What is Health Insurance?

Health insurance will provide you with the coverage you need for any medical or surgical expenses you may incur. You as an individual will pay a monthly set premium for the coverage and in return the health care company will give you benefits to pay for your eligible health care expenses defined in your policy. The amount and services covered will vary depending on your plan.


Why do you need Health Insurance?

Having health insurance is a good way to manage your health care costs such as regular checkups or prescription drug coverage. Here are some additional reasons.

  • It’s important to carry health insurance because you never know when you may need coverage. At any moment you could develop an illness or be the victim of an accident. Carrying health insurance will help you cover the expenses of these unexpected incidents.
  • Health insurance will provide you with the coverage you need to live a healthy lifestyle. Using your insurance allows you to get regular check-ups with your doctor and may cover expenses for any illnesses that require long-term care.
  • Under the Affordable Care Act, carrying health insurance is the law. If you don’t carry a qualifying health insurance plan, you may have to pay a penalty.

Individual Health Insurance

Individual health insurance is a plan that you buy on your own through an insurance agency, from a health insurance company directly, or from your states health insurance marketplace, also called an exchange. Individual health insurance can cover just one person or a family. Since medical expenses can be expensive, it’s a good idea to have insurance for when you or a family member needs it. The premiums, co-pays, and deductibles that you pay and services that are covered will all vary with the type of health insurance plan you choose.


Group Health Insurance

Group health insurance is a policy designed to cover a group of members, typically employees in a company or members of an organization. Group insurance policies are usually cheaper than individual policies as the premiums are lower because the insurer’s risk is spread across a group of policyholders. Also, group plans are made to be more cost-effective for businesses. Premiums are made with pre-tax dollar so employees pay less in annual taxes. This also cuts down on payroll taxes for a business and they can deduct their annual contributions when calculating their income taxes.


Things To Consider And Questions To Ask Your Agent

Part-time employees: As a part-time employee your company has the choice to offer you insurance based on their in-house regulations. Under the Affordable Care Act, anyone working less than 30 hours a week is considered part-time. As an employer, you should review your policy to ensure this is allowed and then set regulations for being a part-time employee who is eligible for health care.

What type of insurance is it? There are two broad categories of health insurance plans, traditional or managed care and these cover four main plans including fee-for-service, Preferred Provider Organizations (PPO), Point-of-Service plans (POS), and Health Maintenance Organizations (HMOs). No one plan is better than the other, it all really depends on your needs and preferences.

For more information on how we can assist you with your Individual or Group Health Insurance Plan, please contact our Bethlehem, PA office for a quote.