Health Insurance
Health Insurance
The purchase of health insurance constitutes the two parties’ formal agreement to a legally binding legal contract. In exchange for payment of a monthly fee, the insurance provider has agreed with the insured individual to pay all or a portion of their medical expenses.
Typically, the contract is an agreement that lasts for one year, during which time the insurer is obligated to pay certain costs associated with treatment for disease, accident, or pregnancy, as well as preventative care.
Exceptions to coverage are typically included in the following areas of health insurance policies sold in the United States:
- A deductible that compels the customer to pay “out-of-pocket” for certain medical expenses up to a specific maximum amount before the insurance coverage from the company kicks in.
- One or more co-payments that the customer is responsible for paying as a predetermined percentage of the total cost of certain services or operations.
In exchange for a monthly premium payment, an insured person is responsible for paying a portion of the costs associated with medical treatment, including surgical procedures and preventative care.
In most cases, the insured person will have fewer out-of-pocket costs if their monthly premium is larger.
Since 2010, the Affordable Care Act has made it illegal for insurance companies to refuse coverage to patients who already have a preexisting ailment. Additionally, it has made it possible for children to stay on their parent’s health plan until age 26 if the parents so choose.
Medicaid, Medicare, and the Children’s Health Insurance Program (CHIP) are all federal health insurance programs that provide coverage to low-income individuals, those with disabilities, and the elderly.
How Does Health Insurance Work?
The healthcare system in the United States is complicated to understand. It is a business that faces competition from various regional and national rivals, each varying offering levels of coverage, prices, and availability from one county to the next and from one state to the next.
Approximately half of all American workers are offered health insurance coverage as a benefit of their employment, with some portion of their premiums being paid for by their companies.
The expense to the employer is tax-deductible to the payer, and the perks to the employee are tax-free, with a few exemptions for employees working for S corporations who are eligible for certain tax breaks.
People who are self-employed, freelancers, or operate on a gig basis can purchase their insurance policies independently. HealthCare.gov is a nationwide database that was ordered to be created by the Patient Protection and Affordable Care Act of 2010, also known as Obamacare. This website enables users to search for basic plans offered by commercial insurers in their geographic area. Taxpayers with lower incomes receive financial assistance to offset the costs of the coverage.
Some states, although not all of them, have developed their own variants of HealthCare.gov specifically geared toward those states’ inhabitants.
Medicare, the health insurance program for retirees, is supported by the federal government, and Medicaid, the health insurance program for low-income families, is also subsidized.
Conclusion
If you have a job, your employer most likely pays for your health insurance. If you work for yourself, you can directly purchase insurance from a private insurer. You can receive financial assistance for the costs if your income is modest. The federal Medicaid or Medicare programs can provide coverage if you are a disabled or older person.
