Health Insurance

Health Insurance in Missouri

Health insurance in the USA isn’t provided by the government for all citizens, and also is not obligatory to have health insurance in the USA. However, it is important to have health insurance because medically necessary health services can cost you a fortune. There are two types of insurance plans in the country: private and public. This means you can purchase plans from private companies or government health exchanges. Health insurance provided by the government is through Medicare, Medicaid, or the Children’s Health Insurance Program. If you don’t have insurance that is provided by your employer or government, you need to purchase it on your own – those types of plans are called individual plans and they can be for yourself and your family. Also, some plans don’t fit into major medical insurance categories like short-term and dental and vision insurance plans.

There are usually major health insurance plans you can purchase: HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), POS (Point-of-Service), and EPO (Exclusive Provider Organization).

Individual and Family Health Insurance Plans

The individual health insurance plan covers only one person, and the family health insurance plan covers the entire family. There are two main types of individual plans: Affordable Care Act (ACA) and Indemnity Plans.

Affordable Care Act Plans

These types of plans must meet all basic medical requirements under ACA and are the most comprehensive plans on the market. This means that by purchasing one of those plans you’ll get a minimum of the essential care benefits like emergency services, hospitalization, out-of-patient services, maternity leave, prescription drugs, substance use for disorder services (like mental health and behavioral problems), pediatric services (including oral vision and care), preventive services for chronic illnesses and rehabilitative services. Also, you can’t be rejected by your insurer for some pre-existing conditions you might have. Although, you’ll need to purchase this plan during the ACA Open Enrollment Period. Four types of ACA Plans are HMO, PPO, POS, and EPO. There are also Catastrophic plans for people under 30.

Indemnity Plans

These types of plans are also known as fee-for-service plans. They are good for those who are looking for more flexibility in choosing doctors and hospitals and aren’t worrying about additional costs.

Short-Term Plans

Short-term healthcare plans are also part of individual plans, but they aren’t part of major medical health insurance plans. They have lower costs but come with much fewer benefits than qualified healthcare plans. However, they are good for people in transitioning periods who are waiting for their long-term coverage to kick in, like people close to 65 who are waiting to be eligible for Medicare, people who are currently looking for a job, people who turned 27 and aren’t under family coverage, students who moved to another country and need temporary coverage, etc. However, those plans don’t follow the rules of ACA basic medical benefits may not be covered, also your insurer can decline your application based on pre-existing conditions (you’ll need to answer underwritten health questions to qualify for short-term plans).

Dental Insurance Plans

Dental insurance plans can be a part of your health insurance plans but not in every case.  You can have a dental plan if you are insured through your employer or buy the plan you purchased from a private insurance company. Also, you always can purchase a standalone dental plan. Dental services can be very expensive and you never know what might happen so it is good to have this plan as an addition to your healthcare. With this plan, you can lower your costs and get the proper preventive dental care. However, plan costs can vary based on which type of plan you decide to purchase. Furthermore, all Qualified Health Plans are obligatory to provide dental care for those under 18.

Vision Insurance Plans

Vision insurance plans aren’t part of any health insurance plans for adults. So, you’ll need to purchase those plans on your own. This type of coverage is always a good thing no matter if you wear glasses or contact lenses. Sometimes it’s not bad to think in advance because even though you might don’t need these benefits now, you’ll need them later. Vision insurance plans include routine checkups, so this is good preventive care because your eye doctor might discover a disease you can treat properly. There are two types of vision insurance: as an addition to your major medical insurance and ancillary plans. Also, all QHP must provide preventive care, annual checkups, and eyeglasses for children under the age of 18. Plan costs can vary from plan to plan.

Health insurance in the USA is a very complex thing but it doesn’t need to be scary. Luckily there are experienced health brokers who can help you in purchasing the right healthcare plan.

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