katyzzzHealth Insurance and Working
July 23rd 2006 04:34
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In 2004, almost 46 million Americans had no health insurance [ref]. Healthcare costs can be very expensive, and the cost of even the most basic care is steadily rising. So, health insurance premiums are rising along with them. Employers typically bear the brunt of the expense for health insurance, but individuals are paying more and more each year as well.
Insurance is a bit like a gamble between you and the insurance company. The company bets that they'll take in more money in premiums than they have to pay out in benefits, whether it's for health insurance, auto insurance, life insurance or homeowners insurance. You're paying a premium every month just in case something happens.
Health insurance is a contract between you and the insurance company that says that the insurance company will pay a portion of your medical expenses if you get sick or hurt and have to visit a doctor's office or hospital. However, he amount of your bill that the insurance company will pay, and under what circumstances (known as coverage) will vary greatly from policy to policy.
The contract (or policy) spells out what the insurance company will pay for and how much of the bill you will have to pay. For example, the policy may cover an office visit but you may have to pay a $20 co-payment. Or, the policy may not cover anything until you've paid at least $250 out of your pocket (known as a deductible). The policy will also state the amount you have to pay each month for the coverage, known as the premium, and the total amount the insurance company will pay out for the life of the policy.
Since a single hospital stay could wipe out your savings (and more) not many people can afford to go without some kind of health insurance -- even if they're healthy. Not only will health insurance protect you from bankruptcy in the event of a major medical event, it also gives you peace of mind.
COBRA :
Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), your employer may be required to continue your health coverage for a limited amount of time. Depending on the circumstances, it can be as long as 36 months. The reason for loss or reduction of employment must be a "qualifying event," meaning there are specific circumstances that do and do not entitle you to continued coverage. For instance, if you're caught pilfering from the company and get fired, you can't expect to continue your health benefits through COBRA.
Just because they're offering you coverage doesn't mean they're still paying for it. You will have to pay for it yourself. Because you're still participating in the group plan, however, you'll be paying less than you would for an individual plan. And, if you have an existing health condition, you won't have to go through a waiting period to get coverage for it when you do get another job and new health insurance.
Pros and Cons :
The primary benefits for managed care are the lower cost, coverage for preventive care and the lack of a lifetime limit to what they will pay. The drawbacks are fewer choices and a little more difficulty getting coverage for some procedures and specialists.
Most types of insurance policies will include limitations and exclusions -- particular services or conditions that they won't cover
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