Health Insurance

Health insurance is a kind of insurance that pays for the bills you get from your doctor, dentist, or pharmacy. Services provided by these healthcare professionals can be expensive, so having health insurance to help pay for it is important.

You can get health insurance through your job or directly from the government if you are unemployed. In either case you can go to a health insurance marketplace (also known as a “health exchange”) to get affordable insurance to help pay your medical bills.

A health exchange is another name for the place where you can shop for health insurance for yourself, and your family.  Every state has a health insurance exchange or marketplace as part of the Affordable Care Act.

You will need to apply for health insurance by phone or on the health exchange website where you can choose from many different health insurance options. Depending on how much money you make,  you may qualify to receive money back to reduce the cost of private insurance, or you may qualify for government programs like Medicare or Medicaid (see below).

Yes, every month you pay a fixed amount called a  “premium”. If you are employed, the cost of that premium is split between you and your job. If you are not employed, or make below a certain amount of money, or meet some other age and wellness criteria, you may be able to get Medicaid or Medicare, and you may not have to pay anything each month. 

If you went to the doctor or other healthcare provider during the month you may also receive a bill for the services they provided. Your bill may include a deductible, copayment, and coinsurance.

How much you have to pay before your insurance starts paying. This is a fixed amount that you decide on when you sign up for your insurance policy.

The specific amount of money you pay when you go to the doctor after your health insurance provider has paid their portion of the doctor’s bill. With health insurance you will usually pay just a small fraction of the total the doctor charges.

A percentage of the total amount you are charged when you go to the doctor.

Medicare and Medicaid are government-run health insurance programs, and they are the most affordable way to get health coverage, and very often are free.

The are a few ways to qualify for Medicare. The most common group eligible for Medicare is any U.S. Citizen over the age of 65. To qualify at age 65, you or your spouse will have had to work for at least 10 years while paying Medicare taxes, which is automatically deducted on most paychecks. Other groups that are eligible are: certain younger Americans with disabilities and people suffering from end-stage renal disease (ESRD) a form of kidney disease.

There are many ways to be eligible for Medicaid. While Medicare is specifically for those over 65, Medicaid is for many other groups, including low-income people, pregnant women, and people with disabilities. Your state’s health exchange will help you determine whether or not you and your family members can get Medicaid.