What is Health Insurance 101: How it Works and Why You Need It

Health Insurance 101: How it Works and Why You Need It

You might not think about it often, but health insurance affects your life every day—from the moment you wake up in the morning to the time you go to bed at night. It impacts what kind of healthcare you receive, how often you see a doctor, and even what you eat. This guide will help answer all of your questions related to health insurance and explain how it works, why it’s important, and how to get it, whether through an employer or through the marketplace.

What Is Health Insurance?

The most common type of health insurance is a plan that you buy from a private company. The insurer agrees to pay for certain types of medical care, like hospitalization or surgery, as long as you pay your monthly premium. There are three different types of plans:

1) Indemnity Plan - this kind of plan offers protection against large financial losses in the event of illness, injury or death

2) HMO - this type of plan offers lower premiums but requires participants to use doctors within the network

3) PPO - this kind of plan offers wider choice in providers but also higher premiums

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What Do I Get with Each Plan?

The first important thing to know about health insurance is what you get with each plan. There are four main types of plans: HMO, PPO, POS, and Indemnity. All four can provide medical services for you to use when you get sick or injured. However, each plan has different rules about what's covered and who pays the bills.

An HMO is a type of health care coverage where you must use doctors that belong to your network. This type of health insurance usually has lower monthly premiums than other types of coverage but may have higher out-of-pocket costs if you visit doctors who aren't in your network.

Are There Any Co-Pays?

The answer to this question depends on a few factors. If you have a job that offers health benefits or if your employer requires you to have insurance, then you may not need to worry about paying for anything out of pocket. However, if you don't have either of these things, then you will likely have co-pays. The amount is usually between $20-$50 per visit.

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What Are My Options After Obamacare?

There are three types of health insurance options available to you after Obamacare: The Affordable Care Act (ACA), a private plan, or the new Medicare program. The ACA requires that everyone have health insurance. If you choose a private plan, you'll have to pay the premiums out-of-pocket until you meet your deductible. The Medicare program offers health coverage for seniors age 65 or older. It's usually financed by payroll taxes that your employer pays, but in some cases, you may also have to pay part of the premium.

What are Deductibles?

A deductible is the amount of out-of-pocket expenses an individual has to pay before their health insurance starts covering them. For example, if your deductible is $500, you'll have to spend that much money on doctors' visits, prescriptions, or hospital care before the insurance company will start paying. If your doctor visit costs $100 and your deductible is $500, then you'll be on the hook for that first hundred dollars. However, if you had a plan with a $1000 deductible instead of $500, then you would only have to spend a thousand dollars before the insurance company would cover anything else.

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What Is A Preferred Provider Network (PPO)?

A preferred provider network, or PPO, is a type of health care coverage where the insurer pays its members to use medical services from in-network doctors. If you're considering signing up for a PPO plan, make sure you know what that means. A PPO is basically a group of doctors, hospitals and other healthcare professionals who have agreed to accept the same payment rate for their service as everyone else in the network does. This can be helpful because it allows you to see any doctor without worrying about whether they will accept your insurance. However, this also means that if you go out of the network, your rates could be much higher than if you stayed within the preferred provider network.

The Covered Medical Services List

Your health insurance plan may or may not cover medical services. If you want to be sure that your plan covers all of the medical services you need, go through the list of covered medical services before signing up for a plan.

The following is a list of some common things you can expect your health insurance to cover:

- Prescription drugs

- Emergency care

- Mental health care

- Maternity and newborn care

- Preventive care (such as cancer screenings)

If your plan doesn't cover something, find out if there are any other ways to get help with those costs. For example, find out if there are any providers in your network who offer discounts for patients without insurance coverage.

Are There Any Pre-Existing Conditions I Should Know About?

Yes, if you have a pre-existing condition, you will typically be excluded from coverage. This is because your condition makes you more likely to need medical care which will result in higher insurance premiums for the company than for someone without the condition. If you are diagnosed with a new or additional pre-existing condition during the course of your policy, you may also not be eligible for coverage. The only way to ensure that your medical history does not exclude you from coverage is by having what's called guaranteed issue health insurance. With this kind of insurance, no matter your health history or any other risk factors, the company has agreed to provide coverage up front as long as you pay your monthly premium each month.