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Health Insurance

What Is It?

A contract between the insured and the insurer to cover a portion of medical expenses incurred by the insured.

Different Types of Coverages

  • Employer Based Coverage – This coverage is obtained through your employer and the employee and employer share in the cost of the premium.
  • Obamacare Health Plans – Plans purchased through the marketplace where families or individuals are responsible for paying the premiums in full or may be eligible for subsidies.
  • Government Plans – These are the Medicare and Medicaid Plans. Medicare plans are available to individuals 65 and older and those who have disabilities. Medicaid plans are available to low income individuals and families. Medicare part A is typically free and Medicaid is free or in some cases has a modest premium.
  • Catastrophic Plans – Also known as high deductible plans have lower premiums but high deductibles. This plan is sometimes attractive because of the lower cost of premiums.

How Does It Work?

Depending on the plan you choose, your insurance will likely be subject to deductibles, coinsurance and co-pays. Your deductible is the amount you have to pay before the insured will make any payments on your medical expenses. Coinsurance is the cost you share with the insurer in covering those expenses. As an example an office visit might be subject to a 90/10 split. In this example you pay 10 percent and your insurer pays 90 percent. A copay is a fixed flat amount that you might pay for certain services. As an example, your policy might state that you have a $100 copay per emergency room visit.

Major Benefits

  • Keep your cost down. The uninsured usually pays more than the insured. When you have insurance, the insurer has established negotiated rates that the insured benefits from. Without these, you would be subject to whatever the physician charges.
  • Preventative Services are available at no cost to the insured as long as you see in network providers.
  • Under Obamacare, individuals and families with no insurance are penalized.
  • Peace of Mind

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