Health insurance is a plan in which large number of population is covered to check the risks associated with medical expenses. It is generally enforced by law which is further enacted by various health insurance agencies, both government and private. Below is the overview of two types of insurance providers.
Government Insurance Providers
According to the Affordable Care Act, US federal and state governments are committed to provide complete medical benefits to all Americans. Health Insurance Marketplace in every state provides different plans based on medical needs and individual or family budget. Some of the popular Insurance providers run by government or through contract are:
- Medicaid: Medicaid is a government insurance program which provides protection against the cost of medical expenses to people who belong to low-income group, people with disabilities, and pregnant women. Medicaid is delivered by state government bundled with other form of insurances such as Children Health Insurance Program.
- Medicare: Medicare as government health insurance plan covers people above 65 or older, young people with disabilities as well as people with end stage renal disease and one with amyotrophic lateral sclerosis. Medicare is not part of the Health Insurance Marketplace.
- Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA): CHAMPVA is regulated by the Department of Veterans Affairs and is provided to the spouse or widow(er) and to the children of a veteran who is permanently disabled in service or died. Veterans who were 65 or older prior to June 5, 2001 eligible for CHAMPVA, will be entitled for both Medicare Parts A and B benefits.
- Consolidated Omnibus Recollection Act (COBRA): COBRA is run by the US federal government to offer continuation coverage to covered employees and their families under group health plan in case of termination or disability.
- Children’s Health Insurance Program (CHIP): The Children’s Health Insurance Program covers uninsured children up to age 19 from families with incomes high enough not to qualify for Medicaid. Under its different implementations, pregnant women and state employees’ wards are also covered.
- TRICARE: Tricare is a healthcare program of the US department of Defence Military Health System covering in-service and retired defence personnel and their families and the survivors of deceased military personnel. The insurance is available under annual deductible, coinsurance and copayment to the insured.
Private Insurance Providers
Private insurance providers are profit based health care insurance businesses which deliver medical services under managed care to the insured and their families. These claims can be made according to the conditions stated in the Benefits statement of the insurance plan. They are becoming popular and also endorsed by many employees as job incentives to their employers. Usually, private insurance companies have their own headquarters where the doctors are paid for their services and other medical facilities such as lab tests become part of the network. They also take services of public medical associations who under a negotiated fee work for them. Under different insurance plans, the insured can benefit by cutting on medical costs. The insurances are available under an annual deductible or monthly premium. The insured can still require to co-payment and coinsurance in most cases. The paperwork is reduced due to introduction of medical card.
Most of the insurance companies will be glad to help the person to make an informed decision. The insurance plans are of type from fixed to flexible medical services and of complete coverage to high coinsurance depending upon different situations. Generally, the beneficiary’s medical history, family history, work environment, lifestyle and finances become important factors in determining the kind of insurance to choose from. Top popular insurance companies in US are United Health, WellPoint Inc., Aetna, Cigna Health, HCSC, and Kaiser Foundation.