Health insurance plays a big role in saving its consumers money, because it covers the costs of physician-recommended health care. In 2010, under the Patient Protection and Affordable Care Act (ACA), health insurance became mandatory.
Here is what you need to know about choosing the right health insurance for yourself.
About Health Insurance
Coinsurance, or as people call it out of pocket costs, applies to almost all health plans and is payed at the time of service by the consumers. Coinsurance includes deductibles and co-payments.
Co-pays or co-payments, and deductibles are another form of co-insurance, meaning that the consumers play part of the cost of the insurance, and usually at the time of service.
Routine visit co-pays: Consumers pay a fee up front when they go to a routine doctor’s appointment.
Prescription co-pays: Consumers pay a fee or a percentage of the cost of prescription medications, and the insured pays the remaining cost of the prescription, making medication more affordable.
Emergency visit and health care: Co-pays for hospitalization or emergency services are usually higher than co-pays for routine visits, but are still far less expensive than paying for the entire cost of a medical emergency or hospitalization out of pocket.
Deductibles are type of a out of pocket costs, payed either at the time of service or after receiving a bill from provider. In case you have a lower health care premium, you must pay a higher deductible.
Limits are set on deductibles, co-insurance and co-payments, and those limits are set by the ACA, and called the out-of-pocket maximum or out-of-pocket limit. It is payed during a policy period by a consumer.
Essential Health Benefits
The ACA defines essential Health Benefits including: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care, and every health plan has to cover these categories.
Types of Health Insurance Plans
Health Insurance Marketplace offers five different levels of plans, including bronze, silver, gold, platinum, and catastrophic plans. Based on these levels, consumers have lowest to highest premiums and deductibles. In case the premiums are the lowest, deductibles will be the highest, and vice versa.
Catastrophic plans cover all essential health benefits after consumer reaches his or her out-of-pocket maximum, plus three primary care visits per year and preventive care are covered with no cost-sharing. These plans aren’t for everyone.
Home Health Care Services Coverage
Some people require home health care services, including full-time aide, visiting nurse and home health care equipment, so health insurance needs to be able to cover those costs.
Long-term Care Insurance
Personal and custodial care in an insured person’s home, a nursing home, a long-term care facility, a community organization, or other setting, are the types of health care services covered by long-term care insurance. These policies pay insured individuals for assistance with activities of daily living such as bathing, dressing, and eating.
Health Insurance Types
Health Maintenance Organizations (HMOs)
HMOs provide health care coverage for services within their networks. In case consumers need to see a specialist, and want it to be covered, they must first get a referral from their primary care physician or from the plan.
Preferred Provider Organization (PPOs)
PPOs provide health care coverage for both in-network and out-network services. Of course, in-network providers usually cost less than out-network ones, and a referral for out-network is a must.
High-Deductible Health Plans (HDHPs)
Higher deductibles and lower monthly premiums is what HDHPs provide to their consumers.
Catastrophic Health Insurance
Only emergency services are covered by this type of insurance.
Health Insurance Buyers
According to the law, people over the age of 26 must have their own health insurance. Many young people, mostly students are purchasing health insurance through school, so that they could be able to use student health centers.
Having an opportunity to purchase health insurance at reduced rates through their employers, is something most of the employees choose to take. Sometimes they purchase insurance for their family members through the same opportunity as well.
Head of Families
Heads of families need to take care of their family members who are age 26 and younger, and purchasing family plans allows them that.
Most of the seniors are entitled to Medicare coverage, but since they have special needs because of their age and medical conditions, they usually purchase supplemental health insurance.
Some Of The Best Health Insurance Companies In USA
Humana was ranked in the top 5 best health insurance companies in the U.S. It offers plans for individuals, business owners, and military personnel.
The company offers health plans that include healthcare, dental, pharmacy, group life, disability insurance, and employee benefits, especially for small, mid-sized and large multi-site national employers. It also covers genetic testing and counseling an industry standard.
In 1977, through the reorganization of Charter Med Inc., which was established three years before, the largest single health company was founded under the name United Healthcare.
Kaiser Permanente covers western U.S. including California, Colorado and seven others. It provides hospital stays at its facilities for its insured.
Cigna has been in business for over 30 years and it offers plans for individuals, families, and employers.
Anthem operates under different names, depending on the state, and it is one of the best known American insurance companies.
Sun Life Financial
Short-term and long-term disability insurance is what Sun Life Financial offers to its consumers.
Arizona, California and Colorado are the areas covered by Health Net, which is a California Market Plan associate.
United American Insurance Company
In 1947, United American was founded. It is based in Texas.
American Republic Insurance Company
This company was founded before the Great Depression. Customized plans are what the company offers to its consumers.
This private online marketplace is allowing individuals and families to get tailored insurance recommendations and plan complarisons. Consumers can use its search tool to make sure they are able to stay with their current doctor. The company also tries to educate their consumers by offering an e-book titled 3 Steps to Understanding the Affordable Care Act. Also, they deliver updated and tips to their consumers’ mailboxes.
Health Plans of America
This company is not a health isurer. They provide consumers with free quotes, age-specific plans, helpful agents, wide range of plans and variety of contact methods. They are best for families, students and seniors.