Private healthcare in America takes a number of different forms, and choosing health care options is confusing for most people.

Employer-provided health insurance is one of the most common forms of private healthcare in the U.S. and may take one of several forms.  In one form, the employer pays the entire premium as an employee benefit.  In others, the employer provides access to a group plan, which significantly lowers premium costs, but requires the employee to pay the full premium.  And still others offer “tiered” plans, with employer-paid basic levels, with additional coverage available at employee expense.

Employer plans range from traditional health insurance, where the patient chooses the medical provider who then bills the insurer to Health Maintenance Organizations (HMOs), where the patient is required to use a medical provider within the HMO’s network of approved providers.  HMOs are often criticized for delays in approving referrals to specialists outside the network.

One problem with employer-provided health insurance occurs when employees change jobs and, consequently, health insurers.  The new employer’s insurer may not offer the same levels of coverage, or may attempt to deny coverage for pre-existing conditions. The COBRA plan was designed to help employees maintain coverage during the transition period between jobs by paying the premiums.  But the premiums are often too high—especially if the employee lacks savings or has no other income between jobs.

Consumers may purchase health insurance directly, either as an individual or as an affiliate of a group.  Group plans usually cost less, as the risk is spread out among more consumers.  Individual plans are expensive, and may be denied if an individual has a serious health condition or even significant risk factors.  In some states, risk is spread out across all age groups, resulting in higher premiums for younger, healthier consumers, while in other states, risk is assigned by age groups, meaning higher premiums for older consumers.

The average individual will pay anywhere from $200-$250 per month to over $1000 a month depending on such factors as coverage, deductible, and copays, as well as age  and health conditions.

Besides traditional health insurance, consumers may purchase specific plans such as

Cancer insurance.

There are also discount programs, where for a nominal membership fee you have access to a network of providers who will provide services at substantial discounts.

Some of the best ways to save on insurance include checking into group rates you may be entitled to through organizations other than work; eliminating non-essential coverage (such as dental or vision), and increasing deductibles.  It’s recommended that females carry maternity coverage even if they aren’t planning a family right away, as it’s often difficult to add maternity coverage unless your marital status changes.  It’s also advisable to shop around, as several companies may differ widely in pricing on the same coverage.

Complications from one accident can incur a six-figure medical bill, so it’s also recommended to make sure that catastrophic coverage is included, as it is well worth the extra premium.

In buying insurance, as with any business transaction, it’s important to read the fine print and be sure you understand what you’re signing.

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