Health Insurance

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What is Health Insurance?

Health insurance covers medical expenses, helping you pay for treatments and medications when needed.

  • Types of Health Insurance
  1. Health Maintenance Organization (HMO): Requires you to choose a primary care physician and get referrals for specialists.

  2. Preferred Provider Organization (PPO): Offers more flexibility in choosing healthcare providers, both inside and outside the network.

  3. Exclusive Provider Organization (EPO): Similar to PPO but doesn’t cover any out-of-network care, except in emergencies.

  4. Point of Service (POS): Combines features of HMO and PPO, requiring a primary care physician but allowing some out-of-network coverage.

  5. High Deductible Health Plan (HDHP): Involves higher deductibles and lower premiums, often paired with Health Savings Accounts (HSAs).

  6. Catastrophic Health Insurance: Provides coverage for major medical expenses and has lower premiums, typically for younger, healthier individuals.

  7. Short-Term Health Insurance: Temporary coverage for individuals between jobs or waiting for other coverage to begin.

  8. Medicare: Government-sponsored health insurance for individuals aged 65 and older or with certain disabilities.

  9. Medicaid: State and federally funded program providing health coverage for low-income individuals and families.

  10. Children’s Health Insurance Program (CHIP): State program offering health coverage for children in families that don’t qualify for Medicaid but can’t afford private insurance.

  • Who should buy a Health Insurance Policy?

Everyone, regardless of age or health, should consider a health insurance policy to cover medical expenses and ensure financial security in case of illness or accidents.

  • Learn a few terms about Health Insurance
  1. Premium: What you pay regularly to keep your health insurance.

  2. Deductible: The amount you pay before insurance helps with costs.

  3. Copayment (Copay): A fixed amount you pay for covered services.

  4. Coinsurance: Your share of costs after meeting the deductible.

  5. Out-of-Pocket Maximum/Limit: The most you pay in a year; insurance covers the rest.

  6. Network: Approved facilities and providers by your insurer.

  7. Health Savings Account (HSA): A savings account for medical expenses with tax benefits.

  8. Preventive Services: Check-ups and screenings to prevent or catch issues early.

  9. Preauthorization: Approval is needed from insurance before certain treatments.

  10. Exclusion: Services or conditions not covered by the insurance policy.

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