29. January 2017 · Comments Off on Cheap Health Insurance · Categories: Health Insurance

The cost of health insurance and medical treatment is increasing day by day. As the cost of medical care and health insurance continues to rise, the demand for cheap health insurance is also on the rise.

Though cheap health insurance offers only limited service, it is an excellent alternative for those who want to get health insurance at a low cost. As an ideal option for budget minded consumers, cheap health insurance offers adequate health coverage at reasonable rates.

Cheap health insurance contributes to the cost of medicine, doctor visits, prescription, and hospital stays; it also provides benefits for eye care, dental work, and other medical expenses. Certain types of cheap health insurance do not cover preventative care, such as doctors’ visits. So while looking for cheap health insurance, make sure that you get what you pay for.

Low-risk indemnity plan is an ideal option for those who want a cheap health insurance. Indemnity plan requires you to pay coinsurance amounts and certain deductibles. With indemnity plan, it is possible to modify coinsurance amounts and deductible levels to fit your particular budget. Even though the coverage provided by the plan is of low quality, low-risk indemnity plan is found to be beneficial to budget minded customers.

With the help of an insurance agency or an insurance broker, you can find an affordable cheap health insurance. Another option to find cheap health insurance is to browse the internet. There are countless insurance companies that offer all types of health insurance.

There are several points to consider prior to purchasing cheap health insurance. The premium cost and coverage of health insurance varies from insurance company to insurance company. So it is necessary to compare cost as well as coverage before choosing a health insurance plan. Also, make sure that you are buying health insurance from reputed companies.

10. January 2017 · Comments Off on #EANF# · Categories: Health Insurance

The health care and health insurance dilemma in the United States penetrates and corrodes the very core of the quality of the American life. Our politicians and legislators are falling all over each other to produce both State and Federally mandated solutions for one of the most expensive problem facing our nation today. Documentaries such as “Sicko” with Michael Moore, and countless television stories and newspaper articles scream the need for change. As the never-ending inflation of medical services and prescription drugs rises, the bureaucracy of the insurance providers keeps pace by increasing premiums, and lowering quality of coverage for most Americans in their health plans. Drug companies are under constant scrutiny to offer more competitive pricing, but face little regulation compared to the foreign countries who have elected to impose cost controls endemic to their individual society’s perceived needs.

So in the face of such a negative equation, how does a capital-driven society like the United States of America re-vamp its health care system, and still maintain the theology of “choice” and “capital market competition”? And how do we do it without killing more Americans?

To answer these questions it is necessary to take in to account what works and what doesn’t in both American society and other societies where socialized medicine is the norm. The problem that Uncle Sam and many self-made American business folks have with socialized programs is the ability of such programs to denigrate a societies progress, and step away from our independent roots, both financially and health-wise. In order to continue to allow health insurance providers to shore up their billions of investment dollars ( a key pillar in our financial framework) and still take care of every American who is sick requires us to radically change the way the risk of such health problems is transferred, but to still collect regular premiums from taxpayers to fund the collective system. My proposed solution will be spelled out in this article in relatively simple terms forming a base architecture which will allow independent insurance providers to remain, independent hospitals and doctors to remain independent, and drug companies to remain competitively profitable while still insuring every American.

Proposal Architecture

I would propose a three-tiered system for Health Insurance, Prescription Drugs, and Medical Providers of all types:

I. Insurance Method

In order to keep insurance companies profitable and provide 100% base health coverage to all Americans at the same time, you need a combination of the net effect of socialized medicine and American free trade. A fund must be created by the federal government which closely mimics a Re-Insurance Company. Most insurance companies whether in the health field or commercial insurers have large re-insurance agreements and policies with major funds. A classic example is Berkshire Hathaway’s “General RE” which underwrites some of the largest global policies in the world in their niche. For description purposes, the federal government needs to take the opposite approach of a non-profit, heavily taxed medicare and insurance system by creating the world’s largest re-insurance vehicle. The re-insurance department is funded by A) a percentage of all health care premiums from all health insurance companies, and B) a 1.5% federal income tax increase across the board for all Americans. From this point forward, all health insurance providers are required to have a BASE INSURANCE LEVEL on all policies which will include a) full prescription coverage included, b) all doctor visits covered, and c) full major medical coverage with no deductible.

From an actuarial standpoint, what you are doing is not eliminating health insurance premiums for Americans. All working Americans who earn more than $16,000.00 per year must pay a scale-adjusted premium of the same category and type for the “base policy”. The scale for premium is driven by total income per individual or household based on their current employment. However, you have just turned the entire insurance industry in to one big “group plan” where the risk is spread out over the entire country. Using the proportion of healthy Americans to those requiring services at any given point, this simplistic approach lowers the premium for the base policy to affordable levels for all wage earners, and gives the base policy for free to low income individuals and families. Those people who meet the low income standards get the same base insurance as everybody else, and are required to file with a private insurance company of their choice for insurance. The federal RE fund pays all insurers a minimum base amount equivalent to what they would get from a paying client. The “Federal RE” model receives 30 to 35% of the private insurance company’s base premiums for all policies. The base premiums and the amount each individual must pay is determined by an actuarial committee of the new federal RE fund, but should be adjusted very rarely. Once the percentage is set, it becomes law, and the 1.5% tax increase across the board is primarily a cushion for the low income and poor.

Insurance companies then endeavor to differentiate themselves by adding features to the base policy for their clients for their marketing and packaging. They do NOT differentiate themselves by providing sub-standard insurance, as it is not optional. The base policy for all is a major medical insurance policy based on California Standards, and covers all co-pays and deductibles 100%. In order to make additional insured dollars, the health insurer must provide more elite services to guarantee a client who is willing to pay for additional features an even better position than the base position. This enables the following to occur in logical order:

* The federal government actually makes money on investing insurance premiums the way insurance companies do by their re-insurance department. Risk is spread out over each American that can afford to pay premiums. Premiums are minimal because of the inflated group size and reduced insurance company risk. The combination of a small federal tax increase to hedge dollar volume and beef up the account combines with receiving the RE premiums and investing them makes this federal program slightly profitable, and with the ability to adjust policy when needed.

* Insurance companies lower their risk, and are able to simplify and streamline their base coverage for major medical. Since all rules apply to all insurers (new or old) they can compete based on important but “ancillary” products to improve the insurance quality of those that can afford extra benefits. Major payouts will be largely reduced due to automatic RE participation on the policy’s base components.

II. Prescription Drug Costs

By making Federal RE the “co-payer” in most medical transactions for both medicine and medical services, you have also created a need for a private-style approach to controlling the cost of drugs and other prescriptions. This is a sticky area, because development costs for drugs are hyped as being out of control if they cannot be later recouped with high prices.

Since the federal government in the form of Federal RE is now a payer/customer of the pharmaceutical companies, prices for medications must find a happy medium to allow for development and free trade, but with sane maximums for purchase. It is the job of the federal government to prevent monopolies. A monopoly is not defined as a single producer of a product (or drug) being the only source for a given product. A monopoly is defined as that single-source-producer charging an amount which hurts our society, and potentially prevents competition. (generic drugs) Standards must be developed for the maximum payment amount allowed for each category of medicine and medical supply. This will be an ever-changing exhaustive piece of work, done on a very ongoing basis by employees of Federal RE. The purpose is never to set prices, but to determine the maximum the fund will allow an insurance company or itself to collectively spend on a medication, taking into consideration all aspects of the newness of a product by using fluctuating actuarial and monetary scales. If a Pharmaceutical supplier will not meet these maximums, then unfortunately, the medicine will not be available until they are willing to bend. This is a flaw in the ointment than cannot be fixed any other way due to the way drugs are really developed in the United States. Americans who add to their “base policy’ with supplemental insurance that covers expensive cutting-edge medicine could receive the medicine, but not the base-only policy holders. Drug companies will therefore be forced by demand to reduce their charges at least to the point of scale, in most normal scenarios. This portion of the plan cannot be altered to appease any particular party, because if you do the entire buying system falls apart. However, groups currently involved in assisting low-income victims could shift their focus to those precious few who are not able to get the most cutting edge product in time. The money simply cannot be covered by Federal RE. That does not mean another vehicle cannot be refocused, whether private or public, to assist in those few cases percentage-wise which require the latest cutting edge medications not charted as buy able.

III. Medical Treatment under Federal RE conditions

Medical treatment at this juncture is now available for all Americans, and in almost all cases their prescriptions are covered also. But now that we are prepared to fill up every clinic and major hospital with patients, how do we control the clinically insane costs of running that clinic or hospital? We can stave off socialized prescriptions via creating a powerful buyer in the market Through Federal RE, and having simple cost-overrun standards that are non-negotiable and consistent. But the clinics, hospitals, and emergency rooms didn’t get any cheaper. Since all Americans (at a minimum) are covered by the best type of major medical insurance money could previously buy, the billing systems and related bureaucracies are naturally streamlined over time. But sadly, medical charges have very little to do with the actual cost of a procedure, and everything to do with what the various hospital and clinical administrations CAN charge in each situation. If we govern the pricing of each procedure too closely, then we are mimicking the socialized policies of countries who we do not wish to be.

I would argue that the same way maximums were set in item #B above, a geographically mapped system to avoid over-charges could be applied. What constitutes an overcharge is again decided by committee at Federal RE in much the same way that pharmaceuticals are banned when costs are unreasonable to both the insurers and the government. Because 100% of the American population is insured with Basic (unless they foolishly “opt out”) the CUSTOMER is now the dual processors of Federal RE and the private insurance company involved in each case. If cost controls are unreasonable by today’s standards to any given clinic, the quality of health care will suffer tremendously when the operating units do not get to charge whatever they want, or whatever they used to feel an insurer will pay. But when medical organizations get 100% continuity in payments through a single-payer style system with few errant delays in the simplified processing, they will actually make far more money than they do now in the world of constant claim disputes, and zero consistency. The monitoring committee, as with the prescription committees, are comprised of qualified professionals at Federal RE who understand the true economics of a hospital or clinic. Severe overcharges that are way beyond scale cannot and will not be honored. Plenty of money will still be spent for procedures (especially at the onset when the system is brand new) but the whole key to controlling price is actually not price controls as the system matures…but rather the lower cost of running a hospital and clinic when the payments are made for services with lightening speed. That’s right..there is no reason to hold up funds under the new program once the services are provided. Medical billing will be a snap, and the incredible amounts of money spent on corrective systems can be lessened for each institution. Speed of payment to medical facilities is a major factor for overall success. So is having a fairly large and very intimate accounting system to track abuses. Frequent audits will replace much of the former aggravation of charging insurance companies, and will be a much more regular event at hospitals. A strong governmental role in auditing each facility regularly is actually a pillar of this plan, and will be gone in to more detail in later articles as to who and how this occurs, and how frequently.

The American dream is still a wonderful thing. We do not have to take away the profit motive from professionals who seek their fortune through honorable health industries, medical jobs, and insurance work. We simply need to define the rules of a new system that uses the age old insurance RULE OF LARGE NUMBERS to create a national group. The same talent required to be a preferred doctor, dentist, or insurance provider still exists in a more comprehensive form. State programs and the endless bureaucracy that encompasses them are eliminated and replaced by the new system. Welfare mothers and low-income households are fully sponsored for the coverage they really need, and the investments of Federal RE: over long period of time pay for most of the built-in deficiency. Hospitals, clinics, insurers, and drug companies all have to compete on the basis of quality and product provided instead of what HMO or PPO they belong to, or what “level of care” is minimally chosen. You will find that in practice it is an absolute fact that Federal RE will actually show a small profit when the smoke clears away, and medical care will improve through TRUE COMPETITION, not the bureaucratic version of it most of us suffer with today.

04. January 2017 · Comments Off on How and Where To Get Health Insurance for Low Income Individuals · Categories: Health Insurance

In the US, reading the statistics of Americans without their health insurance is startling. According to Huffington Post, this 2012, almost 50 million Americans are living without health plans. This is different from years ago. And why does this happen? This is because there are lots of Americans today that don’t have jobs or cannot find stable jobs that can let them have the luxury of paying for their health plans. In some families, paying for their home rent is even a problem. So, is it still possible to secure health insurance for low income families and individuals while in the midst of the crisis? Yes, it is still possible according to experts. We only need to know where to find it.

Health insurance for low income people are actually out there. Unfortunately, some of us know only few of them while other people don’t know how to tap them well. But as we have said, these resources are already here. So in this article we have gathered the most possible sources that we can tap to get almost the same benefits that low premium insurance plans can provide.

Below are the best possible options in place of securing health insurance for low income people.

  1. COBRA. This is the Consolidated Omnibus Budget Reconciliation Act. If you are out of job, you can try applying for COBRA and if you will be eligible you can continue your previous companies’ health insurance through this process. This is better than finding a new health insurance plan but there is a possibility that you may pay higher premium for it.
  2. Workers’ compensation. If you are employed and your job is risky, inquire from your employer if you are under the Workers’ Compensation program. You can have injury compensations if you get injured during your work.
  3. Medicaid. Even if you are employed, better apply for Medicaid especially if you belong to the low income bracket. Medicaid can help you pay your health care expenses or some of it if you can’t afford to pay for it. Medicaid exists through federal and state partnership and was designed to help low income families, disabled and old people with their medical expenses. You can also apply your family to Medicaid because this is an opportunity that your state provides to those who can’t afford paying for regular health insurance plans.
  4. Medicare. This is an option that comes from the government and being administered by the Social Security administration. If you are unemployed or don’t have a regular employment and with a family, you can try enrolling yourselves and your family to Medicare especially if you are getting Social Security benefits. For those who are sixty-five years old or even older, they are most eligible to be under the Medicare programs.
  5. State High Risk State Insurance Pools. All of us do have health problems sometimes and unfortunately when we have pre-existing medical conditions we are usually denied coverage by health insurance companies. If you are denied of such privilege and did not qualify for COBRA while getting health insurance for low income individuals can also be a problem, you can rely on high risk state insurance pools. You can inquire from your city administrators or community hospitals where you can apply for this option. You may still pay premium for the plan but at least this can answer your medical cost even you have pre-existing health conditions.
  6. Short Term Health Insurance Coverage. This is an appropriate option for low income individuals who don’t have regular jobs or just starting to work on their new jobs. This is much like individual insurance policies but in this option you will only be under the coverage for short period of time. You only pay low premium with this one and while you are at it you can find time examining the viability of this insurance company if this could be the right choice for your long-term insurance coverage.
  7. Group Health Insurance. If you are a member of an organization and without the health insurance, you can encourage your group to apply for a group insurance. With this type of insurance, you can choose from various insurance options how you want to be covered. The nice thing about being insured as a group is that you pay lower rates because your premium is scattered among your members. You may not get large benefit from it like what individual insurance plans can provide but at least you are also secured and have something to rely on. If you don’t have a group you can also search for organizations online that accept individuals for their group health insurance.
  8. Group Sharing On Health Expenses. Basically, this is not a type of health insurance for low income people but it is a logical option for those who want financial support during medical crisis. This system works in simple process. You form a group and pool your money and deposit this money to the bank so that you are your own insurance health group. When one of you needed the expenses due to health concerns, the money can be used to support the individual’s medical expenses and he pays when he can be able to work. Religious groups usually do this but this can only be viable if there lots of people who will provide contributions.

With all these given options, providing health insurance for low income individuals is always possible. If all of us would realize the things we can get from these options, we don’t need to worry so much anymore. Getting confined in the hospital or treated with serious injuries without the health insurance is simply unimaginable so the only thing that we can do four ourselves is to rely on these options which equate the benefits provided by health insurance for low income people.

15. December 2016 · Comments Off on Health Insurance Basics – Common Definitions and Tips For First Time Buyers · Categories: Health Insurance

Choosing a health insurance plan that is right for your family can be a bit daunting…but it doesn’t have to be. Becoming familiar with the different health insurance plans that are available both for individuals and families will help you navigate the health care insurance field and make an better informed decision concerning health insurance. Read on to learn some of the health insurance basics.

HOW TO CHOOSE THE BEST INSURANCE PLAN FOR YOUR NEEDS

First, determine if short term or long term health insurance is what you need. If you are unemployed, yet hope to be hired in a few months with a company that offers group insurance, than perhaps short term health insurance is for you. Also some companies require a new employee to work for three to six months before they are eligible for health benefits. Short term could offer the temporary coverage you need. Next, decide if basic health-care coverage or comprehensive health care coverage will better meet your needs.

BASIC HEALTH CARE COVERAGE

This plans covers inpatient hospitalization and out-patient surgery in case of a major accident or illness. The monthly health premiums are lower and are generally the choice for those who are primarily interested in coverage in case of severe accident or illness.

COMPREHENSIVE HEALTH CARE COVERAGE

This plan covers preventative care, Dr’s visits, prescriptions, along with hospitalizations and out-patient surgery. Comprehensive health care coverage has a higher monthly premium, and it generally has a low co-pay at the time of a Dr’s appointment. This plan may be the better choice appropriate for those who have reoccurring medical expenses.

AVAILABLE INDIVIDUAL AND FAMILY INSURANCE PLANS

Health care plans usually fall into two categories, indemnity or managed-care plans. They differ in regard to how bills are paid, ability to choose health care providers and out-of pocket expenses. Generally, you’ll have a broader choice of health care providers with indemnity health-care plans and less out-of -pocket expenses and less paperwork with a managed-care health insurance plan.

MANAGED CARE PLANS

HMO’s (Health Maintenance Organizations), PPO’s
(Preferred Provider Organizations), and POS’s (Point of Service Plans) are all managed health-care insurance plans.

INDEMNITY PLANS

Under this plan, insurance companies pay their share of the cost for services after they receive a bill. This may mean that you will have to pay your bill for medical care at the time of service and then seek reimbursement from your health insurance company.

WHAT ARE SOME OF THE ADVANTAGES AND DISADVANTAGES OF AN HMO PLAN?

– Lower out of the pocket expenses

– Fewer choices in regard to physicians and hospitals than other health insurance plans

– A PCP (Primary Care Physician) is required and will meet most of your health-care needs

– A referral is needed from your PCP before seeing a specialist

WHAT ARE SOME OF THE ADVANTAGES AND DISADVANTAGES OF A PPO PLAN?

– Health insurance companies offer a network of preferred doctors and hospitals

– These health care providers offer the members services at discounted rates

– Usually an annual individual or family deductible must be paid before the health insurance companies begins to pay out money for medical bills.

WHAT ARE THE ADVANTAGES AND DISADVANTAGES OF A POS?

– Combines features of both the HMO and PPO plans

– Members are usually required to choose a Primary Care Physician (PCP)

– PCP services are not usually subject to a deductible

– Preventative care visits are generally covered

HEALTH INSURANCE TERMS

As with any genre, health care insurance is filled with jargon exclusive to its field. The following is a list of terms and their meanings that will hopefully give you good grasp of health insurance terms.

COINSURANCE

The percentage of medical costs you have to paying after meeting the deductible amount that is attached to your plan.

CO-PAYMENT

This occurs under an HMO plan and requires a specified dollar amount be paid to the health insurance provider on each visit.

COVERED BENEFITS

A covered benefit must always be a medical necessity. The determination of whether something is a medical necessity or not is made by the health insurance company.

DEDUCTIBLE

The amount you must pay in medical expenses before your insurance company will begin to cover your medical bills.

DEPENDENT

A dependent is someone other than yourself who is covered under your health insurance plan. This could include a spouse, child, unmarried partner. For children there are age limits at which they are no longer covered under a parent’s health policy.

DISABILITY

In the event that you are unable to work for an extended period of time due to an injury or a medical condition, disability insurance provides funds to cover your living expenses in a specified amount.

GATEKEEPER

Another title for your Primary Care Provider (PCP)

GROUP INSURANCE

Employers often offer group insurance plans. Under group insurance an employee can generally obtain a much more affordable plan.

IN NETWORK/OUT OF NETWORK

In network refers to those physicians who have been contracted under a health care plan to provide services to their members. Staying in network allows lower charges and a smaller percentage of out of pocket expenses. Conversely, going out of network generally means charges are higher and you will have to pay a greater percentage of out of pocket expenses.

GRACE PERIOD

This is a specified period past the due date of a premium during which coverage may not be canceled. This prevents health insurance companies from canceling your policy if payment should arrive a few days late.

OPEN-ENROLLMENT PERIOD

Generally, this is a once-a-year period of time that allows you to make changes to your existing health insurance coverage. (A change in marriage status or the birth of a child also allows you to modify your health insurance plan.

PRE-CERTIFICATION(Pre-authorization)

Before surgery or hospitalization, the insurance company must be contacted to get approval for a medical service to take place. Failure to do so typically means the insurance company will NOT pay for the service. This does not apply in an emergency situation, although the insurance company should be contacted as soon as possible.

PRE-EXISTING CONDITION

A medical condition that existed before an insurance policy became effective. Most insurance companies require a three month to one year waiting period before a pre-existing condition can be covered under their plan.

PREMIUMS

Monthly payments for insurance coverage. Monthly payments can easily reach $100 for singles and two to three times that amount for a family.

REFERRAL

A written form from your Primary Care Provider to another Dr. (usually a specialist) giving consent for you to go to them for medical services.

SECOND SURGERY OPINION

On occasion an insurance company will ask you to be seen by a second Dr. to determine if the recommended procedure is necessary or if an alternate method could accomplish the same result.

URC (Usual, reasonable, and customary)

URC refers to the dollar amount an insurer will usually pay for a service or procedure based on what is customary for the area in which you live. An insurance company will not pay $800 for a procedure that costs only $300.

HEALTH INSURANCE QUOTES

Be sure that you shop around to find the best health insurance plan. Compare quotes from at least 3-5 different insurance companies before you decide to purchase.

10. November 2016 · Comments Off on Cheap Health Insurance , Is It For You? · Categories: Health Insurance

Cheap health insurance is still available, it has not gone the way of the nickel soda or the 10 cent candy bar. As the cost of medical treatment continues to rise, finding cheap health insurance is becoming increasingly difficult. Cheap health insurance is an option for not having any health insurance at all. Choosing cheap health insurance is not something bad, but people have to understand they must go about it the right way.

Cost

Health insurance costs are rising all the time. The costs vary, so do plenty of research before choosing one or another. Many agents will work very hard to get you an affordable health insurance plan for your family at a cost you can live with. The rising cost of health care has made it so that even those with very limited budgets simply have to get some form of health insurance or they run the risk of encountering a large medical bill that can put their financial future in jeopardy. One good tactic to lower your monthly cost is to simply choose a plan with a higher deductible. A good scenario might cost you a couple hundred dollars but a bad scenario could ruin you financially and devastate your family. Check what they cover, deductibles, whether there are maximum payouts under any one category, whether they are for a family or individual health insurance, and of course the cost of the benefits which can vary a great deal. The cost of health insurance can vary greatly depending on the amount of coverage you need, if you were take all the options available in private health insurance then the premium would be astronomical and something which very few people can afford to do. Always check the policy because it might include things which you don’t need, for instance if you are a single man and a policy includes costs for pregnancy then this obviously won’t be needed. If you are considering the lowest cost health insurance then look into purchasing a policy that only covers major illnesses.

Part of the problem is the rising cost of medical care due to uninsured patients. Because of that, hospitals charge inflated rates to cover their own costs. Most low cost health insurance schemes provide for all basic medical and health related expenses, the difference lies in the type and extent of coverage that each of them provides. Low cost health insurance is for people whose annual income falls below a certain range. Health insurance costs depend on the health insurance rate and the range of coverage. Check the monthly cost and amount of deductibles charged and the extent of cost that they cover. There are several ways you can obtain affordable, low cost health insurance.

Search

The costs vary, so do plenty of research before choosing one or another. The best place to start your search for cheap health insurance providers is undoubtedly the internet. However, don’t be tempted to simply perform a search for ‘cheap health insurance’ as there is a high probability that almost all health insurance providers have this statement somewhere in their site’s text. See how cheap term life insurance really be by researching and comparing quote on-line from these top life insurance providers. Generally, health care can be exclusive, therefore if you are searching for a health insurance plan for your family unit, you have to look for plans that are both reasonably priced, and that would offer health coverage you require. Instead, take your time and do your research. With any Commendable Cheap-Health-Insurance plan, you need to read the Cheap-Health-Insurance terms of service of the Cheap-Health-Insurance account and search for any extra Cheap-Health-Insurance fees. As when looking at any health insurance policy, you ought to search for coverage that has a maximum payout of at least $1 million.

Conclusion

As the cost of medical treatment continues to rise, finding cheap health insurance is becoming increasingly difficult. The key to finding cheap Health insurance is knowing every option that is available, a process that can take a long time for an individual to complete. The key with health insurance and especially cheap health insurance is you need to know where health insurance is.

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