Health Insurance

RECENT NEWS
Forbes  18 min ago  Comment 
Government's role in coupling employment and health insurance should serve as a warning for future policymakers.
DailyFinance  May 17  Comment 
Filed under: Finance, Personal Finance, Insurance The percentage of Americans that did not have health insurance coverage set another record low in 2016. This site sells some of the most useful and unexpected kitchen accessories we've...
Clusterstock  May 16  Comment 
The percentage of Americans that did not have health insurance coverage set another record low in 2016. According to the Centers for Disease Control and Prevention's National Health Interview Survey, 9.0% of Americans did not have health...
Insurance Journal  May 16  Comment 
Ken Schnoll has been named general counsel for the California Department of Insurance. Schnoll has more than 30 years of experience, including work in regulatory and transactional matters with health insurers and property/casualty insurers....
NPR  May 16  Comment 
It's a weird twist: If the government refuses to reimburse insurance companies for cost-sharing subsidies, it could make health insurance a lot cheaper for people buying on the exchanges in 2018.
Insurance Journal  May 16  Comment 
Aetna Inc. has informed the Delaware Department of Insurance that it will not participate in the health insurance marketplace in Delaware for 2018. As a main reason for its exit, Aetna cited an approximate $700 million loss for individual policies...
NPR  May 16  Comment 
In some states, a break in health coverage of more than 63 days would let insurers charge premiums of any price for a year — putting health insurance out of reach for many sick people, analysts say.
New York Times  May 15  Comment 
A former executive at UnitedHealth says he was paid bonuses to make patients look sicker than they were, which led to bigger reimbursements.
TechCrunch  May 15  Comment 
 Health insurance in the US is broken. That much seems to be regarded as a universal truth. Oscar Health co-founder and CEO Mario Schlosser acknowledged that the system is need of some major fixes this afternoon during a panel at Disrupt New...




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Types of Coverage

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Private Coverage

Job-Based Coverage

Individual Policies

Association Health Plans

Consumer Driven Health Plans

Government-Funded Coverage

Medicare

Medicare is a federal health insurance program for: a) individuals aged 65 years and above; b) individuals under the age of 65 with certain disabilities; or c) or individuals with end-stage renal disease. There are three types of Medicare plans:

  • Original Medicare Plan, which consists of two parts:
    • Hospital Insurance (Part A): This part pays for inpatient care at public hospitals, critical access hospitals (small facilities that give limited inpatient and outpatient services to people in rural areas), skilled nursing facilities (not custodial or long-term care) as well as hospice care and some home health care. All individuals eligible for Medicare are enrolled automatically and free of charge in Part A.
    • Medical Insurance (Part B): This part pays for doctor visits, outpatient hospital care and other necessary medical services not covered by Part A, such as physical and occupational therapy, and some home health care. Part B is optional and, in 2008, most beneficiaries paid monthly insurance premiums of $96.40. Beneficiaries must also pay an annual deductible before Part B coverage kicks in.
2008 Part B Monthly Insurance Premiums Yearly Income (Single Individual) Yearly Income (Married Couple) Yearly Income (Married Individual)
$96.40$82,000 or less$164,000 or less$82,000 or less
$122.20$82,001 - $102,000$164,001 - $204,000NA
$160.90 $102,001 - $153,000$204,001 - $306,000NA
$199.70$153,001 - $205,000$306,001 - $410,000$82,001 - $123,000
$238.40above $205,000above $410,000above $123,000
  • Medicare Advantage Plans (Part C), formerly known as Medicare+Choice, are private health insurance plans under the Medicare program. These plans pay for more medical services than the Original Medicare Plan by packaging Part A, Part B and additional coverage into one convenient bundle. Part C is optional and beneficiaries often pay higher monthly insurances premiums, but lower deductibles, than those required for Part B. Medicare Advantage is only offered in certain parts of the country and includes HMO Plans, PPO Plans, Medicare Private FFS Plans, Medicare MSA Plans or Medicare Special Needs Plans.
  • Medicare Prescription Drug Plans (Part D) add prescription drug coverage to the Original Medicare Plan, Medicare MSA Plans, some Medicare Cost Plans and some Medicare Private FFS Plans. Each plan is run by a private company and, hence, varies slightly from other plans that fall under Part D. However, all such plans conform to standards set by the federal goverment. Part D is optional and beneficiaries pay monthly insurance premiums and an annual deductible in exchange for a large degree of flexibility in choosing what drugs need to be covered by these plans.

Medicaid

State High Risk Pools

Trends

Number Uninsured and Uninsured Rate (1987-2007)

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Difference in 2-Year-Average Uninsured Rates by State (2006-2007)

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