Health Insurance Basics
Posted June 25, 2013 | Filed under topic Health Insurance Information
In the U.S., the number of people covered by health insurance through their jobs has been on the decrease for a number of years. Between 2000 and 2010, the percentage of those with employer-provided insurance dropped eight percent.
The largest group of uninsured people are foreign-born residents who are not U.S. citizens, low-income families, and young adults ages 19-25. That number will likely rise as more companies cut employee hours from full-time to part-time to avoid providing costly benefits, such as health insurance.
The Affordable Care Act, a.k.a. Obama Care, is designed to eliminate the number of uninsured, but its affordability is greatly in question, and the number of doctors willing to participate are decreasing.
Types of Health Insurance
There are two primary types of health insurance that people can use: Fee-For-Service and Managed Care. Fee-For-Service is the standard situation when a doctor cares for a patient, makes the claim to the insurance company, and then is compensated for each service provided.
Managed Care insurances include health maintenance organizations (HMOs) and preferred provider organizations (PPOs). HMOs offer more comprehensive coverage for patients in the “network,” including financial incentives for seeing health professionals that are part of the HMO to which they belong.
PPOs are similar, but may offer additional prescription coverage and other benefits. PPOs are more expensive than HMOs.
Health Insurance Considerations
When choosing what type of plan you wish to have (if a choice is available), it is important to think about what you and your family’s needs are now and likely to be in the near future.
- The current health of you and your family members. Chronic conditions can be very expensive to treat.
- What limitations are included, primarily regarding the doctors and hospitals you may use.
- What types of costs can you afford, including premiums, co-pays and prescriptions.
- How much you can afford to pay for catastrophic illnesses.
- What does the policy cover in terms of office visits, hospitalizations, emergency treatment, surgery, diagnostic services, rehabilitative care, home health care, ob/gyn services, specialists, and more.
- What would the loss of your income mean to the family.
Not having enough medical coverage can jeopardize your future or your family’s future because health-care costs are among the leading causes of bankruptcy. In fact, those costs contribute to more than 60 percent of all bankruptcies.
Most plans provide some form of basic health care, but if you do not have a plan that meets the needs of you and your family, that basic care may not be enough. That is why it is important for you to meet with experts to determine what insurance you really need and can really afford.