Health Plans

If you are a citizen of the United States of America, you know very well how hard it is to receive medical care. The Federal government has been trying to bring about changes in this scenario and health care services accessible to all. The 1960s saw the introduction of Medicaid and Medicare that helped the elderly and underprivileged citizens of America. In 2010, the U.S. Federal Government implemented Affordable Care Act (ACA).

There has been a tremendous increase in the number of people who have got coverage under ACA. Here is a small list of different health plans that can help you choose the right plan that works best for your medical requirements and budget:

Health Maintenance Plan (HMO)– This offers a range of medical services provided by a network of insurers. Members also get access to a Primary Care Provider (PCP) who provides referrals to specialists.

Health Savings Account (HSA)– Health Savings Account aka HSA health insurance works in case you have bought a Silver or gold health insurance plan, the monthly premiums you would be paying against these plans will be really high.

Preferred Provider Organization (PPO)– These are among the most popular individual and family plans available in the health insurance marketplace. The plan provides you the freedom to choose specialists even from out-of-network.

Medicaid- This is the social protection plan which covers the extremely poor population in the US. Medicaid was further expanded under ACA. The population with income under 133% of the Federal Poverty Level (FPL) qualifies for Medicaid.

Student Health Insurance Plan (SHIP)- Thanks to ACA, those below 26 years of age can remain under the insurance plans of their parents. However, there are some who are above 26 years and are full-time academicians. SHIP is an exclusive student focused insurance plan that helps people above 26 years get affordable health care coverage.

Blue Cross Blue Shield (BCBS)– A group of 38 healthcare organizations in the USA that provide health insurance either directly or indirectly to more than a billion Americans. These insurance companies are independent of each other traditionally, more like franchises that offer insurance to certain defined areas where they operate.

EPO Health Plans– EPO networks with physicians and specialists within their network. If you are a member of EPO health plan network, you receive huge medical facilities within the network but not out-of-network.

Point of Service Health Plans (POS)- Certain properties of HMO and PPO have been included in the POS health plan. Here again, you can avail health care services both out-of-network and in-network. However, the facilities will depend on what services you opt for.

Medicare– Under the Federal health insurance plan, people above the age of 65 years can receive subsidized health care under Medicare. The plan is also available for people who are completely disabled, are renal patients in the terminal stage, and also people having ALS.

Federal Employees Health Benefit Plan (FEHBP)- Along with different public plans like Medicaid and Medicare, there is a health plan for federal employees known as Federal Employees Health Benefit Plan. This is a healthcare coverage to civilian employees working full-time. The Federal Office of Personnel Management manages FEHBP.

High Deductible Health Plan- This plan is a legal designation that enables HSA eligibility. To enroll in a high deductible health plan, you have to opt for a deductible that is above the IRS threshold. The IRS will set a set value for out-of-pocket limits, HSA eligibility, and a set deductible rate.

Indemnity Plan– Early medical policies that are offered by insurance providers on the basis of certain diseases. Here nothing changes between the provider and the health care receiver.

Network Health Plan- These are various programs that depend on the network of the health care providing organizations. These networks can be used to bring down the cost of health insurance plans, to select providers that are cost-effective, and also to make sure providers receive financial benefits to perform more efficiently.

Child Health Insurance Plan (CHIP)- CHIP is both a state and Federal program that is designed to provide medical assistance to children. This plan is provided only for children from families who do not qualify for Medicaid, and cannot afford private insurance.

High Risk- Certain states still hold the authority to deny coverage in case of prevailing pre-medical conditions. However, many other states also offer plans that are similar to individual health insurance plans. In case, enrollees are denied coverage, they can look for these comprehensive individual health plans.

Catastrophic- These plans have been designed to provide care seekers emergency safety to protect them from unexpected and sudden health care expenses.

Pre-Existing Condition Insurance Plan- The PCIP is created under the Affordable Care Act (ACA) and meant for U.S. Citizens residing legally. PCIP is allowed only if these citizens have remained without insurance for the last 6 months and have been denied medical coverage because of pre-existing conditions or other health conditions. PCIP will not be eligible for those who either have a high-risk pool or some other health insurance plan.

So go ahead and use what you have learned here to choose the right health insurance plan for you and your family.