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It is mandated by each state commission product filing that the rate not be changed by any sales entity; therefore, rates will be the same from all websites.  This assures the buyer of always receiving the best rate on any and all products.  

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Advise Notice: We do not provide legal advice on this site. The general information presented on various legal aspects of plans herein are not intended to be relied upon as legal advice. Individuals should always seek the advice of a qualified legal professional.   More >  

 


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Health
Insurance

Health Insurance Defined


Health insurance is defined as an annually renewable insurance contract between a health insurance company and an individual or legal entity.  It insures against loss by illness or bodily injury. Health insurance provides coverage for medicine, visits to the doctor or emergency room, hospital stays and other medical expenses.

Generally, health insurance policies will differ in what they cover.
The insured usually shares in the cost of the claim by paying a deductible and a co-payment.  Most policies that are comprehensive have a maximum out-of-pocket payment for any single year, and some also include a lifetime maximum.

Health insurance was first conceived in the late 1600s.  This coverage was intended for disabilities rather than what we now know as comprehensive health insurance.  It was only in the last 60 years that the health insurance concept evolved into modern health insurance programs. Today, comprehensive private health insurance plans may cover the cost of routine care,  preventive care, emergency health care and more. This may include ancillary coverage for  prescription drugs and dental.

Modern health care providers, doctors, hospitals, etc., will usually bill the insurance company for insured services when an agreement is signed by the insured that will deem the insured responsible for the amount that the insurance company does not pay and /or is not covered.

Health insurance companies also often have a network of providers who agree to accept the reasonable and customary fee and waive the remainder. It will generally cost the patient less to use an in-network provider.

The principle of managed care is to manage and integrate health services.  The managed care organizations provide these health care services to members through doctors, hospitals and other health care providers through contract agreements.  For these reasons, it is important that one understand covered benefits before medical services are rendered. 


Health Insurance Plans in the United States are available through the following resources:


Private Health Insurance

Private health insurance is coverage by a health plan provided through an employer or union or purchased by an individual from a private health insurance company.

Employment-based plans

Employment-based health insurance is coverage offered through one’s own employment or a relative’s. It may be offered by an employer or by a union.

Direct-purchase plans

Direct-purchase health insurance is coverage though a plan purchased by an individual from a private company.

Government Health Insurance

Government health insurance includes plans funded by governments as the federal, state, or local level. The major categories of government health insurance are medicare, medicaid, the State Children’s Health Insurance Program (SCHIP), military health care, state plans, and the Indian Health Service.

Medicare

Medicare is the Federal program which helps pay health care costs for people 65 and older and for certain people under 65 with long-term disabilities.

Medicaid

Medicaid is a program administered at the state level, which provides medical assistance to the needy. Families with dependent children, the aged, blind, and disabled who are in financial need are eligible for Medicaid. It may be known by different names in different states.

SCHIP

SCHIP, the State Children’s Health Insurance Program, is a program administered at the state level, providing health care to low-income children whose parents do not qualify for Medicaid. SCHIP may be known by different names in different states

Military health care

Military health care includes TRICARE/CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) and CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), as well as care provided by the Department of Veterans Affairs (VA).

TRICARE/CHAMPUS

TRICARE or CHAMPUS is a military health care program for active duty and retired members of the uniformed services, their families, and survivors.

CHAMPVA

CHAMPVA is a medical program through which the Department of Veterans Affairs helps pay the cost of medical services for eligible veterans, veteran‘s dependents, and survivors of veterans.

VA

The Department of Veterans Affairs provides medical assistance to eligible veterans of the Armed Forces.

State Specific Plans

Some states have their own health insurance programs for low-income uninsured individuals. These health plans may be known by different names in different states.

Indian Health Service

Indian Health Service (IHS) is a health care program through which the Department of Health and Human Services provides medical assistance to eligible American Indians at IHS facilities. In addition, the IHS helps pay the cost of selected health care services provided at non-IHS facilities.
 

 
 

Compare comprehensive quotes and purchase your individual or family coverage online. 
The quotes generated by this program are not a contract, binder, or agreement to extend coverage and are based on the listed factors and the applicable underwriting criteria for the rate shown. The exact premium can only be determined after an underwriting review and may be different or the policy may not be available. Your information is only shared with the  company underwriter and never distributed in any other way. 
All health insurance definitions defined here are to be understood as being general definitions.  These definition may vary by insurance company and may be found in the company policy or certificate of insurance. Not all products from all companies are available in all states.

 


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