“The article seems to be fine but we would prefer if u can proofread also there is this one word “Individual” that has been used more than 30 times in the article and there could certainly be other alternatives for it as it looks extremely weird ready individual in every line, please make the necessary changes.
Also write the pros and cons of the plans at the end of every point so that the visitor find’s it easier to understand and choose. There are also few lines that have grammatical issues, please read carefully. Also at the end of the article include some of the top most health insurance companies list (don’t describe or write anything about the companies but a small section saying some of the top most health insurance companies you can check out would make some sense (prefer companies that have presence all over and if u don’t find much about them then list companies that have presence in US).
Everybody wants to lead a hale and healthy life. After working very hard throughout his career, an individual at least needs a guarantee that his life and lives of his family members are secure and in safe hands. An individual looks for health security, the confidence that he/she can face even major ailments without having financial issues. To make this possible, an individual needs to insure his/her health. Health insurance is an insurance against the risk of incurring medical expenses among individuals. By estimating the risk of health system expenses before hand, the insurer devises a strategy which requires the individual to pay premiums accordingly and the insurer company will ultimately see to it that health and medical expenses will not be a burden to the individual (even in his/her difficult times). Here, we discuss different types of health insurance plans, their advantages, their scope of health security and premium levels that individuals need to pay.
1. Health Savings Account
Health Savings Account allows you to save money for present or future medical expenses on a tax free basis. However, you will have to pay the timely deductibles which are timed quarterly, half yearly or yearly. This plan involves the companies for which an individual works; companies are the ones which offer such insurance plans. It includes deduction of salary timely and addition of funds to the health savings account. It is an effective way of cutting taxes, at the same time saving something for your health. The health benefits include catastrophic health care, reimbursement on damaged eyeglasses and hearing aids. They might also include traditional health checkups, preventive cares and child checkups sometimes.
2. Indemnity Plans
Indemnity plans is basically related to hospitals and medicine. This plan allows you to go to the best doctor or the best hospital available. Sophisticated and advanced medicines prescribed by the doctor can also be taken. The hospital submits a bill to the insurance company and claims the medical fee reimbursement. The major parts of the expenses are reimbursed by the insurance company. However, the minor parts of the expenses are to be paid by the individuals. Sometimes, the individuals will have to pay the excess amount incurred. The cost incurred before the start of reimbursement also needs to be paid by the individual. Every company wants their employees to be hale and healthy; so has an insurance plan in place for its employees. Such insurance plans are offered to the employees of a company with collaboration with an insurance company. Most of such plans offer a lifetime benefit.
3. Health Maintenance Organization
This insurance plan enables you to pay a fixed amount of premium and enjoy a wide range of health benefits. The individual need not pay for individual health plans/benefits. The health benefits start off with preventive care and go up to complicated surgeries. Individual needs to choose his/her own general practitioner who will take care of his/her health throughout. The practitioner chosen should be qualified and experienced. A qualified and established physician’s advice can be taken to make the choice of the practitioner. Sometimes insurance companies have their set of hospitals and doctors, individuals require to go to those concerned doctors/hospitals to avail insurance. Companies must have negotiated discounts with those hospitals/doctors.
4. Preferred Provider Organization
Preferred Provider Organization allows you to visit any doctor/hospital and get your medical care or treatment done for a subsidized fee. You will have to pay premiums on a timely basis which are quite low comparatively. PPOs have deals negotiated with several doctors/hospitals which form the PPO network. If you chose to consult a doctor within the network, you will just have to pay the fixed service fee (low); if you chose to go to a doctor outside the network you will have to bare 20-30% of the expenses. In the second case, insurance doesn’t help you out completely. The main advantage with PPO is that it allows you to choose any doctor without consultation by paying the annual/quarterly/half yearly premium.
5. Point of Service plans
Point of Service plans are plans devised with Health Maintenance and Health Care as their main motives. It has the features of both HMO and PPO. The individual is given two options when it comes to this insurance plan: She/he can have her/his primary care physician, go to him and get the medication done by paying the doctor the co-payment (service fee). The second option gives individuals the freedom to go to any doctor or hospital they like irrespective of its inclusion in the company network. However, the individual will have to pay the part of the bill (20-30%). POS plans require the individuals to pay deductibles apart from the above mentioned fee. Deductibles are to be paid before the insurance period starts/reimbursement of medical bills start.
6. Child Health Insurance Programs (CHIP)
CHIP provides free or low cost health coverage for children up to the age of 19. Children belonging to families whose combined income is less than 50,000$/year. Eligibility criteria is that the individual should be a Green Card Holder of a particular country. However, CHIP schemes differ from state to state. The differences are in terms of eligibility, benefits, premiums and renewal procedures. The common mandatory benefits that CHIP of every state offers are routine checkups, immunization, dental care, lab and X ray services. Preventive services are free of cost but other services require premiums to be paid. The enrolling procedure for CHIP is also quite easy. It is all digitized and is via the internet.
Medicare is a health care program that provides insurance and coverage to the elderly and disabled individuals irrespective of their income levels. It is administered through special MEDICARE centers and the coverage benefits differ based on several factors like doctor’s office location, whether it is a home treatment and resources being utilized. Any person who is above the age of 65 or who has a disability or who is suffering with a renal disease/ kidney failure is eligible for MEDICARE benefit. Once you are enrolled into this plan, you are given cards of different colors based on your illness, age or your eligibility criteria. The services include skilled nursing facilities, x ray, mental health care, drugs cost reimbursement and Hospice. The individual has to pay a monthly premium of around 100$ during his ‘working’ days to enjoy this ‘privilege’ in his/her old age.
Medicaid is a series of programs administered by the government to provide health insurance coverage to individuals. The ‘individuals’ here include disabled, children and pregnant women with low income levels. It also covers the poor people satisfying the motto ‘Every American should be healthy, no matter what’. The government pays waivers to the poor and they will not have to pay anything to Medicaid ‘organization’. But, others will have to pay insurance premium. The features offered are Dental Care, HIV protection, several preventive and health measures. For this plan to be efficient, poverty should be defined specifically. The poverty income/annum should be defined as well. This is a centralized policy but different states have different versions of this plan. The versions are different in terms of their scope and eligibility criteria.
9. Managed Care
Managed care plans have the following procedure: All managed care plans have some negotiations made with a few doctors/clinics/hospitals. All these together form the managed care network. Managed care plan requires the individuals to go to doctors/clinics which are part of this network for the reimbursement to happen. Policy holders are given incentives in various forms by the insurance companies. Before the individuals adopt a policy, they have to go through a formal procedure which indicates about all the incentive plans and also assures quality medical treatment. This form of insurance gained popularity in the last 10 years and is followed by all the people with a private health insurance.
10. Catastrophic Health Insurance Plan
A Catastrophic Health Insurance Plan ‘protects’ an individual from paying sky high medical fee in case of an accident or a serious illness. The individual will have to pay premiums which are quite low comparatively. She/he will also have to pay deductibles on a yearly basis. You are insured for all major ailments but this plan doesn’t cover general checkups and drug/medicine cost. These plans are available only to the people who are below the age of 30 and to the ones who have hardship exemptions (they don’t have to pay the fee). These plans offer the facility of free primary care visits and preventive services for the first three years (once in a year). The only con with this plan is that individuals will have to pay heavy deductibles i.e. heavy investments even before the main insurance plan starts.