Health insurance is an insurance policy that pays for medical health expenses. However, many use the term broadly to include disability insurance or long-term insurance. Health insurance is available through government health insurance plans or from private health insurance companies. Individual health insurance or group health insurance are two main options available to the American public from private insurers.
The health insurance plans cover medical expenses associated with health treatment dictated due to sickness or injury. The level and type of medical insurance offered by insurance companies vary across the board. The extent of your health insurance coverage is outlined in your health plan or Evidence of Coverage booklet. Here are important health insurance terms to know about your coverage:
premium: this is your customary payment for maintaining your health insurance coverage
copayment: this is the flat fixed amount you must pay out of pocket before the insurance company pays for a health service or prescription
coinsurance: this is the payment made by you which is a percentage of the total medical costs incurred. Basically, it is your part of the medical costs in terms of percentage of costs as outlined in the health policy
deductible: this is the out-of-pocket amount before the health insurance plan pays for the rest
coverage limits: certain healthcare insurance policies offer health coverage up to a certain dollar amount and subsequently, you must to pay for the remaining expenses
exclusions: health services which aren’t covered by health insurance. Medical care excludes expenses that have to be paid out of pocket by you
out-of-pocket maximums: this is the opposite of coverage limits except in this case, your financial obligations terminate when the out-of-pocket maximum is reached, and the insurance company pays all extra covered costs
Picking the right health insurance plan or company involves understanding various components of health insurance. There is no such thing as standard health insurance coverage, breadth and depth of coverage differs from one health insurance plan to another and from one health insurance company to another.
As the saying goes, “you get what you pay for.” So it is true in the case of a health insurance, the lowest premium is not necessarily the best health plan with the most benefits. You should choose a health plan that provides health services that best meets your needs at a competitive cost. Essentially, the main differences between health insurance policies come down to three entwined elements: costs, benefits, and restrictions.
The cost associated with health plans differ with each plan, your premium payments are the principal costs associated with your health medical coverage. Coinsurance costs, in-network costs, and out-of-network services, deductibles, exclusions, coverage limits, and more, all are different.
Majority of health insurance plans provide coverage for hospital bills or physician services, with a variety of limits. Many benefits such as, psychotherapy, glasses, prescription drugs, preventive care, screening, and immunizations may or may not be covered under your plan.
Generally, health managed-care plans restrict your choice of healthcare providers and may require pre-approval for medical services. Additionally, certain health policies are accompanied with limitations in terms of deductibles, co-payments, and uncovered services. Due to inherent restrictions in managed plans, choice in physician care can be limited to physicians within the healthcare plans.
In order to make the best decision regarding your choice of health insurance plan, it is important that you choose the appropriate insurance company. Below are tips on choosing the right health insurance company:
discover the company’s insurance offerings
research the company’s credit rating by rating firms like Moody’s
ask detailed questions of the insurance agent or representative, as needed
evaluate the health insurance policy offerings, what is covered and what isn’t
find out what your copayment, deductible, and other out of pocket costs associated with individual plans, find affordable health insurance
Furthermore, here is a list of some of the best health insurance companies and their A.M. Best Financial Strength Ratings
Aetna Aetna – A –
AIG – A+
Altius Health Plans – B++
Anthem Blue Cross and Blue Shield – A
Blue Cross and Blue Shield – A
Cigna – A-
Coventry Health Care – B+
Genworth – A+
Golden Rule – A
Great-West Healthcare – A-
Guardian – A+
Health Partners – C+
HealthAmerica – A-
Humana – A-
Medica Health Plans – B
State Farm – A+
UNICARE – A-
United Healthcare – A-
WellPath Select – B++
Zurich North America – A
Ultimately, your decision to get health insurance is of critical importance, so make sure you take the necessary steps to choose the right health plan and health insurance company.
*A.M. BEST Financial Strength Key:
A++, A+ (Superior) A, A- (Excellent) B++, B+ (Good) B, B- (Fair) C++, C+ (Marginal) C, C- (Weak) D (Poor) E (Under Regulatory Supervision) F (In Liquidation) S (Rating Suspended)