Health Insurance

RECENT NEWS
Forbes  Feb 2  Comment 
Whether it’s inpatient mental health care or an outpatient surgery, health insurance denials can be costly and even dangerous. Fortunately, there is a potential solution in the appeals process.
Motley Fool  Feb 1  Comment 
A critical ruling by the Supreme Court this June on the legality of federal subsidies could affect millions of Obamacare enrollees. Find out, based on a recently released analysis, what a ruling in favor of the plaintiff could mean for overall...
Forbes  Jan 30  Comment 
Some of the biggest health insurers are baking faulty math into their earnings forecasts by factoring in payments from Uncle Sam that may never materialize
Yahoo  Jan 29  Comment 
The U.S. government estimates as many as six million households may have to pay a penalty for not having had health-insurance coverage last year as required under the Affordable Care Act.
Forbes  Jan 29  Comment 
Joining the parade of health insurance companies leaving fee-for-service medicine in its wake, Anthem (ANTM) says it, too, will ramp up value-based payments to providers of medical care beyond the nearly $40 billion annual commitment it is already...
Insurance Journal  Jan 28  Comment 
More than 9.5 million people have signed up for 2015 individual health insurance on the new exchanges created under the national healthcare reform law, the U.S. government said on Tuesday, a number that surpasses its enrollment target for the...
Insurance Journal  Jan 26  Comment 
Obamacare will cost 7 percent less than expected over the next decade for federal subsidies to help lower-income people pay for private health insurance, congressional researchers said on Monday. A report by the nonpartisan Congressional Budget...
Benzinga  Jan 26  Comment 
Health insurance companies were mixed Monday following news that the Obama administration will make a “historic” shift in how Medicare pays doctors and hospitals. The new payment methodology hopes to move the program away from paying based...
Insurance Journal  Jan 26  Comment 
The Obama administration appears to be making broader changes to protect consumer information on the government’s health insurance website, after objections from lawmakers and privacy advocates. The Associated Press reported last week that...
Motley Fool  Jan 24  Comment 
Healthcare.gov enrollment is highest in Florida, Texas, North Carolina, Pennsylvania, and Georgia during this enrollment period.




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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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