Health insurance plan

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What is a health insurance plan?

A health insurance plan is a specific agreement for health insurance. They are sometimes referred to as health plans.

A health insurance plan is structured as a commitment by a health insurance company or public health insurance program to provide and pay for specific healthcare services in exchange for a monthly payment known as a premium. Some public health insurance programs are structured as an entitlement and do not require a premium if certain eligibility criteria are met.

An individual who agrees to a health insurance plan is known as a health plan member. Health plan members have access to healthcare services when they are sick or injured under the health insurance plan terms. Additionally, health insurance plans may provide access to services that promote health and wellness.

There are many types of health insurance plans that are managed by both public and private organizations.

  • Some publicly administered health insurance plans include: Medicare, Medicaid, and the Children's Health Insurance Program.
  • Privately administered health insurance plans include commercial available plans that are offered through an employer's benefits program or through an individual marketplace.