What is Health Insurance and Who Benefits the Most?

What is Health Insurance and Who Benefits the Most?

Some people think that having health insurance means they are entitled to the very best care, but that is just not true. In terms of care quality, your insurance, and the amount your insurer will pay, is more like the silver, gold and platinum rooms in airports. In other words, the more you pay, then the more likely it is that you will receive care at a prestigious and/or very high-quality clinic or hospital. However, before getting ahead of ourselves, let us first examine what health insurance is and who it benefits the most.

Insurers Pay for Care From Medical Providers

An insurer pays for the services of a provider. In the broadest terms, a provider, as defined by health insurance companies, is a doctor, hospital, clinic, laboratory, pharmacy or healthcare practitioner. When you use Compare Health Insurance to find your quote, insurers are offering premiums in return for covering your costs with providers if you ever need treatment.

The last definition, “healthcare practitioner” is probably the grayest area in health insurance circles. For example, where one policy or one insurer pays for healthcare practitioners like physiotherapists and home help, others will only pay for podiatrists, health visitors, and so forth.

If you are the one who is insured, then you are the one with the health insurance coverage. Being the policyholder doesn’t always mean you are the one covered. For example, if you bought health insurance for your teenage child, then you may be the policyholder, but your child is the one who is covered.

Is my Employer Already Paying my Health Insurance?

Thanks to tax incentives, and a willingness to keep staff, many companies in the US and Australia will offer health insurance as part of the deal. Larger companies can save a bundle on these types of deals because they get very large group discounts.

It is important that you take care of your own health insurance. If you have good cover from your job, you still need to cover for things your job doesn’t cover. You may also need to get health insurance for the rest of your family. Plus, remember that when you leave your job or lose your job, your health insurance ceases.

The Two Types of Health Insurance

If you do not count the health insurance you get at work, then there is only private insurance and government-funded health insurance. In places like the USA, around 65% of the population under the age of 65yrs old has private health coverage.

Government health insurance is often a policy where the insured person still pays, but the government subsidizes the insurance. There are also some countries where health insurance is paid by the government under certain conditions, such as if somebody is a war veteran.

These are the only two types of health insurance, but sometimes the way a company administers its plan means it is called something else. For example, a managed care plan is where you pay a lower premium, but you are restricted to a certain set or providers and you have to pay extra if you go outside the network. Other examples of insurance variations include:

  • Indemnity, or fee-for-service plans
  • Health maintenance organizations (HMOs)
  • Preferred provider organizations (PPOs)
  • Point-of-service (POS) plans

People Who Benefit The Most Are Unlucky People

It sounds a little sour, but the truth is that unlucky people are the ones who benefit the most from health insurance policies. In other words, they are the people who get the most value for money, and who take the fewest losses due to bad luck.

Bad luck has a broad definition that rests rather well with the notion that unlucky people come out winners. Having bad luck may be as simple as breaking a finger, in which case health insurance can save you hundreds. It might be bad luck like having liver failure, in which case health insurance can save you thousands. A tricky pregnancy can be very expensive unless you have a good health insurance policy to help you pay.

Health Insurance Helps Keep You Out of Debt

As you probably know, health insurance debt is a thing in itself. Even when you apply for a credit card, they mention your types of debt and court actions for your debt, and then they mention (separately) your health services debt and any actions that have occurred in court about health payment debts.

Becoming ill, or even something as nasty as whiplash from a fender bender, is going to cost you money when you start having treatment. The costs can quickly run into the thousands, and it puts you in a lot of debt very quickly. Also, as is the nature of medical problems, these debts often arise just at the time when you are suddenly unable to work or to earn as much as you normally would. It is at times like these when health insurance can really help you save thousands of dollars.