You need to know: What is the Health Insurance?

Overview

Most health care in the United States is paid for by health insurance. Health insurance is a contract between an individual or a family and insurance company to cover their health care costs when needed. When covered by an insurance policy, the policy owner pays a fixed amount, or premium, on a regular basis to the health insurance company.  In return, the insurer agrees to pay a pre-arranged share of the cost when healthcare is needed. Every company provide varieties of the insurance plans. Although each insurance plan is different, most health plans have three main parts: benefits, networks, and costs.

Benefits: Benefits are only those paid for checkups, prescriptions and medical care under the plan.

Networks: Networks are groups of doctors, hospitals or other health care providers contracted to provide discounted services within the health plan.

Costs: Costs are like premiums, deductibles, co-payments and co-insurance affect how much your family pays for health care.  An individual or family may be covered by a private or public insurance program.

Health insurance costs

Health insurance comes with some basic costs:

  • A premium is a monthly fee you pay to your insurance company.
  • The deductible is the annual amount you pay before the insurance company starts paying your share of the costs.
  • A copay is a fixed amount you pay at each visit to the provider or for each prescription filled.
  • Coinsurance is the percentage you pay for health care services after you meet your deductible.

 Costs vary depending on your health plan and the type of health care or prescription you’re getting.   To learn more about health insurance costs, read about general health insurance terms.

An individual or family may be covered by a private or public insurance program.

Private health insurance

You can buy private health insurance individually or through an employer.

You can buy your health insurance directly from the insurer.   Or you can buy it through your state or federal government-run health insurance marketplaces.   Costs and number of plans vary by state.   Find more details by state on the Marketplace link opens in a new window.

With employer-based coverage, your employer may pay for all or part of your health insurance.   Typically, an employer will provide several health insurance plan options.

Read it Insurance Claims: Here’s What You Need to Know

Transitional health coverage – COBRA

COBRA stands for Consolidated Omnibus Reconciliation Act.

When you leave your job or reduce your work hours to care for a child, you may still get some coverage through your employer’s group health plan for a limited time.

The employer’s human resources department can give you details on COBRA coverage options and related costs.

Health insurance assistance programs

If you buy insurance through the state or federal marketplaces, a Premium Tax Credit may be available to reduce the cost of insurance premiums. The size of your premium tax credit is based on your income. If you have a lower income, you get a larger credit to cover insurance costs. During enrolment, you can calculate an estimate of the amount of this tax credit. Or, you can get the full amount of the premium tax credit when you file your income tax return. To learn more, visit the eligibility page on the IRS website Link.

Cost-sharing reductions (CSRs) are programs that help lower the amount you pay for deductibles and co-payments. CSRs may be available through your state or federal marketplace and can reduce your out-of-pocket expenses. The amount will depend upon:

  • Your income
  • Your insurance plan
  • If you meet certain conditions (eligibility)
  • To qualify for these reductions, you must be enrolled in specific plans.

Public health insurance

Two main types of public insurance programs cover families and children: Medicaid and the Children’s Health Insurance Program (CHIP).

Medicaid

Medicaid is a government health insurance program for people with low incomes. It covers children, elderly, disabled, and other eligible people who get federal income payments.

Every state gives families with low incomes the option to get free or low-cost public health insurance.

Each state has a different name and income requirement for its Medicaid program. For example, in Wisconsin, Medicaid is known as BadgerCare. Medicaid in California is known as Medi-Cal.

For Medicaid coverage, enroll any time of year and be covered right away. To find out how to qualify, contact a state Medicaid agency.

Children’s Health Insurance Program (CHIP)

CHIP provides low-cost health insurance to children in families who do not qualify for Medicaid.

Each state has a different name and income requirement for its CHIP. For example, in Rhode Island, the Children’s Health Insurance Program is known as Rite Care. In New York, it is known as Child Health Plus.

42 thoughts on “You need to know: What is the Health Insurance?

  1. I am really impressed with your writing skills and
    also with the layout on your blog. Is this a paid theme or did you customize it yourself?
    Anyway keep up the nice quality writing, it’s rare to see a nice blog like this one today.

  2. Undeniably believe that which you said. Your favourite justification seemed
    to be at the web the easiest factor to be mindful of. I say to you, I definitely get annoyed whilst folks consider worries that they plainly don’t know about.
    You managed to hit the nail upon the highest as smartly as defined out the entire thing with no need side-effects , other folks could take a signal.
    Will likely be again to get more. Thank you

  3. I’ll immediately snatch your rss as I can not in finding your e-mail subscription hyperlink
    or newsletter service. Do you have any? Kindly allow me understand in order that I could
    subscribe. Thanks.

  4. It’snot myy first time too pay a quock vvisit this wweb page, i amm
    browsing this weeb page daailly andd tazke fastidious infodmation from hesre all tthe time.

  5. Do you have a spam problem on this website;
    I also am a blogger, and I was curious about your situation; we have created some nice methods and we are looking
    to exchange methods with other folks, why not shoot me an email if interested.

  6. What’s upp it’s me, I aam also visiting tis
    web sie on a regular basis, this web page is genjuinely fastidious and
    the peoplke aare genuinely sharing pleaeant thoughts.

  7. Deginitely believe that whichh you stated. Youur favorite reason appeared tto
    bee on thee net thee simplest thing to bee awre of. I saay
    to you, I drfinitely get irrked wyile pedople tgink abbout
    wolrries tyat they plpainly don’t kno about. Youu manabed to hiit thee nail
    upkn the toop annd defiuned oout the wholpe thing without havung side-effects , people
    cohld twke a signal. Willl probably be bck tto gett more.

    Thanks

  8. Hellko there! Thhis blog poost couldn’t be writfen anyy
    better! Goig through this artiocle reminds mme off myy previous roommate!
    He continuallly kept taslking about this. I will forwqard thos
    information to him. Faiorly certaiin hee will have a very gokod read.

    Many thamks for sharing!

  9. When I initiallly commented I clicked thhe “Notify me when new comments are added” checkbo aand
    nnow eazch time a comment is aadded I gett four e-mails with thee same comment.
    Is tbere any way you can remove people fom thhat service?
    Thank a lot!

  10. I gott this webb page frpm my ppal who topd mee regardiing tnis wweb paqge andd now this tine I aam browsing this webb site aand reading vvery informative
    cpntent att ths place.

  11. It’s truly a gredat annd helful piece off info. I’m satisfied tthat yyou simply shared thiss useful info
    with us. Pllease sttay uus informed like this. Thank you for sharing.

  12. Hey! Do you know iff they make anyy plugiins to assist wifh SEO?
    I’m trying too gett myy blog too rank foor ssome targeed
    keywords buut I’m noot seekng very good results. If you kmow of anny pledase share.
    Thank you!

  13. Hi, I do think this is a great website. I stumbledupon it 😉 I am going to revisit yet again since
    i have book marked it. Money and freedom is the greatest way to change,
    may you be rich and continue to guide other people.

  14. Hey! This post couldn’t be written any better! Reading this post reminds
    me of my old room mate! He always kept talking about this.
    I will forward this post to him. Fairly certain he will have a good read.
    Thanks for sharing!

  15. Thanks a lot for sharing this with all people you really
    realize what you are speaking about! Bookmarked. Kindly additionally talk over with my web site
    =). We could have a hyperlink alternate arrangement between us!

  16. Greetings from Colorado! I’m bored at work so I decided to
    browse your blog on my iphone during lunch break.
    I love the knowledge you provide here and can’t wait to take a look when I get
    home. I’m surprised at how fast your blog loaded on my mobile ..

    I’m not even using WIFI, just 3G .. Anyways, awesome site!

  17. First of all, the established structure of the organization allows us to evaluate the meaning of the forms of influence. We are forced to build on the fact that the existing theory determines the high demand for the corresponding conditions of activation.

  18. My spouse and I absolutely love your blog and find many of your post’s to be precisely what I’m looking for.
    Do you offer guest writers to write content available for
    you? I wouldn’t mind writing a post or elaborating on some of the subjects you write concerning
    here. Again, awesome web site!

  19. Hi there! I understand this is kind of off-topic but I needed to ask.
    Does running a well-established blog such as yours take
    a lot of work? I am completely new to operating a blog however I do write in my journal everyday.
    I’d like to start a blog so I can easily share my experience and thoughts online.

    Please let me know if you have any kind of recommendations
    or tips for new aspiring bloggers. Appreciate it!

  20. We’re a gaggle of volunteers and starting a brand new scheme in our community.

    Your site provided us with useful information to work on. You have done
    an impressive process and our whole neighborhood will be
    thankful to you.

  21. Yesterday, while I was at work, my cousin stole my apple ipad and tested to see if it can survive a 30 foot drop, just so
    she can be a youtube sensation. My apple ipad is now broken and she has 83 views.

    I know this is entirely off topic but I had to share it with someone!

  22. Hello this is somewhat of off topic but I was wanting to know if blogs use WYSIWYG
    editors or if you have to manually code with HTML.
    I’m starting a blog soon but have no coding expertise so I wanted to get
    advice from someone with experience. Any help would be greatly appreciated!

Leave a Reply

Your email address will not be published. Required fields are marked *

Share via
Copy link