Access to good quality healthcare is a global goal for a majority of countries. However, medical conditions are unpredictable and cause you an undue financial burden. It is recommended that you get health insurance coverage for you and your family to protect you in such times.
Although health insurance has its benefits, many people are yet to get on board. Navigating the medical landscape can be strenuous without health insurance. The government of the U.S has introduced the Affordable Care Act and other programs to help the less privileged in society to get insurance cover and access health care.
Today, we share top tips on how to navigate the medical industry with or without insurance. Keep it here for more insights.
Importance of Health Care Insurance
1. Fight Lifestyle Diseases
Lifestyle diseases are at an all-time high and are affecting each demographic. Obesity, heart diseases, diabetes, and respiratory problems previously prevalent in the older generation are now affecting children and young adults. Major contributors to these diseases include poor eating habits, stress, pollution, inactive lifestyles, and lack of discipline in addictions.
Although preventive measures can help slow down and combat some of these diseases, others are genetic, hence inevitable. In addition, coping with such conditions can be financially challenging, thus why insurance cover is beneficial. The insurance covers regular tests, annual check-ups, vaccinations, scans, and screenings that help in the early detection of these illnesses. If discovered, the cover also takes care of the medical expenses.
Without insurance, these illnesses can cause a bulge in medical expenses in their advanced stages, making it unmanageable to treat them successfully. However, with medical insurance, you have one less thing to worry about.
2. Protect Your Family
Health insurance cover comes in different packages to meet various needs. For instance, you can choose a family plan for your entire family to protect them. In addition, your aging parents and dependent children who have no way of paying for health insurance can benefit from this all-inclusive cover. They all deserve quality medical care should anything happen to them.
3. Deal With Medical Inflation
The medical industry is dynamic and is constantly making changes and adopting new technologies. Unfortunately, with new improvements comes a new and increased cost of treatment. Medical expenses increase in consultations, tests, surgeries, emergency ambulance services, medicines, and room costs. All these additional charges could strain you financially, but you can beat the inflation costs with health insurance cover while still getting quality treatment.
4. Counter Inadequate Insurance Covers
For employed people, their employers remit monthly payments to cater for their insurance cover. However, most of these payments only cover the basics and may be insufficient when faced with potential genetic and lifestyle diseases. For more comprehensive insurance cover, you may need an additional insurance plan to take care of any eventualities.
5. Safeguard Your Savings
Healthcare expenses can drain you emotionally and financially. You may empty your savings catering for one illness. Comprehensive insurance coverage helps you manage your expenditure and caters to your expenses so that you do not have to dip into your savings every time you are faced with a problem. Therefore, you can use your savings for their intended purpose. In addition, most insurance covers offer tax credits, which can further increase your savings.
Services Covered By Health Insurance
Lab services are an essential component of quality healthcare. These tests help doctors provide efficient and effective services through early detection and diagnosis. Such services are covered by health insurance, and patients are required to go for regular screenings and scans for better management of lifestyle diseases.
If you are not comfortable going in for a physical check-up, your physician can organize mobile lab services at the comfort of your home, and your insurance policy will cater for the expenses.
Home Care Insurance
The majority of health insurance covers do not include in-home care in their plans. This is because it falls under the category of long-term care and can be costly. However, there are private insurance companies that offer such cover. In addition, Medicaid also provides medical in-home care insurance for a short term.
In most cases, in house, health care is recommended by a physician where a qualified professional will be assigned to the patient over a short period. During this period, the professional will be responsible for attending to the patient by administering doses, changing and dressing wounds, among other services. However, health insurance will not cover the costs for non-medical care such as bathing, meal preparation, and assisted living.
If your health insurance coverage cannot cater for in home care, you can substitute your life insurance to pay for home care.
A health insurance cover for the entire family will include a primary care physician who is in charge of all family consultations, tests, annual check-ups, and vaccinations. The family doctor is only the first point of contact, and your insurance coverage will cover all costs for the services they provide.
However, the physician is not specialized in all areas and will refer you to other specialized physicians if a diagnosis is outside their jurisdiction. If the tests done reveal potential diseases not covered by your health insurance, you will require additional insurance coverage or pay out-of-pocket.
Dental Coverage
Your family’s oral health is essential for their overall health care. For your kids, you can get a pediatric dentist under your insurance cover from your employer. You can also get a private stand-alone dental plan.
Unfortunately, insurance rarely covers adult orthodontic care because it is considered different from medical care. Since you cannot predict when you will need a dental filling, you can request your clinic to offer you an uninsured plan. The payment structure allows you to make affordable monthly payments towards your dental bills. With this plan, you can access dental care at an affordable cost whenever you visit your dentist.
Surgeries
The majority of insurance plans cover surgery. However, terms and conditions apply for these surgeries to be conducted. The surgery has to be medically necessary. If it is lifesaving, the insurance is likely to cover the expenses. Surgeries come with additional expenses, such as preoperative and post-operative tests. Medication, inpatient care, surgical tech jobs, and medical equipment are also included in the costs.
You must go through your policy document to understand the extent of coverage for your surgery. Additionally, you can clarify the terms with your provider, as some may only cover the surgery expenses and exclude the additional costs.
Referrals
At times, your primary care physician may not be able to handle all your medical-related issues. You will therefore be referred to another specialist to handle your case. For instance, if you walk into your doctor’s and complain of stomach pains, you will be scheduled for tests to diagnose the problem. Once the tests come out, your physician will analyze whether it falls under general healthcare or specialized care.
If your stomach symptoms appear severe, you will be referred to a specialist such as an acid reflux relief doctor who deals with such disorders. For your health insurance to cover the expenses, the referral must originate from your primary care physician. Your insurance company will then authorize payment.
If you skip the primary care physician and go directly to your chosen specialized doctor, your insurance may not cover the expenses. You will then be forced to cover the costs out of pocket. However, you may request prior authorization from your insurer before visiting the referral hospital. Then, if they deem the procedure necessary, your expenses will be covered.
Hiccups
To this day, there are no known hiccups treatments. Hiccups are not considered severe medical conditions that require insurance. When you get a hiccup, you can get rid of them using recommended home remedies such as quickly drinking a glass of water or swallowing a spoonful of honey.
If the hiccups do not disappear, you should visit your family doctor for further consultation. The hiccups could be a result of underlying conditions. The doctor may recommend medication or a surgical procedure to block your phrenic nerve and stop the hiccups. If the surgery is deemed necessary, your insurance may cover the costs.
Cosmetic procedures
Insurance rarely covers procedures done to enhance appearance because they are not considered medically necessary. Therefore, procedures such as dental implants, liposuction, facelifts, and nose jobs are excluded from the insurance policy.
While regular insurance may not cover you, you can choose to invest in insurance cover specifically dedicated to protecting you if your surgery backfires. Since you cannot predict the outcome of your cosmetic surgery, you can insure against surgery complications as a safety net if you are unhappy with the result. This way, the financial burden of correcting the mistake will not fall on you.
Tips To See A Doctor Without Insurance
- Assess Your Eligibility
If you are unemployed, you may not be eligible for many insurance programs. However, you may still qualify for the Affordable Care Act, Medicaid, or Medicare Health Insurance Plans. These are federal programs that help low-income families access quality healthcare services. You can research and find one that is suitable for you.
Medicare health insurance plans also cover specific demographics such as adults over 65, disabled young people, and other special ailments. Medicare is affordable because most plans are premium-free. In addition, with assisted living programs such as hospice, you can get insurance coverage under Medicare.
- Ask Around
Prices vary across different health institutions. The price differences may be up to 2000% for similar procedures. Therefore, you need to do your due diligence by asking around and finding institutions within your budget.
- Ask For Discounts
If you don’t ask, the answer will always be No. When looking around for an insurance provider, ask whether they can offer you a discount on your policy. More often than not, they are willing to provide you with a discounted price under certain conditions. For example, if you select the family policy, you will get a given percentage of the total as a discount.
- Opt For Community Health Centers and Free Clinics
Several healthcare institutions offer services at little to no cost. The majority of these health centers are federally funded, and you can easily get essential services such as vaccinations, tests, and other services free of charge. In addition, uninsured individuals are typically eligible for these clinics.
- Consider Urgent Care Centers
In cases of emergency, you can opt for urgent care centers. They are well equipped to handle various cases such as respiratory infections, food poisoning, minor fractures, and high blood pressure. In addition, these facilities offer high-level care compared to local pharmacies and cost less than top-level hospitals.
- Keep Good Records
Uninsured individuals do not have the advantage of having a primary care physician who keeps and maintains their health history records. Therefore, you must keep your records whenever you visit the doctor to help you and your doctors from performing redundant procedures or offering duplicate medication.
Ensure you keep track of the tests you take, their results, and the prescribed medication. Also, keep a list of the pharmacies you have used and their longevity. In addition, your family’s records will also come in handy when it comes to managing genetic illnesses.
The benefits of health insurance are vast, making it an essential service for quality affordable care. Unfortunately, there are a lot of uninsured individuals who cannot afford insurance plans. With the Affordable Care Act and Medicare, low-income families can access healthcare services easily. It would be best to get individual cover dedicated to the specific problem of services not covered under health insurance. This will allow you to navigate the medical landscape without undue financial burden with or without health insurance.