Q. What is health insurance?
A. Health insurance is a contract with an insurance company, which agrees to pay some or all ofyour medical bills based on your "coverage," or the terms of your policy. In exchange, the insurer is paid a set amount of money -- a "premium" -- on a regular basis. Most Americans have private health insurance, either through their employer's group plan or through buying their own individual policy. Others are covered under public "safety net" programs such as Medicaid and Medicare.
Q. Why do I need health insurance?
A. It's no secret that health care is expensive today. The government says the cost to treat a broken leg can run $7,500 and an average three-day hospital stay can set you back $30,000. Without insurance, many Americans would be one health setback away from financial ruin. Regularly paying a set premium for health coverage assures that money will be available todefray the cost of everything from routine checkups to catastrophic medical bills.
Q. What is an HMO?
A. HMO stands for Health maintenance organization. With an HMO Plan you must choose a primary care physician (PCP) from a network of local healthcare providers who will refer you to in-network specialists or hospitals when necessary. All of your care is coordinated through that PCP. Currently at this time Student Health Services is not contracted with insurance companies and we are not eligible to be your Primary Care Physician (PCP.)
Q. What is a PPO?
A.PPO stands for Preferred Provider Organization. A PPO health insurance plan allows for more flexibility and more choices when it comes to your healthcare. A PPO plan offers a network of healthcare providers to choose from, and you have the freedom to receive care from any in or out of network doctor, specialist or hospital without a referral-even when you travel. Keep in mind, however, that your out of pocket medical costs are lower when you choose an in-network provider. This means you can schedule a specialist visit without needing referral.
Q. What's the difference between a deductible, a copayment and coinsurance?
A. All three are medical charges you must pay out of your own pocket, even if you have insurance. Your deductible is the initial amount you must pay each year for covered health services before your insurer will start to chip in. Plans may have separate individual and family deductibles and/or deductibles for separate services such as hospitalization. A copayment is a fixed amount you pay toward each medical service, such as $25 for a checkup. Coinsurance is a fixed percentage, rather than a flat amount, that you pay toward each service.
Q. I can't afford to buy health insurance. What should I do?
A. Depending on your income, you may be eligible for lower-cost, subsidized coverage purchased through state health insurance exchanges. Or, you may qualify for free or low-cost coverage through Medicaid or the Children's Health Insurance Program, aka CHIP. Please visit the PA Department of Human Resources website at http://www.dhs.pa.gov/ .