Private Medical Insurance Information

Significance

Health insurance subsidizes medical costs for patients and generates revenue for health care providers. According to the Centers for Disease Control and Prevention, 68 percent of adults ages 18 to 64 were on a private health insurance plan in 2008.

Warning

Private health insurance is costly, and factors such as age, smoking and gender cause premiums to increase. This is why many people choose to enroll for benefits under a group plan through their employer. Although not required, employers usually subsidize some of the insurance cost, making health insurance affordable for their employees.

Effects

New members may have a waiting period for pre-existing conditions. If the patient has already been treated or diagnosed for a condition prior to enrolling on the plan, the insurance may not pay benefits until the member has met their pre-existing conditions waiting period. Having to meet this waiting period may cause a patient to refrain from seeking care because they are not able to pay for services on their own.

Types

Traditional HMO (health maintenance organizations) plans are now leaving the system and new PPO (preferred provider organizations) plans are taking over the insurance market. PPO plans give patients the ability to choose any in-network provider without the need for a referral from a primary care physician. Plans are also requiring members to meet an annual deductible before issuing payment in addition to an office copay and coinsurance. Health care is a growing and costly industry. Families need coverage for children who are required to have immunizations before going to school. The elderly need coverage for their prescriptions. We live in a time where obesity, cancer and heart disease are three major and common illnesses, and they are the driving reasons why most people choose not to live without health insurance.