Health Insurance

Health Insurance

What You Need to Know About Health Insurance

The Affordable Care Act passed a few years ago made it easier for people to get affordable health care. But even with the law in effect, there is still a wide range of costs and coverage levels. Here are some things you should know about health insurance policies in general.

Must Fully Cover Preventative Care

If you have a health insurance policy, even if it is one that requires you to pay a large deductible, you don’t have to pay anything for preventive care. Preventive care includes a routine doctors visit to check your general health in the form of a physical, a visit to get recommended vaccines, such as the flu vaccine or gynecological checkups for women. The ACA requires your insurer to cover such visits 100 percent without charging you anything, although you can be charged for some other service that is unrelated to the visit, such as if your doctor decides to prescribe you medicine based on something he or she finds during the visit.

Varying Levels of Coverage for Other Things

Beyond preventive care, insurance policies can have widely varying levels of coverage, although they cannot have a deductible higher than the level set by the ACA. What your policy covers and how much it pays largely depends on how much you pay in premiums. For example, the lower your premium, generally the higher your deductible is.

Some policies may require you to pay a co-pay for doctor visits, which is a set fee for every time you visit your physician. There may be different co-pays for different services. For example, you may pay one co-pay for doctors visits, one co-pay for prescriptions and another for a hospital stay.

Most health insurance policies also have a deductible, which is an amount you must pay on your own before the policy will start paying for anything. Many policies require you to pay the full cost of your care for injury or sickness until you reach a certain level and then the policy will start paying a certain percentage until you hit another level. Once you hit that level, the policy starts paying your costs 100 percent.

Health Insurance Doesn’t Cover Everything

Health insurers are all about managing their costs, and so anything they can exclude by law, they often will. For example, the ACA doesn’t require health insurers to cover procedures or drugs that are considered experimental or that haven’t been approved by the appropriate regulatory agency. Health insurers also often won’t cover medical treatments that are considered outside the mainstream, and most won’t cover something that isn’t deemed medically necessary, such as plastic surgery that is used solely for cosmetic reasons.

Do You Homework

When looking to buy a health insurance policy, make sure you do your homework. If you get a policy through your employer, your choices may be limited, but you still should understand what you are getting. If you get your insurance on your own through one of the government marketplaces, be sure to study policies carefully so you can pick the one with the right level of coverage for your needs.