Overview on USA Healthcare Insurance - Availing Health Insurance Products and Services– Individual and Group Policies

Availing Health Insurance Products and Services– Individual and Group Policies

How to avail health insurance?

In USA, majority individuals acquire health insurance cover through their employers or the organizations to which they belong. This is also referred to as Group Insurance.

There are numerous instances when certain individuals do not have access to Group Insurance policy cover. In such cases, the individuals may choose to purchase their own Individual Health Insurance directly from Insurance Company. There are many Americans who get health insurance through government sponsored programs that operate at the National, State, and local levels. Examples include Medicare, Medicaid, and programs run by the Department of Veterans Affairs and Department of Defense. About

Group Insurance

Group Health Insurance policy cover is typically offered by employers for the welfare of their employees. There are other instances of deriving Group Insurance cover - especially in cases, if an individual is a member of a union, professional association or other group, he/she may be provided group coverage through that organization. Nowadays, there are many employers that offer option to their employees to choose between several healthcare insurance plans that include both - Indemnity Insurance and Managed Care. There are other instances when employers may offer only one health plan. Some group plans offer dental and/or vision benefits in addition to the medical benefits. Hence, it becomes imperative to compare health insurance plans to find out the benefits customized or tailored to meet your requirements. It must be borne in mind that once enrolled in a health insurance plan, he/she cannot change or switch over to another plan until the next open season, usually set once a year. In instances where Group Health Insurance is an Employee benefit, the employer usually pays a portion or the entire Premium. This implies that an individual’s healthcare expenses for health insurance premiums will be much lower than they would be incase, if the individual has to bear the entire premium alone. In instances where an individual acquires Group Health Insurance through membership in an organization, he/she benefits from being a member of a large group. In this manner, he/she would pay less for premiums than an individual would pay under normal circumstances. However, there are numerous instances where organizations do not contribute their share towards the premium meant for Group Health Insurance, meaning that the individual is responsible for paying the entire premium by himself/herself.

Advertisement

Individual Insurance

If an individual is self-employed or his/her employer does not offer healthcare insurance policy cover, he/she may not have access to group insurance. Under such circumstances, he/she may, however, be able to avail individual coverage directly from an Insurance company. When an individual purchases his/her own health insurance cover, he/she will be solely responsible for paying the entire premium rather than sharing the costs with their employer. Under such circumstances, the individual should shop around to find a plan that fits his/her needs or customized based on the individual’s requirements, at a price that he/she is willing to pay.

Most self-employed individuals are able to deduct their healthcare insurance premiums from their Federal taxable income, thereby providing such individuals with an important Tax-Saving benefit. Most States across USA offer similar tax preferences. If an individual is self-employed and purchases individual health insurance, it becomes essential that he/she should consult a Tax Advisor to find out if he/she is eligible for this deduction.

Health Insurance Plans greatly differ from one company to another and within an insurance company, from one plan or product to another. Some healthcare plans have multiple options to choose from. It becomes imperative for a consumer or a prospective insurance buyer to read carefully the “fine prints”, so as to ascertain and to make sure the various choices or offers being offered under the plan, any hidden costs, any deductibles, any costs/expenses that are not covered under the policy etc.