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Health InsuranceGet a Quote

The rising cost of medical care and health insurance premiums continues to make your health insurance options a #1 priority.  The information below will answer questions about health insurance so you can make an intelligent choice at a reasonable price.

CRG benefit specialists will help you determine the best plan for you.

Here is a brief description of the types of available health insurance plans: Indemnity Plans; Managed Care Options; and Government-sponsored Health Insurance

A. Indemnity Plans

Cafeteria/Flexible Spending Accounts (FSA) are employer-sponsored plans that allow the employee to design his or her own employee benefit package.  Several types of Flexible Benefits or Cafeteria Plans are used by employers, including  pre-tax plans, flexible spending accounts, and employer credit cafeteria plans. Cafeteria and FSA's are a cost effective way to pay for eligible out-of-pocket expenses not covered by your medical or dental plan.  For more information about these choices, contact your employee benefits department.

Indemnity Health Plans allow you to go to any doctor, hospital or other provider you select for a set monthly premium. The plan reimburses you or your health care provider on the basis of services rendered. You may be required to meet a deductible or pay a percentage of each bill. However, there is also often an annual limit on out-of-pocket expenses, so that once an individual or family reaches the limit, the insurance covers the remaining eligible medical expenses in full. Indemnity plans sometimes impose restrictions on covered services and may require prior authorization for hospital care or other expensive services.

Health Savings Accounts (HSA)
HSA's combine a helthcare plan with a tax-advantage health savings accout you establish through your employer.  Use the money in your acccout to pay for eligible health care expenses for you and your eligible dependents, or save it for future health costs.  Instead of paying a premium, you establish a tax-free savings account that covers your out-of-pocket medical expenses.  This means that you own and control the money in your HSA.  (only spend on qualified expenses) You also decide what types of investments to make with the money in the account in order to make it grow.  However, if you sign up for an HSA, you are required to participate in a High-Deductible Health Plan as well.

High-Deductible Health Plans (HDHP) are sometimes referred to as catastrophic health insurance coverage. An HDHP is an inexpensive health insurance plan that kicks in only after a high deductible is met.

B. Managed Care Options

Health Maintenance Organizations (HMOs) offer access to an extensive network of participating physicians, hospitals and other health care professionals and facilities. You choose a primary care doctor (PCP) from a list provided by the HMO.  You must contact your primary care doctor to be referred to a specialist. Generally, you pay fewer out-of-pocket expenses with an HMO, but you are often charged a fee or co-payment for services such as doctor visits or prescriptions.

Point-of-Service (POS) plans are an indemnity-type option in which the primary care doctors in the POS plan usually make referrals to other providers within the plan. If a doctor makes a referral out of the plan, the plan pays all or most of the bill. However, if you refer yourself to an outside provider, the service is covered by the plan, but you will be required to pay co-insurance.

Preferred Provider Organizations (PPO)  The participating doctors, hospitals and health care providers are paid by the insurer on a negotiated, discounted fee schedule. Costs are lower if you use in-network healthcare services, but you have the option of going out-of-network. If you choose an out-of-network provider, you are generally required to pay the difference between what the provider charges and what the plan pays.

C. Government-sponsored Health Insurance

Medicaid is a federal/state public assistance program created in 1965. It is administered by the states for people whose income and resources are insufficient to pay for health care or private insurance. All states have Medicaid programs, though eligibility levels and coverage benefits vary.

Medicare is a federal government program for people 65 and older, or those with certain disabilities, that pays part of the costs associated with hospitalization, surgery, doctors’ bills, home health care and skilled-nursing care.

State Children’s Health Insurance Program (SCHIP) is administered at the state level and provides health care to low-income children whose parents do not qualify for Medicaid. SCHIP may be known by different names in different states.

Military Health Care includes TRICARE/CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) and CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) as well as care provided by the Department of Veterans Affairs (VA).

State-specific Plans are available for low-income uninsured individuals. These plans are known by different names in different states.

Indian Health Service (IHS) is a Department of Health and Human Services program offering medical assistance to eligible American Indians at HIS facilities. In addition, the HIS helps pay the cost of selected health care services provided at non-HIS facilities.



With Permission © Insurance Information Institute, Inc. - ALL RIGHTS RESERVED.
Located in Broken Arrow, OK and Bartlesville, OK. We also serve Bartlesville, Bixby, Broken Arrow, Muskogee and Owasso - Licensed in Arkansas, Arizona, Colorado, Georgia, Iowa, Kansas, Louisiana, Missouri, Montana, North Dakota, Nebraska, New Mexico, Nevada, Ohio, Oklahoma, Oregon, Texas, Utah and Washington
1700 W. Albany, Suite 200 Broken Arrow, OK 74012 | Phone: 918-317-3200 | Fax: 918-317-3205 | Toll Free: 800-523-0241 | Email Us | Get Map
1740 SE Washington Blvd., Ste. 200 Bartlesville, OK 74006 | Phone: 918-333-9500 | Fax: 918-333-9505 | Email Us | Get Map
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