Understanding Medical Insurance in Details

General Overview of Medical Insurance

Medical InsuranceMedical insurance represents one of the most crucial types of investment a person can make. Various sicknesses, unexpected injuries, as well as other medical conditions can turn out to be extremely costly if there is a requirement of surgery, hospital appointments, and other important actions are necessary. Likewise, having health insurance is the best way to ensure that everyone does not end up paying for emergency medical costs on his own.

Nowadays, according to various sources the percentage of uninsured people across the developed countries still remains quite low. Those people continue paying around 30% of medical expenses on their own and deal with higher bills comparing to people with medical insurance. Based on 2013 summary by CNBC, up to 2 million of U.S. citizens suffered from bankruptcy resulting from high medical bills.

Pre-requisites before Getting a Medical Insurance

In order to acquire an appropriate level of insurance, one needs to understand the basics behind health insurance functionality. The summary below discusses the essential concepts governing the industry of health insurance, as well as highlights some of the most widely-known medical insurance sources.

In general, the medical insurance plan of your choice should be based on the most suitable case that meets one’s personal and family requirements. Once you have confirmed the coverage type that fits with your personal or family requirements, the next step is to identify an appropriate structure of your plan. This is a sophisticated process, since there is major overlap among various plans, and also substantial number of details related to every option.

Benefits to Health

In ideal case, the properly selected plan entitles you to get medical treatment anytime you require. Certain insurers cap amount of primary care visits per year, whereby others are more tolerant and provide you with flexibility to have as many appointments as you need. Prior to receiving a new plan, it’s crucial to confirm any limitations related to number of primary care visits.

Associated Costs

If you are a health-oriented person who visits the healthcare specialist for a check-up on annual basis, then the most suitable option is a high-deductible plan with a low premium. Whereby, if you suffer from a pre-existing condition, which involves a massive treatment, prescribed drug or therapy, then a low-deductible plan will be a better option. Even though, it involves higher premiums every month, but the savings from out-of-pocket funds in a long run are more significant.

Doctors and Healthcare Providers

If it is very important for you to keep the current doctor or healthcare provider, then prospective coverage of physician’s network is the best option, as long as it covers the costs associated with visiting a specialist outside of the network too. Another important consideration is related to PCP (primary-care physician) requirement, and whether you are permitted to actually appoint your trusted doctor as PCP.

Understanding Existing Plan Options

After confirming the coverage type that satisfies your personal expectations and selecting a suitable plan structure, it is highly advisable that you do some research about the plans, such as: HMO (Health Maintenance Organization), EPO (Exclusive Provider Organizations), PPO (Preferred Provider Organizations), POS (Point of Service Plans), HSA (Health Savings Account), HRA (Health Reimbursement Arrangements), FSA (Flexible-Spending Account), Catastrophic Health Insurance and others. Each abovementioned plan has its own set of rules and pre-requisites; hence it is of high importance that you spend some time to research about each of them in order to be able to select the most appropriate one.


Undoubtedly, medical insurance is very crucial for everyone’s life, taking in consideration the diverse risks associated with contemporary world and lifestyles, as well as circumstances. However, do not rush in taking quick decisions and spend some considerable amount of time on researching about the available coverage plans in order to find the one that will ultimately benefit you as well as your loved ones.