What are the Different Types of Health Insurance and Why Do You Need Them

Types of Insurance

Ah, the world of health insurance—it can be mind-boggling. Before you strain your brain too much, let us help decipher all the different types of health insurance and why you need them.

Basically, there are two types of insurance:  private health insurance and public health insurance.

Public Health Insurance

Medicaid

Public health insurance is funded by the government. Medicaid is state-run and offered by the government to help low-income individuals and families with medical care. Individuals and families must meet an income requirement to be eligible for Medicaid, and those requirements vary depending on the state.

Medicare

Medicare is government health insurance provided to the elderly (age 65 or older). Medicare covers most medical costs. There are four main parts or Medicare:

Part A covers care in hospitals and nursing facilities

Part B is your medical insurance. It covers doctors and outpatient care, and also covers some things not included in Part A, like physical therapy and home health care.

Part C is called the Medicare Advantage Plan and this allows you to get health coverage for Part A and B through a private health plan

Part D is for medication and covers some prescription drug costs. Low income individuals may qualify for additional coverage.

Private Health Insurance

If you don’t qualify for public health insurance, you must opt for private health insurance. Most people get this through their employer. Under the Affordable Care Act (ACA), you can also buy health insurance on your own, but it usually costs significantly more than plans available through an employer, because you pay for the entire plan yourself rather than the shared employer cost.

Types of Private Health Insurance

HMO (health maintenance organizations) require you to obtain medical care from their provider network. It costs less, but you have less choice of doctor.

PPO (preferred provider organizations) allow you to choose in-network or out-of-network doctors. Costs are covered, but in-network care costs less.

Reimbursement plans reimburse you based on your costs.

Indemnity plans pay based on what happens.  For example, if a person were to break their arm, the plan would pay a set amount for the needed health care.  It is considered to be a fee-for-service plan and has no restrictions on your choice of doctors or hospitals. The insurance company is paid a fee each time you get medical care. Naturally, with indemnity plans, your out-of-pocket costs are higher than in an HMO or PPO.

 


Understanding Health Insurance Series
Understanding Health Insurance
The Basics that Every Person Needs to Know about Health Insurance

4 Reasons Everyone Needs to Have Health Insurance

What are the Different Types of Health Insurance and Why Do You Need Them?

3 Answers to Common Health Insurance Questions

What is the Minimum Amount of Health Insurance Coverage that I Should Have?

 

4 Reasons Everyone Needs to Have Health Insurance

Why You Need Health Insurance

One of the hot political topics right now is health insurance.  Who should be able to have it?  What about costs?  Can you go without it?  What is the penalty?  BJI is here to help.  This month, we’re talking about what you need to know to make the best decisions that you can about health insurance.

One of the most basic questions is whether or not you actually need health insurance.  Read on, and we think you might realize why everyone should have it.

Life is Unpredictable

Although life’s spontaneity sometimes is pleasant, unpredictable occurrences can have dire consequences for your health and your budget. Significant illness that you don’t expect (such as cancer, diabetes or a suddenly needed operation) and traumatic events have high medical costs that can ruin your credit rating.  Medical bills are one of the most common reasons for personal bankruptcy and easily can set you back for years.

Whether it’s an illness you didn’t expect or an accident that wasn’t supposed to happen, health insurance needs to be in place BEFORE you need it.  Of course, the hope is that there’s no need for urgent care or a hospital stay, but it is a good feeling to have the peace of mind knowing that you’re covered.  You won’t have to worry about the stress of paying medical bills while recovering, AND your budget won’t be blown from an unplanned emergency.

Maintain Your Most Valuable Asset – Your Health

Your health is valuable! Many of us think about insurance in terms of covering accidents and illnesses, but maintaining good health is just as important. It keeps one of your prized assets – your health – in tip-top shape.

Without health insurance, you may be less prone to visit the doctor for a routine checkup. However, having a health insurance policy allows you to take advantage of “preventive care” that is included in most plans.  You are able to see your doctor for regular checkups, get vaccines, and participate in other benefits (such as health screenings) that help you to maintain better health.  The plan you choose will determine what actually is included.

Reduce Your Costs

Insurance companies have special negotiated rates with doctors who are in-network.  When you have health insurance, covered in-network health care costs less for you – even before you meet your deductible.

Avoid Paying a Penalty

In addition to your health being valuable to you personally, it is also valuable to your budget. Current health insurance laws require you to carry health insurance or pay a penalty.  For any month that you, your spouse or tax dependents do not have “minimal essential coverage.”  The fee is either a percentage of your household income or per person whichever is higher.  You can avoid this penalty just by having health insurance.  Later this month, we will discuss this topic a bit more.

Obtaining health insurance is important for everyone. You never know what the future holds, but you can be sure to get the best health care you need with the right insurance coverage. BJI is here to help.  Contact us today.  We will show you options and to help you decide what type of health insurance fits your situation and your budget.  Click here.

 


Understanding Health Insurance Series
Understanding Health Insurance
The Basics that Every Person Needs to Know about Health Insurance

4 Reasons Everyone Needs to Have Health Insurance

What are the Different Types of Health Insurance and Why Do You Need Them?

3 Answers to Common Health Insurance Questions

What is the Minimum Amount of Health Insurance Coverage that I Should Have?