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.
Many people think that health insurance is a kind of price discount, but that is not true. Now that you know it is really a kind of risk management, you can see that there can be many kinds of plans to suit many different kinds of needs. If you have the money, you can even have an insurance company write a custom policy just for you. To keep costs down, health insurers offer set packages of benefits, and each package would include a slightly different menu of benefits. Normally, for many people, the term, health insurance plan, means something that pays for hospital and doctor care for either a single individual or for a family. Employer or union group health insurance is a policy offered through an employer or union to offer coverage for their employees. The kind of policy you choose, and the kinds of policies an employer makes available, depends on how much risk you want managed.
The search for health insurance plan information can seem overwhelming at first because there are so many plans, policies, and companies. Common well-known names that you might encounter could be, Cigna, Banker’s Life and Casualty, Blue Shield, Kaiser Permanente, Anthem Blue Cross, Tonik, Humana, Sterling, and the list goes on and on. These are all private insurance companies regulated by Federal and state insurance laws and all are in competition with each other. For that reason, you find that there are many different policies (or packages of health care benefits) and many different premium prices and cost sharing arrangements. In order for the policy you choose to work for you and your family, you must prioritize your health needs and then search for the company and policy that will give you the closest match. The company you choose then becomes the payer on your medical costs. In a private health insurance system, as exists in the United States, there can be many different payers because there are many different companies competing for your business.
Whereas private insurance includes numerous different payers, a single payer health insurance program usually describes a system in which the government manages all health care costs. The government program is the single payer. In the purest form of this, there would be no interaction at all with the private sector. The closest example of single payer health insurance in the U.S. is probably Medicare, the Federal health insurance program for individuals age 65 and older. When Medicare first became law in 1965, the Federal government was the single managing entity and payer. In more recent years, the Federal government has allowed private insurance companies to manage Medicare benefits through private managed care plans in the form of Medicare HMOs (health maintenance organizations), PPOs (preferred provider organizations), and PFFS plans (private fee for service plans). The private Medicare plans are called Advantage Plans, and even though the government still supervises and authorizes the plan, it has allowed other payers to participate in the Medicare program.
How do you choose what is best for you? If you are approaching age 65, Medicare will very likely figure into your insurance plans. Everyone else must sift through the many different insurers and plans on the market. The vast number of choices and policies can be overwhelming. Kinds of health insurance include dismemberment insurance, continuation of coverage insurance, hospital inpatient only policies, catastrophic coverage, long term care, temporary health plans, policies that are specific to a particular disease, health savings accounts, point of service options, supplemental health insurance, and the many different kinds of managed care plans.
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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