Your Guide To Understanding Healthcare Insurance

The Basics 

Healthcare Insurance is a form of insurance that helps to cover any medical bills accrued by you and your family. In the same way that Home Insurance covers your house if it is damaged if you get sick or injured your Healthcare Insurance will cover you. It is also possible to get Healthcare Insurance that covers preventative healthcare as well – this would include blood tests, and visiting your doctor.  

The most important thing to remember about Healthcare Insurance is that it doesn’t cover 100% of your medical bills. The system is designed to help you pay, rather than pay it for you. 

Healthcare Insurance employs a system called an out-of-pocket limit. After you have exceeded this limit your Healthcare Insurance will then cover 100% of your medical bill. 

What is an out-of-pocket limit?

An out-of-pocket limit is a limit agreed by your Healthcare provider of what you will have to pay for any injury you get or medical service you require. 

What this limit is will depend on your Healthcare provider’s policy. This limit does not include the premium you pay the provider every month. You should also be aware that hitting your limit does not stop you from having to pay your premiums. 

Example: 

If your out-of-pocket limit is $4500: 

You dislocate your hip falling over and are charged $55,000 in medical bills. With a limit of $4500, you will only have to pay the hospital $4500, and your Healthcare Insurance will cover the other $50,500. 

Why you should buy healthcare insurance?

We often get asked: Who should buy Healthcare Insurance? 

Our answer? Everybody. 

Medical bills can rack up quickly and no one can afford to pay them out of pocket unexpectedly. In the US unpaid medical bills are the leading cause of home foreclosures and consumer debt. 

Purchasing Healthcare Insurance can save your life in more than the obvious way. It can ensure that you have a life to go back to after you leave the hospital. 

The following categories of people may have to take out special Healthcare Plans: 

• Families
• Pregnant women
• Married Couples
• Military members and veterans
• On low income
• A Senior citizen
• A student
• Self-employed

10 essential features any good healthcare should provide

If the policy you are looking at doesn’t offer the following 10 benefits then you should think twice about purchasing it.

1. Prescription Drugs
2. Emergency Services
3. Laboratory Services
4. Pregnancy, Newborn, and Maternity Care
5. Outpatient care (also known as Ambulatory patient services)
6. Mental Health Services, including substance abuse disorder support
7. Hospitalization (including overnight stays, surgery, and other conditions)
8. Pediatrics cover (cover for children including dental and eye services)
9. Chronic Disease Management, Wellness, and Preventative Care
10. Rehabilitative and habilitative services and devices

These are the absolute basics of what your Healthcare Insurance should cover. 

Supplement Healthcare Insurance

Here are the 4 types of Supplement Healthcare Insurance you should be looking for: 

1. Gap Insurance – this type of Supplement Insurance helps you to cover your out-of-pocket expenses. Companies like Transamerica Medicare Supplement help to minimize the amount you have to pay when injured or sick
2. Dental Insurance – this type of Supplement Insurance helps to cover dental bills. They work in a similar way to Healthcare (with the out-of-pocket limit), but on a smaller scale.
3. Vision Insurance – this is a Supplement Insurance that covers bills related to any vision-based treatment you receive. This includes contact lenses, eye exams, and glasses. Any surgeries are considered to be medical necessities and should be covered by your Healthcare Insurance.
4. Critical Illness Insurance – traditional Healthcare plans don’t cover many terminal illnesses. Particularly, ones that require long and expensive treatments – like Cancer, Alzheimer’s, and Strokes. This is where Critical Illness Insurance comes in. If you are covered when you are diagnosed you will most likely receive a lump sum of money.

What will affect the cost of your Healthcare Insurance?

A lot has changed in the last 10 years, previously there were many factors that could affect the cost of your Healthcare Insurance. Healthcare providers are now banned from letting your medical history and gender affect your premiums. Due to the changes enacted by the Affordable Care Act, only 5 things are allowed to affect your Healthcare premiums: 

1. Your age
2. Where you live
3. Whether you use or smoke tobacco
4. If you are looking for individual or family coverage
5. The level of your coverage (catastrophic, platinum, gold, silver, bronze)