THINGS TO KNOW IF YOU HAVE INSURANCE

Even if you have health insurance, there is still a wide variety of problems that you may encounter. This chapter will explain the fundamental components of health insurance and describe six of the most common problems people experience related to coverage.

Health insurance is a form of “risk pooling,” which, basically, means that a large group of people agree to “share” the risk that a few of them may become sick by setting aside money (premiums) to pay for it when this happens.

Eighty-fve percent of Americans are enrolled in some type of health insurance program. There are public insurance programs like federal Medicare for the elderly and disabled, state Medicaid for the poor, and SCHIP for children and pregnant women. There are also “private” or “commercial” insurance companies. These commercial companies sell insurance to employers who then provide it to employees as an employment beneft. Employers will pay the majority of the premium and the employee will pay a smaller part through payroll deductions. The fve biggest commercial insurance companies in the U.S. are:

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