Health insurance is essential. Even if you feel healthy, accidents and sudden illnesses can happen. However, navigating health insurance, the costs, definitions, and procedures can be overwhelming. Breaking it down into steps can help make it more understandable.
The first step is obtaining health insurance through one of these ways:
- Parents can cover dependents up to age 26.
- Employers offer most full-time and some part-time employees health insurance that is paid for by payroll deduction.
- Colleges offer student health-insurance plans.
- Social service offices offer applications to apply for Medicaid.
- The federal health insurance exchange has plans that can be purchased by individuals.
The second step is to review what is covered in your health insurance plan. As you review what is covered in your plan, consider what your most important health needs are:
- Do you have a medical condition that needs monitoring?
- Are you pregnant or plan to become pregnant?
- Do you do work that can cause injury, or be more exposed to illness?
In general, plans will cover:
- Preventive and well-care visits (most at no cost)
- Labs, X-Rays, and scans
- General and Specialist doctor visits
- Procedures and surgeries (check for maternity care)
- Hospitalization
- Mental health care
- Therapy (physical, occupational, etc)
- Prescriptions
- Urgent care and emergency room treatment
The cost of these benefits can vary widely based on your plan and are often described using common insurance terminology:
Premium: The amount you pay for the coverage, usually monthly.
Deductible: The amount you have to pay out of pocket for services before insurance will pay its portion.
Co-insurance: Once the deductible is met, the insurance company may only pay for a percentage of the medical cost and you will pay the remaining percentage. Example: Plan will pay 80% of the cost of a procedure and you pay the remaining 20% of the procedure.
Co-pay: Set fees you owe to providers upfront as described in your plan.
By reviewing what is covered and what your needs are, you can compare plan costs to see which are more affordable.
When in doubt, ask your plan administrator questions! Your health is important and taking these steps can make taking care of yourself easier.
Source and more help:
For more definitions, go here: https://www.medmutual.com/For-Individuals-and-Families/Health-Insurance-Education/Glossary-of-Terms.aspx
https://www.healthcare.gov/medicaid-chip/getting-medicaid-chip/
By Joyce McCauley-Benner, Editor
