Health insurance

Health insurance

Health insurance: How it protects you from health and financial risks

No one plans to get sick or hurt, but most people need medical care at some point. Health insurance covers these costs and offers many other important benefits.

• Health insurance covers essential health benefits critical to maintaining your health and treating illness and accidents

Health plan may offer the following services: Coverage may vary but Company.
– Ambulatory patient services (outpatient care you get without being admitted to a hospital)

– Emergency services
– Hospitalization (like surgery and overnight stays)
– Pregnancy, maternity, and newborn care (both before and after birth)
– Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
– Prescription drugs
– Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
– Laboratory services
– Preventive and wellness services and chronic disease management
– Pediatric services
– Others

• Health insurance protects you from unexpected, high medical costs.

Health insurance provides important financial protection in case you have a serious accident or sickness.
People without health coverage are exposed to these costs. This can sometimes lead people without coverage into deep debt or even into bankruptcy.

It’s easy to underestimate how much medical care can cost:

Fixing a broken leg can cost up to $7,500

The average cost of a 3-day hospital stay is around $30,000

Comprehensive cancer care can cost hundreds of thousands of dollars

Having health coverage can help protect you from high, unexpected costs like these.

• You pay less for covered in-network health care, even before you meet your deductible.

Insurance companies negotiate discounts with health care providers, and as a plan member you’ll pay that discounted rate. People without insurance pay, on average, twice as much for care.

This means when you use a network provider you pay less for the same services than someone who doesn’t have coverage – even before you meet your deductible.

Sometimes these savings are small. If you’re insured and use a network provider, you may pay $25 for a flu shot instead of the $40 someone without coverage pays.

In other cases the savings can be big. If use a network provider, you may pay $85 for an office visit instead of the $150 someone without coverage pays. Savings can be even higher for more expensive services.
So even if you don’t reach your deductible during the year, you can save a lot of money on your covered medical services just by being enrolled in an insurance plan.

• You get free preventive care, like vaccines, screenings, and some check-ups, even before you meet your deductible.

Most health plans cover a set of preventive services — like shots and screening tests — at no cost to you.

• If you have a Marketplace plan or other qualifying health coverage, you don’t have to pay the penalty that people without coverage must pay.

If you don’t have qualifying health coverage, you must pay a penalty known as the individual shared responsibility payment.

The penalty is 2.5% of your household income or $695 per adult — whichever is higher. The fee rises with inflation. Final 2018 amounts will be published when available.

So if you don’t have health insurance, you have to spend money on a penalty — and pay for all of your health care yourself.

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