Health insurance is the primary means people use to pay for medical care in the United States. In exchange for paying a provider a set of fees, an individual receives coverage for doctor’s visits, hospitals stays and prescription drugs. In the end, they save thousands of dollars, since they are not responsible for the majority of their medical expenses. Of course, the exact amount a person pays will depend on the type of healthcare plan they have. In the United States, the most popular ones will fall into one of three categories: group insurance, managed care and national insurance.
Most people will end up using group health insurance. With this type of healthcare, a person signs up for a plan through their employer. Acceptance is almost always guaranteed, thanks to HIPAA laws. Even if an employee has a preexisting condition, if they have been working at a company past their probationary period, they are eligible for the insurance. This is assuming their employer even has such a policy. If an employer does not have a waiting period, an individual can sign up for the insurance immediately. In addition, since most of the fees are taken out with each paycheck, employees do not have to worry about budgeting for their healthcare expenses. Under the best plans, they only have to worry about a small co-pay.
However, if a group plan is provided through a managed care network, things work a little differently. This is a type of health insurance where providers work with a specific network of doctors, clinics and hospitals. In an HMO managed care plan, a person must stick with one particular provider in their network. If a person goes to a doctor outside of that network, they will not receive coverage. This works in contrast to the PPO, another type of managed care plan. While PPOs still have a specific list of providers, a person is not restricted to them. Should they stray from the list, they will receive partial coverage for their care. Either way, both HMOs and PPOs tend to have higher deductibles and out-of-pocket expenses than group plans. But on the plus side, for self-employed individuals, these networks do offer individual coverage.
Finally, there is national health insurance, a body of plans provided through the United States government. Medicare and Medicaid are the most well-known. Medicare provides coverage to anyone over 65, while Medicaid grants insurance to disadvantaged groups. Lesser-known plans include Tricare, COBRA and high-risk insurances.
Tricare is designed for military personnel while COBRA temporarily covers people who have lost their jobs. Then there are high-risk insurances, which are designed to help people with pre-existing conditions. They offer a more affordable alternative, at least in comparison to what one might find among managed care plans.
If you need assistance in locating particular coverages at a pre-determined price, we can help you find a reduce health insurance premium today.