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Description
Health insurance can be as confusing as it is necessary. This approachable guide answers readers' questions about this important aspect of our healthcare system.
Part of the Q&A Health Guides series, this book offers a broad introduction to health insurance in the United States. The book's 47 questions explore the various forms of health insurance, types of coverage, and key concepts such as premiums, deductibles, and copays. Readers will find practical guidance on topics such as choosing a plan, understanding EOBs, and navigating potentially difficult situations such as pre-authorization and appeals. This book serves as an especially useful guide for young adult readers who may be enrolling in health insurance through their school or employer for the first time.
Augmenting the main text, a collection of 5 case studies illustrate key concepts and issues through relatable stories and insightful recommendations. The Common Misconceptions section at the beginning of the volume dispels 5 long-standing and potentially dangerous myths about health insurance, directing readers to additional information in the text. The glossary defines terms that may be unfamiliar to readers, while the directory of resources curates a list of the most useful books, websites, and other materials. Finally, whether they're looking for more information about this subject or any other health-related topic, readers can turn to the Guide to Health Literacy section for practical tools and strategies for finding, evaluating, and using credible sources of health information both on and off the internet.
Table of Contents
Acknowledgments
Introduction
Guide to Health Literacy
Common Misconceptions about Health Insurance
1. I'm young and healthy, so I don't need health insurance
2. The plan with the lowest monthly premium will be the cheapest plan overall
3. I can see any doctor or go to any hospital I want, and my health insurance will cover it
4. All preventive care is covered 100 percent by health insurance
5. Uninsured people don't have health insurance because they're unemployed or illegal immigrants
Questions and Answers
The Basics
1. What is health insurance? How does it work?
2. What type of health insurance system does the United States have, and how does that differ from other countries around the world?
3. What is the history of health insurance in the United States? Are there likely to be major changes to health insurance in the United States in the near future?
4. Am I required by law to have health insurance?
5. What is an insurance premium? Are plans with lower premiums always the best option? What happens if I miss a premium payment?
6. What is a deductible and how does it affect my coverage?
7. What are copayments and coinsurance?
8. What is an annual out-of-pocket maximum? What happens after I meet it?
9. I have multiple insurance plan options -- how do I choose the one that's right for me?
10. When can I enroll in health insurance and who can be on my health insurance?
11. Can I be denied health insurance or charged more if I have a pre-existing condition?
Health Insurance Options
12. What is private health insurance?
13. What are healthcare exchanges under the Affordable Care Act (ACA)?
14. What is Medicare and who is eligible?
15. What is Medicaid and who is eligible?
16. What is COBRA and who is eligible?
17. What is a health sharing plan or health ministry? Is it the same as health insurance?
18. If I have health insurance through my employer, do I have to use it or can I shop around elsewhere?
19. If my employer doesn't offer health insurance, what types of health insurance options are available to me?
20. If I'm self-employed, what types of health insurance are available to me?
21. If I'm unemployed, what types of health insurance are available to me?
22. If I'm a student, what types of health insurance are available to me? Can I just stay on my parents' health insurance plan?
23. Can I have more than one health insurance plan at the same time?
Coverage and Accessing Healthcare with Insurance
24. What does a typical health insurance plan cover?
25. What is supplemental health insurance? Do I need it?
26. What is preventive care, and is it covered by all health insurance plans?
27. How does health insurance coverage work for prescriptions?
28. Does health insurance cover mental health?
29. Does health insurance cover complementary and alternative treatments such as acupuncture and chiropractic care?
30. How can I find out if a health insurance plan covers a specific procedure or type of care?
31. What's the difference between PPO, HMO, HDHP, EPO, and POS plans?
32. How can I tell if a doctor or facility is in-network or out-of-network, and how will this affect coverage and cost?
33. What is a primary care physician vs. a specialist?
34. Why do I need a primary care physician? What is the advantage of having a “designated” primary care doctor?
35. Can I keep my primary care doctor if I switch health insurance plans?
36. Do I need prior authorization from my insurance company for certain medical services?
37. What is a waiting period, and when does it apply?
38. Can I use the same health insurance if I move to a different state? What about a different country?
39. If I travel outside the country and get injured, would my health insurance plan cover me?
Billing and Payments
40 .What is an explanation of benefits (EOB), and how do I understand it?
41. Do I have to file health insurance claims myself, or will the healthcare provider do it for me?
42. Should I wait for my insurance claim to be processed before paying the bill my provider sent me? When exactly is the bill due, and what happens if I miss the deadline?
43. Are payment plans available if I can't pay the full amount upfront?
44. How can I confirm that my insurance has been billed correctly before paying? What should I do if I think an error has been made?
45. Can I get discounts on services if I'm uninsured or if I choose to self-pay instead of using my health insurance?
46. If my claim is denied, what can I do?
47. What are flexible spending accounts (FSAs) and health savings accounts (HSAs)? How do I use them?
Case Studies
Case 1: The Policy Puzzle: Ricky Confronts A Maze of Health Coverage Options
Case 2: The Backstage Battle: Will Alicia's Insurance Cover Acupuncture?
Case 3: Beating the Medical Billing System: Can Noah Self-Pay?
Case 4: The Cost of Staying Alive: Elizabeth Needs Insulin Refills
Case 5: Breaking Point: Hidden Costs of Olivia's Mental Health Crisis
Directory of Resources
Glossary
Index
About the Author
Product details
| Published | May 13 2027 |
|---|---|
| Format | Hardback |
| Edition | 1st |
| Pages | 160 |
| ISBN | 9798765140574 |
| Imprint | Bloomsbury Academic |
| Dimensions | 9 x 6 inches |
| Series | Q&A Health Guides |
| Publisher | Bloomsbury Publishing |
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