Posts Tagged ‘preferred provider organizations’

What Is Single Payer Health Insurance And What That Means For You

Monday, August 2nd, 2010

What health insurance is best for you? The answer to that question depends on your understanding of what health insurance is and what your particular needs are. First, it is not discounted health care. Generally speaking, insurance is a kind of risk management. Your premium is your monthly payment to the company to assume the risk of expense. In one sense, this is a sort of gambling. In this case, the health insurer is betting that you will not need care, and the premium you pay every month is your hedge to offset the consequences should you face large medical expenses. Your health insurance benefits are what you get when the company “loses” and has to pay out.

Now that we know that a health insurance policy is a way to manage risk, it is important to understand that there are a number different kinds of agreements, or policies, available depending on your needs. Generally, the subject of health insurance brings to mind questions about doctor and hospital care available for individuals and families through privately purchased policies, and/or employees through an employer group health insurance plan. When choosing a health insurance policy, you (or an employer) must decide what your tolerance for risk is and how much risk you want managed. To that end, there are many private companies selling insurance plans.

The search for health insurance plan information can seem overwhelming at first because there are so many plans, policies, and companies. Common well-known names that you might encounter could be, Cigna, Banker’s Life and Casualty, Blue Shield, Kaiser Permanente, Anthem Blue Cross, Tonik, Humana, Sterling, and the list goes on and on. These are all private insurance companies regulated by Federal and state insurance laws and all are in competition with each other. For that reason, you find that there are many different policies (or packages of health care benefits) and many different premium prices and cost sharing arrangements. In order for the policy you choose to work for you and your family, you must prioritize your health needs and then search for the company and policy that will give you the closest match. The company you choose then becomes the payer on your medical costs. In a private health insurance system, as exists in the United States, there can be many different payers because there are many different companies competing for your business.

Is there such a thing as single payer health insurance? The answer is both yes and no. In the United States the insurance program that most closely approximates a single payer is the Federal health insurance program for retired individuals age 65 and above. This program is called Medicare and became law in 1965. Although the government manages Medicare, it contracts with private insurance companies to handle the day to day operational logistics of administration. So you see, even though the government is the single payer, it still involves the private insurance industry. The Federal government has gone even further involving private insurance by creating the Medicare Advantage Plan program, which essentially allows private insurance payers to manage Medicare benefits through private, managed care plans.

Health insurance choices can seem to be overwhelming. After all, there are not only many different insurance companies but many different kinds of policies as well. Some examples include, supplemental insurance designed to supplement or add on to an already existing health insurance policy; there is dismemberment insurance, temporary health insurance, hospital only insurance, disease specific health policies, and policies designed to pay only when your total out-of-pocket expenses reach a certain limit. The question of course, is how to do you choose?

In order to figure out what health insurance will work best for you, it is important to list your costs, special needs, and any specific circumstances that need to be taken into account. For example, if you work in an environment where there is a high risk of injury, you may need a particular kind of insurance, such as a dismemberment policy. Another example would be industrial diving. Divers who risk decompression illness would need to be sure their insurance covers the expenses of a decompression chamber. For many of us, health insurance simply means coverage for basic doctor, outpatient, and inpatient care. However, making sure that you get the best low cost policy for you starts with an exact understanding of your health care needs.

Find the best cheap health insurance quotes for you. Heard about Anthem Tonik? Find out about Tonik Health Insurance right now.