What is the best health insurance? This is question that many people just like you are asking themselves every day. How you answer that question really depends on what health insurance problems you want to solve. In other words, have you identified your specific insurance needs? It is important to understand that health insurance is not a discount off the price of health care. Insurance means risk management, and the monthly premium you pay is the price you pay the health insurer to take on the risk of your health care expense. One way of looking at this is that the company is making a bet that you will not need care. When the company pays the costs of your medical care, it has lost the bet, and you win in the sense that most of your expenses are paid.
Now that we know that a health insurance policy is a way to manage risk, it is important to understand that there are a number different kinds of agreements, or policies, available depending on your needs. Generally, the subject of health insurance brings to mind questions about doctor and hospital care available for individuals and families through privately purchased policies, and/or employees through an employer group health insurance plan. When choosing a health insurance policy, you (or an employer) must decide what your tolerance for risk is and how much risk you want managed. To that end, there are many private companies selling insurance plans.
Some well-known health insurance company names that you might encounter when researching policies include, Assurant, Anthem, Blue Cross, Aetna, Cigna, Banker’s Life, Mutual of Omaha, United Health Care, Humana, Kaiser, and Tonik. This is really just the tip of the iceberg, and the point of listing these names is only to show you that there are many, many insurance companies all offering their own benefit packages and prices. When you choose a plan, you are choosing one health insurance company to be the payer on your health insurance costs. The way this works is that your doctor submits a bill (called a claim) to the insurance company for services provided, and the company reimburses the doctor an agreed upon rate. How much the insurer pays and how much you pay as your share of costs (deductibles and copayments) depends on the agreements set forth in the policy.
Is there such a thing as single payer health insurance? The answer is both yes and no. In the United States the insurance program that most closely approximates a single payer is the Federal health insurance program for retired individuals age 65 and above. This program is called Medicare and became law in 1965. Although the government manages Medicare, it contracts with private insurance companies to handle the day to day operational logistics of administration. So you see, even though the government is the single payer, it still involves the private insurance industry. The Federal government has gone even further involving private insurance by creating the Medicare Advantage Plan program, which essentially allows private insurance payers to manage Medicare benefits through private, managed care plans.
Health insurance choices can seem to be overwhelming. After all, there are not only many different insurance companies but many different kinds of policies as well. Some examples include, supplemental insurance designed to supplement or add on to an already existing health insurance policy; there is dismemberment insurance, temporary health insurance, hospital only insurance, disease specific health policies, and policies designed to pay only when your total out-of-pocket expenses reach a certain limit. The question of course, is how to do you choose?
Making a sound choice depends on a number of factors. You will need to make a list of your costs, needs, circumstances. For example, do you need medical care for only a limited period of time? If so, then a no frills temporary policy might work better for you than a more comprehensive, expensive plan. If you need coverage that will include all of your family, then you will probably look at a more comprehensive plan including both hospital and medical benefits. However, let’s say that you work in an environment where there is a realistic expectation of injury. In that case, you might consider catastrophic coverage, or possibly a dismemberment policy. When searching for health insurance, your understanding of your needs will be of primary importance in finding a policy that suits not only your needs but your budget.
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