If you’re struggling to navigate the healthcare system, we have several healthcare system tips and resources for patients. That’s because it’s our job at My Healthcare Direct to help you make an informed decision and assist you in choosing the right health insurance for your unique situation.
As a first-time applicant, you may feel confused by all the healthcare options available to you. By learning about each type of insurance, you will be better equipped to determine which policy best suits you.
5 Major Forms of Coverage
For help navigating healthcare, here are some healthcare system tips and resources on the five most common forms of care.
1. Medicare
The government, specifically the Social Security Administration Office, is in charge of enrolling you in Medicare. To qualify, you must be 65 years or older. But if you have a disability such as end-stage renal disease or ALS (Lou Gehrig’s disease), you may also be eligible. However, Medicare also allows dual coverage, which links with employer insurance.
Medicare has four major components: Parts A, B, C, and D. Parts A (hospital insurance) and B (Medicare insurance) are the base levels of coverage.
Part A is premium-free, while Part B consists of monthly payments. Medicare Advantage, a.k.a. “Part C,” allows the beneficiary to select more benefits to add to their initial policy, like dental or vision care.
Prescription drug coverage goes under Part D which includes monthly premiums based on your chosen plan. But costs of each may change each year. Given the limited eligibility, you should contact an insurance expert at My Healthcare Direct to determine if you qualify.
2. Medicare (Medigap) Supplement Insurance
Beneficiaries can add supplements, or Medigap, under Part C. Therefore, Medigap will pay certain hospital bills associated with a Medicare-approved stay.
It is important to note that not all expenses are covered. Pricing is community, issue-age, and attain-age-related. Some plans cover 0% of a particular category, while others cover the entirety.
For example, Plan B covers Part A deductibles, while Plan A doesn’t cover the Part A deductible.
Similar to Medicare, Medigap has 10 different plans that provide additional options. Plan A will offer 20% coverage of the total. While Plan B also pays 20%, it also encompasses hospital deductibles.
To find the official cost breakdown, contact your insurance agent at My Healthcare Direct.
3. Short-Term Health Insurance
Short-term health insurance may benefit you if you’re in between coverages. This option is great for those awaiting new coverage or seeking temporary healthcare.
These plans have lower premiums and cover
- Urgent care
- Emergency visits
- Preventative care
With a higher deductible, you will be responsible for paying out-of-pocket expenses upfront before the plan starts.
While short-term health insurance is a great interim plan, it does not cover
- Maternity care
- Prescription drugs
- Pre-existing conditions
For more information about short-term health insurance, check out our short-term insurance page here.
4. Tri-Term Health Insurance
Tri-term insurance is a type of short-term plan expanded to cover three years (36 months). This plan is best for adults aged 18 to 65 without access to traditional insurance.
Since you don’t have to pay premiums up front, tri-term is more affordable than traditional policies. However, the premiums will rise in price in the second and third terms.
With year-round enrollment, Tri-Term handles a wide range of services while providing you with a larger network of professionals.
- Prescription costs
- Hospitalization
- Preventative care (ie: immunizations)
- Office visits
- Dental, vision
- Mental health
- Home health care
- Hospice
- Rehab
- And more
5. Affordable Care Act (ACA)
In 2010, the Affordable Care Act (Obamacare) was created to provide more access to healthcare coverage. Unfortunately, it has been criticized for its tax increases and higher premiums.
Despite this, it has helped many people. To improve the ACA, it has been reformed to cover patients with pre-existing conditions and reduce prescription costs.
With annual open enrollment, you can make changes to your current coverage. Nonetheless, ACA is appealing due to its affordability and wide range of services, such as
- Newborn and maternity care
- Prescription drugs
- Hospitalization
- Mental health and substance use
- Rehabilitation
- Lab screening
- Chronic disease management
- Outpatient care
- Pediatric services
Healthcare Resources for Patients
Should you need additional resources, visit our blog for some of the best articles about short-term health insurance, Medicaid, and more.
Looking for information about Medicare? Check out Medicare Changes for 2023 or Medicare Plan Options in Florida for detailed information regarding Medicare and Medicaid Services.
If you would like personal help from one of our friendly representatives, contact us, and we will be happy to help you navigate the healthcare system and understand your options. Our healthcare agents are standing by to provide you with tips and resources right now.
Healthcare System Tips and Resources for Patients
If you need help deciding on a healthcare plan, our insurance experts at My Healthcare Direct will provide you with detailed and reliable information. Our company operates 100% independently, offering you in-depth knowledge of insurance products, policies, companies, and guidelines.
Our experienced agents are ready to serve you, regardless of your question or concern. Contact us today to speak to an agent at My Healthcare Direct so we can help you find your way through the healthcare system.