Health Insurance in 2020
Health insurance in 2020 can pay for any medical services you receive. Depending on the plan you pick, it may also cover prescription drugs. After purchasing coverage, you and your insurer will agree to pay a portion of your medical expenses.
How to Get Coverage?
There are several ways to get health insurance coverage. Your employer may offer it or purchase a plan through a group.
You may also choose to buy it from an agent or a federal health insurance marketplace. If you are qualified, you can apply for Medicare or Medicaid, which is a government program.
Types of Medical Insurance Plans
There are several options but most of them are categorized into three groups.
1.) Exclusive Provider Organization
By exclusive, it means that you can only use the providers in the plan’s network. If you choose a specialist outside the network, you will pay the entire cost of your medical care.
2.) Health Maintenance Organizations or HMOs
They are ideal for preventive care. This type of coverage has lower copayments. Unfortunately, your choice of providers is limited as you can only pick the doctor who is part of the plan. If you choose a provider who is not part of the network, then you might need to pay for the entire cost of your medical care.
Should you need a specialist, you must obtain a referral first from your primary care physician.
3.) Preferred Provider Organizations (PPOs)
This plan is more flexible than HMO as you can pick any provider. Just like HMO, this, too, has lower co-payments, if you choose doctors who are part of the network. Then again, you do not need to obtain a referral from your primary care physician if you have to see a specialist.
4.) Point-of-Service (POS)
It works like PPO. That is, you can go to any doctor of your choosing. However, you can lower your out-of-pocket costs if you choose physicians in the network of your plan. You will have a primary care physician and you will need to obtain a referral from your primary care to see a specialist.
How to Get Coverage for Your Family?
You can purchase an insurance plan that can cover you and your family. It is possible to include your dependent kids on your plan up to a certain age. You can also add your married kids on your plan. However, their respective spouses or children are not covered.
Open Enrollment Period for 2020
For individual plans and marketplace, the open enrollment period typically starts in November 2019 and it ends on December 15, 2019. You may, however, purchase at other times. But it is only possible if you got married or divorced, having or adopting a child.
When you have a work health plan, you are given 31 days to choose whether you wish to join the plan or not. For the coverage to start, you will have to wait for 90 days. Furthermore, if you have decided to join the work plan, drop out or change coverage, you must wait until the open period starts.
Pre Existing Condition
Insurers cannot choose a specific group of people to sell their plans. They are obligated to sell their various types of health insurance in 2020 to anyone who applies. Furthermore, they are prohibited to charge you or deny you coverage if you have a disability or a preexisting condition.
What is the Cost of Getting a Medical Insurance?
It depends on the coverage you obtain. It is vital to remember though that you still have to pay a part of the cost of your medical care, in addition to the premium you are paying per month.
When deciding your premium, your insurer will consider your age and your residence. Your premium also depends on whether you smoke or not. They do not consider your health history or gender.
For individuals plans, the premiums are the same for one year. They only change when you renew the plan to reflect your age. If you smoke, you might need to pay more.
How Much is Your Share for the Cost of Your Medical Care?
All health insurance plans involve cost-sharing.
It is the amount you pay before your insurer pays. For example, if your plan has a deductible of $500, you need to pay $500 yourself before your insurer will pay a certain amount. Each year, you need to meet a deductible.
Depending on the plan, you may pay more than one deductible. That is one for in-network care and another deductible for getting out-of-network medical care. Other plans, however, do not have any forms of deductibles.
Every time you get a medical service, you will need to pay a fee, which is known as co-payment. For example, you might need a co-payment for going to a doctor or filling a prescription. The amount may vary from one plan to another.
You may pay it for getting a covered service after meeting your deductible. Coinsurance is typically in the form of a percentage of the entire cost of the medical service.
For instance, your medical insurance might require you to pay 10% of the medical service and the remaining 90% is covered by your insurer. In an HMO, you do not have any coinsurance.
Federal law establishes limits on how much you can pay out of pocket in a plan per year. After reaching the limit, you do not need to pay any coinsurance or copayments for the remaining months of the plan year. But you must still settle your monthly premium.
Making an Informed Decision
Choosing a health insurance plan requires you to read the fine print. You also need to evaluate your medical needs.
For example, would you like the freedom to pick your own doctor? Do you need specialists? Does it cover special treatments or home care?
Some insurers combine major and basic coverage for the types of health insurance in 2020 they offer. You must check your policy before signing anything. In that way, you can be sure that you have the right protection you need. Use our website to compare one plan to another to help you make an informed decision.
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