The Walters Agency
With all the talk the past year about the Affordable Health Act and the need for health/medical insurance, many individuals are attempting to find employer-based insurance, or medical insurance that is offered as a condition of employment. To learn the basics of employer-based health coverage, continue reading.
What It Is?
Health/medical insurance is a program designed to help pay for certain medical costs. Employer-based health/medical insurance is provided by the employer. In most cases, the cost of the health coverage is shared by both the employer and the employee. The employees cost is deducted from his or her paycheck each pay period.
Who It's For?
With the recent change in the laws, everyone is now required to have some sort of medical insurance. Individuals who cannot get coverage from their employers are required to purchase an insurance policy from a private company or from the "marketplace". Employer-sponsored policies are generally offered as single plans for the employer or as family plans that cover the employee and his or her family members. Family plans are significantly more expensive than single plans.
How It Works?
Health insurance provides help paying for medical expenses up to certain limit. Insurance policies typically have a deductible, which is the amount you must pay each year before the insurance will begin paying. For instance, with a $500 deductible, you must pay the first $500 before the insurance will pay. Once the deductible is paid, the insurance company will pay a percent of whats left. In a policy referred to as 80/20, the insurance company pays 80% of the medical bills and the employee pays 20%. The higher the deductible, the lower the cost of the insurance.
Different Types of Coverage
Health/medical insurance generally covers major medical expenses such as doctor visits, hospital stays, emergency medical care, x-rays, preventative care, outpatient care and prescriptions. Some policies are only for major medical expenses such as hospitalizations. Some employer-based medical insurance policies also provide vision and dental care.
The benefits that are covered by health policies may vary from company to company; however, the Health Care Reform Act has mandated that health coverage provide certain major benefits, which may include hospitalization, emergency care, ambulatory services, substance abuse and mental health care, prescriptions, maternity and newborn care, pediatric services, laboratory services, and preventative care.