Health Insurance

What is Health Insurance?

Health insurance or medical insurance is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance is a risk among many individuals.

Types of Health Insurance

If you are not covered as a dependent under someone else’s health plan, such as a spouse/partner or parent, it’s a good idea to have health insurance. A health insurance plan can help you manage your health care needs, as well as costs.

Knowing the various policy types and health plan names will prepare you for evaluating your options when you’re ready to enroll in a new plan. The more familiar you are with the different insurance plan types, the better equipped you’ll be to pick one to fit your company’s budget and needs.

Essential Health Benefits

Most insurance plans will cover a set of preventive services. This does not mean they are free. You may still need to pay deductibles, copayments, or other out-of-pocket costs.

These preventive services include shots and certain health screenings. If you buy a plan through the Health Insurance Marketplace, your insurance will cover the preventive services. It will also cover at least 10 essential health benefits required by the Affordable Care Act (ACA). All private health insurance plans offered in federally facilitated marketplaces will offer the following 10 essential health benefits (EHBs):

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital).
  • Emergency services.
  • Hospitalization (such as surgery).
  • Pregnancy, maternity, and newborn care (care before and after your baby is born).
  • Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy).
  • Prescription drugs.
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills).
  • Laboratory services.
  • Preventive and wellness services and chronic disease management.
  • Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t EHBs).

State-run marketplaces are also required to offer 10 EHBs, but the list of benefits may differ from those offered by federally facilitated marketplaces. Plans may offer additional coverage.

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