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Health insurance is essential to protect against the unpredictable costs of medical care.
Health issues can arise unexpectedly—from a seasonal flu that worsens to an unforeseen accident—leaving you with hefty bills.
In the U.S., the average American spends $13,493 annually on healthcare, more than double the cost in other high-income countries.
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With U.S. healthcare spending at $4.5 trillion, having health insurance can make the difference between financial stability and overwhelming debt after a single hospital visit.
What is health insurance?
Healthcare is your way out of the incident or a hospital visit that can make you bankrupt in a day.
Imagine getting in a car accident, or visiting a dentist for the extraction of a painful wisdom tooth, and coming back home with a heartache instead of a toothache.
It is because that’s how expensive healthcare is in the USA. It is not easy for a person with an average income to afford medical bills and then go through monthly expenses easily.
Health insurance is the only solution for this problematic scenario.
Health insurance is an agreement between a company and a client, in which the company agrees to pay all or some cost of a person’s healthcare.
If you buy health insurance, then you have to pay monthly premiums, depending on how long the policy is designed for. Healthcare agreement is mostly designed for a year.
There are several healthcare plans in the USA to help people get through their medical expenses.
Federal healthcare plans like Medicaid, Medicare, and CHIP (Children’s Health Insurance Program) are designed to pay for most of your healthcare.
How does it work?
Health insurance is a critical matter in the United States. There is a huge number of regional and national health insurance providers, who have different coverages, rates, and benefits, that vary from state to state.
The availability may also depend on the state or country you are living in.
More than half of US citizens get health insurance as an employee benefit, so their premiums are somehow covered by the company, Employees have to pay some amount too, but then they can enjoy tax-free benefits.
People who are working individually, or self-employed like freelancers or gig workers, have to buy health insurance privately.
The ACA (Affordable Care Act) healthcare insurance from 2010 made it easier for self-employed people to find and buy specific healthcare insurance plans according to the place where they live.
Taxpayers with incomes ranging from 100% to 400% of the federal poverty level are eligible for subsidies to help cover the costs of ACA-based insurance.
Who needs health insurance and why?
Everyone; yes, health insurance is not just about those who are sick or require regular medical checkups and hospital visits.
If you want to stay healthy, like everyone else, then you need health insurance. Everyone who is healthy, or unhealthy, needs health insurance to stay healthy.
Why health insurance is important? Because it can cover the whole cost of preventive care if you stay connected, you can get your annual checkup, flu shot, and any other medical checkup, that can cause you huge bills.
If you don’t have health insurance, you would have to pay the full cost in case of any medical checkup.
In case you have an accident or get sick, you will have to pay all the bills from your pocket, which may disturb the budget for an entire month or even a few months.
To avoid all that, buy health insurance so you are covered in case of an emergency.
How do you get health insurance?
Getting health insurance is not that tricky. If you are in the United States, there are multiple options to get health insurance.
You can either get health insurance as an employee benefit. In that case, you will have to pay some amount from your pocket and the rest of the cost will be covered by the company.
If you are self-employed, then you can buy insurance directly from private insurers.
If you are over 65, you will automatically qualify for federal Medicare policy.
People with low incomes also get subsidized health coverage through Medicare or Medicaid.
Types of Health Insurance:
There are different types of health insurance. But the main two categories of health care insurance are: public and private.
Most of the people in the United States get private health insurance, as an employee benefit, or buy directly from insurance providers.
Other people go for public health insurance which is organized by the government such as Medicare, Medicaid, or Veteran’s Health Administration.
Health insurance can sometimes be complicated, so you have to keep your eyes open.
For every policyholder, there is a network of designated healthcare providers, if you seek help from them, you will be covered, otherwise, your insurer has every right to refuse the payment if you have to go outside the network.
Mostly, by managed care plans, patients are allowed to choose a physician for their regular visits, checkups, and overall patient’s condition, they can provide referrals for other medical specialists, which can be covered by the insurer.
What are the top 3 health insurances?
There are some health insurance providers in the United States, but not all of them are private.
The top 3 federal health insurance plans are Medicaid, Medicare, and CHIP.
They are enhanced and expanded to offer coverage for old, disabled, and low-income people.
ACA/Medicaid:
ACA (Affordable Care Act) was announced by President Barack Obama in 2010, which expanded the government program Medicaid, which is designed to cover low-income people.
The ACA allowed child patients to be covered by health insurance until they were 26 years old. This act also restricted insurance companies from refusing insurance coverage for patients with existing medical conditions.
In addition to that, the ACA marketplace was introduced, which is a user-friendly platform to find and purchase health insurance at affordable rates, where you can get 10 essential health benefits.
Medicare:
Medicare is a public healthcare plan designed by the federal government for old age and disabled people.
This health insurance covers old and disabled people, people over the age of 65, or people with disabilities, but it doesn’t cover long-term care in nursing homes for old citizens.
On the other hand, long-term care is covered by Medicaid.
CHIP (Children Health Insurance Provider):
CHIP is also a federal health insurance plan designed by the government to offer subsidized coverage for children under the age of 19.
How much does health insurance cost?
Health insurance cost varies, based on different factors such as; the type of plan you opt for, the amount of deductibles, the scope of coverage, and your age when you sign up for health insurance.
If you want to get an idea about costs then you can look at four different levels of coverage offered by Federal healthcare plans, including, bronze, silver, gold, or platinum.
All of them are designed differently according to the type of coverage and corresponding costs.
What are affordable health insurance plans?
The federal government of the United States has designed basic health insurance plans for citizens of the USA. In addition to the ACA, Medicare, and CHIP, there are some more options:
- Short-term health insurance programs: They offer short-term coverage but are not very useful as they lack essential benefits.
- Employer-sponsored programs: Often, an employer offers healthcare as part of employee benefits, and it is more affordable as most of the premium cost is covered by the employer.
- State-specific programs: Some states introduce their healthcare marketplaces with additional subsidies and coverages with extra benefits.
You can find out more about affordable health insurance plans on Healthcare.gov.
If you live in the United States, you would know the healthcare system works, and how expensive it is.
Staying healthy is not an option, and if you don’t buy health insurance, it means you are risking it.
After reading this guide, buying health insurance in the USA will not be very difficult for you.
If you don’t already have health insurance as an employee benefit, then buy one today from a private insurer to ensure medical safety.
