Health Insurance Articles

Basic Health Insurance Options For District Of Columbia Residents

2010-02-15

In today's world, health insurance is a necessity. Consider what can happen if someone is uninsured and becomes seriously ill or is injured. Medical bills can be financially devastating, and can even send people into bankruptcy. Though the choices involved in selecting a health care plan are complex, with a little guidance, it is possible to fully understand the basic health insurance options that are available to District of Columbia residents.

First, when choosing a health insurance plan, several key factors come to mind. Affordability is often at the top of the list of considerations. Deductibles, co-payments, and limits on lifetime care should be weighed heavily to decide whether a plan is appropriate. Continuity of care is also a concern for many patients. The ability to remain with current providers, rather than having to start over with new physicians, is especially attractive to people with long-term or chronic illnesses. Perhaps most important is the quality of care that a particular health insurance policy will provide.

Actual types of health insurance coverage vary widely. For example, under fee-for-service coverage, the patient chooses the doctor and the insurance company picks up all or part of the tab based on a schedule. These plans may be offered at group rates through an organization such as employer or a trade association, or they may be offered at individual rates that do not require affiliation with a particular group. Fee-for-service plans also have deductibles and co-payments which should be accounted for when evaluating the plans. Health maintenance organizations - better known as HMOs - require payment of a monthly flat fee with little or no deductibles or co-payments. This fee essentially pays for services from approved providers in advance. The trade-off is that patients who choose to use providers outside of the approved network will usually pay most, if not all, of the cost of treatment. Preferred provider organizations (PPOs) allow patients to choose from a group of providers that the insurance company has contracted with for a discounted rate. As with HMOs, deductibles and co-payments are usually minimal. However, PPOs do provide more flexibility for patients who wish to see doctors outside of the approved network. Finally, there is the possibility of COBRA for people who leave a job that provided healthcare - insurance provided at the cost of the employer's premium plus a 2% administrative fee.

There are many health care options for residents of the District of Columbia. The smart thing to do is to become familiar with them in order to make the best decision both in terms of health and finances.