Health Insurance Quotes in Puerto Rico
Compare Health Insurance Quotes and Plans in Puerto Rico
Health insurance is a type of coverage that covers some of the cost accrued through surgical and medical health expenses. As with other types of insurance, there are various types of health insurance policies that provide people with different levels of coverage. Typically, the insurance company will pay the provider directly or the customer pays the expenses out-of-pocket and is then reimbursed by the insurance company when a claim is filed. Comparing health insurance in Puerto Rico is easy with MyRatePlan and provides you with a free online quote with the best coverage at the best prices.
In Puerto Rico, health insurance is usually made available through either private insurance companies or through employers. Medicaid and Medicare provide health insurance to low-income individuals and senior citizens respectively. Medicaid and Medicare are both available at rates that are lower than those of private insurance providers. However, these types of healthcare coverage have to be applied for.
As stated earlier, health insurance plans are available at different coverage levels. To cover only major medical emergencies, a plan can be obtained at a lower cost. However, full coverage plans typically cost more. Most consumers will anticipate potential healthcare needs before deciding on a specific plan and provider to ensure they are covered for potential medical needs.
Comparing Health Insurance Coverage in Puerto Rico
Logically speaking, people do not have the means to know exactly what their healthcare needs will be in the long-term. After all, life happens in the most unpredictable of ways. Therefore, figuring out what type of health insurance plan to go with can be a challenging decision to make. This decision needs to be made with careful consideration, as changes to plans can only be made on a yearly basis. Looking at past healthcare needs is a great place to start in considering the options for different plans. Another aspect that helps a great deal is knowing how a person's family history looks. If things like diabetes and cancer or heart problems run strongly in their family, then they want to make certain that their health insurance can at least help with some of those costs should a similar situation arise. Looking at both of these areas can help to make an educated guess of what will be needed for coverage over the course of the next year. People in Puerto Rico who are rather healthy might not need to do more than visit with their primary care provider a few times over the course of a year. When a chronic disease comes into play, visits to doctors of various specialties become necessary. These factors will change the type of health insurance coverage that is needed.
People living in and around the Puerto Rico area can purchase inexpensive plans that merely cover catastrophes, should they strike. It is important to understand that this coverage only helps with a yearly exam with a primary care doctor and situations that can be life-threatening, like a heart attack or a stroke. This plan would not be a good idea for people who travel a great deal or who spend time with dangerous hobbies as it does not cover emergency room costs. A higher premium plan will be needed to cover emergent care.
Therefore, it goes without saying that monthly premiums will be higher for people who need more coverage. As people pay more in premiums, the health insurance plan can provide more help in paying for those providers and services. The only way a proper decision can be made about what plan to purchase in Puerto Rico is by looking at personal and family health histories, as mentioned previously. Having a little more coverage than what is expected to be used is a better situation than being underinsured should something financially devastating take place. Sometimes, paying more for coverage means saving a great deal on out of pocket expenditures in cases where a person is underinsured.
The Different Types of Health Insurance Policies in Puerto Rico
Quite a few different types of health insurance plans are available in Puerto Rico. While these types can have similar levels of coverage, other factors, including how convenient they are to use and their flexibility, will vary considerably. Common plan types include health management organizations (HMOs), preferred provider organizations (PPOs), point of service plans (POS), health savings accounts (HSAs), health reimbursement accounts (HRAs), flexible spending arrangements (FSAs) and medical savings accounts (MSAs).
HMOs in Puerto Rico are popular and often affordable options for health insurance. These include a network of providers, and the individual picks one doctor from that network as his primary care physician. The primary care physician is essentially a gatekeeper for any health needs that patient has. If the patient needs to visit a specialist, he first goes to his primary care physician, who chooses whether to approve it and provides a referral. Although HMOs typically have lower premiums, their networks can be more limited than other plans. On the plus side, out-of-pocket costs tend to be reasonable and these plans don't have deductibles.
A PPO also has a network of providers, and the individual can visit any doctor within this network in Puerto Rico. He can also see specialists without getting a referral first. For the best financial coverage, the individual must go to healthcare facilities within his network. He can typically get partial assistance for costs incurred at out-of-network providers. With a PPO, policyholders have deductibles and co-pays, along with limits regarding yearly out-of-pocket spending.
A POS plan blends how HMO and PPO plans work. The individual chooses a primary care physician from the plan's network, which is usually a decent size. Visits to providers within the network have low co-pays and no deductible, but visits outside the network will have high deductibles and co-pays.
The remaining types of plans are nontraditional and far less common than the three described above. HSAs, HRAs, FSAs and MSAs all involve either the individual or his employer putting money into a tax-exempt savings account, which is then used for all medical expenses, such as doctor's visits, surgeries, prescriptions and sometimes even over-the-counter medications. These plans tend to be flexible and some let the policyholder roll over unused funds to the next year.
Breakdown of Health Insurance Costs in Puerto Rico
You may have heard the term "premium" when it comes to health insurance. A premium is the amount of money you pay monthly to have health insurance coverage. Whether you use your insurance or not, this money is never returned to you. Another familiar term is "deductible." This is the additional money you are required to pay to any healthcare providers before your insurance company starts to make their promised contributions for any medical costs.
Keep in mind that deductibles are different from out-of-pocket costs. A deductible is an annual financial responsibility but out-of-pocket refers to how much you have to spend before your insurance company will pay 100% of your bill.
Deductibles and out-of-pocket costs typically reset each year, with the previous year's expenses having no impact moving forward. So if you have a deductible of $5,000, for example, and you spent $3,000 out-of-pocket last year and your insurance renews with the sample plan in place, your out-of-pocket expenses are reset to $0 and that $3,000 from last year does not roll over. However, some plans in Puerto Rico offer an exception to this rule and allow a rollover of your paid deductible amount from the previous year into the first quarter of the new insurance year.
Co-payments, also known as co-insurance, refers to your financial obligation of a medical visit or service. If your co-payment for visiting a primary care physician is $25, then every time you see your primary care physician, you pay $25. From there the insurance covers the balance if the services rendered are within coverage on your plan. Co-payments are not applied toward deductibles.
You may also receive a lifetime benefit from your insurance company. This refers to the maximum amount of money that your insurance company will pay in total for your healthcare. Medical claims will no longer be paid by the insurance company once this maximum amount is reached.
Your employment has a significant impact on the health insurance plans that are available to you in Puerto Rico. Working for a large company will likely qualify you for their group health insurance plan. This is usually more affordable than getting individual healthcare, but no one is required by law to participate in these group health insurance plans.
Being self-employed or unemployed presents the option of purchasing private, individual health insurance. If you are a senior and do not work, you are eligible for government financial assistance through Medicare. Low income individuals can apply for government assistance as well, which is called Medicaid.
It is important to check with your doctor to see which health insurance plans they accept in Puerto Rico if you want to continue visiting a specific physician. Notify your doctors if your insurance plan changes, and be sure to check with your insurance company regarding any specific questions or concerns about your coverage.
Get Quotes On Health Insurance Plans in Puerto Rico Online
Health insurance is one of the most important decisions you can make for yourself and your family. Make sure you take the time to consider all of the health insurance options available to you in Puerto Rico. As you assess all these factors in choosing a health insurance plan, MyRatePlan can help simplify the process greatly. Just enter your ZIP code above and see many ways in which you can save money on your health insurance policy.