What Is Medical Insurance and Who Needs It?

Medical insurance in the United States is a contract with an insurance company, according to which you pay a certain amount to the insurance company every month, which, in turn, assumes part of the medical expenses in case of your illness.

Medicine in America is really very expensive, so you can not neglect insurance. Another significant argument in favor of running and concluding a contract is that according to the Affordable Care Act, medical insurance is compulsory for all legal residents of the country. There is even a penalty for her absence (on average, $ 350-400).

For reference: US citizens, green card holders, refugees, persons granted political or humanitarian asylum, and nonimmigrant visa holders  (including workers and students ) are considered legal residents.

How to Get Medical Insurance?

Depending on your life circumstances and financial gain level, you can:

  • purchase by yourself;
  • part of the costs incurred by the state;
  • the state pays for insurance in full;
  • insurance is fully or partially paid by the employer.

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What are the types of health insurance?

HMO - health maintenance organizations

The cost of health insurance in the United States of this type is the lowest. And all because of the very limited number of doctors and medical institutions that you can attend. You will need to be treated in the institutions of one network, and you will have a primary general practitioner who will issue referrals to other specialists. Coverage does not include services provided outside the network, except in cases of emergency medical care.

PPO is the preferred provider of organizations

The network of institutions is still present, but it is much broader. You can be treated both in the network institutions and outside of it (but the conditions in the network will be much more favorable). Also, you do not need to take a referral to specialists, they will take you on insurance without it. Buy medical insurance in the United States of this type will cost much more than all the others.

There also are an alternative, less fashionable varieties of insurance. Point-of-service (POS) assumes that victimization the services of doctors and hospitals from the network, you'll pay less. The Exclusive supplier Organization (EPO) is the same because of the health maintenance organization, solely while not a primary doctor and necessary referrals to specialists.

What are insurance plans and how much does it cost?

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Depending on the percentage of medical expenses covered, there are five basic insurance plans:

  • platinum - about 90% paid by the insurance company;
  • gold - the insurance company pays about 80%;
  • silver - the insurance company pays about 70%;
  • bronze - the insurance company pays about 60%;
  • Minimal insurance - designed only for emergency cases and is available exclusively to persons under 30 years of age or to those who can confirm that they are in a difficult financial situation.

It is also worth remembering that insurance plans differ in a number of important points, like: co-pay (a fixed amount you pay for each medical service, and the balance is covered by the insurance company), deductible (the amount you need to spend before the insurance coverage), co-insurance (you pay a certain percentage of the cost, the rest is the insurance company), out-of-pocket maximum (the maximum amount spent during the year you start to receive 100 percent coverage from the insurance company).

Dental and ophthalmological insurance are traditionally bought separately. Dentist services include only children's medical insurance in the United States.

The cost of insurance, for the foremost half, can rely upon your financial gain, the region and also the designated insurance set up. as an example, insurance sort health maintenance organization from Kaiser Permanente in 2016 for a family of 1 person can value from $ a hundred and sixty (minimum insurance plan) to $ 315(platinum plan) per month. To calculate the price directly for you, use the special search and Compare Tool calculator on the official web site. Covered California.

Where and when to buy insurance?

You can buy medical insurance in the US through the Health Insurance MarketPlace. This is such an insurance market. there is a nationwide resource however, some states have their own websites.

In the US, there is also a certain time to buy insurance - from November 15 to February 15 of each year. But insurance prices during this very year remain unchanged. Of course, cases of relocation, changes in family composition and the like are the exception and allow you to purchase insurance outside the prescribed period.

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