The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) and nicknamed Obamacare.
The Affordable Care Act was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance
coverage and reduce the costs of healthcare. It introduced mechanisms including mandates, subsidies and insurance exchanges.The law requires insurers to accept
all applicants, cover a specific list of conditions and charge the same rates regardless of pre-existing conditions or sex.
Individual Health Insurance
Individual health insurance is coverage that a person buys independently. Also called private health insurance, this type of coverage is ideal for the self-employed and anyone looking for a wide variety of options and pricing structures from which to choose. After group health plans, personal health insurance is the most widely available form of medical coverage. It can be sold to a single individual, to a parent and dependent children, or to a family. The majority of Americans get their health insurance coverage through an employer or through a government program, but five percent of the population purchases private health coverage on an individual basis. Each state separately regulates how individual policies may be marketed and sold. In most states, individuals can be denied coverage for any number of reasons, so it is wise to request and compare more than one individual health insurance quote.
Family Health Insurance
Family health insurance is no different than individual health insurance plans and usually they are sold under the same name. Families that have proper health insurance are more likely to receive preventive medical care resulting in early diagnosis and treatment of illnesses before they become serious. Family health insurance also provides a family with financial security in the event of an unexpected illness or injury. Even if you do receive coverage through an employer-sponsored health plan, you should consider the cost-saving benefits of switching to a family medical insurance policy or moving some of your family members off of your group policy into a family plan. When adding more people to the application, the chances of denial increase, so you should request multiple family health insurance quotes and be prepared to apply to several family health plans.
Group Health Insurance Plans
Most Americans receive their health coverage through some type of group health insurance. Although large corporations with hundreds or even thousands of employees have the bargaining power to negotiate with medical insurance companies for custom health plans for their workers, the small business owner must still research options and compare prices from multiple providers. Small Group Health Insurance, Give your employees the choice and flexibility of a Small Business Health Insurance plan.
Short-Term Health Insurance
Short-term health insurance is more of a stopgap measure for preventing an insurance coverage gap. Such gaps occur when switching jobs, moving to a new state, or graduating from college among other things. During these times an individual is temporarily without credible medical coverage and therefore open to the financial burden that can result from a major medical expense caused by an accident. Short-term medical insurance has an expiration date and can be purchased for periods varying from 30 days to 1 year. It is typically a very affordable health plan designed only to cover major medical expenses. If you are going to be without insurance, protect yourself and request a free health insurance quote for short-term insurance today.
Student Health Insurance
Most major colleges and universities require their full-time students to have medical insurance. While many of these same schools also offer their own student health plan, it is wise to explore your options. Typically the school will provide the minimum requirements that a health policy must meet in order to waive coverage under the school's policy. By choosing a private student health insurance plan, you have more choices about the doctors and hospitals you use. If you choose a plan that meets only the minimum requirements, then you can also often find a cheaper plan.
Supplemental Health Insurance Plans
Supplemental health insurance is a type of insurance policy designed to cover the gaps that your regular health insurance may have due to deductibles and co-payments. Supplemental health insurance covers additional expenses that your primary insurance doesn’t cover, such as lost income and living expenses. Those who should consider supplemental health insurance are the self employed, families with children, those financially unprepared to handle large medical bills or time off from work due to illness or injury, and those on Medicare. Changes in recent years to the federal government's medical insurance program for seniors has created a complex system with rigid enrollment timelines. Medicare supplemental insurance is designed for people on Medicare who wish to have more comprehensive coverage. These supplemental plans may include Managed Care HMO plans or Medigap PPO plans that provide you with greater access to participating physicians.
Different types of managed care plans work differently and include preferred provider organizations (PPOs), health maintenance organizations (HMOs), and point-of-service (POS) plans.
Types of Health Insurance Plans
In the United States, there are two broad categories of health plans - plans from private companies and government-sponsored plans. Most working adults obtain their healthcare coverage from privately-owned insurance companies or managed care plans. Governmental (public) programs are available to support the healthcare needs of children and adults with limited income, the retired and those who have been injured on the job or otherwise disabled.
Most Americans who have health coverage are enrolled in private health plans. The majority get this coverage through their employer, but some have to buy coverage on their own in the individual market. Private insurance can generally be categorized into two types of plans -major medical (also known as fee-for-service or indemnity) and managed care. There are three basic types of managed care plans: health maintenance organizations (HMOs), preferred provider organizations (PPOs) and point-of-service (POS) plans. Unfortunately, there are serious (and growing) problems with private insurance. Prices are spiraling upwards, leading employers to raise the share paid by workers, cut back on benefits, or drop coverage altogether.
While there are two major types of private health insurance, plans are also available for special needs or for select groups of individuals. Such plans include short–term medical coverage, student plans, catastrophic care coverage, disability policies and policies that supplement Medicare (Medigap).
A variety of governmental programs are available to assist the retired and those in financial need. They include Medicare, Medicaid, Workers' Compensation, Disability, State Children’s Health Insurance Program (SCHIP), and new children's healthcare initiatives
Health care in America is changing rapidly. Thirty years ago, most people in the United States had indemnity insurance coverage. A person with indemnity insurance could go to any doctor, hospital, or other provider (which would bill for each service given), and the insurance and the patient would each pay part of the bill.
But today, more than half of all Americans who have health insurance are enrolled in some kind of managed care plan, an organized way of both providing services and paying for them.
Difference between Traditional, PPO and HMO coverage
Traditional: There are no lists of physicians and hospitals. You may use any Doctor you want to, and the plan will pay the bill (subject to UCR clauses). Some plans consider a physician as a "licensed practitioner of the healing arts, which practices within the scope of their license". This lets you use Naturopathic and Chiropractic practitioners.
PPO: A Preferred Provider Organization is a network of physicians and hospitals that have agreed, by contract, to discount their rates to members. The networks are typically very large, and the members are free to seek care from any physician or provider within the network, including specialists without a referral. Members may also access non-contracted providers, but at a higher out-of-pocket cost. If you were to buy a PPO plan instead of a Traditional plan, you would never know the difference as long as you used the provider list. Typically PPO plans might offer some front-end co-payments for such services as doctor visits and prescriptions. Most other covered services (i.e., inpatient hospital services and surgeries) are typically subject to a calendar year deductible and/or coinsurance (where applicable).
HMO: A Health Maintenance Organization provides benefits for preventive care coverage and low out-of-pocket costs. There is typically no coverage for care from doctors or hospitals outside your HMO. Plans usually offer comprehensive benefits and affordable premiums with no deductibles. You choose a Primary Care Physician from a network; This Doctor oversees all your care, and may provide referrals to specialist if needed.
Compare plan details from many medical insurance companies like Aetna, Assurant, Celtic, Golden Rule, Health Net, Humana, Nationwide, PacifiCare, Unicare, United Health Care and Blue Cross and Blue Shield of various states.