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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For Your Protection

As noted above, federal criminal and civil penalties can be imposed against anyone who sells you a policy that duplicates coverage you already have unless you sign a statement declaring that the first policy will be cancelled, or unless you have Medicaid and the state Medicaid agency pays the premium for your Medigap policy. Penalties may also be imposed for claiming that a policy meets legal standards for federal certification when it does not, and for using the mail for the delivery of advertisements offering for sale a Medigap policy in a state in which it has not received state approval.

Additionally, it is illegal under federal law for an individual or company to misuse the names, letters, symbols or emblems of the U.S. Department of Health and Human Services, the Social Security Administration, or the Health Care Financing Administration. It also is illegal to use the names. letters, symbols or emblems of their various programs.
This law is aimed primarily at mass marketers who use this information on mail solicitations to either imply or claim that the product they are selling whether it be insurance or something else—has either been endorsed or is being sold by the U.S. government. The advertising literature used by these organizations is often designed to look like it came from a government agency.

If you believe you have been the victim of any unlawful sales practices, contact your state insurance department immediately. If you believe that federal law has been violated, you may call 1-800-638-6833. In most cases, however, your state insurance department can offer the most assistance in resolving insurance related problems.

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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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