Have you ever visited a hospital for a check-up and got startled by the payment? Health care often demands a massive amount of dollars regardless of the urgency of any medical treatment.
So, is there an alternative to decrease the struggle to remain healthy in the United States? Here are the things you must know about medical insurance USA.
4 Types of Medical Insurance USA
It is undeniable that insurance needs to be aligned with your wants and needs. Otherwise, paying anything the insurance provider demands will be hard. Medical insurance actually offers several benefits according to the type. These are the most common ones that you may choose to fulfill your health needs.
1. Health Maintenance Organizations
Health Maintenance Organizations or HMOs offer the opportunity to maintain your health with a Primary Care Provider (PCP). In other words, you may only receive health care from a local hospital, a doctor, a professional, and a facility of your choice. All of them are going to assist you in coordinating all of your health treatments.
This type of medical insurance USA is well-known for being the lowest cost among all types. Your health care will hopefully go smoothly if you stay in the network.
2. Exclusive Provider Organizations
Like HMOs, Exclusive Provider Organizations or EPOs provide coverage from an in-network health provider. Additionally, unless there is an emergency, the insurance plan is not responsible for the cost of an outside-of-network provider. In other words, you must pay the expense yourself.
Furthermore, the plan may require you to choose your own PCP. It also depends on whether you want to visit a specialist through your PCP.
3. Preferred Provider Organizations
Preferred Provider Organizations or PPOs a medical insurance type that allows you to visit a large network of providers. Hence, you have various hospitals, doctors, and other healthcare facilities and professionals. There is a possibility for you to choose a provider that is outside the in-network ones.
However, you must pay more with your own money. Additionally, the type of medical insurance USA may permit you to see a professional without using a referral from an in-network provider.
4. Point-of-Service
Point-of-Service plan or POS allows you to pay smaller costs for in-network service. Its difference with PPO is the network; usually, it is smaller yet does not lack variety. Additionally, in terms of PCP, you are permitted to choose your own, but it must be within the offered network of participating professionals.
They will be in charge of your health and what you may require in the future. Furthermore, if there comes a time when you need a specialist, you must get a referral from the in-network of healthcare provider.
If you insist on choosing one outside the network, you will be responsible for your own expense regardless of the payment cost.
How Much Does Health Care Insurance Cost in the USA?
Medical insurance USA is known to be quite expensive. Studies suggest that the cost will reach approximately $7,739 for an individual per year, whereas $22,221 is to be said for a family. These numbers are significantly increasing by about 4% between 2020 and 2021.
But you may take note that the cost may vary in different regions. For example, you will face a health insurance cost of $9,972 per year as an individual in West Virginia. On the other hand, you will need to pay about $8,556 on average in New York City.
Why is Health Care So Expensive in the USA?
The cost of health care is not expensive without reasons. Despite being one of the primary needs, several factors affect the cost. Below are the explanations.
1. Administrative Costs
Earning good health treatment involves various people. The professionals are the ones who understand specific competencies. They follow numerous pieces of training and studies which elevate their qualities, and therefore their compensation is massive. But without them, it will be challenging to receive any health care.
You will either face a high expense or complexity during enrolment for insurance. This may be due to the new system the country has applied: Affordable Care Act.
It separates enrolment dates, funding sources, and out-of-pocket costs for public and private insurance companies. Hence why, the administrative cost becomes high.
2. Costs of Drug Prescriptions
Either general health care or using medical insurance USA, drug prescriptions must be involved. Unfortunately, according to data, citizens of America pay, on average, twice more than other modern countries for drug prescriptions.
Automatically, healthcare expenses are potentially more unaffordable, especially for low-income families and individuals.
It happens due to a different system. In European countries, drug prices are based on the benefit or profit they provide patients. On the contrary, American drug companies tend to weigh on the prices more than their production costs. It might be because of the high cost of drug testing and approval that is obligatory before being sold publicly.
3. Lifestyle
Health entails lifestyle. There is a higher risk of visiting health facilities if you pay less attention to your diet. It can go worse, especially if you do not exercise regularly. Fortunately, you can actually control this factor.
If you rarely get sick and live a healthy lifestyle, surely it will be rare for you to face a high cost of health care maintenance. Additionally, it will be better if you reduce your intake of several bad things that contribute to developing serious illnesses in the future, such as alcohol and cigarettes.
Ready to Use Insurance?
So, that is all about types, costs, and the reasons why medical insurance USA is expensive. You may not be able to change the regulation applied to the health care treatments of American citizens.
However, you can pay attention to your lifestyle by eating a healthy diet and exercising regularly. By doing those, you will definitely need to visit the hospital lesser.