US Healthcare Insurance System

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us healthcare insurance system

Tags | US healthcare insurance system, current US health insurance system, us healthcare insurance workflow, how does the US health insurance system work

US Healthcare Insurance System Explained

US Health insurance is a type of insurance coverage that covers the cost of an insured individual’s medical and surgical expenses. It depends on the type of health insurance coverage.

US Healthcare Insurance Workflow

Health insurance is very complicated, and many people are overwhelmed and annoyed with the process. Here’s an explanation of health insurance, and how it got to be the dominant delivery vehicle for health care in America.

In this us health system article I will discuss us health insurance process and us health insurance structure. US Health Insurance is divided into Public/Government and Private sectors. Find the structure below:-

  • Public/ Government

    • Medicare
    • Medicaid
  • Private

    • Employee-sponsored
      • Managed Care
        • HMO
        • PRO
        • EPO
        • POS
    • Individually Purchased 
      • Managed Care
        • HMO
        • PRO
        • EPO
        • POS
      • Free for service

Medicare

  • Medicare is a Federal Insurance program
  • Eligibility:
    • People who are
      • 65 or older
      • Under 65 with certain disability (Amyotrophic lateral sclerosis disease)
      • of any age and having to end-stage renal disease

Medicaid

  • Medicaid is a joint Federal and State Program
  • Eligibility:
    • Low income
      • Pregnant
      • Children under 19
      • People who are 65+
      • Those people who are blind
      • People who are disabled
      • Those people who need nursing home care

Managed HealthCare Plan Types

Managed health care plans provide a health insurance policy to individual members of a group or employer. A managed healthcare plan will help beneficiaries (members of the plan) by getting them more favorable rates or discounted medical insurance services from their plan’s health provider network.

Managed Care Plan Types

Managed Healthcare: An agreement between an insurer and specific supplier to give health care at a reduction to a member of an insured group.

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