The Many Faces of Health Insurance

admin — Mon, 15 Mar 2010 02:00:39 +0000

One of the most widely circulated and hotly debated forms of insurance in America today, health insurance is the subject of intense political and social debate. A rapid and extremely complex, health insurance is also one of the most important benefits offered by many employers. Types of insurance Medical insurance covers general and specific levels of payment for physician visits and treatment, medications, hospitalizations, emergency room visits, surgery, and so on. There are large variations in coverage plans, with many combinations of covered and excluded items, different coverage levels, deductibles, and other variables that make it impossible to give a general statement on all the plans cover. Many employers offer an open enrollment period each year during which employees may select from different coverage plans. Careful selection of the appropriate plan for each individual is a critical task. Dental insurance is sometimes included in the medical, but more often it is a separate policy. Virtually all dental plans cover annual or semi-annual cleanings and checkups, with many plans to increase the percentage covered Participation regular appointment time. Routine treatments such as cavity fillings, bridges, etc., are usually treated, even if the amount of coverage may vary. Braces are sometimes covered for minor dependents, and more rarely for adults. Cosmetic procedures are generally not covered. Vision insurance is often offered as a separate plan to go with medical insurance. Vision plans typically cover an annual review, with glasses or contacts covered to a predetermined limit, every year or two. Necessary, medical procedures to protect or correct eye health are usually not covered. At this time LASIK or other corrective procedures are rarely covered. Managed Care One of the biggest trends in health insurance over the last two decades the United States have been the place of managed care as a model for providing primary medical care. Based on the concept of centralized decision making, the pooled resources and effective delivery of services, Health Management Organizations, or HMOs, do offer an economic hedge, often at much lower premiums than private insurance management. Critics, however, point to longer wait times for appointments, fewer doctors to choose from, and often the need for referrals to specialists as weaknesses of how HMOs. Whatever the advantages or disadvantages of HMOs, it seems certain that this organizational model will continue to grow in popularity. Medicare and Medicaid The Government of the United States have for many years, has funded two special programs to help extend health coverage to people who may not be able to access other health care needed. Medicare is designed to help older Americans pay for their health care. More recently, the Medicare Part D program was created to help seniors pay for prescription drugs. Medicaid is intended to help poor Americans get health care, but with high administrative costs, reimbursement rates low, and often a complicated set of restrictions and requirements, the number of doctors who accept Medicaid has declined steadily recent years.

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The Many Faces of Health Insurance