What You Need to Know About Health Insurance


Save Time and Money by Understanding the Basics

by Wes Markham

In the United States, health care costs are one of the largest expenditures for people and their families. As laws on health care continue to change and costs continue to rise, it is important to understand the fundamentals of health insurance to ensure you make smart and informed choices.

Types of Coverage

In America, there are several types of coverage to choose from: Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and High Deductible Health Plans (HDHPs).

HMOs and PPOs pay for all or part of your medical expenses, all allow you to choose your own doctor. POS provides a broad range of coverage as long as you choose from a selected network of health care providers who have an agreement with your insurance company.

Where Do You Get Health Insurance?

The most common place to get health insurance in America is through your employer. Other people may purchase insurance through a school or college. You can also purchase your own, individual plan. Individual plans are more customizable than those purchased through an employer or other organization, and may save you money.

What Should Health Care Cover?

A strong health insurance policy will cover doctor’s visits, surgical expenses and related costs, emergency room and hospitalization fees as well as diagnostic tests, such as X-rays and MRIs.

Comprehensive plans may also include coverage for additional benefits such as dental, vision, mental health, and prescription drugs.

Provisions and Limitations

There are numerous provisions and limitations with nearly any health care plan. In order to obtain insurance, you may need to undergo a physical to ensure that you do not have any “pre-existing conditions,” such as cancer, leukemia, or any other number of diseases or medical complications. A pre-existing condition almost guarantees that the insurance company will have to pay large sums for your health care, and some providers may decline to insure a person who has one.

Most insurance companies also have a limit which they will pay up to for certain aliments or health complications. Once the insurance provider has paid up to the stipulated limit, policy holders may have their insurance cancelled or be forced to pay out-of-pocket. This can lead to large loans or excessive debt, so it is important to speak with your provider about their policy limitations in advance. Be sure to read and understand all the fine print before signing any contract.

Costs

Health insurance carries a monthly premium, which must be paid in order to retain the health care provider’s services. Additional costs include co-payments, which are a flat fee that must be paid for each prescription or visit to the doctor. Another fee is the deductible, the amount that must be paid annually before the insurance company pays any claims.

Investigate all your options and shop around before deciding on any plan. Staying informed to all your possibilities will help you find the best deal as well. Health care laws vary by state, so be sure to know what is expected and required of both you and your provider before making any final decisions.