Health Insurance

RECENT NEWS
Forbes  7 hrs ago  Comment 
UnitedHealth Group's CEO Stephen Hemsley is handing over the company's reigns of the nation's largest health insurer to company president Dave Wichmann effective Sept 1.
MedPage Today  Aug 15  Comment 
(MedPage Today) -- Multiple hurdles face 'must pass' bill to fund children's health insurance
NPR  Aug 15  Comment 
In South Florida, people with health insurance are the target of "body brokers" who can earn lucrative kickbacks — $500 per week — for referring vulnerable patients to centers that bilk insurers.
NPR  Aug 15  Comment 
Since Congress hasn't passed a fix, employers who offer generous health care plans may look to shift the tax burden to employees if the so-called "Cadillac tax" kicks in.
Insurance Journal  Aug 15  Comment 
Pennsylvania Insurance Commissioner Teresa Miller issued a letter to federal Department of Health and Human Services Secretary Tom Price detailing the urgent need for stability in the individual health insurance market as health insurers prepare...
New York Times  Aug 13  Comment 
A decision to extend the deadline for insurance companies to calculate rate increases for 2018 adds to the uncertainty over the future of health care.
Forbes  Aug 10  Comment 
A new survey shows that a significant proportion of cancer patients suffer financial distress, even though they have health insurance.
NPR  Aug 8  Comment 
Three years ago, only about a quarter of the nation's large employers were "very confident" they would offer health insurance to their workers in 10 years. That number has now risen to 65 percent.
Insurance Journal  Aug 8  Comment 
For all its absurdity, the debate over Obamacare has accomplished something positive: It has educated people that insurance is really about risk pooling — as in you need both healthy and sick people to participate if it’s going to be …
New York Times  Aug 8  Comment 
State commissioners are debating what to do if President Trump stops subsidies paid to insurance companies on behalf of millions of low-income people.




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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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