Medical Insurance Basics Coverage

Medical Insurance


Medical Insurance is bought to protect one from expensive medical treatment, cost of medical emergencies, and to guarantee negotiated lower rates with selected physicians and hospitals through an accreditation scheme.

By 2014 under the Obamacare program, all individuals are required to have Medical Insurance or pay a tax penalty. This is known as the Individual Mandate. Individual Mandate refers to who are exempt from the tax penalty due to their circumstances. For instance, religious churches, people in jail, non-US citizens are all exempt from the program and the tax penalty.  For those who will not get the minimum Medical Insurance, the tax penalty may be 1% of the income, $95 per person, or $285 for a family of more than 3 members.

There are 2 kinds of Medical Insurance: Individual or Employer. The Individual Medical Insurance is voluntary so the amount and coverage will depend on the policy holder. It is assumed that the policy holder will get at least the minimum requirement under the law.

The Employer Medical Insurance is also known as a group plan. It has friendlier premiums because you are enrolled as a member of a large group. The insurance premium is automatically deducted from your pay.

Medical Insurance Basics

With Medical Insurance, there is a term called “Pre-existing conditions.” This refers to the increase in the premium based on a medical condition that exists at the time of application. A few examples would be hypertension, a smoking habit, or a family history of heart problems. The insurance company may also opt to add a clause in the policy protecting them from claims against pre-existing medical conditions. Fortunately, under the new health insurance for 2014, no insurance company can deny an application or charge higher for medical insurance based on pre-existing medical conditions.

The coverage of Medical Insurance also includes hospital stay, surgery, doctors’ fees, and lab or diagnostic fees and medical tests. Some plans also include Dental and Eye Insurance.

The Best Way To Shop For Medical Insurance

In anticipation of the new law in 2014, it pays to start shopping around for your best options. Here are a few quick tips:

  • You are not required to provide personal medical history to anyone
  • You should never give out your Social Security number as well as private finance account numbers like credit card and bank account numbers without verifying the request
  • Do ask as many questions as you want before agreeing to any policy
  • If you are suspecting someone of trying to commit fraud, you can report the incident to online Complaint Assistant of the Federal Trade Commission

If you are unemployed, you qualify for Medicaid and your children are covered under the Children’s Health Insurance Program. The amount of aid will be determined by an estimate of your household’s income for the year.  You may also be eligible for lower premium rates based on your income level. Part-time workers without medical insurance from their employer may also apply for lower premiums through Medicaid as well.