Health Insurance

RECENT NEWS
Wall Street Journal  Dec 9  Comment 
Six former executives and managers at Insys Therapeutics were arrested and charged with conspiring to defraud health insurers and bribe doctors in exchange for prescribing the company’s fentanyl painkiller, Subsys.
MarketWatch  Dec 8  Comment 
Insys Therapeutics Inc. shares dropped as much as 16% in Thursday afternoon trade after the Department of Justice said several former employees, including its former chief executive offer and president, had been arrested and charged with bribing...
Clusterstock  Dec 8  Comment 
For years, Republicans in Congress have been clamoring to repeal the Affordable Care Act (ACA), better known as Obamacare, President Barack Obama's signature legislative achievement. With President-elect Donald Trump set to take office, the GOP...
NPR  Dec 7  Comment 
As patients' share of medical bills has grown with the rise in deductibles, copays and coinsurance, providers have become laser focused on getting payments up front.
Insurance Journal  Dec 7  Comment 
U.S. health insurers signaled Tuesday that they’re willing to give up a cornerstone provision of Obamacare that requires all Americans to have insurance, replacing it with a different set of incentives less loathed by Republicans who have...
Forbes  Dec 7  Comment 
A repeal of Obamacare without a replacement ready would cause 30 million Americans to lose health insurance and send the private insurance market into a “death spiral,” the Urban Institute said.
New York Times  Dec 6  Comment 
One of two large trade groups publicly outlined for the first time what its members want if they are to stay in the state marketplaces.
NPR  Dec 6  Comment 
Most of the state prison systems in the places that expanded Medicaid under Obamacare have come up short on enrolling exiting inmates, despite the fact that many of them are chronically ill.
Insurance Journal  Dec 5  Comment 
The federal government will continue for another year to fund an Oklahoma program that uses a combination of state tobacco tax revenue and federal Medicaid money to help provide health insurance coverage for nearly 20,000 low-income Oklahoma...
New York Times  Dec 5  Comment 
Rich and poor mostly must buy the same sort of plan, even though income affects how much health care you might be willing to pay for.




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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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