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Health Insurance: Overview

One of the major expenses for many families and individuals in the US is the cost of health services. Rising premiums in the recent years made it either more expensive or hard to afford service.

Unlike the national health law in many countries, the health insurance carriers in the US are for profit organizations, regulated by each state. The health insurance carriers have the power to accept or reject new clients as well as terminate existing insured under the federal and the local state regulations.

There are 2 major health systems: The HMO and the PPO. There are 2 major health insurance contracts: individual (for single person/family) and as member of a group.

Each health insurance contract has covered services and exclusions. The details are varies from contract to contract.

Each health insurance carrier has a network of doctors, pharmacies and hospitals in which the health services cost is based on a negotiated fee-schedule. Any IN-NETWORK service is the most cost effective choice for the patient. Services given OUT-OF-NETWORK without the insurance authorization could end up with thousands of dollars of medical bills.

Most insurance plans are available until the retirement age, where the federal Medicare system kicks in for coverage.

DENTAL Coverage is not part of the medical health insurance plans; it may be purchased as an additional service, or as a stand-alone plan.

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