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Understanding the different types of managed care

In order to make the best choice when it comes to your health insurance, you need to understand the different types of managed care insurance policies that are available.  Most insurance coverage these days involves one of the three main types of managed care and you need to decide which one works for you. At Arial Insurance Group in Chicago, IL, we understand health insurance and we will share our knowledge to help our customers make the right choice. 

The Different Types Of Managed Care: What You Need To Know

HMO

The HMO (Health Maintenance Organization) is the most common type of managed care, 34% of those with insurance have an HMO. One of the reasons, no doubt, is that it is the least expensive. But the trade-off is that it is also the most restrictive. With an HMO, you must have a primary care physician within the network and they manage your care. You will usually need to get a referral to see a specialist. You must see providers who are in the network in order to have coverage. In most cases, you are only allowed to go outside the network in case of an emergency. 

PPO 

With a PPO (Preferred Provider Organization), you still have a network of providers that are the most affordable to use. You are not required to have a primary care physician and you don’t need a referral to see a specialist. You have the option of going outside the network and you will be covered, but you will likely have to pay more than you would with an in-network provider. 

POS

POS stands for Point of Service and it is a hybrid of an HMO and PPO. You must have a primary care physician and need a referral to see a specialist, but you can go outside the network. 

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Contact Arial Insurance Group in Chicago, IL for the personalized service that only an independent insurance agent can provide. 

Navigating Health Insurance: What You Need To Know

Health insurance can feel overwhelming. At Arial Insurance Group, serving Chicago, IL, we can help you navigate this important yet confusing type of insurance coverage. Keep reading to find out more.

Do I Need Health Insurance?

With rising health insurance costs in America, some people wonder if they should even invest in health insurance. It is important to remember that health care costs are also rising. This means that if you have need of extensive health care, you could be left financially vulnerable if you were to pay out of pocket. Health insurance protects you from this vulnerability.

What Is Open Enrollment?

Open enrollment is a particular time when you can sign up for health insurance each year. This window varies from company to company. You will need to talk with an insurance agent who can advise you on when open enrollment is. 

Why Are There Different Types of Health Insurance Plans?

Health insurance plans vary because different people need different levels of health care coverage. A very healthy individual will not need the same type of coverage as someone with significant health problems. 

What’s The Difference Between Premium and Deductible?

A monthly premium is how much you pay for health insurance each month. A deductible is a set amount that you will need to pay out of pocket before your health insurance will kick in to pay for your health care services. In most cases, a smaller monthly premium will have a higher annual deductible, whereas a higher monthly premium will have a lower annual deductible. 

If you want to learn more, please contact us at Arial Insurance Group, serving Chicago, IL, and the surrounding areas. 

 

Health insurance FAQs

When it comes to health insurance and choosing your plan for the year, most people have lots of questions. It is an important decision and much depends on getting it right. Many factors need to be considered if you don’t want to end up with coverage that just isn’t right. At Arial Insurance Group in Chicago, IL, we have 30 years of experience helping clients to find the correct insurance for their needs. 

How do I know if my doctor takes the health insurance I am considering? 

All carriers have networks of providers and you need to go online to their website and check to make sure your doctor is in the network for the plan you are considering. Another option is to call your doctor’s office and ask them. You can also call the carrier to double-check. 

Who should have a high deductible plan?

A high deductible plan is good for you if you don’t have a serious illness and need ongoing care. It also works well in combination with an HSA that allows you to save tax-free for your out-of-pocket medical expenses. 

Can I see a provider out of network?

You can always see a provider outside of your network. The correct question is will my insurance pay if I visit a provider outside of my network. The answer is, it depends on the type of health insurance plan you have. If it is an HMO, no, you won’t be covered for an out-of-network provider. If you have a PPO or a POS you will have more options for going out of your network. 

What is a copay?

A copay is the portion of a service that your insurance covers. Most services require a copay. 

Contact Arial Insurance Group in Chicago, IL when you need to discuss your health insurance needs. 

Hidden Health Insurance Facts To Be Aware Of

Arial Insurance Group helps Chicago, IL residents find the coverage they need to protect what matters most. We strive to establish long-lasting relationships with our clients. We work with multiple carriers across the Midwest to give our clients a wide variety of options.

Hidden Health Insurance Facts

Health insurance helps you take care of yourself. The policy covers emergency visits and preventative care measures such as routine checkups with your primary care physician. Health insurance also covers your prescription medications if your doctor recommends that you take something to feel better. As you research different types of coverage, pay attention to these hidden health insurance facts.

Alternative Treatment

Your health insurance policy may include coverage for alternative forms of treatment. The recent technological advancements have led to the creation of several innovative treatment methods. Your health insurance may cover massage therapy, acupuncture, and chiropractic visits as part of your rehabilitation.  

Mental Health Coverage

Mental health has become a hot topic of discussion. You can amend your health insurance policy to cover treatment if you are dealing with mental health issues, such as bipolar disorder. You can also add mental health checkups as part of your preventative care.

Incentives

Your health insurance policy may include incentives for striving to live a healthy lifestyle. For example, your policy may include incentives for becoming a member of a local Chicago, IL gym. If you have a weight loss goal that you would like to reach or set up a plan to stop smoking, you can outline those goals in your policy.

Arial Insurance Group Will Help You Find The Right Coverage

Visit our website today to learn more information about health insurance.

Health insurance terms you need to know

When it comes to choosing health insurance, it can be very confusing. With so much information, trying to compare policies is enough to make your head spin. Before you can make sure you are comparing apples and apples, you have to understand some health insurance terms. You can’t make an educated choice without the correct information. Having an insurance agent that you trust makes the whole process much easier. If you live in Chicago, IL, Arial Insurance Group is an independent insurance agency with an experienced team. They will help you get through the process of choosing health insurance that gives you the coverage you need at a price you can afford. 

Network

If you have your own doctors, one of the first things you should do when looking at an insurance carrier is to check their network to make sure your doctors participate in that network. Every insurance carrier makes deals with groups of doctors and medical professionals. They negotiate the rates. These are the doctors and hospitals you will need to use with that carrier. 

High deductible

A high deductible is an amount you must pay for covered services before the insurance policy begins to pay. With high deductible policies, this usually starts at around $5000. 

Formulary

The formulary is the listing of drugs that are covered under the prescription plan that you are choosing. Checking to make sure your drugs are on the list and how much each refill will cost is important information for you to know. 

When it is that time of year again, when you renew or look for new healthcare coverage, give us a call at Arial Insurance Group in Chicago, IL. We will help you get the health coverage you need. Call our office to set up an appointment or to ask us any questions you may have.

Partner Carriers

  • Aegis
  • Aetna
  • Allstate
  • American Modern
  • American Strategic Insurance(ASI)
  • Assurant Flood Solutions
  • Berkshire Hathaway Guard
  • Blue Cross Blue Shield
  • Capital Premium Financing
  • Chubb
  • Cigna
  • Dovetail
  • Foremost
  • Grange
  • Hagerty
  • Humana
  • Kansas City Life Insurance Company
  • National General
  • Nationwide
  • Old American Life
  • Openly
  • Progressive
  • Prudent Pet Insurance
  • RLI Surety
  • Safeco
  • State Auto
  • Stillwater
  • Travelers
  • United Healthcare
  • USLI