For the past several years, the soaring cost of healthcare coverage and medical insurance has been a hot social and political topic. It’s an issue unlikely to go away any time soon. As healthcare costs continue to rise, so too do medical insurance costs. And that is just for those Americans lucky enough to have coverage.
In 2007 alone, over 45-million Americans were without medical insurance coverage of any type. That accounts for an increase of almost 8-million since 2000. It does not include the millions of Americans since then or the estimated 14,000 who are losing coverage every day due to the global economic crisis.
If you are uncovered, finding low cost, high-quality medical insurance may seem nearly impossible. It is tricky, but it isn’t impossible. The better educated you are, the more likely you will find affordable healthcare coverage tailored to meet you and your family’s needs.
InsuranceUSA.com provides the following information with the hope that it will help you navigate the medical insurance maze and come to the best decision for you and your family.
Medical insurance: What is it and how do I get it?
Medical insurance is precisely what the name says it is, insurance designed to protect you and your family from the high costs normally associated with healthcare
Medical insurance can be offered by the government or a private company. Most individuals obtain coverage through their employer. Policies are usually renewable monthly or annually, and will typically cover a pre-determined set of items (hospital stays, emergencies, etc.). Usually there is some sort of prescription drug plan available as well.
If your employer doesn’t offer medical insurance – many small businesses and companies cannot afford it – you will have to purchase it privately.
Is medical insurance really necessary?
You might be in peak condition. You’re never sick and rarely get hurt. You might think, “why spend money on medical insurance, if there is nothing wrong with me?” Fact is though, life is full of surprises. So before you decide to leave it all to chance, consider the following:
* Without medical insurance you won’t seek regular and routine check-ups. Problems can go unnoticed and develop unchecked. Also, people will less likely seek therapeutic aftercare when problems are addressed.
* Without medical insurance you’ll be often be required to pay upfront before services are rendered, unless the situation is life-threatening.
* Without medical insurance you’re more likely to ignore problems, which can lead to a costly trip to the emergency room if the problem gets worse.
* Without medical insurance you face the prospect of towering medical bills that you can’t pay.
* Finally, without medical insurance, you’re less likely to be able to provide your children with the regular healthcare they need to ensure they grow up healthy and strong.
Frequently-used medical insurance terms
Here are some important terms you should know when researching medical insurance plans:
* Out-of-pocket expenses are any amounts the insured must pay themselves.
* Out-of-pocket maximum is how much out-of-pocket expense the insured must pay before the insurer is required to pay the rest.
* The amount you pay out-of-pocket before medical insurance covers a service or procedure is called a co-pay or co-payment.
* Coinsurance is where the insured pays a percentage of the total cost. Coinsurance has no upper limit.
* Coverage limit is the absolute maximum a medical insurance company will pay before the rest is the insured’s responsibility.
* A premium is the monthly amount a person must pay for their medical insurance.
* You will usually have a deductible. That is the amount you will have to pay before your plan kicks in. For example, if you have a $500 deductible, you will pay $500 out-of-pocket for medical services before your medical insurance pays anything.
* An exclusion on a medical insurance policy means that a service or procedure is not covered (such as for an elective procedure like cosmetic surgery) and the insured is responsible for paying for it out-of-pocket.
* Explanation of Benefits or (EOB) is a document the medical insurance company prepares which explains exactly what services they cover and how much they are covering.
* Prior authorization verifies that the medical insurance company has approved payment for a medical service or procedure before it is performed.
What you should look for in a medical insurance company
Take your time and do some homework before you purchase any medical insurance. There a few things you should consider before you make your decision.
Every medical insurance provider is going to have different plans to suit different people with different needs. Knowing more about an insurance company will help you know what kind of services they provide. Find out how well-established a company is. Have they been around for decades or years? How extensive is their network of physicians? What kind of experiences have other customers had with a particular company? Look around and do some research.
Once you’ve narrowed your search down to a few likely contenders, see what kind of products each one offers. Not all medical insurance plans are the same, particularly among different companies. It is also very important to know the differences between Preferred Provider Organizations (PPO), Indemnity Plans or Point of Service Plans (POS), and Health Maintenance Organizations (HMO).
Finally, know your coverage. If you’re going to pay for medical insurance, you should know exactly what you’re getting. A plan might seem like a great deal, but it may or may not suit your needs. Before deciding on anything, know what the plan covers and what it doesn’t.