Sources of Health Insurance

Getting and keeping health insurance is a major concern among adults in the United States. Receiving quality medical care for yourself and your children becomes difficult and financially devastating without insurance, yet the large selection of companies, plans and options can be overwhelming. There are three major sources of health insurance in America, and each has its own set of rules, eligibility and types of coverage.

Government Health Insurance

• The United States government offers two kinds of insurance to citizens, Medicare and Medicaid. Both of them have strict eligibility requirements that must be met before a person can begin coverage. Medicaid is a joint venture between the federal government and the states, and is generally administered and managed by individual states. A state does not have to participate in Medicaid, but as of 2010, all 50 states do. A state may also contract its Medicaid program out to private companies. Medicaid is based on income and resources. In New York, the threshold for which a single person without children can qualify is a salary of $8,479 annually. This goes up slightly for pregnant women, the blind, the disabled or people older than 65 years. Medicare is a federal health plan generally offered to people 65 years or older. Disabled persons and those with end-stage renal failure may also qualify regardless of age. If you or your spouse is a citizen or permanent resident who has worked for 10 years or more in Medicare-covered employment, have end-stage renal disease or are eligible for Social Security, you may qualify for Medicare Plan A without paying a monthly premium.

Employer-Based Health Insurance

• In the past, most people depended on their employers as the sole source of health insurance. This is changing, but according to a 2008 report by the Employee Benefit Research Institute, employment-based insurance is still the most common source of health benefits, used by the majority of non-elderly people. Employers tend to offer employees coverage through one health insurance company, although employees often have a choice of plans within that company. Some employers pay or co-pay monthly health insurance premiums for workers, while others put all the financial responsibility on employees. Employer-based insurance may only be open for new enrollment once a year, or at specific times during the year. Employees often have to have worked for the company for a certain length of time before being eligible as well.

Private Insurance

• There are numerous companies in the U.S. that offer private health insurance directly to families and individuals. Private health insurance offers numerous options and can often be customized to include options like dental and vision benefits. Customers can also choose between HMO and PPO plans, plans with low or high deductibles, and benefits that include prescriptions and doctors' visits and those that don't. However, private insurance can often be reluctant to cover someone with recurring health problems or a pre-existing condition. Private health insurance is also the most expensive, particularly for families.