What is a health insurance plan?
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UPDATED: Feb 14, 2011
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A health insurance plan is a plan or insurance policy that is purchased or made available for sale to companies or individuals. Each type of health insurance plan has a variety of costs and benefits associated with it. What medical service is covered under your health plan depends on which plan you have, each different plan has different levels of coverage. Health insurance plans also have a variety of providers of medical services such as doctors, hospitals, and specialists associated with them. These medical service providers are part of the insurer’s network.
Health insurance plans in the United States are governed by a variety of laws, both at the state and federal level, that cover such topics as what treatments and medications must be covered, how much coverage can be offered, and in what cases coverage must be given or denied. There are numerous health insurance laws associated with health insurance plans.
One set of laws deals with parity, or equality, in treatment, and is often used in regards to mental health insurance plans. Other laws cover the regulations required to offer or sell health insurance, as well as the health coverage that is provided by employers. COBRA, for example, requires that employers continue to offer employees health insurance at a group rate for up to 18 months after the employee is terminated, as long as the employee is able to begin paying the premiums. Implied laws of good faith and fair dealing mandate that insurance companies actually provide the coverage that they have promised to provide and impose strict penalties on insurance companies that deny claims in bad faith or without case.
There are also pending changes to health insurance laws which are expected to begin taking affect through 2014. These health insurance laws require more employers to cover more workers, and also mandate that everyone obtain health insurance or pay penalties and fees. The future of health insurance under these health insurance laws remains to be seen as the changes go into affect.