What is it?
Health insurance reduces the amount of money that individuals might potentially pay for health care. Private health insurance companies offer various medical plans that will offset the cost of your health care, including doctor and other provider visits, prescription drugs, procedures, and hospital stays; the insured patient will have to pay a preset co-pay for visits and drugs, and usually have to meet a deductible for procedures, treatments, and hospital visits.

Learn more:
Wikipedia: Health Insurance


Why do I need it?
Health insurance greatly reduces the amount of expenses you will incur taking care of your and your family’s health. American health care costs have been rising year after year, and without insurance, a major health crisis—such as an accident or an illness—could leave your family bankrupt. A policy not only covers tragedies that might occur, they provide benefits for preventative care, such an annual physical exams and vaccinations. Having health insurance helps your family get healthy and stay that way.

How does it work?
If you are receiving a health plan through your employer, there are a few types of plans that apply to your situation:

1. Indemnity: Also known as a reimbursement plan, this plan lets you select your own health care providers. After you meet the required deductible, benefits will start being paid.
2. Health maintenance organization (HMO): This type of managed care plan tends to provide more thorough coverage, and requires that all your health care be handled through a primary care physician (PCP) that you select from a pre-approved list. If you need a referral to another type of doctor, the PCP will provide the referral to someone within the same health care network. Should you see a provider outside your network, your insurance company may not pay for this treatment.
3. Preferred provider organization (PPO): This type of managed care plan lets you choose your health care providers from a variety of networks. In a PPO, the insurance company has special discounted contract rates with providers. If you choose to see a doctor outside the network, though, you will not receive as much benefits and probably pay more.
4. Point of service (POS): This managed care plan is similar to HMOs in that a PCP manages your health care, although you will receive benefits for referrals outside your network.

Low-income earners may be eligible for government assistance through Medicaid. Find information at the Centers for Medicare & Medicaid Services. Children of low-income earners may be eligible for coverage through the State Children’s Health Insurance Program.

People 65 and older are eligible for government assistance through Medicare. Find information at the Centers for Medicare & Medicaid Services as well as from The U.S. Department of Health & Human Services. If you are under 65 and disabled or have end-stage renal disease, check Medicare guidelines for your eligibility.

If you do not get insurance from your employer or are self-employed, and are seeking for a policy you can afford yourself, you may want to explore association health plans. If you belong to an association such as an alumni or civic group, your group may be able to purchase insurance from an insurance company. One downside to this type of plan, however, is that it is not a traditional group health plan, so premiums may vary among members.

COBRA (short for Consolidated Omnibus Budget Reconciliation Act of 1985) is a federal law that ensures that if you lose your job, you can extend your coverage for you and your dependents for up to 18 months. However, you need to pay the premium each month to keep your policy active, and your company must have employed at least 20 employees.

Supplemental insurance
To offset health care costs even more, some people choose to purchase supplemental insurance. This insurance type can help cover co-pays and deductibles, or provide income if you are unable to work. Supplemental insurance can include:

• Disability insurance
• Long-term care insurance
• Accident insurance, incl. accidental death and dismemberment
• Cancer insurance
• Medicare supplemental insurance

Who provides it?
Many private health insurance companies—and even a few government departments—offer a variety of insurance options.

There are plenty of consumer resources to help guide you in making a decision about health insurance coverage, including:
Health Care Coverage Options Database
nahu.org

What if I’ve been turned down before or have health issues?
It may be more difficult and expensive for you to obtain coverage, but there are options. You might qualify to enroll in a state-funded high-risk pool.

Learn more:
National Association of State Comprehensive Health Insurance Plans (NASCHIP)
naschip.org