Health insurance has become a difficult commodity to attain for many Americans, since nearly fifty million don’t have any health insurance, while millions of others are underinsured. Many of us who do have health insurance are restricted to whatever health insurance plan our employer offers. For those of us who do have options, however, there are alternatives available.
Most insurance plans are health maintenance organizations, or HMOs. In exchange for a monthly premium, you are able to seek medical help by making a co-payment to a physician authorized by the HMO for an office visit. Co-payments would also apply toward hospitalizations, medications, surgical procedures, and diagnostic procedures as x-rays, EKGs, CAT scans. These plans require that you visit physicians who are registered providers for the HMO. Your premiums will depend on the amount of the co-payment, and the array of services covered. In general, HMO’s are the most affordable option for comprehensive coverage, but selection of physicians is limited to those who accept the insurance.
Another option is the Preferred Physician Option, or PPO. The advantage to this plan is that you can see any physician, or go to any hospital. The downside is that PPO’s tend to charge higher premiums than HMO’s, and they typically have a deductible. This means that you would have an initial out-of-pocket expense before the insurance plan’s coverage takes over. Your premium would depend on the amount of the deductible, which could range from $250 to $1,000 per year. The higher the deductible, the lower the premium.
Seniors have the option of either going on Medicare, or selecting an insurance plan that is paid by Medicare, which is typically an HMO. Seniors on Medicare often carry secondary insurance to cover expenses not fully paid for by Medicare. Medicaid is only available to those whose income falls below that amount that is determined by each state.
Having medical insurance is a necessity; especially for those with young children, and those with pre-existing medical conditions. The cost of health care now makes up nearly one-fifth of the United States Gross National Product, and is expected to increase at an accelerating rate because of the medical needs of aging Baby Boomers. The Federal government under the Obama administration is working on a plan that will require a total overhaul of our current health care system. A government sponsored insurance plan is being hotly debated in Congress. It is clear that more affordable health care options are needed.