Modern American Health Insurance Is Complicated – How Do You Know You’re Covered?

Modern American Health Insurance Is Complicated – How Do You Know You’re Covered?

New studies have shown the clear extent of just how uneven the American healthcare insurance system is. Healthcare equality advocates The Commonwealth Fund have found that 43% of US adults aged 19 to 64 were inadequately covered by their total healthcare package, putting them at risk of serious financial difficulties if they became ill. Whether through poorly arranged access to Medicare, poor quality health insurance, or lack of engagement with the Medigap – or a combination of all of these factors – the need is clear. A lot of work has been produced to espouse the coverage of insurance throughout the past two years, but the reality as to what many Americans are experiencing is quite different.

The Medigap

Medicare has seen significant expansion in recent years. According to KFF, only 12 states have failed to adopt Medicare expansions over the last few years, meaning that the vast majority of the country is subject to changes in their coverage. This isn’t, however, always met with adaptation from those individuals. It should be. The Medigap, referring to the amount of cover left open following the rate at which Medicare will take on expenses, can vary in size depending on the person in question. Furthermore, as the type and breadth of cover changes, the best companies for the job are changing, too. For instance, frequent visitors to the doctor may most benefit from Plan F cover – the best supplier in that case has, arguably, changed.

Some solidity

While the healthcare system continues to change, there is at least some amount of evidence that things will remain the same – for now. Reuters reports that the Supreme Court, in June, rejected a President Trump-led challenge against the ACA – ‘Obamacare’. With the defeat of this latest challenge, the third of its kind, observers are hoping that this will mean that healthcare and insurance cover is a little more predictable than it has been in the past. The lack of legal challenge means that state and federal bodies can more confidently expand care and promote cover to patients and customers. This should lead to a more consistent and easily understood system. However, changes may be afoot in the long-term.

New developments

It is at their own risk that Americans stop here when it comes to their medical insurance cover. New changes are afoot in response to the pandemic, and Voice of America is now reporting that the Biden administration is seeking guidance from President Obama and his advisors on how best to widen protections. This could lead to an expansion of what the state will guarantee in regards to healthcare, but could also mean further shakeups of the insurance industry and how they are allowed to provide cover.

The key principle underlying a proper understanding of the healthcare system is flexibility. Things are always changing, and different plans will have impacts on different people. Being up-to-date with the facts of the system, and how changes can – and will – affect how people obtain their healthcare, is crucial. More discussion is needed on how this system can be made more equitable.


Anna is an avid blogger with an educational background in medicine and mental health. She is a generalist with many other interests including nutrition, women's health, astronomy and photography. In her free time from work and writing, Anna enjoys nature walks, reading, and listening to jazz and classical music.

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