Simply stated, Health Insurance, also known as
Medical Insurance, pays expenses related to the treatment of
covered illnesses or injuries. However, as with most things,
Health Insurance can be much more complicated than
that. Health Insurance
policies can contain a dizzying array of exclusions, deductibles,
co-pays, coverage limits and treatment restrictions. In this section, we will explain
some of the basics of health insurance. But as always, we encourage you
to ask your health insurance agent questions about your policy.
Currently, most Americans with Health Insurance
get their health insurance through their employers. Health insurance plans offered
through employers are known as Group Plans because your eligibility
is dependent upon your inclusion in a specific Group, in this case
your employer. Group
Plans are very advantageous because you are automatically covered
upon payment of the premiums based on your inclusion in the group
and you cannot be denied coverage because of your past or current
health condition. Many
times, an employer will pay a portion of the health insurance
premiums and the employee will pay the remainder. The percentage paid by the
employer is decided by the employer and can range from 0% -
100%. In addition to
employers, other types of groups can also offer group health
plans.
It is important to remember that employer group
health plans are sponsored by the employer but they are run and
administered by private insurance companies. In the event of a claim, you will
deal directly with the private insurance company that wrote your
health insurance policy, not your employer. In most cases, your employer will
have no decision making ability in whether a claim is paid or
denied.
Many other Americans are covered by Social
Insurance plans.
Social Insurance plans are insurance plans run by the government
such as Medicaid or Medicare. Their benefits and coverages are
determined by the government, not private insurance
companies. They
normally cover certain populations such as the elderly, the very
young, the disabled or the poor. Social plans are paid for
entirely with public taxes and their benefits are government for
local, state and federal governments.
You can also obtain insurance directly from a
private insurance company. But unlike Group and Social plans
which cannot deny you coverage, a private insurance company can
refuse to cover you with a policy if you are already in poor
health. In addition,
private policies are generally much more expensive to obtain than
most group policies.
Therefore, if you have access to an employer sponsored health
insurance plan, that is generally the best and most cost efficient
way to obtain health insurance.
Because health insurance policies can be complicated, we recommend
that you obtain a health insurance agent and together, thoroughly
exam your situtation and decide which health insurance policy or
plan is right for you. If you are looking for health
insurance on your own, below is a list of leading health insurance
companies in your area.