PHCS Health Insurance Quotes, Plans, and Company Review

When looking for health insurance it is very important to keep in mind that there are many companies out there that will try offering you the best prices for your needs. However, not all of them are known all around the United States and not all of them offer you the same benefits. One of the many companies offering coverage in the continental United States is Private Health Care Systems best known as PHCS. They are the primary national PPO network and care management product of the company MultiPlan.

Before talking about PHSC it’s important to know a little bit more about the parent company. MultiPlan was founded in 1970 and is the oldest and largest of independent, network-based cost management solutions. They have more than half a million health care providers that service an estimated 40 million consumers. To top it all of the estimated millions of consumers have about 70 million claims that are processed through MultiPlan’s networks each year. How about that for a health insurance option?

On the other hand Private Health Care Systems (Owned by MultiPlan as said before) has the largest proprietary preferred provider (PPO) organization in all the United States. With about 450,000 members attending one of the 4,000 facilities PHCS members have access to a variety of providers around the United States. They are also the first and only propriety network to earn five endorsements due to quality from two nationally recognized quality assurance organizations, URAC and the National Committee for Quality Assurance (NCQA).

PHCS’ job is to contact their providers in order for them to allow their network member to visit them at lower costs. The network also has something referred to as a “High network retention rate” which means that once a customer selects a Primary Care Physician (PCP) that doctor will remain available all through their health plan. Most of the people that are members of this great network include large employers such as companies and enterprises, commercial insurance carriers, regional managed cared organizations and third party administrators. The PHCS network offers the following to its members:

National Access with Excellent Cost Savings: No matter where the members are, they offer a variety of services from coast to coast. You can contact them at (866) 750-7427 to see how much they can save you in health care costs.

PHCS Healthy Directions: Eliminates the need of having an HMO, PPO or POS because it pays full charges for services when a member travels or goes to school outside the coverage area. As a member you will be able to have freedom in order for you to choose a provider from within the national network, to lower your out of pocket costs for members with providers in the PHCS Network, and to call a toll free number in your I.D. card for provider information.

Quality: PHCS didn’t just link a variety of little networks and pierce them together, instead they created a national network that allows them to credential and re-credential their providers to maintain good quality healthcare.

Private Health Care Systems is a care management company as well as network based insurance. PHCS is the second largest independent care management company functioning in the United States today. Their care management specialists review any patients’ cases to make certain that patients receive the best treatment available as well as giving them freedom to from a variety of options that nest suit their unique utilization review needs. You are able to employ this care management system in the area of your business where it will make the biggest impact. PHCS Core Plan includes the following utilization management products, however, is important to keep in mind that you can add some supplemental products that will be discussed below in addition to the Core Value ones.

Core Value Plan:

1. Concurrent Review

2. Certification

3. Discharge Planning

Additional Supplemental Modules that can be purchased:

1. Chiropractic Review

2. Selective CT/MRI Review

3. Podiatry Review

4. Outpatient Rehabilitation Review

Pros and Cons of Critical Ilness Insurance Coverage

Critical illness insurance is a relatively new type of policy that is frequently misunderstood. Today, we will clarify what it is, and what it covers.

How Does Critical Illness Insurance Work?

Critical illness is similar to term life insurance, except it is paid out when you are diagnosed with an illness covered by the policy, rather than being paid out upon death. However, some people confuse this type of insurance with disability insurance, which substitutes your income if you become disabled.

Illness insurance, like term life insurance, is paid in a lump sum, should you be diagnosed with a pre-defined disease such as cancer. You decide how this amount will be spent – some people put it into additional medical treatment (especially if there are some treatment methods that are not covered by provincial healthcare), others decide to take time off work to spend with family, or to travel.

As with many insurance products, this type of insurance plan comes with an extensive insurance quote, application and underwriting process that the insurer analyzes before you can get a policy; and as with any insurance policy, a critical illness policy comes with both pros and cons.

Let’s take a closer look at the pros and cons of this type of insurance.

Pros of Critical Illness Insurance

There are several positive aspects:

  1. Funds that can help where needed: The lump sum you receive if you are diagnosed with a critical illness will allow you to get better treatment and, hopefully, fully recovery in some cases. You can also spend these funds on other needs or projects (such as travel or taking items off your bucket list).
  2. Protection for your own business: If you have your own business, you might need to work part time, after being diagnosed with a critical illness (reduced work hours are common when extensive medical treatment is required). It closes the financial gap created by your reduced hours at your company. With the funds, you could hire somebody to help out with your business.
  3. Stackable protection: Unlike disability insurance, critical illness coverage is “stackable”. With disability insurance, coverage is limited because it is based on your income, and you cannot go over that limit even if you have several disability policies. You can, though, have several policies with varying coverage amounts of different diseases. If you have, for example, two policies with benefits of $250,000 and $300,000, you can get a $550,000 payout when you make a claim.

Cons of Critical Illness Insurance

  1. Expensive: This type of insurance policy is not cheap. As an example, a Term 10 insurance policy with $500,000 coverage (Term 10 means a policy that covers you for 10 years) for a 35-year old non-smoking male without any pre-conditions costs around $180/ month (exemplary quote) whereas a Term 10 life insurance policy with coverage of $1,000,000 for the same person costs around $50.
  2. Definitions matter: If a diagnosed disease, such as a heart attack, is not aligned with the definition of this illness in the policy, your claim may be not paid.
  3. Does not cover you immediately: Policy typically comes with a waiting period (e.g. 90 days) during which you are not covered.
  4. Payout is not immediate: If you are diagnosed with a critical illness, there is “survival period” – (e.g. 30 days). If you die within that period, your claim will be not paid.

Summary

Critical illness insurance provides solid coverage for being unexpectedly diagnosed with a serious disease, but this coverage comes at a cost. It’s a good idea to work with an insurance broker to get a critical illness insurance quote and to apply for a policy. Brokers have access to multiple insurance companies and will help you navigate through the complex application process, especially if you have medical pre-conditions.

Health Insurance Plan for Parents and Children

A health insurance plan that covers not only you but your whole family is a solid deal. In a single premium you get to cover up to 15 members of your family. Such comprehensive health insurance plan is called a family floater plan. Since, it is a single policy that takes care of every family member of yours; you are escaped from the task of maintaining records of numerous individual health policies and keeping track of their renewal dates. Also, a family floater policy costs you cheaper than taking numerous individual policies.

As cost of other things rises, the cost of medical expenses also rises. Health insurance policies offer the feature of increasing the sum insured after some years. Sometimes, as a reward for your timely renewal of policy and no claims, the insurance company increases the amount of your sum assured. A family floater policy is a life saver for the house and keeps you ready to face any medical contingency with confidence. In case of medical emergencies, many times the cost of treatment causes more fear and pain than the emergency itself.

For what was earlier considered as a luxury is now a necessity. The service sector has boomed exponentially in India over the past decades. And thus, this boom has passed on economies of scale to the insurance and banking sector as well. The premiums are quite affordable and the service has bettered. The IRDA since its setup in 1999 has taken good measures to regulate the insurance industry and win the trust of masses in insurance. Earlier people were very skeptical whether their claim would be paid or not but that scenario has changed a lot since.

Earlier the only health insurance people used to have was the one done by their employer for them. Apart from that only a select few used to buy it. Some people used to buy health insurance only for the tax benefits. One can get a handsome tax exemption under section 80D, but is not the only motivation to go for a health insurance plan. With increasing awareness people now know how beneficial a health insurance plan is to them.

You can also take health plans exclusively for your parents. Such plans have no entry age limit, cover pre-existing diseases like Diabetes and Cardiac conditions and 100% claim settlement without co-pay.

Aging parents have more medical needs to tender to. If parents are senior citizens you can get additional tax rebate up to Rs. 20000 for the money paid as premium.

Compare health insurance plans to avail the best deal and a plan loaded with attractive and suitable features. Following the experts, one should compare plans of at least three companies before buying. Being more informed about the market, you can take advantage of the competition. Thus, a healthy advice is to do ample market research and evaluation. A healthy family signifies happiness and prosperity!!