There’s no question about it — you need health insurance, but you also want to find the best, most affordable health insurance possible.
So, what’s health insurance for and why do you need it? A few reasons:
- Accidents or health problems can happen at any time.
- Medical expenses are so high and can even lead to bankruptcy.
- You safeguard your family’s physical and financial health.
Health insurance allows you to gain access to a network of doctors and hospitals that have negotiated lower rates with insurance companies. We’ll guide you to help you learn more about health insurance and walk you through the steps to get it.
What is Individual Health Insurance?
Health insurance covers medical expenses for illnesses, injuries and medical conditions. But unlike a plan through an employer, you select individual health insurance and pay for it on your own.
What is Group Health Insurance?
Group health insurance covers employees or members of a company or organization. A group health insurance plan offers health insurance coverage to its members at a lower cost since the risk spreads across the members of the group health plan.
How Does Health Insurance Work?
The simple answer is that health insurance protects your assets from high medical bills. You could wipe out your life savings with one accident. We’ll go into more details on how it works and how to get it, step by step, later on in the article.
How much does an individual policy typically cost per month?
In 2020, the average national cost for health insurance was $456 for an individual and $1,152 for a family per month, according to ehealthinsurance.com.
What does health insurance typically cover or not cover?
Health insurance typically covers most doctor and hospital visits, prescription drugs, wellness care and certain medical devices. However, it’s up to you to check your coverages. Most health insurance will not cover elective or cosmetic procedures, beauty treatments or other specific procedures not medically necessary.
How Do Claims and Payouts Usually Work?
Let’s say you choose an in-network doctor for a medical procedure. If that doctor is in your plan, he or she will submit the claim for you. Next, your doctor will send a bill to your insurance company for services he or she provided. A claims processor at the insurance company will check it for complete accuracy and coverage under the plan.
Depending on your benefits, the insurance company will process it and pay the amount agreed upon in your plan. You receive an explanation of benefits (EOB) that goes over how the insurance company paid in your plan. You’ll have to pay for any remaining coverage. The insurance company keeps tabs on your copay, deductible and out-of-pocket maximum (we’ll define a few of these terms in a second).
Tip: Only pay your health care provider after you compare the services listed on the final bill with your EOB.