Health Insurance

RECENT NEWS
Forbes  4 hrs ago  Comment 
How One Small Business Owner Saved $25K On Health Benefits
The Hindu Business Line  Jul 20  Comment 
Aditya Birla Health Insurance Co Ltd, promoted under a joint venture agreement between Aditya Birla Financial Services Ltd (ABFSL) and MMI Strategic Investments (Pty) Ltd (MMI), South Africa, has bee...
New York Times  Jul 19  Comment 
Antitrust officials are concerned that Aetna’s deal with Humana and Anthem’s pursuit of Cigna would harm competition in the health insurance industry.
Forbes  Jul 19  Comment 
The U.S. Justice Department is expected to challenge health insurance company mergers including Aetna's proposed purchase of Humana and Anthem's acquisition of Cigna.
Financial Times  Jul 19  Comment 
Anthem’s $48bn Cigna purchase and Aetna’s $37bn bid for Humana under a cloud
Forbes  Jul 18  Comment 
A new study shows that in states with legal medical marijuana, prescriptions for drugs to treat conditions that might also be treated with marijuana have fallen significantly. After just 17 states had passed legalization, Medicare was already...
MedPage Today  Jul 15  Comment 
(MedPage Today) -- Policy scholars critique Democrats' healthcare plans
Insurance Journal  Jul 14  Comment 
An Illinois health insurance co-op with 49,000 policyholders in the state has become the latest casualty among a dwindling group of nonprofit alternative insurers set up under the Affordable Care Act. Illinois regulators took steps on July 12 to...
Wall Street Journal  Jul 14  Comment 
Firms’ ability to raise drug prices is firmly intact despite pushback from health insurers and scrutiny by U.S. lawmakers. More than two-thirds of the 20 largest pharmaceutical companies said price increases boosted sales of their biggest...
Insurance Journal  Jul 13  Comment 
Twenty-four workers laid off by Spirit AeroSystem in 2013 have sued the aircraft parts maker alleging it targeted older workers covered by its health insurance who had costly medical conditions. The former employees, members of the Society of...




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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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