A Brief Idea About Employer Health Insurance

For an individual, if his employer provides health insurance, he might be choosing from several health insurance schemes. Most of the times, the plans include types of managed care plan, like HMO (health maintenance organization) or PPO (preferred provider organization). If he chooses an HMO, the insurance scheme shall only pay for healthcare if he consults a particular hospital/doctor in the network of that plan. If he chooses a PPO, the scheme shall pay usually more if he gets his health service done within the network of the plan. However, the PPO shall pay a part of the care if he goes outside of the network, but then, more he shall have to pay.

The employer might offer many healthcare plans whose cost depends upon the services offered. The costs can include a payment each time he sees his doctor or brings a filled prescription as well as some yearly deductable, that is the sum he pays for health services in the starting of the year before the health insurance starts.

The employer may also require that he pays more as premium for plans which are more expensive. A scheme which requires the use of a network provider generally has high deductable, & high copayments shall have low premiums. A scheme which allows him use any network provider, has much lower deductibles, and lower copayments shall have much higher premiums


If one is young, has no serious disease, and he leads a normal healthy lifestyle, he might think of choosing a health scheme which has high deductibles & co-payments – he is not likely be needing care and his monthly premiums might be very less.

If one is older and have some chronic condition (maybe diabetes) which requires frequent visits to the doctor and prescribed medicines, he might think of a health scheme which has low deductibles & copayments. He may pay little more every month for his part of premium, but then this may be edged out by less extra-pocket expenses in the whole year.

To get knowledge about health scheme options, one should meet a representative of his human resources dept. or he should read the content provided by the healthcare scheme. He can also visit online and gain more information and details about every healthcare plan.

If one is self-employed, his employer is not providing proper health insurance, or he is uninsured & is not eligible for a government sponsored health insurance scheme, he can purchase health insurance on his own.