Can anybody explain to me how Medical Insurance works, please?!?


Question:
I have been in the States fro 2 years and I just got a Medical Insurance: I now have a job that offers medical coverage. I cover my husband, too. I got the card but I have NO IDEA how it works. I need some guidance. I know what is deductible and I know we have PPO ( whatever that means). That's all. Medical insurance is just being introduced in my home country and I am not familiar at all with the mechanism and the system.
My Husband has varicoses and he'd like to get a treatment or even a surgery for it as it started to bother his leg. I do not know what should be our first step.
Please, help.
Thank you.

Answers:
Here is info on PPO
http://en.wikipedia.org/wiki/Preferred_provider_organization
Be sure you know which doctors are in your PPO. If you see someone who isn't, you'll have to pay more.

In general, your premiums go to the insurance company, who will pay for your care, but you will have to pay a deductible (amount before your insurance kicks in) and/or copays (small amount when you see the doc).

Something like varicose vein treatment could be considered cosmetic, and excluded by your coverage, so read your plan document (especially the section titled "exclusions") carefully.

It might be a good idea to find a 'family' doctor, or general practice physician, who can give you both a general physical and discuss any concerns you have. That doctor can help with a referral to any specialists you may need to see. (note that general physicals are excluded from coverage by some policies!)

good luck and good health!

Other Answers:
Contact your insurer. Coverage and deductibles vary per plan and provider, if you want to know how it works, as the source!!

As you already contacted your insurance you may be knowing your coverage details. Go to only those doctors who are in the providers list, otherwise you have to pay more. And finally, if you would like to start any treatment or even a surgery, you have to notify the insurance people before. They will let you know if they are going to cover it or not.




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