Health insurance is important coverage every American should have to avoid expensive health care expenses. You can obtain health care coverage through your employer, or you can get health care coverage through a state or federal government exchange. Millions of Americans have insurance from private and public insurance providers. The health insurance market has become more complex and costly over the last 20 to 30 years. Yet, health insurance remains a necessity for individuals and families.
The Basics of Health Insurance
A health care plan covers most of your health care expenses. You pay for your health care cost up to a certain point, then the insurance plan you choose covers the remaining health care expenses. The expenses you are responsible for include:
• The deductible – The amount you pay before your insurance plan starts to pay
• The copayment – The flat fee you pay for specific services like prescription drugs
• The coinsurance – The amount you pay after you reach your deductible
The Most Common Health Care Plans
A Preferred Provider Organization, or PPO, is a flexible health plan. This plan allows you to see a doctor within the PPO network at a low cost or an out-of-network doctor at a higher price. A PPO typically has expensive premiums, but you do not need a referral from your primary care physician to see a specialist. A PPO is a good choice if you need options for your health care.
An HMO, or Health Maintenance Organization, is another health plan many people choose. An HMO requires you to select a primary care physician from a list of physicians in the network. An HMO offers low-cost treatments for inpatient and outpatient care. Your primary care physician handles coordinating your health care. You will need to get a referral from them to see a specialist.
Medicare is a federal health insurance plan available to everybody over 65 years of age. Medicare recipients receive free or low-cost medical treatments. There are four parts to Medicare. Part A covers in-patient hospital care. Part B covers outpatient doctor’s visits. Part C, or Medicare Advantage, allows you to purchase private insurance. Medicare Advantage is not a supplemental insurance plan. Finally, Part D covers prescription drug costs.
A health care plan does not cover all your health care expenses. There are supplemental insurance plans that you may consider to cover medical expenses not covered by health insurance. Dental and vision insurance are two familiar supplemental insurance plans that people have. Gap insurance helps you pay for the coinsurance, the healthcare expense after you reach your deductible. You can also get critical illness supplemental insurance. This insurance covers the cost to treat long-term illnesses like cancer or Alzheimer’s disease.
Although the internet has helped make it easy to find affordable, quality health insurance plans, you still should research before selecting any health plan. Many doctors do not accept all health insurance plans. Ask about payment options, deductibles, copayments, and coinsurance with any health care insurance plan before signing up with the plan. Find a health care plan that fits your needs at a price you can afford.
