Health Insurance

RECENT NEWS
The Hindu Business Line  Jun 23  Comment 
Asking insurers to get the best and cost-effective services for health insurance claimants, regulator IRDAI has directed them to pass on discounts, if any given by hospitals, to policyholders.
CNNMoney.com  Jun 22  Comment 
There are five major health insurers in America. There soon may be only three. What will that mean for you?
New York Times  Jun 22  Comment 
About 6.4 million people could lose subsidies if the court decides the Affordable Care Act does not allow them in states without their own insurance marketplaces.
New York Times  Jun 21  Comment 
Anthem’s $47 billion takeover bid for Cigna comes as companies look to become even bigger to take advantage of the changes in the health insurance market.
Wall Street Journal  Jun 21  Comment 
Health-care companies in the S&P 500, ranging from health insurers to medical-device makers, have risen 26% in the past year. Now, some are starting to look too rich for investors’ taste.
Motley Fool  Jun 21  Comment 
The Supreme Court will soon decide whether subsidies to people buying health insurance in states without their own exchange is legal.
New York Times  Jun 20  Comment 
The move is the latest step toward an expected consolidation among health insurance companies.
Motley Fool  Jun 20  Comment 
Amid the flurry of M&A activity, these 3 insurers are stand outs for investors.




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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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