Understanding Health Insurance
What is health insurance?
Health insurance helps you pay for your health care costs. Having insurance can help protect you from high medical costs, and it may help cover expenses if you need unexpected care. It also can make it easier to have routine doctor visits and preventive care. Insurance sometimes helps pay for prescription medicine costs.
Health insurance pays some, but not all, of your medical costs. Some plans pay more of your costs than others.
How can you get health insurance?
Many people get a health insurance plan through their work. The employer often helps pay for the plan. Some people buy health insurance on their own, directly from an insurance company, rather than getting a plan through an employer.
The United States government provides health insurance for people who qualify, such as seniors, people with certain disabilities and health problems, and some people with low incomes. Medicare and Medicaid are government insurance programs that help pay certain medical expenses for people who are eligible.
There are different kinds of health insurance plans to choose from. To get the best care, it's important to read your insurance plan closely. Be sure you understand the plan's rules and costs, how it works, and which medical services are covered.
Types of Health Insurance
Private health insurance is often offered through employers or other organizations. Some employers offer only one type of health insurance plan. Others may allow you to choose from more than one plan.
Buying health insurance on your own, instead of getting a plan through an employer, usually costs more. You pay for the plan yourself, rather than sharing the cost with an employer.
Some insurance plans work with certain health care providers and facilities, which are part of the plan's network, to provide care at lower costs. This is called managed care. There are different kinds of managed care plans:
Indemnity (fee-for-service) plans are different from managed care plans. The choice of doctors or hospitals you can use for your care is not restricted. Your health care provider is paid a fee each time you get medical care covered by the plan. The costs you have to pay on your own (out-of-pocket) could be higher than they are with some managed care plans.
Public (government) insurance
Medicaid is a state-run, government insurance program that helps some people with lower incomes pay for medical care. Medicaid pays your health care provider. You may have to pay a small amount for certain medical care.
Medicaid is available only to certain low-income people and families who are eligible. Rules about who is eligible and what services are covered vary from state to state. To learn more about Medicaid, go to www.cms.gov.
Medicare is health insurance provided by the government for people age 65 or older. People who have certain disabilities or health problems, such as long-term (chronic) kidney failure treated with dialysis or a transplant, also may get insurance through Medicare. It covers some, but not all, medical costs for people who qualify.
Medicare has four parts:
To learn more about Medicare, go to www.medicare.gov or call 1-800-MEDICARE.
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