Health Insurance: Meaning And How It Works

As a human, taking care of your health should be your top priority. The same way you think about the food you eat and the clothes you wear is the same way you should think about taking care of your health. One of the many ways to take care of your health is by purchasing health insurance.

Health Insurance: Meaning And How It Works

Health insurance is important for everyone. It is important for both the old and the young. And aside from just purchasing insurance, you also need a good health insurance plan.

With a good insurance plan, you will be able to access medical services that you need at an affordable price. If you need medical care and you don’t have health insurance, you will end up paying a huge amount of money just to get treated.

And sometimes, no medical provider will even treat you. Health insurance might seem costly to you. But what is more expensive is health care: doctors, hospitals, prescription drugs, and rehabilitation medical equipment.

What is Health insurance?

Health insurance, also known as medical insurance, is some sort of agreement or contract between a company and a policyholder. It is a situation where the company agrees to pay all or some of the insured person’s healthcare costs. In return, the insurer will make a monthly payment called ”Premium.”

The contract usually lasts for a year, and during this period, the company is responsible for paying the insurer’s medical expenses. They will pay for medical expenses relating to injury, preventative care, pregnancy, or illness.

How Does Health Insurance Work?

It is very simple. It is done by dividing the cost of healthcare between the company and the policyholder. In most cases, there is no splitting; the insurer takes full responsibility for the cost of healthcare. However, this depends on the agreement between the policyholder and the company.

How Much Does Health Insurance Cost?

The price of health insurance is high, but it is worth it. When it comes to your health, you should not think about the price. The average monthly premium for a bronze ACA health insurance plan is $420 for a 40-year-old.

The average monthly cost for this same age increases to $549 for a silver plan and $713 for a gold plan. Note that all of these averages do not include tax credits or subsidies.

Who Needs Medical Insurance?

Everyone needs health insurance. Both the elderly and children need medical insurance. If you have a minor medical issue or a major one, your health plan will cover the cost. It will also cover the costs of treatments for life-threatening ailments, debilitating conditions, and surgeries as well.

Factors That Influence the Cost of Health Insurance

There are certain factors that influence the amount of money you pay for insurance, and these factors include:

• Where You Live

Your residence area is one of the things that influences how much insurance you will pay. Insurers in most states have minimal medical insurance plans on the marketplace. They may also charge more for coverage since there are only a few companies within that area to share the cost.

• Your Household Income

Your household income is another thing that influences the cost of medical insurance. However, this will save you more money on your premiums and out-of-pocket costs.

• The Number of People Covered

The number of people covered by your insurance also influences the cost. Single coverage costs less than when you have multiple people on your health plan.

• Whether You Smoke

Health insurance companies usually charge a smoker up to 50%, while a non-smoker will be charged less.

What Does Health Insurance Cover?

There are numerous coverages that your medical insurance covers. If you are purchasing an insurance plan, you should know the coverage that it offers.

• Prescription Drugs

Your medical insurance covers prescription drugs. But the type of drugs and brand that are covered depends on the insurer.

• Outpatient Care

It covers the cost of procedures that do not require you to stay in the hospital overnight.

• Mental Health Care

Your insurance plan covers any mental health care that you need. This also includes seeing a psychologist and treatment for substance use.

• Pediatric Services

It covers all pediatric services, like medical and vision coverage, for children less than 18 years old.

• Hospitalizations

It covers anything that has to do with surgery and other procedures that require you to stay at the hospital overnight.

• Maternity and Newborn Care

Your health insurance will cover all expenses for maternity and newborn care. This includes treatment for pregnant women and newborns, and doctors visit all of them.

What Does Health Insurance Not Cover?

Your insurance plan does not cover things like:

  • Cosmetic procedures
  • New medical technologies
  • Off-label prescriptions
  • Fertility treatments

If, for any reason, you are denied coverage for a procedure or treatment your doctor says is important, you can appeal to your insurer to allow such coverage.

How Can I Apply for Health Insurance?

There are multiple ways you can apply for medical insurance. You can use any of these methods to apply.

• Use A Certified Enrollment Partner

You can apply for an insurance plan through an insurance company or an online medical insurance seller. Visit the website ( to search for an insurance company near you.

• Find Help in Your Area

Here, you have to go to and enter your ZIP code for a list of local people and organizations that can help you apply for coverage.

• Use to Apply Online

If you want to apply using this method, you have to create an account to get started. Go to the official website to do so.


What is the Difference Between Health Insurance and Medical Insurance?

They both mean the same thing. If you hear these terms, just know they are interchangeable, and they mean the same thing.

Can I Negotiate the Cost of Health Insurance?

No, you cannot negotiate the cost of health insurance. The only thing the insurer will do for you is offer you another plan that fits your budget.

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