Health Insurance

RECENT NEWS
The Hindu Business Line  Apr 5  Comment 
Co-payment clauses require you to pay for your treatment
The Hindu Business Line  Apr 1  Comment 
The Rashtriya Swasthya Bima Yojana (RSBY), the health insurance scheme for below poverty line workers in the unorganised sector, will no be longer be handled by the Labour Ministry. With...
The Economic Times  Mar 30  Comment 
The acquisition would bring complementary platform and servicing capabilities to HGS in sales and enrollment areas for the US and global health insurers.
The Economic Times  Mar 30  Comment 
To utilise the enhanced deduction limit on health insurance, don’t just increase your mediclaim cover but supplement it with a critical illness policy, he says.
New York Times  Mar 27  Comment 
In a significant bipartisan move backed by President Obama, the House agreed on changing the formula for doctors’ fees and extending the Children’s Health Insurance Program.
New York Times  Mar 26  Comment 
In a significant bipartisan move backed by President Obama, the House agreed on changing the formula for doctors’ fees and extending the Children’s Health Insurance Program.
Forbes  Mar 25  Comment 
The Affordable Care Act (a.k.a. Obamacare) mandates that every U.S. citizen must: 1) purchase qualified health insurance, 2) obtain a qualified exemption, or 3) pay a penalty. You'll find the majority of the qualified exemptions in this article.
NPR  Mar 25  Comment 
Figuring out the penalty for not signing up for health insurance is just one complication. Tax filers who made more money last year than they anticipated may have to pay back some of their subsidy.




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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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