What is the best health insurance? This is question that many people just like you are asking themselves every day. How you answer that question really depends on what health insurance problems you want to solve. In other words, have you identified your specific insurance needs? It is important to understand that health insurance is not a discount off the price of health care. Insurance means risk management, and the monthly premium you pay is the price you pay the health insurer to take on the risk of your health care expense. One way of looking at this is that the company is making a bet that you will not need care. When the company pays the costs of your medical care, it has lost the bet, and you win in the sense that most of your expenses are paid.
When you understand that a health insurance plan is essentially a kind of risk management tool, it is easier to understand just why there are so many different kinds of insurances, policies, and plans. People have many different kind of needs, and so in theory, insurance can provide policies to cater to those needs. When you think of health insurance, most of us think of payment for doctor and hospital expenses. Generally speaking, you either buy an individual or family policy, or you might get coverage through an employer or union plan if you are employed and your employer offers health insurance as a benefit. In order for you to know what you are getting, you must know exactly what benefits are listed in the policy and how much the policy will pay out for the benefits listed.
Some examples of household names that you are sure to recognize are Aetna, Blue Cross Blue shield, Humana, United Healthcare, Sterling, and Mutual of Omaha. Insurance companies are also known as “payers” because they are responsible for paying out on your insurance claims when need arises. Though there may be a relatively small number of companies with instant name recognition, there are literally hundreds upon hundreds of health insurers, and these are all separate payers offering different policies with different selections of benefits catering to different kinds of insurance needs. There are so many because health insurance is largely managed by private insurance companies regulated by Federal and State laws.
Is there such a thing as single payer health insurance? The answer is both yes and no. In the United States the insurance program that most closely approximates a single payer is the Federal health insurance program for retired individuals age 65 and above. This program is called Medicare and became law in 1965. Although the government manages Medicare, it contracts with private insurance companies to handle the day to day operational logistics of administration. So you see, even though the government is the single payer, it still involves the private insurance industry. The Federal government has gone even further involving private insurance by creating the Medicare Advantage Plan program, which essentially allows private insurance payers to manage Medicare benefits through private, managed care plans.
Now, the issue of which health insurance is best for you is answered in part by what specific health care needs are in question. There are many different kinds of policies, and the choices can be overwhelming. For example, there is disability insurance, accident and dismemberment insurance, temporary health plans, continuation of coverage insurance, hospital only insurance, catastrophic coverage, disease specific, long term care, supplemental, and fee for service and managed care polices.
Making a sound choice depends on a number of factors. You will need to make a list of your costs, needs, circumstances. For example, do you need medical care for only a limited period of time? If so, then a no frills temporary policy might work better for you than a more comprehensive, expensive plan. If you need coverage that will include all of your family, then you will probably look at a more comprehensive plan including both hospital and medical benefits. However, let’s say that you work in an environment where there is a realistic expectation of injury. In that case, you might consider catastrophic coverage, or possibly a dismemberment policy. When searching for health insurance, your understanding of your needs will be of primary importance in finding a policy that suits not only your needs but your budget.
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