Health Insurance

RECENT NEWS
Insurance Journal  May 2  Comment 
Legislation that requires health insurers to cover the treatment of children with autism has received final legislative approval in the Oklahoma House. The House voted 65-26 for House Bill 2962 and sent it to Gov. Mary Fallin for her signature. …
MarketWatch  May 2  Comment 
Sheetz, a family-owned and operated convenience store chain, said Monday that it will hire more than 8,000 employees in Pennsylvania, West Virginia, Virginia, Maryland, Ohio and North Carolina. Sheetz offers a number of benefits including...
The Hindu Business Line  Apr 30  Comment 
Zydus Cadila group firm Cadila Healthcare today said it is planning to raise up to Rs 18,500 crore through issuance of shares and various other securities. The board of directors at its meeting to ...
Insurance Journal  Apr 29  Comment 
New York state will soon require health insurers to cover depression screening for pregnant women and new mothers. The move follows a recommendation from a federal panel that insurers cover maternal depression screening without a co-pay or...
MarketWatch  Apr 28  Comment 
Increasing numbers are now on their own for health insurance and retirement saving.
Reuters  Apr 27  Comment 
Pfizer Inc has agreed to pay $784.6 million to resolve allegations that Wyeth, which it acquired in 2009, underpaid drug rebates to Medicaid, the federal health insurance program, the Justice Department said Wednesday.
NPR  Apr 26  Comment 
Sleep researchers say about 30 percent of employees at big firms are so tired they're making as many mistakes as if they were coming to work drunk. Some offices now have "napping pods."
The Hindu Business Line  Apr 22  Comment 
Seeks to expand to newer categories like air masks
The Economic Times  Apr 21  Comment 
The scheme would be voluntary and the government would appeal employers to contribute towards health insurance for their domestic help.
New York Times  Apr 20  Comment 
A study builds on earlier evidence that offering the poor health insurance helps them avoid financial shocks.




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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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