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The Lowest Health Insurance Quotes

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Here is why our quotes are the "lowest" health insurance quotes:

No health insurance agent/broker (producer) can adjust, discount, or negotiate any health insurance quote. The insurance "agent" or "broker" is in most states licensed as a "producer", and is paid a commission for producing successful health insurance applications which result in a policy for which earned premium is paid.

The insurance producer (agent/broker) is authorized to advertise the health insurance quote set by the health insurance company and not ANY other premium quote. The insurance producer (agent/broker) does NOT decide ANY individual or family health insurance quote or final rate WHATEVER!

When an application is processed, some cost-conscious health insurance companies will increase the premium because of health history and other factors such as smoking, height-weight table, or occupations and avocations. The agent/broker cannot negotiate that and so has no control over what the final cost is, irrespective of the initial health insurance quote, which is always supplied by the health insurer to the producer.

Even if the agent/broker is "working for the customer", it is the insurance company that creates, uses, and pays the occupation of agent/broker/producer only when a health insurance application is "produced" as an independent contractor. That's because it is more cost-effective for the competitive health insurance company and makes a small contribution to a generally lower health insurance quote. There is some variation in terminology from state to state, but licensed agent, licensed broker, and licensed producer all amount to the same thing for every individual health insurance quote.

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Types of Coverage

There are two important models for addressing health insurance needs.

In one form of health insurance, a group of medical providers, in association with a financial operation that collects premiums and provides administration, promises to provide care for the subscriber in return for periodic payment of a premium. That aspect of the plan provides financial protection but is not indemnity health insurance. It is a pre-paid plan.

In the second form of health insurance, the insured receives medical care from independent providers and a health insurer pays the bills incurred according to the terms of the insurance contract. That is actual indemnity health insurance.

A particular health insurance description may combine both forms, e.g., a pre-paid arrangement with a group of physicians, plus indemnity insurance coverage for inpatient hospital covered expense with different deductible and coinsurance. For all health insurance, the exclusions, and whether prescriptions are covered, should be noted.

Indemnity and PPO

Indemnity health insurance takes two major forms. The "preferred provider organization" (PPO) form involves a pre-arranged protocol for medical providers to file claims so patients do not have to. The reimbursement for each medical procedure is also pre-agreed. The list of doctors, hospitals, laboratories, etc., is called a "network, hence the term "PPO network". Typically, the health insurance company will still pay for claims from providers not in the network, but with a higher out-of-pocket cost to the insured. Often, the out-of-network deductible and coinsurance are double the in-network amounts.

In the second form, now not as common, there is no network, nothing pre-agreed with any providers. The charge is incurred by the insured/patient, and it is up to the insured to file the claim with the health insurer.

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The health insurance company and the provider may disagree as to whether the claim is fair and reasonable, often called "usual and customary". The insured may be expected to pay the difference. Because of the inefficiency of the process, such health insurance plans have higher premiums and are not very popular. This form of coverage is often called indemnity to distinguish it from the PPO, although they are both an indemnification in contrast to a pre-paid plan.

There is a third form of indemnity health insurance. That is an "exclusive provider organization" (EPO). There is a network, but the health insurer will not cover any expenses incurred by non-network medical providers, i.e., no out-of-network coverage. This form is also not as popular as the PPO, which has the most flexibility of all.

The HMO takes various forms, but generally, there is no access to specialists unless a referral is made by a primary care physician. The idea is to give more control to the insurer and the hope is that it will stop insureds wasting money by ignorantly seeing the wrong specialists along with other cost saving measures. The HMO has developed into a number of forms and may be for a specific group of salaried physicians or may be organized by a health insurance company utilizing independent providers as PPO coverage does.

Typically, there are more cost control mechanisms in the HMO than the PPO and because of its nature, the indemnity will have much less. Consequently, for similar benefits, the health insurance quote for an HMO plan will generally be lower than that for a PPO or indemnity health insurance plan.

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¶ Nothing here constitutes advice or recommendation of any nature, whether legal, tax, financial planning or otherwise. The comments above represent only the author's understanding of health insurance and may be incorrect or out of date, and should not be relied upon.