Medicare

Medicare is a governmental program which provides medical insurance coverage for retired persons over age 65 or for others who meet certain medical conditions, such as having a disability.

Medicare was signed into legislation in 1965 as an amendment to the Social Security program and is
administered by the Center for Medicare and Medicaid Services (CMS) under the Department of Human Services.

Medicare provides medical insurance coverage for over 43 million Americans, many of whom would have no medical insurance. While not perfect, the Medicare program offers these millions of people relatively low cost basic insurance, but not much in the way of preventative care. For instance, Medicare does not pay for an annual physical, vision care or dental care.

Medicare is paid for through payroll tax deductions (FICA) equal to 2.9% of wages; the employee pays half and the employer pays half.

There are four "parts" to Medicare: Part A is hospital coverage, Part B is medical insurance, Part C is supplemental coverage and Part D is prescription insurance. Parts C and D are at an added cost and are not required. Neither Part A nor B pays 100% of medical costs; there is usually a premium, co-pay and a deductible. Some low-income people quality for Medicaid, which assists in paying part of or all of the out-of-pocket costs.

Because more people are retiring and become eligible for Medicare at a faster rate than people are paying into the system, it has been predicted that the system will run out of money by 2018. Health care costs have risen dramatically, which adds to the financial woes of Medicare and the system has bee plagued by fraud over the years.

No one seems to have a viable solution to save this system that saves many people throughout the country.

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Catastrophic Health Insurance Coverage

A catastrophic or major medical insurance plan is a deductible and comparatively cheaper form of health insurance with an element of speculation to it.  A deductible is the amount you pay out of your pocket for medical expenses before the insurer pays the balance. For instance, if your deductible is £5,000 and the hospital bill is £12,000, the insurance company will pay only £7,000. The general rule is the higher the deductible, the lower the premium. When you opt for this plan, you're gambling that you will not face major medical problems in the near future.   

It is a calculated risk. According to one survey, the annual medical expenses of 90% of the U.S. population are less than £2000; for 73%of the population, it is below £500. 

Two groups that normally opt for catastrophic health insurance are young people in their twenties who are confident of their health condition, and older men between fifty and sixty-five who are still waiting for Medicare eligibility.

Catastrophic health insurance coverage is only meant to protect against major hospital charges and not routine medical expenses. It normally does not cover maternity care, doctor’s visits and prescription drugs. Certain pre-existing medical conditions and cases involving mental health and substance abuse are usually excluded from the coverage. A catastrophic health insurance policy can be purchased as an individual plan or as part of a group plan. In fact, there appears to be a trend among employers to encourage employees to opt for this type of medical cover. The maximum lifetime limit could be as high as £3 million.

Rates vary according to where you live and your age. In certain states, the saving on premiums could be two-thirds. For example, a 21 year old, non-smoking female may pay as little as £30 per month as a premium.

It is advisable to seek professional guidance from insurance companies andor agents and compare quotes before making a decision.

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Advantages to Managed Care Plans

There are many different types of Health insurance plans out there. Picking the right one for yourself can be troublesome in the beginning, especially if you don’t know what you are looking for. You might have trouble deciding which one would be better for you.

Health insurance is divided into two large categories—indemnity and managed care plans. Indemnity plans, also commonly called reimbursement plans, will reimburse your medical expenses up to a certain limit. Under the Reimbursement plan, the insurer pays a percentage of the total charges, regardless of how much the charges are. With the indemnity plan, the insurer will pay a specified amount every day for a specified number of days. The amount reimbursed does not rely on the cost of medical care, but what you are reimbursed will never exceed your expenses.

The other popular type of health insurance plans is managed care plans. The three types of policies categorized as managed care plans are HMOs, POSs, and PPOs. This type of insurance is more popular than the indemnity plan, as they offer more flexibility. With these types of options you either pay a monthly fee no matter how many times you see a doctor, or pay a co-payment but no monthly fee. With managed care plans, you are given options of care. The plan you choose and the amount of money you wish to pay determines how big of a network of doctors and specialists you can see and still be covered under the plan. Some managed car plans (most often PPOs) offer sponsorship programs from a network of hospitals and medical services. You can often get this kind of plan through your employer.

Managed healthcare plans are better for the average person due to the fact that they are more cost effective. While indemnity plans may give you a lot more freedom in cost, you will have to use the healthcare provider that the insurer chooses. If you have a specific disability, this can present itself as a problem. In the long run, a managed care plan will save you money, especially if emergencies arise when you are out of town. These types of plans also are more flexible in policy. Before you purchase any kind of health insurance, be sure to research the many options available for you and your family to ensure you receive the best coverage possible for the lowest monthly premium or deductible.

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Obesity and Health Insurance

When it comes to health insurance, we all seem to be paying high premiums.  The cost of healthcare has risen and it is reflected in the quotes we receive.  However, if you are considered obese, your health insurance premiums may be significantly higher or some health insurance companies may simply deny you coverage.  If you were to lose weight, however, you could find a health care insurance much cheaper and have more options.

The fact is health insurance companies have different policies regarding obesity.  When an applicant for health insurance falls out of the normal weight standards, they may be either denied health insurance coverage or their premiums will be raised.  Many insurance companies may even require an applicant to get a pre-approval physical before they accept the applicant for coverage.  The fact is obesity is costly to the insurance companies and they apply very strict standards for their coverage in relation to the weight of the applicants.

Due to the fact that treating the obese is very costly, the health insurance premiums have skyrocketed over the past few years.  With obesity comes many other diseases such as cardiovascular disease, high blood pressure, and diabetes.  Treatment for these disorders are costly and the insurance companies are paying.  This is the reason for their strict weight standards.  Just one individual who is obese can cost an insurance company thousands of dollars each year.  Many individuals get health insurance coverage from their employers.  Because the insurance premiums have risen so much over the past few years, many employers, especially small businesses, can not afford to offer coverage for their employees.

The fact is when someone is obese, they will generally have health problems and are often having tests done, as well as being on medication.  This, of course, is an expense that could be prevented if the person lost weight.  Research has proven that the obese are inundated with more health problems than thinner people.  However, this does not stop individuals from gaining weight.

More and more people are gaining weight and falling into the category of being obese and this includes children, as well.   According to a recent study conducted by The Thompson Corporation, in 2004, as many as 16 percent of the children in the United States could be diagnosed with obesity.  The healthcare costs for children who were treated for obesity were astronomical.  The cost for those children who were covered by Medicaid were approximately $6,700 annually for each child and those with private insurance paid out approximately $3,700 per obese child.

While obesity is only partly responsible for the rising cost of health insurance, it does place a burden on society, as well as the patients themselves.  However, the continuing rise of health insurance will not end and neither will obesity.   If an obese individual could lose the weight, they would find their health insurance premiums would be much lower and they would have a much easier time gaining access to health insurance coverage.

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Medical Coverage on Your Auto Policy

Car accidents can happen at any time to anyone.  They can be devastating and cause unnecessary stress to everyone involved.  If you are injured in a car accident the last thing you will need at that time is a problem with your medical insurance coverage.  Insurance can be a tricky subject.  Sometimes it is hard to determine what is covered under certain policies and what is not.  That is why it is a very good idea to invest in an auto insurance policy that includes medical coverage.  Medical coverage on an auto insurance policy ensures that you will be covered for any injury resulting from a car accident.  Most auto insurance policies that include medical coverage also cover injuries sustained from accidents you may be involved in as a pedestrian. 

Most auto insurance policies that include medical coverage in the event of car accidents cover all passengers in your vehicle at the time of the accident.  If you are involved in a car accident and have two or three passengers in your car at the time, all the medical expenses of yourself and your passengers will be covered by your auto insurance policy.  It does not matter if the car accident is your fault or the fault of another driver, if you are involved in any type of accident where you have medical expenses due to the accident, those expenses will be covered.  Medical expenses can be considerably expensive since they may include everything from ambulance transportation to x-rays to surgery to an extended hospital stay.  No matter what your injuries may be you can rest assured that you will not have to worry about them at the time of the accident.  In addition, medical coverage can cover any additional expenses after your initial injuries have been treated.  If you require long term care following the accident, medical coverage can help with the financial expense of long term care.  If you are left unable to care for your children for a period of time following the accident and must hire child care support, certain auto insurance policies that offer medical coverage can assist in child care finances due to injuries from an accident as well.

If you are not insured at the time of an accident, you will be left relying on other types of insurance.  If you have health insurance you need to figure out what and how much is covered under your policy.  Some health insurance policies only cover portions of medical expenses during major accidents where expenses can run high.  Oftentimes with health insurance, the insurance holder will also need to pay a co-pay when getting professional medical help.  You may want to look into the price of emergency room co-pays, as they are often more than co-pays to a regular doctor’s office.  If you do not have health insurance then considering auto insurance that includes medical coverage is a must.  Car accidents are completely unpredictable.  You and your family could be involved in a car accident at any time.  Just because you drive safely does not mean someone else on the road will be driving safely.  Even if the accident is not your fault, you will still face mountainous medical bills.  Trying to pay them without any type of insurance will be an extremely difficult task that you do not want to be faced with.

Another medical coverage option that many auto insurance policies offer is personal injury protection.  This option of medical coverage in the form of personal injury protection is not offered in every state but if you live in a state where it is offered it may be a smart choice for you.  The difference between regular medical coverage in an auto insurance policy and personal injury protection coverage is that only those people specified to be covered in the policy will be covered in the event of an accident.  Instead of having any passenger in your vehicle being covered by your insurance, only those people who you have specified in your policy and who are in your car at the time of the car accident will have their medical expenses covered by your insurance.  In some cases people do not want those who are not close family members being covered by their insurance.  If this is the case then you may want to opt for personal injury protection, as it allows you to determine which individuals would be covered by your insurance policy in the event of a car accident.

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A Simple Way To Save Money

Is there such a thing as cheap health insurance? It hardly seems possible when you look at the rise in hospital costs and physician services. Insurance companies have the task of underwriting the medical risk for insurance. The insurer then issues and delivers the policy to the insured once they are accepted into the plan. The policyholders then receive the policy declaration pages that list all of the benefits and features.

What are those benefits and features? How do they work after a hospital stay? When you begin to find the answers to those questions then you begin to understand what makes up the total premium. When you receive your first benefit statement after a hospital stay then you will begin to understand how the deductible is applied and how the coinsurance works.

Simple claims analysis

1.Total inpatient expense for 4 days in the hospital including physician services amounts to £4000.

2.Your policy has a £500 deductible with an 8020 coinsurance clause with a maximum out of pocket £2000.

3.You must pay the first £500 for your stay leaving a balance of £3500.

4.You will pay 20% of that £3500 or £700 and the insurance company will pay £2800.

When your 20% reaches £2000 then the insurance company pays 100% of the remaining costs up to a million pounds (or 2 million etc).

The health insurance buying trends indicate that people are purchasing health insurance with higher deductibles. Deductibles bring down the premium dramatically. There are some plans with deductibles as high as £5000. This is called self-insuring because in essence that is what you are doing for the deductible amount.

Health Savings Accounts are also starting to become very popular. These savings accounts are tax deductible. They are like medical IRA’S. Contact your tax advisor or accountant for more details.

Please see our recommended source for insurance quotes. We have done the research so you don't have to.

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