While not everyone has health insurance in the United States, everyone has a right to health care under a 1968 federal law. This law states that all patients seeking care in an emergency room must be given at least the minimum treatment even if they cannot pay for the medical care in full or do not have health insurance. The law does only apply to those hospitals that participate in Medicare health insurance.
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According to Ohio’s Department of Insurance not having health insurance can be a risky decision. If you don’t have health insurance you run the risk of financial disaster if you have an accident or develop a serious illness to which you would need medical attention.
What are the types of health insurance plans?
There are many options when seeking out health insurance. Most people will look for jobs where the employer covers a good chunk of the cost of health insurance, but individuals also have several plans they can choose from as well.
Managed care is a health insurance plan where certain providers have contracts with the health insurance company. These providers are put together in a network to provide care to the patients who have that company’s health insurance. These include HMO, POS and PPO plans.
- HMO health insurance plans, or Health Maintenance Organizations, are plans that are prepaid with a monthly premium. Those who have HMOs can receive care from doctors, for hospital visits, x-rays and therapy that are in the comprehensive network of providers.
- PPO (Preferred Provider Organization) plans contract with independent health care providers at a discounted rate. Those who have a PPO health insurance plan can receive care outside of the network, but would pay more for health care services from a provider outside the network.
- POS or Point of Service plans are a blend of both the PPO and HMO plans. This is where you can use doctors in the HMO networks or you can choose a health care provider outside of the network. You will pay more for a doctor outside of your network, however.
What are some other types of health insurance besides managed health insurance?
There are individual health insurance plans for those who don’t receive health insurance through their employers or a spouse’s employer. In those situations you can look into the private health insurance market, state sponsored insurance, temporary insurance such as COBRA, or getting group insurance through organizations you belong to.
Individual health insurance can be expensive and time consuming when searching for the right company to work with. It’s important to research all of your options, policy types and any background information on the health insurance companies you are considering.
For those who don’t want the price tag of individual health insurance or who cannot afford it there are other options. Another option is to look into organizations you belong to in order to receive the discounted group rates.
For example, being a member of the American Automobile Association (AAA) will afford you many benefits and group discounts that you might not have be able to receive otherwise. There are also government programs that are set up for those individuals or families who are low income and cannot afford group health insurance or private health insurance.
What if I don’t receive or can’t afford health insurance?
There are many people who don’t receive managed health insurance through their employers and can’t afford to buy individual health care. For those people who qualify there are government funded health insurance programs.
Medicaid offers health insurance to those people with low incomes who either have inadequate medical insurance or who don’t have any health insurance. The government has established guidelines for these benefits.
While the eligibility for Medicaid varies from state to state there are some general requirements:
- You must be a U.S. citizen or permanent resident to qualify for Medicaid.
- You must also be of low income.
- Medicaid will also cover those who are pregnant and uninsured, have a child or more than one child with a disability, or be responsible for a child or children under the age of 19.
There are also government programs for those seniors who need assistance with health insurance, Medicare. There is also a government program set up for children to receive health insurance called Child Health Insurance Plus (CHIP).
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