Health insurance continues to be a hot topic in United States culture, especially with the presidential election coming up. The United States is unlike any other developed nation; it’s the only industrialized country in the world that doesn’t have Universal Health Coverage for all citizens. The World Health Organization (WHO) defines Universal Health Coverage as “all people have access to the health services they need, when and where they need them, without financial hardship. It includes the full range of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.”
Did you know that almost 30 million Americans are uninsured, a number which is only expected to increase once these people lose their jobs and the health insurance benefits covered through their workplace?
With much of the nation uninsured or underinsured, what happens when those seeking medical care? With the high cost of ER bills being the main concern, many people will be afraid to seek professional help.
To stay prepared for what’s to come for future health needs, it’s vital to have some sort of health insurance to prevent huge hospital bills if you become ill and need treatment. This article will present an overview of health insurance options, health insurance plans, and the health insurance marketplace.
Health Insurance Options
The United States is the only developed country that allows its citizens to be uninsured and for a person’s employment to determine whether they have insurance and what insurance they have. While the Affordable Care Act (ACS) was a step in the right direction for giving individuals and families access to affordable health insurance options like medical, dental, and vision, and other types of health insurance that they couldn’t get on their own or through an employer, it’s still a long way away from Universal Health Coverage. Under the ACA, you can purchase health care through a state or federal marketplace that has plans to choose from, you can’t be refused coverage based on pre-existing conditions or gender, young adults can stay on their family’s insurance until they’re 26-years-old, and seniors can get discounts on their medications if they’ve been affected by the Medicare Prescription Drug Plan coverage gap.
Health Insurance Plans
Health insurance helps you pay for medical services and it covers some prescription drugs. After you purchase health insurance coverage, you’ll come to an agreement with your health insurer about how much you’ll pay for your medical expenses. It’s usually a certain dollar amount or the percentage of your expenses and the rates depend on your plan and health insurer.
Many jobs provide health insurance and you may be eligible through your partner or spouse’s job. If you’ve been let go from a job recently, you may be eligible for Consolidated Omnibus Budget Reconciliation Act (COBRA), which your former employer covers on a temporary basis. Government programs like Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) also provide health care coverage and if you’re a veteran or military personal, the Veteran’s Administration or TRICARE offer health care coverage to all beneficiaries. Also if you’re under 26-year-old, you are still under your parent’s insurance plan.
If these qualifications don’t apply to you, you can purchase a plan from a health insurance company, through your state, or through the Health Insurance Marketplace.
Health Insurance Marketplace
Health Insurance Marketplace, also known as Marketplace or exchange, provides health plan services through websites, call centers, and in-person help. Operated by the federal government, it helps people enroll in affordable health insurance. Small businesses can provide health insurance for their employees through the Small Business Health Options Program (SHOP). For individual and family coverage through Marketplace, you’ll need to provide income and household information to find out if you qualify for premium tax credits and other savings that make insurance more affordable and if you’re eligible for coverage through Medicaid and Children’s Health Insurance Program (CHIP) in your state.
Types of Health Insurance Plans
There are three categories for health insurance plans: traditional fee-for-service health insurance plans, health maintenance organizations (HMOs), and preferred provider organizations (PPOs). Traditional fee-for-service plans are the most expensive, but they give you more choices for picking your health care providers. HMOs have lower co-payments and they cover the cost of most preventative care, but your choice for health care providers is limited to those in your plan. PPOs offer lower co-payment like HMOs, but you have more choices for providers. Before deciding on a health insurance plan, it’s important to do your research to see which option is the best match for you. If you frequently see a doctor, have prescription medications, or plan on getting pregnant, these are all things to consider before choosing a health insurance plan.
Long-Term Care
Long-term care is limited or excluded from most health insurance plans and Medicare. If you’re looking for long-term coverage, you’ll need to get a separate long-term health insurance policy. The services covered under long-term care insurance include personal and custodial care in your home, community organizations, or facilities. With long-term care, insurance companies reimburse the daily amount (up to a pre-selected limit) for services that help with daily living activities like dressing, bathing, and eating. But, if you’re already ill or are receiving long-term care services, you may not qualify for long-term care insurance. It’s important to note that many long-term care policies have limits on how long and how much they are willing to pay.
Health Insurance For People With Disabilities
The government has three options for health coverage for those with disabilities that include Medicaid, Medicare, and the Affordable Care Act Marketplace. Medicaid provides free or low-cost medical benefits for those with disabilities who have low incomes, Medicare is available for people with disabilities, people who are 65 or older, or those with end-stage renal disease, and the Affordable Care Act Marketplace offers plans for people with disabilities that aren’t eligible for disability benefits.
