Health insurance coverage is on the rise, and for good reasons. According to the U.S. Department of Health and Human Services (HHS), the national uninsured rate reached its lowest of 8% at the beginning of 2022, with about 5.2 million people gaining insurance coverage since 2020.
You are probably asking, why is it so important to have health insurance? It’s imperative that you understand what health insurance is and why enrolling for insurance is essential for your healthcare.
Health insurance is a contract between two parties – an insurer ( insurance companies) and the insured. The insured pays premiums to benefit from medical cover. In other words, the insurer caters for part or full medical bills for the insured.
In this article, we’ll discuss in depth why it is essential to have an insurance plan. Also, please keep reading to understand the different types of health insurance; and why it is necessary to have a health insurance plan.
Different Types Of Health Insurance
There are a couple of health insurance services, and they include;-
- Point-Of-Service plans
- Health Maintenance Organizations
- Preferred Provider Organizations
- Exclusive Provider Organizations
Not sure about the type of health insurance that suits you best? Don’t worry; the following is an overall explanation of the different health insurance plans.
Point-Of-Service (POS) Plans
In this plan, you must choose your Primary Care Provider (PCP), such as a doctor from the plan’s pool of healthcare providers. Your PCP is primarily your home care health provider, and they get to give you personal health care advice and service. They coordinate all your healthcare needs.
Suppose you need the services of a specialist. In this case, choosing one from the plan’s network would be best. However, you’ll be liable for filing any claims if you go for a specialist away from the plan’s pool of healthcare providers. Also, you will share more costs.
Health Maintenance Organizations (HMOs)
This plan also requires choosing hospitals, doctors, healthcare facilities, and specialists from their local network. Additionally, you are required to choose a Primary Care Provider (PCP) from the same network.
Your PCP will be responsible for your home care, and when the need calls for a specialist, they will refer you to one within the network. What’s more, the cost of an HMO plan is generally lower than others, and the trick is to stay in-network.
Preferred Provider Organizations (PPOs)
PPOs have a more extensive network of service providers and facilities at your disposal, such as doctor offices, hospitals, etc. The plan allows you to seek medical services outside the plan’s network, but it will cost you a lot more.
Also, getting a Primary Care Provider in these plans is not mandatory; you can also seek any specialist services without a referral.
Exclusive Provider Organizations (EPOs)
Although EPOs only allow in-house medical providers, the plan will also cover out-of-network care when your case is due to an emergency. Also, according to your plan, you may not be required to choose a Primary Care Provider, and when you need to see a specialist, such as an ear doctor, you do not need any referral to attend hearing aid clinics.
What To Consider Before Choosing A Health Plan
Probably, you now have your answer to the question – why is it so important to have health insurance plan? In this case, it will be wise to consider the following before choosing a health plan.
A premium is your monthly remittance due to your insurer for coverage. Regardless of whether or not you use a pharmacy or medical services, monthly premium payments are mandatory. Failure to do so may jeopardize losing your cover. In this case, you need to know how many monthly premiums you’ll be paying and if you can keep up with your payments.
Insurance plan and the provider network
You’ll need to determine whether the healthcare system matches your preferences. For example, whether a hospital you like or professionals, such as a specific dentist you fancy, is among the plan’s network of medical practitioners.
Also, it is essential to note that the plan covers in-network services. However, out-of-network benefits will require you to pay from your pocket.
Before taking a health insurance plan, it will be wise if you first check whether your regular prescriptions are in the coverage. Usually, insurers have a list of medicine (formulary) covered by the plan. If your medication is not on the formulary, it may take a lengthy process to include them in the coverage, or the cover may not include your prescription.
Coinsurance or co-pay
It will be wise to double-check if you’ll incur extra fees to access care. For example, some health coverage may require paying a certain percentage for service or medicine (coinsurance). Or, probably, co-pay (flat fees you must pay for services or prescriptions). Usually, the costs are on the back side of the insurance card.
Why Is It So Important To Have Health Insurance Plan?
Suppose you are not satisfied with your question’s answer: Why is it so important to have a health insurance plan? In this case, you may want to understand the benefits that come with it, such as preventing illness, it is a safety net, and many others covered below. Let’s start! .
Whether you seek individual health insurance services, obtain a cover through your employer, or probably a government-run program such as CHIP, Medicare, or Medicaid. You’ll be entitled to several health checks essential in detecting a developing disease such as cancer, which is curable in its initial stages.
Early screening, in such a case, can also be viewed as a preventive measure against diseases. For example, suppose during a covered dentist appointment detects the possibility of developing a jaw disorder or tooth decay; they may advise you to use braces to prevent the condition in the first place.
Possessing health insurance will enable you to access and cover your regular preventive healthcare, which includes:-
- Screenings and scans
- Lab work and blood tests
- Annual checkups
Such tests keep you healthy by detecting a developing disease early. Which will help manage any diagnosis at an early stage.
Suppose you suffer from a chronic condition, such as high blood pressure, diabetes, or depression. Insurers usually have disease management programs for such situations. Also, they may be able to point you to a qualified specialist.
Everybody needs preventive care checkups, especially for children and pregnant mothers, and the best way to keep them safe is through health insurance coverage. In this case, if this question is – why is it so important to have health insurance plan? Pops up, your answer should be it is a measure to prevent illness.
Your Safety Net
Suppose you get sick or accidentally injured and can’t afford to pay for your treatment. In this case, what do you do? That’s where your health insurance coverage comes in to cover the costs. It becomes your safety net.
Generally, health care is expensive and can quickly leave you bankrupt. For example, expenses such as scans and examinations, surgery, prescription drugs, and emergencies can add up very quickly and become a substantial financial burden.
The good news is with insurance coverage; you do not have to face such financial challenges as an individual. With an affordable monthly premium, your insurance will cover most of your medical costs – if not all.
So, why is it so important to have health insurance plan? Simple answer. Your safety net covers humongous bills that’d proven otherwise tricky on your behalf.
Peace Of Mind
Having health insurance coverage will help you reduce your stress level. It gives you peace of mind, allowing you to be secure from accumulated huge medical bills and bankruptcy from an illness.
What’s more, health insurance coverage reassures that you are in good hands in case of any medical emergency, injury, or terminal disease. Also, the cover makes you feel secure in a capable medical care system, eliminating any fear of being locked out of the care system while giving you the feeling of self-love and care.
Also, the insurer ensures to keep all your medical paperwork, saving you the headache of tedious medical filing, documentation, and voluminous paperwork. You’ll not be filling tonnes of paper at the point of service, as your medical history and current treatments are readily available from the insurer, making billing easier – if any.
Usually, people without health insurance coverage often feel stigmatized and marginalized. And this trend is driven by the fact that many people; believe their lack of being insured is because they are irresponsible, have life failures, or can not afford health insurance. In this case, having health coverage will help you evade such stigmas.
In the case of lifestyle diseases, you’ll always be sure that when need be, you’ll have quick access to a medical professional quickly. Also, depending on your care package, you’ll have ease of mind, for you will have immediate access to your Primary Care Provider, to walk with you.
Protects Your Assets and Finances
This question, ‘Why is it so important to have health insurance plan?’ is probably among the most challenging questions for a healthy young adult. But anyone who benefited from the cover will likely tell you it is the best financial investment for good reasons.
Making healthcare affordable is one of the main reasons for a health insurance plan, ensuring you get the best healthcare services in case of an injury, accident, or diagnosis without breaking the bank.
Although young adults (who rarely get sick) may consider health insurance an expense, they can easily forgo it, but accidents or illnesses can happen at any moment. Without any medical cover, you’d be responsible for footing the whole bill, and sometimes the bill can amount to thousands of dollars.
It makes sense to say that a health insurance plan is no longer an expense. It is now considered a worthy investment for everybody. Failure to do this, you’ll be putting you at severe financial risk.
Suppose you have a huge medical bill with no insurance coverage. In this case, how would you pay for the bill? Mostly, you’ll have to liquidate your assets – if you have any, to pay your bill. Or secure a bank loan if you are lucky. But both scenarios will negatively affect your finances.
To avoid bankruptcy and bad loans due to escalated medical bills, it would be best if you considered applying for medical insurance coverage. With a couple of health insurance plans available, be sure you’ll get the plan that suits you best.
In Summary: Why Is It So Important To Have Health Insurance?
Health insurance coverage has become necessary in our society, where lifestyle diseases such as diabetes, depression, hypertension, etc., are common. Majorly, it is due to the convenience that comes with it, such as easy access to preventive care, makes health care affordable, gives peace of mind effect and protects your assets and finances.
Health insurance is not a standardized plan. It is now a tailor-made care solution that meets the different needs of particular clients, and these plans are namely; Point-Of-Service plans (POS), Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Exclusive Provider Organizations (EPOs).
Before taking your health insurance plan, it would be wise to consider whether you can afford the monthly premiums. You’ll need to research if there are any mandatory out-of-pocket expenses and find out if the healthcare system matches your preferences. In case of a lifestyle disease, finding out whether your prescription will be covered will be very helpful.
It is now easy to answer this question, ‘Why is it so important to have health insurance?’ due to the many advantages associated with health coverage insurance. Also, depending on your plan, health coverage is customizable to fit your demands.
Insurance is not only limited to healthcare coverage only. You’ve probably never heard of unique insurance coverage solutions, such as compressor insurance. In this case, it is wise to visit an insurance company for more coverage information.