Health insurance is an agreement to provide medical services and pay the costs of medical care. The Affordable Care Act of 2010 introduced new legal standards for health insurance and created methods for reducing its cost. It is for individuals and families, and based upon the state and county of residence, everyone can get coverage despite age, sex, health, and pre-existing medical conditions. The major benefits of health coverage include quality medical care at affordable prices. The costs of medical care are substantial. Without insurance, a single minor event could wipe away years of savings and all of an individual’s or family’s assets.
A healthcare policy provides basic medical care such as annual checkups, tests and immunizations. This basic coverage often involves two or three visits to a primary doctor. The policy covers additional care, but are subject to payment of an amount called a co-pay and an overall amount called a deductible. The co-pay is the amount that consumers must pay to receive any services beyond the basics. It is a set amount, for example, each doctor’s visit might require an agreed upon co-pay amount. The deductible is a threshold amount determined on an annual basis which the consumer must pay before the policy begins to pay for covered services. Once paid, the deductible triggers benefits from the policy and consumers must usually only pay an agreed co-pay amount for each service.
Individuals and families can purchase coverage through a state healthcare exchange, get coverage as a member of a group, or through an employer-based plan. There are two primary systems for coverage; these are networks of doctors and hospitals under contract to provide medical services to members or subscribers. The major types are the Health Maintenance Organization (HMO) and the Preferred Provider Organization (PPO). The HMO relies upon a primary care physician to deliver and approve services within the network. HMO’s focus on wellness and prevention. PPO’s permit consumers to see doctors inside or outside of the network and without prior approval. Speak to one of our agents to learn how you can benefit.