Health Insurance Definition

Take out insurance is sort of a gambling game between you and the insurance company. The company bet that will make more money than the tuition will have to pay benefits, whether it is health insurance, car, life or property. You pay a monthly fee for the event of an unforeseen to happen.

A health plan is a contract between you and the insurance company that says the company will pay a portion of your medical expenses if you get sick or hurt and need a doctor or hospital. However, the value of your account that the company will pay and under what circumstances (coverage) will vary greatly from policy to policy.

The contract (or policy) dictates what the insurance company will pay and how much you will have to pay. For example, the policy can cover a query, but you have to spend $ 20 in payment of contribution. Or the policy may not cover anything below $ 250 (so-called franchise). The system also defines how much you will pay each month for coverage, your monthly payment and the total amount the insurer will pay for the policy.

As a day in a hospital can end their economies are not many people who can use this service without some health insurance, even if they are not sick. Health plans are not just to prevent you go bankrupt in case of medical emergencies; they also give you peace of mind.


Most people under 65 have a health plan in their jobs, a collective insurance. According to the National Coalition on Health Care (English) – National Union of Health Services, in 2004, employers were responsible for 61% of insured workers. Businesses and other organizations can provide better rates because they have a greater number of people to cover. Insurers see this as a good risk because they will probably end up paying tiny for several individuals in the group, while receiving tuition of them all.

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Even if employers are not required by law to provide a health plan, it will be difficult to get good employees if they do not offer. They can not pay the full tuition, but even the smaller companies usually get better rates on health insurance than a person can achieve individually. In the case of business plans, are not required medical examinations and questionnaires for the purchase of health insurance.

As the rates of health plans are renegotiated each year, based on the previous year’s costs, some employers offer health care programs for their employees. Maintain healthy employees can reduce spending on medical care. Participation in these programs sometimes makes the employee deserves a plan with small monthly payments. For employees who pay part of the tuition fee (which is very common), this means that this part can be reduced or eliminated. The rules of the Health Insurance Portability and Accountability Act (HIPAA – Portability Act and Health Insurance Responsibility), however, limit how programs can change the values of fees based on health status.

National health insurance (Medicare / Medicaid / SCHIP)

The federal government also has health insurance for those who have this right. The government program of health care for the elderly (Medicare) is a health insurance for people 65 years or older, people under age 65 with certain disabilities, and people of all ages with chronic kidney disease (permanent kidney failure that requires dialysis or kidney transplantation). Medicare includes hospital insurance (Part A), medical insurance (Part B) since January 2006, drug coverage.

Medicaid is a health insurance administered by the state, available for people and low-income families that fit certain patterns. We must meet specific criteria and considerations include age, pregnancy, disability, blindness, income, resources and citizenship (or legal immigrant). The rules vary from state to state.

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If a family has income above the allowed to qualify for Medicaid, you may still be eligible for the State Children’s Health Insurance (SCHIP – State Children’s Health Insurance). Another program administered by the state, SCHIP covers children uninsured under nineteen whose families have annual incomes of less than US $ 36,200 (for a family of four). For a low cost or for free, the SCHIP paid consultations, vaccinations, hospitalizations and emergency room visits.

Individual Health Plans

Individual health plans are the most expensive option for people who do not have coverage (or do not have enough coverage) business. Medical examinations and questionnaires are usually part of the contract so that people with health problems pay much more expensive. Most insurers offer individual health insurance plans and are specialized in short-term coverage for periods of between one job and another when the individual may be without coverage.


And now, what happens if you have a health insurance company and lose the job? Thanks for the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) – a federal law that ensures the employee and their dependents who leave the health plan of the company, the opportunity to acquire and maintain the same health coverage for a variable time so that employee can continue protected. Depending on the circumstances, the time coverage after the termination of the employee can be up to 36 months. The ratio of job loss should be considered as particular circumstances qualify or not the individual for continuing coverage. For example, if you are caught stealing your company and is sent away, you can not enjoy the benefits of health insurance by COBRA.

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Moreover, it is not because they offer continuous coverage, which still pay for it. The advantage is that to still be participating in a business plan, you will pay less than you would pay for an individual plan. Also, if you already have a health problem, you will not need to go without coverage to get another job and join a new corporate health plan.
Would you like to read more about this topic? This book might interest you: Health Insurance.