Your family deserves the best health plan possible.
What is health insurance and why do I need it?
Health insurance is a contract between an individual and an insurance provider that covers a portion of the costs associated with medical and surgical expenses. It helps protect individuals from the financial burden of unexpected healthcare expenses. Health insurance is essential because it allows you to access healthcare services, receive necessary medical treatments, and afford prescription medications without incurring significant out-of-pocket costs.
How Health Insurance Works
- Individuals pay a monthly premium to an insurance provider.
- When they need medical services, they present their health insurance card to the healthcare provider.
- The healthcare provider bills the insurance company for the covered services.
- The insurance company pays the agreed-upon amount directly to the healthcare provider.
- The individual may be responsible for deductibles, copayments, or coinsurance as defined by their policy.
About Medicare
Medicare is a federal health insurance program in the United States primarily designed for individuals aged 65 and older. It also covers certain younger individuals with disabilities or end-stage renal disease (ESRD). Medicare provides health insurance coverage for hospital care (Medicare Part A), medical services and doctor visits (Medicare Part B), and prescription medications (Medicare Part D).
It's important to note that Medicare policies and coverage details can vary, so individuals should review their specific plan documents or consult with Medicare or an insurance professional for accurate and detailed information.
Parts of Medicare
Medicare Part A: Often referred to as hospital insurance, it covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home healthcare services.
Medicare Part B: Often called medical insurance, it covers medical services such as doctor visits, outpatient care, preventive services, and durable medical equipment.
Medicare Part D: This optional prescription drug coverage helps individuals with the cost of prescription medications.
Eligibility
Individuals aged 65 and older are typically eligible for Medicare.
Individuals under 65 may qualify if they have certain disabilities or end-stage renal disease (ESRD).
Enrollment
Most people are automatically enrolled in Medicare Part A when they turn 65, as long as they are receiving Social Security or Railroad Retirement Board benefits.
Medicare Part B requires enrollment, and individuals may need to pay a premium based on their income.
Medicare Part D plans are offered by private insurance companies, and individuals can choose and enroll in a plan that best suits their needs.
Coverage and Costs
Medicare covers a portion of the costs for eligible medical services and supplies. However, there are deductibles, copayments, and coinsurance that individuals may be responsible for.
Medicare beneficiaries can choose to supplement their coverage with private Medicare Supplement Insurance (Medigap) plans to help with out-of-pocket costs.
Medicare Advantage
Medicare Advantage (Medicare Part C) is an alternative to Original Medicare (Part A and Part B) offered by private insurance companies approved by Medicare.
Medicare Advantage plans often provide additional benefits beyond Original Medicare, such as prescription drug coverage and dental or vision care.
About Health Savings Plans
Health Savings Plans, also known as Health Savings Accounts (HSAs), are tax-advantaged accounts designed to help individuals save for qualified medical expenses. They are available to individuals enrolled in high-deductible health insurance plans. Contributions to HSAs are tax-deductible, and any earnings on the account are tax-free. The funds in an HSA can be used to pay for a wide range of eligible medical expenses, including doctor visits, prescription medications, and certain medical supplies. HSAs offer flexibility as the funds roll over from year to year and can be invested for potential growth. They provide individuals with a way to save for healthcare costs while enjoying potential tax benefits.
How It Works
- Health Savings Plans (HSAs) are available to individuals enrolled in high-deductible health insurance plans.
- Contributions to HSAs are tax-deductible, reducing the individual's taxable income.
- The funds in an HSA can be used to pay for qualified medical expenses, such as doctor visits, prescription medications, and medical supplies.
- The money in an HSA rolls over from year to year and accumulates interest or can be invested, allowing the account balance to grow over time.
- HSAs provide individuals with a tax-advantaged way to save for healthcare costs and offer flexibility in managing their healthcare expenses.