An illness or injury could be a heavy burden for your family budget if you don't have a health insurance coverage of your bills. Besides, if your health insurance policy doesn't provide the necessary amount or type of coverage, you and your family are still vulnerable.

The month of November was declared as Health Insurance Awareness Month by the DC Department of Insurance, Securities and Banking (DISB). This is aimed at raising awareness about health insurance possibilities and encouraging families to review their health insurance needs.

What Health Insurance Plan Options Are On The Market?

Major Medical Plans

This type of health insurance plan is primarily used in cases of serious injury or illness where the costly services like hospital care, doctors' visits and drugs are payed for. Such coverage can be delivered through a variety of possibilities:

• Indemnity plans–This type of health insurance plans usually has a pre-set deductible and delivers the highest degree of flexibility concerning the place you will receive care.
• Preferred Provider Organization (PPO) plans–This type of health insurance plans supposes the insurance company to get a contractual base with certain healthcare facilities and specialists in order to get a discount for their services. Having a PPO health insurance plans, you will face higher insurance rates in case you choose to receive care from a facility or a doctor, which do not make part of the PPO list with your insurer.
• Health Maintenance Organization (HMO) plans–In case of an HMO plan you are required to choose your primary care physician (PCP) from predetermined list of healthcare providers. To have your claim reimbursed through the HMO plan you have to receive a referral from your PCP for services rendered by any network specialist. In case you address a healthcare provider outside the network, you will not be covered to the full extent or at all by the insurer .
• Point of Service (POS) plans–This type of health insurance plans is essentially a cross-over between HMO and PPO plans. It provides a higher degree of flexibility compared to HMO plans, although still require a primary care physician (PCP) to be chosen. The elements of PPO, is that you can address your issue to any facility out of the network for a higher cost.

Limited Benefit Plans

Limited health insurance plance are aimed at providing coverage in pre-set cases of certain conditions, injuries or illnesses. These are some variations of such plans you might be offered:

• Basic Hospital Expense Coverage–provides coverage of continuous in-hospital services for a period of usually not less than 31 days as well as some other services.
• Basic Medical-Surgical Expense Coverage–provides coverage of costs for a necessary surgical intrusion as well as for a period of hospital care, which usually is not less than 21 days.
• Hospital Confinement Indemnity Coverage–a type of coverage that pays a certain amount of money (not less than $40) for each day spent in hospital. This is not the percentage of the actual care costs you are subjected.
• Accident Only Coverage–provides insurance coverage in case of accidental injury, disability, dismemberment or death. There's an option of covering only certain types of accidents.
• Specified Disease Coverage–health insurance coverage provided in case the policy holder is diagnosed and treated against a specific disease or range of diseases.
• Other Limited Coverage–this type covers only specific health care services, like vision or dental care.

Risk-Sharing and Discount Plans

Discount plans and risk-sharing plans are different from health insurance plans! Prior to signing the contract, make sure that you are fully aware of the benefits this program will bring you and the ways it actually works.
Discount Plans–You have certainly run across advertisements of cheap healthcare services in return for a monthly fee. Don't confuse these with licensed health insurance plans because their participants don't have the same insurance coverage. Insurance specialists strongly recommend that you perform an in-depth investigation of any discount plan that promises considerable reductions in healthcare costs.

Non-Licensed Risk-Sharing Plans–There may be offers from groups of individuals, who will request a monthly fee that will be introduced to a trust or a savings account, which is used to cover the healthcare costs of all the participants. Do not confuse such offers with licensed insurance plans, because they don't provide the necessary coverage. It is also recommended to study such plans with much attention.

State Consumer Protections

The consumers are also provided with a set of protection options by the District of Columbia state legislation. Some of them are:

• Coverage of specific treatments and services.
• Access to certain specialists and health care providers;
• Prompt payment of claims;
• The appeal of coverage decisions to an impartial external reviewer;
• The appeal of coverage decisions within the insurance company;
• If you have questions about protections in the District of Columbia, contact the DC Department of Insurance, Securities and Banking (DISB) or (202) 727-8000.
  
  Other Important Protection Options for Consumers
• COBRA Continuation Coverage–The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) imposes the employer, who has more than 20 employees, to continue the insurance coverage of an employee, leaving the job. Smaller employers may also be imposed to continue the coverage by the District. The federal Department of Labor, Office of Employee Benefits Security Administration website will provide with all the necessary information on COBRA continuation of group health insurance plans.  
• HIPAA–The Health Insurance Portability and Accountability Act of 1996 regulates the insurance company's ability to delay or deny claims, protects the consumer from the possibility losing existing insurance coverage, allows switching between different health insurance plans in a less risky manner, and prevents cases of insurance discrimination due to health conditions. To learn more about HIPAA visir the Centers for Medicare and Medicaid Services website.

Additional Recommendations on the Purchase of Buying Health Insurance

• Make sure that you trust the agent or the insurance company you want to sign the plan with.  It would be wise to address your local state insurance department and learn if the company or agent are licensed for this activity in the state of your residence.
• Different health insurance plans address different insurance needs, so it is better for you to evaluate all the possibilities. Ask questions, learn more about health insurance plans and consider all options available.
• Before signing the application be sure to read carefully through all the clauses and be confident about every aspect. Don't hesitate to ask additional questions and make sure that you're signing an actual insurance service application and it is stated so throughout the document.