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Health Insurance in the USA

Healthcare can undoubtedly be very expensive in the United States, with a single doctor’s office visit costing as much as hundreds of dollars. With health insurance, however, American citizens have a way to scale down these costs to more affordable figures. Like any other insurance, health insurance works straightforwardly; one makes upfront premium payments to a health insurance provider and gets covered. The premiums paid will cover both the insurance buyer themselves and their relatives, also known as enrollees.

Where to Receive Health Care

With health insurance cover, one can receive healthcare services from hospitals, pharmacies, laboratories, physicians, and other medical facilities. Typically, health insurance companies partner with multiple healthcare providers to offer insurance services to their clients. If a provider happens not to be in a plan’s network, the patient may need to pay for medical bills from their own pocket.

What the Plan Covers

Thanks to the Affordable Care Act, insurance plan benefits have been standardized in the country. Before this standardization, health insurance benefits varied drastically, from one plan to another. For instance, while some plans covered prescriptions, others never recognized them. With this act, all health insurance plans in the country are required to cover the so-called "essential health benefits." These include the following:

  • Hospitalization
  • Prescription drugs
  • Substance abuse and mental health treatment
  • Laboratory tests
  • Rehabilitation services
  • Emergency services
  • Pediatric services, including vision and dental treatment
  • Outpatient care
  • Preventive services, including certain immunizations
  • Chronic disease management
  • Newborn care
  • Maternity

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