Health Insurance in USA: Health Insurance Services and coverage
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Health Insurance in USA: Health Insurance Services and coverage



However, life is synonymous to health and as such should be treated with ultimate care and attention, in Insurance there are sections or categories and insurance companies that deals mostly with health and life, taking care and safeguarding the life of the insured. Meanwhile, health insurance in USA just gives you the best of benefits as you undergo the process of been taken care of so as to maintain a good health or a normal body condition.

Health Insurance in USA

Health insurance in the United States is any program that helps pay for medical expenses, whether through privately purchased insurance or a social welfare program funded by the government.


Brief Introduction on Health Insurance

Health insurance is a type of insurance that covers medical expenses that arise due to an illness. These expenses could be related to hospitalization costs, cost of medicines or doctor consultation fees. Get secured against personal accidents and medical emergencies with travel insurance cover. Buy a travel insurance designed to provide cover against risks associated with travelling. Get travel insurance. Family travel protection. Accepted by all embassies.

Therefore, health insurance is used to describe any form of insurance providing protection against the costs of medical services.

Health insurance in the US is voluntary for citizens, expats, however, to save yourselves from high medical costs in the US, health insurance is highly advisable, especially for expatriates whom cannot benefit from the government-subsidized schemes.


USA have good quality healthcare services and renowned for its sky high medical treatment costs with high levels of annual medical inflation, healthcare costs etc.

Health Insurance can cover the following (Health Insurance in USA)

  • Emergency services
  • Hospitalization
  • Laboratory tests
  • Maternity and newborn care
  • Mental health and substance-abuse treatment
  • Outpatient care (doctors and other services you receive outside of a hospital)
  • Pediatric services, including dental and vision care
  • Prescription drugs
  • Preventive services (e.g., some immunizations) and management of chronic diseases.
  • Rehabilitation services

Types of Health Insurance in the USA

Meanwhile, there are two categories for this for private health insurance and public health coverage mostly through Medicare and Medicaid programs.

Government-funded insurance schemes 

National health insurance – Medicare

Medicare covers about half of the healthcare expenses of those enrolled, and the rest of the costs are paid by either a privately or from your pocket.

Medicare is a social insurance program funded at the federal level, and focuses primarily on aiding the older population.

Age limits mostly on the basis and range between (adults over 65 years old) by covering the cost of their healthcare.

National social healthcare program – Medicaid

Medicaid is a social healthcare program that runs in the US, it is also a federal and state program that helps offset the medical costs of certain groups of people. This are people  with limited income and resources.

Medicaid provides free healthcare to eligible persons: low-income children, pregnant women, elderly people, and disabled people.

Private health insurance in the USA (Health Insurance in USA)

Most Americans residing or working in the US purchase private health insurance, or receive private health insurance for themselves and their families.

Since the cost of healthcare is so high in the US, even a local US plan can cost as much as an international  medical plan.

Some individuals often seek to purchase add-ons, or top-up insurance depending on the benefits and coverage provided by their employer-sponsored insurance.

It is advisable for expats to purchase locally compliant US health insurance, or an international health insurance plan.

9 Factors That Affect Payment for Health insurance

Here are 10 key factors that affect health insurance:

  1. State and federal laws dictate what health insurance must cover and how much insurers can charge.
  2. Whether you are insured an employer’s group plan or buy it on your own.
  3. Your income. Low-wage workers tend to pay more through employers but may pay less through a federal or state exchange.
  4. Your employer’s size. Insurance is usually cheaper at large companies.
  5. The state you live in.
  6. Which county you live in. Some counties have only one plan, while others have more competition, which can help reduce prices.
  7. The type of plan you choose. Preferred provider organizations (PPOs) and platinum plans through the federal health insurance marketplace tend to cost the most.
  8. Your age older individuals may pay up to three times more.
  9. Your tobacco use. it can cost up to 50% more.

Health Insurance companies in USA

Based on NAIC’s 2018 data, below are accident and health insurance groups:

1. UnitedHealth

The group invests more than $3.5 billion in technology and innovation and processes approximately 1.1 trillion transactions annually.

UnitedHealth Group serves clients and consumers in the US and more than 130 other countries through two distinct platforms.

A diversified health and well-being company, UnitedHealth Group’s core capabilities are clinical expertise, advanced technology etc.

The platforms are: UnitedHealthcare provides healthcare coverage and benefits services, while Optum provides information and technology-enabled health services.

2. Kaiser Foundation (Health Insurance in USA)

Kaiser Foundation Health Plan, Inc. operates as a non-profit healthcare organization which offers allergy, audiology, cardiology, dermatology, oncology, hospice, laboratory, nephrology, occupational therapy, pain management, pediatric rehabilitation etc.

3. Anthem, Inc.

In this paragraph, is all about Anthem, Inc. is a health benefits company that is committed to improving lives and communities and making healthcare easy for people.

The group’s affiliated health plans have created various HMOs, PPOs, network-based dental products, it aims to be the most innovative, valuable, and inclusive partner.

Anthem, through its affiliated companies, serves more than 78 million people, including over 41 million within its family of health plans.

Individual members and employer groups can select from basic and comprehensive plans to meet their specific needs.

They provide health plan services that combine the attributes consumers find attractive with effective cost control techniques.

Finally, a wide range of related specialty products and other services is also available, including flexible spending accounts etc.

4. Humana (Health Insurance in USA)

Meanwhile, human’s cultural foundation is dedicated to helping members achieve their best health by providing personalized, simplified, whole-person healthcare experiences.

Humana creates innovative solutions and resources to help people live their healthiest lives on their terms. They know each person, family, and community’s healthcare needs continue to evolve.

5. CVS

CVS has more than 9,800 retail locations, nearly 1,100 walk-in medical clinics, a pharmacy benefits manager with about 93 million plan members.

The company, CVS Health is with a purpose to help people on their path to better health. It is a diversified healthcare benefits company serving about 22.2 million medical members, a dedicated senior pharmacy care business serving more than one million patients per year,

This they do through its health services, plans, and community pharmacists, it pioneers a new approach to total health. Also nexpanding specialty pharmacy services, and a standalone Medicare Part D prescription drug plan.


HCSC offers a wide variety of life and health insurance products and related services through its affiliates and subsidiaries, including Dearborn Group, Dental Network of America.

The company serves more than 16 million members across five states – Illinois, Montana, New Mexico, Oklahoma, and Texas – and employs more than 23,000 people in over 60 local offices.

Health Care Service Corporation (HCSC), a mutual legal reserve company, is the largest customer-owned healthcare insurance company in the US.

HCSC Insurance Service Company are; Medecision, Availity, Prime Therapeutics, and TriWest Healthcare Alliance.

8. Cigna Health (Health Insurance in USA)

Meanwhile,the Cigna Corporation is a global health service organization with more than 165 million customer and patient relationships in over 30 countries.

Its insurance plans and products include healthcare insurance for individuals and families, dental insurance plans, Medicare plans, Medicare supplemental plans.

9. WellCare (Health Insurance in USA)

WellCare Health Plans, Inc. focuses on delivering government-sponsored managed care services to individuals, families, children, and complex medical needs. They serves about 6.4 million members nationwide as of Sept. 30, 2019.

In Conclusion

However, choosing a health insurance plan can be tricky because of plan rules regarding in- and out-of-network services, deductibles, copays, and more. Meanwhile, in 2020, the average national cost for health insurance is $456 for an individual and $1,152 for a family per month. However, costs vary among the wide selection of health plans. Moreover, understanding the relationship between health coverage and cost can help you choose the right health insurance for you.

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