Do I Really Need Medical Insurance?

[10/11/06]
Today you probably hear a lot about medical insurance. About the rising costs of medical insurance, about the over 40 million people in America who do not have medical insurance, and you may wonder I'm young; I'm relatively healthy - what is the big deal? Do I really need medical insurance? Well, the answer is a resounding yes. Think about it, you wouldn't think of driving your car without insurance - well you buy medical insurance for the same reason that you buy other insurances, to shield yourself from financial ruin should a problem occur. If you should be injured or have a serious illness medical insurance not only can pay the costs for treatments, but may be able to help with your other bills if you find yourself unable to work. Having medical insurance is the responsible thing to do for you and your family. And remember with the rising costs of health care today even routine medical care can take a significant bite out of your annual budget without medical insurance.

There are many different types of medical insurance. Most people receive medical insurance from their place of employment, or are covered because a family member has coverage at work. Depending on the company all or part of the cost of the medical insurance is paid by the company. Medical insurance comes under what companies call benefits. It is often these benefits that make a particular job with a given company more attractive than another, when looking for a job some people consider medical insurance as important if not more important than salary. There are basically three types of medical insurance coverage.

  • Fee for Service Plans - This is the long-established style of medical insurance where the insurance company pays a set portion of the fee to the healthcare professional for the services provided, once you have reached a certain level of payments called a deductible. For example the company will pay 80% of the bill and you are responsible for the other 20%. Usually with fee for service medical insurance you can see any doctor or healthcare provider.
  • Health Maintenance Organizations (HMO's) - In an HMO you pay a monthly premium in exchange for care provided by the HMO or doctors contracted to the HMO. With this type or medical insurance you are limited to receive care only from the HMO or its contracted health professionals, often a small co-pay in the area of 5.00 to 25.00 is required when you see a participating practitioner.
  • Preferred Provider Organizations (PPO's) - A PPO is kind of like a hybrid between Fee for Service medical insurance and an HMO. In PPO like in an HMO there are participating doctors who are part of the plan, often called a "network", but unlike an HMO you can use a doctor outside of the plan, you just have to pay a higher proportion of the bill yourself.

Unfortunately, not all businesses or companies are in a position to offer their employees medical insurance; many are just too small to afford it. In that case and for the person who is self employed, there is the option of buying individual medical insurance. You can get either Fee for Service, HMO or PPO coverage as an individual but costs and benefits vary hugely from company to company. According to the United States Department of Health and Human Services, when looking for individual medical insurance you should:

  • Shop Around
  • Make sure the policy has catastrophic protection - protection form large medical costs
  • Carefully read and make sure you completely understand the policy - the language in insurance polices can be confusing, perhaps you should have someone else read it as well before you commit to the policy
  • Be sure they offer a "Free Look" clause - most reputable agencies will allow you a ten day period to look over the policy and be sure it is right for you and allow you to cancel for a full refund within the "free look" period

Many people consider insurance an investment, when it comes to securing your future, with medical insurance you are protecting your most valuable asset - your health.

Individual or
Family Health

Group / Small
Business Health