designed to  reduce or even eliminate your duty to pay directly for your medical care. Traditional health  Insurance Policy comes in three parts:

California has four basic options for choosing a health care plan:

1. Health through an employer or association

2. Health Insurance Policy through Income eligibility such as Medicaid

3. Health care for high risk individuals such as those that have had cancer or a heart attack

4. Individual Insurance

Hospitalization

Hospitalization covers defined expenses incurred while in the hospital. Generally, the Insurance Policy will commit for all of the covered   services rendered by the hospital staff. However, if the Insurance benefit is an indemnity payment, the payment will be for  a fixed  sum regardless of the actual expenses incurred. This fixed sum will usually be far below the daily charge actually  made by the  hospital.

Medical/surgical

This part of a traditional health plan covers the expensive costs of medical care other than the bill from the hospital.  Services  such as doctor visits, treatment charges, etc., are covered here. Medical/surgical usually has a deductible and  requires  co-payments by the insured (payments you make for charges not covered by the Insurance), typically 20 percent  of the doctor’s fee.

Catastrophic or major medical

There are usually lifetime maximum payments that hospitalization and medical/surgical plans will pay, after which the well  runs  dry. Unfortunately, these maximums may not be sufficient to give for all of the care required if a major illness or injury  should  strike, since such afflictions can eat up hundreds of thousands or even millions of dollars worth of health services.  Thus,  catastrophic coverage adds to your umbrella of protection in an amount sufficient to protect you from the  horrendous expenses of  such serious and prolonged illnesses. These policies also fill in some of the gaps not covered by  hospitalization or  medical/surgical.

Health Maintenance Organizations or Private Insurance Policy in California

The health maintenance organization (HMO) is a relatively new player in the health Insurance game, although it has been  around in a  limited fashion since the 1930s. The idea behind an HMO is to commit one premium and receive all of your health  care at no or a  nominal additional cost. The point is to save money compared to traditional health plans that was more to  purchase and require  more out-of-pocket payments from the insured. What you, the insured, give in exchange for reduced  cost is a substantial loss of  your freedom to choose who will take care of your health needs.

Preferred Provider Organizations

Preferred provider organizations (PPOs) seek to give both the benefits of traditional health plans and the money savings of  HMOs.  They do this by paying higher benefits as a reward for your using the doctors or hospitals they preselect for that  purpose.

Disability Insurance

Disability Insurance does not pay for health care; rather it pays for lost wages caused by a disabling injury or illness.

How Health Insurance Is Priced

Ask anyone how health Insurance Policy is priced and you will get a simple answer: expensively! Beyond that, there are  underwriting  criteria used by health Insurance Policy providers, whether they are for-profit or, like Blue Shield/Blue Cross,  nonprofit.

Underwriting Criteria

Age

The older you are, the more likely you are to get sick; therefore, the higher your health Insurance premiums will be.

Number of people covered

Many somebodies buy family coverage rather than individual policies. This means that there will be adults as well as minor  children  protected by the same design. Some companies will charge based on the size of the family. Others charge a basic  family rate without  regard to the number of members.

Gender

Unlike life Insurance Policy, where women get the better end of the bargain than men, in health Insurance women often commit higher  premiums.  This is based on health Insurance industry statistics which indicate that the female of the species tends to need  medical care more  often than the male.

Health history

Insurance Policy operates on statistical probabilities. If you have had a poor health history, statistically you are more likely to  have a  more expensive health care future. This, in turn, means that you will pay higher premiums-if you can get health  Insurance Policy at all.

Occupation

The more likely you are to suffer injury or illness because of the work you do, the more likely the health Insurance industry  will  be to charge excessively for benefits. This may be well and good for professional deep-sea divers.  But the industry  has begun to  stretch the concept into areas that have nothing to do with the inherent danger of the work.

Lifestyle

In your application for health Insurance Policy you will be asked questions About your personal habits. Your answers will have a lot  to do  with the was of your premiums. If you smoke, you will probably commit more for health Insurance Policy. If you drink to  excess, you will  probably give more for health Insurance Policy. If you are known to be under a great deal of stress, you may commit  more for health Insurance Policy.  California does reward the health care Insurance Policy consumer with lower premiums if they have  practiced good health policies.

One of the most important things you can do as a health care consumer is to engage in preventive care. Not only will you  be able to  spot serious diseases at an early stage, thereby increasing your chances of effective treatment and cure, but  you should be able to  save money as well, since it is usually far less expensive to treat a disease when it’s a molehill rather  than a mountain.