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Health insurance can protect you from significant out-of-pocket medical expenses that accumulate during an illness or hospital visit. Many employers provide basic health insurance under a group policy availabe to company employees. If you are unemployed, self-employed or if your employer does not provide basic coverage you can usually purchase health insurance independently through an insurance agent or broker. Health insurance helps pay for out-of-pocket expenses incurred for diagnosis and treatment of covered medical conditions. It is important to choose a plan that best fits your budget, age, family needs and lifestyle.
Individual and family health insurance plans ususally fall into one of two categories commonly referred to as indemnity or managed-care plans. The major differences between the two categories are evident in how you choose your provider, how out of pocket costs are handled and how bills get paid. For example, under an indemnity policies you usually can choose any doctor or hospital that you wish when seeking services. Under a managed-care plan, you either select a primary care physician who treats and directs all health care for you or you are given a list of preferred providers from which you can chose any provider. Under indemnity plans, you often to pay upfront and are reimbursed after a deductible is applied. Under a managed care plan, providers agree to perform services for patients at pre-negotiated rates and usually the provider handles the claims processing for you.
Under the Health Care Reform Act of 2000, New York introduced a 'Healthy NY' program to help promote comprehensive and quality health care for small business owners and their employees. In addition, uninsured sole proprietors and workers whose employers do not provide health insurance can purchase comprehensive coverage directly through the Healthy NY program. New Yorkers also have a 'Family Health Plus' program that provides comprehensive coverage with minimal co-payments for some Family Health Plus services. Health care, under the Family Health Plus program, is provided through participating managed care plans. New Yorkers can provide health insurance for their children under the 'Child Health Plus' program if they not eligible for Medicaid and if they don't already have health insurance and are not eligible for coverage under the public employees state health benefits plan. New Yorkers also have a Prenatal Care Assistance Program (PCAP) that offers pregnancy care to women and teens who live in New York State. Additionally, the Medicaid Obstetrical and Maternal Services (MOMS) Program provides similar pregnancy services in areas of the state where PCAP health centers are not located. If you meet eligibility requirements, there are no cost for MOMS or PCAP.
Be sure to talk with an insurance agent for more information on eligibility requirements, costs and benefits provided under each of these programs.
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