About Health Insurance in the USA

Currently, medicine in the United States is one of the leading in the world and the most expensive. Some Americans are having difficulties with getting general insurance and medical assistance. Only children under 19 years old can receive free medical services. To save on health care, many Americans go to Mexico.

In this article, we will discuss the health insurance in the US to make everything more clear.

What Is Health Insurance?

In a nutshell, insurance is when you pay now so as not to overpay later.

Medical insurance is a contract with an insurance company, according to which you pay a certain contribution every month, and the insurance company helps you to smooth out medical expenses, if necessary. When you buy medical insurance, you protect yourself from unexpectedly high costs in the event you need medical help.

Who Needs Insurance?

If you are a resident of America, you are required to comply with the Affordable Care Act. It has not yet been canceled, which means that you may be fined for the absence of insurance.

The fine is 2.5% of the annual income for a person. However, many prefer to pay for it instead of paying for insurance.

How Does Insurance Work?

You just go to the doctor and show him your insurance.

In the registry, all necessary information will be written from it and returned. After this, you can go to the doctor. Based on the conditions of insurance, after the visit, you will be informed whether you need to pay extra or not. The conditions can be the following:

  • Co-pay is a fixed amount that must be paid for each medical service, and the insurance company covers the rest of the cost.
  • A deductible is money that you spend seeking medical care before insurance coverage begins.
  • Co-insurance is the agreed percentage that you pay yourself, and the rest is paid by the insurance company.
  • The out-of-pocket maximum is the maximum amount you spend during the year and you get 100% compensation from the insurance company.

At the end of treatment, all documentation is sent to the insurance company, which, according to your policy, pays money to the hospital.

You will receive an explanation of benefits about how much the medical services cost you, how much the insurance has covered, and how much you still need to pay.

Types of Health Insurance in the USA

Before buying, you will need to determine the type of insurance and the plan. The types of insurances can be the following:

  • EPO limits its clients to treatment only in a specific network of medical clinics. Insurance will not apply to visits to private doctors.
  • HMO obliges you to choose a personal therapist. And he will recommend other doctors. Only in this case, the insurance will pay for all medical appointments.
  • PPO is the freest option. You can independently choose which doctor to go for treatment.


According to numerous ratings, the United States occupies a leading position in social, pension, and medical care. And it largely happens thanks to the insurance system, which is the foundation of all America.

Jeff Campbell

Jeff Campbell is a husband, father, martial artist, budget-master, Disney-addict, musician, and recovering foodie having spent over 2 decades as a leader for Whole Foods Market. Click to learn more about me

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