Health Insurance Articles
Medical Insurance Coverage Options For New Policy Holders
2010-11-21
With the passage of the new federal health care mandate, all uninsured Americans will have to obtain medical insurance coverage, or they will face paying a penalty for lacking insurance. Insurance options for new policy holders will take a variety of forms, some of which already include employer-paid plans, Medicare and Medicaid, and individual plans. New to this mix will be state-run insurance exchanges, where uncovered individuals can shop for the best plans, with features that promise to meet their needs at prices that are competitive. For those who can't afford the premiums that these plans charge, subsidies will be available. The recent health care reform also guarantees that no one will be denied medical insurance coverage because of a pre-existing condition or because of treatment spending limits, and all plans are required to cover all preventive services without charging a deductible or co-pay.
New policy holders have a variety of factors to consider when choosing medical insurance coverage. Plans vary substantially in the areas of cost and range of benefits offered. Some plans don't include prescription coverage, for instance, while some require a significant deductible before providing coverage at a reasonable cost. Some plans cover only major medical costs, like hospitalization, but provide no outpatient care. Some medical insurance coverage includes nursing and hospice care, and some provides payment for alternative treatments that fall outside the traditional doctor/patient network.
Most important for some new policy holders will be reproductive care. Health care reform did not include any provisions for women seeking abortions, and so for those policy holders who believe that choice regarding all sexual and maternal health issues is fundamental, care should be taken to ensure that medical insurance plans don't restrict payments for reproductive or contraceptive services. Some new policy holders will also be concerned about fertility treatments and pre- and post-natal care. Plans vary too with regard to these options. Some plans cover maternity care, for instance, but not pre-natal care, and most plans don't cover fertility treatments.
Medicare plans often require supplemental insurance to cover what is referred to as the "doughnut hole," which is the amount beyond initial coverage that a prescription plan won't pay until a substantial deductible is paid. Because this amount can be prohibitively expensive, particularly for people on fixed incomes, many opt for additional plans that close this spending gap (which the new health care law promises to close in the coming years).
In sum, new medical insurance policy holders have many options to consider when choosing their coverage plans. Taking into account immediate and long-term health care needs, as well as budgetary restrictions, is the only way to make the best choice.
