Nearly everyone gets injured or ill at some point in their adult lives, and sometimes, this means going to a hospital, a clinic, or a similar healthcare provider for recovery through surgery, medicine, or physical therapy. This is a business, and because of that, hospitals will give their patients bills for healthcare services received. Paying for healthcare often means having health insurance, and health insurance is often a staple of adult life, especially for adults who expect to visit the hospital often, such as senior citizens or those with high-risk jobs like construction workers. There are variants of health insurance such as catastrophic health insurance or other health care plans, and those with less risk of injury or illness may choose a more minimalist health care plan. In short, an adult American will choose a healthcare plan that is tailored to their needs and their risks of sustaining injury or getting ill. How does all this work? How can one find health insurance plans?

Healthcare in the United States

There are some general trends to show how Americans spend on healthcare, and the process of getting healthcare insurance is fairly straightforward and often vital for having fair bills after a hospital or clinic visit. This is a big industry; the Centers for Medicare and Medicaid Services, in the year 2015, the total healthcare expenditure came out to $3.2 trillion, and in that same year, about 32.2% of national healthcare spending went toward hospital care. Ever since 2015, healthcare costs have gone up nearly 30%, and for this reason, Americans everywhere may want to make sure that their own healthcare insurance is the best it can be. Out-of-pocket expenses are often $500, at least; a recent analysis done by TransUnion Healthcare revealed that 49% of out-of-pocket costs for healthcare were under $500, on average, in the year 2017. And in that same year, data shows that some $698.3 billion was spent for physician and clinical services in the United States, showing just how essential those services are. How can a person understand this system and take part of it? It’s not as daunting as some young adults might think.

Healthcare Insurance Basics

There are just a few parties involved when healthcare and bills are involved, and there are some basic terms to know. A health insurance company will offer privatized healthcare to all of its customers, who are known as policyholders once they own a healthcare policy, and the exact details of each policy will vary; there are many to choose from, based on a policyholder’s expected medical needs. Once a policyholder gets medical care at a facility such as a clinic, a physician’s office, or a hospital, that person’s information and policy data will be generated by the hospital using specialized healthcare, and this forms a medical claim that the healthcare provider will then send to the patient’s insurance company. Based on the care received and the policy that the patient holds, the insurance company will pay for a part of that medical care or even all of it, and the policyholder may pay a deductible up to a certain amount for the bill, and the insurance company pays the rest. But in some cases, the insurance company might reject the bill because the services rendered are not covered by the policy, and if this is the case, the patient will have to pay for everything themselves. And in some cases, the medical claim has incorrect information, and the insurance company will send it back until the correct data is involved.

Someone new to health insurance can search online for healthcare insurance providers, and maybe get recommendations from their doctor for certain companies. The person may search for local aid such as “Healthcare coverage Broomfield Colorado” or “healthcare insurance Boston MA” to find local companies that offer policy packages. The customer can browse different policies and choose one whose features and cost fit their needs. Senior citizens may need a more comprehensive package due to their advanced age and associated illnesses or conditions, while younger or more physically fit customers may get more bare-bones policies that work for them. Lifestyle may also impact what type of policy is chosen.