No matter if you have health insurance or not, getting the appropriate care at the right time is critical for both your wellbeing and finances. Despite policy adjustments to help people access and remain covered during COVID-19 pandemic, millions of Americans remain uninsured or underinsured.
Individuals without coverage or having gaps in their coverage for part of the year are more likely to put off necessary medical treatment due to cost concerns. They may skip recommended tests or follow-up visits, fail to see specialists as needed, and neglect filling prescriptions.
The Basics
Health care and insurance are essential for everyone, no matter their age or income level. Without them, many would find themselves facing enormous medical bills if they got sick or injured.
Health insurance works like this: you or your employer purchases a plan, pays a monthly or yearly premium and then the insurer covers any covered medical costs – from preventive care to treatments for chronic diseases and hospitalizations. It’s as straightforward as that!
Depending on your plan, you may also have to pay copayments or coinsurance. Furthermore, your insurer might have contracted with a group of doctors, hospitals and suppliers in order to get you the best value.
The most recent and expensive option is an “open referral” model, in which your insurance company determines who you can see and what treatments they will cover. Unfortunately, this approach may not be the most cost-effective or efficient way to receive healthcare services.
Preventive Care
Routine health care visits such as check-ups, vaccinations, screenings and more can help you stay healthy. They also detect issues before they escalate out of control and keep illnesses from getting worse.
Most plans provide preventive care at 100% coverage – meaning your deductible and copays don’t matter. This is part of the Affordable Care Act’s efforts to guarantee more Americans have access to essential services for healthier, longer lives.
Preventive care is important at every age and stage of life, including regular check-ups, vaccinations, screenings for certain conditions like cancer or diabetes, and counseling on how to avoid illness and improve your health. In certain cases, these services may even be provided at no cost to you or your family based on age and sex guidelines.
Treating Illnesses
Treatments are an integral part of healthy living and disease prevention. They may involve medications, surgeries, dietary modifications and other therapies to alleviate or prevent health conditions.
Certain illnesses, like tobacco addiction and chronic illnesses, require a comprehensive treatment plan over time. This combination of medicines, procedures and therapies can keep you healthy and living your best life.
When it comes to illnesses, the treatment of choice depends on your individual circumstance. For instance, if you are dealing with a cold, resting and drinking plenty of fluids should help relieve symptoms. More complex conditions may require seeing a primary care provider; having an insurance plan in place is the best way to ensure regular access to health care when needed most.
Coverage Gaps
One of the most challenging aspects of healthcare and insurance policy is coverage gaps. These can occur for various reasons, such as unemployment, divorce, and job changes.
Uncovering a health insurance gap can leave someone without access to affordable care and medical services. This situation may lead to long-term financial and psychological strains that are difficult to overcome in the long run.
Coverage gaps can also result in reduced use of preventive services and unpaid medical bills. Studies have demonstrated that those with gaps in coverage are less likely to receive regular screenings such as mammograms, Pap tests, or flu vaccinations.
According to a recent study by economists Kenneth Brevoort and Daniel Grodzicki, Medicaid expansion reduced medical debt per person by $920. Multiplying this figure by the 2.2 million people without coverage gaps in non-expansion states suggests that closing this gap could result in savings of over $2 billion on medical debt.
