Health insurance is one of the most vital parts of our life. Yes, we need insurance as health costs are rising. We need protection for ourselves and family members in case of serious illnesses.
However, finding the right health care provider (as well as the most affordable one) is sometimes not that simple. Also, some of us still don’t understand what most health policies cover.
What do Health Insurances Cover?
According to the requirement from the Affordable Care Act (ACA), there are at least ten benefits covered by health care policies. All private health plans offered in marketplace will include ten benefits, including:
- Ambulance patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Maternity and newborn treatment (care before and after the delivery)
- Mental health and substance use disorder services (includes behavioral health treatment as well as counseling and psychotherapy)
- Prescribed drugs
- Rehabilitative and habilitative services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical abilities
- Laboratory care
- Preventive, wellness services, and chronic disease care
- Pediatric care
Health policies offered in the state-run market are also required to meet these requirements. However, there are some additional benefits that are stated as additional coverage.
Also, there are some preventive services covered by health insurance starting in 2015. Previously, health plans didn’t cover preventive services until December 31, 2014. Preventive methods will vary by state. Therefore, you need to review the plan offered in the marketplace carefully.
There are some preventive services covered, from anemia screening (for expecting women) to vision screening (all ages). For kids, there are also autism screening, behavioral assessments, and many more.
Why is Private Health Plan So Expensive in the US?
There are two primary reasons why US health plan is so costly. Based on book titled The Healing of America written by T.D Reid, the US health insurance is expensive because the government doesn’t control the prices (unlike in other countries) and the complicated system adds more cost.
According to a report from Commonwealth Fund, most Americans still think health insurance is unaffordable, despite the subsidies. The report shows that 60% of respondents surveyed said they had not checked health insurance in their state’s marketplace because they think they can’t buy it. Also, 54% of respondents surveyed were unaware that financial assistance is available for health plans while 53% of respondents didn’t realize that the health care reform law can be accessed in some states.
The percentage of uninsured Americans kept declining, from 20% in 2013 to 13% in 2015. Based on the report, almost 70% said they had their new insurance for health care while 62% said they would not be able to purchase health insurance if it weren’t subsidized. 66% of respondents who got the health plan through Medicaid were previously uninsured.
The researchers of the Commonwealth Fund report write that those who are still uninsured are disproportionately poorer, younger, and Latinos. However, the report also showed that millions of people will remain uninsured in states that are not covered by Medicaid expansion.
How to Find Lower Health Insurance?
If your income is lower than your expectation or you are self-employed, you may get confused in purchasing a health plan with the lower premium rate. However, there are some useful tips to lower your premium for health care. Check these out:
- Stop Smoking: Because smoking can cause a lot of diseases, being a smoker can increase your rates.
- The more you pay, the less you pay too: Try to increase your deductibles. The more you pay out of your pocket, the less you buy your premium.
- Go to in-network doctors: Make sure you check doctors included in the provider’s network plan.
- Compare plans with another supplier: If you and your spouse have health insurance provided by workplaces, compare and calculate which one will cover both sides at the lower cost.
- Don’t skip subsidies, please: The Affordable Care Act (ACT) described the level of income eligible for a subsidy. Make sure you get subsidies by purchasing a plan in your state’s Marketplace. You can check the chart whether you are eligible or not.