Health Plans – How to Cover Medical Bills?

Health Plans - How to Cover Medical BillsToday, the prices for medical insurance in the United States are unreasonably high. As a result, if the system is not changed, then the prices for insurance and medicine in general will only grow. One of Barack Obama’s campaign promises was to reform and make healthcare available to all Americans. The draft of this reform is called Obamacare. There were many obstacles on the way to the implementation of the reform. However, as Obama said, “It came here to stay,” the reform was launched and is currently being actively promoted among all residents, promising affordable prices for health insurance.

The main goal of the ongoing reform is to insure all uninsured who are unable to purchase insurance at affordable prices, starting January 1, 2014. Immediately after the launch of the official website, which turned out to be completely inoperable, criticizing comments were sent to Obama starting from ordinary people to the political elite. But the Obama team is working to improve the project and still invites everyone to search for available insurance on the site.

Who does the Obamacare program care about in the first place?

Obamacare cares about those who are unemployed, or who are employed but do not have access to employer-sponsored insurance, and the elderly – that is, all those who have limited access to low-cost insurance for various reasons.

Can we hope that this program will offer you interesting rates in the insurance market if you are employed and your employer offers insurance, albeit not with the best prices? More likely not than yes, because you have access to insurance, which, albeit in part, is sponsored by your employer. If, of course, your salary is not lower than the minimum.

The best way to check is to apply at the official website and wait for the results, which are not coming very quickly at the moment. You will be asked to provide all information about yourself, including your status and income. You will then be told if you are eligible for free Medicaid / Medicare, or if you are eligible for discounts on market plans and how much. Next, you will need to compare different insurance plans and choose the one that suits you best.

The insurance purchase period for the next year began on October 1, 2020 and will be open until March 31, 2021. If the insurance was purchased before December 15, 2020, it will be effective from January 1, 2021. If later, then the insurance begins to operate from the 1st day of the next month, provided that you purchased it before the 15th day of the current month. The policy is purchased for a year, and it will not be possible to refuse it during this year, and it is possible to make changes to the purchased plan only in certain cases.

How US health insurance works?

Some of the largest players in the Illinois insurance market today are Aetna, Humana, Coventry, Blue Cross Blue Shield, Cigna, and others. Each company has many insurance options, and you need to know to determine which one is best for you:

The patient’s insurance plan looks like this:

What you need to know when choosing insurance in the USA?

In general, many insurance plans can be divided into three main groups:

As you can see, the prices can vary significantly, and the examples of prices shown were found according to the given parameters, as indicated above – for a resident of Illinois at the age of 27. From the examples it can be seen that the higher the monthly payments, the lower the deductible and out-of-pocket maximum, and vice versa. However, when choosing a plan, it is important to pay attention to all the details of the proposed coverage.

Often, each type of insurance covers 100% for preventive visits to a doctor once a year (including a gynecologist), for vaccinations, diagnostics associated with these preventive visits. And then, if there are more medical expenses, the patient pays the deductible, and the further algorithm is already clear to you.

At the same time, you should always remember that each insurance company offers the best rates when choosing doctors from its network (in-network), and if you go to out-of-network doctors, all payment conditions deteriorate sharply. And if the high / gold plan also offers to partially sponsor these costs, then medium / silver will offer you a completely uninteresting percentage of co-insurance, and the catastrophic plan will not cover such costs at all.

This is important to know when choosing insurance, it is worthwhile to study in advance how wide the network of doctors and medical institutions that are covered by this insurance company, and always be careful about choosing a clinic or doctor.

Category: General

Tags: healthcare, insurance