Affordable Medical Health Care Insurance Coverage

With health care costs on the rise, it's more important than ever to find affordable medical health care insurance coverage.

About Affordable Medical Health Care Insurance Coverage

In general, if you have the option to purchase health insurance through your employer's group plan, it will almost always be less expensive than buying a policy on your own. With most employer sponsored health plans, the business is paying at least some portion of the premium, reducing the amount that the individual has to pay out of pocket. Even in cases where the employer does not contribute, businesses are often able to negotiate lower rates because they represent multiple customers.

There are other things you can do to keep your premiums down. Many of the options are available for both individual and family coverage. You may be given similar options for coverage through your employer.

Deductibles

The more financial risk you are willing to accept, the lower your premiums will generally be. If you and your family are in good health and seldom visit the doctor, ask about an option for higher deductibles, higher co-pays, or limited prescription coverage. If anyone in your family suffers from a chronic medical condition or takes regular medication, however, this may not be the best choice since the extra out of pocket expenses may more than offset the lower premium.

Major Medical Options

Major medical coverage has at least one thing in common with high deductible policies - premiums are kept lower because you assume more of the financial risk. Unlike most high deductible policies, major medical insurance usually does not cover routine doctor visits or checkups. Prescription coverage also may not be available. As the name implies, major medical coverage will only pay in the event of serious illness or injury, such as situations where hospitalization is required.

Choose an HMO

When looking for affordable medical health care insurance coverage, you may find that you have to choose between several types of insurance plans such as health maintenance organizations (HMO) or preferred provider organizations (PPO). These plans have some similarities, and may offer the same deductibles or co-pays, but the HMO option is usually cheaper. The difference is in your choice of doctors.

With an HMO, your choice of doctors is hospitals can be very limited. You are required to specify a primary care physician from an approved list, and this doctor acts as a gatekeeper. You cannot see a specialist without a referral from the primary care doctor unless it is an emergency, and you will not be reimbursed if you go to another doctor.

In PPO programs, you choose a primary doctor from the insurer's approved list, but you also will be given a list of specialists and medical facilities that are within the network. You can use any doctor or facility that are in the network without needing prior approval. You also can choose to go to a doctor that is not on the provider list, but these expenses will be covered at a much lower rate if they are covered at all.

Government Programs

For low income families, the elderly, and the disabled, government programs may provide another option for affordable medical health care insurance coverage. Most people are familiar with Medicare but assume that it is only for older people. That is not completely accurate, and Medicare may be available for people with some disabilities.

Medicaid is a similar program but it is designed for lower income individuals and families. Eligibility guidelines are set on a state-by-state basis, and while income is a primary factor, it is not the only issue affecting eligibility. A caseworker can help you determine if you qualify for the program.

For families with children, the Children's Health Insurance Program (CHIP) may provide coverage for the children but not for the parents. CHIP is designed as a safety net program to protect children in families who don't qualify for Medicaid but do not have access to affordable private insurance. CHIP is also administered on a state-by-state basis, so you will need to contact a caseworker for assistance with eligibility.