How does health insurance work in USA?


Health insurance is among the most important in the United States. The Government also runs various programs to protect low-income people, and these can be combined with insurance plans for added protection.

What do US health insurance plans protect?

Some health plans are supplemented by those offered by the Government within its Medicaid and Medicare programs . Medicare plans cover expenses for Hospitalization, medical care and drugs. When combined with private plans, protection is improved at a certain cost.

There is a wide variety of medical insurance that protects against all kinds of illnesses or accidents, with the exception of those conditions existing at the time of contracting the policy. In various cases the pre-existence can be covered, especially when there is a change from one insurer to another.

They are generally classified into accident and illness coverage . There are plans that establish annual or limited benefit limits for each specific coverage, but there are also plans without limits.

The simplest policies tend to protect against the most serious chronic diseases and common health conditions. The most comprehensive policies even cover home care up to the person’s rehabilitation. Other covered medical expenses include necessary medications, diagnostic studies, chemotherapy, radiological treatments, and others. Most insurers cover maternity expenses.

Other medical expenses that may be included are dental, both preventive and to solve problems due to illness or accidents. There is also optical protection to acquire lenses or glasses.

How do health insurance insurers operate?

It depends on the insurer. Some operate by reimbursement, others pay directly for the services received by the insured. This depends on whether they use their own network of medical services, preferred providers, or if you can go to any preferred doctor or hospital, including services abroad.

The most comfortable services are where the insurer pays directly to the hospital or doctor, however it may not be available in all cities depending on the insurer and the network used.

Reimbursement policies require the insured to pay for the services received and subsequently submit the request with the medical bills to obtain the corresponding payment from the insurer.

Are the companies that sell health insurance reliable?

Yes, although it is always possible that there is some discrepancy between the insured and the insurance companies, they are usually easily clarified. If the problem persists, you can go to the NAIC, the Consumer Advocacy or the courts in each state.

In our list of health insurance you can see some of the most reputable insurance companies in the United States.


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