The main difference between a critical illness separate plan and a comprehensive plan is that while the first will give you a lump sum payment of your total sum assured in case you get admitted for a critical disease, the latter will pay only the amount spent on the treatment within the sum assured limits.
Health plan vs. health insurance
Historically, HMOs (Health maintenance organization) tended to use the term “health plan”, while commercial insurance companies used the term “health insurance”. A health plan can also refer to a subscription-based medical care arrangement offered through HMOs, preferred provider organizations, or point of service plans. These plans are similar to pre-paid dental, pre-paid legal and pre-paid vision plans. Pre-paid health plans typically pay for a fixed number of services (for instance, $300 in preventive care, a certain number of days of hospice care or care in a skilled nursing facility, a fixed number of home health visits, a fixed number of spinal manipulation charges, etc.). The services offered are usually at the discretion of a utilization review nurse who is often contracted through the managed care entity providing the subscription health plan. This determination may be made either prior to or after hospital admission (concurrent utilization review).
What Does the Average American Pay for Health Insurance?
This is a complicated question to answer. More than 85 million Americans get health insurance through the government, including Medicare, Medicaid, veterans’ benefits, and the military (both active duty and retirees). Currently, more than 45 million Americans have no health insurance.
Made public in October 2009, America’s Health Insurance Plans (a trade group representing health plans) presented some information that gives a sense of what a health insurance policy costs when purchased by an individual.
- On average, the annual premium was $2,985 for a single person and $6,328 for a family.
- The annual premium differed from state to state. For example, the premium for a family health plan in New York was $13,296, while a similar plan in Iowa was $5609.
- The annual premiums for health plans were also different depending if the annual deductible was high or low. For example, family plans with no deductible had an average premium of $12686 each year, while plans with an annual deductible of $10,000 had an average premium of $5380 each year.
What Do Health Insurance Costs Include?
There are many things that determine how much your health insurance will cost you each month. Premiums – A premium is the monthly fee that is paid to an insurance company or health plan to provide health coverage, including paying for health-related services such as doctor visits, hospitalizations, and medications.
Out-of-Pocket Expenses – Out-of-pocket expenses are what you pay for health-related services above and beyond your monthly premium. Depending on your health plan, these expenses may include an annual deductible, co-insurance, and copayments for doctor visits and prescription drugs.
Deductible: A deductible is the amount you must pay out-of-pocket each year for health-related expenses before your insurance policy begins to pay.
Coinsurance: Some health insurance requires that you pay a percentage of the cost of covered health-related services after you have met your annual deductible. This is known as coinsurance and most often is about 20% of what your health plan approves