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Health insurance: Pros and Cons

Health insurance refers to the medical insurance policy that offers financial coverage for all medical expenses when the policyholder is hospitalized; this plan ensures cashless treatment reimbursement of medical costs, daycare hospitalization expenses, during accidental or other health crisis. Many affordable premiums can cost substantially less, sometimes even half of what is charged for an Affordable Care Act health plan. Premium savings can be used to purchase other forms of care, like dental or vision coverage.

Health Insurance is essential because lifestyle-related ailments are common these days, and healthcare is becoming increasingly expensive, and it is difficult for a family to arrange for vast amounts of money required for treatment quickly. Most of the savings of a family are in the form of fixed assets, which cannot be liquidated promptly. Short Term Health Insurance has a broad network of healthcare providers and is accepted at many of the top hospitals. According to the Health Insurance Plans, it mainly possesses ten essential benefits, including mental health and maternity. There is no review of the applicant’s health status or pre-existing conditions so that applicants won’t be denied coverage based on their health.

Moreover, it carries broad coverage of many generic, brand names, and specialty drugs. Often they offer different levels of health insurance benefits. It gives the members a cash payment upon a qualifying incident (e.g., accident or critical illness). Apart from this, some plans provide additional wellness benefits such as telemedicine, so members have access to doctor consultations via phone or online video chat 24*7 at no extra cost.

Rising costs of healthcare as well as the evident need for adequate healthcare today makes health insurance a definite must. When it comes to critical illnesses, the strain that it can put on a family’s wellbeing is undeniable, leaving people to turn to their life savings for aid. This, however, does not ascertain a concrete solution due to inflation, which implies savings are rarely sufficient to meet such healthcare expenses. In a typical average Indian household, the male head of the family is usually the only earning member with about 3-4 dependents. Often, if the primary breadwinner’s ability to work is compromised due to significant illness, the rest of the family remains in dire straits. It would not be possible for them to sustain their lifestyle, repay debts, or even afford the high costs of treatment.

Applications for insurance are not limited to the open enrollment period and can be made any time during the year. Prescription discounts are often included under the policy plan. Plans offered by Agile Health Insurance do not require any medical underwriting, so applications will not be rejected based on health status. Apart from all the advantages, there are some disadvantages too. One of the main problems of having health insurance is the cost. Health insurance can be very costly, even for those who have a health insurance plan through their employers. Prices may be so high that many of them end up struggling to make payments. Health care coverage for families may cause an added financial burden.

Another disadvantage would involve people who have a pre-existing illness. They have to undergo a waiting period which is typically four years. Insurers usually require you to wait for four years for any pre-existing disease to be covered. This becomes a significant obstacle for older individuals with pre-existing medical conditions. It is particularly so because pre-existing illnesses doesn’t only include illnesses you may have received treatment for in the recent past, it also contains diseases for which there were signs or symptoms 48 months before the payment of the first premium, which doesn’t provide coverage of pre-existing medical conditions. Pre-existing conditions and health status are considered a part of the application approval process, and applicants can be denied coverage. There could be significant coverage restrictions for prescribed drugs if they’re covered at all. Some benefits, like maternity coverage, are not included and excluded. Enrollees are still subject to Affordable Care Act Shared Responsibility Tax

It has very high deductibles. Many plans limit enrollees to a narrow network of healthcare providers. In many geographic areas, especially rural counties, Obamacare includes only one insurer. Health insurance choices are limited to the selection approved by the employer.

Small employers often subsidize health insurance at a lower level than large employers. If you have pre-existing conditions, they most likely won’t be covered within the first twelve months of coverage. Benefits are tied to particular incidents, such as a hospital admission or doctor visit. General illnesses like diabetes or conditions such as pregnancy don’t have benefits. They provide medical expense coverage at a rate much lower than major medical plan. Enrollees are still subjected to Affordable Care Act Shared Responsibility Tax if they do not have Obamacare/Affordable Care Act-compliant insurance, but this will end beginning in 2019.

However, with so many health insurances schemes available in the market, choosing the right policy has become a challenge. Policies from different insurers have different features and to pick the right one that suits both your needs and your budget has become a complicated exercise. Short term health insurance can be an excellent alternative if you’re looking for temporary coverage that helps protect against catastrophic medical expenses. On the other hand, premiums are generally less than primary medical insurance. It may not be a good fit if you need more comprehensive, long-term coverage or are eligible for a subsidy that could substantially reduce your significant medical premium. You’ll have to weigh the pros and cons to decide for yourself.

Health Care Cost Control:

While every country faces the challenge of controlling health care costs, they vary significantly in their methods for doing so. Fundamentally, there are only four broad strategies for managing health care costs: demand-side cost-sharing (using prices imposed on consumers to encourage them to reduce utilization); supply-side cost-sharing (using amounts paid to suppliers to reduce utilization and/or reduce plan payments per unit); non-price rationing (setting limits on the quantity of critical resources).

 

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