Health Insurance

RECENT NEWS
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.
Forbes  Jan 23  Comment 
Continuing the health insurance industry’s march further away from fee-for-service medicine, UnitedHealth Group (UNH) executives said this week they will increase value-based payments to doctors and hospitals by 20 percent this year to “north...
TechCrunch  Jan 22  Comment 
 Oscar, the New York-based startup that’s trying to shake up health insurance, is eyeing a debut on the West Coast by next year. The company is in the process of applying to operate in California for the 2016 individual exchange. “We...
MarketWatch  Jan 22  Comment 
Roughly 6.3 million people just above the poverty line will drop their Obamacare coverage or face using as much as half of their income for health insurance if a Supreme Court ruling dismantles subsidies in states that haven’t established their...
WA Business News  Jan 22  Comment 
Australians with private health insurance could be hit with premium increases of up to 7 per cent from April 1.




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Types of Coverage

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)

Difference in 2-Year-Average Uninsured Rates by State (2006-2007)

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