For readers who would like to familiarize themselves with the US health insurance landscape, startups looking to enter the US market and investors of US health-tech companies, this overview maybe helpful. There are two main government led health insurance programs known as Medicare and Medicaid, as well as Employer Sponsored Insurance. These are outlined below.
Thanks Namrata, great summary. On the employer sponsored side, it is further divided into 2 groups.
Fully insured: the employer pays a premium to a commercial insurance company to assume all medical expenses.
Administrative Service only: All medical expenses are paid by the employer and as commercial insurance company simply handles the paperwork with providers.
This matters because startups need to understand how to present their technology/service in terms of cost of care reduction for the employer or benefits to the employee.
Thanks Namrata, great summary. On the employer sponsored side, it is further divided into 2 groups.
Fully insured: the employer pays a premium to a commercial insurance company to assume all medical expenses.
Administrative Service only: All medical expenses are paid by the employer and as commercial insurance company simply handles the paperwork with providers.
This matters because startups need to understand how to present their technology/service in terms of cost of care reduction for the employer or benefits to the employee.