Types of Health Insurance

Typesof HealthInsurance

Typesof HealthInsurance

Healthinsurancerefersto programsthat are startedto shield enrollees from highmedicalcosts.Itis a specialtypeof contractthat ismadebetween theinsurancefirm (privateorpublic)andtheinsuredperson.Thispaperwill describefour healthinsuranceprograms(includingMedicaid, Medicare, Tricare, andCHAMPVA) that areusedin theUnited States.

Medicaid

Medicaidrefersto a healthcareprogramthat wasdesignedforindividualsandfamiliesthat havelimitedresourcesandearnlowincome.AlthoughMedicaid is managedby thestates,its fundscomefrom both thestateas wellas thefederalgovernment(Center forMedicaid Services, 2015). Managedcareis one of thekeyfeaturesof Medicaid, which allowrecipientsto enrollin privateplansandreceivea fixedpremiumfrom thestategovernment.Theeligibilitycriteriavaryfrom one groupof recentto theotherandfrom stateto state.However,allstatesconsiderthelevel of incomegeneratedby an individual,familysize,age,resources,andmedicalneedsof theapplicant(CMS, 2015).

Medicare

Medicarerefersto a nationalsocialinsuranceplanthat ismainlyadministeredby thefederalgovernmentof theUnited States. Currently, theprogramcoversabout 40 million Americans (Center forMedicare Services, 2014). Theprogramwasstartedin 1965 with theobjectiveof providinghealthinsuranceforolderAmericans with an ageof at least65 years.However,theeligibilityforthisprogramhas beenextendedto coveryoungpeoplelivingwith differenttypesof disabilities,amyotrophic lateralsclerosis, andend-stage renal disorder.Medicare isfundedfrom three sources,which includethepayrolltaximposedon workersandemployers,generalfundrevenue,andpremiumpaidby enrollees. Eligiblepersonsshould be at least65 yearsold,U.S citizensorhaveresidedintheU.S. foraperiod of atleastfiveyears,disabled,orundergoingcontinuingdialysis (CMS, 2014).

TRICARE

TRICARErefersto a healthinsuranceprogramthat wasdesignedto coverthemilitaryretirees andmilitaryofficerswhoare stillworkingas wellas their dependents.Thisprogramis managedby Tricare Management Team, which collaborateswith healthinsurancecompaniesto helpitin theprocessing of claims.Tricare has severaloptionsthat peoplecan selectdepending on their qualifications.Forexample,Tricare Standard is a planthat is reservedforretiredmilitarystaffwhileTricare Prime includesthepersonnelon dutyaswellas their familymembers(Defense Health Agency, 2014). Tricare’s eligiblemembersare categorizedinto sponsors(includingactiveandretiredpersonnelfrom theArmy, Navy, Airforce,Marine Corp, andothermilitaryagencies)andmembersof their families.

CHAMPVA

CHAMPVArefersto a healthcarebenefitsprogramthat allowstheDepartment of Veterans to somecostsof particularhealthcareservicesas wellas suppliers with beneficiarieswhoare eligible.However,thisprogramwasdesignedto coversomehealthservicesandservicesthat are consideredto be psychologically andmedically necessary(Military Advantage, 2014). Eligiblepersonsincludea spouseora kidof a veteranwhois totallydisabled,spouseorakidof a deadveteran,andspouseora kidof militarypersonnelwhodiedwhileon duty.Eligiblemembersreceivehealthservicesthrough theVA caresystem.

Inconclusionhealthinsuranceis an importantprogramthat protectspeoplefrom thenegativeeffectsof thehighcostof healthcare.Thisis becauseinsurancecompaniesorprogramsareabletopayforallorpartof themedicalbillsforenrollees from a commonpoolof funds.

References

Centerfor Medicaid and Medicare Services (2015). Learning how to apply forcoverage. CMS.Retrieved February 23, 2015, from http://medicaid.gov/

Centerfor Medicaid and Medicare Services (2014). Is my test, item, orservice covered? CMS.Retrieved February 23, 2015, from http://www.medicare.gov/

DefenseHealth Agency (2014). Stateemergency issued in multiple states.Falls Church, VA: DHA.

MilitaryAdvantage (2014). CHAMPVA overview. MilitaryAdvantage.Retrieved February 23, 2015, fromhttp://www.military.com/benefits/veterans-health-care/champva-overview.html

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