Health insurance is a necessity. So why do so many people go without health insurance? You might be asking yourself this question, or you may even have health coverage but are considering dropping it. Health benefits can seem like a complicated topic to research. But there are some basic things you should know about insurance before making the decision to get it or not.
We hope that this article has helped you understand health care and how important it is for your future health!
What is health insurance?
Health insurance is a program or plan that helps pay health care costs. It can be provided through an employer, the government, your school, etc.
Why do you need health insurance?
It’s important to have health coverage because going without it can cause major financial issues for you and your family in the event of a medical emergency. Some health issues can be very costly, and insurance will help cover the costs of medical bills.
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It is always a good idea to have health coverage because it helps protect your family from financial ruin if you or someone in your household has an unexpected health emergency such as getting sick, suffering an injury (intentional or not), etc. And even if health insurance does not cover everything, it can still help reduce the cost of health care.
Are there different plans?
There are different health insurance plans that provide coverage for things like:
– hospitalization and surgeries (e.g. major medical insurance)
– prescriptions (i.e., health/prescription drug plan)
– emergency room visits, urgent care, etc.(i.e., emergency health insurance). These can be a great option for those who do not go to the doctor often but need health coverage if they ever get sick or injured.
– dental and vision (i.e., insurance that also provides a plan for eyecare and teeth)
Do you qualify?
You may be able to receive health insurance through an employer/union; however, it depends on the healthcare plan and your employer. Some health benefits plans (e.g., major medical insurance) can be expensive and may not cover pre-existing conditions, which means any health issues you had before signing up for health care could cause problems getting coverage in the future.
What is a health insurance network?
A health insurance network is a group of doctors, hospitals and other health care providers that have an agreement with a health insurer to accept rates from the health insurer. The size of your health plan’s network can impact how much you pay for medical care because if there are not as many providers in your network, then out-of-network costs may apply.
It is important to research healthcare plans before signing up for health care so you know what’s covered, how much it will cost per month, if there are any deductibles or co-pays involved and more.
What is the affordable health care act?
The health care act is a law that requires health insurance companies to offer minimum coverage. This means health plans must include certain essential health benefits, such as prescription drugs and maternity care in all their plan options for individual/family policies sold through the Insurance Marketplace (also known as an exchange).
What is better HMO or PPO?
HMO insurance provides you with a health plan that requires you to choose a primary care physician. You must get a referral from your PCP before seeing any other health care providers and it will be easier for your PCP to monitor the treatments/prescriptions he or she orders because they oversee giving referrals, rather than having several health care providers giving referrals.
PPO insurance doesn’t require you to choose a primary care physician and allows freedom for choosing health care providers, including specialists. You can see whomever you want without getting a referral from your PCP first; however, it is more difficult for your health plan/insurance company to monitor treatments/prescriptions.
You should speak to an insurance agent about health coverage options for you and your family. An experienced insurance agent can help explain the health care act, different types of health plans (e.g., HMO or PPO) and other factors that could affect choosing between different health plan options, so you are able to make the best decision for your health care.
What is the average cost?
The cost of health insurance varies between health plans and depends on:
– the health plan (e.g., major medical health benefits)
– deductible levels, co-pays, and coinsurance costs; these will vary depending on your premium level (i.e., bronze, silver, gold, or platinum). For example, a lower insurance premium can mean paying higher health care costs.
– health plan, including whether the health insurer has tighter doctor networks that limit your choice of doctors and hospitals to lower out-of-pocket expenses (i.e., HMO)
– age/gender; women are usually charged more than men for health plans because they require maternity health care services.
– health status; health plan companies can deny coverage to people who have pre-existing conditions because they are more likely to claim insurance than healthy individuals.
Are there different premium levels?
Yes, health insurance premiums vary depending on the type of health plan you choose. The four levels are:
– Bronze plans have low monthly premium costs but high deductibles and co-pays; bronze health care is for people who want to pay less up front every month in exchange for higher health care expenses throughout the year
– Silver insurance plans have more expensive monthly health care premiums than bronze health coverage but lower deductibles and co-pays. Silver health plan is for people who want to pay higher up front in exchange for low health care costs throughout the year
– Gold insurance has even more expensive monthly premium rates, however gold health plans have lower deductible levels and lower health care costs throughout the year
– Platinum insurance has the most expensive monthly premium rates; however, platinum health plans have lower deductible levels and co-pays. For example, a health plan with a $100 per day inpatient hospital copayment required for days 61 through 90 is gold level coverage, whereas one with a $200 copayment is platinum health plan coverage.
If you want to discuss options for health insurance, please call us at 561-732-9305 our quoting hours are Monday through Friday from 8:30 AM to 5:00 PM. In addition, you can request a quote online. Please remember, We Handle All the Work, While You Save!
Robert Macoviak is the President of Oyer, Macoviak and Associates. Oyer, Macoviak and Associates is the oldest independent insurance agency in Boynton Beach and has been in business since 1953. Oyer, Macoviak and Associates are vested members of the community who are committed to doing business face-to-face and being your insurance advocate in times of need.