Advantages and Disadvantages of Health insurance
Health insurance in the US is complicated and that’s a fact. But now a new era is dawning where the vase majority of people who do not have health insurance can get a better chance of getting coverage.
Health insurance is supposed to cover the medical billing needs of you and your family and of your employees.
Health insurance: A modern perspective
But it does not work like that! Getting any type of medical insurance is really expensive and the coverage provided by different employers is different too. There is a huge amount of difference in what businesses offer their employees in the form of coverage and there is an equally large gap in the way insurance companies behave!
Factors which affect health insurance coverage!
The amount of health insurance which is provided by businesses is governed by state laws, government laws and the state of the economy. At present according to a government survey about 67% of U.S. employees have some sort of health insurance. And the opportunity of good health care is a prime consideration for skilled employees who looking out for jobs. Out of the three job offers that a skilled employee will have, the one which offers the most comprehensive coverage is usually preferred over all others!
What are the types of insurance offered by employers?
There are several different options which are available for employers to offer to their workers and the benefits of each differ from person to person. Let’s take a look at the common ones.
- Traditional insurance also called as Indemnity Insurance - Almost everyone has this type of health coverage where you as the insurer have to pay a monthly or yearly premium. You can choose the healthcare provider you want and after the treatment the costs are reimbursed by the insurance company. Up until a few years back this was a really favorite option as it allowed employers and employees the fluidity to set their premiums and choose their own health care provider. Today this does not work out well as logistical problems set in. With large companies and workers who stay all over the county it becomes really difficult for insurance companies to reimburse and track payments.
- Health Maintenance Organizations (or, HMOs) - HMOs are organized companies of trained doctors, hospices, and other care providers who work in collaboration with insurance providers. The advantage of this type of HMO working with an insurance provider is that you get quality care at a pre-negotiated lower price. But here are disadvantages in this system too. The main drawback being that a primary physician or PCP is the first doctor to check out the patient approves any further specialist care if needed. Any further care must also be approved by the PCP. And this means that the PCP can filter care procedures that keep the cost to the insurer down so that a profit is possible. Due to the collaboration effort, premiums also turn out to be considerably lower.
- Preferred Provider Organizations (or, PPOs) - PPOs are just like a HMOs. But this model of insurance delivery has its own advantages and disadvantages. More often than not, this model is not as good as the others purely because the choice of health care providers is severely restricted. A PPO will have only a specific listed network of hospitals and care providers which are recognized to offer you treatment. All care should take place by a physician who works inside the system and is pre-approved. If the patient opts for treatment outside the system, then all or part of the payment will have to borne by the patient. This does work out in large cities which have a large network of well-established hospital. But the main problem arises as the patient is restricted to only those on the lists.
- Medicare and Medicaid - Medicare and Medicaid are two governments set up insurance care providers who offer health insurance for those who are elderly, handicapped, very poor or terminally ill.
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