Meeting The Cost Of Medical Care Without Health Insurance

Meeting The Cost Of Medical Care Without Health Insurance

Health care spending is rising faster today than at any time in history and a staggering 80 percent of all Americans now say that they are dissatisfied with the manner in which health care is both managed and funded. Indeed, 60 percent of all Americans went as far as to say that they were very dissatisfied.

National health expenditure in the United States is now nearly $2.5 trillion (which represents more than $7,500 per person) and this figure is expected to rise to more than $4 trillion over the next ten years. At present this is more than twice the health care spending in countries such as Switzerland, Germany, France or Canada and is more than four times the amount the United States spends on national defense.

In short, the United States spends more on health care than most other industrialized nations (many of which provide health care for all of their citizens) and yet, despite this incredibly high level of expenditure, there are more than 47 million Americans without any form of health insurance. This is a national disgrace!

But this of course is only part of the picture because things are often little better for those with health insurance. The cost of medical insurance is now so high that half of all Americans cite it as their top economic concern and an increasing number of people are either limiting their cover to meet their budget or accepting what are in reality already unmanageably high deductibles and other out-of-pocket expenses.

Every 30 seconds somebody in the United States files for bankruptcy as the result of a serious medical problem and more than half of all bankruptcies today are in part the result of problems with medical bills. Indeed, the average medical bill debt for people filing for bankruptcy is now $12,000.

When we talk about the cost of medical care without health insurance we are not talking just about the financial cost but are also talking about the cost in terms of ruined lives. Of course medical bills do not force everybody into bankruptcy, but many families are forced to make significant changes to their lifestyle to pay their medical bills and millions of Americans delay treatment for often serious medical conditions simply because they cannot meet the cost.

In this Presidential Election season it is not surprising to find that health care, and health insurance in particular, comes high on the agenda but will it simply be used as a political weapon to get votes or will there be a significant change in direction during 2009 to begin to solve this enormous problem? Only time will tell of course, but a look back over the past few years can hardly inspire any of us to believe that, whoever ends up in the White House, he or she is likely to be able to do anything to make a significant difference for those of us who want nothing more than to provide adequate protection for both ourselves and our families.

Health Insurance - Anthem and Medical Mutual

Health Insurance - Anthem and Medical Mutual

If you find yourself out of work without health insurance or self-employed and looking for affordable coverage there are a number of options in Ohio. Companies like Anthem and Medical Mutual have put together a large network of providers in Ohio to keep the costs down for their subscribers.

If you are looking for a plan similar to the one offered by most major employers, Anthem's Premier coverage is the closest. This plan is aimed at families and emphasizes preventive care for children and adults alike. The premiums are higher than the other plans that Anthem offers but because it pays for wellness visits it could end up being more affordable in the long run. Costs can also be controlled by taking higher deductibles and coinsurance rates.

If you are looking for individual coverage or don't have children, Anthems' Smart Sense may be better suited to your needs. This plan provides basic coverage at some of the companies' lowest rates. Smart Sense requires copayments for the first three doctor visits each year and covers all generic drugs as well as some brand name drugs. The premium you pay will be based on the size of the deductible you choose.

Medical Mutual of Ohio also offers a variety of coverage plans to fit your needs and budget. You can pick from high deductible plans and plans with a variety of copays. Medical Mutual through its SuperMed One plans also offer value plans which combine traditional health insurance with health savings accounts. The government allows considerable tax savings for people who set up health savings accounts to help pay medical expenses. The savings accounts can be combined with high deductible plans to make sure that your family isn't wiped out by a catastrophic illness.

Medical Mutual and Anthem both also offer short term insurance plans that are perfect for someone caught between jobs without health insurance. These coverage plans offer similar benefits to the other plans. It also might be worthwhile to check the alternatives the companies offer to COBRA because in many cases your premium will be less expensive.

The Most Popular Health Insurance Plans Available

The Most Popular Health Insurance Plans Available

When shopping for health insurance there are many things to consider for your options. There are a couple of plan styles to choose from in the healthcare marketplace, lets look at them.

HMO: Health Maintenance Organizations (HMOs) are legally organized entities that share the common characteristics of responsibility for both financing and delivering comprehensive health care services to a defined group of members for a prepaid, fixed fee. HMOs differ from traditional insurance indemnity plans in that they are both the financing and servicing mechanism. They emphasize preventative medicine and early treatment through prepaid routine physical examinations and diagnostic screening techniques. At the same time they, provide complete hospital and medical care for sickness and injury.

PPO: Preferred Provider Organizations (PPOs) are groups of health care providers that contract with employers, insurance companies, union trust funds, or others to provide medical care services at a reduced, negotiated fee. Like HMOs, they make take the form of group practices or separate individual practices. PPOs typically differ from HMOs in two aspects. First, they provide benefits on a fee-for-service basis as their services are used. Fees are usually subject to a schedule that is the same for all participants in the PPO. Second, plan participants have financial incentives to use the preferred provider network. A participant's access to specialist is not controlled by a primary care physician, as is the case in HMO plans.

EPO: Exclusive Provider Organizations (EPOs) are similar to PPOs in their organization and purpose, but unlike PPOs, EPOs limit their participants to participating providers. In general, individuals covered by an EPO are required to receive all their covered health care services from providers that participate with the EPO. Because of the severe restriction on choice of provider.

POS: Point-of-Service-Plans (POS) are not really a health care provider per se; however they are more of a hybrid arrangement that combines aspects of traditional medical expense plan with an HMO or PPO. In a POS plan, a participant's access to a provider network is controlled by a primary care physician. Participants retain the option to seek care outside the network but at reduced coverage levels. POS plans are sometimes referred to as open ended HMOs. The POS plan is the fastest growing health plan in the United States.

PHO: Physician-Hospital-Organizations (PHOs) are organizations that are jointly owned and operated by hospitals and their affiliated physicians and typically are developed to provide a vehicle for hospitals and physicians to contract together with other managed care organizations to provide healthcare services. Carve-out-plans are health care programs managed separately from an employer's general health care plan by HMOs or PPOs that specialize in a particular type of care. An HMO or PPO that specializes in a particular type of care may be more successful at controlling cost for that type of care than a general purpose medical care network. Mental health, substance abuse, prescription drugs, and dental care are some of the more common types of care approached in this manner.

Accident Health Insurance - Plan For the Emergency Room

Accident Health Insurance - Plan For the Emergency Room

Accident health insurance supplements are being used to cover upfront injury related expenses for the ER. Plans can be used to compliment an existing health insurance policy or just as a personal injury plan to pay for any unexpected ER visits or surgeries.

Many Americans are concerned with insuring the everyday mishaps like bodily injuries and emergency room coverage. Of course, insuring things like Cancer and Heart Attacks are important, but for younger adults and especially kids, emergency room visits are far more prevalent. Unfortunately, a trip to the emergency room isn't cheap and the healing process from a serious bodily injury can be exhausting. Damaged body parts often need to be surgically corrected and the post operation Physical Therapy sessions feel like a Sylvester Stallone Rocky Movie. I'm not going to lie, the Rocky Four soundtrack got me through my Physical Therapy workouts post ACL Knee surgery.

Health insurance for the self-employed is especially complicated when it comes to emergency room visits. To qualify for a Major Medical PPO plan one must go through underwriting and medically qualify. Assuming you get approved, you'll need to select a deductible and plan style. The most cost effective PPO policies in the individual health insurance market are the HDHP (High Deductible Health Plan) plans. Deductible is the out of pocket expense the insured has before the health insurance policy picks up the bill. PPO stands for Preferred Provider Organization and is the type of health insurance that lets you choose any doctor. Choosing any doctor isn't necessarily true, theirs a lot of gray area with "being in network or out of network" with PPO's.

Deductible options for individuals in the PPO market are $1,500, $2,500, $3,500, and $5,000. Typical family deductible options are $3,000, $5,000, $7,000, and $10,000. You'll want to choose a co-insurance of 100%. Co-insurance is the shared expense between you and the insurance company after the deductible. Most people are familiar with 80/20 % co-insurance. 100% co-insurance is popular because you won't need to understand Calculus to figure out any future hospital bills. Insurance plan picks up 100% of the bills after deductible with this option. On a side note, it's a good idea to set up a Health Savings Account. HSA's have some decent tax advantages and you can set up an account equivalent to the deductible amount. So a $10,000 HDHP can have a $10,000 health savings account attached to it. The yearly max contribution to the health savings account is determined by your HDHP deductible. Ask your CPA about health savings accounts if your self-employed.

Higher deductible health insurance plans have lower monthly premiums. However, with that high deductible comes risk of having to owe that deductible amount if you use the health insurance. A $5,000 dollar deductible hospital bill is one broken bone away. Guess how a lot of Americans end up paying that HDHP $5,000 deductible? You guessed it, in the emergency room from a accidental bodily injury.

Accident health insurance supplements have been doing a good job filling this ER gap for years. Other names used for this plan include personal accident insurance, emergency room insurance supplement, accident medical coverage, personal injury insurance plan, 24 hour accident coverage, and accident supplemental benefit plan. These plans are under marketed in my opinion, and most licensed health insurance agents are doing a disservice to their clients if they don't bring it up. I say this because so many people are shelling out a lot of money each month to insurance companies, and if they actually use the insurance could be stuck with a huge deductible bill.

Opposite the PPO health insurance industry is Guarantee Issue insurance products. Emergency room insurance supplements fall into this category and are automatic approval. Online applications have zero health questions but do need social security numbers and birth dates. This type of guarantee issue accident medical expense coverage is an indemnity. Indemnity's compensate members with a predetermined benefit amount.

Personal injury insurance plans in this category are membership based associations. The membership organization helps individuals and families in the United States gain access to discount programs and in this case, the pound for pound most practical emergency room insurance supplement I've seen so far.

Each association member can choose a benefit level of accident coverage to fit their monthly budget or to match the HDHP deductible. Plans cover the HDHP deductible giving high deductible health plans a virtual zero deductible effect. Remember, a lot of HDHP's max out deductibles from ER visits due to injuries. ER plan pays injury related expenses to pay off the PPO deductible. Again, plans only cover ER related expenses due to injury and not sickness.

Members can choose a emergency room coverage level of $2,500, $5,000, $7,500, or $10,000. Accident compensation benefits pay out per injury and have no limits on use. Typically a person will have a $100 dollar deductible per covered accident. ER policy pays up to the $2,500, $5,000, $7,500, or $10,000 per accident excluding the $100 deductible. In simple terms, you'll owe $100 dollars for any covered injury assuming the bill doesn't exceed the policy benefit max of $2,500, $5,000, $7,500, or $10,000.

Here's some figures on what the leading personal accident insurance dues are. Indemnity plan rate increases are seldom because it's an association based health insurance product.

-$24 dollars a month: $5,000 benefit individual plan.

-$29 dollars a month: $7,500 benefit individual plan.

-$36 dollars a month: $10,000 benefit individual plan.

-$35 dollars a month: $5,000 benefit family plan.

-$41 dollars a month: $7,500 benefit family plan.

-$47 dollars a month: $10,000 benefit family plan.

(family policy prices include everyone, it's the same price for a 3 person family or 12 person family)

It doesn't matter what accident health insurance plan brochure you pick up, all plan brochures EOB (Explanation Of Benefits) page say the same important benefit: Members may choose any Doctor, Hospital, or Emergency Room. Since this is accident indemnity, benefits have no restriction on health care providers to choose from. Accidents are unpredictable and so is knowing what emergency room you'll be showing up at. I can't imagine accident plans would sell if they came with some lame network provider booklet of acceptable doctors. This brand of accident coverage is 100% portable and can be used up to two months outside the United States while traveling abroad.

Accident Plan benefits at a glance:

-Hospital Emergency Care

-Doctor's fee for surgery (in and outpatient)

-Laboratory Tests.

-X-Rays and MRI's.

-Ambulance Expense.

-Registered Nurse.

-Hospital room and board.

-Operating Room Costs.

-Anesthesia.

-Prescription Drugs.

-Physical Therapy (super important post operation)

-Doctors visits (inpatient and outpatient).

-Dental treatment for injury to sound natural teeth.

-Splints, Crutches, and Casts.

United Health Care - A General Overview of Good Health Insurance

United Health Care - A General Overview of Good Health Insurance

United Health Care is one of the largest health insurance companies and offers near universal acceptance by medical facilities. Those who are looking to purchase United Health Care insurance have plenty of plans from which to choose, including copay, high deductible, short term medical, health savings accounts, and student coverage. United also offers dental insurance for those who do not receive coverage through an employer.

People with pre-existing medical conditions may find it easier to receive coverage through United Health than through other insurance companies, although they will still have to go through an exclusion period.

Individuals and families who are looking for a United Health Care insurance plan with many of the same benefits as those provided by an employer should choose the copay option. You will need to pay a set fee for preventive care and office visits, but after copayment, 100% of exam costs will be covered. Most copay plans also cover all prescriptions. This plan offers $3 million in lifetime coverage, with the option to purchase up to $5 million if you find it necessary. This plan is best for families and individuals who visit the doctor often and like the convenience of co-payments.

Another option to consider is a high deductible insurance plan. With this option, you will pay for all medical expenses until your yearly deductible requirement is met, but all subsequent medical expenses will be covered in full. Although the deductible is much higher than other plans, this option offers lower premiums and is a good choice for anyone who is healthy and has money set aside for sudden illnesses or accidents. In this scenario, you might end up saving money even though the deductible is higher. It does require a high level of financial responsibility before any insurance benefits kick in.

Students can also take advantage of United Health Care's student insurance plan. Although many parents are still covered by their parents' insurance while they are attending school, others may be forced to shoulder the responsibility of medical bills themselves. By getting United Health Care insurance, students can receive coverage for medical expenses incurred both on- and off-campus as well as 24/7 access to registered nurses via NurseLine. United Health Care is also accepted nearly anywhere, a huge benefit for students who may be attending school far from home. However, your school will have to offer United Health Care for you to take advantage of their special student insurance coverage.

This has to be one of the best carriers available in the individual marketplace, if you would like some more detailed explanations regarding these benefits, please visit our website at http://www.health-insurance-buyer.com and provide your contact information so we can educate you.

Health Insurance Rules

Health Insurance Rules

Many dual income couples, include their children on each group health insurance plan to maximize benfits. However, without some sort of system in place to help the health insurance companies coordinate benefits, it's possible that either you or your doctor would be reimbursed for more than 100 percent of the actual cost of your claim.

To prevent this, health insurance companies typically designate one parent's health insurance plan as the primary plan and the other as the secondary plan. (That's why the patient questionnaire at your doctor's office asks for information on primary and secondary coverage.) The primary plan is responsible for paying covered expenses up to the limits of the policy. If any unpaid costs are left over, the secondary coverage kicks in.

THE DATE OF BIRTH DETERMINES WHICH HEALTH INSURANCE PROVIDES COVERAGE

The birthday rule is often used to determine which plan is primary and which is secondary. Under this rule, the plan of the parent whose birthday occurs first in the calendar year is designated as primary. The date of birth is the determining factor not the year so it doesn't matter which spouse is older.

Like most rules, the birthday rule has exceptions:

- If both parents share the same birthday, the parent who has been covered by his or her plan longest provides the primary coverage for the children.

- If one spouse is currently employed and has health insurance through a current employer, and the other spouse has coverage through a former employer, the plan belonging to the curently employed spouse would be primary.

- In the event of divorce or separation, the plan of the parent with custody generally provides primary coverage. If the custodial parent remarries, the new new spouse's coverage becomes secondary. And finally, the non custodial parent's health insurance plan would provide a third layer of insurance protection. This order of payment can be altered by a court issued divorce decree or by agreement, but the health insurance companies must be notified.

THESE ARE JUST HEALTH INSURANCE RULES NOT THE LAW

Keep in mind that these practices are common among health insurance companies, but they are not governed by law. Practices may vary from one insurer to another. Read your policy carefully to make sure you understand how your insurance company handles dual coverage. If the policy coverage is unclear, ask for help from your employers benefit specialist or your insurer's customer service department.

What to Do if You Don't Have Health Insurance - You Might Not Beat the Odds

What to Do if You Don't Have Health Insurance - You Might Not Beat the Odds

Have you been working hard and paying your bills on time your whole life? Saving your money and trying to get ahead, looking forward to retiring some day? You read in the paper and hear on the news about so many people that are uninsured. Uninsured, and don't have health insurance because they can't afford it. Are you one of the uninsured people like I am? Are you worried about having a health care emergency and not knowing how you would pay your medical bills? You know you really can't switch jobs. You feel you're getting too old or under skilled to be hired by anyone else. You might even be self-employed too. You know you can't or don't want to learn a new skill to get a new job at a bigger company that has group health insurance. Your present employer really can't afford health insurance for his employees and you don't see that changing where you work.

You have gotten by this long without health insurance and you know that you should do something about it. But health insurance is expensive and getting health insurance is a good idea and something you have always been planning to do. But, we just keep putting it off, until it is too late. So what is a man with a family, or a single person do if you barely can find the money to pay for the necessities, like the rent, or a mortgage, the higher price of gas and food, much less expensive health insurance?

Do you think you can beat the odds? For men it is one in three, for women one in five that you will have a major health care emergency hospitalization and incur medical bills for surgery, hospital stay, outpatient medical care, therapy and prescription drugs. Do you worry and lay awake at night, wondering how you would pay for emergency care, if you needed it?

Ever wonder what you will do if the worst happens and you had to go to the hospital without health insurance? In a word. Bankruptcy. The retirement you worked your whole life for and dreamed about... the retirement you always envisioned is gone...taken away from you in an instant. And by a calamity you have tried to avoid. A calamity that broad sided you, and you had no warning and you never knew what hit you.

Imagine this scenario. You are 55, been in great shape your whole life, you work hard and live right, don't smoke, eat healthy foods, watch your weight and have been taking care of yourself the best way you know how. But lately you have been getting a little short of breath. You shake your head and say "it's just getting old" and keep right on working on the house, the car, the lawn, the crops or a new project you just have to get done. While working, all of a sudden you feel really short of breath. You stop, sit down and can't breathe. You look down and your arm is feeling funny and tingly. All of a sudden you feel a shooting pain running up your arm into your shoulder, "ah...just overdoing it again" you say to yourself. I'll just rest a spell and it will go away. But this time the pain does not go away like other times. You feel the numbness and worse, a stabbing pain goes into your shoulder. Quickly the pain intensifies and travels deeper and is shooting across your chest, a crushing pain and now you are really scared. "Wonder if this is a heart attack?" You know you waited too long and it's too late...This time it's for real. You are in the middle of a heart attack.

You are desperate and in stabbing pain. You know calling 911 might save you...if you can get to a phone. You call for your wife and she is inside the house and does not hear you. You try to get up and feel faint and you have no strength and your legs just can't move. You holler louder, it hurts so bad and she hears you this time. She rushes to your side and you are so short of breath you can't talk, the pain is too great. You point to your chest and she can see by the look on your face you are suffering and in great pain and something is terribly wrong. She runs to call 911, frantic about you and tells the ambulance to come right away and she thinks you are having a heart attack. She runs back to your side and you both are terribly scared and all you can do is wait.

The bad news has just begun...When the ambulance arrives, you find out the very worst has happened. You really are having a heart attack...they rush you away to the hospital, taking your vitals and giving you the drugs to save your life. Expensive surgery follows with angioplasty to open up your blocked arteries in your heart, and you get a stint to keep the worst blocked artery open. The doctors say that you should make a good recovery with adequate care, rest and therapy. You will have to take heart medications and high blood pressure drugs the rest of your life. Already the worry has started, and you think to yourself. "how am I going to pay for this"? The deep financial worry never leaves you. You have heard stories of financial disasters happening to good people with no insurance, Tragic consequences happening to people getting hit with huge medical bills for surgeries in the tens of thousands of dollars. You lost...you did not beat the odds.

Now what can you do? Your retirement dream is gone, now you will have to work the rest of your life to pay your medical bills off. The story, I shared is real, this medical tragedy happened to my brother, a farmer, a hard worker, a self-employed bulldozer operator in the prime of his life. No health insurance and he now faces a $45,000 medical bill he can't pay. Not unless he wants to sell the beautiful log cabin home he built with his own hands and the farm he worked his whole life for. He is worried sick and tied to heart drugs for the rest of his life. Heart drugs and a stint that make him feel even more sick. He has decided to sell part of his land to pay the hospital and clinic bills. He hates to do this, but has no choice.

He tried to pay the hospital and clinic with agreed upon payments of a $1,000 a month each, paying every penny he could, but that was not fast enough or good enough. The hospital and the clinic still turned his account over to the collection agencies even though he was paying over $2,000.00 a month. He is an honest man who worked hard his whole life and did not deserve this. He can barely afford the heart drugs and makes just enough money so he does not qualify for state-assisted health care or prescription drug benefits.

One more thing is important...That is not the only calamity. He is not eligible for any type of health insurance for his heart, even if he could afford to pay $850.00 a month for health insurance coverage, plus his monthly medical bill payment to the collection agency. Why? Because now, he is uninsurable. In order to be covered under health insurance for his heart, he would have to not have any hospital care or treatment related to his pre-existing condition for seven years to quality for having that heart condition covered under any health insurance policy. For my brother, he will have to work harder than ever to pay this debt off, just when he should be taking it easier and not working so hard to prevent yet another heart attack. There will be no retirement for him, he is 59 and that is a terribly hard price to pay.

What does this mean for you? Don't wait, don't let a major health problem ruin your chances of retirement. Health care coverage can be purchased and can be budgeted for. If my brother knew what was going to happen, he would have budgeted the money for a health insurance policy. He could have spared a couple thousand a year for an inexpensive health care policy with a high deductible. This would have cut the medical bills he received by a significant amount, and he still would have health insurance to cover him in the future. When you're lying in bed at night, think of the people you know that have had their lives turned up side down by a health calamity, lost their jobs, their homes, all their savings and their cherished retirement. This is too big a price to pay. Take care of yourself, and your family. Protect your retirement dream. Getting an online insurance quote, is easy, and safe and can help you take a step in the right direction. Help remove most of the worry, about "what if a medical emergency occurred to you or a loved one". Would you be covered? Let's hope the answer is "Yes."

When I got laid off from a great job due to a large corporate company downsizing, at the age of 50, I lost my group health insurance. I went on the Internet and found the online insurance quote websites a real help. The easy to fill in forms "just fill in your zip code" got me started with my online quote. The websites were easy to use, and I enjoyed getting free insurance quotes. The websites connected me with top insurance agents who helped me figure out how to compare the quotes. The agents were friendly, easy to talk to, and I got a policy to protect me at a cost I could afford. Please click on the link above and get some health insurance that will protect you and your loved ones. Just knowing something really can happen and taking the right steps to protect yourself can help remove some of the worry. Don't try to beat the odds, you may not win. Don't let a small financial burden become an impossible one. Do it for yourself, do it now before it is too late.