Private health insurance is the main source of health coverage for the majority of people in the United States. Approximately 58% of all Americans have private health care coverage. For elderly citizens and eligible children and families from low-income households, public programs are the primary source of health cover. Public programs include Medicare, Medicaid, and SCHIP. TRICARE and the Veterans programs also provide some coverage.
If you are not covered by a publicly funded program, or if your coverage is only partial, you will need to have some kind of private health insurance.
The Patient Protection and Affordable Care Act
In March 23rd, the US health care system underwent the beginning of a major reform, which may have changed the way many people go about getting health cover. The Patient Protection and Affordable Care Act included a mandate that every American must have medical provision, or pay a fine. Some details of the Act are still awaiting a Supreme Court ruling.
The provisions of the Act roll out over the next few years. Some provisions came into effect within months of the Act being signed into law. Most of the changes so far have affected seniors, children, those with pre-existing conditions, and young adults. Within the next few years, there will be new programs that include co-ops and online exchanges.
In 2014 a provision comes into effect, called Promoting Individual Responsibility, which says that the majority of citizens must purchase health insurance – if they don’t, they could face having to pay a fine.
Buying health insurance on your own
If you are not covered through your employer, or part of a COOP, and are not eligible to state funded programs, you will probably have to buy health insurance as an individual.
When selecting the right insurance option, the purchaser needs to be aware of various factors. For example, should the plan include prescription coverage or not? A female of childbearing age is more likely to opt for a plan that covers pre-natal visits.
Pre-existing conditions – there are now government-assistance programs, as well as new provisions in the new legislation to help those with pre-existing conditions get cover. Pre-existing conditions, for people aged under 19, are no longer permissible reasons refuse coverage in family plans. If you want to enroll somebody under 19 on their own, in some cases they need to be part of an open enrollment period.
Insurance companies today are required to spend a good portion of the money they collect from their insured contributors on health care.
For those who cannot afford the price of health care insurance, there will be financial assistance in 2012.
Offspring over the age of 19 and under 26 may now be added to their parents’ insurance plan.