What Is Health Insurance?
Health Insurance is a type of insurance coverage that pays for medical and surgical expenses that are incurred by the insured.Hence the “insured” is the person who is owner of the health insurance policy; the person with the health insurance coverage. By estimating the overall risk of health care and health system expenses, among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for the health care benefits specified in the insurance agreement.According to the Health Insurance Association of USA, health insurance is defined as “coverage that provides for the payments of benefits as a result of sickness or injury or surgical expense.It also includes insurance for losses from accident, medical expense, disability, or accidental death.
Is Health Insurance Human Right??
Some countries, such as the United Kingdom or Canada,considered health care coverage as every citizen’s right and it should be provided by state.It is also ranked along with public education, the police, firefighter and public road,in other words it should be considered as a part of a public service for the nation.
But some countries, such as the USA, health insurance coverage is seen somewhat differently -it is considered as citizen’s responsibility to be insured except few groups, such as old or disabled people, veterans and some others. In USA, the government has introduced laws and make health insurance mandatory for every citizen and there are penalties for those who fail to have a policy of some kind.
Article 25 of the Universal Declaration of Human Rights 1948 states that “Everyone has the right to a standard of living adequate for the health, and well-being of himself and his family…”.
According to World Health Organization’s (WHO) constitution also declares that it is one of the fundamental rights of every human being to enjoy “the highest attainable standard of health”. Inherent in the right to health is the right to the underlying conditions of health as well as medical care.
Types of Health Insurance Plans:
The three most common types of health insurance plans are:
Health Maintenance Organizations (HMOs)
Participating Provider Options (PPOs)
Consumer Directed Health Plans (CDHPs).
Health Maintenance Organizations HMOs:
It is a type of health insurance plan which gives you direct access to certain doctors and hospitals, also called contracting doctors and hospitals (sometimes called “providers”).
When you sign up contract, you choose a primary care physician (PCP) from a network of doctors.
Your PCP is your first point of contact for most of your basic health care needs.
Women can also select an OB/GYN for obstetrical and gynecological care.
If you need special tests or need to see a specialist, your PCP will give you a referral to see another doctor.
HMO plans actually provides the lowest cost for you – when you use doctors, hospitals and specialists that are in the network.
Participating Provider Options PPOs
Like HMOs, PPOs often feature a network of doctors, specialists and hospitals; however, there are some differences between the two types of plans.
In PPO plan, there is no need to choose a primary care physician.
You have the option of receiving care from doctors, hospitals and specialists in the network or outside the network, and you don’t always need a referral to see a specialist.
CDHPs and the HSA Option
Consumer Directed Health Plans (CDHPs) often involve pairing a high deductible PPO plan with a tax-advantaged account. For an individual to establish an HSA and contribute money to the account each year, he or she must be considered an HSA-eligible individual. Eligibility includes enrollment in an HSA-qualified high deductible health plan.
If the plan uses a PPO network, you don’t have to choose a primary care physician.You have the option of receiving care from doctors, hospitals and specialists in the network or outside the network, and you don’t always need a referral to see a specialist.