Individual and Family Medical Insurance is a type of health plan that covers the cost of medical care for individuals or families. It provides protection for routine medical expenses or against unpredictable health care costs that may arise due to illness or injury. Covered expenses may include the cost of routine doctor visits, specialists, prescription drugs, preventative care, emergency room visits, urgent care, and hospitalization. All health insurance plans that meet the Affordable Care Act (ACA), signed into law by President Obama (Obama Care), must provide preventative care at no cost to the member. This includes preventative care for women, men, and children. These benefits must be included in both individual and group health insurance plans.

Who Needs Health Insurance?

Everyone needs health insurance regardless of their age, gender, or health. Health insurance provides protection for the entire family. A sudden illness or injury can happen to any member of the family at any time. The financial cost of medical illnesses can severely cripple a family’s budget and can even lead to bankruptcy. Getting regular health checks and screenings can either prevent or catch diseases in their early stages, thus resulting in a better health outcome.

What Are the Costs Associated with Medical Insurance?

Health insurance companies share the risk of insurance among many individuals. These are some of the costs that are associated with your health insurance plan:

• Premium – This is the amount you pay each month to the insurance company.
• Deductible – This is the amount you are required to pay (other than preventative care) before your plan begins to pay for covered services. It is important to note that your plan may or may not have a deductible.
• Co-pay – This is a fixed dollar amount that you pay for a covered healthcare service. For example, $20 for doctor visits.
• Co-insurance – This is a percentage of the cost of a covered healthcare service that you pay. For example, 10% for hospitalization or other specified services.

Benefits of Health Insurance

Health insurance provides benefits that are important in maintaining your health and treating illnesses and injury. A qualified health plan should cover these essential benefits:

• Preventative and wellness services (certain vaccines, health screenings, colonoscopies, mammograms, COVID-19 vaccines and testing)
• Lab services
• Outpatient care
• Emergency room services
• Hospitalization benefits
• Prescription drug services
• Pregnancy, maternity, and well-baby care
• Pediatric care
• Mental health and substance use disorder
• Rehabilitation and habilitation benefits

Benefits may vary by insurance companies.