What are the different types of health insurance?
What are the different types of health insurance?
When’s the last time you thought about your health insurance? If you didn’t recently fill a prescription or need to see a doctor, it’s possible that the last time you thought about your insurance plan was last fall, during open enrollment. You can hit the ground running this year before open enrollment by understanding the different types of health insurance you can consider.
What is the Affordable Care Act?
The Affordable Care Act (ACA), also called Obamacare or Bidencare, was put in place to help make health insurance easier for people to get. Marketplace or ACA plans are sold on the health care Marketplace, or Exchange. They focus on preventive care, cover pre-existing conditions, and provide benefits for things like doctor visits, prescriptions and lab tests. If you're looking for Marketplace coverage, you usually need to enroll during the established enrollment period. Check into UnitedHealthcare Individual & Family ACA Marketplace plans to find a variety of affordable, quality coverage options.
Learn more about UnitedHealthcare Individual & Family ACA Marketplace plans
What's the difference between ACA plans and short-term insurance plans?
When it comes time to choose a health insurance plan, it's important to know the details about how the plans work. There are different plans for different stages of life — and knowing the differences may help you choose. Take a look to learn the differences between Affordable Care Act (ACA) and short-term limited duration insurance health plans.
Read about the differences between ACA plans and short-term health insurance
What is Medicare?
Medicare is a federally funded and operated health insurance program originally designed for people who are 65 or older. Throughout the years, Medicare has expanded to include disabled people under 65 and those with special circumstances. The program is divided into four parts: A, B, C and D, and is the same nationwide.
Discover how Medicare can work for you
What is Medicaid?
Medicaid is a federal and state program in place for low income families, seniors and individuals with mental or physical disabilities. People qualify for Medicaid by meeting federal income standards. The program is operated on a state-by-state basis, and may be called different names depending on where you live. In Minnesota, for example, Medicaid is called Minnesota Medical Assistance.
How do I apply for Medicaid services?
What's the difference between Medicaid and Medicare? Can I have both?
Medicare and Medicaid are terms you often hear together. That’s because both are government programs. However, they work differently. There's another types of plan called a Dual Special Needs Plan (D-SNP). D-SNP plans include both Medicare and Medicaid benefits. People may qualify for Medicare, Medicaid or both, depending on their situation.
Learn more about the difference between Medicare and Medicaid
Learn about D-SNP plans
What are health insurance plans through work?
Around 49% of Americans get health insurance coverage through their employers. That’s nearly 157 million people.1 Employer-sponsored health plans play a big role in benefits packages. Depending on your employer, there may be several health plans for you to choose from. If you get your health plan through work, check into UnitedHealthcare plans to learn what benefits are included with our plans. From personalized support to helpful digital tools and large provider networks — there's a lot to consider when making your choice.
Learn more about health plans through work
What are HMO, PPO, EPO and POS health insurance plans?
Which insurance is most affordable? Which health insurance plan is right for you? For a lot of people who get their health insurance through their employer, it comes down to what options are available. If there is more than one choice, you likely have to decide between an HMO, PPO, EPO or POS option. People shopping for Medicare plans may also be choosing between these same types of options. Not everyone has the same options, but it may help to understand more about how each of these plans work.
Learn more about how HMO, PPO, EPO or POS provider networks work
What is COBRA?
COBRA stands for the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), a program that may help if you need coverage between jobs. If you lose your job, become furloughed or experience reduced hours and it changes your health insurance coverage, you may look into COBRA for health care coverage. With COBRA, you can continue the same coverage you had when you were employed. That includes medical, dental and vision plans.
Learn more about how COBRA works
What is short term health insurance?
Short term health insurance, also called temporary health insurance or term health insurance, may be right for you if you need to fill a gap in coverage until you can choose a longer-term solution. It might be a good option if you’re in between jobs, waiting for coverage to start, looking for coverage to bridge you to Medicare, turning 26 and coming off your parents’ insurance or many other situations. Short term health insurance offers flexible, fast coverage for those dynamic times of change in your life.
Learn more about short term health insurance
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Related content
How does health insurance work?
Understanding health insurance costs
What is open enrollment?
Understanding health insurance
More like this:
Types of health insurance costs
How COBRA insurance works
ACA vs. short-term insurance
Footnote
How many Americans get health insurance from their employer, January 2021
Disclaimers
UnitedHealthcare Individual & Family ACA Marketplace plans:
Medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization, Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc.; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in LA, TN and AL; Optimum Choice, Inc. in VA and MD; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of Texas, Inc.; and UnitedHealthcare of Oregon, Inc. in WA. Administrative Services provided by United HealthCare Services, Inc. or their affiliates.
Some plans may require copayments, deductibles and/or coinsurance for these benefits. Plans in metal tiers varies and are subject to plan deductibles, copayments, and coinsurance. This policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. By responding to this offer, you agree that a representative may contact you.
To qualify for a $0 monthly premium, you must meet household income requirements for Advanced Premium Tax Credits.
© 2023 United HealthCare Services, inc 2023
Health Insurance Coverage in the United States: 2020
Introduction
Download Health Insurance Coverage in the United States: 2020 [PDF - <1.0 MB]
This report presents statistics on health insurance coverage in the United States based on information collected in the Current Population Survey Annual Social and Economic Supplement (CPS ASEC).
Highlights
In 2020, 8.6 percent of people, or 28.0 million, did not have health insurance at any point during the year.
The percentage of people with health insurance coverage for all or part of 2020 was 91.4.
In 2020, private health insurance coverage continued to be more prevalent than public coverage at 66.5 percent and 34.8 percent, respectively. Of the subtypes of health insurance coverage, employment-based insurance was the most common, covering 54.4 percent of the population for some or all of the calendar year, followed by Medicare (18.4 percent), Medicaid (17.8 percent), direct-purchase coverage (10.5 percent), TRICARE (2.8 percent), and Department of Veterans Affairs (VA) or Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) coverage (0.9 percent).
Between 2018 and 2020, the rate of private health insurance coverage decreased by 0.8 percentage points to 66.5 percent, driven by a 0.7 percentage-point decline in employment-based coverage to 54.4 percent.
Between 2018 and 2020, the rate of public health insurance coverage increased by 0.4 percentage points to 34.8 percent.
In 2020, 87.0 percent of full-time, year-round workers had private insurance coverage, up from 85.1 percent in 2018. In contrast, those who worked less than full-time, year-round were less likely to be covered by private insurance in 2020 than in 2018 (68.5 percent in 2018 and 66.7 percent in 2020).
More children under the age of 19 in poverty were uninsured in 2020 than in 2018. Uninsured rates for children under the age of 19 in poverty rose 1.6 percentage points to 9.3 percent.
Related Blogs
Research Matters Blog
Transitions in Health Insurance Coverage: A Look Inside Annual Health Coverage Statistics
Top 10 health insurance companies in the US
America's largest accident and health insurance groups according to recent data from the NAIC.
Life & Health
In the US, there are a host of private healthcare insurance specialists. However, life/annuity and property/casualty insurers also write this coverage, often referred to as accident and health insurance, as outlined by the Insurance Information Institute.
In 2020, the accident and health insurance industry’s direct written premiums reached $1.25 trillion, up by almost 84% from $680 billion in 2011. The largest 10 insurers collectively wrote 55.3% of the total US market, according to the National Association of Insurance Commissioners (NAIC). That is a huge number, although it is not surprising when you consider that health insurance is one of the most common types of insurance.
Listen in: Sign up for our IB Talk podcasts to get the most in-depth insurance discussions
Based on NAIC’s 2020 data, here are the top 10 accident and health insurance groups:
1. UnitedHealth
Direct Written Premiums: $176.7 billion
Market Share: 14.1%
A diversified health and well-being company, UnitedHealth Group’s core capabilities are clinical expertise, advanced technology, and data and health information.
UnitedHealth Group serves clients and consumers in the US and more than 130 other countries through two distinct platforms: UnitedHealthcare provides healthcare coverage and benefits services, while Optum provides information and technology-enabled health services. The group invests more than $4 billion in technology and innovation and processes approximately 1.1 trillion transactions annually.
2. Kaiser Foundation
Direct Written Premiums: $104.2 billion
Market Share: 8.3%
Kaiser Foundation Health Plan, Inc. operates as a non-profit healthcare organization. The organization offers allergy, audiology, cardiology, dermatology, oncology, hospice, laboratory, nephrology, occupational therapy, pain management, pediatric rehabilitation, and pharmacy services. The company serves patients in the US.
Read next: Here are the basic insurance terms everyone should know
3. Anthem, Inc.
Direct Written Premiums: $76.9 billion
Market Share: 6.2%
Anthem, Inc. is a health benefits company that is committed to improving lives and communities and making healthcare simpler. Anthem, through its affiliated companies, serves more than 106 million people, including over 42 million within its family of health plans. It aims to be the most innovative, valuable, and inclusive partner.
The group’s affiliated health plans have created various HMOs, PPOs, network-based dental products, various hybrid and specialty products, and health plan services that combine the attributes consumers find attractive with effective cost control techniques. Individual members and employer groups can select from basic and comprehensive plans to meet their specific needs. A wide range of related specialty products and other services is also available, including flexible spending accounts and COBRA administration.
4. Centene Corp
Direct Written Premiums: $75 billion
Market Share: 6%
Centene Corporation, a Fortune 500 company, is a diversified, multinational healthcare company providing a portfolio of services to government-sponsored healthcare programs, focusing on uninsured and underinsured individuals. It operates in 50 states and three international markets and has more than 25 million managed care members.
Centene operates local health plans and provides a range of health insurance solutions. Also, it contracts with other healthcare and commercial organizations to offer specialty services, ranging from behavioral health, dental benefits, life and health, and pharmacy benefits management to care management software, correctional healthcare services, in-home health services, managed vision, specialty pharmacy, and telehealth services.
5. Humana
Direct Written Premiums: $73.9 billion
Market Share: 5.9%
Humana’s cultural foundation is aligned to helping members achieve their best health by providing personalized, simplified, whole-person healthcare experiences. Recognizing that each person, family, and community’s healthcare needs continue to evolve, Humana creates innovative solutions and resources to help people live their healthiest lives on their terms – when and where they need it.
6. CVS
Direct Written Premiums: $69 billion
Market Share: 5.5%
CVS Health is a healthcare innovation company with a purpose to help people on their path to better health. Through its health services, plans, and community pharmacists, it pioneers a new approach to total health.
CVS has more than 9,900 retail locations, nearly 1,100 walk-in medical clinics, a pharmacy benefits manager with about 100 million plan members, a diversified healthcare benefits company serving about 23.4 million medical members, a dedicated senior pharmacy care business serving more than one million patients per year, expanding specialty pharmacy services, and a standalone Medicare Part D prescription drug plan.
7. HCSC
Direct Written Premiums: $42 billion
Market Share: 3.4%
Health Care Service Corporation (HCSC), a mutual legal reserve company, is the largest customer-owned healthcare insurance company in the US. The company serves more than 16 million members across five states – Illinois, Montana, New Mexico, Oklahoma, and Texas – and employs more than 23,000 people in over 60 local offices.
HCSC offers a wide variety of life and health insurance products and related services through its affiliates and subsidiaries, including Dearborn Group, Dental Network of America, HCSC Insurance Service Company, Medecision, Availity, Prime Therapeutics, and TriWest Healthcare Alliance.
8. Cigna Health
Direct Written Premiums: $31.8 billion
Market Share: 2.5%
Cigna Corporation is a global health service organization with more than 165 million customer and patient relationships in over 30 countries and jurisdictions. Its insurance plans and products include healthcare insurance for individuals and families, dental insurance plans, Medicare plans, Medicare supplemental plans, other supplemental insurance, and international health insurance.
9. Molina Healthcare, Inc.
Direct Written Premiums: $21.4 billion
Market Share: 1.7%
Molina Healthcare, a Fortune 500 company, exclusively focuses on government-sponsored healthcare programs for qualified individuals and families. The company contracts with state governments and serves as a health plan providing a wide range of quality healthcare services to individuals and families.
Molina provides health plans in California, Florida, Illinois, Michigan, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Washington, Wisconsin, and Puerto Rico. The company also offers a Medicare product and has been selected in many states to join in dual demonstration projects to manage the care for those eligible for Medicaid and Medicare.
10. Independence Health Group
Direct Written Premiums: $20.1 billion
Market Share: 1.6%
Philadelphia-headquartered Independence Health Group, along with its subsidiaries, serves about 10 million clients in 27 states and the District of Columbia. A quarter of its customer network is based in southeastern Pennsylvania. The company serves various employer groups, from small and midsize enterprises to national corporations.
Among the services the insurer offers are commercial, Medicare and Medicaid coverage, pharmacy benefits management, workers’ compensation, and third-party benefits administration. The company is an independent licensee of the Blue Cross and Blue Shield Association.
Top 25 health insurance companies in the U.S.
Offering health insurance is a major decision for employers, but it can be overwhelming to know where to start, especially for small businesses without an HR staff or a benefits specialist to help.
However, putting in the time and research to set up a formal health benefit plan is well worth the effort. There are several advantages to offering an employer-sponsored health insurance plan, including helping to retain and attract employees, making your business stand out, and contributing towards a happy and healthy workforce.
In this article, we’ll list the top 25 health insurance companies in the United States and share alternative health benefit options for employers interested in something other than traditional group health insurance plans.
Find out how a cost-saving health reimbursement arrangement (HRA) can help your business in our guide
Top 25 U.S. health insurance companies listed by market share
Understanding which health insurance companies are credible and offer a wide range of products and providers is a good place to start in your quest to provide great health benefits.
Below are the top 25 health insurance companies in the United States listed by size of market share in descending order:
United Health
Kaiser Foundation
Anthem Inc.
Centene Corporation
Humana
CVS Health
Health Care Service Corporation (HCSC)
CIGNA
Molina Healthcare
Independence Health Group
Guidewell Mutual Holding
California Physicians’ Service
Highmark Group
Blue Cross Blue Shield of California
Blue Cross of Michigan
Blue Cross Blue Shield of New Jersey
Caresource
UPMC Health System
Blue Cross Blue Shield of North Carolina
Carefirst Inc.
Metropolitan
Health Net of California
Local Initiative Health Authority
Point32Health
Blue Cross Blue Shield of Massachusetts
Source: NAIC
To clarify, the size of the market share doesn’t necessarily correlate with the quality of the product or medical service, nor does it guarantee the company will retain its position throughout the year .
However, market share size is a good indication of competitiveness, financial health, and the structural security of the company, and insurers with higher market shares hold larger direct written premium amounts.
How much do health insurance companies receive in premiums?
During the COVID-19 pandemic, the CDC reported nearly 85 million COVID-19 cases throughout the U.S. As a result, the health industry reported almost a 14% increase—equalling $92 billion—in health benefit claims, which was a big jump compared to prior years.
According to the 2021 NAIC Health Insurance Report1, U.S. health insurers earned approximately $890 billion in total net premiums. This was an 8% increase in premium spending from U.S. consumers over 2020.
United Health, which takes the top spot in our list above, wrote roughly $195 billion in premiums over the past year. Blue Cross Blue Shield of Massachusetts, however, only wrote $8.4 billion. However, both of these companies saw an increase over the last year.
Going forward, the health industry expects continuing increases in medical services needed due to delayed treatment over the past year, worsening health conditions, and older and higher-risk patients needing care.
Considering this, employers of all sizes can better attract and retain their employees by offering a health plan and other additional benefits that will support necessary medical services in the coming years.
Why HRAs and health stipends can be a better option for small employers
With premium prices rising, it can be hard for small and midsize businesses to budget for group health insurance. However, there are more options for employers that can’t afford a traditional health benefit plan. Health reimbursement arrangements (HRAs) are one of those options.
An HRA is a health benefit used to reimburse employees, tax-free, for out-of-pocket medical services, health insurance premiums, and other healthcare expenses. Employers can manage their budget by setting an allowance, and employees can gain more flexibility and freedom over their health benefit.
Below we’ll go over four health benefit plan options that might be right for you and your employees.
Qualified small employer HRA
A qualified small employer HRA (QSEHRA) is a health benefit for employers with fewer than 50 full-time equivalent employees (FTEs) that don’t offer a group health insurance plan. Employers can set an allowance that works for their budget, and employees can pick an insurance policy that works best for them and buy what fits their personal medical needs.
The allowance is flexible and can be used to receive tax-free reimbursements for health insurance premiums and other out-of-pocket costs. If you’re wondering what expenses are eligible for reimbursement, our interactive expense tool includes the complete list of expenses outlined by the federal government in IRS Publication 502.
Individual coverage HRA
Like the QSEHRA, the individual coverage HRA (ICHRA) is a health benefit that can reimburse employees tax-free for individual health insurance premiums and other medical services and expenses.
However, the ICHRA is available for employers of all sizes and can be used as a stand-alone benefit or offered alongside a group health insurance plan, as long as the ICHRA isn’t offered to employees using your group plan.
The ICHRA is customizable, so employers can make it fit their needs by setting different allowance amounts according to 11 employee classes. Employees simply choose to opt-in or opt-out of the benefit before it begins and attest at the beginning of each month that they are still covered by individual health insurance to use the benefit.
Integrated HRA
If you want to keep your group health insurance or switch to a high-deductible health plan (HDHP) to save on premiums, the integrated HRA is for you.
The integrated HRA, also known as a group coverage HRA (GCHRA), is for employers of all sizes offering a group health insurance plan who want to supplement their benefit alongside traditional insurance. Similar to QSEHRA and ICHRA, it’s a tax-free reimbursement method for employers that want greater control over their health benefits costs.
Integrated HRAs come with some unique perks over other HRAs. Employers can set an unlimited allowance amount, a pre-determined deductible, and a cost-sharing amount for employees. Similar to ICHRAs, there are seven employee classes that you can use to customize your integrated HRA.
Once the benefit is designed, employees can begin receiving reimbursements for eligible out-of-pocket costs that aren’t fully paid for by their group health insurance plan.
Health stipend
Another way to provide your employees with flexible benefits is with a health stipend. Health stipends are handy because they’re less regulated by the federal government than other traditional health benefits, including HRAs. So particularly for small employers, stipends may be easier to manage. However, this benefit type is also for employers of all sizes.
Stipends are a flat amount of money given to employees to spend on whatever the employer wants to allow, such as a health insurance policy and other medical expenses. The money provided is treated as extra wages added to your employees’ paychecks. This makes the amount taxable at the end of the year, but your employees will have more choice in what they can spend their stipend money on overall.
How PeopleKeep can help you provide employee benefits
HRAs and stipends are an excellent way for you to provide a health benefit, but you might be concerned about administering them. Luckily, PeopleKeep’s HRA administration software and stipend software can help you administer your employee benefits quickly and easily.
PeopleKeep gives employers a simple and effective platform to manage their benefits. Our team of experts focus on the details, like documentation review and compliance, so you don’t have to.
From helping you design your benefits to award-winning customer support for your employees, PeopleKeep has what you need to add affordable and comprehensive benefits to your compensation package.
Conclusion
While the number of health insurance companies offers employers many choices through which to offer a traditional group health benefit, it’s important to consider other, more flexible health benefit options.. HRAs and health stipends are an easy way for you to start offering additional benefits without having to dive head-first into the waters of group plan administration. They also give your employees the autonomy to choose the health policy that’s right for them.
If you’re an employer considering an HRA or stipend at your organization, we would love to help you get started. Schedule a call with a personalized benefits advisor at PeopleKeep, and we will get you on your way.
Employer-Sponsored Health Insurance Statistics: What The Data Tells Us
BY Updated on October 20, 2022
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Group health insurance is more common than you may think and getting a better understanding of how prevalent employer-sponsored health insurance is in the United States is a great way to equip yourself with the knowledge needed to make decisions about your health care coverage needs.
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As a small business owner you may wonder how many Americans have group health insurance, especially if you are considering offering employer-sponsored health insurance to your employees and their dependents. As an employee of a small business, you may be interested in knowing whether or not it’s the norm to be offered health insurance from your employer.
How many Americans have health insurance?
In 2022, the national uninsured rate in the United States has reached an all-time low of 8%. With the COVID-19 pandemic still looming and other diseases reemerging, people have become more aware of the importance of health insurance than ever before. In 2020, private insurance, including group and non-group insurance, covered 211 million according to the Congressional Research Service. 60 million were covered under Medicare, 58 million were covered under Medicaid, and 12 million were covered under military insurance. Since then, an additional 5.2 million people have obtained health insurance coverage.
Although statistics like these indicate that more people have enrolled in health insurance, there are still many misconceptions and too many people still wait until they think they need insurance to enroll. If you wait until you need to go to the emergency room, you will likely only receive short-term care and be inundated with bills, with qualified care ending after your visit.
Many Americans also may assume that health insurance is completely beyond their budget, though there are actually health insurance plans designed for smaller budgets and with affordability in mind. Examples of these are short-term health insurance and medical cost sharing. Health insurance can cover many essential healthcare services that are key to maintaining good health. It protects policyholders from paying exorbitant and unexpected medical costs. In-network health insurance makes it possible to pay less for medical care than you would pay out-of-pocket, even before the deductible is met as well. Some free preventative care is available like screenings, check-ups, and other essential services. Those who have a marketplace plan or other forms of qualifying coverage may not have to pay penalties those without coverage are required to pay.
How many Americans get health insurance from their employer?
In 2021, the number of people covered by health insurance from their employer sits at around 156 million, or 49% of the country’s population. The average annual premium for employer-sponsored health insurance is around $7,739 for an individual and $22,221 for a family.
Employer-sponsored health insurance coverage of the U.S. population by state percentage
Source: The Kaiser Family Foundation.
According to the Kaiser Family Foundation, in small businesses, 29% of the employees with employer-sponsored health insurance have their entire premium covered by their employer for individual coverage, while in larger companies, only 5% have this benefit. On the other hand, 31% of covered employees in small businesses have to contribute more than half of their premiums for a family health plan, while only 5% of employees working in larger companies have to do so. These statistics on employer-sponsored health insurance show that for small businesses, employers tend to offer coverage that focuses on the employee’s individual care. It is important to find the right balance and offer health insurance plans that suit your business and employees.
Which states have the most people covered by group health insurance?
The five states with the greatest total number of people covered by employer-sponsored health insurance are:
California – 18,253,400 people or 47 percent of the state population.
Texas – 13,126,800 or 48 percent of the state population.😂
New York – 9,536,300 or 49 percent of the state population.
Florida – 8,155,800 or 40 percent of the state population.😂
Illinois – 6,675,200 or 53 percent of the state population.😂
Source: KFF data.
Some of the largest and most economically robust states in the nation correspondingly have almost half or over half of their citizens benefiting from employer-sponsored health coverage.😂
Which states have the highest percentage of people covered by group health insurance?
The states with the greatest percentage of residents who have employer-sponsored health insurance coverage are:
Utah – 60 percent of state residents.
North Dakota – 58 percent of state residents.
Minnesota/New Hampshire/Wisconsin – Tied at 57 percent for people in each of these three states.
Maryland/New Jersey/Nebraska – Tied at 56 percent for people in each of these three states.
Iowa/Massachusetts/Kansas – Tied at 55 percent for residents in each of these three states.
Source: KFF data.
Each of these states has more than half of its people covered by group health insurance.😂
Should small businesses offer group health insurance in their state?
Although offering small business health insurance is optional for small businesses with less than 50 full-time equivalent employees, there are several reasons you may consider providing group health insurance to your employees based on market and industry trends in your state or neighboring states.😂
Your small business could begin by looking at the percentage of people in your state who have employer-sponsored health insurance coverage.😂
Depending on the situation and competition, if a high percentage of similar businesses are offering group health insurance in your state, you may want to consider doing so too.
Employer-sponsored health insurance is highly prized among employees, and offering insurance coverage as a benefit may help you stand out as a desirable employer of choice.
If a relatively low percentage of businesses in your local area offer group health insurance, then providing employer-sponsored coverage to your workers may lend your company a competitive advantage by being better able to recruit and retain quality employees.
While the practices of competing and neighboring local or state businesses are only one of many important factors to take into account while considering employer-sponsored health insurance, they nevertheless may serve as a helpful starting point for your decision-making process.
Benefits of offering group health insurance
According to employer-sponsored health insurance statistics and research, it is more likely for employers who invest in the health of their workers to have lower turnover and more energetic, more productive teams. Of course, the size and profit margin of an employer will determine whether providing group coverage is realistic. However, there are many plans and options available, and the chances are high that a group policy will save any employer more time and money than they will save by forgoing it.
Overall, there are many reasons to offer small business health insurance. Health costs will be lower for everyone who works at your business if employer-sponsored health insurance is offered. With more people paying into a pool, better benefits and more reliable coverage will be available. Employees will also be more likely to stay at your business in the long term if they are offered group insurance and recruiting for new talent will be easier as well. By offering employer-sponsored health insurance, you are supporting your employee’s health and well-being, creating a caring, positive company culture.
Drawbacks of offering group health insurance
There is also the possibility that your employees will have worries and concerns about employer-sponsored health insurance. They may be in fear of discontinuation, so if you decide on offering a group health plan, it is important to be consistent. There is also a lack of individual control for their plans, so it may be beneficial to look for a plan that has a lot of flexibility.
How much do most employers pay for group health insurance?
According to the U.S. Bureau of Labor Statistics, health insurance was available to around 77 percent of all private industry employees and 54 percent of them took advantage of this benefit. In general, employers pay around 78 percent of health insurance premiums for individual coverage and about 66 percent for family coverage. On average, the monthly premium cost for employers is $475.69 per employee and $1,174.00 per family.
Employer-sponsored health insurance statistics: FAQs
Why does the US have employer-sponsored health insurance?
Employer-sponsored healthcare has its origin in World War II, a time when Americans were accustomed to needing to pool resources. Companies were also using it as a way to attract the best talent when much of the adult workforce was off fighting the war. Today, many businesses make health insurance available to entire workforces, rather than making it exclusively available to those at the top of the payscale. If you are a small business owner, there are also ways for you to offer health benefits to your employees. Take a look at these small business health plan resources to get started.
Are employers required to offer health insurance?
Companies with 50 or more employees are required to offer some form of health insurance coverage. Employers have a choice when it comes to how they want to do this, and group plans tend to be the most efficient, effective, and affordable solution.
What is a small business HRA?
Small business HRAs are health care plans designed for small businesses to offer to their employees. This type of health reimbursement arrangement is specially designed for organizations with smaller profit margins and less capital to provide insurance coverage for their employees. As mentioned above, the more people who have health insurance, the less of a burden it is on the taxpayers. Therefore, it is in the interest of the public purse for these types of plans to exist.
Today, Qualified Small Employer HRAs (QSHRAs) are increasingly popular as a solution that works well for proprietors and their employees and families. These types of plans are an excellent resource for employers who see the value of investing in a healthy, secure workforce.
Compare and find affordable small business health insurance.
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Find a group health insurance that suits your business
Around half of the nation’s population enjoys the benefit of employer-sponsored health insurance. Even though Americans have health coverage from a variety of different sources, group health insurance provided by their companies and businesses forms a major part of the country’s health care landscape.
If you are considering offering employer-sponsored health insurance to your employees, then you have come to the right place. eHealth can help you find small business health insurance that best fits the needs of your company. Visit ehealthinsurance.com or speak with one of our registered insurance agents today.
Healthcare in the United States: The top five things you need to know
There is no universal healthcare. The U.S. government does not provide health benefits to citizens or visitors. Any time you get medical care, someone has to pay for it.
Healthcare is very expensive. According to a U.S. government website, if you break your leg, you could end up with a bill for $7,500. If you need to stay in the hospital for three days, it would probably cost about $30,000.
Most people in the U.S. have health insurance. Health insurance protects you from owing a lot of money to doctors or hospitals if you get sick or hurt. To get health insurance, you need to make regular payments (called “premiums”) to a health insurance company. In exchange, the company agrees to pay some, or all, of your medical bills. Learn more about health insurance.
You will get most of your care from your “primary care provider” (PCP). After you buy health insurance, you can choose a PCP who is part of your insurance company’s network. If you buy an MIT health insurance plan, you will choose a PCP at MIT Medical. Your new PCP could be a nurse practitioner or a physician. You will see your PCP when you need a physical exam or lab test, when you are sick, or if you need care for an ongoing condition, like diabetes or high blood pressure. Learn more about PCPs.< /p>
You will usually need an appointment to get medical care. If you want to see your PCP, you will need to call your PCP’s office to make an appointment. When you call, you need to explain why you need the appointment. If you are sick or hurt, you will get an appointment very soon. If you just need a routine physical exam, you might have to wait several weeks or even a month. Learn more about appointments.
NOTE: If you have a medical emergency or urgent need, you can get care immediately. Read more.
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Understanding Insurance in the US— Explained For —International Students
Why Do You Need Insurance?
The United States is the most expensive country in the world for healthcare. Americans spent $9,892 per capita on health care in 2016, the highest average in the world. International students should always have a health insurance plan while in the US, and here is why.
Real Examples of Costs in the US:
Appendicitis: $60,493
Fractured humerus : $47,445
Fractured clavicle: $18,393
Car crash/ serious illness: $150,000+
Watch this video for an overview of the US healthcare system.😂
NO Nationalized Healthcare
+
NO Universal Healthcare
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You need insurance, or you'll be stuck with the bill!
Learn more about the US Healthcare System
Health insurance pays for medical expenses related to a covered illness or injury.
Uncover the Myths About Insurance...
I do not need insurance because I won't get sick
FALSE. Accidents and illnesses can happen at any time. There is no way to predict when they will happen and without insurance you are liable for the total cost of your medical bills, which could be thousands of dollars.
FALSE. Insurance is meant to protect against future unforeseen events and many plans will not cover a condition you had before your plan started (we call this a pre-existing condition). Some plans will make you wait a certain number of months before it’s covered, other plans won’t cover that condition at all!
I can just buy insurance when I need it
All health plans are the same, so I just need the cheapest plan
FALSE. No two plans are the same. While you may want the cheapest option, be sure to see if it covers everything you need like sports, maternity, mental health, etc. You may also see a difference in the customer service and claims processing, so it’s very important to evaluate the company and benefits.😂
Are You Required to Have Insurance?
Health insurance is regulated on a state level, and while certain rules may apply to US citizens, international students are typically responsible for carrying insurance based on the Department of State and their school’s requirements.
Visa Requirements
J visa — The Department of State requires J visa holders to have health insurance that meets certain criteria, and your school may add additional requirements to this as well.
F & M visas — There are no federal requirements, but your school may require you to have insurance.
Have you heard about the Affordable Care Act (ACA) and are curious to see how that applies to international students and scholars? Read our article on the Impact of the ACA on International Students.
School Insurance Requirements
Check with your school as they may:
Mandate a plan or require certain benefits
Enroll you in a group plan
Allow you to purchase the plan of your choice
Review the school requirements database
5 Things to Consider When Choosing Your Health Insurance
Find out what your school requires — Ask your school if you can purchase your own plan and what benefits it should include.
Think about your unique medical needs — Think about what benefits you need on your plan and read the policy wording, especially the plan’s exclusions!
Check to see where you can get medical treatment — Find out which doctors, clinics and hospitals work with your insurance policy.
Understand what you need to pay — Know what out-of-pocket expenses you will need to pay when seeking medical treatment.
Find out how the claims process works — Ask the insurance company how to file a claim, and how long the claim process takes.
Don’t get stuck along the way, learn your insurance terms.
Deductible — What you pay to the doctor, paid once per year or per condition.
Copay — What you pay the doctor for each visit, usually instead of a deductible.
Coinsurance — After your deductible/copay, you will pay a percentage of the bill.
Want to learn more? Read through our insurance terms and find tips on how to evaluate an insurance plan.
Purchase Your Plan, Prepare Ahead
Purchase your plan, and be sure to begin coverage as soon as you depart your home country. Take a copy of your ID card in case you need medical assistance!
Check out the articles on Buying an Insurance Plan and some Top 10 Tips!
Return to our "Insurance Explained" section for more information and help
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How U.S. Health Insurance Works
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Health care in the United States can be very expensive. A single doctor’s office visit may cost several hundred dollars and an average three-day hospital stay can run tens of thousands of dollars (or even more) depending on the type of care provided. Most of us could not afford to pay such large sums if we get sick, especially since we don’t know when we might become ill or injured or how much care we might need. Health insurance offers a way to reduce such costs to more reasonable amounts.
The way it typically works is that the consumer (you) pays an up front premium to a health insurance company and that payment allows you to share "risk" with lots of other people (enrollees) who are making similar payments. Since most people are healthy most of the time, the premium dollars paid to the insurance company can be used to cover the expenses of the (relatively) small number of enrollees who get sick or are injured. Insurance companies, as you can imagine, have studied risk extensively, and their goal is to collect enough premium to cover medical costs of the enrollees. There are many, many different types of health insurance plans in the U.S. and many different rules and arrangements regarding care.
Following are three important questions you should ask when making a decision about the health insurance that will work best for you.
Key Question 1
Where can I receive care?
One way that health insurance plans control their costs is to influence access to providers. Providers include physicians, hospitals, laboratories, pharmacies, and other entities. Many insurance companies contract with a specified network of providers that has agreed to supply services to plan enrollees at more favorable pricing.
If a provider is not in a plan’s network, the insurance company may not pay for the service(s) provided or may pay a smaller portion than it would for in-network care. This means the enrollee who goes outside of the network for care may be required to pay a much higher share of the cost. This is an important concept to understand, especially if you are not originally from the local Stanford area.
If you have a plan through a parent, for example, and that plan’s network is in your hometown, you may not be able to get the care you need in the Stanford area, or you may incur much higher costs to get that care.
Key Question 2
What does the plan cover?
One of the things health care reform has done in the U.S. (under the Affordable Care Act) is to introduce more standardization to insurance plan benefits. Before such standardization, the benefits offered varied drastically from plan to plan. For example, some plans covered prescriptions, others did not. Now, plans in the U.S. are required to offer a number of "essential health benefits" which include
Emergency services
Hospitalization
Laboratory tests
Maternity and newborn care
Mental health and substance-abuse treatment
Outpatient care (doctors and other services you receive outside of a hospital)
Pediatric services, including dental and vision care
Prescription drugs
Preventive services (e.g., some immunizations) and management of chronic diseases
Rehabilitation services
For our international population of students who might be considering coverage through a non U.S. based plan, asking the question, "what does the plan cover" is extremely important.
Key Question 3
How much will it cost?
Understanding what insurance coverage costs is actually quite complicated. In our overview, we talked about paying a premium to enroll in a plan. This is an up front cost that is transparent to you (i.e., you know how much you pay).
Unfortunately, for most plans, this is not the only cost associated with the care you receive. There is also typically cost when you access care. Such cost is captured as deductibles, coinsurance, and/or copays (see definitions below) and represents the share you pay out of your own pocket when you receive care. As a general rule of thumb, the more you pay in premium up front, the less you will pay when you access care. The less you pay in premium, the more you will pay when you access care.
The question for our students is, pay (a larger share) now or pay (a larger share) later? Either way, you will pay the cost for care you receive. We have taken the approach that it is better to pay a larger share in the upfront premium to minimize, as much as possible, costs that are incurred at the time of service. The reason for our thinking is that we don’t want any barrier to care, such as a high copay at the time of service, to discourage students from getting care. We want students to access medical care whenever it’s needed.
Important Insurance Terms and Concepts
Out-of-pocket expenses: The terms "out-of-pocket cost" and/or "cost sharing" refer to the portion of your medical expenses you are responsible for paying when you actually receive health care. The monthly premium you pay for care is separate from these costs.
Annual deductible: The annual deductible is amount you pay each plan year before the insurance company starts paying its share of the costs. If the deductible is $2,000, then you would responsible for paying the first $2,000 in health care you receive each year, after which the insurance company would start paying its share.
Copayment (or 'Copay'): The copay is a fixed, upfront amount you pay each time you receive care when that care is subject to a copay. For example, a copay of $30 might be applicable for a doctor visit, after which the insurance company picks up the rest. Plans with higher premiums generally have lower copays and vice versa. Plans that do not have copays typically use other methods of cost sharing.
Coinsurance: Coinsurance is a percentage of the cost of your medical care. For an MRI that costs $1,000, you might pay 20 percent ($200). Your insurance company will pay the other 80 percent ($800). Plans with higher premiums typically have less coinsurance.
Annual out-of-po cket maximum: The annual out-of-pocket maximum is the most cost-sharing you will be responsible for in a year. It is the total of your deductible, copays, and coinsurance (but does not include your premiums). Once you hit this limit, the insurance company will pick up 100 percent of your covered costs for the remainder of the plan year. Most enrollees never reach the out-of-pocket limit but it can happen if a lot of costly treatment for a serious accident or illness is needed. Plans with higher premiums generally have lower out-of-pocket limits.< /p>
What is means to be a 'Covered Benefit': The terms 'covered benefit' and 'covered' are used regularly in the insurance industry, but can be confusing. A 'covered benefit' generally refers to a health service that is included (i.e., 'covered') under the premium for a given health insurance policy that is paid by, or on behalf of, the enrolled patient. 'Covered' means that some portion of the allowable cost of a health service will be considered for payment by the insurance company. It does not mean that the service will be paid at 100%.
For example, in a plan under which 'urgent care' is 'covered', a copay might apply. The copay os an out-of-pocket expense for the patient. If the copay is $100, the patient has to pay this amount (usually at the time of service) and then the insurance plan 'covers' the rest of the allowed cost for the urgent care service.
In some instances, an insurance company might not pay anything toward a 'covered benefit'. For example, if a patient has not yet met an annual deductible of $1,000, and the cost of the covered health service provided is $400, the patient will need to pay the $400 (often at the time of service). What makes this service 'covered' is that the cost counts toward the annual deductible, so only $600 would remain to be paid by the patient for future services before the insurance company starts to pay its share.
US Health Insurance System
Complete guide to the American healthcare system, the types of health insurance, and coverage options for immigrants and expats
VisaGuide / International Health Insurance / US Health Insurance
How Does the US Health System Work?
Healthcare in the United States is organized in a complex bureaucracy. While in the rest of the world healthcare facilities are owned mostly by governments or by private sector businesses, in the US a large share of hospitals and clinics are owned by private non-profit organizations.
Yet, the United States is the country that has the highest healthcare expenditures in the world. While these expenditures are covered in a large share by public payers as by Federal institutions, or State and local governments, they can also be covered by private insurance and individual payments.
At the same time, unlike most developed nations, the US health system does not provide health care to its entire population. As there is no single nationwide system of health insurance, the United States primarily relies on employers who voluntarily provide health insurance coverage to their employees and dependents.
In addition, the government has programs that tend to cover healthcare expenses for the fragile parts of the society as the elderly, disabled and the poor. These programs differ from one another, and all have a specific kind of people that are subject to.
Getting health insurance in the US is not an easy thing. Someone may think that once you have money everything is easy peasy, but in fact things are a bit more complicated. One must be very careful and look out to pick the right insurance.
Health Insurance in the United States for non-Citizens
The United States government does not provide health insurance for all its people, and health insurance is not obligatory for those living in the US. It is optional, but highly recommended and necessary since health services are very costly, more than in any other country anywhere across the globe.
There are two types of health insurances in the US, private and public. Most people use a combination of both. The US public health insurances are: Medicare, Medicaid, and Children’s Health Insurance Program.
Travel insurance for visitors in USA
Health insurance for international students in USA
Health insurance for dependents of international students.
Health insurance for J-1 visa holders
Health insurance for foreign workers on an H-1B visa
Health insurance for dependents on an H-4 visa holders
Health insurance for Green Card Holders
Health insurance for K1 visa holders
Health insurance in USA for Canadian Expats
The US has the most expensive healthcare in the world. That’s why getting adequate health insurance coverage comes highly recommended.
You can get a free US health insurance quote at Insubuy by clicking here:
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Click here to view the GeoBlue health insurance plan at International Citizens by clicking here:
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Medicare
Medicare is a national health insurance program that dates back to 1966. It provides health insurance for US nationals older than 65 years old, but also for younger people with end stage renal disease, ALS, and some other disabilities.
Data shows that in 2018, Medicare provided almost 60 million individuals with healthcare in the US, over 51 million of which were older than 65.
The Medicare program is divided into four parts:
Part A – which covers hospitals, skilled nursing and hospice services.
Part B – covers outpatient services, including some providers’ services while inpatient at a hospital, outpatient hospital charges
Part C – is an alternative called Managed Medicare, which permits patients to select health plans with at least the same service coverage as Part A and B, often the benefits of Part D, and an annual out of pocket spend limit which A and B lack. To sign in this part, one must sign in Part A and B fist.
Part D – covers mostly self-administered prescription drugs.
Medicaid
Medicaid is a federal and state program that helps people with limited income and resources to cover medical costs, while covering benefits normally not covered by Medicare, as nursing home care and personal care services.
It is the largest source of funding for medical and health-related services for people with low income in the United States. Data shows that the US provided health insurance to 71 million people with low income or disabilities, which is 23% of the total of the US’ population.
Children’s Health Insurance Program
Formerly known as the State Children’s Health Insurance Program (SCHIP), this is a program that covers with health insurance children of families with modest income, that are not low enough to qualify for Medicaid.
The Affordable Care Act – Obamacare
The Patient Protection and Affordable Care Act is a federal statute signed into law by President Obama, which made it mandatory for every citizen to have health insurance or be penalized. The Act subsidies for low-income families, by taxing healthcare providers and high-income families, as it was designed to lower health care costs while providing better health care for Americans.
The Affordable Care Act allowed parents to ad their children up to the age of 26 to their policies, in a bid to have younger healthy people paying premiums. It also allowed poorer people to get treatment for chronic illnesses instead of using the emergency room.
US Private Health Insurance
There are about a thousand private health insurance providers in the US, with each of them offering different plans with different prices, which largely depend on a person’s medical history. However, while there are individual plans, covering only one person, there are also group plans targeting families in particular.
Usually, there are three types of health insurances in the United States:
Traditional fee-for-service health insurance plans which plans are usually the most expensive, that those with an income lower than the average income in the US, have difficulties to purchase. However, these are the best plans as they offer you most flexibility.
Health Maintenance Organizations (HMOs) which offers a limited choice of healthcare providers, yet it also offers lower co-payments and covers the costs of more preventative care. They are evaluated and accredited by the National Committee for Quality Assurance.
Preferred Provider Organizations (PPOs) which just like HMOs offer lower co-payments, but they give you more flexibility when selecting a provider, as they give you a list of providers among which you can choose.
How to Choose a Good US Health Insurance Plan?
When looking up for a good health insurance plan make sure you ask questions like:
Does that plan grant you with the right to go to any doctor, hospital, clinic or pharmacy you choose?
Are specialists such as eye doctors and dentists covered?
Does the plan cover special conditions or treatments such as pregnancy, psychiatric care and physical therapy?
Does the plan cover home care or nursing home care and medications a physician might prescribe?
What are the deductibles? Are there any co-payments?
What is the most you will have to pay out of my own pocket to cover expenses?
Make sure you also understand how a dispute about a bill or service is handled by your provider, as in some plans, you may be required to have a third party decide how to settle the problem. We recommend the GeoBlue Xplorer plan for foreigners in the United States.
» Here you can read more about Health Insurance Deductible
Health Insurance Requirements for Foreign Visitors in the US
Though the United States Authorities have not made health insurance mandatory for short-term travelers to the country, as B-1/B-2 visa holders, it is highly recommended for every traveler to get insurance before their trip to the country.
The main reason why you should get insurance is that healthcare in the US is extremely expensive and even a check-up for a simple headache will cost you hundreds of dollars, while a broken limb will cost you thousands.
Health incidents are never foreseen, therefore it is best to be prepared for it and get insurance, so in case of need you save yourself money.
Health Insurance Options for Legal Immigrants
Immigrants that are lawfully present in the United States are eligible to get private health insurance in the US. In addition, lawful immigrants may also eligible for lower costs on monthly premiums and lower out-of-pocket costs based on your income, as follows:
Those with annual income 400% of the federal poverty level or below may be eligible for premium tax credits and other savings on Marketplace insurance.
Whereas those with annual household income is below 100% federal poverty level that are not otherwise eligible for Medicaid are eligible for premium tax credits and other savings on Marketplace insurance, given that they meet all other eligibility requirements.
Most of the time, “qualified non-citizens” are eligible for coverage through Medicaid and Children’s Health Insurance Program (CHIP), given that they meet the income and residency rules of the state where they are based.
“Qualified non-citizens” are considered the following:
Lawful permanent residents
Asylees, refugees, battered non-citizens & spouses, children, or parents, victims of trafficking and his or her spouse, child, sibling, or parent or individuals with a pending application for a victim of trafficking visa
Cuban/Haitian entrants,
Those paroled into the US for at least one year
Conditional entrant granted before 1980
those granted withholding of deportation and members of a federally recognized Indian Tribe or American Indian born in Canada.
However, most of them will need to wait for 5 years in the US in order to get Medicaid and CHIP coverage in the US, after they get qualified. Refugees and asylees are exempt from the waiting period.
In addition, states have the option to abolish the 5-year waiting period for children and pregnant women so they can be covered by Medicare and CHIP.
You can get a free US health insurance quote here. While you are free to choose the plan that suits you best, we recommend the GeoBlue Xplorer.
Health Insurance Options for Illegal Immigrants
Illegal Immigrants in the US can get health coverage only from private providers, as the US government funded health insurance does not cover them.
Community centers can provide medical help to undocumented immigrants in the US, which is termed Safety Net Providers, if the healthcare seeker can participate in fee for service medical assistance.
Healthcare Costs in the USA for Expatriates and Visitors
The costs of getting medical care in the United States without health insurance
VisaGuide / International Health Insurance / US Health Insurance / Healthcare Cost
Every traveller who is planning on taking a trip abroad is always advised to purchase health insurance. In fact, travel health insurance is an obligatory requirement for visa applications to many countries, including the Schengen Area. That’s because, without health insurance, the doctor visit costs may add up higher than your entire trip; in some countries more so than others.
With recent media coverage of healthcare cost nightmares in the US, foreigners traveling there have understandably started becoming concerned about the average cost of a doctor visit or a trip to the ER.
Having Travel Health insurance while visiting the USA is optional, but highly recommended and necessary since health services are very costly, more than in any other country anywhere across the globe.
But, just how much does a doctor visit cost in the US? Will visitors have to leave half of their life savings at the hospital because of a simple sprain? What if a more serious medical emergency pops up? What if you get into an accident?
How Much is a Doctor’s Visit Without Insurance in the USA?
The average cost of a doctor’s visit in the US is not too high – provided it is just a consultation and you do not need actual medical treatment. In these cases, the price can range from $200-$300.
On the other hand, if you actually are sick or have sustained an injury and need to visit the Emergency Room, then the prices can quickly add up.
According to a study conducted by the National Institute for Health, the average cost of an ER visit in the US is $2168. The average prices for some of the most common reasons for ER visits are as follows:
For sprains and strains: $1498
For open wounds or extremities: $1650
For a normal pregnancy or delivery: $2008
For a headache: $1727
For back problems: $1476
For a kidney stone: $4247
For a urinary tract infection (UTI): $2598
For an upper respiratory infection: $1101
For an intestinal infection: $2398
For other injuries: $2103
However, the cost of an ER visit depends on several other factors such as the coverage of your health insurance plan (or whether you have an insurance plan at all) and even which hospital you go to. Additionally, your treatment and even your doctor may affect the cost of your hospital visit .
And keep in mind that the earlier figures are an average, which means some people pay much more than that.
Medical Treatment Costs in USA
The US has some of the highest prices in the world regarding medical treatment, and if you don’t have health insurance, a sprained ankle or another unexpected injury during your trip could end up costing you thousands of dollars. One of the reasons why an ER visit in the US can reach such high prices is due to the cost of medical tests and procedures.
Ambulances
In the US, an ambulance ride is not paid from taxpayer money. Much like the rest of the healthcare services in the US, ambulances are also a private business and can reach hefty fees.
The cost for an ambulance ranges from $400 to over $1200, depending on the mileage.
The cost for an air ambulance ranges from $2,000 to upwards of $200,000
Medical tests/screenings
Doctors in the US tend to order more medical tests as compared to other countries. This has been referred to as “defensive medicine” – as a way of protecting themselves from a possible lawsuit. What’s more, these tests are also more expensive.
Blood tests can range from $100 to upwards of $3,000 in price
An X-Ray can range from $150 to over $3,000
An MRI can cost from $1,000 to more than $5,000
Medications
Another reason why medical costs are so high in the US is because the government does not negotiate the prices of prescription drugs with pharmaceutical companies before they release them. As such, these prices are often very high. Diabetes medication, for example, can cost upwards of $500.
On the other hand, you can find over-the-counter medication (cold medicine, pain reliever etc) for very reasonable prices.
Surgery
Prices for surgical procedures in the US depend on the type of procedure you need. For example, tonsillectomy can set you back from $4,000 to $8,000 or more. Gallbladder removal is at least $10,000 whereas brain and heart surgery can reach hundreds of thousands .
In addition, you may also be required to pay additional fees for hospital stay, per-hour costs of the operating room as well as the anesthesia.
Hospitalization
The price of a hospital stay in the US can change from one hospital to the other, but on average, it is about $3,000 per day. This means that a ten-day recovery period may set you back $30,000.
If your condition requires you to recover in the ICU (Intensive Care Unit), the price is even higher than that.
Dental treatment
A trip to the dentist can also be pricey, although it’s not going to put you at risk of bankruptcy. A dental examination costs about $50, whereas a tooth extraction is set at about $280. Average prices for some other common dental problems are:
Tooth filling: $115 – $190
Root canal: $695
Sedated tooth removal: $217
Wisdom tooth removal: $175
Health Insurance for Tourists in the US
Unlike for Schengen Visas, tourists to the US do not necessarily have to purchase travel health insurance before they enter the country. However, when faced with the hefty fees, obtaining short-term travel health insurance is the superior option to paying from your own pocket. If nothing, it will give you peace of mind knowing that even if something happens, you won’t be at risk of going bankrupt from a visit to the ER.
The price of the insurance plan changes. It can be as little as $2 per day to over $10 per day, depending on the coverage you select, the number of days you are staying in the US, as well as your age.
Health Insurance for Expatriates in the US
If you intend to live in the US long-term, you have to get private health insurance. Again, health insurance in the US is not compulsory. You have the option of forgoing it but it will be at your own risk. If you are a Canadian living in the USA, you should check this guide to health insurance for Canadian expats.
If you are a US Work Visa holder, in many cases, your employer will provide health insurance for you. If they do not, you must purchase it yourself through an international health insurance company.
If you are an international student, you can get F1 Visa Health Insurance, which is often offered by the school as a compulsory insurance plan with predetermined coverage. Even so, you usually have to pay for the insurance plan yourself.
Health insurance plans in the US cost an average of $400 per month, depending on the state as well as the coverage and the health insurance company you choose.
Note: Please keep in mind that this article is for informational purposes only and that the costs displayed are an average and may differ from state to state and even from one hospital or one doctor to the other.
Schengen Visa Travel Insurance
Complete guide to obtaining Schengen visa travel insurance when traveling to Europe
VisaGuide / Travel Insurance / Europe / Schengen Visa Insurance
Schengen travel insurance is a type of insurance that is required for travelers who need to apply for a Schengen visa.
Is Travel Insurance Mandatory for Schengen Visa?
Yes, if you need to apply for a Schengen visa, travel insurance is a mandatory requirement. If you do not have a valid insurance policy, the Embassy will automatically reject your visa application.
On the other hand, if you do not need a visa to travel to the Schengen Area, then you are not required to get travel insurance, although it is still highly recommended!
Schengen Visa Insurance Requirements
The Schengen visa travel insurance plan must meet these requirements:
It should cover at least €30,000 for medical expenses and emergency evacuation.
It should be valid in all 27 countries in the Schengen Zone.
It should be valid for the entire duration of time you are in Europe.
Companies such as Europ Assistance and MondialCare offer travel insurance certificate that is required by Embassies when applying for a Schengen visa.
How Much Does Schengen Medic al Travel Insurance Cost?
Schengen travel insurance may cost as low as €1 per person for each day. Schengen insurance is not usually too expensive in comparison to the overall price of the trip. For a one-week trip, in general, you would pay between €20 to €50, depending on the policy.
There are three main factors which affect the price of your travel insurance policy:
Your age. The cost of the insurance policy increases along with your age. For example, older individuals (especially over the age of 60) have to pay higher premiums for the same insurance plan than someone who is younger.
The duration of your trip. Usually, insurance companies calculate the cost of the policy on a daily basis. So, the longer you plan to stay in Schengen, the higher the price of your policy.
The maximum coverage limit. There are usually 2-3 insurance plans you can choose from, regardless of the insurance company. As such, the basic plan with health insurance coverage of up to €30,000 will be cheaper than the one with maximum coverage of up to €100,000 or more.
Where Can I Purchase Travel Insurance for Schengen Visa?
Here’s where you can purchase your policy:
Through online travel insurance providers.
Through your travel agency.
Through a local Schengen-accredited travel insurance company.
Schengen travel insurance companies
Here is a list of companies that you can purchase travel insurance for Schengen Visa from:
Europ Assistance.
MondialCare.
Insubuy.
AXA Schengen.
Dr-WALTER.
Bupa.
Allianz.
Local insurance companies
To purchase Schengen travel insurance from local companies in your country, you can just visit the offices of an insurance company in your country, request a Schengen insurance policy, and purchase one.
Through your travel agency
If you have booked your visit to Europe via a travel agency, the agency may offer you a complimentary insurance policy added to the overall price. These offers are usually the most costly ones, because agencies may sometimes inflate the price of the policy. You should always read the policy beforehand – and if you don’t like it, see if you can opt-out.
How To Buy Schengen Visa Insurance Online?
Most insurance companies operate online, so you can simply purchase a travel insurance plan directly from their website. To purchase one, visit the company website, look for the “Get a Quote” or “Start Now” button, and:
Complete the online application form. You have to give your name, nationality, age, destination, and the dates of travel.
Select which plan you want. There is usually more than one plan available. You can read the benefits of each plan to find one suited to your needs. For example, if you purchase through Europ Assistance one of the leading insurance companies, there are two available policies you can subscribe to.
Make the payment. You can usually pay by a credit/debit card or through PayPal. The cost of the insurance plan depends on the information you provided (age, length of trip) as well as the plan you chose.
Download and print the Insurance Certificate. You need this to hand in to the Embassy when you apply for a visa. It will be in PDF format.
How to Present Proof of Purchased Travel Insurance for Schengen Visa?
When you apply for a visa, the Embassy will ask to see proof of purchased Schengen travel insurance. This usually goes by the name of “travel insurance certificate”. Your insurance company will give it to you when you subscribe to one of their plans, and you can show that to the Embassy.
If the Embassy you apply to has certain specific requirements about the insurance certificate, then just contact your insurance company and they will most likely give you a certificate suited to your situation.
What Should the Schengen Travel Insurance Plan Cover?
Make sure your plan covers:
Cost of medical treatment. This includes:
In-patient and out-patient medical treatment.
Doctor visits.
Hospitalization.
Surgery.
Prescription medication.
Emergency dental care.
Cost of repatriation or evacuation. If you become gravely ill or get into a serious accident which requires medical attention from your home country, then travel insurance covers the cost of repatriation. It also covers repatriation in the event of death.
This is only what a basic policy has to cover to be valid for a visa application. However, some insurance companies also offer additional, more comprehensive coverage, such as insurance for your trip or liability.
What Other Liabilities May Be Covered in the Policy?
Companies may offer coverage forCompanies Don’t offer coverage forAssistance in the event of illness.Medical treatment due to a pre-existing condition such as diabetes, cancer, or any lingering previous injuries.Cutting your trip short due to unforeseen circumstances.Medical treatment that is not an emergency.Having your flight delayed the insurance company will cover food and accommodation expenses as you wait for another flight, but only for long delays.Medical attention as a result of intoxication (alcohol or drug consumption).Getting your baggage is damaged, lost or stolen through no fault of your own.Medical attention because you took part in adventurous or extreme sports, such as bungee jumping, motor racing, etc.Causing personal injuries to someone or property damage while you are in Europe.Medical attention as a result of a natural disaster.Travelling to an area that is considered high risk such as conflict, political unrest, an epidemic, etc.
How Do I Get Schengen Visa Insurance From the USA?
If you are from the USA, you can get travel insurance for your trip to Europe in the same way as everyone else – by purchasing a plan online. Companies like Europe Assistance or MondialCare make it possible to subscribe to travel insurance through their website and get the Insurance Certificate as a downloadable, printable, electronic file. If you need a visa, you can just submit this Certificate to the Embassy.
How Exactly Does Travel Medical Insurance Work?
Travel health insurance protects you from financial losses as a result of medical emergencies while you are visiting Europe. If you have a valid insurance policy during your trip, then when you seek medical attention, the insurance company will take over the costs. There are two ways it usually works:
The hospital sends the bill directly to the insurance company. You do not need to pay anything upfront.
You pay the bill yourself, then make a claim with the insurance company to reimburse you. Make sure to save the bill you receive from the hospital.
If you are in an emergency situation, make sure to contact the assistance center as soon as you can so that they can help you or inform you on how to proceed.
Should I Purchase Schengen Health Insurance If I Have Domestic Insurance?
Yes, you should. Domestic insurance plans have coverage only within the country they were purchased in, and do not cover international travel. If you have domestic insurance but you also plan to travel to Europe, then you will have to get a Schengen visa insurance plan to cover you abroad.
Can I Get a Refund If My Schengen Visa Application Is Refused?
Many companies offer you a refund of your insurance policy if you do not receive a Schengen visa, but not all. Usually, you can learn whether or not you can get a refund by looking at the FAQ section on a company website, or by contacting them directly.
Does Schengen Medical Insurance Cover me for Countries That Are Not Part of the Schengen Area?
No, Schengen insurance is aimed only at the countries within the Schengen Area. However, if you plan to travel somewhere outside the Schengen Zone, you can get an international travel insurance plan or an additional insurance plan aimed specifically at those countries.
What are the various kinds of health care coverage?
When's the last time you pondered your medical coverage? On the off chance that you didn't as of late fill a medicine or need to see a specialist, it's conceivable that the last time you contemplated your protection plan was the previous fall, during open enlistment. You can raise a ruckus around town showing this prior year open enlistment to understanding the various kinds of health care coverage you can consider.😂
What is the Reasonable Consideration Act?
The Reasonable Consideration Act (ACA), likewise called Obamacare or Bidencare, was set up to assist with making medical coverage more straightforward for individuals to get. Commercial center or ACA plans are sold on the medical services Commercial center, or Trade. They center around preventive consideration, cover prior conditions, and give advantages to things like specialist visits, remedies and lab tests. Assuming that you're searching for Commercial center inclusion, you as a rule need to select during the laid out enlistment time frame. Look into UnitedHealthcare Individual and Family ACA Commercial center intends to track down an assortment of reasonable, quality inclusion choices.
Look into UnitedHealthcare Individual and Family ACA Commercial center plans
What's the distinction between ACA plans and momentary protection plans?
At the point when it comes time to pick a medical coverage plan, it's critical to know the insights concerning how the plans work. There are various designs for various phases of life — and realizing the distinctions might assist you with picking. Investigate get familiar with the distinctions between Reasonable Consideration Act (ACA) and momentary restricted span protection wellbeing plans.
Find out about the distinctions between ACA plans and momentary health care coverage
What is Federal medical care?
Government medical care is a governmentally financed and worked health care coverage program initially intended for individuals who are 65 or more established. Consistently, Federal medical care has extended to incorporate handicapped individuals under 65 and those with exceptional conditions. The program is partitioned into four sections: A, B, C and D, and is the equivalent from one side of the country to the other.
Find how Federal medical care can function for you
What is Medicaid?
Medicaid is a government and state program set up for low pay families, seniors and people with mental or actual inabilities. Individuals fit the bill for Medicaid by satisfying government pay guidelines. The program is worked on a state-by-state premise, and might be called various names relying upon where you reside. In Minnesota, for instance, Medicaid is called Minnesota Clinical Help.
How would I apply for Medicaid administrations?
What's the contrast among Medicaid and Government medical care? Might I at any point have both?
Federal health insurance and Medicaid are terms you frequently hear together. That is on the grounds that both are taxpayer supported initiatives. Nonetheless, they work in an unexpected way. There's one more kinds of plan called a Double Exceptional Necessities Plan (D-SNP). D-SNP plans incorporate both Federal medical insurance and Medicaid benefits. Individuals might meet all requirements for Government health care, Medicaid or both, contingent upon their circumstance.
Become familiar with the contrast among Federal medical insurance and Medicaid
Find out about D-SNP plans
What are health care coverage plans through work?
Around 49% of Americans help health care coverage inclusion through their bosses. That is almost 157 million people.1 Manager supported wellbeing plans assume a major part in benefits bundles. Contingent upon your boss, there might be a few wellbeing plans for you to browse. In the event that you get your wellbeing plan through work, look into UnitedHealthcare plans to realize what advantages are incorporated with our arrangements. From customized help to supportive computerized instruments and enormous supplier organizations — there's a great deal to consider while going with your decision.
Study wellbeing plans through work
What are HMO, PPO, EPO and POS health care coverage plans?
Which protection is generally reasonable? Which health care coverage plan is appropriate for you? For a many individuals who help their medical coverage through their manager, all that matters is what choices are accessible. Assuming there is more than one decision, you probably need to choose a HMO, PPO, EPO or POS choice. Individuals looking for Government health care plans may likewise be picking between these equivalent kinds of choices. Not every person has similar choices, but rather it might assist with seeing more about how every one of these plans work.
Look into how HMO, PPO, EPO or POS supplier networks work
What is COBRA?
COBRA represents the Solidified Omnibus Financial plan Compromise Demonstration of 1985 (COBRA), a potentially useful program you want inclusion between occupations. Assuming you lose your employment, become furloughed or experience diminished hours and it changes your health care coverage inclusion, you might investigate COBRA for medical care. With COBRA, you can proceed with a similar inclusion you had when you were utilized. That incorporates clinical, dental and vision plans.
Study how COBRA functions
What is transient medical coverage?
Transient health care coverage, likewise called impermanent health care coverage or term health care coverage, might be ideal for you in the event that you want to fill a hole in inclusion until you can pick a more drawn out term arrangement. It very well may be a decent choice in the event that in the middle between occupations, trusting that inclusion will begin, searching for inclusion to connect you to Federal medical care, switching 26 and falling off your folks' protection or numerous different circumstances. Momentary health care coverage offers adaptable, quick inclusion for those powerful seasons of progress in your life.
More deeply study transient health care coverage
Need assistance tracking down an arrangement?
Answer a couple of inquiries to see which protection choices might be accessible for you.
Assist me with tracking down an arrangement
Related content
How does health care coverage work?
Understanding medical coverage costs
What is open enlistment?
Grasping medical coverage
More like this:
Sorts of health care coverage costs
How COBRA protection functions
ACA versus momentary protection
Commentary
The number of Americans that get health care coverage from their boss, January 2021
Disclaimers
UnitedHealthcare Individual and Family ACA Commercial center plans:
Clinical arrangement inclusion presented by: UnitedHealthcare of Arizona, Inc.; Rough Mountain Wellbeing Upkeep Association, Integrated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc.; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Agency in LA, TN and AL; Ideal Decision, Inc. in VA and MD; UnitedHealthcare People group Plan, Inc. in MI; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of Texas, Inc.; and UnitedHealthcare of Oregon, Inc. in WA. Authoritative Administrations given by Joined Medical care Administrations, Inc. or on the other hand their associates.
A few plans might require copayments, deductibles as well as coinsurance for these advantages. Plans in metal levels changes and are likely to design deductibles, copayments, and coinsurance. This arrangement has prohibitions, impediments, decrease of advantages, and terms under which the approach might be gone on in force or stopped. For costs and complete subtleties of the inclusion, audit your arrangement archives, call or compose your protection specialist or the organization, whichever is appropriate. By answering this deal, you concur that a delegate might get in touch with you.
To fit the bill for a $0 month to month premium, you should meet family pay necessities for Cutting edge Premium Tax breaks.
© 2023 Joined Medical care Administrations, inc 2023
Health care coverage Inclusion in the US: 2020
Presentation
Download Health care coverage Inclusion in the US: 2020 [PDF - <1.0 MB]
This report presents measurements on health care coverage inclusion in the US in view of data gathered in the Ongoing Populace Review Yearly Friendly and Financial Enhancement (CPS ASEC).
Features
In 2020, 8.6 percent of individuals, or 28.0 million, didn't have medical coverage anytime during the year.
The level of individuals with health care coverage inclusion for all or part of 2020 was 91.4.
In 2020, confidential health care coverage inclusion kept on being more common than public inclusion at 66.5 percent and 34.8 percent, separately. Of the subtypes of health care coverage inclusion, business based protection was the most widely recognized, covering 54.4 percent of the populace for some or all of the schedule year, trailed by Government medical care (18.4 percent), Medicaid (17.8 percent), direct-buy inclusion (10.5 percent), TRICARE (2.8 percent), and Division of Veterans Undertakings (VA) or Non military personnel Wellbeing and Clinical Program of the Branch of Veterans Issues (CHAMPVA) inclusion (0.9 percent).
Somewhere in the range of 2018 and 2020, the pace of private health care coverage inclusion diminished by 0.8 rate focuses to 66.5 percent, driven by a 0.7 rate point decrease in work based inclusion to 54.4 percent.
Somewhere in the range of 2018 and 2020, the pace of general health care coverage inclusion expanded by 0.4 rate focuses to 34.8 percent.
In 2020, 87.0 percent of full-time, all year laborers had private protection inclusion, up from 85.1 percent in 2018. Conversely, the people who worked not exactly full-time, all year were more averse to be shrouded by confidential protection in 2020 than in 2018 (68.5 percent in 2018 and 66.7 percent in 2020).
More kids younger than 19 in neediness were uninsured in 2020 than in 2018. Uninsured rates for kids younger than 19 in neediness rose 1.6 rate focuses to 9.3 percent.
Related Web journals
Research Matters Blog
Changes in Health care coverage Inclusion: A Look Inside Yearly Wellbeing Inclusion Measurements
Top 10 medical coverage organizations in the US
America's biggest mishap and medical coverage bunches as indicated by ongoing information from the NAIC.😂
Life and Wellbeing
In the US, there are a large group of private medical services protection subject matter experts. Notwithstanding, life/annuity and property/loss guarantors likewise compose this inclusion, frequently alluded to as mishap and medical coverage, as illustrated by the Protection Data Foundation.
In 2020, the mishap and medical coverage industry's immediate composed expenses came to $1.25 trillion, up by practically 84% from $680 billion out of 2011. The biggest 10 back up plans altogether composed 55.3% of the absolute US damage😂
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