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04/12/2010
Nevada’s insurance division has recently launched a campaign against deceitful medical insurance plans while persuading consumers to ’check before writing a check’.
The Nevada Division of Insurance along with The Nevada Surplus Lines Association targets the confusion that sometimes envelop health insurance and health insurance scams aimed at individual consumers as well as small firm owners across Nevada. They launched the ’Question the Company and their Plan‘ 2010 Public Education Campaign, which playfully discusses to consumers the importance of gaining complete information before buying a particular policy linked to health insurance plans or ’checking before writing a check’.
The campaign was launched Sunday throughout the state including website banners and upgrades to www.nvinsurancealert.com and television spots to provide consumers and insurance agents information regarding their concerns. The viewers are about to see various amusing ads of pitchman ‘Herm Sleaster’, who promotes the plan that will provide consumers the “fruitcake, a pooch and health insurance coverage for only $29.95 a month…not including some tax”.
The television spots expose the ‘not far from the truth’ re-enactment of how a pitch for a fraudulent health plan might look . It also aims to remind consumers that some of the medical insurance plans sold are invalid, strongly reinforcing that it is always best to use a reputable Health Insurance provider.
The 2010 campaign urges consumers to increase their level of awareness regarding the possible effects of deceitful fraudulent health insurance products and plans or illegal insurance companies.
Author: Van Kelsey

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04/08/2010
Democratic US Representative Bob Etheridge believes that the healthcare law will see an increase in support as the public’s awareness regarding its benefits widens.
He said that Republicans falsely viewed the healthcare law for considering it a ‘government takeover’ of the healthcare industry, reports Rob Christensen.
"It's not true", said Etheridge on Wednesday when he met with reporters and editors of The News and Observer. "We are putting together a framework that operates in the private sector".
According to Etheridge, the bills supporters have to explain how the healthcare law’s benefits everybody, including those suffering from pre-existing health conditions like cancer, those who have gone through heart attack, or pregnant women. Under the newly established law, those individuals would be provided with medical insurance in the easiest way possible.
“We have to push back", he said. "We have to tell the truth. It's hard to get the truth out. It's a lot easier to be against something".
Etheridge said the criticisms aimed at the healthcare law are like those aimed at other social bills.
"If you go back and read about what happened in Medicare in the sixties and Social Security in the thirties a lot of the same words were being used", said Etheridge, adding that doing nothing will not improve the system and also make it worst.
Etheridge voted for the bill despite the majority of people in his district being opposed to the measure. Etheridge believes public opinion on the healthcare law will be more favorable by this November once people actually see it working.
Author: Warren Blumberg

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04/06/2010
The medical journal Lancet, in its most recent lead editorial, has applauded the US Health Care Reform Bill for extending health care access and for aiming to reduce the gap between health outcomes and expenditure.
According to the editors, the winners are the 32 million uninsured US citizens who were previously too poor or too sick to obtain medical insurance, but will now have coverage starting in 2014. It is also said that by 2019, the coverage will extend to 95% of the population.
The new bill pushes insurers to take in all applicants regardless of their health status. While the increase in coverage will promote the private health industry, the journal stresses that Medicaid and Medicare – the insurance program for low income and elderly citizens, which currently cover 28% of Americans – “will have a catastrophic additional operational and financial burden for which solutions are not clearly defined within the current bill.”
The editorial stated that the suggested cost-saving options, like the initiative to pay for the quality and not the quantity of care (known as pay-for-performance instead of the fee-for-service), and also the proposal to reprimand medical institutions for high rates of readmission, are “welcome but will probably not reduce health-care costs.”
Preventive health care, which includes healthier eating and more exercises, are the key to success of the new bill. The editors wrote, “Preventive behavioral changes, necessary for the well being of the entire society, are not only the most difficult to bring about but are also those that, if unaddressed, will have a heavy toll on the cost of the country's health care.”
“The success of the health-care reform bill will greatly depend on its acceptance by the public,” they added.
Author: Avery Smith

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03/30/2010
The new healthcare reform will allow young people to be covered under the medical insurance plan of their parents until aged 26, a provision a healthcare policy expert and GW professor says will greatly help college students.
At present, young individuals over 22 years old are unable to receive healthcare through the insurance plan of their parents, placing a large burden on many college students – both in the graduate and the undergraduate level – to find coverage amid the increasing tuition cost.
“Private health insurance that the parents have will now include dependents up to the age of 26, so generally speaking students and young adults who've graduated from school may still be eligible for coverage under their parents' policy”, said health policy professor Leighton Ku of the School of Public Health and Health Services. “So that's really great for students”.
He said majority of students at the George Washington University are in favour of this part of the health insurance legislation, adding that most students are usually misinformed or uninformed of the bill’s effects.
This provision may also influence 10% of GW students who acquire health insurance from the Student Health Services, claimed Dr. Isabel Goldenberg, director of SHS. Students may now be covered by their parents’ health insurance, making the SHS insurance unnecessary.
According to Goldenberg, students must evaluate all their healthcare options before calling off their SHS plan, as the dependent’s age extension will only take effect after a few months.
“Students should review their family's policy if they are under age 26 and compare cost, benefits and access to health care to make an informed decision about the best coverage”, she said.
Author: Van Kelsey

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03/26/2010
US President Barack Obama is now promoting the historic healthcare reform, as a recent survey shows that Americans are split over the sweeping bill he signed into law last Tuesday.
Obama promoted the reform during his speech before an audience in Iowa on Thursday. During the speech he stated that the new medical insurance reform bill is now the country’s law.
On Thursday, the US Senate also authorized changes to the new rule, sending them out to the House of Representatives. Several minority Republicans attempted to stall these changes through a succession of amendments; however, all were rejected.
A number of Democrats in the House called for the changes in exchange for the approval of the original healthcare reform bill.
The Republicans are firmly against this new law. In a survey conducted by Quinnipiac University, results indicate that Americans are generally divided over the issue, with almost 50% of the respondents saying that they do not approve of the new legislation, while around 40% claim they approve.
Congressional Democrats have also been the target of acts of vandalism and threats following the vote over the healthcare bill.
Democrat Nancy Pelosi, a speaker for the House of Representatives, and Republican Minority Leader John Boehner stated that those measures do not have a place in US politics.
Steny Hoyer, the House Majority Leader, said that at least ten members of the Congress have received some threats to themselves or their families over the last couple of days.

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03/24/2010
Illinois will not be trying to impede the implementation of the new healthcare reform bill passed by Congress.
Governor Pat Quinn claims he welcomes the new reforms, unlike several other American states. “We aren't going to be dragging our feet, whinning and complaining,” he explained. “We [want] this to be a reality...we want to save money for families and businesses.”
The Illinois governor said that the residents of the state will benefit in several ways. “It's going to eliminate things like pre-existing conditions as a basis of denial or exclusion... it will lead to more equal pricing and price stability, we'll get more for our insurance premiums that we're getting today.”
Quinn went on to say, “Unwarranted rescissions in insurance policies will be prohibited and it will help families in Illinois with their financial security.” According to him, the major cause of bankruptcy in families is unexpected medical expenses.
Quinn added that the new reforms should also require free wellness programs to be set up by health insurance companies, to help promote health and hopefully reduce health related problems.
When implemented, the reform will expand Medicaid. Quinn does not believe that adding participants to the health care rolls will add to the state’s deficit; however, he says that cost estimates are yet to be completed.
The governor admits that the new reforms are not flawless and still have a long way to go; nevertheless, he looks forward to working with US President Barack Obama on their implementation.
By: Van Kelsey

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03/23/2010
Sandy Praeger, the insurance commissioner of Kansas, has spoken out to help clarify the confusion that surrounds the new healthcare reform.
Among the things consumers will immediately notice include health insurance firms not being able to set a lifetime or annual cap on the cost they should pay out in covering health care.
The federal government will provide states billions of dollars to aid in lowering the premiums for individuals with pre-existing health conditions, since insurance firms can no longer reject coverage based on the health history of a person.
Children up to 26 years old will be covered by the health plans of their parents. Individuals who are on Medicaid will be eligible to get drug discounts and more people will be entitled for health care as the requirements ease up.
Some parts of the healthcare plan claim that all routine medical examinations, such as immunizations, will be administered for free. Consumers will no longer need to have a co-pay for preventative visits to doctors.
In covering the national healthcare program’s cost, everyone will have to acquire medical insurance. While several individuals are dismayed by this requirement, authorities said that it is vital for the plan to work.
“If they can't exclude you from a pre-existing condition, you just wait until you're sick to buy the coverage so you really need to have a requirement that everyone has to have the coverage,” said Praeger, speaking to KCTV 5 News.
Officials still do not know the exact cost for consumers each year; however, they hope that the competition as well as adding 32 million uninsured individuals to the health plans will, maintain the low cost.

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03/22/2010
US President Barack Obama has said he will issue an executive order once the health insurance reform bill is passed, which will reaffirm the longstanding restrictions regarding the utilization of the federal government’s funds for abortion.
This announcement seems to have appeased the conservative Democrats headed by Michigan Representative Bart Stupak, who allegedly claim that they will now back the healthcare reform given the votes to pass.
According to President Obama, the bill as written preserves current law; however, the executive order offers additional protection to ensure that the situation is maintained and imposed, and that the restrictions of the health care legislation over the public abortion funding cannot be avoided.
The House of Representatives is set to vote on the health care reform, with about 216 votes needed for its passage.
The $940 billion package is projected to extend the medical insurance coverage of around 32 million individuals by 2019. It will also make insurance more affordable by offering health care’s highest middle class tax cut in history, cutting down costs for numerous families as well as small business owners, who are presently rated out of coverage.
The bill also establishes a new competitive health insurance industry, giving millions of Americans the same insurance alternatives that the members of the Congress will have. It is also expected to end discrimination against people with pre-existing health conditions.
According to the non-partisan Congressional Budget Office, the health care plan will reduce the federal deficit by around $138 billion within 10 years and will amount to around $940 billion in costs over the course of a decade.

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03/19/2010
US President Barack Obama has delayed his trip to Australia and Indonesia to work with legislators on having the health care bill approved.
White House spokesperson Robert Gibbs stated on reports that the president will reschedule his travel for June.
“The president greatly regrets the delay,” he said.
According to Gibbs, Obama has spoken to President Susilo Bambang Yudhoyono of Indonesia and will talk to Prime Minister Kevin Rudd of Australia; and both leaders understand the significance of the health care reform and Obama’s wish to see it through.
“The president believes right now the place for him to be is in Washington seeing this through,” Gibbs explained.
In the past days, he said that Obama has appealed to “more than two dozen” lawmakers to help assure votes for passage. On Sunday, the House is aiming for a possible vote on the sweeping reform, which would provide health care coverage to over 30 million Americans and enforce new rules on the health insurance industry. The president will carry on with his outreach in order to secure 216 House votes, said the press secretary.
He also disclosed that Obama had an influence in persuading Catholic nuns to back the health care bill. Gibbs, who pertained to the nun’s support as “very, very important,” said that Obama had recently convened with Sister Carol Keehan, the Catholic Health Association president.
The president was set to leave on Sunday morning for his first overseas trip this year. Obama and his aides did not want to wait till the last minute to call on to Australia and Indonesia and say “we’re not coming,” said Gibbs.
“That would cause some problems...in just common sense and manners,” he added.

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03/18/2010
Press Secretary Robert Gibbs explained on Tuesday that the White House would not mind to see the House employ a legislative approach that would let the Democrats vote on changes to the health care bill of the Senate, but not on the bill itself.
"There are I'm sure those that are going to want to make this about the legislative process rather than the heart-wrenching stories of people like Natoma Canfield," Gibbs said. Canfield is a woman from Ohio who was diagnosed with leukaemia after she dropped her health insurance for the plan had become very expensive.
The process being discussed is referred to as ‘deem and pass.’ It allows the House to pass changes and forward them to the Senate, while considering the original bill to have been ratified.
According to Republican critics, the idea is more like a ‘demon pass’ or a devilish effort to evade recorded votes concerning the Senate bill’s more controversial matters, such as special deals with certain states and abortion language.
"The majority plans to force the toxic Senate bill through the House under some controversial trick," Republican House Minority Leader John Boehner said. "There is no way to hide from this vote."
Gibbs said that Republicans made use of the ‘deem and pass’ in times of congressional majorities.
‘Deem and pass’ is also included in the ‘budget reconciliation’ process, which has also been the subject of debate of different political parties.
Through ‘deem and pass,’ Senate Democrats would be allowed to sign off in a final health care reform bill by keeping away from a Republican filibuster.

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03/16/2010
Hill Physicians Medical Group, Northern California’s largest Independent Practice Association (IPA), and the Physicians Integrated Medical Group are under negotiations regarding a merger, said both groups on Monday.
Brisbane-based PIMG represents around 500 doctors practicing in San Mateo County and San Francisco; while the San Ramon-based Hill, headed by CEO Steve McDermott, constitutes around 3,000 physicians in Northern California situated mostly in the Sacramento region, the Bay Area, and the Central Valley.
The merger received a unanimous approval from PIMG’s board of directors, which recommended this move last week to its IPA members, they said.
Plans involve the suspension of PIMG’s independent operations by midyear, “enabling a smooth transition of physicians and members”, explained PIMG Chief Executive James Rodriguez in a statement.
“This orderly transition will enable each of our patients the opportunity to remain with their primary care physician and positions our physicians to realize the benefits that come with being part of a nationally recognized, geographically broad medical group”, he said. “I believe it is likely that most of PIMG’s primary care and specialty physicians will make the move to Hill Physicians Medical Group”.
According to Rodriguez, around one-third of IPA’s doctors in Brisbane already have medical group affiliation with Hill; thus, expanding the association is natural. Of its 500 physicians, PIMG considers 300 to be the group’s core members.
PIMG, which was established in 1995 to offer care to San Francisco Health Plan members, also provides PPO and HMO coverage to patients through Aetna, PacifiCare, Health Net, Blue Shields of California, and Anthem Blue Cross, as stated in its website.
Meanwhile, Hill is already the largest IPA in the region, constituting 3,000 physicians on health plan contracting as well as other business transactions, and providing around 300,000 HMO enrollees.

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03/15/2010
Congresswoman Nancy Pelosi of San Francisco, spent most of the past weekend promoting healthcare reform and denying allegations that the Democratic Party lacks the necessary votes to pass it.
The Democratic leader, during a break in a dedication ceremony at San Francisco’s Chinatown, said it’s more crucial than ever for some type of healthcare reform to be passed in the near future.
“It’s very clear that the status quo is not acceptable. Too many people in our country do not have health insurance,” she stated.
However, Republican Congressman John Boehner of Ohio, who appeared on CNN’s State of the Union Program, disagreed with Pelosi, saying:
“The only bi-partisanship that’s going on in this town right now with regard to health care is the bi-partisan opposition to what they’re attempting to do.”
He went on to say that the Democrats don’t have enough votes to pass the health insurance bill through; because if they did, then the deal would have been completed months ago.
Pelosi said that the Democrats will continue to push for the bill to go through, though she did not give further details on what would make up the bill once the vote takes place.
According to newly elected Republican Senator Scott Brown of Massachusetts, the debate over the matter has been a waste of time. He said the present reform needs to be scrapped and then start over again.
An “entire year has gone to waste” as the Democrats take on what he defines as a “destructive” effort, Brown explained.
Author: Van Kelsey

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03/12/2010
The House of Representatives are unlikely to set a vote by March 18 on the medical insurance reform, said White House spokesperson Robert Gibbs on Thursday, adding that the Congressional Democrats are carrying out actions to consolidate position within their own party.
According to him, it may take several days after March 18 before the House could finish the bill. Last week, Gibbs told reporters he thought the House was scheduled for voting on the legislation by the 18th, when President Barack Obama departs for overseas trips to Australia and Indonesia.
Prior to Gibbs’ statement, Senate Majority Leader Harry Reid told the media that the Congressional Democrats are “not going to set any arbitrary deadlines,” because of issues still to be discussed in order to advance the reform.
The White House was urging for an early vote on the health insurance bill. Obama said during a rally in St. Louis, Missouri, on Wednesday that “the time to talk is over. It's time to vote”.
Reid officially informed the Republicans that the Democrats “plan to use the regular budget reconciliation process that the Republican caucus has used many times”.
Reconciliation only needs a simple majority to press forward a contentious budget reform, as the Democrats are lacking just a single vote for a filibuster-proof supermajority in the Senate.
The Democrats are now taking actions to secure their needed votes, particularly in the House, where several politically-vulnerable Democrats fear that the bill may bring damage to them in an election year.
House Speaker Nancy Pelosi met with the House Democrats on Thursday to address, ‘member-by-member,” the issues they raise.
“We have a pretty good idea of where we are going,” Pelosi said.

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03/11/2010
The US Senate passed a $140 billion jobs bill on Wednesday that would extend the deadline of the unemployment insurance until the end of 2010 as well as extending some tax breaks which will soon expire.
The bill passed the Senate with a 62-36 vote and will now advance to the House for voting. The majority of the 15 million unemployed Americans would like the White House to act more to produce jobs, and this jobs bill does not include new major initiatives. Nevertheless, it does include a $15 billion job creation effort however; some Americans believe that more needs to be done.
In December alone, a $154 billion job creation bill passed the House, and a number of Republicans are worried of adding additional money to the deficit.
The new bill will extend the COBRA health insurance benefits, as well as unemployment insurance benefits for those without work, till the end of 2010. Under the new jobs bill, tax credits that had expired by the end of 2009 will be extended until the end of December this year, there will also be a deduction for teachers’ education expenses and a research and development benefit for businesses.
Unemployment has been steadily increasing over the past few months. In Utah for example the unemployment rate in December was 6.7%, up from six percent in August.

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03/10/2010
Major business groups announced on Tuesday a multimillion-dollar advertising campaign to oppose President Barack Obama’s healthcare bill as it draws nearer in a make-or-break voting in the House.
The ad buy, amounting from $4 million to $10 million, is set to start on nationwide cable outlets Wednesday. Later this week, the campaign will shift to around 17 states home to conservative and moderate Democrats. Their votes are vital to the president’s endgame for passing the bill to overhaul the health insurance industry and expand coverage.
The ad comes as Obama builds up momentum in his last healthcare drive. However, congressional Democrats still lack votes to pass the bill, and they are encouraging several of the same legislators targeted by business groups.
Health insurance firms, criticized by Obama regarding a recent wave of premium increases, help in paying for the ads, claimed US Chamber of Commerce’s top lobbyist Bruce Josten, who coordinates the campaign.
“Health care costs will go even higher under this bill, making things even more difficult for business,” he said. “We are trying to tell Congress to stop with this bill and start over, and get it moving in a direction that makes it more affordable.”
Jeri Kubicki, an expert in employee benefits with manufacturing groups, said that employers are holding up the hiring of new employees due to concerns that the passage of the bill would increase their costs.
The ad’s script says: “Health care costs will go even higher, making a bad economy worse.” It advises the public to tell their lawyers: “Stop this health care bill we can't afford to pay.”
The president’s health plan would not demand companies to grant coverage to their employees; however, it would increase the fees of firms, whose employees would get taxpayer-subsidized policies with the new medical insurance market.

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03/09/2010
In an unexpected turnaround, Blue Care Network in Southfield, Michigan, has ended its plan to purchase Physicians Health Plan of Mid-Michigan for 45 million dollars from Lansing-based Sparrow Health System.
Ever since, Attorney General Mike Cox of Michigan and competing health plans have objected that the merger would lessen competition and result to higher costs of health care.
Officials from Sparrow and Blue Cross argued that the acquisition would raise the benefits of both plans’ subscribers by cutting down administrative costs and enhancing services.
Sparrow and Blue Cross believed that the deal would be given regulatory clearance last year. However, a joint statement of the two companies concluded that the deal would not be granted clearance without litigation.
Blue Care President Kevin Klobucar said that unless they could get a federal clearance over a short time, which they have been warned impossible, “a prolonged period of uncertainty would be extremely difficult for client employers, health plan members and employees at both organizations”.
“It was not a desire of either organization to continue to focus our time and resources to litigate this matter”, he further exclaimed.
In a statement, CEO of Physicians Health Plan, Scott Wilkerson, said that PHP intends to continue serving its members.
“Despite this outcome, we are pleased that PHP has operated on a business-as-usual mindset throughout this lengthy regulatory process”, he stated.
According to him, the customer-focused strategy of the company has allowed them to continue to offer “high-quality, cost-effective care that people have come to expect from our award-winning health plan”.

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03/08/2010
As the debate on national healthcare advances in Washington, Illinois residents are experiencing an abrupt increase in medical insurance costs.
Insurance companies in Illinois are increasing their premiums by up to 60% – during a time when they are also enjoying their profits at maximum, according to Senator Dick Durbin, an advocate of President Barack Obama’s healthcare reform bill.
“For those who say go slow, I can tell them this -- the health insurance companies aren't going slow when it comes to raising premiums”, said the Illinois senator at a press conference on Sunday.
According to him, passing the healthcare reform bill would help in changing the existing system, which permits medical insurance to earn while the patients suffer.
”Families are facing skyrocketing costs”, said Durbin. “Emergency rooms are overflowing. Health centers are struggling to meet the increasing demand. Yet insurance companies continue to raise premiums for hardworking families and, consequently, their profit margins”.
Over the past ten years, insurance premiums throughout the country have increased by 131%, while the wages have increased by only 38%, explained the senator. The cost crunch implies that an average of around 11,000 workers in America lose their insurance coverage each day; while the top ten health insurance firms, on the other hand, saw their profits increase by 250% over the last ten years.
Durbin said in a statement that the profits of insurance companies are “the only thing rising faster than insurance company premiums”.
President Obama’s bill will eliminate the unexplained and unprecedented increase in premiums and end the abuses of insurance companies, he claimed.
“It’s what Americans deserve, and we’re too close to let this opportunity pass us by”, said Durbin.

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03/05/2010
A report from Families USA – a non-profit consumer healthcare advocacy organisation – says that failure to pass the reform on healthcare this year would result to around 300,000 premature deaths across the country in the next ten years. Ron Pollack, the organisation’s executive director, explains that the report also considered the conditions from the past fifteen years and discovered numerous needless deaths.
“Approximately 295,000 people died due to a lack of health coverage”, says Pollack. “In Iowa, about 1,600 people between the ages of 25 and 64 died due to a lack of health insurance coverage”. He claims that the organisation has also estimated figures for the next decade if there is no healthcare reform.
In Iowa, the organisation approximates that around “1,500 people will die in the next decade due to a lack of health care coverage, if health reform fails”. Pollack says that on average, it would amount to about “three (Iowans) dying per week over the next 10 years”.
The Families USA executive director states this is mainly because under-insured or uninsured people are less probable to have regular medical check-ups; hence, they are not screened for possible diseases and get no pre-emptive care. Majority of individuals with no health insurance delay treatment though they are already in pain, simply hoping it would go away. Pollack stresses that this situation needs to change.
According to him, numerous people will die unnecessarily and prematurely in the next ten years because “our terribly flawed health care system excludes these ordinary Americans”.
He says that failure to enact the healthcare reform and not doing anything to make healthcare affordable would result to a “huge and terrible cost” and Americans may continuously “pay in tragic, unnecessary deaths” for the next several years.

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03/04/2010
President Barack Obama on Wednesday signed into law the Temporary Extension Act of 2010 (HR 4691), just hours after it was passed in the Senate with a 78–19 vote.
The bill’s main purpose is the extension of health care subsidies and unemployment benefits for unemployed individuals. However, through March 31, 2010, it also extends a federal tax credit, allowing the government to subsidize around 65% of the cost of Consolidated Omnibus Budget Reconciliation Act (CORBRA) premiums. The new law also refined the treatment of COBRA continuation, which results from the reduction of hours consequent to employment termination.
COBRA was initially approved as a part of the American Recovery and Reinvestment Act of 2009, PL 111-5. The provision states that group health plans must consider an eligible individual as having his/her premium fully paid provided that the person pays 35% of the COBRA continuation coverage premium. Those eligible persons may receive the subsidy for over fifteen months, and 65% of the subsidy is reimbursed on the employer by taking credit on their tax returns.
Eligible individuals are those who have been unwillingly terminated from their jobs between August 31, 2008 and April 1, 2010. The bill extended the eligible period’s closing date from February 28, 2010 to March 31, 2010.
The newly signed bill also added particular rules for those individuals who lost their health insurance coverage due to a reduction in their working hours. Under the provision, if a person failed to make COBRA continuation coverage election after his/her working hours have been reduced, followed by an involuntary termination from employment, it will be regarded as qualification for COBRA continuation coverage.

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03/03/2010
The supervisors in Cerro Gordo County in Iowa, US, agreed on Tuesday that individuals employed after July 10th will not be entitled to the health insurance offered to early retirees.
The health insurance of employees taking an early retirement – those aged 58 with 30 years of service or aged 62 with 20 years of service – has been paid by the county until they were eligible for Medicare under a scheme that was launched in 1998.
The insurance policy only included the employees. If they wanted their family to be covered, they needed to pay an extra amount.
According to County Administrative Officer Tom Drzycimski, after 1 July, the insurance coverage would still be accessible to retirees and current employees hired before July 10th, provided that they conform to the minimum eligibility requirements.
He stated that the Government Accounting Standards Board is now requiring local governments to pay for future financial liabilities such as the early retirement program’s insurance policies.
“In order to limit our obligations over time, the county decided to discontinue the program”, Drzycimski further explained.
In a related issue, he told the county supervisors that elected officials, their deputies, and non-bargaining workers will experience an increase of 4.9% in insurance premiums for their family. Cerro Gordo County would continue to pay the employees’ premium on single-coverage.
Employees in the county with family insurance policies will see an increase in their contribution from $234 to $245.60 per month.

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03/02/2010
President Obama is currently exploring four heath care plan proposals, according to a letter he sent to congressional leaders today.
Discussed at the bipartisan health summit last week, the GOP ideas include proposals to expand the use of fraud investigators disguised in patients' clothing to help uncover wasteful behaviour and abuse in federal programs like Medicaid, as proposed by Republican Senator Tom Coburn. Obama has stated he is also open to more ambitious pilot programs to change the rules governing malpractice lawsuits within the medical profession, a longtime GOP issue.
Among the ideas to be added to President Obama's $950 billion plan which were discussed last week also include a proposal by Republican Senator Chuck Grassley, calling for higher Medicaid reimbursements for doctors, and a proposal by Republican Senator John Barrasso to look into the expansion of health savings accounts.
"After decades of trying, we're closer than we've ever been to making health insurance reform a reality," Obama's letter stated. "I look forward to working with you to complete what would be a truly historic achievement."
Obama will discuss an updated version of the plan on Wednesday at the White House, however he stated that other Republican proposals will not be included, nor will proposals that republicans have attacked in recent weeks, such as maintaining Medicare Advantage benefits from Florida residents, and exempting the state of Nebraska from Medicaid costs.

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03/01/2010
House Majority Leader Steny Hoyer promised on CBS’s ‘Face the Nation’ on Sunday that the health care reform would push forward after the historic bipartisan healthcare summit on Thursday with US President Barack Obama.
“We're going to move ahead”, he said in the interview with Bob Schieffer. According to him, the reform on health plans is essential as it will bring down health costs. “We think it will improve the health of America”.
The House’s number two Democrat described Thursday’s summit as ‘extraordinary’.
“I can't remember a similar meeting held by any president, certainly in the 30 years I've been in Congress”, he said. “It was a civil and substantive discussion. I think the American public got the impression that very serious debate and discussion and there were differences”.
However, Hoyer avoided questions on whether there had been enough votes in the House of Democrats to pass the outlined health plans. Although a reform package was approved in the chamber in November, several analysts believe that it may be difficult to acquire the votes next time.
“I don't think we have the votes in terms of a specific proposal because there's not a specific proposal on the table yet”, Hoyer added.
He said he believes that a specific proposal would be set forth within the next two weeks, and then the Democrats would start counting the votes for the bill.
The House Majority leader appeared on the ‘Face the Nation’ program together with Senate Democrat Kent Conrad of North Dakota, as well as Republicans Representative Marsha Blackburn of Tennessee and Senator Tom Coburn of Oklahoma.

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02/25/2010
Congressional Democrats, still holding slight hope for the televised bipartisan summit on medical care, are ready to try a more comprehensive bill in the next few weeks without even one Republican vote.
A bipartisan cooperation appears to be highly unlikely, said the members of the two parties on Wednesday. The insurance reform procedures the Republicans might endorse need Democratic-backed measures that the GOP greatly opposes, like government subsidies to allow low-income Americans to purchase health coverage.
Senator John Cornyn of Texas said that the White House’s health reform program “displaces Texas' priorities with Washington's priorities”.
According to Senate Minority Leader Mitch McConnell of Kentucky, with Democrats reluctant to start from scratch, “I think it's nearly impossible to imagine a scenario under which we could reach an agreement”.
With these remarks, Democratic leaders say that they are hoping to convince House Democrats to take back their objections and support a health bill passed by the Senate last December. In return, the Senate Democrats would be compelled to agree to make several changes under the Senate budget reconciliation policy, which stops GOP delaying strategies.
On Wednesday, the Democrats easily closed on one of the more famous health care concern, as the House had voted 406-19 against the exemption of the health insurance industry from federal antitrust error. Independent experts greatly agree that the change would have the least effect, partly due to the regulatory role the states are already playing.
“In Texas alone, we have seen insurance industry premiums increase by 104 percent since 2000. It's time to open markets and block closed-door collusion”, said Central Texas Representative Lloyd Doggett on Wednesday.
Author: Van Kelsey

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02/24/2010
California lawmakers said on Tuesday that they were surprised by the attempt of Anthem Blue Cross to raise individual insurance premiums by around 39% during a time when the policyholders are striving to pay for health coverage.
A hearing was opened by the Assembly Health Committee to look into the proposal of the largest for-profit health insurance provider in California.
The increase is to take effect on 1 May and will likely affect over 700,000 individual insurance policyholders in the state.
The hearing came in amid an intense national debate on healthcare reform and a day prior to the congressional committee is set to question WellPoint Inc. – Anthem’s parent company.
“How are Californians supposed to afford health insurance with these rate increases?” asked Democratic Assemblyman Dave Jones from Sacramento, California, upon starting the hearing. “What level of profit is enough?”
Jones, who is the committee’s chairman, said that the state could not wait for the federal government to take action.
California has an obligation to protect its businesses and consumers from “outrageous rate increases”, he explained.
According to Anthem, it needs to boost premiums partly because healthier, younger individuals have been abandoning health insurance coverage since the recession, passing it on a group of policyholders who are older and much more in need of healthcare services.
The most recent increase would total to 25%; however, for those who have acquired individual policies, it could reach to 39%.
The firm’s 7.3 million remaining policyholders in California are within employer-sponsored schemes and will not be affected, said Anthem’s spokeswoman Kristin Binns.
Author: Mark Kelsey

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02/23/2010
On Monday, US Representative Leonard Lance of New Jersey disclosed a legislation he has written that will assure that preventative services, like mammograms, cannot be refused coverage by health insurance providers or group health plans as an effect of federal rule.
At the Summit news conference, authorities connected with the North Jersey and Central/South Jersey Affiliates of Susan G. Komen for the Cure declared their support for Lance’s bill, entitled "Safeguarding Access to Preventative Services Act of 2010."
The bill came as a response to the declaration made by the US Preventive Services Task Force which stated that women should only receive a mammogram whey they reach the age of 50, a proposal Lance and cancer groups have strongly rejected.
Lance said that, “While we don't know the cause or cure for cancer, we do know that early detection is still the best protection. My bill would make sure that women can't be denied coverage for the preventative screenings they need despite the misguided federal guidelines."
Those who joined Lance at the news conference include Dr. Jan A. Huston of the Medical Advisory Council of Susan G. Komen for the Cure North Jersey, Deborah Q. Belfatto of Komen North Jersey Affiliate, Lisa Berkower of Komen North Jersey Race for the Cure, and Nancy Healey of Komen Central and South Jersey Affiliate.
Barbara Waters, Advocacy for the North Jersey Affiliate of Susan G. Komen for the Cure’s co-chair, said: “Breast cancer continues to be the most commonly diagnosed cancer in women. It is important that we continue to work to increase awareness and maintain access to life-saving screening measures."
Moreover, the legislation would forbid the US Secretary of Health and Human Services from employing any proposal of the US Preventive Services Task Force to decline coverage for a service or an item by health insurance providers or group health plans.
Author: Avery Smith

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02/22/2010
In Lake County, California, several months after the Board of Supervisors’ approval to give eligible employees a one-time stipend worth $700 from a health insurance assistance holiday, the supervisors have also recently accepted the payment. All of them have pledged to give their respective shares to charity.
In November and December, Lake County accepted a “premium holiday” from its respective insurance carriers, which was approved last year by the board to be returned to employees through a one-time stipend.
Presently, the decision lies with the board on whether to accept the reimbursement for the members, who also contribute into the county’s medical insurance plan.
Supervisor Denise Rushing has raised concern on how the board could cast their vote on an issue that would aid its members financially. However, County Counsel Anita Grant stressed that this process can be compared with the board’s vote for salary increases.
Supervisor Rob Brown stated that the board has the option not to accept it. However, he also proposed that they can also accept it and give it to community groups.
Board Chair Anthony Farrington noted that the only manner in which he can cast his vote on it is if a regulation can specifically identify where he would be giving the money. He also inquired whether the auditor-controller of the country could write the check for him so that it will be given directly to Hospice Services of Lake County and Clear Lake High Sober Grad.
Supervisor Jeff Smith also said that it would be disappointing if the ordinance was not approved. “I think it's a good way to get some money out there in the community,” he added.
Brown decided to advance the decree to February 23, which was seconded by Comstock. It was approved 4-1 on its initial reading, with only Farrington rejecting it.
Author: Van Kelsey

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02/19/2010
On Thursday, majority Democrats stated that they will back an initiative that would compel health insurance providers to offer justification for sizeable rate increases, and to be more receptive regarding factors that can lead to cuts in rates.
House Commerce Committee Chairwoman Representative Janet Petersen said that action on the initiative could be reached in the coming week. She contended that immediate action was necessary to tackle this disturbing trend in the insurance industry.
She said, "We really do not have a full picture of what is impacting Iowans' health care costs. This is a good first step in having more accountability.”
The initiative was influenced by the announcement of Wellmark Blue Cross Blue Shield of its plan to increase the rates of medical insurance for approximately 80,000 Iowans by 18%.
Under this new initiative, the Insurance Commissioner of Iowa would be obliged to make an itemized report regarding health expenditures, including health care expenses, data on rate increases, and factors associated with medical insurance costs.
Moreover, Senator Becky Schmitz said that she will advance the initiative in the Senate.
She said, "As lawmakers, it's our job to ensure that the insurance rate hikes are justified, and that the insurance companies aren't taking advantage of small businesses and families."
Des Moines Wellmark spokesman Rob Schweers said that the company is open with the details of the increase of insurance rate. He reiterated that the increase was essential so that they can meet the demands on health care.
Senate Majority Leader Michael Gronstal also said that he will support the initiative, which will give state regulators the power to collect more information on the issue.

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02/18/2010
Consumers in a minimum of four states who purchase their own medical insurance are being burdened with 15% or more premium increases. It is said that consumers in others states might also experience the same predicament.
WellPoint Inc.’s subsidiary Anthem Blue Cross has been criticized by politicians and regulators for the past week because it has notified its individual policy holders, numbering to 800,000, in California that it is planning to increase rates by possibly 39% on March 1.
The Indianapolis-based WellPoint stressed that it must increase its rates because the low economy has caused fewer people to remain in California’s individual insurance market. Added to this, a great number also have critical health problems. The company said that their healthcare costs have risen because the fees of healthcare providers have also increased and diagnostic tests have been commonly used.
In Oregon, various insurers were allowed to implement a 15% increase this year. This came after a 25% increase had been assigned last year to customers who buy individual health insurance, instead of acquiring the coverage through their respective employers.
Moreover, premiums are more unstable for individual policies in comparison with those purchased by large groups and employers. And as more individuals become unemployed, the healthy ones have opted not to have health insurance, reducing the number of premiums acquired by insurers.
The National Association of Insurance Commissioners’ Sandy Praeger said on Friday that increases of 20% to 30% will be observed on individual health plans in the near future. She noted that most states do not have the legal power to reduce or block the rate of increases on health insurance.

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02/17/2010
Georgia Governor Sonny Perdue has recently announced that Representative Matt Ramsey, a floor leader for the governor in the House, has instituted House Bill 1184. This legislation is set to increase access to medical insurance.
“This legislation will open up the individual insurance market and allows consumers to find the plan that best fits their needs,” the governor said. “It will also help those that are uninsured find a plan that works for them.”
It is said that the legislation will permit families and individuals to purchase health plans that were already approved for sale in other US states. Insurers who are licensed to operate in Georgia, but who also have other products that are marketed in other states, will be allowed to vend those policies in Georgia too.
Added to this, permitting the acquisition of medical insurance across state lines will enable reasonably priced health insurance to become more accessible. It will also increase the kind of health plans that can be offered to Georgians.
Representative Ramsey stated, “This legislation empowers Georgians to find a health insurance plan that meets the needs of their family.”
Governor Perdue initially publicized this proposal on health insurance in January. He made use of the Georgia Chamber of Commerce’s Eggs and Issues breakfast to inform his constituents regarding this measure on health care reform.

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02/16/2010
The IRS said that it will help Michiganians who were forced to purchase medical insurance after losing their employment because of foreign competition or because their retirement benefits and pensions were terminated.
Den Black, who is representing retirees of bankrupt car supplier Delphi Automotive LLP, said: "It has literally made the difference for people who were bankrupt or foreclosed upon, where they have a chance to survive economically."
Those employees lost their life and health insurance coverage last year and will have reduced pensions now that the US government’s pension insurance provider, Pension Benefit Guaranty Corp., has absorbed the responsibility to continue the health plan.
The IRS is implementing some measures to publicize the Health Coverage Tax Credit, which aims to refund 80% of premiums on health care and can help in settling the majority of the premiums every month thereafter. This credit covers individuals whose employment loss is verified by the Trade Adjustment Assistance Act, and those aged 55 and above whose pension arrangements have been assumed by the pension board.
The tax credit can be claimed by employees as a form of refund by completing IRS Form 8885 and the proper documents accompanied by a federal tax return. They can also sign up with the IRS so that IRS can charge them 20% of premium on health insurance, with the IRS completing the required payment every month.
Luis D. Garcia, the spokesman of IRS in Detroit, said that 40,300 employees in Michigan are qualified for the program. He added that, "Having this kind of help with your health insurance premium can be a game-changer for people, and really increase their quality of life."

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02/15/2010
Jayme Martinez, who belongs to a legal group connected to the University of Nevada‘s Boyd Law School in Las Vegas, is helping prepare a legislation that can assure boxers that they have health insurance coverage upon entering the ring. Martinez was greatly inspired by the medical condition of Filipino boxer Z ‘The Dream’ Gorres, who had a brain injury and suffered from partial paralysis after fighting in November 2009 at the House of Blues in Mandalay Bay. Gorres’ medical expenses at the University Medical Center (UMC) reached approximately $600,000, but his medical insurance only managed to cover $50,000 of the medical costs.
Martinez said that the boxer’s condition pushes them to help boxers in securing health insurance.
She, together with law teacher Robert Correales and law students Ryan Devine and Jonathan Winn, met with Gorres and asked the boxer whether there is an urgency to increase the health insurance of boxers. Gorres said boxers need help.
Gorres’ medical expenses will be partially shouldered by the taxpayers of Southern Nevada because the current state legislation only requires boxing promoters to assign $50,000 worth of medical insurance for every boxer before a fight.
Dr. Benito Calderon, who monitors Gorres’ medical condition, befriended the boxer after the bout that transformed his life. After Gorres was released from the UMC, Calderon has been helping the fighter in his rehabilitation.
Moreover, Martinez has been working to promote boxers’ safety because her husband also trains young boxers. She has also started researching on the injuries of boxers in Nevada, with the goal of determining the amount of health insurance that should be given to them.
Author: Warren Blumberg

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02/12/2010
On February 1, Congressman Joe Sestak of Pennsylvania held a town hall-style conference at Eastern Univeristy with local residents, students and faculty. He is currently the 7th district’s representative, and is eyeing to defeat Senator Arlen Specter to become the official candidate of the Democratic Party in the senatorial elections in 2010.
He opened the meeting by emphasizing his priorities, which include establishing more jobs, promoting “accountable leadership”, and passing the House healthcare. He reiterated the need to pass the bill, which has now become controversial. Concerns regarding healthcare reform were the major topics during the meeting.
Sestak stressed his support for compulsory individual health insurance, saying that when uninsured people get ill, taxpayers generally shoulder the bill. When asked how he can aid college students in paying for their mandatory medical insurance, he said the House’s healthcare bill would permit youths to be covered by the insurance of their parents until they are 27 years old.
He emphasized the need to initiate measures to stop individuals with pre-existing medical conditions from being excluded in getting health care, and assured that there will be equality in gender in terms of insurance prices. He also stressed that he will help small businesses to keep healthcare costs at manageable levels.
Meanwhile, Sestak trails Senator Specter in terms of voter polls party support and recognition. Specter has been a prominent figure in the politics of Pennsylvania since he was elected in 1965. This is his first time running as senator since changing affiliations from Republican to a Democrat in April. The primary voting will be held on May 18.
Author: Mark Kelsey

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02/12/2010
The healthcare legislation might have been suspended in Congress; however, the $80-billion employment legislation’s draft that was just released by the Senate has several provisions on healthcare.
While Majority Leader Harry Reid is preparing to propose the legislation’s final version before the month ends, experts are already inquiring whether this jobs legislation is another form of health-care reform. Last December the House passed it’s own version of a jobs bill that amounted to $154 Billion.
The provisions being considered by the Senate employment legislation include a Medicare physician compensation fix which will last for seven months. This will prevent scheduled Medicare reimbursement cuts to physicians, and delay a possible 21% payment cut to doctors.
People who are newly unemployed would receive an extension of three months to their individual health insurance to aid them to continue purchasing insurance coverage through their former employers.
An upward alteration in the computation of Medicare Advantage compensation rates for 2011 will also be included.
Moreover, the provisions propose payment extensions of one year for Medicare programs like ambulance add-on fees, Medicare Part B treatment caps, improved payments for services on mental health, and extensions related to the Long Term Acute Care Hospital Moratorium, which is scheduled to expire in December 2010. The majority of these provisions are only temporary. They are aimed at maintaining programs until lawmakers can settle concerns through healthcare legislation towards the end of the year.
It is expected that Senator Reid will attempt to bring the final legislation to a vote for the succeeding two weeks.
Author: Avery Smith

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02/11/2010
Key Senate Democrats unveiled last Thursday a health care revamp bill that imposes a fine of more than $1,000 for Americans who refuse to avail themselves of affordable health coverage. The bill aims to fulfill the top domestic priority of President Barack Obama. In a statement, Obama supported the legislation saying that it “reflects many of the principles I’ve laid out, such as reforms that will prohibit insurance companies from refusing coverage for people with pre-existing conditions and the concept of insurance exchanges where individuals can find affordable coverage if they lose their jobs, move or get sick."In the proposed health care system, it would be an obligation for citizens to be covered by health insurance as it is necessary for motorists to get auto insurance coverage now. The government would also subsidize health insurance for the poor and even for middle-class families. However, those who decline to apply for health care coverage would face penalties.  As estimated by the Congressional Budget Office, the said penalties can raise $36 billion in 10 years. The penalty system is patterned after the method used in Massachusetts, which imposes an annual penalty of about $1,000 per individual who declines to get medical coverage. Federal legislation also dictates for the fines to be higher on families. Data from a survey by the Kaiser Family Foundation show that in 2008, employer-paid health care family plans averaged at $12,680 while individual plans were at $4,704. It is estimated that the cost of the revised federal health plan will be less than this.The penalties will be set at half the price of basic medical coverage. Called “shared responsibility payments,” the penalty aims to urge people to avail themselves of a health plan while they are still healthy and not wait until they get sick. Penalties shall be collected through the income tax system.  Author: Warren Blumberg

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02/11/2010
Key Democratic senators are pushing for a government-managed insurance policy to provide alternatives that will compete with private health plans. This proposal, which aims to help President Obama’s health care reform, will also require large companies that do not provide insurance to their employees to pay an annual fee of $750 per worker. Democratic Senators Edward M. Kennedy of Massachusetts and Christopher Dodd of Connecticut said that the modified proposal would be cheaper compared to its previous version. The revised proposal aims to cover up to 97 percent of the American population.Two weeks ago, the Congressional Budget Office estimated the cost of the previous proposal at $1 trillion over 10 years. The revised proposal on the other hand will cost around $611.4 billion. This modification on the actual cost of the proposal also “virtually eliminates” the earlier prediction that many companies would be forced to drop health insurance coverage for their employees.On Wednesday, the two senators wrote to the members of the Senate Health, Education, Labor and Pensions Committee in anticipation of the return from vacation of lawmakers to the Capitol.As early as next week, the Health Committee could finish its version of the bill. A party-line vote is virtually guaranteed because of the proposed government-run health insurance alternative.On the other end, the Senate Finance Committee is working separately towards a companion measure that aims to achieve a bipartisan concession. At the end of the month, the three House committees working on the legislation are expected to arrive at a vote that is sure to include the proposed insurance option from the government.  Obama is pressing for Congress to pass legislation within the year. Author: Van Kelsey

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02/11/2010
WASHINGTON – From the very start, President Obama’s administration has been working hard to sell health care reform to the middle class as part of the solution to increasing medical costs, and not just as something costly for the benefit of the poor.But with the way legislation is being shaped by Congress, the most important issue yet to be addressed is whether the extent of the benefits for the middle class will be sufficient to gather their support.Back in the 1990s, President Bill Clinton’s health insurance regulations failed because of the “Harry and Louise” ads. The insurance industry used these ads to suggest that Clinton’s health plan was “a bad deal” for the middle class. Even though recent polls suggest some public discontent with the way Obama is handling the issue, the President is yet to go down the same road as Clinton.According to Len Nichols, New America Foundation’s health policy program director, the middle class’ decision will decide the fate of this year’s health care debates. "It will come down to Obama's portrayal of the benefits of the new world," and his solutions to the rising cost of insurance premiums. "All this is complicated. All this is hard to show.”Obama is selling a different payoff to Americans who are going to shoulder most of the bill that will cover the uninsured. Even though the portrayed payoff is generally appealing, quantifying it would be more difficult to do as compared to the subsidies needed to help cover the poor. The President wants the public to underwrite the cost of legislation and look forward to smaller premium increases in the future and guaranteed coverage. Author: Mark Kelsey

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02/11/2010
The purpose of health insurance is to provide medical and financial protection. But according to estimates, three-quarters of those who filed for personal bankruptcy due to medical problems were actually insured.As Washington pushes to cover almost every American in the proposed health insurance reform, many health-policy experts agree that having everyone insured will not fix the rough edges of the system. With many people already covered, a medical crisis would definitely mean financial calamity.Lawrence Yurdin, a computer security specialist, filed for bankruptcy even though he had medical insurance. The 64-year-old’s Aetna policy indicated up to $150,000 worth of coverage per year. However, almost his treatments at a hospital in Austin, Texas, were not covered by his policy. Last December, Yurdin and his wife filed for bankruptcy with $200,000 worth of medical bills to pay.Lawmakers are struggling with legislation details that would create minimum insurance coverage standards. With the expensive price tag, lawmakers could lean toward less comprehensive coverage for some policy holders.However, patient advocates stress the necessity of laying down basic levels of insurance coverage to protect individuals like Yurdin from bankruptcy. They also want new federal rules that would prevent some insurance firms from selling worthless and incomprehensive policies.According to Elizabeth Warren, a law professor from Harvard who studies medical bankruptcies, “Underinsurance is the great hidden risk of the American health care system. People do not realize they are one diagnosis away from financial collapse.”Republican senator Charles E. Grassley from the Senate Finance Committee points out the same thing as he emphasizes the need to make “meaningful” insurance policies more accessible and affordable. “Until that happens,” Grassley continued, “any presentation of limited-benefit plans ought to be completely straightforward, and not misleading in any way.” Author: Warren Blumberg

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02/11/2010
Standard Insurance Company (“The Standard”) recently signed a partnership agreement with Health Advocate, one of the leading health advocacy and assistance companies, in a bid to simplify healthcare plans and services. The Standard, a subsidiary of StanCorp Financial Group, Inc., announced today its new offering—the Health Advocacy Solution—in collaboration with Personal Health Advocates.Luce Giroux, Second Vice President of Product Management at The Standard, said that the Health Advocacy Solution would help increase worker productivity by reducing the employees’ stress in navigating the healthcare system. “The Health Advocacy Solution offers direct access to our Personal Health Advocates who will provide more efficient ways of solving healthcare-related issues.” Giroux said the Health Advocates are mostly nurses or well-trained assistants who will help workers navigate the usually complex healthcare system. They will help locate doctors, explain and clarify billing statements and negotiate fees, explain benefits plans and healthcare-related terminology, and even give assistance on issues related to prescription drugs.  Moreover, the Health Advocates, backed by medical doctors and other health experts, also extend their help to their client’s spouse, parents, parents-in-law, and dependent children. Regardless of industry, groups with at least 10 employees can avail themselves of the Health Advocacy Solution at a discounted rate, in addition to The Standard’s other health insurance plans and services.  David Rocchino, Chief Sales Officer of Health Advocate, Inc., also expressed his gratitude for The Standard’s partnership with his company. “We are indeed very pleased to be part of The Standard’s offering. Our advocacy complements their services and programs… This new service can help clients save time and money,” he added. Author: Van Kelsey

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02/11/2010
President Obama will visit northern Virginia on Wednesday to hold another town-hall meeting as he continues to push for the overhaul of the country’s healthcare system. Those who want to participate in the event are encouraged by the White House to send questions and video responses online. People can visit the White House’s official Web site or connect through social networking sites like Facebook (http://facebook.com/Whitehouse) and Twitter (#WHHCQ). According to Sheryl Gay Stolberg of “The New York Times,” Obama’s administration has created a multi-pronged strategy to help the president promote his health plan to the public. The strategy aims to persuade government officials outside of Congress, like state governors, to help by acting as Obama’s emissaries. However, the strategy contains many potential risks, like funding problems, which will be tackled by lawmakers when they return to Capitol Hill next week from recess. “If Mr. Obama waits too long to exert his presidential muscle to forge consensus on Capitol Hill,” Ms. Stolberg warns, “his moment of opportunity could pass. He could also lose control of the final outcome if lawmakers cut backroom deals he dislikes, for example, by deciding to pay for the expansion by taxing employee health benefits, a move that worries Mr. Obama’s political advisers because it could cause the president to break a campaign promise.” According to senior adviser to the president, David Axelrod, the administration wants “as many people as possible” to take part in the nationwide discussion about the healthcare reform.Dan Balz and Shailagh Murray of the “Washington Post” analyze the administration’s plans. Just like healthcare, the energy and immigration bills will also face tough opposition in the Senate. Author: Avery Smith

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02/11/2010
Despite the strain of soaring costs, the government is continuing to head towards a huge health care overhaul, which, it is feared, will lead to sky-high costs for everyone. Americans are supportive of President Barrack Obama’s proposed health insurance reform plan yet many are worried about its impact.In a forum held last week at the White House, which was broadcasted live on the ABC television network, President Obama presented his health insurance reform plan to the public. Obama confidently answered questions on his proposed insurance reform, including questions relating to how people can keep their existing individual insurance plans.A fact check on the President’s speech and his answers to questions show that he is eager to pursue his reform but that he sometimes glosses over details in his explanation of how he plans to make the reform successful.The president campaigned for his health care plan and informed the audience that the costs of health care have increased three times faster than wages in the United States. Some studies, however, like the one prepared by Family USA, a group that is advocating for reforms in health care, reveal that heath care insurance costs have actually increased five times faster than wages in the US, as reported in October 2008.The president said, “If you are happy with your current [health care] insurance plan and happy with your doctor, we don’t want you to have to change.” However, some speculate that the president’s plan cannot change the fact that private companies have the freedom to choose the health care plans of their employees.Moreover, it has been found that Americans find it important for President Obama to offer a reform on health care without adding to the national deficit. But the price tag for this health care proposal is pegged to be between $1.3 and $1.6 trillion, which means it will clearly need more revenue for it not to add to the deficit. Author: Warren Blumberg

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02/11/2010
Most health insurance providers in Guam will start covering ambulance services as the Guam Fire Department starts to charge fees for the use of ambulances on July 1.According to Bri Hosei Habin, Health Care Management Division chief at Moylan's NetCare Life & Health Insurance program, various health insurance plans provide different levels of coverage for ambulance services. This means that a subscriber must pay ambulance fees or make a co-payment if he does not meet his health insurance deductible.Based on Public Law 29-02, the Guam Fire Department will charge $95 for non-emergency ambulance services and $195 per transport for emergency ambulance services.The bills for the services rendered will be mailed to health insurance providers while those uninsured will be charged directly, Edward Cruz, Fire Chief Aide, said during a press conference.Cruz said that beginning July 1, the Guam Fire Department will issue ambulance invoices and bill health insurance providers.Invoices for non-emergency purposes will cover the transport only while the fees for emergency services will include equipment and supplies used to provide medical care, such as a defibrillator, masks and oxygen, Cruz added.Cruz also said that the funds from the ambulance services will be utilized to train personnel and maintain medical equipment.Calvo's Select Care program health plan administrator, Frank Campillo, said that most ambulance services in the country’s mainland are offered by private companies. He further added that ambulance services are given by most health insurance companies in the island but that the Guam Fire Department did not charge for this before and will only start charging for them now. Author: Avery Smith

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02/11/2010
For small-business owners, maintaining their workers’ health insurance is becoming increasingly difficult with the soaring costs and a weak economy.Pedro Alfonso, owner of the small telecommunications firm Dynamic Concepts Inc. said subsidizing the health plans of his 85 employees now entails out-of-pocket costs. Alfonso says that before, his company could afford 70% of its workers’ insurance premiums. Now, however, it can only pay 35%.Alfonso, 61, said that rising health costs is hard for workers. “But it’s also hard on us,” he added.Small companies, such as Alfonso’s, are among those which the non-partisan Congressional Budget Office (CBO) is concerned about. With higher health costs, 15 million people employed in small companies may lose their health plan benefits or may voluntarily drop their health insurance. Moreover, about 10% of small-business employers are now contemplating dropping their workers’ health coverage next year due to the sky-high health care costs. Based on an incomplete bill in the Senate Health, Education, Labor and Pensions Committee, employees working in small companies are more vulnerable, especially if their company is paying for high premiums.  Policy analyst at the Heritage Foundation, Greg D’Angelo, agrees that the current insurance system does not work for owners of small companies. “The number of people who will lose their health-plan benefits depends on what the lawmakers are still negotiating,” he added.Based on CBO estimates, over 10 million people who receive low wages would choose to terminate their current, high-cost insurance plans. With the government’s proposed health care overhaul, workers at small firms will most likely buy cheaper insurance in the open market. Author: Mark Kelsey

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02/11/2010
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), the federal economic recovery plan offers a subsidy for employees who wish to continue their health insurance after job loss.  As long as they are qualified for a new health insurance plan, the subsidy will pay 65% of their insurance premium for nine months.COBRA offers continuing group/business health insurance for workers who lost their jobs. Signed into law in February 2009, this new subsidy covers involuntary job loss between September 1, 2008 and December 31, 2009, and applies to those who were terminated for any cause as long as it was not because of gross misconduct, as set in the IRS guidelines. Workers cut in large layoffs may also avail themselves of the subsidy.In a notice, the IRS explains, “If the company would have terminated the employee’s services and the employee had knowledge that he/she would be terminated, the retirement is involuntary.”  Moreover, although COBRA mostly covers offices with at least 20 workers, smaller companies or groups that are under state mini-Cobra plans may also avail themselves of the subsidy. If the employee worked in a company that pays for COBRA premiums, he/she is only required to pay 35% of the total health plan for up to nine months.Once qualified, a laid-off employee can use the Health Coverage Tax Credit, which shoulders 80% of health premiums for retirees that receive financial support from Pension Benefit Corporation. This also covers workers who lost their jobs due to technical modernization or deferral trade policies. Workers who do not qualify for the subsidy are those who have a gross income of more than $125,000 a year or $250,000 for joint filers. Author: Van Kelsey

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02/09/2010

A proposed health insurance plan for the employees of Fair Lawn Borough, New Jersey could take effect on April 1.
 
Borough Manager Joanne Kwasniewski, in a letter addressed to borough workers, said that the agreement between Insurance Design Administrators (IDA) and the borough relating to a self-insurance program will be laid out for approval through via resolution at the council meeting on February 9.
 
Borough authorities recognized the proposed change to a self-insurance program at the council’s meeting on January 25 while trying to control concerns between the local unions regarding changes to their health benefits.
 
The present union contracts allow the borough to change the medical insurance scheme; however, the borough must offer "equivalent or better coverage" in any program of insurance.
 
Kwasniewski said, "I want to emphasize again that the exact same benefits that are provided in the Horizon (Blue Cross and Blue Shield) plan will be the benefits provided under the borough’s self insurance program."
 
Mayor Joe Tedeschi said that the borough’s present insurer, Horizon Blue Cross and Blue Shield, has planned to raise its rate in 2010 by 25%. This influenced the borough to consider a self-financed insurance plan. Tedeschi has projected that the borough can save $1 million under the new insurance plan.
 
Robert Ventrella of IDA mentioned in an interview that if his company’s arrangement with the borough will be formalized, IDA would then proceed to cover about 350 borough employees under the specifications of the borough. 

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02/08/2010

HealthNow New York is spreading out its local third-party administrator based in Pennsylvania to cover national operation. It hopes to take advantage of the growing trend of employers in self-insuring their corresponding healthcare costs, although they are in need of someone to administer their health plans.
 
The Buffalo, New York-based parent company of Blue-Cross BlueShield of Western New York is establishing a new company, HealthNow Administrative Services, to offer outsourcing and administrative services covering self-financed benefit plans.
 
HealthNow already acquired Philadelphia-based Brokerage Concepts in 2006. During that time, it was already serving 900,000 participants and 5,000 clients.
 
The company noted that the new company will handle clients in the mid-Atlantic states and New England, while Brokerage Concepts will continue to operate in Pennsylvania.
 
It has also started trading employee benefit services and products across the US. It aims to develop a business which can cover the whole country.
 
HealthNow Chief Executive Officer Alphonso O’Neil-White said, “We believe there’s a significant market out there.”
 
The company has already opened a client and sales administration department in Dallas to serve the Southwest. Additional staffs are also deployed in Phoenix, Louisville and Boston to aid with countrywide services and marketing. O’Neil-White cited Arizona, Kentucky, Texas and California as among the states that are attractive. This development in HealthNow’s operations focuses on broadening its services and products to stay competitive, particularly with national insurers. 

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02/07/2010

This week, the House of Representatives is planning to cast their vote on – and probably pass – a bill which aims to remove the antitrust protection of health insurers. This is considered as Congress’ initial step in its desire to overhaul the health care system of the US.
 
Independent experts said that the plan to eliminate the 65-year-old exemption will not affect consumers that much. Center for Studying Health System Change’s Paul Ginsburg stated, “I don’t think this will have much effect. This is strictly political posturing.”
 
This action of the House is done to reactivate the stalled efforts of Congress on medical care. The health plans were greatly affected when Republican Scott Brown won the senatorial race in Massachusetts, once occupied by Democratic Senator Edward Kennedy. 
 
Dialogues on health care reforms have been initiated by the Senate and House Democratic leaders; however, not much progress has been achieved. 
 
Boston University’s Austin Frakt said, “The market power of insurers has been blamed for increased health insurance premiums." He also said that the rising costs emanate from the money which goes through insurance associations to providers of health care, such as hospitals and doctors.
 
Ginsburg has also mentioned that insurers are now prohibited from conspiring to merge and from increasing their prices. 
 
Moreover, the bill will have a hard time in the Senate. Leaders of the House note that putting an end to the antitrust exemption will help consumers. They are also hoping that the health care initiative will benefit freshmen Democrats, who will be judged in the elections in November. 

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02/04/2010

Lawmakers in Missouri are closing in on their goal to ensure that medical insurance providers offer coverage for autistic children. On Wednesday, the Senate and House committees voted to pass legislations that would ensure coverage for treatment and diagnosis for persons up to 21 years old.
 
Gov. Jay Nixon has expressed his concern on this medical issue in his State of the State speech wherein he said that, "Children with autism shouldn't have to wait for their parents to come up with the cash or for insurance companies to grow a conscience."
 
Rep. Kevin Wilson, chairman of the House Health Insurance Committee, mentioned that an undisputed bipartisan backing for autism legislation is prevalent in the committee. The committee also modified bills that were previously submitted to form a new legislation which contained a ranked approach to insurance coverage. If approved, this new legislation would give younger children more benefits in comparison with young adults and teenagers. 
 
Rep. Dwight Scharnhorst is hoping that he can negotiate some changes to the new legislation when it will be submitted to the conference committee. "They're out there struggling and in need, and we've got a lot of little people that we want to make sure that they have the opportunity to have a value of life comparable to anyone else and hopefully an improvement," he said.
 
It is thought that one in every 110 children in the United States have some form of Autism Spectrum Disorder.

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02/03/2010

Democratic Senator Jim Brochin of Baltimore County has sponsored a bill that will allow individuals aged 25 to 29 to be covered by their parents’ medical insurance. However, members of insurance industry have confided to the Senate Finance Committee that this expansion could cause employers to stop coverage and insurance providers to increase their rates.
 
The bill will compel insurance providers in group and individual markets to lengthen the age of eligibility of dependents for medical insurance to 30 years old. On the other hand, it will exempt small companies that have 50 or less workers.
 
A fiscal expert has projected that the bill will cost Maryland $3.8 million in 2011, and by 2015, the cost will reach $24 million. This is due to the fact that eligibility keeps on growing as well as medical costs rising.
 
Brochin refuted these claims in a hearing on Wednesday. He insisted that people who are in their mid to late 20s are generally quite healthy.
 
Maryland Chamber of Commerce’s Ron Winehold said that his organization did not object the expansion of eligibility of dependents to 25 years because the General Assembly approved it in 2007. However, he commented that increasing the age to 30 is not feasible.
 
Prior to 2007, children could be covered by their parents’ medical insurance until they the age of 19 and in the case of college students, they were eligible until they were 23. The 2007 legislation has permitted dependents to be covered until they are 25, whether they are students or not. 

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02/02/2010

On Tuesday, Republican lawmakers have proposed a constitutional amendment that they said was targeted at impeding any kind of federal mandate that would require Kansans to purchase medical insurance. They said that the initiative was imperative due to the possibility of passing a Democratic health reform in Congress, which requires medical insurance coverage.
 
Senator Mary Pilcher-Cook said, “We can provide health-care reform in our state without forcing citizens to take certain actions, and we can provide good health care in Kansas without putting citizens at risk of being sent to jail.”
 
The “Kansas Health Care Freedom Amendment” is outlined after a proposition by the American Legislative Exchange Council (ALEC).
 
Christi Herrera, ALEC’s Health and Human Services Task Force director, insisted that health care option is still an issue in civil liberties.
 
The Kansas Republican legislators supporting the amendment include House members Todd Tiahrt, Lynn Jenkins, and Jerry Moran as well as approximately 15 state lawmakers. Representatives Brenda Landwehr, Peggy Mast, and Pilcher-Cook were the ones who introduced the amendment.
 
Glenda Overstreet of NAACP has labeled the measure as “disingenuous.” She also said that without the reform on health care, insurance providers will continue dropping coverage relating to pre-existing conditions. In addition, she said that 300,000 Kansans who have no insurance will not be given a chance to be covered.
 
The proposal will be discussed on Tuesday. If it can pass the scrutiny of the Senate and the House, it will be included in the November election to be decided by Kansas voters. 

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02/01/2010

Legislators in Missouri have enforced an order to stop the operations of various companies that have promised health plans, though in reality they have left thousands of dollars’ worth of unpaid medical expenses to a lot of consumers.
 
The order from the Missouri Department of Insurance’s consumer affairs division, which was filed on Monday, insisted that 12 individuals and 14 companies must answer the charges of defrauding Missouri consumers. The companies were ordered to be present at the February 17 hearing to answer the allegations. They could receive a fine of $250,000 as well as cease-and-desist orders.
 
The charges stemmed from the complaints of around 150 consumers who have purchased services from these companies that were promoted as insurance, utilizing the terms “Group Health Plan,”  “dependent coverage,” and “PPO.” Moreover, some of these companies have promised low-cost medical insurance.
 
Missouri has started administrative enforcement measures against the following companies: Beema-Pakistan Assurance Ltd. a/k/a Beema-Pakistan Co. Ltd.; Serve America Assurance Ltd. a/k/a Serve America Assurance Ltd. Co. a/k/a Serve America Assurance; Professional Benefits Consultants a/k/a PBC Direct a/k/a Professional Benefit Consultants of Del. Inc.; National Alliance of Associations; Affinity Group Benefits Association Inc.; Peak Membership Alliance; Spencer & Associates LLC; Real Benefits Association; Americans for Affordable Healthcare Inc.; and Smart Data Solutions LLC, among others.
 
Missouri Department of Insurance Director John Huff further said, “State law provides severe punishment for any company selling unauthorized health plans in Missouri.” 

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01/31/2010

The American Cancer Society said that the medical bills of cancer patients who depend on oral chemotherapy for treatment accumulates much faster than cancer patients who receive intravenous chemotherapy as treatment.
 
The American Cancer Society’s Dana Dzwonkowski mentioned that under various health plans, expenses can reach as high as $9,000 each month for a treatment such oral chemotherapy. This treatment, in most instances, belongs to the pharmacy benefits of a patient, and it is not subjected to the stipulations of a plan on health insurance, she added. 
 
Relative to this, Representatives John Kefalas and Randy Fischer have affixed their signatures on House Bill 1202, with the conviction that this can help the financial problems of patients undergoing oral chemotherapy. The American Cancer Society further said that patients who undergo such treatment comprise 15 to 20 percent of all patients with cancer.
 
The bill is set to require all medical insurance plans that cover intravenous chemotherapy medication to offer coverage for oral chemotherapy medication under a similar patient cost.
 
Kefalas said that the bill “creates greater equity, and it helps cancer patients because a lot of times insurance plans don’t cover oral chemotherapy.”
 
Moreover, Fischer stated that he signed the legislation because he is convinced that chemotherapy must be covered by insurance schemes, despite the kind of technology utilized.
 
Dzwonkowski said that, “There are a lot more situations now where oral chemo-therapy is the only kind of chemotherapy that can treat some kinds of cancer.” She added that oral cancer medicines are very expensive, and only two of these generic drugs are available in the market. 

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01/30/2010

The rising cost of health insurance prevents employers from availing this benefit for their employees. Despite the fact that it can attract many applications from the brightest and the best in the industry, it can require a very large budget from a company.
 
The health insurance cost is the main obstacle in providing the workforce a health plan. However, there are many options available where people can obtain health insurance plans that are affordable. One option is by creating or joining a health insurance co-op to reduce the costs of the total health plan package. Small businesses employ this type of health insurance to achieve a win-win situation for both employers and employees.
 
Group health insurance can be far more reasonably priced than many employers believe.
 
The Consumer-directed Group Insurance Plan is preferred by many different sized companies. This health insurance plan provides low monthly fees for both the employers and the employees.
 
The Health Savings Account Plans and the Cafeteria Plans are two of the most popular consumer-directed plans being availed by businesses.
 
The Comprehensive Group Health Insurance, on the other hand, gives consumers the options to manage a health insurance group. This plan creates a network of specialists, doctors, medical professionals, and hospitals for an affordable and discounted medical plan. The employers and employees will benefit from this plan because of its low premium fees, coinsurance and copayments.
 
The Preferred Provider Organization (PRO), Health Maintenance Organization (HMO) and Point of Service (POS) are the most affordable comprehensive group health plans that are availed by employers for their workers. 

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01/30/2010

The dwindling economy of America has put a strain on people as they struggle to keep themselves insured.  With companies putting emphasis on cost efficiency schemes, layoffs have become a common practice.  This has caused an increase in the unemployment rate and those without jobs find themselves in a position without medical insurance or a health care plan.  But one option has been put in place to assist unemployed individuals without medical coverage. 
 
COBRA (Consolidated Omnibus Budget Reconciliation Act) is a law allowing those who have been laid-off to purchase health coverage for 18 to 36 months. COBRA acts as a safety net and allows laid-off employees to continue their health plans as they seek new health insurance coverage through state-sponsored or private market plans or a sponsored plan from a spouse or a new employer. 
 
The economic stimulus package signed by President Barack Obama has allowed Congress to reduce the cost coverage of COBRA.  However, COBRA could still be expensive for most individuals and in some instances may not be a good option for some.
 
COBRA could be expensive compared with a regular sponsorship from an employer.  In some states, there are less expensive, short-term medical insurance policies offered, allowing an individual to save up to 35 percent more than other private plans.
 
Workers from companies that have cancelled their health coverage are also not entitled to the terms under COBRA.  These workers may purchase insurance from state-sponsored or private plans.
 
To fully consider COBRA, research is necessary.  One must also be aware of all insurance options, including the costs of policies.   The fact remains that an individual should always be covered and options for coverage should remain accessible

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01/30/2010

Companies interested in purchasing group health insurance are advised to carefully weigh their options to ensure that health plans are tailored according to the needs of the employees.
 
In searching for the right group health insurance, it is important to understand the needs and preferences of an employee with regards to healthcare plans. Research is necessary in order to know about the different policy types and coverage needed.   
 
It is also important to verify with the department of insurance if a company engaged in business/group health insurance is licensed.  Companies must stay away from small, unlicensed business insurance companies even if they offer a good deal.
 
Another way to determine a good group health insurance program is to check the company ratings. Standard & Poor’s, Moody’s, and A.M. Best Company are examples of firms that review and rate insurance companies based on credit obligations and financial credit. Some of these firms even offer information on companies that offer health plans for employees.
 
Referrals from other companies that utilize the services of a group/business health insurance company would greatly help in choosing the right program for employees. This could provide insight on the service quality as well as the contact information of a specific insurance company.
 
To examine the website of a group health insurance company is also a must. Details such as products and services, investor information, claims, customer services, and press releases, could help in determining how the health insurance company works.
 
Oftentimes, the chosen “best deal” is not exactly a good deal when reviewed properly. Thus, it is important to keep in mind that a good group health insurance plan is cost-effective and of high quality.
 

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01/30/2010

When it comes to researching health insurance plans, any person would be tempted to only glance over the jargon and the fine print. But this method would not be beneficial when a person is comparing the different types of health insurance. One has to spend time carefully analyzing the various alternatives that are available. This could help the individual save a lot of money when seeking the best insurance deal.
 
Health insurance comparisons are not hard to do, especially these days. It is not necessary to call a lot of people on the telephone since information gathered over the Internet is easily accessible. Information about the majority of insurance companies can be found as easily as clicking a mouse button. Aside from this, searching for information is not limited to regular office hours only. Don’t just visit the website of a specific insurance company – utilize comparison sites that contain a broad range of information on health plans and their providers.
 
Spending enough time when dealing with health insurance comparisons is a wise decision to make since everyone has different needs. The health plans that the various companies offer might be similar in their structure, their rates could be significantly different and some health plans may have options that are not necessary to the applicant. Effective health insurance comparisons will help the applicant decide on what health plans will provide them greatest benefits.

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01/30/2010

The population of elderly people is rapidly increasing and this means providing a better and more efficient medical insurance plan for them.
 
Americans have put pressure on the government to implement improved health care insurance packages that should provide complete services to people including senior citizens.
 
However, the cost of the health care package for older people has skyrocketed, with Medicare benefit payments totaling $374 billion in 2006. The total cost accounts for 12 percent of federal government expenditure and 20 percent of the total health care spending in the country.
 
The elderly now amounts to 13 percent of the population but they use up more than one-third of the country’s health care services, including out-of-pocket expenditures and supplemental insurance policies. Over the next decade, an 8-percent increase in spending will be seen annually.
 
Elderly patients are no always aware of cost in terms of their medical care consumption, including their use of prescription drugs. Studies show that elderly people would lessen their medical insurance consumption if cost sharing was to increase.  When prices of drug co-payment go up, elderly people’s drug consumption is reduced as well.  The research also suggests that the demand for any kind of drugs is price sensitive.
 
Therefore lower consumption of essential drugs, as a result of a high price tag, may lead to a person becoming more ill.  This event may maximize his or her need for hospitalization, leading up to more costs.
 
It is, therefore, important to remember that the most adequate health insurance plan would have health status linked to cost sharing.  

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01/30/2010

A lot of people are allergic to something, whether it be an object or an environmental condition. Though these allergies can be prevented, there are certain instances wherein people come into contact with some of these things, thus, resulting to pain and discomfort.
 
An allergic reaction is usually triggered by something that is not usually harmful to other humans. This reaction is connected to the person’s immune system and caused by a variety of things including pollen, pets, medication and dust.
 
According to experts, being allergic to something is generally inherited from the parents but it can also be caused by other factors such as changes in the environment. Some of the most common manifestations of allergy are sneezing, itching, swelling, and rashes.
 
For a doctor to identify the type of allergy a person is suffering from, he or she should undergo a rigorous allergy exam. This would entail the methodical documentation of one’s medical history. The person will be screened of the different kinds of allergy-related symptoms and assessed by the doctor in terms of how the body reacts to certain allergens.
 
The coverage of a person's HMO might be affected depending on the allergy.  Most medications for allergies are not covered by the person’s insurance.  However, there are other health plans that include allergy-related illnesses in their premiums.

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01/30/2010

Traveling is a great way to unwind and free your self from the confines of everyday living.  No one wants their special trips to be ruined by any worry, which is why it pays to be extra cautious when it comes to safety and health. After all, one travels to reach places and relax. With this, medical insurance has to be considered.
 
Before going on a journey, make sure to ask your health care provider about their coverage policy when it comes to trips. Your policy might only be applicable in your state alone and may not be valid if used for emergency room care, doctor visits, or medications outside your state. If your trip is within the U.S. only, take note of the providers, facilities, services, and facilities in the area in case of emergency, like sudden illness.
 
Undergoing medical treatment outside the US can be costly.  Even one’s arrival can carry risks.  For instance, if a foreign government denies your passport because of your health condition, you may spend up to $50,000 just for medical evacuation.
 
American health plans are often not accepted abroad.  Services of US programs like Medicare and Medicaid are strictly to be used within the country.  They also do not cover for expenses obtained outside the U.S. If your current health plan does not provide coverage for medical expenses outside the country, then you might consider purchasing a major medical plan or a short term health plan.
 
Some companies even offer health insurance designed for overseas travel.

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01/30/2010

A health insurance exchange is a venue to purchase an organized health insurance set up, may it be governmental or quasi governmental, to assist insurers  in terms of dealing with the policy in a cost-efficient way, to allow consumer protections, and to aid in the expansion of insurance to more individuals.  These exchanges are not insurers per se, but they are responsible for contacting private insurers in order to present a public plan option to cover specific individuals like those without coverage from employers or those given coverage by small employers.
 
This exchange allows accountability and transparency in insurance coverage.  This also assists in enrollment and delivery of subsidies, and takes part in spreading risk and containing costs.  But this can also increase premium rates, force an exchange clearance, and allow cherry-picking among customers because of restriction in terms of eligibility and a small market share.
 
However, insurance exchanges promote efficiency in the markets.  Since most health insurance markets are not organized, these exchanges could make them more structured when it comes to seeking requirements or coverage.
 
The health reform initiative of the U.S. government emphasizes the importance of a health insurance exchange.  Health plan issues can be addressed as individuals will be given the option to choose the right health plan.  Prices and benefits will also be laid down for people to assess.  Health insurance will not be denied despite a preexisting medical condition, benefit packages will be made affordable, and those affected by catastrophes will be fully covered. 
 
With a health insurance exchange, individuals will definitely experience a proper health care coverage.

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01/30/2010

There are 46 million Americans without health insurance.  The number may come as a surprise, but it is true.
 
While the Congress continues to debate over America’s Affordable Health Choices Act of 2009, the Congressional Budget Office has revealed that implementing this proposed law will cost the government $1 trillion. By 2019, the federal deficit will reach $239 billion.  At this cost, it is important for the issue to be analyzed carefully.
 
Health care is different from a health insurance.  Health care is a basic right applicable to everyone living in the US, including illegal settlers. It is stated in the 1968 federal law that patients in need of hospital attention “must be given a minimum level of treatment,” including those who are unable to pay.
 
Health insurance does not have a financial guarantee. According to the New York Times, three-quarters of American people with health insurance filed for bankruptcy because of medical problems.
 
Despite the increasing number of uninsured Americans, the Congressional Budget Office believes that this problem is only temporary.  Many individuals may have lost their health plans because of the lay-off, but they will regain it again once hired. In fact, in 2007, the Census Bureau reported that 253.4 million or 85 percent of Americans were able to obtain health insurance.  The Census Bureau also revealed that 10 percent of the 46 million uninsured people are not American citizens at all.
 
Meanwhile, it was also discovered that the 18.3 million people who had the chance to avail of health insurance chose not to get it. 

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01/30/2010

More and more Americans are foregoing individual health insurance even if health care costs are getting more expensive. Because of this, health care reformers, as well as politicians, have been looking for ways to address the anxiety of consumers. There is even a proposal to link the rates of medical plans to lifestyle choices like exercise, smoking, and dieting.
 
A study, recently conducted by The University of California, shows that on the average, $72 billion is being spent for treating medical conditions associated with smoking. A separate survey, done by the Centers for Disease Control, shows that for health issues linked to obesity, $75 billion is being spent. The cost for the treatment and management of the said conditions contributes to the increase in the price of the premium paid by individuals who are covered by a medical insurance. According to some experts, unhealthy lifestyle choices contribute to the increase in the price of a premium so much that they have become causative factors in making health plans unattainable for roughly 50 million Americans.
 
Those supporting this plan propose that people with healthy lifestyle choices (like those who exercise regularly, maintain an ideal weight, avoid drugs and alcohol, and refrain from smoking) should not be burdened with expensive health insurance premiums.  Rather, they should benefit from cheaper ones.
 
Even if this is a controversial proposal, rewarding a person for his or her healthy lifestyle is an example of how people are willing to give extra effort to lower the cost of health insurance so that more Americans, who currently do not have medical coverage, would be able to afford it.

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01/30/2010

Due to the economic crisis, a lot of companies have implemented different tactics to reduce expenditures and increase profit. Some made adjustments in their company’s marketing tactics while others, in production. However, most companies resorted to lay off, or simply removing employees from their job posts.
 
When one speaks of job loss, everything else follows. A simple employee will be ripped off the benefits he or she has received while working. One of the most important benefits is that of the HMO. The government thought of a plan to reduce the burden of those who lost their jobs and came up with COBRA or the Consolidated Omnibus Budget Reconciliation Act.  Under this, the government should subsidize almost 65% of those who wish to continue to avail of a health plan, even after being fired from their jobs.
 
This system will allow the people who lost their jobs between September 1, 2008 and December 31, 2009 to continue their group/business health insurance as they wish, provided that the cause of the termination fulfilled the guidelines of the IRS.
 
In addition, COBRA does not only cater to employees from large companies.  Those from small businesses can also be part of the said government program. If an employee comes from a company that has acquired COBRA premiums, the person will only be required to pay the remaining 35% of his or her health plan for nine months. Once the person is deemed qualified to be part of the program, he or she can use his or her Health Coverage Tax Credit to shoulder a portion of the insurance premium.

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01/30/2010

Insurance first gained popularity during the revolutionary era. Eventually, people began to realize the importance of securing oneself from accidents or disasters.
 
When availing of hospital services, people felt the burden of rising medical bills. Consequently, the cost of training for medical practice became more expensive along with medical equipment and technology. Hospitals needed to augment the medical fees charged among patients. Moreover, doctors needed to address demands on new therapeutic means and agents. Researches on effective medicinal cure for acute illnesses added to the cost of maintaining a health service center.
 
Soon enough, Texas' Baylor Hospital came up with an idea of spreading the cost
of a patient's health expense over a connected group in 1929. The idea gained approval from hospital administrators and doctors. The "Blue Cross" health insurance program was supported primarily by teachers, and soon became popular among three million Americans.
 
The effectiveness of the "Blue Cross" health insurance concept had caught the attention of private insurance companies, which later on began offering customized health care program with additional medical benefits and nursing care.
 
The State saw the plight of some uninsured employees when faced with sudden accidents or disasters. Since then, it has offered the option of tax exemption to companies with a condition of providing customary health insurance plan among their employees.
 
The legislation of Medicare in 1960 offered medical insurance for senior citizens and added new health care features for employees. The acceptance of health insurance in the United States eased the cost for availing professional medical services. Group health insurance plan has continued to provide consolidated health assistance solutions.
 
Current U.S. President Barack Obama supports the national health insurance exchange proposal, which highlights lower insurance premium dues and wider standardized health care assistance.

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01/30/2010

Health insurance statistics shows that 57 percent of US citizens avail of health plans as employee benefits from their companies and employers. The government provides health care coverage to 29 percent of Americans through Medicaid or Medicare.
 
Self-employed people, on the other hand, usually turn to private providers that offer individual health plans.
 
Availing of individual health insurance is basically more difficult than getting a group plan. With this option, policies are handed out individually resulting in a close scrutiny of insurance companies to an applicant’s medical history.
 
Since health insurance companies are profit-oriented institutions, they expect to benefit more from consumers through the monthly premium, than through paying of medical bills.
 
If someone has had a pre-existing medical condition prior to its application for an individual health plan, the insurance company will not likely approve the application, the reason why most apply for insurance before having medical problems.
 
Moreover, it is important for a person to disclose his complete medical history once applying for health plan coverage. Otherwise, he may fall in the prey of ‘rescission--’ a practice in the industry where an insurance company may claim that it has received an undisclosed medical condition, problem, or inconsistency about their client.
 
So, people must beware of agents who suggest deleting a part of the applicant’s medical history. These people usually don’t help, as they only aim to close the deal.
 
Lastly, it is important to avail of health insurance for the family as well. Statistics shows that 60 percent of family bankruptcies were due to unpaid medical bills. Also, there are about 137,000 Americans who died because of lack of health insurance.
 

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01/30/2010

Most people think of healthcare as having those bottles of pills prescribed by their doctors, and this makes prescription drugs account for over $230 billion of the health care expenses in the country.
 
Amid the rising costs of many products in the market, one should consider the best value drugs to be able to afford the necessary medications at a reasonable cost. It would help one to compare the prices of medicines on the Internet to find out which options to choose from.
 
One of the more practical ways to cut one’s health care budget is by choosing a medical insurance plan that covers prescription drug benefits.
 
Some insurance providers offer prescription drug benefits depending on the coverage, whether one is eligible for a brand-named drug or a generic drug, or whether the drug is included in the provider’s list.
 
The price of the prescription drug benefits is normally included in the medical premiums of the insured. The copayment will also depend on the type of medical insurance program, or what kind of drug is available, whether it is branded or generic.
 
The types of available drugs vary from the costs included in the health insurance coverage. Generic drugs are often the cheapest and brand-named ones are usually double the price of the generic. Brand-named drugs that are not included in the list of the insurer cost more than the usual ones.
 
Also, some insurance plans have prescription drug benefit that allows the insured the option for services such as mail-order prescription. It would just require a prescription that was written for a three-month supply of the needed medication.
 

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01/30/2010

Lack of health insurance has been a countrywide problem in America, causing the local, the state and the federal governments to respond.  The number of uninsured individuals will continue to grow unless the health insurance coverage undergoes a change.  To solve this, three options for reform have to be taken into consideration. 
 
First, there exists an option for employers to pay the health insurance of workers.  These employer mandates are costly yet they can increase the number of insured individuals.  This scheme involves the “pay or play” option.  Employers could “pay” the state to provide the necessary insurance to their employees or “play” by paying for the insurance themselves.  Part time employees or smaller firms are not included according to the legislation.  This option, however, can cause an employee’s status to shift from full time to part time. 
 
Another option is to expand the Medicaid coverage for those who cannot afford insurance plans.  This option, funded by the federal government, could increase employment and allow a shift in employment status from part time to full time.  One initiative from this option is the State Children’s Health Insurance Program established by the Congress in 1997 that extends Medicaid to children in families who previously failed to qualify. 
 
Tax credits, meanwhile, would allow individuals with low-income tax to earn a federal tax credit.  Under this measure, a certain amount of money would be allotted for an individual or a family.  This may not be as costly as the two previous provisions yet it is the least effective.
 
One has to weigh what these measures can offer to create that needed change and give individuals better health plans.  They may affect those uninsured, but they too can be costly to the federal government.

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01/30/2010

 
Being covered under medical insurance is important, especially for the elderly. Some senior citizens even want to purchase additional health plans just to cover other medical expenses that are not covered by their existing health plan.
 
Medicare is the most common medical insurance for the elderly. Medicare is a federal health plan specially designed for seniors under the Social Security Act of 1965. Any applicant who wishes to have a Medicare health plan should have worked for at least 10 years to become eligible. If the applicant doesn't meet this requirement, he needs to pay for a health insurance premium.
 
The coverage of Medicare is expansive, although there are some services such as in-patient hospital deductibles that have separate fees. Seniors usually avail of secondary health insurance plans, apart from their existing Medicare health plan, to ensure that their health-related expenses get covered. One of the most popular options when purchasing supplemental health plans is Medigap, an individual health insurance policy for seniors.
 
Another important reason why seniors need a health plan is medication. Seniors need a lot of medicines, and since Medicare only covers limited prescription drugs, most of them opt to avail of the Elderly Pharmaceutical Insurance Coverage. The EPIC Program subsidizes the cost of prescription drugs, and the good news is that it covers most prescription drugs. Their deductible plan can also be availed by seniors who earn $20,000 annually.

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01/30/2010

Medicare Advantage offers additional benefits of hearing, vision, dental and fitness. It includes the Medicare program Part A (Hospital coverage), Part B (Medical coverage), as well as Part D (Prescription drug program).
 
Medicare Advantage can be availed through most plans such as Health Maintenance Organizations (HMOs), Medicare Special Needs Plans, Preferred Provider Organizations (PPOs), Medical Savings Account Plans (MSAs) and Private Free-for-Service Plans.
 
Medicare Advantage offers services including all coverage in the original Medicare plan plus the assistance on prescription drugs. Medicare Advantage is best for employees seeking additional benefits in routine dental check up and eye lens upgrade. Medicare Plan C also covers wider health services in various hospitals in the country.
 
The state includes Part C in the premium of every employee or insured person. Medicare Advantage offers flexible payment program for out-of-pocket expenses compared to original Medicare. Unlike HMO that limits the options for covered hospitals and doctors, Medicare Advantage allows more freedom in availing special health care. 
 
Medicare Advantage program is available for Private Fee-for-Service (PFFS) Plan, which allows people to avail of the services through a Medicare-approved health professional or hospital. If the insured person avails of out-of-network services, additional charges will apply.
 
Medical Savings Account offers more flexible terms as it allows the insured person to select more affordable health service fee. Prescription drugs are covered in PFFS, while MSA requires membership to Medicare Prescription Drug plan to avail medicine assistance.
 
Medicare MSA program features a bank account, which allows the insured person to deposit certain percentage of money. At some cases, out-of-pocket fees are needed. Special Needs Plan offers maximum coverage for senior citizens needing nursing care, and extended health assistance. It covers all prescription drug expenses.

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01/30/2010

Even though a lot of people living in the United States are aware of Medicare being the federal health insurance program that provides health plans for those over 65, they are probably not familiar with the term “Medigap”. This stands for Medicare Supplement Insurance, and it was designed to take care of the parts of the healthcare coverage that have not been covered by Medicare. Medigap is ideal for people who have medical costs that are not covered by Medicare.
 
Why is it a good idea to purchase Medigap for health plans? Medicare handles two parts; Hospital insurance falls under Part A. This helps pay for some home hospice and health care, as well as inpatient care inside a skilled nursing establishment or hospital following confinement. Medical insurance, on the other hand, falls under Part B. This helps pay heavy-duty medical equipment, outpatient hospital care, physician’s fees, and other supplies and services that are not handled by Part A.
 
Since some health plan expenses are not paid by Medicare, it is advisable to get extra insurance to cover the costs like the Part B yearly deductible, and hospital co-payments that are out-of-pocket. Medigap can take care of the payments for co-insurance, co-payments, and the deductibles that are not handled by either Part A or B of Medicare.
 
To avail of Medigap insurance, the applicant must have signed up for both Parts A and B of Medicare health plans. If the applicant has already signed up for a supervised care plan like a PPO (Preferred Provider Organisation) or an HMO (Health Maintenance Organisation), they cannot anymore avail of Medigap.
 

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01/30/2010

Mental Health Insurance provides mental health coverage for the insured person and his or her children. It offers services such as counseling for children, adolescents and adults. It has professional clinical psychology intervention, medication, inpatient, respite care, office visits and day hospital services.
 
Mental Health Insurance cares for over-all family mental health with long term assistance and guidance. It has flexible insurance payment terms and can be modified for the person to have the freedom to pick his or her preferred hospital and/or doctor. Managed care companies usually encourage insured members to choose mental health professionals within their network.
 
If the child of the insured member prefers a clinical psychologist outside the accredited list, the HMO (Health Maintenance Organisation) will ask the insured member to pay for the health expenses. Most companies offer alternatives on mental health insurance plan, which allow partial or a maximum of 80% coverage on mental health expense.
 
The mental health insurance plan works similarly as with the Medicare program. Mental health insurance specializes in child and adolescent psychiatry along with clinical intervention. Insured members similarly need to inquire about yearly deductibles. Insured members may also ask for policies concerning utilization review.
 
The utilization review is done by professional clinical psychologists and nurses. It informs the managed care company or mental health provider about the required treatment.
 
Parents may also request a special review in case of a child’s sudden behavioral change. The preferred psychiatrist will coordinate with the utilization reviewer and administer the needed treatment.
 
Mental Health Providers have an open customer relations program that eases the needed counseling. Payment terms are flexible and customized according to each client's needs. 

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01/30/2010

Availing of professional health services often calls for wise selection. Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO) may limit options for accredited hospitals and doctors.
 
Some insured persons prefer to avail of private or family doctor services, and may encounter queries on coverage plans. A wise choice for health insurance plan is the flexibility of out-of-network health assistance.
 
All health services availed from non-accredited hospitals and doctors are called non-network services. Some private specialists are not yet enlisted among HMOs and PPOs network. HMO charges insured persons for full payment, while PPO charges a certain percentage.
 
PPO plans have higher premiums, yet it allows the flexibility of a co-payment, covering a maximum of 80% in health expenses. The insured person needs to pay for the remaining 20% of the total health expense. Most insured persons decide to seek professional medical services inside HMO network, as it offers maximum coverage and faster benefit claims process. As a result, most health insurance providers arrange payment modes to accommodate insured persons who need special health assistance outside of the network.
 
Private specialists update their accreditation documents to accommodate more insured patients. On the other hand, managed-health-care providers are creating new means to address the changing health needs of the citizens. Special Needs Plan coordinates with nursing facilities to widen convenience in extended health care service. Private family clinics and pediatrics are encouraged to complete accreditation documents to accommodate families with children needing medical assistance.
 
Professional dentists are also invited to coordinate with Medicare Advantage arrangements. An effective health insurance provider allows maximum coverage for medical and health care services, along with flexibility of options and payment modes

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01/30/2010

In the United States, there are many types of health insurances that cater to different needs and preferences. One of the most common health insurance is the PPO or Preferred Provider Organization.
 
PPO, also referred to as preferred provider option, is a group of health care providers who work with an insurance company or a third-party administration to provide inexpensive health care to a policy-holder. In a Preferred Provider Organization (PPO), an individual subscribes to a specific policy that allows them to receive discounted charges from “preferred” health care providers of PPO.
 
Preferred Provider Organization (PPO) features a utilization review wherein the policy-holder or the third-party administration reviews the medical records of the treatments provided to check if it was given as a treatment for a specific condition, or just being used to get higher reimbursement.  In addition, PPO also has pre-certification requirement. This requires non-emergency admissions and some outpatient surgeries to be pre-approved by the policy-holder, and have undergone “utilization review” beforehand.
 
PPOs earn profit by implementing an access charge to a particular insurance company for using their network. The organization negotiates with health care providers in terms of establishing fee schedules. In addition, they also supervise disputes between the providers and the policy-holders.
 
Moreover, PPOs also create an agreement with each other to establish a stronger position within a particular area. Theorically speaking, this set-up is advantageous for both the insurer and the providers. The policy-holders remain to receive discounted medical expenses when they contract the services of a “preferred provider”. In turn, there will be a significant increase in the provider’s business since all insurers take advantage of the “preferred” provider’s services.
 

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01/30/2010

Family planning has been an ongoing concern of both HMOs and advocates of reproductive health. Both parties sometimes disagree regarding their coverage, or their terms, when it comes to the issue of family planning. This growing issue concerns the definition or boundary of the insurance’s comprehensive care.
 
Insurance companies include in their family planning coverage the use of contraceptives or access to it. However, there are groups and organizations that are not in favor of their terms and coverage, such as churches and religious sects.
 
Through different kinds of legislations, the boundaries of family planning have been expanded, and insurance terms now cover a wider scope when it comes to preventive measures.
 
Today, states require HMOs to provide their clients with a complete list of all the contraceptives that are FDA-approved. The list includes all pills, injectables, patches, IUDs and other types of contraceptives. Nonetheless, even though insurance companies cover these contraceptives, employers in most states who wish to have these scratched off their coverage are allowed to do it so. This allows the insurance clients to have more flexible terms, and provides a wider variety of choices for their employees’ benefits. In addition, only about 19 states allow this kind of setup, and so it would be beneficial for religious sects to inquire about their own federal rule beforehand.
 
It is important to note that state-sponsored health plans are required to provide the people with a complete coverage on family planning as this allows the poor to have a greater access when it comes to health care.

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01/30/2010

As one prepares to go to college, parents will usually have basic things on the checklist including, laptop, allowances, groceries and other things, but one should never forget to include health insurance.
 
Students will be more secure knowing they have medical insurance especially those who are more prone to catching illnesses like medicine students who are exposed to infectious diseases, or those who are likely to get injured from strenuous activities like athletes.
 
In selecting the most appropriate health insurance, it is important to check out the available options and compare it with others. Information is the best way to decide on the best coverage for anyone.
 
It would also help one sort out the best coverage by considering what the maximum value would be that one would be covered for; if there is any deductible; its cost and how it varies with different deductibles.
 
Deductibles should be one of the priorities when deciding on an insurance plan. A physician’s professional courtesy does not always cover the deductible and it’s something one cannot rely on.
 
Knowing whether there are any restrictions on which physicians to use, and what is beyond the insurance’s coverage are also some things to consider.
 
There are many insurance providers that accommodate students, and college student health insurance plans can be obtained in all states from a host of providers. Also, health insurance coverage differs by state.
 

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01/30/2010

During the last century, a number of individuals who suffered cancer, stroke or heart attack died early. Their families mourned their death while medical insurance companies made the insurance payments.
 
Nowadays, doctors are now making advances to prevent people from dying. However, the downside to this is that people who suffered these conditions can no longer go back to their old life. According to experts, the last 20 years offered major advancements in science and technology. This led to major changes in people’s lives and financial plans.
 
Insurance companies believe that an individual’s health and income-earning ability are the most important assets one can have. Anyone is vulnerable and may suffer from cancer, stroke or heart attack anytime. Given that scenario, it is necessary to think of the things that should be taken care of right away including medical insurance plans. In the event of a stroke instead of death, one must plan carefully and take care of things that need to be addressed.
 
Almost 50% of all bankruptcies in the United States are due to critical illnesses. Once an individual is diagnosed with a critical disease, these people often end up using all their sick and vacation leaves and their credit cards leading to disability.
 
More or less, 70% of those who file for bankruptcy had medical insurance when the disease began; however, health insurance coverage gets lost since the insured is no longer able to pay their monthly COBRA premiums. 
 
Thus, it is important to have a health care plan to help people safeguard their health and protect their future. 

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01/30/2010

Americans have long been battling for their right to a proper and secured health care insurance, and women are deemed to need this privilege more since their health could be at risk during pregnancy and even before and after conception.
 
According to studies, there are as many as 1.94 million unplanned pregnancies each year that is why the government has funded family planning in the US to prevent the number of unplanned pregnancies from rising.
 
These services have helped alleviate the numbers of unplanned pregnancies and abortion among women of different ages and economic status in the US every year.
 
More importantly, women who are under these family planning programs by the government are also entitled to health insurance programs that are publicly funded.
 
Through these public-supported insurance programs, women are eligible to receive prenatal, delivery and postpartum services that are supported by the medical insurance program.
 
Since the past several years, the number of women enrolled to publicly-funded medical insurance program has risen. Hence, early pregnancy rates among teenaged women have dropped.
 
Encouraging pregnancy prevention among young women also helps them improve their health and well being.  
 
Moreover, publicly funded health services have a broader coverage wherein women can avail of breast exams, diabetes and hypertension screening, and other tests for chronic illnesses. They are also evaluated in order to identify whether there is a need for counseling in relation to mental health or substance abuse.
 
Other important services that women can avail of in publicly-funded family planning centers nationwide include pelvic exam, Pap test, and even HIV testing and counseling

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01/30/2010

Getting sick is becoming more and more costly. With the medical fees you need to pay for hospitalization, and medicine, on top of the receding economy, getting sick is not an option.
 
People say that quality medical assistance in the USA is now becoming a burden, and it seems to be true. The price of quality health care is ten times higher compared to what it was some few years ago.
 
In this situation, having a health insurance plan is the best option. Not only because it can spare you from expensive medical treatments, it could also give you protection just when you need it the most. Financially speaking, it is best to be prepared at all times.
 
So how do health plans work? The insurance company shoulders the medical expenses of their insured members if the said member becomes ill. The policy provided by the medical insurance company contains a list of accidents or causes of illnesses they cover. In return, the insured member pays for a monthly premium for the said coverage. Medical insurance are provided by both government \agencies and private insurance companies.
 
Health plans cover everything under the policy, ranging from basic physician check-ups to advance medical treatments like surgery. Some companies even cover medications and prescribed drugs, thereby reducing their costs and making them more affordable. Even visits to the dentist are covered by health insurance plans. So only for the price of the monthly premium, a person can get his health and his life covered.

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01/30/2010

Because the rates of prescription medication for health plans are going up, people have started to look for some cheaper alternatives. Prescription plans offer a resolve for the expensive prescriptions. Discounts and plans can be dramatically different.
 
A lot of plans offer discount cards to the customers, and then the customers present the cards whenever they buy any prescriptions. A yearly fee is usually charged to compensate for the health plans, and the cards can be obtained from non-profit groups, insurance companies, chain drug stores, and drug companies.
 
It is difficult to make generalizations about the various health plans since fees are normally tiered. These fees use discounts in varied ways that depend on the preference of the member who is buying generic medicines or pills with brand names. One medicine may have a discount as big as 30%, but a generic form of that same medicine may be sold at half the price despite showing up on a similar drug organization card. If ever the doctor gives a prescription that involves a number of manufacturers, the individual may realize that obtaining discounts from the prescriptions may require more than one card.
 
It might be a challenge to find out about all the details regarding some health plans since prescription plans are so varied and there are a lot of them out there. It is advisable to take some time in analyzing the discounts that are associated with the health plans, what medicines the health plans take care off, and what expenses may incur when these health plans are used.
 

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01/30/2010

A growing number of Americans are not covered by a basic health insurance program. This calls for immediate action to address the basic health needs of 45.8 million citizens.
 
This reality prompted Democrats and Republicans to legislate reforms on health care, requiring adjustments on inexpensive health insurance plans. Many analysts across the country offered suggestions such as the "single payer" program and the "pay or play" program.
 
Uninsured persons can benefit from the proposed "single payer" program. Under this, the state will pay or subsidize the insurance premium. On the other hand, employers may choose the "pay or play" program. Employers may choose to provide customary health insurance plan or pay bigger taxes instead. The tax will be used to subsidize health care programs for the uninsured.
 
One of the arguments raised by many employers is the high regulatory tax. Company owners candidly explained the difficulty of recovering revenues since the recession began. Most companies may struggle to provide medical insurance assistance.
 
The State places strict regulations on health insurance policies. The State also places limitations on the rating rules of health insurance providers. It also prohibits ungrounded repudiation. The State health reform program also enforces restrictions on the selection of medical providers.
 
Under the health insurance reform act, premiums are given a limit. Insurance companies cannot increase dues in excess of the stipulated rate. The law requires health insurance providers to ensure the availability of medical facilities and the ease of benefit claims. The State also obliges health insurance companies to provide discounted rates to senior citizens.

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01/30/2010


According to a report recently released by the Government Accounting Office, nearly 1.7 million college students are not insured. This is sad news because young Americans are also among those who are most likely to have medical emergencies.
 
The report also showed that back in 2005, the uncompensated, non-injury-related medical expenses reached between $120 million to $255 million. Recent reports even show that around two-thirds of uninsured young adults do not seek treatment because of its high cost.
 
Fortunately, colleges are willing to change these figures and recently, many colleges have done something about this, such as requiring proof of health insurance prior to enrollment.
 
While some colleges ask students for proof of health insurance when enrolling, there are also numerous colleges that offer coverage options through student health insurance. According to GAO, around 60% of colleges offer these health plans to students. Student health insurance is offered by 82% of four-year public colleges while 71% of four-year private colleges offer the said plans.
 
The eligibility requirements for availing student health plans are less restrictive compared to individual plans. If a student opts to take advantage of the student health insurance offered by his school, he should be qualified for coverage once he enrolls as a full-time student. There are even student health insurances that allow the insured to extend it even after graduation.
 
Student health insurance comes with different benefits and at different costs, so it is important to check the policy’s benefits first.
 

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01/30/2010

Acupuncture has the uncanny ability to remedy pain yet a lot of insurance companies still prefer treatments involving massage and herbal supplements for their health plans. This method of treatment is referred to as CAM or Complementary and Alternative Medicine and there are several insurance companies that provide coverage for a number of alternative therapies and medicines depending on the situation.
 
The quickest way for an insurance company to incorporate alternative treatments in their health plan is to formulate an excellent situation that requires a person to undergo alternative therapy. The ideal way to go about this is to get a prescription from the physician. Information on the frequency and length of the therapy is necessary. Some examples of alternative treatments include homeopathy, stress management for the body and mind, acupuncture, herbal remedies, chiropractic care, and massage treatment.
 
A number of insurers could save a lot of money if alternative medication becomes part of their health plans.  Alternative treatments like biofeedback and acupuncture are cheaper compared to the usual therapy for chronic back pain.   To add to this, a handful of individuals believe that usual therapies are not as efficient as the alternative ones. A session of acupuncture, for example, costs around $200, but conventional treatment could go as high as $600. Surgery could take away an amount close to $10,000, but going through alternative treatments again and again could take away just as much money as usual therapies would.
 

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01/30/2010

Most people take travel insurance for granted. Some think that having individual health insurance will suffice in case something happens while they are on a trip. Truth of the matter is one should get travel insurance since there are certain health plans that have limited coverage.
 
If you are planning trips to local destinations, one might not need to purchase travel insurance anymore. However, if the trip is international, it would be smart to purchase travel insurance since most insurance companies do not have networks outside of the country.
 
Travel insurances cover illnesses, accidents, deaths and the like. The good thing about this type of insurance is that it also covers losses during one’s travel, such as baggage and personal belongings. Since there are also a lot of types of travel insurance, one should choose the best type of travel insurance he or she needs.
 
One of these is emergency medical assistance. This assistance will cover medical expenses that are not usually covered by one’s individual health insurance.
 
The terms of travel insurances are flexible and are varied to cater to the needs of the traveling individual. One can choose single trip insurances or those that are extended over a certain period of time.
 
Prices of travel insurances depend on different factors, such as the age of the person, the type of coverage, and the amount of the whole trip.

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01/30/2010

A lot of insurance companies nowadays are offering different kinds of health plans to suit the needs of different people. Depending on what the person wishes to avail of, all health care providers have flexible terms and provisions that are deemed beneficial for everyone who wish to have their own insurance.
 
Since there are a lot of offerings in the insurance industry, people sometimes get confused as to what type of insurance they will avail. Perhaps, one of the simplest options when it comes to getting insurance coverage is term life insurance.
 
Some may not be familiar with this type of insurance. It would be best for people to familiarize themselves with all types of insurance for them to be able to pick the best insurance for themselves and their families.
 
This type of insurance is only applicable for a certain duration or term. The time period of the insurance coverage will depend on what the person chooses.
 
Although both permanent life insurance and term life insurance serve the same purpose—that is, to provide benefits to the dependents of the insured upon his or her death—there is a big difference between the two. Permanent life insurance encompasses both insurance and investment. On the other hand, term life insurance only includes life coverage. The latter is the best option for those who are young and healthy since they will be able to avail of a much higher death privilege at a much lower premium.

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01/30/2010

The US health reform created a big buzz among Americans. This issue has produced several debates in Congress, which includes one on the cost of health insurance.
 
The cost of health insurance depends on the age, health condition, income, and job status of an American.
 
People should be resourceful when searching for the most suitable health plan for themselves. One may acquire online health insurance quotes from the internet to find the best health plan that will cater to their needs.
 
It is also part of an employee’s benefits. Majority of companies give health insurance to their workers. Most Americans with health insurance availed of it through their companies.
 
If a company does not offer this benefit, or if you are self-employed, you can avail of health insurance by purchasing it yourself.
 
There are also health plans given by state governments. Medicare and Medicaid, for example, are government health insurance that are available to people 65 years old and above, disabled, or those with minimal and no income.
 
The cost of health care insurance will depend on different things, such as the income that you earn in a month.
 
Health insurance also covers premiums. These are monthly fees that are paid by the insurance holders.
 
If your health insurance is provided by your company, the premium is paid by your employer. Most of the time, it is deducted from your salary. If you purchased your own insurance, the entire fee is your responsibility. 

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01/30/2010

It is crucial to obtain a dependable health insurance policy, especially if the person finds out that he or she has breast cancer. It is necessary for an individual to receive the fundamental Health Plans to keep this disease at bay.
 
A lot of clinics offer mammograms and breast tests on a regular basis.  This gives individuals a better chance of overcoming breast cancer, especially if they are enrolled in an excellent HMO.
 
Despite of gender or age, every human being is a likely candidate for breast cancer. The earliest detection of breast cancer is very important because the possibility of getting rid of the cancer is a lot higher at this point. Clinics that conduct breast examinations and mammograms on a regular basis, as part of their Health Plans, produce the best methods of detecting breast cancer. These tests should be performed regularly to make sure that the cancer cells are discovered at the earliest possible time.
 
A lot of women are susceptible to breast cancer. Women have to make sure that they are enrolled under Health Plans that could offer examinations such as mammograms and vital medical attention needed in the event of a breast cancer diagnosis.

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01/30/2010

Every human being goes through a low phase at one point in their lives. Young individuals who are entering the stage of adolescence are likely to experience a difficult period because of their emotional state.
 
It is normal to feel melancholic or to experience a short fuse while going through this phase.  Going through an emotional high from time to time is also considered natural among teenagers. These feelings are usually caused by constant pressure triggered by various forms of activities and educational requirements.  And if these intense feelings continue to stay with the teenager or if the emotions become uncontrollable, it might lead to a case of teenage depression.
 
The good news is that a young person does not have to carry this burden alone. The teenager has to search for help and keep in mind that one can control his or her depression.
 
The most important thing is for the person to be aware that s/he is not alone during this stage of conflict. Teenage depression happens to a lot more teenagers than expected, and the solution to this issue can easily be accessed.
 
In spite of what an individual feels or believes in, it is a fact that many people are concerned about the well-being of a teenager. The young person just has to be brave enough to express his/her feelings and share his/her experiences because being vocal is the initial and most important step to get over depression.
 
Depression should not be blamed on oneself, but there are methods, such as maintaining one’s health, and health plans that can assist an individual in controlling his/her that would eventually make him/her feel better.
 

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01/30/2010

Diabetes is a medical condition wherein the body does not have the capacity to produce enough insulin. This results to an increase in the level of blood sugar. Insulin is a type of hormone produced by the pancreas and it is needed in converting sugar to energy. There are a lot of risks involved in having diabetes. Complications arise because of this disease. These include kidney failure, strokes, amputation, and heart diseases.
 
The absence of a health plan for diabetic patients puts them all the more at risk. Their treatment options become limited, making them candidates for complications.
 
It is indeed important for diabetics to get covered. Different medical insurance companies provide ways for diabetes patients to manage their disease through doctor visits, insulin, and the necessary medical treatments. Furthermore, since diabetes is a lifelong illness, long term health plans are the best choice for paying medical expenses.
 
There are things that should be considered by diabetics if they want to purchase medical insurance to cover their medical needs. The policy should cover almost all possible medical treatments and medicines needed in diabetes, including insulin shots. The policy should also cover prescription medicines. Get a health plan that has wide coverage.
 
Purchasing a health plan when diagnosed with the disease may be difficult. However, there are laws that protect people with pre-existing health conditions, such as The Health Insurance Portability and Accountability Act. It is stipulated under this law that employers are required to shoulder the medical expenses of their employees who already have pre-existing conditions.

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01/30/2010

There is a growing concern in the public regarding the rising costs of health care. Experts offer no easy answers, but can only give straightforward explanations.  Experts say that this situation occurs because insurance companies are working around highly-regulated and fixed operating margins.
 
In addition, an increase in the premium payments for health plans are the expenses passed to the insurance company by hospitals, doctors and other medical expenses. Other factors, such as the use of new medical technologies, inflation, and social problems, affect the rising cost of health care in the United States. 
 
There are many ways through which people can reduce their medical expenses. One way to reduce medical expenses is to look for an alternative health-care provider that offers inexpensive services. Some health plans provide discounts to patients when consulting a “preferred” doctor.
 
Another way is to make sure that one’s health plan covers most, if not all, areas of medical care. Look for insurance companies that offer comprehensive yet inexpensive health-care programs. In addition, it would be better to have a higher deductible with low premium plans.
 
Some insurance companies offer discounts to those who pay their premiums yearly. This greatly reduces the costs one has to take care of every month. Moreover, it would be helpful to review the policies of one’s health plan and check for any changes or improvements. This would also help in deciding whether the current plan is still suited to one’s current needs and preferences.
 
There is no easy way to reduce health care costs. However, proper planning and healthy living can prevent these additional costs. 

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01/30/2010

Cost is an important word when it comes to health insurance or benefits. There is a need to reduce it without compromising the quality of care. However, this is only possible if the right system is in place. 
 
One option is for an individual’s health care needs to be coursed through Health Maintenance Organizations or HMOs, the solution to costly health plans. The HMO model involves a copayment cost share scheme, in which one would pay a general payment upon the use of a service.  
 
The coverage of a PPO (Preferred Provider Organization) is considered to be the least expensive of all. Under the PPO, a discount could be obtained instead of paying the regular rate. But unlike the HMO, a copay is not involved in this program. However, it does have a deductible and a coinsurance feature. 
 
A POS or a point of service plan, meanwhile, is quite similar with HMO or PPO. However, it could be more costly if a patient decides to move away from some of its features. If a patient, for example, decides to stay in the network of providers and seek a referral for the services of a specialist, a copayment is applicable. But once the patient uses an out of network provider without seeking a referral, a higher amount will be tagged.
 
An HSA or a Health Savings Account, on the other hand, offers different ways for health care to be paid. It allows individuals to pay current health care expenses and at the same time save for future health expenses, tax-free. However, individuals must be covered by the High Deductible Health Plan (HDHP) to obtain HSA.

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01/30/2010

There are three different types of managed health-care plans available. One plan offers an inexpensive plan but has a limited choice of health care providers, while another plan offers more flexibility but at a higher premium.
 
The answer to this dilemma is Point-of-Service (POS). POS is a healthcare plan that combines the flexibility and inexpensiveness of the two other managed health plans (PPO and HMO). Just like HMOs, POS offers members a list of affiliate health-care providers and they can designate a primary-care physician. The PCP takes care of everything with regard to the health care of a patient. However, the insured is not required to elect a PCP.
 
In addition, it also includes the flexibility of a PPO. POS health plans allow members to seek medical advice complete with their benefits from any doctor, even if the said doctor is not affiliated with the network.
 
Moreover, there is no need for pre-approval when consulting with a preferred doctor. However, a referral is needed when consulting a non-network doctor. The insured would need to shoulder around 40% of the total cost incurred when consulting a non-network health care provider.
 
One should also keep in mind that the medical costs incurred when checked by a PCP is less than the costs when checked by in-house health care providers.
 
The POS health plan is gaining popularity among those in search of inexpensive health care coverage because of the combined benefits of HMO and PPO. POS is great for companies that have employees that work at several places. This health plan gives the impression that inexpensive and fuss-free medical care is possible. 

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01/30/2010

Health savings accounts (HSA) and individual health insurance help in saving money on medical expenses. HSA also earns interest and is tax-free.
 
HSA is available to those who have an eligible health-care insurance plan, which means that one’s health plan has a high deductible. An individual can discuss HSA with his employer, insurance companies, banks or credit unions.
 
People with individual health insurance can use HSA for specific medical expenses, or HSA qualifying expenses. There are a number of medical expenses that are covered, such as expenses for chiropractors, orthodontists, dentists, eyeglasses and prescription medicines.
 
One can also use HSA for purchasing over-the-counter medicines such as antacids and aspirin.  In addition, HSA can also be used for paying medical expenses incurred anywhere, even in other countries.
 
People who have saved money on their HSA won’t have to worry about losing it since it works just like an ordinary savings account. If the owner wasn’t able to use the money by the end of the year, it will carry over to the next year.
 
In the event that the owner lost their individual health insurance, one can still use their HSA despite not having a high-deductible health plan. However, one can no longer contribute money to the HSA.  The savings in the HSA can be used as payment for the health insurance’s monthly premiums while one receives unemployment benefits provided by the state or the federal government.
 
With regard to the HSA savings contribution, a single individual can pay a maximum of $2,850/year while a family can pay a maximum of $5,650/year. 

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08/05/2009

Among the direct results of the complexity of a highly civilized society are diverse lawsuits. Dockets are heaped with various cases, and there are lawsuits that involve Health Maintenance Organizations or HMO’s.
 
The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that provides the guidelines or the minimum standards concerning health, retirement and other welfare benefit plans, as well as life insurance, disability insurance, and apprenticeship plans. This law also prescribes the limitation of the amount of damages patients employed by private entities may recover when they file a case against an HMO.
 
Texas was the first state to enact a law that makes it legally possible for a patient to file a lawsuit against an HMO when the latter fails to apply ordinary care in making decisions in health care treatment. This Texan law was put into effect in 1997. In 1999, Georgia and California followed suit. The law in Georgia, however, is slightly different. An HMO in Georgia may only be sued when there is failure on the part of the organization to adjust claims in an appropriate and timely manner. The Californian law, on the other hand, has a wider scope. While it also covers the failure to use the amount of precaution expected in providing medical care, such a failure must be proven to have caused serious damage or harm and resulted in a health care service being denied, delayed, or changed.
 
There are also other states that give patients the right to sue their HMO’s. These states are North Carolina, Oregon, Washington, West Virginia, New Jersey, Maine, and Arizona.

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08/05/2009

Most of the top universities and colleges in the U.S. require their full-time students to have a student health insurance plan. There are several options regarding health plans from which a student can choose. In order to choose well and make an informed decision, he or she must be knowledgeable regarding the ins-and-outs of student health insurance policies. One such important aspect is the limitations and exclusions of student health insurance plans.
 
All insurance companies that offer student health insurance will provide a student with a list of medical costs that are not included in the policy he or she is acquiring. Additionally, they will let the client know which of the covered benefits have limitations and what the limitations are. This information is easily accessible in the plan brochure and included in the “Exclusions and Limitations” section.
 
Here is a list of common exclusions in most student health insurance plans:
 
Pre-existing conditions (usually for a certain time period from the date of initial enrollment)
Acne treatment
Treatment of drug or alcohol addiction
Elective surgeries
Acupuncture
Non-severe mental illness
Self-inflicted injury or attempted suicide
Elective abortion
Dental and vision
Maternity
Congenital conditions
 
Additionally, here is a list of common limitations in most student health insurance plans:
 
Out-Patient prescription medications or drugs (usually there is a maximum yearly payable or a particular drug formulary)
Preventive health care
Repatriation
Prostate screening
Annual physical exams
Psychotherapy
Treatment of diabetes
Mammograms and pap smears
Emergency medical evacuation
Emergency dental

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08/05/2009

Everyone has felt emotionally down at some point in their lives. Many people have experienced depression that manifests itself as having very little energy to perform their jobs. Some people who are suffering from it prefer to be detached from the world for no clear reason. The symptoms of depression may vary from one person to another and it can have a negative impact on your daily routine and it can also put a strain on your relationships.
 
Depression is not just a state of mind and there may be several reasons for it. It can also be caused by the chemical activities that take place in our brains, which we cannot control. Chemical imbalances may affect the transmission of impulses to our brains that may lead to a change in our mood and behavior. Other factors such as genetics, stress levels, trauma, illnesses and other psychological disorders may cause depression. A person who has undergone traumatic pain or experiences may also suffer from depression for a while. Difficulty in work, in school, or peer pressure may elevate stress levels and may also cause depression.
 
If you have been feeling depressed for more than two weeks, then you may be experiencing clinical depression. If you have a health plan or Health Maintenance Organization, it is advisable that you seek the help of medical professionals. If you seek your doctor’s help early, you can prevent your condition from worsening. Overcoming depression will not happen overnight and it may occur again in the future. With the help of your doctor, you can manage depression and evolve ways to help you live a more productive life.

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08/05/2009

Many types of insurance, including individual health insurance, life insurance, and casualty and property insurance are regulated by the state. However, it is the federal government that regulates job-based group health insurances. In the U.S., people who receive health insurance from their employers enjoy the same protection and rights. A number of federal statutes were issued to establish these rights.
 
The Employee Retirement Income Security Act, more popularly known as ERISA, was enacted by Congress in 1974. All the types of benefits enjoyed by employees are regulated by the act. Not only does it regulate job-based group health insurance plans but it also regulates retirement plans and pensions.
 
With the act, all employees who have health insurance plans as part of their job benefits have a right to information about their health plans. Information on the health plan must be offered to the employees by the administrator of the health plan. This information includes financial information, rules of the plan, and the management and operation of the plan.
 
In 1985, the Consolidated Omnibus Budget Reconciliation Act (COBRA) was enacted. It required employers who had more then 20 employees to offer a continuation of the coverage to their employees who need to leave their health plans because of certain reasons.
 
The employer must offer this continuation to the employee (including the employee’s dependents) when one of these qualifying events occurs to the employee: reduction of working hours, death, legal separation or divorce, termination of employment, becoming eligible for Medicare, and when an employee’s dependent child loses eligibility.
 

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08/05/2009

The total premium of a health insurance policy should be clearly shown on the proposal’s summary page. With all of the various financial figures that one usually finds in group health insurance proposals, locating the important numbers can sometimes be confusing.
 
Group or business health insurance proposals are formatted in various ways, but they have some common points that one can look for. Upon inspection, the group proposal should have a “Plan Summary” or “Plan Grid” included in it. This part of the proposal should provide a summary of the available group or business health plans from the different insurance providers represented in the quote. One segment in this summary will display the main details of the plan like co-payments, deductibles, out-of-pocket limits, coinsurance percentages, coverage for prescription drugs and hospitalization benefits. With the health plan choices listed in the summary table, there is usually also a total cash amount connected to each of the health plans. Usually, this amount will correspond to the total premium for all the individuals and their dependents included in the quote. This amount may or may not represent the premium cost that the employer will pay per month. It will also depend on how much of the total premium the employer intends to shoulder, as percentage of the employee and dependent premium.
 
For instance, it is given that the employer intends to shoulder 75% of the premium for all the members or employees and dependents. For Health Plan X, which displays a total premium worth $2,000 on the quote summary, the employer will pay $1,500. The remaining $500, or 25% of the total, will then be charged to the employees.
 

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08/05/2009

Many U.S. residents see Alzheimer’s as a very alarming disease. But what is even more alarming is the thought of paying for health care for an Alzheimer’s sufferer with the current American health care system. However, there are actually health plans for those who cannot afford the costs associated with Alzheimer’s. These options include long-term care insurance, Medicare, disability insurance, and Medigap.
 
Around 42 million Americans are covered under the Medicare insurance plan. People who are 65 years old and above and people who have qualifying disabilities receive insurance coverage funded by the government through Medicare. However, many people still need to supplement their Medicare coverage. Many private insurance companies offer this supplementary coverage called Medigap.
 
As supplementary coverage, Medigap can be combined with an individual’s Medicare coverage. Health insurance companies throughout the U.S. offer this kind of insurance coverage. State and federal laws define the coverage of the policies of Medigap. These policies include details regarding hospital and coinsurance costs that are not included in the person’s Medicare coverage, as well as deductibles that are associated with a stay in the hospital.
 
For those worried about contracting Alzheimer’s, one of the better options might be disability insurance. Insurance companies only offer this kind of insurance before the diagnosis of the disease.
 
In case a person does not have disability insurance but is stricken with Alzheimer’s disease, he or she can qualify for Social Security Disability Income, which is offered by the U.S. government.

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08/05/2009

If you are considering having liposuction, breast enlargement, rhinoplasty, or breast reduction you are not alone. Plastic surgery has become very common nowadays, so that people can now have an express treatment done over a coffee break within a busy day. In 2006, around 11 million plastic surgery procedures were completed in the United States. However, having an elective surgical procedure can be very expensive. Only a very small number of individual health insurance policies provide coverage for these procedures. An example of a covered procedure is reconstructive surgery or if the cosmetic procedure is necessary for your health. Usually, coverage of these procedures is only provided for special cases, and even so, it is possible that not all of the expenses will be covered by the policy.
 
Health insurance companies usually provide coverage for elective procedures under a number of special circumstances. These special circumstances include being in an accident (reconstructive surgery), being excessively overweight (liposuction), having a mastectomy (breast reconstruction), and having problems with one’s respiratory health (rhinoplasty).
 
To know whether the elective procedure that you wish to have is covered by your plan or not and how much it would cost you if it is not covered, you must consult with your health insurance provider. However, it might be better for you to get another insurance plan if the operation you wish to have is just for cosmetic purposes. Getting a different plan could lessen the cost.
 

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08/05/2009

Finding individual health insurance at an affordable rate is an achievable reality. There are many ways in which health insurance can be obtained. The rule of thumb to keep in mind is that the plans that have the most members are more likely to provide more, and therefore better, savings for their members.
 
Self-employed individuals can apply for health insurance plans through the National Association for the Self-Employed (NASE). NASE is the country’s leading resource for micro-businesses that brings together a wide range of benefits to assist entrepreneurs and to contribute to the growth of this important segment of the US economy. This organization has programs known as the 105 HFR through which small businesses are given the option to subtract all of their non-insured medical expenses and premiums from the federal, state and self-employment taxes.
 
Also by simply becoming a member of organizations such as alumni or trade associations, an employee may secure a cheap, individual health plan. Employees should join an association that is pertinent to their job description. For instance if the employee is a journalist their best option is to join the American Society of Journalists and Authors. Nevertheless, an association does not always have to be job-related in order to be relevant to an individual. An organization can be relevant to someone just because he is a single dad.
 
These associations can offer affordable, individual health insurance plans because, unlike group health plans, they are not intensely scrutinized by state regulations. One must bear in mind that the premiums offered to members will not always be uniform as is the case for premiums in group health plans.

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08/05/2009

Medical insurance plans usually do not include coverage for medical issues that arise during a visit to foreign countries. However, health issues, such as illnesses and accidents, do arise. Travelers’ insurance guarantees that the insured need not worry about any of these possibilities during his/her trip to foreign countries.
 
Medical insurance companies offer several plans, including medical travel policies, which can assist a traveler with his/her medical needs when traveling. The cost of this kind of insurance policy varies, depending on the medical limits the insured person chooses and his/her age. Some medical travel insurance policies even cover trip interruption and evacuation benefits. Some offer one-year coverage while others offer shorter periods of coverage.
 
Another type of plan, the package travel insurance policy, covers more than just the traveler’s medical needs. It also offers assistance with lost passports, money transfers and some legal issues. The cost of this plan also varies depending on inclusions, age of the insured, cost of the trip and the length of the trip.
 
Travelers may also consider medical evacuation policies to be important. This type of travel insurance provides transportation to the closest hospital in the event of illness or accident. Other medical evacuation policies even cover transportation back to the United States.
 
In the event of a terrorist attack, some evacuation plans also allow the insured to cut short their vacation, cancel their insurance and receive reimbursement. So when obtaining travel insurance coverage for acts of terrorism should also be considered.
 
Since the cost of travelers insurance is usually 4%–8% of the insured person’s travel cost, it is best to explore the diverse coverage that insurance companies offer and find the one that best suits your needs.

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08/05/2009

Unfortunately, having your health insurance claim denied is a common occurrence in the U.S. While there is always hope that your claim was denied due to a misunderstanding, a resolution of the issue is never easy.
 
Never assume that the first “no” answer you receive from your insurance company is final. You are always legally allowed to appeal the insurer’s decision. If you do choose to appeal a denied claim, you need to act quickly. Usually, insurers will only give you 40 days after the denial to start the process of your appeal.
 
The first thing you should do is to outline your argument as to why the insurer should honor your claim. Read your health plan policy document carefully in order to determine exactly which treatments are included in your coverage and which are not. Insurance companies usually cover treatments that are explicitly included in the health plan policy.
 
During your appeal process, your physician may be able to write a letter of appeal on your behalf. Many denied claims also get resolved by changing the method by which they are billed. The billing department of your physician may be able to modify the method of billing and resubmit it.
 
You may also seek help from non-profit organizations, such as the Patient Advocate Foundation. Since 1996 the foundation has assisted more than 21 million people, involved in disputes with their insurers. It also assists those searching for affordable treatments who are not insured.
 
Your physician and foundations such as Patient Advocate can help you phrase your arguments in a way that is acceptable to the health insurance companies. The process of appeal usually takes up to four business days, but for claims of more than $10,000, the process may take up to 30 days.
 
Even with repeated denials, determination always tends to get the best results.

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08/05/2009

Some companies or organizations may want to be selective when it comes to deciding which of their employees should receive health insurance, or they may want to offer different levels of health insurance through different insurance providers, depending on employee level or class. For instance, a company may wish to make health insurance benefits available to their employees at the managerial level. Placing limits on the number of employees or members that are able to obtain group health insurance is called “group carve out”. Some common examples of group carve outs are “management only”, “salary vs. non-salary” and “union vs. non-union”.
 
It is the insurance provider’s right to decide whether it allows carve outs or not. The provider may also put certain limitations on which kinds of group carve outs it accepts. The insurance carrier may also require that a carve-out group meets the standard requirements for minimum participation. In addition they may even request full, or 100%, participation of all the qualified members or employees in that carve out group. Some insurance companies may also set a minimum number of members per carve-out group.
 
Most of the time carve-out groups are not included in the state health insurance law that mandates guaranteed issue for small business or group health plans. Therefore an insurance company may require each member or employee in a carve-out group to answer health questionnaires. If a member of that group is categorized as high-risk, the insurance company may decline their application for insurance coverage. The options and choices available to group carve outs are often limited. Additionally, insurance providers may also restrict the carve-out group’s employer from offering alternative choices or options through other insurance companies.
 

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08/05/2009

Usually an employee must work for a company for a specified amount of time before he or she becomes eligible for that company’s group health insurance plan. In the terms of the health insurance policy, this is called a “waiting period”. If an employer is going to establish a new group health insurance plan, he or she must select a preferred waiting period for newly hired employees from several choices or options. The options available for waiting periods may differ from one insurance carrier to another, and it can range from one month to one year following the date of employment.
 
The waiting period does not affect or apply to employees who are employed by a company at the time the group health plan is initially established. However, a company may impose the waiting period on recently hired employees who do not meet the group health policy’s selected waiting period.
 
Most of the time, group health insurance plans have a “first of the month” effective date for the inclusion of any new qualified employee. This means that if a company has a waiting period of one month, a recently hired employee may enroll in the group health plan on the first day of the month following the date he or she began working for the company. For instance, if a newly hired employee starts working on November 18 for a company that has a waiting period of one month, he or she will then be qualified to enroll in the group health plan on January 1. A company’s selected waiting period at the time of the group health plan’s establishment must be applied to all new employees.

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08/05/2009


Group insurance is one of the most important benefits a company can offer its employees. In these difficult days, some workers even choose to stay with a company just to keep their health insurance coverage. Even businesses with as few as five employees can offer health care coverage through group health insurance.
 
Group health insurance is employer-sponsored health-care coverage issued to a group, such as trade associations and credit unions, which provides health coverage for group members and their dependents. With group health insurance, business owners usually pay at least half of their workers’ health-care monthly premiums.
 
How does group health insurance work? When the employee and his/her eligible dependents satisfy the "deductible," which is the first part of the total eligible costs that occur within a given year of coverage, the insurance company usually shoulders 80% of the eligible expenses. Moreover, group health insurance provides the insured with health coverage regardless of any pre-existing medical condition.
 
Group health insurance usually covers physician fees, nursing services, X-rays and medicines. Exclusions from the provision of medical benefits under group health insurance include certain mouth conditions, rest cures, expenses incurred due to self-inflicted injuries and the medical expenses of a member of another Health Maintenance Organization (HMO).
 
If the insured has two insurance plans, one health plan becomes the primary health insurance which shoulders the insured’s health care costs until the maximum eligible expense level is reached. Usually a health plan covers health care costs of up to $5,000. The other plan, which is the secondary insurance, pays for the expenses not covered by the primary plan 

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08/05/2009

According to a report, more than 60% of Americans with health insurance get their coverage through a group health insurance plan sponsored by their employer. These employers make use of health insurance plans that are specifically designed for small or large businesses. It is a fact that for many employees, health insurance is the most valuable benefit that their job offers them. A large percent of the revenues that health insurance companies earn is made up of the billions of dollars spent by U.S. companies on their employees’ health insurance.
 
Recently, for companies in the U.S., the cost of providing health care insurance for employees has seen a remarkable increase. This increase is principally due to the increasing costs of prescription drugs and health care. Many U.S. companies have been forced to reduce the benefits enjoyed by their employees under their group health insurance plans because of these continually increasing insurance costs. As a result when employees need prescription drugs or medical treatment, the expenses that come out of their own pockets increase as well.
 
Due to the health insurance offered by U.S. employers, a large number of Americans are compelled to stay with their company. This is even more common amongst those employees who depend on the benefits provided by their employer because they have a pre-existing medical condition that prevents them from acquiring an individual health insurance plan. It even comes to a point when such employees are willing to continue working for a company despite a lower salary, just to enjoy these benefits.
 
U.S. companies that offer these kinds of health care benefits usually have a low rate of staff turnover. Attracting quality employees and lowering the rate of employee turnover are actually the two main reasons given by employers for offering such benefits in the first place.

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08/05/2009

Access to health insurance usually requires a steady income. Most insurance plans in the United States are provided by employers through group insurance plans and as a result unemployed Americans are frequently at a disadvantage with regards to obtaining affordable health insurance.
 
Thanks to some federal programs and numerous private insurance companies, unemployed Americans and their families can now get short-term medical insurance. Among the federal programs that offer subsidies to employees who wish to continue their health insurance after losing their job is the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA).
 
COBRA helps pay 65% of the former worker’s insurance premium for up to nine months. COBRA provisions, however, only cover those who lost their job involuntarily. It also applies to those whose employment was terminated for a reason other than gross misconduct. Workers who are made redundant as a result of a large layoff may also obtain the subsidy. Applicants must be eligible for employer-provided health insurance the day before their last date of work.
 
COBRA is an excellent choice for those who are able to plan their resignation. However, it can be very expensive, with an average monthly payment of $700 for families. In 2003 only 7% of laid-off workers could afford COBRA.
 
For someone who is expecting to get another job soon or those who just lost their student health insurance plan, finding other short-term health insurance may be a better option. A typical short-term insurance policy offers six months of coverage, although some cover up to one year.
 
Health coverage of up to $2 million, low monthly premiums and fast approval of applications make short-term coverage a good option for anybody who is still in the transition process.
 

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08/05/2009

According to the American Pregnancy Association, every year, 13% of pregnant women are not enrolled in any health plan. In addition, because pregnant women find it difficult to purchase health plans, many of them either shoulder all the medical expenses of their pregnancy or receive insufficient pre-natal care.
 
Pregnant women are frequently denied health coverage by insurance companies mainly because pregnancy prior to obtaining insurance is considered a pre-existing condition. To many insurance companies people with pre-existing medical conditions, such as cancer, liver and heart disease, are “high risk candidates” who need more financial assistance. The law allows health insurance providers to decline applicants who are classified as “high risk”, and many of them do so.
 
However, pregnant women who do not have maternity coverage in their health plan or who do not have any medical insurance at all still have options that can assist them with their medical expenses. One important option for uninsured pregnant women is AmeriPlan, an American company that offers discounted maternity coverage. For a very low monthly fee pregnant women can have access to an array of maternity and prenatal care services. AmeriPlan also gives as much as a 50% discount at some health care providers.
 
Pregnant women with low incomes may also seek assistance from Medicaid, a health care program funded by the federal government. Women, Infants and Children (WIC), another government-funded organization, provides an additional option for uninsured pregnant women. WIC even provides grants or assistance, such as health care referrals and even food supplements to low-income pregnant women as well as to children under five years of age who are found to be at nutritional risk.
 

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08/05/2009

A discount health-plan organization provides its members with access to discounted health care. Members of discount health plans pay for membership on a monthly or yearly basis. This type of health plan also provides discounted rates on medical-related services.
 
Companies that run or offer discount plans are not insurance companies. Discount plans are also not insurance policies that provide broad health coverage.
 
Many discount plans offer discounts of up to 40% on medical, vision, hearing and dental services. A discount health plan is often an attractive option for those who cannot purchase health insurance due to pre-existing conditions. Discount health plan providers, unlike insurance companies, do not pay health care providers for their services.
 
Before enrolling in a discount health plan, make sure that the total amount you will pay for your membership fees annually will not exceed the money you are going to save in discounts. It is also wise to make sure that there are enough drugstores and health care providers in your local area and that these providers are trustworthy. A disadvantage of a discount plan is the fact that there is no regulatory agency monitoring discount-plan companies. Therefore, verifying whether the company you are considering is reputable or not is often a challenge. It is necessary to assess every aspect of the discount plan before choosing to sign up.
 
However, if you think you will spend a lot on prescriptions and health care services over the following year and if you do not have health insurance, a discount health plan might be the right solution for you.

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08/05/2009

As well as the usual considerations when entering college, prospective enrollees and their parents should check their insurance policies and providers to ensure that their health coverage will continue to be comprehensive and uninterrupted.
 
As colleges stress the importance of student health insurance they continue to create measures, such as requiring proof of health coverage, which prospective students must satisfy before being admitted. This gives students another question to think about before deciding to enroll in their college of choice, which colleges impose insurance requirements? From that point on, it’s all about considering different coverage options.
 
According to a report from the Government Accounting Office, 1.7 million college students in the U.S. do not have health insurance coverage. The report also reveals that students without coverage spent around $255 million in non-injury-related medical expenses in 2005.
 
Aside from requiring enrollees to provide proof of insurance coverage, many colleges are also offering coverage options via student health insurance plans. The GAO report estimated that around 60% of all the colleges in the country provide student health insurance.
 
Compared to individual health insurance plans, the eligibility requirements for student health plans are less restrictive. If students take advantage of the policies provided by their respective colleges they should automatically be qualified for coverage once they register as full-time students.
 
The only drawback of student health plans is the variation in benefits and cost. Coverage is very specific. That is why it is important to examine how any policy would deal with specific claims before deciding to buy coverage.
 

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08/05/2009

The second most common cause of cancer-related death in women in America is breast cancer; the leading cause is lung cancer. One out of eight American women will have breast cancer at sometime in their life. However, only one out of 28 American women will die of it. If you are diagnosed with breast cancer it is important to have a reliable health insurance policy, which will help you get the necessary health care. With the availability of regular breast examinations and mammograms conducted in clinics, you will have a greater chance of surviving breast cancer if you have a good health insurance policy.
 
Everyone, regardless of age or gender, can develop breast cancer. It is extremely important to detect breast cancer early as the chances of curing it are then much higher. Regular mammograms and breast examinations conducted in clinics are the best ways of detecting breast cancer. These should be done on a regular basis to detect the cancer as early as possible.
 
A great number of women are affected by breast cancer. It is important that all women have health insurance policies that not only cover mammograms, but also the necessary medical attention that they will need if they are diagnosed with breast cancer. Breast reconstruction, mastectomy, chemotherapy and follow-up appointments with the doctor should all be covered by the policy. By law health insurance policies that cover mastectomy procedures must also cover breast reconstruction.
 
In 1998 the Women’s Health and Cancer Rights Act was passed. It protects patients with breast cancer who wish to have breast reconstruction after undergoing a mastectomy. Under this act insurance companies and other HMOs (Health Maintenance Organizations) who offer coverage for mastectomies must also offer coverage for breast reconstruction.

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08/05/2009

Pre-existing conditions are medical conditions that a person has before he or she signs up for a health insurance policy. The term usually has a negative connotation. A pre-existing condition could make you ineligible for health insurance. If an individual with a pre-existing condition is eligible for health care coverage, he or she will probably pay higher premiums than usual.
 
Individuals with pre-existing conditions who would like to get health insurance should not worry as some insurers do offer coverage for people in this situation. However, a number of restrictions may be applied. Each insurance company that offers health plans will have a different underwriting procedure.
 
Pre-existing conditions come in a variety of forms. Obesity, diabetes, arthritis, depression and pregnancy are just some of the most common pre-existing conditions. Some insurance companies have a list of the pre-existing conditions for which they offer insurance coverage. Each insurance company as well as having its own list will also have its own standards when it comes to offering insurance for pre-existing conditions.
 
Usually an insurance company will ask a newly insured person to go through a waiting period. It is only after this period that a person’s pre-existing condition will be covered by his or her health insurance. A number of individual health insurance policies will ask the individual to go through a waiting period that is usually from 12 to 18 months long. Only after this period will the company pay for any medical expenses that arise from the person’s pre-existing condition.
 
Fortunately, people with pre-existing conditions who get health insurance are protected by a number of laws. One of these is the Health Insurance Portability and Accountability Act (HIPPA).

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08/05/2009

A large number of men in the United States and across the world are affected by prostate cancer. Erectile dysfunction and difficulty urinating are some of the symptoms of the disease. Prostate cancer is the most common form of cancer experienced by American men. It is estimated that in 2007, 218,890 American men will have been diagnosed with this type of cancer.
 
Age is one of the important causative factors for prostate cancer. Around 70 percent of American men who have been diagnosed with prostate cancer are 65 years old and above. According to the American Cancer Society, African-American males have a greater risk of being diagnosed with the disease than White, Asian and Hispanic men. Another factor that influences the disease is genetics. The risk of having prostate cancer is directly correlated to the number of relatives a man has who also developed prostate cancer.
 
With the abundant research done on the disease one conclusion is clear, men with individual health insurance are less likely to die because of prostate cancer.
 
This does not mean, however, that men with health insurance will not develop prostate cancer. It only means that these men can get the health care they need to ameliorate the adverse effects of the cancer. This is one of the strongest arguments in favor of men having health insurance. When you are searching for a good health plan, ensure that the policy will cover prostate treatment as well as preventive care.
 
Yearly prostate examinations are recommended for men who are 50 years old and above, men who have a high risk of cancer and men who have a family history of prostate cancer. Prostate examinations will help detect the cancer at an early stage, thus making treatment more effective.

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08/05/2009

With the soaring costs of hospitalization and medicines, health care has become too expensive to bear personally. Thus, it is necessary to purchase health plans and thereby save money.
 
Insurance companies offer a wide range of options in terms of health insurance plans. The two most common types of health insurance are reimbursement or indemnity plans and managed care plans, such as preferred provider organizations (PPO), health maintenance organizations (HMO) and point of service (POS) plans.
 
With the indemnity plan the insured can choose his or her own physician and pay for health care expenses in full or on an installment basis. Managed care plans offer wider coverage, involving an arrangement between the insurance company and a selected network of health care providers, such as hospitals and doctors. Some HMOs require that a doctor in the network manages the entire health-care needs of the patients, referring the patients to specialists within the network as and when required.
 
If you are enrolling in a medical insurance plan, it is necessary to completely understand the type of coverage offered by health insurance companies. Insurance companies offer different types of insurance, such as hospital expense insurance, which covers expenses for room, board and incidental service costs if the insured is hospitalized; surgical expense insurance which provides coverage for surgeon’s fees and other fees associated with surgery, and physician’s expense insurance which pays for doctors' visits.
 
Major health insurance plans provide extensive coverage and benefits designed to protect the insured from the costs associated with injury or illness. When purchasing a health plan, one should always examine the policy carefully and read between the lines. Check for additional benefits, such as preventive care, coverage for prescription drugs, mental health benefits, vision care, maternity care and others.

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08/05/2009

It is very tempting to just scan through the fine print and the jargon when reading about health insurance. However, this will surely not help when you are performing health insurance comparisons. Take the time to study carefully the different options that are available to you. Doing so can help you save money.
 
It is not difficult to perform health insurance comparisons. This is particularly true today. You don’t have to make a lot of phone calls as with the advent of the internet gathering information has become much more convenient. There is a huge of amount of information available online. You can find information on many insurance companies with just a click of a mouse button. Finding information is also no longer confined to business hours. As well as visiting individual company websites, you can also visit websites that have information on a wide range of health insurance providers and their plans.
 
You will be spending your time wisely when you take time to make health insurance comparisons. Health plans from different companies may be similar, but the prices can differ significantly. It is also important to take your time when comparing health insurance plans because each person has different health needs. A plan may have an option that you don’t need. Comparing health insurance plans will help you select a plan that features the options that you need.
 
When making health insurance comparisons, take the time to read the fine print and to understand the jargon. It is important to do this before you choose your provider. The time you spend researching can certainly make a big difference when it comes to the costs that you will eventually have to pay.
 

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08/05/2009

With a multitude of health care plans available, choosing the appropriate one can be tough and tedious. That’s why it is important to understand the different considerations before choosing a health insurance policy.
 
Some of the health care providers require you to use treatments and services within their network. If you already have a personal doctor, you can inquire whether he is included in the health provider’s network. If you need a new doctor, you can ask your health provider for a list of doctors within their network.
 
Specific medical conditions need specialists. Just like doctors, you must check whether your specialist is part of your provider’s network. If you don’t have one, and you feel that you’re going to need a specialist in the future, ask your health care provider if you need to consult with your primary-care physician before seeing a specialist.
 
Pre-existing medical conditions are also a vital factor to consider when making health insurance comparisons. Even though this is common sense, some people still forget to ask their insurance providers about the coverage for pre-existing conditions. Others just assume that they are covered. For those who join a new group health insurance plan, the Health Insurance Portability and Accountability Act or HIPAA makes sure that their pre-existing conditions are covered, provided they have had insurance for the past 12 months.
 
By taking into consideration some of the important factors in choosing the right health insurance plan, you will have a rough estimate of the cost of your insurance plan. When it comes to cost, you must take into consideration variables such as deductibles and co-payments.
 
Following these tips will help you find the type of insurance that suits your needs.
 

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08/05/2009

Nowadays, it is difficult to find an affordable health insurance plan. The rising costs of health care as well as those of health insurance have contributed to this. However, do not let this discourage you from acquiring insurance or force you to get the first health insurance plan you see. Remember that you have several options that will still leave you with health insurance costs that you can afford.
 
To be able to choose the health care insurance plan that is right for you, you will need to spend some time looking at your options critically. Going through this process will help reduce your health insurance costs. It is also important for you to accurately assess the kind of health care that you need. People require different kinds of health care depending on their age and health status.
 
You will be able to save money when you get an individual health insurance plan that only covers the kind of health care that you need. To get reduced health insurance costs, take your time and research the various options that are available. You will find that the differences between the prices of similar health plans from different insurance companies can be astonishing.
 
These days, it is very easy for anyone to look for health insurance plans. With the internet, finding the best choice for you just takes a little bit of effort and time. With many plans and providers just a click away, you can easily find a plan at an affordable cost.
 
Even though costs are rising, you still have several options that you can choose from. You just need to do some research and take the time to plan.

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08/05/2009

The U.S. health-plan market is run by a complex system of federal state laws and regulations that are already out of date and therefore counterproductive. One of these laws is the federal tax code. People receive unlimited tax breaks when purchasing health plans, if they get their coverage through their employers. Outside the workplace, Americans pay for health insurance with after-tax dollars. The solution to this inefficient system is a statewide insurance exchange, which offers individuals and families the chance to obtain the health insurance of their choice without losing tax benefits.
 
By law many health insurance tax benefits are only available to those who are subsidized by their employers or are in an employer-based system. Purchasing health plans outside this system often entails not only inflexible government mandates and high administrative costs, but also state and federal tax breaks. Losing these tax breaks can mean an addition of 40 to 50 percent to the total cost of the purchased health care plan, compared to the cost of obtaining it with an employer's subsidy.
 
The solution to this problem is a single health insurance market, which should be designed to work well for everyone, not just for employees working for large companies.
 
A health insurance market exchange should be designed to work as a market for every type of insurance plan, including health maintenance organizations, health savings accounts, traditional health insurance plans and other options that might present themselves in response to people's demands
 
In principle a health insurance exchange should work like a stock exchange, which functions as a single market for all sorts of stocks and which regulates the costs of selling, purchasing and trading stocks.

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08/05/2009

A health plan is definitely something to consider whenever you are about to have a baby or if you are going to adopt. To protect the health of your baby, a health plan is certainly necessary. To provide the new member of your family with the same coverage as you, the best option is to include your baby in your existing individual health insurance policy.
 
If you currently do not have health insurance coverage, it would be very wise to consider getting a health insurance policy. This would not only be good for your health care needs, but for your baby’s needs as well. If you already have a health insurance policy, another option would be to make its coverage level higher. Now that you have a child, you must also ensure that you are able to maintain your health so that you can take care of your child.
 
If you plan on adding your baby to your health insurance policy, make sure that your policy will allow you to do that. If possible, compare the increase in your policy’s premium after the addition of your baby to your policy with the premium for a new policy. Choose the one which is the most efficient in terms of cost.
 
It is also important to understand the requirements that must be satisfied when adding your baby to your policy. Doing this will help you stick to the rules set by the company and thus enable the quick addition of your baby to your policy.
 
Finally consider your policy options and the kind of coverage that they include. It is important that your baby is fully covered. Immunizations, visits to the doctor and others should be included.
 

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08/05/2009

Insuring the safety and health of one’s child is a top priority for all parents. It is therefore very important to find a health insurance plan that will meet your child’s needs. Health insurance will not only help protect your child’s health, but it will also protect you from expensive medical fees. Frequent visits to the doctor and check-ups are normal for children. With health insurance, you can have peace of mind and ensure that your child is being well taken care of.
 
Parents usually find it difficult to search for affordable health insurance for their children. It is not surprising that they only want the best coverage option for their children. Although the health care needs of a child are a primary concern of every parent, it is also important to find a plan that will fit the family’s financial requirements. Fortunately, it is no longer difficult to find appropriate health insurance for one’s child.
 
Nowadays, parents have many options when choosing their child’s health insurance plan. An individual health insurance plan is one of these options, which parents can get from public and private entities. A large number of PPOs and HMOs have individual health insurance plans designed specifically for children. For families with a low income, federal and state plans, such as the State Children’s Health Insurance Program, offer individual health insurance custom-made for children.
 
Parents can also add their children to their group health insurance plans if their employers provide them with group health coverage. If you cannot access a group health insurance plan from your employer, you can look for one through private agencies. A large number of HMOs and PPOs offer family and group health insurance plans.

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08/05/2009

College life is exciting for most students. For some, it will be their chance to live independently from their parents. Others may see it as an opportunity to set the course of their future career that will enable them to live the life that they have always dreamed of.
 
Maintaining a healthy mind and body is especially important to students who are attending college because of the tough academic-related deadlines and rigorous training that they face. Students who are physically, mentally and emotionally fit perform better in school than those who are often sick. Thus, it is logical for college universities to demand that their students have credible student health insurance or a health plan within their budget.
 
If you are a foreign student or a domestic student attending college in the United States, a student health insurance plan will provide you with medical coverage and protection, in case of emergency, until you finish your degree. Students can also opt to remain with their parents’ group health insurance plans. One of the advantages of obtaining private health insurance is that you can access medical services above that which your school can offer.
 
It is best to know the requirements of the school that you are attending to ensure that your preferred health service provider meets the minimum requirements of the school. To make sure that this is accomplished, research and seek advice from professionals to guide you in choosing a health insurance plan that will suit your needs and budget.
 

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08/05/2009

Every year the United States has a large number of visitors. People come either as tourists or to visit their relatives living in the U.S. Others also come as prospective immigrants on various kinds of visas.
 
Health care in the U.S. has become so expensive that in the event visitors get sick or need hospitalization, it is often difficult to meet the costs. Since no one knows when they will become ill or have an accident, it is necessary for a visitor to enroll in a medical insurance plan, even a temporary one, covering his or her stay in a foreign country. Medical insurance is necessary for visitors who are staying longer, such as parents of green card holders. Older people, especially those coming from tropical regions, cannot adapt to the cold climate as well.
 
The US Department of Health provides free visitor insurance quotes and information about this topic. Medical health insurance plans usually provide coverage for hospital stay, surgery, prescription drugs and doctor visits.
 
Before entering the U.S. potential visitors should check the websites of medical insurance companies for benefits, hospital facilities and premiums. Look for insurance companies that offer affordable and much-needed benefits. Many visitors and new immigrants recommend nriol.net as a source for good medical insurance agents that give quick responses to inquiries.
 
Insurance companies offer different health plans. Although there are several medical insurance plans for travelers, these plans can be classified into two categories: Fixed Benefit Plans and Comprehensive Plans.
 
Fixed benefits plans include "Inbound USA", "Inbound Immigrant" and "Visitors Care." Examples of Comprehensive Benefits plans are "Diplomat Long Term Insurance", "Visit USA Healthcare Insurance" and "World Long Term Insurance."
 
You might think, especially if your stay is a short one, that traveling to a foreign country without medical insurance is acceptable. However, although medical insurance for foreigners may be costly, it provides peace of mind and if you should be unfortunate and require medical treatment you will be glad that you purchased medical insurance.

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08/05/2009

For low-income earners in the U.S., the rising cost of health care in the country has become a very big problem. According to the Commonwealth Fund, 96% of families who earn $60,000 or more per year have health insurance that they can use to pay the burdensome expenses of health care. On the other hand, 53% of families who are considered to have low incomes are either uninsured or have had a lapse in their coverage.
 
For families without insurance, the consequences can be devastating. Unlike persons and families with insurance, individuals and families without insurance tend to avoid going to a doctor. Because of high costs these uninsured individuals or families do not get the urgent or preventative care they need. A lack of access to preventative care often means that uninsured individuals are diagnosed with serious diseases when they are already at an advanced stage.  In addition a third of families without insurance find it extremely difficult to pay for their medical bills.
 
If PPOs and HMOs are too costly for a family’s budget, there are alternative options. These options include the Health Savings Account and the Mini Medical Insurance Plan.
 
A Mini Medical Plan can cost as little as $50 per month. This would include coverage for prescription drugs, hospital benefits, a number of visits to a doctor and partial accident coverage.
 
Another relatively new and inexpensive way to get coverage for one’s health needs is the Health Savings Account (HSA). HSAs work when used together with a health plan called the High Deductible Health Plan (HDHP). The premium for an HSA is significantly lower than premiums for PPOs (Preferred Provider Organizations) and HMOs (Health Maintenance Organizations).

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08/05/2009

A student who wishes to obtain formal education abroad must secure a good health insurance policy. There are two types of health insurance policies a student might consider, international travel insurance and student insurance in the country where they plan to study. The type of insurance commonly bought in a student’s home country before they go abroad is international travel insurance. Student health insurance, on the other hand, allows a student to pay only a percentage of the medical expenses at the time when medical services are rendered. This medical cost is called co-pay.
 
For an international student who wishes to pursue full-time study, at least six credit hours in the United States, he or she must be at least 14 years of age but not older than 65. Such a student must be eligible to enroll or should have enrolled in one of the required courses. These courses are as follows: a formal university ELS program, Ph.D., master, bachelor or associate. Also, the student must be a holder of a J1 or F1 visa. Spouses and unmarried children aged 19 or below may be included in the health insurance policy.
 
There is also pre-existing-condition exclusion for a period of one year, which means that for a period of one year medical treatment required because of existing health problems will not be covered by the plan.
 
For US residents who wish to study abroad, the terms and conditions of student health insurance policy are similar, though the amount of coverage may be different, depending on the country.

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08/05/2009

Millions of Americans are totally uninsured, while millions more struggle to fit ever-increasing health insurance premiums or the high out-of-pocket cost of covering gaps in their policies into budgets that are already stretched to the limit.  It is clear that most Americans are ready for a change. The only question is:  “What kind of healthcare reform makes the most sense?”
The current system of medical insurance in America has several glaring problems.  The freedom of choice that makes American business so unique—supply and demand, consumer-driven competition, etc.—is virtually non-existent in the health insurance industry.  The tax incentives for employers who offer medical coverage to their workers, along with federal and state insurance regulations that make policies the property of these employers, limit the free market system.  Patients are taken almost completely out of the equation and are usually forced to settle for the coverage their employer has chosen for them.  Furthermore, because policies are owned by employers, employees must leave their insurance when they leave their job.  This eliminates portability of coverage and, in some cases, continuity of care.  Finally, moral and religious objections of patients who participate in group plans are overlooked.  Group premiums are combined to pay for a wide range of services for all members.  This can include things like abortion, birth control, and stem cell treatments.  If an employee objects to a procedure on a moral or religious basis, they are powerless to redirect their premium payments away from those services because their employer controls which insurance policy they are offered and what types of coverage those plans include.  The employee’s only choice is to reject coverage altogether, which is never an attractive option.
Liberals who support health insurance reform tend to favor a single-payer, government sponsored system similar to those in many European countries.  These plans would provide universal coverage to all Americans, regardless of employment or income status.  Contributions would be combined into a single fund that would be used to pay healthcare providers for all services rendered.
Conservatives largely oppose the liberal model, believing a single payer system will actually raise healthcare costs for all Americans.  Some conservatives propose a federal tax credit that would extend to individuals who purchase their own insurance the same tax breaks enjoyed by employers who offer group coverage to their workers.  Others advocate a plan that would allow people to keep the same medical coverage no matter where they work, and to take a plan from job to job.  Another faction supports allowing individuals to purchase health plans from states other than their own without penalty.
No matter which reform model they champion, the ultimate goal of activists is to bring true freedom of choice to health insurance and open a free market system in the industry.  This would make coverage more affordable for millions of people and would expand a patient’s control over his or her personal healthcare.  Insurance companies would be forced to offer more competitive rates, premiums, benefits, and coverage options; thus opening access to essential health insurance for a multitude of uninsured Americans.

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08/05/2009

When you enroll in a group health insurance plan you join a group of other people and combine your purchasing power in order to obtain healthcare.  Since the insurer covers the whole group rather than individuals, everyone shares the costs.  Payments are combined and used to help offset the cost of care for all members—healthy people essentially pay for treatment for sick people with the understanding that this same help will be available to them if or when they need it because they, too, are members of the group.  This system reduces the risk of personal financial disaster due to healthcare costs that may arise from injury, illness, or medical condition.
The following is an example of how a typical group health insurance plan works:
Joe has a medical health insurance plan through his job with a $1,000 yearly deductible, 15% patient responsibility after the deductible has been met, a $4,000 out-of-pocket limit per year, and a $5 million lifetime maximum.  At his annual physical, Joe’s doctor tells him he’ll have to have an operation that is going to cost $100,000.  Joe doesn’t panic, though, because the operation is an approved treatment and will be covered by his medical insurance.  With his deductible—the amount Joe must pay out of pocket before his insurance policy coverage kicks in—Joe must pay the first $1,000 of the cost of his surgery.  After that, Joe’s insurance will kick in with a percentage of the total cost called coinsurance.  Because his policy has a 15% patient responsibility, after Joe pays his deductible his insurance company will pay 85% of the remaining cost of the surgery, or $84,150.  Joe must pay 15%, but only until his annual out-of-pocket maximum is reached.  The out-of-pocket cap is the maximum amount a patient will have to pay for healthcare each year.  Joe’s out-of-pocket maximum is $4,000, so Joe will be responsible for his $1,000 deductible as well as an additional $3,000 to reach his out of pocket cap.  Joe’s insurance company will assume responsibility for the remaining $11,850.  This brings the insurer’s total contribution to the cost of Joe’s surgery to $96,000.  Even if Joe has to go to the hospital again before the calendar year is up, because his annual maximum and deductible have been met, his insurance will pay 100 percent of his expenses.  Joe’s lifetime maximum is $5 million, so his insurance will continue to pay his medical bills up to that amount for the life of his policy, provided Joe pays his premiums on time, and meets his yearly deductibles, his percentage of coinsurance, and his out-of-pocket maximums as needed.  Joe’s surgery is a success and he goes to see his doctor for a follow-up appointment.  The surgeon’s office charges $250 for a visit and Joe’s insurance plan requires a co-payment for doctor visits.  If Joe’s plan has a $20 co-pay then Joe is responsible for that amount and his insurance company will cover the remaining $230 for the cost of the appointment.

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08/05/2009

When choosing a health insurance plan it is important to honestly assess your current health, your risk factors for future conditions, and your budget.  Plans vary in terms of services covered and cost, but remember that the cheapest premium or the greatest number of covered benefits does not always mean the best value.  Obviously, the goal is to choose the plan that will cover the services you need at an out-of-pocket price you can afford.  This is what determines the best insurance value for your money.
Every insurance plan will cover doctor and hospital bills, with varying limitations.  Virtually everything else—prescriptions, vision care, dental care, mental health treatment, preventative care—may or may not be covered depending on the plan.  It is important to make a list of the services you and your family regularly use.  Once you’ve made your list, note the benefits for each category as laid out by the plan you are researching. For example: prescriptions, 50 percent covered; pediatric care, 100 percent covered; eyeglasses, not covered; etc.  This will help you identify healthcare plans based on the services you actually need and use, and will help you determine how comprehensively each plan will meet your particular needs. 
In this tight economy, we are all concerned about the bottom line.  If you are in good health and do not use any medical services, your out-of-pocket costs will be limited to your monthly premium.  If you regularly use several medical services, your actual out-of-pocket expenses may be hard to gauge since you will have to factor in deductibles, co-pays, excess charges, and payment for treatments that are not covered.  The cost for joining a Health Maintenance Organization (HMO) is fairly easy to estimate as patient fees are fixed and nearly everything is covered once the premium has been paid; so long as services are rendered by an approved network provider.  For other types of medical insurance, doing an accurate cost evaluation can be more difficult because out-of-pocket expenses are based on whether you seek care within the organization’s network or choose an outside provider or treatment facility. 
Many insurance plans limit patients’ choice of providers to a list of approved doctors and specialists.  Some plans require patients to seek approval before getting treatment or using services.  If you have special needs or are already established with a trusted physician who does not participate in your new plan, you may want to reconsider changing your insurance. You will have to pay more out of pocket—sometimes even the total cost of care—if you want to continue to see your own doctor.  Financial inhibitors linked to policy restrictions include higher out-of-pocket fees like co-payments, deductibles, and increased patient responsibility for services not covered by the plan. 
Before you make a decision about medical insurance, be sure to educate yourself about all the benefits, costs, and restrictions of a particular plan to help you determine the best value for you and your family.
 

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08/05/2009

Several democrats are voting against the health care reform legislation if it does not have an insurance program commandeered by the government.
 
They also opposed a health plan of Rep. Henry Waxman, D-California and four moderate Democrats, which entailed offering small businesses and individuals a health insurance plan as another option to private insurance, but they intend to negotiate the health care providers’ rates.
 
The Democrats, who opposed the plan of Waxman et al., want the public to be able to pay the same rates that they pay to Medicare, which is lower compared to private insurers.
 
A letter sent to House Speaker Nancy Pelosi, Waxman et al. had this to say about higher reimbursement rates than Medicare rates, “would ensure higher costs for the public plan, and would do nothing to achieve the goal of ‘keeping insurance companies honest,’ and their rates down,” The chairmen of two other committees with jurisdiction over health care reform also received the same letter.
 
The letter also opposed the reduction in insurance subsidies for middle-income Americans, which was in the compromise bill.
 
“We simply cannot vote for such a proposal,” the letter read.
 
Outside the Capitol on a Thursday afternoon Rep. Lynn Woolsey, D-Calif. spoke at a press conference saying that most of the signers support a single-payer health care system, i.e. Medicare for everyone. They have settled for something that still falls short of what they are really expecting; they are no longer willing to compromise more than that,” Woolsey said.
 
Sounds of the protesters were heard on the Capitol grounds shouting, “Single-payer now.” The protesters held their rally near the press conference.
 
Rep. Raul Grijalva, D-Ariz., told the Obama administration and the House leadership before that they believed in their vision of the health care reform because of the solid public insurance plan included there.
 
While the press conference was in motion, Waxman’s committee worked on the legislation. A health care reform bill has already been passed by two other House committees, which includes a public plan that the liberal Democrats would like more. Some of the people on Waxman’s committee and several others balked at this provision, which pressured Waxman to broker another deal just to get enough votes to pass the legislation. Waxman’s committee is expected to vote on this bill on Friday.
 
House leaders will have a difficult task managing the Democrats’ dissension, when Congress comes back from its August break. The bill has two versions that the Congress has to mould into one, and one of the two groups of Democrats (Blue Dogs and Liberal) are going to be disappointed with the final verdict.
 
Insurance companies and several business groups do not approve of the public plan. They argue that the charge on private users is higher compared to Medicare because Medicare pays below-market rates for their services. If the government makes a public plan based on the rates of Medicare the problem would only worsen, which will cause premiums to increase for those businesses that are covered by private insurers.
 
Some people are afraid that this might force private insurers out of the market, which will leave the pubic plan as the people’s only choice.
 
But Rep. Nydia Velazquez, D-N.Y., stated that a public plan might just be the thing to nudge private insurers to lower their rates and try to compete.

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08/05/2009

Health Maintenance Organizations (HMOs) are a form of managed healthcare insurance.  Customers belong to a larger group of plan participants and pay fixed monthly fees in order to receive care.  Providers receive a fixed, pre-negotiated fee from the insurance company in exchange for their services.  Most HMOs only cover services provided by a limited network of doctors and facilities.
Many employers and government agencies use HMOs to offer health insurance for employees.  The overall goal of the HMO is to keep medical costs low for all members.  Insurers accomplish this by contracting with specific doctors, dentists, clinics, hospitals, and other providers, and insuring large groups of patients.  This allows the company to negotiate for lower prices based on volume participation.  HMOs also lower premiums by identifying and eliminating certain procedures and treatments they deem medically unnecessary. 
As with any health plan, there are advantages and disadvantages associated with HMOs.
The cost of a monthly HMO premium is relatively inexpensive when compared to other types of health insurance.  Premiums are fixed and co-payments are usually the only required out-of-pocket expense for patients; some HMOs do not charge co-pays at all.   Most HMOs require patients to designate a primary care physician who acts as a single point of contact for all other care.  While some see this aspect of HMOs as a disadvantage, others find it comforting to know that their care is being managed by a single provider who has access to their complete medical records and healthcare history.
Choosing a primary care physician can be problematic, however, as patients may have to switch doctors and thus interrupt continuity of care.  Patients typically have less control over their own care and may have to wait to receive treatment if they need specialized care.  If a patient wishes to see a specialist, she must first make an appointment with her primary care physician.  If the primary doctor deems the specialized service medically necessary, he will submit a referral to the HMO.  The HMO either approves or rejects the proposal and, if the referral is approved, only then is the patient free to make an appointment with the specialist.  If the referral is denied, the patient must then choose to forego the treatment or will have to pay the total cost of services out of pocket.  Another disadvantage of HMOs is that they typically limit coverage in an effort to cut costs, focusing on treating conditions as they arise rather than on preventative care and long-term health.
When considering purchasing an HMO plan, think about your particular needs.  Do you have a condition which requires specialized care?  Might you need this kind of treatment in the future?  If you already have a doctor you trust, will you have to find a new one?  Would a change in physician interrupt your care?  Finally, research the HMO’s reputation in your area and figure out if the cost of the plan is reasonable for the level of care you will receive as a member.
 

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08/05/2009

The high price of health insurance can be intimidating, deterring many people from taking on the additional expense, especially during these difficult financial times.  However, even a minor motor-vehicle accident resulting in injuries can run up expenses that may seriously drain personal savings.  In the long run, not having any medical coverage can cost much more than paying a monthly health insurance premium.
According to a 2008 survey conducted by the Kaiser Foundation, the average cost of employer-sponsored health insurance for an individual was about $4,700 per year; the cost for a family of four was just over $17,700.  For those who do not have the benefit of a health plan through an employer or spouse’s job, the cost of purchasing an independent individual or family plan can be considerably higher.  If you are thinking about buying health coverage on your own, use these figures as a baseline for your own research.
When it comes time to comparing plans and prices, be sure to keep in mind the factors that may affect your final premium.  These include age, gender, health history, location and the type of plan you select.  Because older people typically require more medical treatments and preventative care, most health insurance plan premiums jump significantly for consumers over the age of 50.  Females can expect to pay more for health insurance, though the exact reasons for this are unclear.  A history of good health translates into lower premiums, while some pre-existing conditions could exclude you from coverage altogether.  Prices for health plans vary from state to state, so your residency could also have an impact on how much you will pay for coverage. 
When you begin your search, check the Internet for online health insurance quotes.  Your initial quote will take into account only your most basic information:  your age, gender and state of residence.  This figure is meant as a starting point only and may not give you a comprehensive picture of your final cost.  Once you have made a decision about the kind of plan that best suits your needs, you will complete an application and receive a more accurate final quote.  The application will likely include detailed questions about your health history and any pre-existing medical conditions; some health plans may even require a doctor’s physical examination or basic medical tests.  The number generated by this second quote will be much more representative of what you can expect your monthly premium to be.
Of course, if you prefer not to go it alone when purchasing health insurance, you can always turn to a reputable broker.  These insurance experts will have expert knowledge of the market in your particular area, as well as personal relationships with several insurers that will help you make a truly informed decision.  You can also visit your state’s insurance department website for more information about the rules and regulations specific to your location, or to explore state-sponsored healthcare plans you may qualify for. 
 
 

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08/05/2009

Choosing a primary care doctor or a specialist can be a daunting task, but it is an undoubtedly important decision and worth taking the time to do the proper way.
First, check with your insurance carrier for a list of approved providers.  If your plan restricts you to seeing certain medical professionals, you’ll want to know this ahead of time.  This will help you narrow your focus to only those doctors in your plan’s approved network and will save you the out-of-pocket expense of treating with a non-network provider.
Once you have a solid list of leads from your insurance company, ask around for recommendations.  Talk to neighbors, friends and co-workers; see if they have any experience with or knowledge of any of the physicians on your list.
Next, do a background check.  This is easy to do online and you can get important information about a doctor’s educational history, records, licenses, board certifications, and even any disciplinary action or lawsuits brought by patients.  Your state medical licensing board is a good place to start.  You can also consult the Administrators in Medicine database or the American Medical Association’s Physician Select website.
Consider why you need a doctor.  Do you have any family history of serious illness or medical conditions?  Do you or a dependent family member require specialized care for an ongoing health concern?  Are you seeking homeopathic or alternative medicine?  What personal factors would make you most comfortable—is a doctor’s age, gender, primary language, or years in practice important to you?
When you have chosen a doctor or two, schedule an interview appointment.  This is the best way to get a feel for a doctor’s personality.  Judge a potential candidate on the factors that are important to you. Did the doctor answer your questions?  Listen to your concerns?  Take his or her time in the interview to make sure you were satisfied?
Some other questions you might want to consider:  How far is the doctor’s office from where you live or work?  Which hospital does the doctor use?  Where would you go to have lab tests or x-rays done?  Is the doctor accepting new patients and, if so, how long will you have to wait to get an appointment?  What is the office staff like?  How would you get help if you needed to speak to someone after hours?  How does the doctor handle referrals?  Will the office staff take care of insurance paperwork for you or will you have to file claims and seek reimbursement on your own?  How many other doctors are in the practice, and will you be able to see your own doctor every time you visit?
If you conduct a careful search and educate yourself not only about potential healthcare providers, but also about the details of your insurance plan, you’ll find that choosing a quality physician is much less intimidating than it may have seemed at first.  
 

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08/05/2009

Medicaid is a federally-sponsored health insurance plan that serves low income individuals and their families.  As the third largest provider of medical insurance in the US, the program makes it possible to get health care for those who would otherwise have to go without because of financial difficulties.
Medicaid generally covers three types of crucial protection:  insurance for low-income families with children and people with disabilities, long-term care for older Americans and those who are disabled and supplemental coverage for low-income Medicare beneficiaries to pay for services not covered by Medicare, including co-pays, deductibles, premiums and the cost of prescriptions.  No monies are paid directly to Medicaid recipients; all funds associated with care go instead to the providers offering treatment.
Each state sets its own guidelines for Medicaid.  States decide on income limits, program benefits, and which services are covered or excluded.  Some states require patients to pay a nominal fee for doctor visits and other services.  Requirements for eligibility range from state to state, as well.  However, typical factors that influence eligibility include a patient’s age, disability status, pregnancy, legal blindness, income level and financial resources such as bank accounts, property, or other assets; and citizenship or immigration status.  There are special qualification rules for those living in nursing homes and for disabled children living at home.  The program covers children provided they are US citizens or lawfully documented immigrants, even if their parents are not. Program specifics vary greatly from state to state; check with your state’s Medicaid office to find out the particular regulations for your location.
Income level is just one factor that determines a person’s eligibility for Medicaid enrollment.  Financial hardship alone is not enough to qualify someone for coverage and Medicaid does not provide coverage for all poor persons.  In order to be eligible for the program, applicants must meet income level limits and fall into one of the following categories:
-Pregnant women, married or single -Infant children of women on Medicaid -Children under age 18 -Disabled children under age 18 being treated in a 24-hour nursing facility who could be cared for at home with access to money for special services -People aged 65 and over who are blind or disabled -Patients who are terminally ill and desire hospice care -People being treated in 24-hour nursing facilities who could be cared for at home with access to money for special services -People leaving welfare programs and in need of medical coverage -Those who are pregnant, under age 18, over age 65, blind or disabled with very high existing medical bills they cannot pay.
Once Medicaid eligibility is determined, coverage is usually retroactive up to three months prior to the approval date, provided the applicant would have qualified for Medicaid during that time period.  Program eligibility stops as soon as a participant’s financial circumstances improve enough to put them over the income limit set by the state.  Each state employs several qualified caseworkers to help potential applicants determine their Medicaid eligibility status and benefits according to state regulations.

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08/05/2009

Medicare is a federal health insurance plan for individuals over the age of 65, or for any disabled person under the age of 65 and any person with end-stage kidney disease.  There are four basic parts to the Medicare structure:  Part A, which covers hospital care; Part B, which is traditional medical insurance and covers doctor visits and other services; Part C, sometimes called Medicare Advantage and only offered in certain areas of the country; and Part D, which is optional prescription drug coverage.
Once a person is eligible for Medicare, there is a seven-month enrollment period.  This includes three months before the applicant’s 65th birthday, the month of the applicant’s birthday and three months after the applicant’s 65th birthday.  Program registration is automatic if the applicant is already receiving Social Security benefits or railroad retirement income, or by self-enrollment if neither of these conditions applies. 
Upon initial enrollment, all Medicare recipients are automatically covered by Part A for hospital bills.  There is no premium for this part of the program; funds come from Medicare taxes paid during an individual’s working years.  Part B coverage is optional and pays for doctor visits, outpatient procedures and other services; a monthly premium is required.  To avoid paying more for Part B coverage one must still be working and enrolled in an employer-sponsored health insurance plan at the time of Medicare eligibility, or purchase Part B coverage within eight months of the end of a group policy protection.  It is generally wise to sign up for Part B coverage upon initial Medicare enrollment, regardless of employment status at the time of eligibility.
Medicare Part D prescription coverage is also optional and available to all eligible recipients regardless of income level or health status.  Registration is required and coverage for prescription medications is provided through an approved private insurer.  Costs for prescriptions will vary depending on the plan and there are penalties if Part D enrollment is delayed upon initial Medicare registration.  The only way to avoid these penalties is to have been covered through an employer or union at the time of enrollment.
Medigap coverage, also called Medicare supplemental insurance, is an increasingly popular option for many Medicare enrollees.  This insurance, purchased through a private underwriter, helps bridge gaps in Medicare coverage.  These policies pay for things like deductibles and co-pays, while some provide additional services not offered by Medicare.  Most states require these plans to be standardized to allow consumers to compare them more easily.  Applicants have up to six months following Medicare enrollment to purchase gap insurance without penalty for pre-existing conditions or medical history.  This open enrollment period happens just once and finding coverage later on could be more difficult, as some companies deny protection for certain conditions.  Those who are still employed or covered by a spouse’s work policy can save their open enrollment until it is needed.
Contact your local Social Security office for more information about Medicare, program eligibility, enrollment procedures and coverage options.
 

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08/05/2009

Individual states have regulated private insurance companies since the late 19th century.  State regulation is meant to make insurance affordable to more people to make sure insurance companies are financially viable, to protect consumers against fraud, and to ensure customers receive the benefits they have been promised.
While states remain the primary regulators of insurance companies and the products they sell, federal standards are set for employer-sponsored medical plans and all states must work within this larger framework imposed by the federal government.
Rules and policies vary widely from state to state and each state in the US has a unique set of standards that insurers selling policies there must adhere to.  However, there are some common guidelines that all states impose; most of these involve claims activity.  Insurers are always required to be financially secure enough to pay for claims made against policies.  All states require prompt payment of claims benefits and fair claims practices.  Aspects of health insurance that vary by state include access, rating, and coverage.
As for-profit organizations, insurance companies—like any other business—seek to maximize profits while minimizing loss.  Some states regulate this activity with guaranteed-issue laws, which prohibit insurers from denying group coverage to individual applicants based on health history or current medical conditions.  Some states extend this right to individuals, as well.  Guaranteed renewability laws are another way to combat unfair practices.  Several states have laws that prevent insurers from cancelling group coverage based on claims or sudden diagnosis of a serious illness.  In these states, all group and individual plans must be renewed annually once issued so long as the company continues to sell policies in that state.  To stop unfair market practices, some states mandate that insurance companies must promote all of their coverage options to businesses regardless of employees’ health or previous claims history.  Several states also require companies to guarantee access to insurance for special populations.  These polices are usually meant to protect infants, disabled children, and disabled adults who have been covered under a parent or guardian’s policy since childhood.  A few states have continuation laws, which force small businesses to offer COBRA insurance to former employees whether or not those companies are subject to the federal COBRA program.
Rating practices in some states prohibit or restrict the ability of insurers to charge higher premiums based on a patient’s current health status, claims history, or any future risk for illness or injury.
States with covered benefits legislation often have a wide range of standards governing the types of medical services and procedures that insurance companies are required to include in polices sold in the state.  These are sometimes called “mandated benefits.”
Every state has an insurance department charged with overseeing all policy issuers marketing products in the state, performing audits, implementing corrective measures, taking legal action when necessary, and educating the public about companies operating in the state.  Your state’s department is an excellent source of information about healthcare coverage regulations in your particular location. 
 
 

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08/05/2009

One of the most common types of managed care health insurance plans are Preferred Provider Organizations (PPOs).  A PPO supplies medical services for members at discounted prices by providing a network of approved providers and facilities for patients to choose from.  However, PPOs also allow group members to seek covered care outside of the network for slightly higher fees.
The main advantage of a PPO over other kinds of managed care health insurance is the flexibility patients have to manage their own care.  Policyholders do not have to designate a primary care physician or coordinate referrals for specialized care, nor are they limited to seek treatment within the plan’s network.  This means that patients can typically choose any doctor, hospital, clinic, or lab they want.  Though the cost of obtaining care outside of the health plan’s network is slightly higher, non-network services are still covered and the PPO will pay a portion of the cost of care.  For example, a PPO might cover 90 percent of the cost of heart surgery if performed by a doctor in the plan’s network.  If a patient chooses to use a surgeon outside the network, the PPO might pay only 70 percent of the cost.  The patient would then be responsible for the remaining balance.  Another advantage of the PPO model is that patients can refer themselves to specialists at any time, for any reason.  With other managed care plans, a primary care physician must first deem a procedure medically necessary before issuing a referral for treatment with a specialist.  In a Preferred Provider Organization, members are free to decide if and when they see a specialist without needing approval from another doctor or the plan.
Perhaps the biggest disadvantage of PPOs is the cost.  These types of plans usually cost more than other managed care options because of the increased flexibility the PPO offers.  Deductibles and premiums are usually higher as well.  Most PPOs require patients to pay a small amount out of pocket for medical services like doctor visits and prescriptions, whether care is obtained in-network or out.  These co-payments can range from just a few dollars to more than $30 depending on the service.  Furthermore, there is little room for negotiation in seeking treatment outside of the plan’s network.  Even if the care you need is not offered by a PPO network provider, you will still have to pay more to use an out-of-network doctor.
As you consider which health plan is best for you and your family, your budget and specific medical needs will determine the type of insurance you choose.  If specialized care is something you use frequently, or if you want to have the freedom to manage your own medical care, a PPO might be your best option.  If you can manage a slightly higher monthly premium and yearly deductible, a Preferred Provider Organization will provide the flexibility and expanded choice in coverage that will help you get the care you need.

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08/05/2009

The average lifespan for an American is about 80 years.  Although there is an increasing focus on making better lifestyle choices like diet, exercise, and preventative care, no one is immune to the effects of aging.  Some kind of physical or mental incapacity will eventually drive many of us to spend at least part of our later years in long term care situations. 
In 1994 about seven million Americans needed some form of long term care, at an average cost of $44,000 per person, per year.  By 2000, that number had risen to more than nine million people and nearly $56,000 per year.  Currently, the cost for long term care hovers around $75,000 per person annually; and, it has been projected that by 2030 more than 23 million Americans will need some kind of long term care, at an average cost of up to $300,000 per person yearly.
So what is long term care and why is it so expensive?  Long term care provides essential medical services either in the home or in 24-hour nursing facilities for elderly people with conditions like Alzheimer’s, Parkinson’s, stroke, and those related to the effects of advanced age like dementia and physical incapacitation.  Care is usually tailored to meet a patient’s particular needs and involves constant monitoring by nurses, doctors, therapists and aides.  There are several different levels of long term care:  in home care by family and friends, in home care by a professional caregiver, residence at an assisted living facility, and comprehensive care at a skilled nursing facility -- also called a nursing home.
While studies have shown it is more beneficial for patients to remain in their own homes for as long as possible, the costs for this type of care can add up quickly.  Families are then forced to make important decisions about the long term care of their loved ones based solely on financial factors rather than on the course of treatment that would provide the most benefit for the patient.
Most health insurance plans do not cover long term care, and Medicare will only pay for care for a limited time period and under very specific circumstances.  Medicaid and plans offered through the Veteran’s Administration do pay for long term care; but because funds to these programs are limited, the quality of care is sometimes lacking.
Purchasing a separate long term care insurance plan, therefore, makes sense.  Long term care coverage supports your independence as you age, gives you more choice in your care, and protects your loved ones from financial hardship.  Premiums for this type of insurance generally increase as you age; however, once a policy has been purchased, the price is locked in for the life of the policy regardless of a patient’s aging or health.  Experts recommend people as young as 40 start thinking about long term care insurance.  For those who can afford the monthly premiums, this option ensures a lifetime of protection at a reasonable cost. A price comparison of long term care insurance plans can be conducted online.
 

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08/05/2009

As people continue to struggle through the recession, there’s increased focus on taking care of savings and other assets in order to secure the future.  One of the best ways to provide a safety net for your loved ones is by purchasing life insurance.  There are two different kinds of life insurance:  term life and whole life.
Term life insurance is generally the best fit for the largest number of people.  Simply, this is life coverage only, meaning in the event of the death of the named insured the policy pays face value to a designated beneficiary.  Term life can be purchased in increments of one to 30 years.  Except for the extremely elderly, these policies are always less costly than whole life insurance.
Term life insurance has two types of premiums.  Level-term premiums remain constant over the life of the policy and can be paid in increments; annual renewable premiums increase as the policy holder ages.  Some term policies offer the option to convert to whole life later on without a medical examination.  This can be a good choice for policy holders who have become seriously ill or have developed a severe medical condition, but for the average life insurance customer these conversions are generally not advisable.
Whole life insurance combines a traditional term policy with an investment piece—typically bonds and money market accounts or stocks.  The investments attached to the policy build cash value over time which can be borrowed against before the policy term is reached.  The two basic elements of whole life policies are the mortality charge, which is the part of the premium that pays for coverage, and the reserve, which goes toward the investment portion that earns interest.  As the policy holder ages the reserve portion of the premium gradually decreases and the mortality charge increases.  Some whole life companies credit the reserve annually with investment dividends.
Whole life polices may seem like easy money, but the fact is that they are risky.  The value of the policy can fluctuate along with the markets and usually do not earn as much return on the initial investment as other more traditional portfolio options like stocks, bonds and mutual funds.  Whole life is also very expensive and those on a fixed income or limited budget probably cannot afford to purchase as much coverage as they need.
When estimating how much life insurance coverage you need, calculate the approximate amount your spouse or dependents would need to maintain their current lifestyle in the event of your death.  Factors to consider are any retirement income or pension you would eventually be eligible for, when that income would begin, and the age of your dependent children at the time you purchase the policy.  Most experts recommend buying coverage equivalent to at least ten years’ worth of your current salary.  People over a certain age and those with pre-existing medical conditions tend to pay higher premiums so it’s a good idea to purchase life insurance while you’re relatively young and healthy, though you should hold off until you have dependents.

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08/05/2009

For those who cannot afford private health insurance, there are several public health insurance options available.

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08/05/2009

Short term health insurance, sometimes called major medical coverage, is a category of health plans offered by private insurance companies that protect otherwise healthy people from the possibility of a serious health crisis that could cause severe financial hardship.  Short term insurance is meant to be just that—temporary—and can be a viable option for people in transition.
Most short term policies can only be purchased for a specific, predetermined period of time, usually up to six months.  Some companies do offer policies with longer terms, though, some up to a year or more.  Coverage ranges, but is generally focused on treatment in the event of a significant accident or injury.  Plans that offer more comprehensive coverage are generally much more expensive than catastrophic plans, making them a less popular option for many customers. 
Short term medical insurance policies often have very strict qualifying standards and usually do not cover pre-existing medical conditions.  These types of temporary polices are not a good fit for patients who require extensive or long-term care for an illness or injury, or for those who are looking for a policy that encompasses a variety of services.  Short term policies generally do not cover things like mammograms, physicals, immunizations, pregnancy or childbirth, dental, or vision care.  All plans also clearly exclude coverage for pre-existing conditions, defined as an injury or illness that has been diagnosed or treated within the previous three to five years.  Purchasing a short term plan also negates a patient’s eligibility for participation in the Health Insurance Portability and Accountability Act (HIPAA).  HIPAA plans cover treatment for pre-existing medical conditions that would make it difficult for patients to find other kinds of health insurance.  Patients who qualify for HIPAA should not consider short term medical insurance.
While short term medical insurance is not meant to be a lasting solution to health coverage needs, it can be a smart choice for many people.  This type of coverage is best suited to those between jobs, those waiting for insurance from another source such as a new job or spouse’s plan, for early retirees who are not yet eligible to enroll in Medicare, and for recent college graduates, discharged military personnel, or the recently divorced.  The application process is relatively simple and involves a few basic questions about medical history; coverage usually begins immediately, sometimes within 24 hours of application approval.  Most plans offer flexible payment options with a wide range of premiums and deductibles to choose from.  Policy holders typically have the freedom to choose their own doctors and hospitals without restriction, though sometimes financial incentives are offered—in the form of lower co-pays and fewer out of pocket expenses—for seeking treatment with network providers. 
Certainly, short term or major medical policies are not for everyone.  Yet for already healthy people looking for an affordable safety net to protect their assets in the event of a catastrophic injury or illness these plans are an excellent fit.

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08/05/2009

If you choose to enlist the help of a professional insurance agent in deciding on a health plan, the following are some important questions to ask before committing to a policy:
1.  What kind of agent are you, and what company or companies do you represent?  Some agents are “captive”, meaning they are only licensed to sell products from a single company. Other agents are independent, which means they can represent a variety of companies.  An independent agent usually has more flexibility in helping you find coverage to suit your needs.
2.  What is this plan’s deductible? Does this amount apply to each individual on the policy or my family as a whole?  Most plans have a per person/per year deductible, which means each person in your family has his and her own deductible that has to be met before coverage kicks in.  Some plans offer a “worst case scenario” deductible, which applies if your family is in a serious accident together or everyone gets sick at the same time.  In these cases, the deductible only applies to one or two people before coverage takes over for the entire family.
3.  What is this plan’s patient responsibility and stop-loss?  Patient responsibility, or coinsurance, is the percentage of the cost of services that the policyholder is responsible for paying.  A stop-loss number sets the maximum dollar amount that an insured’s coinsurance percentage can be applied to. It basically works to set a limit on a patient’s out-of-pocket expenses for a calendar year.  Once this stop-loss number has been reached, the insurance company will pay 100 percent of the cost of services for the remainder of that year.
4.  What is this plan’s yearly maximum out-of-pocket expense?  This will include things like co-payments, deductibles, coinsurance percentages, and other fees.
5.  What is the lifetime maximum benefit, and does this plan have a per-illness maximum?  Most plans have either a $2 or $5 million lifetime maximum, which is the ultimate amount the insurance company will pay if you or someone in your family becomes seriously ill.  Per-illness caps are restrictions placed on how much an insurance company will pay for individual illnesses or serious injuries.  Some plans require patients to stay within these limits in order to qualify for the lifetime maximum benefit.
6.  Is this a scheduled plan?  Some health insurances stipulate a scheduled structure—fixed costs for procedures—even if those procedures cost more than the policy allows.  Patients are responsible for paying any remaining balance out of pocket.
7.  Are yearly doctor visits limited?  Most quality plans let you visit your doctor as many times as you want, but some plans restrict how often you can see a physician in a single year.
8.  Does the plan offer prescription drug coverage?
9.  Are there any other fees associated with this plan?  Hidden fees can add up quickly and may become seriously burdensome if you or one of your dependents requires long term care, a lengthy hospital stay, or emergency room care.      
 

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08/05/2009

Many Americans over the age of 50 have a difficult time qualifying for health coverage.  Some of these people are self-employed, have taken early retirement, or have exhausted COBRA coverage following a lay-off.  Because Medicare benefits do not take effect until age 65, the only option for many of these “in-betweeners” is to purchase individual health insurance coverage.
While buying an individual health insurance policy is a viable option for many people, several problems can arise for those over the age of 50.  Some insurance companies require new applicants aged 50 and older to undergo a physical or series of medical tests to rule out potential health issues.  Also clients with a pre-existing condition such as cancer or diabetes may be rejected for coverage based on their medical history.
There are options available for those over the age of 50 who are looking for health insurance.  Fee-for-service plans offer the most freedom, but premiums are higher than with any other individual coverage, making them cost-prohibitive for many people.  Managed care is perhaps the most popular choice for individual health insurance.  In managed care, HMOs, PPOs, etc., insurance companies establish contracts with doctors and hospitals to provide care for plan members at an agreed-upon rate.  These types of plans typically involve a network of approved providers and plan members are free to choose facilities and services from the network.  Choice can be limited, however, and patients may have to pay more out of pocket to see a non-network provider.  Managed care plans often require small co-pays for office visits and prescriptions.  Open enrollment managed care is another attractive option.  Customers have a one-month window of opportunity during which the insurance company must let people join regardless of medical history or pre-existing health conditions.  This is an excellent choice for those who have been excluded from other plans or have been denied coverage based on their health.  Open enrollment managed care usually does not require a medical exam. 
For those who are members of a trade organization or labor union, association-based health insurance may be available and offered at discounted group rates. 
Some states have programs called high-risk pools, which are good options for those in poor health who have been denied coverage elsewhere.  This is a last resort kind of plan and in order to qualify an applicant must have been refused medical coverage by at least two independent insurers and be unable to find coverage anywhere for less than the monthly premium offered by the risk pool.  Another option for those who are struggling to get coverage is a specific disease policy.  These limited plans pay only for care associated with a particular medical condition such as cardiovascular disease, cancer, diabetes or hypertension.  Coverage can be spotty, though, and it is generally advisable to find a more comprehensive plan if possible.
The process of comparing and purchasing health insurance can be daunting.  Consult with a trusted broker for help in deciding which plan best suits your needs. 
 

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08/05/2009

According to a recent government study, roughly two million American college students are uninsured and these students account for almost $300 million in uncompensated, non-injury related health expenses each year.  While young men and women are generally considered healthier than other demographic groups, they are also far more likely to need emergency medical care.  Furthermore, many uninsured college students simply choose not to seek necessary care or treatment because the expense is too great.  The issue is of such importance that some colleges now require prospective students to produce proof of adequate medical coverage as a condition of acceptance.  Luckily, there are several options for these students and their families.
Because so many colleges and universities require students to have medical insurance, most schools—both public and private—now offer health plans to new enrollees.  In fact, more than half of American colleges have some sort of medical insurance for students.  Eligibility requirements are less stringent than with private individual plans, coverage begins immediately upon full-time enrollment, and some plans even extend benefits for several months beyond graduation.  However, there are huge variations in cost and coverage depending on the school.  Some plans cover students only while they are on campus, and most suspend benefits when students are at home or travel abroad.
The majority of college students between ages 18 and 23 who do have medical insurance are covered under someone else’s plan—usually a parent or guardian.  The benefits of dependent medical insurance are that there is no interruption of coverage, the plan terms remain the same even though a student does not reside in the home full-time, and there are none of the restrictions imposed by school-sponsored health plans.  There are also drawbacks to this kind of coverage, though.  Most employer or union plans require students to be enrolled full-time, meaning that if a student drops below a certain minimum number of credit hours coverage could be suspended or terminated.  Many of these plans also have age limits when coverage automatically drops for dependents; this can present a challenge for students who plan to pursue advanced degrees following their undergraduate work.  Finally, married students are often excluded from coverage as dependents regardless of age or university enrollment status.
Other options include employer-sponsored medical insurance for students who work full time, private medical insurance plans purchased from an agent or provider, or state-sponsored plans like Medicaid.  In these cases, students can obtain coverage tailored to their specific needs and budget.  Complications can arise, though, for those with pre-existing medical conditions—many companies will deny coverage for these kinds of risk factors.  However, different plans have different guidelines and requirements so it pays to shop around even if coverage has been refused because of an existing condition.  Many state-sponsored risk plans offer medical insurance for those who have been denied by a private insurer because of a health condition.
No matter what, always carefully review the options, restrictions, benefits and costs thoroughly before committing to a plan.

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08/05/2009

Sometimes even the most comprehensive health insurance plans do not provide coverage for dental and vision care, or severely restrict patient access to these important services.  Purchasing extra coverage for dental and vision care services can be a smart way to supplement an existing health insurance policy or obtain essential coverage to help you and your family stay healthy.
A dental health maintenance organization (DHMO) is typically the least expensive option for supplemental dental insurance.  Members of DHMOs are required to choose from an approved list of network providers and, as long as patients use an in-network provider, most services are fully covered including cleanings, x-rays, braces, implants, and even some cosmetic procedures like teeth whitening and veneers.  A small co-payment for services is often required, but there are no limits to the number of times members can see their doctor during a calendar year.
Dental indemnity plans give patients complete freedom to choose any provider they wish.  Indemnity insurance will pay a portion of the fees related to services and the insured individual is responsible for the remaining balance.  These kinds of plans are usually the most expensive option, but they remain an attractive possibility because of their flexibility. 
Preferred Provider Organizations (PPOs) are less expensive than an indemnity plan, but usually cost more than a DHMO.  Patients have the option to choose a provider from the PPO’s approved network or to pay slightly more out of pocket to see an oral healthcare professional outside of the group’s network.
A scheduled plan reimburses patients for a set amount of money based on a list, or schedule, of covered services.  For example, if a policyholder’s dentist charges $50 for a routine cleaning and insurance pays $25 according to the schedule, the patient is responsible for the remaining $25.  Many scheduled plans set a maximum calendar year benefit, which means that a patient is responsible for any and all charges that exceed this amount in a single year.  There are also yearly deductibles, and some plans require a waiting period before patients are allowed to seek certain types of care.
Dental discount plans are not the same as insurance.  For an annual membership fee, patients are given a card that provides access to specially discounted rates on services.  All costs are paid out of pocket by plan members.  Usually these discount plans offer unlimited use within an approved network of providers.
Vision insurance can help defray the costs of things like annual eye exams, eyeglass frames and lenses, contacts, and even vision correction procedures like LASIK surgery.
A vision benefits package provides services in exchange for an annual premium.  There are usually yearly membership fees, deductibles and patient co-payments, as well.  Like dental discount plans, vision discount programs offer comprehensive, unlimited care at discounted rates.  These plans may require an annual membership fee and deductible.
Both dental and vision supplemental insurance are relatively inexpensive and are a good investment if your comprehensive health plan does not offer coverage, or limits access to these services.
 
 

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08/05/2009

State Children’s Health Insurance Programs (SCHIP) were established by the federal government in the late 1990s to provide health insurance to children in families living at or below the national poverty line who do not qualify for Medicaid.  SCHIPs are meant to protect children whose working families make too much to be eligible for Medicaid, but not enough to afford private health insurance.  The program is administered by the US Department of Health and Human Services.
At its inception in 1997, SCHIPs were the largest expansion of taxpayer-funded health insurance coverage for children in the US since Medicaid began in the 1960s.  Several attempts have been made recently to expand SCHIP coverage and funding in order to reach an increasing number of uninsured children, but each measure was met with opposition by federal lawmakers.  Finally, in February 2009, President Barack Obama signed a bill extending SCHIP coverage to an additional four million children and pregnant women. This bill also eliminated the waiting period for legal immigrants to begin receiving coverage.
Every state has an SCHIP. Each state has the flexibility to design its own plans and maintain control over their state-specific eligibility requirements and kinds of coverage offered while working within broader federal guidelines.  States have several options when structuring SCHIP.  The funds can be used to expand income limits for Medicaid, which opens up public-sponsored health insurance to more children. An SCHIP can operate as a completely separate entity -- independent of Medicaid -- or states can create a program that combines these two approaches.
Eligibility requirements vary by state, but most states stipulate that uninsured children in families that earn up to twice the amount of the national poverty level qualify for SCHIP.  Some states set higher income limits, while a few states have lower limits.
SCHIP coverage also varies by state, with some states offering more comprehensive care to program participants than others.  In broadest terms, SCHIP provides necessary well-child care, regular check-ups, immunizations, dental care, and treatment of illnesses for millions of children who would otherwise go without medical care.  Studies have shown that children enrolled in SCHIP are nearly two times more likely to see a doctor and get routine dental care on a consistent basis than children who do not have any health insurance at all.
SCHIP is vitally important for the millions of American families struggling to pay for medical care.  In just the first seven years of SCHIP existence, from 1998 to 2005, the number of uninsured children dropped by nearly three million; despite the continued growth of child poverty populations and the significant decline in the number of children whose families have access to employer-sponsored health insurance.  The number of children enrolled in SCHIPs has steadily increased since the program’s inception, and the latest legislation amendments should continue these positive results.
As the current economic recession continues to drag on, SCHIPs provide some relief for working parents who cannot afford health insurance.  At the very least, their children—some of the most vulnerable victims of the healthcare crisis—can have access to quality medical and dental care through SCHIP.
 
 

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08/05/2009

PRIMARY CARE DOCTORS:  Some health insurance plans require patients to use only those doctors included in a limited network of providers and you’ll have to pay more of your own money to see someone outside the network.  If you must choose a new doctor, research credentials and background information through the American Medical Association website.
SPECIALISTS:  If you have an existing condition you are currently being treated for or anticipate you will need specialized care in the future, find out how the plans you are considering deal with this.  Some insurers require a referral from a primary care doctor in order to approve specialized treatment, while other plans let you choose your own specialists as you see fit.  You should also find out if your plan requires specialists to be part of a network of approved providers.
MEDICAL CONDITIONS:  Health plans vary in coverage for pre-existing conditions—some cover them 100 percent, some exclude them totally, some fall in the middle.  The Health Insurance Portability and Accountability Act (HIPAA) guarantees coverage for existing medical conditions if you are forced to join a new plan through an employer or if you were insured for at least 12 consecutive months by another carrier, regardless of your current health status.
EMERGENCY CARE AND HOSPITAL STAYS:  Find out what treatment facilities are covered by your plan.  You should also find out how your plan defines an emergency medical situation.  Some insurance plans set restrictions on urgent care, and some require patients to contact their primary care provider before seeking emergency treatment.
PREVENTATIVE CARE:  Will your plan cover things like yearly physicals and health screenings?  If you have dependent children you will need to know if the plan pays for things like well-baby visits and immunizations.
PRESCRIPTIONS:  If you currently take prescription medications, or think you might someday need them, consider plans with good prescription drug coverage already built in.  Find out which prescriptions are covered, whether you have the freedom to choose generic or name brand drugs, and what costs you will incur out of pocket for your medications.
OBSTETRIC AND GYNECOLOGICAL CARE:  For women, you will want to find out if your plan covers routine gynecological care.  If you are thinking about having children, find out if your plan covers fertility treatments, prenatal care, and labor and delivery costs.
ADDITIONAL SERVICES:  Some patients may also be interested in seeking coverage for things like substance abuse, mental health, home health services, hospice, experimental medicine, and alternative or homeopathic treatments.  If any of these areas are of interest to you, be sure to research plans that offer the type of coverage you want.
COST:  Be certain you understand a plan’s fee structure, premiums, deductibles, co-pays, coinsurance, and lifetime maximums before you make a decision.
EXCLUSIONS, RESTRICTIONS, LIMITATIONS:  Now that you have educated yourself about what your plan will pay for, make sure you ask about anything that will not be covered.  These exclusions and restrictions can run up high out-of-pocket expenses quickly if you are caught off-guard.
 

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08/05/2009

A Health Savings Account (HSA) is a way for people to save money that they can use to pay for medical expenses.  The funds contributed to these accounts are designated to pay for routine medical care or can be left to build interest.  The money can either be withdrawn during the year to pay for healthcare, or can be left alone and used as a savings account for the future.  The program was signed into law in December 2003; and first became available in January 2004.
All HSAs have two major qualifications:  participants must already be enrolled in a high deductible insurance plan, and the account is subject to the same regulations as a tax-free trust made up of a combination of savings and investments. 
An HSA only covers qualifying medical expenses as determined by the IRS.  This prevents fraud and helps secure funds for when people need them most.  The coverage options for an HSA are quite broad and include things like dental and vision care that many traditional insurance plans do not offer. 
The premiums for an HSA are generally much lower than those of some comprehensive plans that also require co-pays, as well.  Since the funding for an HSA is theoretically generated from the fact that money is not being spent on an insurance plan, participants are spared co-pays and yearly deductibles.  Individuals can also deduct the annual deposits to their HSA from their gross yearly income, resulting in tax-free savings.  This all generates a comparatively lower out-of-pocket cost for participation in an HSA than a more traditional healthcare plan.
The policy of allowing money to stay in the HSA even if it is not being used also encourages consumers to become educated about their health insurance, and makes policy purchasers more of a driving force in the process of buying and selling health insurance.  Owners of HSAs have more incentive to check medical bills carefully, compare the costs of treatments, and to honestly evaluate their medical needs in order to protect their savings.
Not everyone is able to start an HSA; eligibility standards do apply.  Patients must first have a high deductible health plan (HDHP), which means that the annual plan deductible for an individual must be at least $1,050 with out-of-pocket expenses not exceeding $5,250 per year.  For families, a policy qualifies as an HDHP if the annual premium is at least $2,100 and out-of-pocket expenses are no more than $10,500.  These HDHPs may not charge co-pays for doctor visits or prescriptions, but they can be network plans like HMOs or PPOs.  An HDHP may have a low deductible benefit so long as that benefit only applies to preventative care.  HDHP family plans only qualify for an HSA if insurance will not cover any services until the entire plan deductible is met.
If you set up an HSA but do not have a qualifying high deductible health plan you can be penalized by the federal government.  If you think you might qualify for a health savings account or want more information, consult an insurance professional before taking action. 

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08/05/2009

Due to the current economic state of the world, hundreds of people are being laid-off. In addition to that, some employers are reducing or eliminating health benefits, which lead to several people having no health insurance policy. In order to survive these trying times, here are a few tips on how to keep your health insurance policy:
 
1. In the event that you get laid off, use COBRA (Consolidated Omnibus Budget Reconciliation). COBRA gives you the opportunity to keep your health plan for 18 months even when you have lost your employer health coverage. As long as your health plan is still in existence COBRA can let you use it. You can qualify for some health insurance that your employer is offering if his/her business is still operating. Despite it being expensive COBRA is much cheaper than individual or private health insurance plans.
 
2. Living healthily will definitely aid you in times of economic struggle. By living healthily you have a better chance of avoiding sickness and therefore not having to use your health insurance policy.
 
3. Consult your doctor about discounted fees or certain treatments and drugs that are more affordable.
 
4. Try to live with lesser stress. Stress is one of the major killers and you shouldn’t take this lightly. A stress-free life means lesser trips to the doctor and lesser chances of using that health insurance policy. So exercise regularly, sleep early and avoid stressful situations. Also try getting into yoga and other activities that help the body relieve stress and promote well-being.
 
5. Quit smoking. Smoking has always been harmful to your body and it doesn’t take a genius to know that once you stop smoking the better you will feel. Also, by not smoking you are more likely to be approved for another health insurance policy/plan. Insurance companies deem non-smokers as more risk-free so they give them lower premiums.
 
6. File an application for Medicaid.
 
7. Get a Medicare plan, which caters to those who are 65 years of age or older, and qualify for a certain requirement.
 
8. Seek alternative medical treatments, such as herbal remedies and acupuncture.
 
9. If your spouse or partner has a health insurance plan, you can use that to your advantage by applying as a dependent. The cost might be expensive but at least this will result to lesser coverage rejections compared to applying for independent or private health insurance policies.
 
10. Apply for a lower paying job because more often than not these companies have a better health insurance. Health is very important and as our economy is struggling it is much wiser to opt for a job with lower pay but better health plans, than take a high-paying job with minimal medical benefits.
 

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08/05/2009

Travel can be exciting, especially when it takes you to far-off places, and no one wants that thrill ruined by thinking about serious matter like health and safety.  However, it pays to take precautions and to at least consider the worst-case scenario if you are planning an extended trip away from home, whether in the US or overseas.  This applies especially to medical care and health insurance.
Before embarking on your trip, be sure to check with your insurance carrier about coverage extensions outside your usual area.  Your current policy may not cover medical costs incurred out of state for things like doctor visits, emergency room care or medications.  If you plan to stay within the US, be sure to have close at hand a list of covered providers, facilities and services in the area where you will be travelling in the event of a sudden illness or injury.
Obtaining medical treatment outside the United States can be expensive, and even simply arriving at your destination carries risks.  If a foreign government was to deny your passport because of an infection or other condition, medical evacuation can cost upwards of $50,000.  American medical insurance is usually not accepted overseas; Medicare and Medicaid are strictly US programs and do not provide coverage for costs sustained while travelling abroad.  If your current medical policy does not cover care outside the US you may want to consider purchasing a short term or major medical plan that does.
Along with short term policies, some companies also offer plans specifically designed to cover travel abroad.  Like short term or major medical coverage, these can be purchased in increments of time depending on the length of your trip—anywhere from a few days to six months.  Check online or with a trusted insurance or travel agent to review options, benefits and costs.
Aside from making sure your insurance coverage is in order, there are several other safety measures you can take that will make your trip more enjoyable.  If you have a medical condition that requires prescription medication you might want to carry a note from your physician describing your situation and any drugs you are currently prescribed, including the generic names for those medications.  Be sure to leave prescriptions in the original pharmacy packaging with the label clearly visible.  Check with the foreign embassy of the country where you’ll be staying to make sure your prescription is not an illegal narcotic there.  Pack your medications in your carry-on luggage and consider leaving a back-up supply in your checked baggage just in case.  If you wear eyeglasses or contacts, take an extra pair with you; pack these in your carry-on as well.  If you suffer from allergies or any other unique medical condition you should wear a medical alert bracelet or carry a letter from your physician indicating proper care procedures should you fall ill suddenly and not be able to communicate. 
In taking these few simple steps to plan your trip more completely, you can relax knowing that you will be taken care of in the event of an emergency.

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08/05/2009


Diabetes is a disease in which blood sugar levels are high because the body does not produce adequate insulin. Insulin is a hormone used by the body to convert sugar into energy. Enough amount of sugar in the blood is necessary but too much blood sugar is not good for one’s health.
 
There are several types of diabetes: type 1, type 2 and gestational diabetes. Type 1 diabetes is common among young adults and children. This condition usually lasts most of their lives and in most cases, requires insulin shots. The most common type of diabetes is type 2 diabetes which can occur at any age. This type of diabetes can usually be treated with good diet and medications. The other type of diabetes, gestational diabetes, only occurs in pregnant women. It disappears once the woman gives birth.
 
Although the cause of diabetes remains a mystery, genetics appear to play a great role. Environmental factors such as lack of exercise, obesity, or too much sugar intake can cause the development of the disease.
 
Having diabetes is quite scary. It is a struggle that complicates nearly 21 million American children and adults. Most of them are uninsured, thus, significantly limiting their options for treatments and leaving them at high risk for other illnesses. If you are diagnosed with diabetes and you do not have a health plan that covers it, you should be aware of the risks that may arise later for being uninsured. Diabetes usually leads to a broad range of diseases. Health complications can arise as a result of diabetes. These include strokes, heart diseases, blindness, kidney failure, and lower limb amputation.
 
Thus, a good health insurance plan is indeed necessary for diabetics. Health plans offer a way for people diagnosed with diabetes to control their condition through insulin, doctor visits, and medical treatments necessary in treating the disease and its accompanying medical issues. Moreover, since this condition is usually a lifelong illness, health care should be constant and long term insurance is the best option to pay for your medical needs.
 
If diagnosed with diabetes, there are some things to consider when purchasing a health plan to cover your medical needs. You should get a policy that covers all possible medical needs in treating diabetes. Also consider the necessary needs for insulin shots. Get an insurance plan that covers a good amount. It should also cover the costs of other prescriptions.
 
When requesting a health insurance quote, consider those insurance providers who are committed to helping you get the best available health insurance.
 
It may be difficult to obtain an insurance policy if you are already diagnosed with diabetes. With pre-existing conditions such as diabetes, the new insured usually undergoes a waiting period before the insurance policy starts to cover his health expenses. Usually, the waiting period is 12 to 18 months. The good news is that there are laws that help protect those with pre-existing conditions. The Health Insurance Portability and Accountability Act requires every company to pay for the medical coverage of their workers who have pre-existing conditions. Also, under this law, people who have previously been covered by a group health insurance and are purchasing a new type of health insurance may also be able to have their pre-existing conditions covered provided that they meet certain criteria.
 

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08/05/2009

Many individuals with serious medical conditions like AIDS, cancer, diabetes, heart and kidney disease, depression, or a history of heart attacks, are ineligible for or cannot afford health insurance to help them pay for the essential medical care they need.  If you have a pre-existing condition, there are options for affordable insurance that will cover your medical needs.  You just have to be creative and educate yourself.
Most of the plans that do provide coverage for pre-existing conditions have extremely high premiums and very limited coverage.  Although this is certainly not an ideal scenario for someone with a serious medical condition, it is usually a much better alternative to going without coverage altogether.  If you manage to find a company that will insure you despite your health issues, take the coverage until you can find something better.
The first place to search is within an employer-sponsored group plan, professional organization or trade union coverage, or private individual health insurance.  Some states have laws meant to protect people with pre-existing conditions who are forced to change insurance plans because of a new job.  If none of these is an option for you, though, there are still other avenues to explore.
State risk pools are allowed in some states and protect people with serious medical conditions.  These programs give access to either private insurance or special health plans for the uninsurable, and provide access to comprehensive private plans.  The premiums for these policies can be very high — sometimes twice as much as the cost of private insurance for a healthy person — and enrollment is often limited to certain times of the year, or requires placement on a long waiting list.  These risk pools are generally a last resort for people who need care for a medical condition, are currently paying astronomical fees for insurance, or cannot find an insurer at all.  Certain conditions and requirements are usually mandated for enrollment into these pools. Your state’s Insurance Department website will have more information.
Guaranteed-issue insurance for the uninsurable and for those with pre-existing conditions that exclude them from eligibility in a quality health plan -- also called “mini-meds” -- are not discount health card plans.  Guaranteed-issue plans are usually quite affordable, and coverage is often surprisingly good.  Most plans cover pre-existing conditions after one year.  These types of plans are not intended to be used as comprehensive insurance; they will only pay in limited scope for things like doctor visits, hospital stays, surgery, and emergency care.  Most guaranteed-issue plans require a medical questionnaire or physical to qualify.
Medical discount cards are not insurance, but offer reduced rates on many services and procedures.  Yearly membership is generally required and some plans have deductibles as well.  Research discount card programs carefully before making a decision as many of these organizations have been known to front scams or never deliver as much as they have promised.
If you have been turned down for individual health insurance because of a medical condition, continue to explore other avenues for care before you give up on getting the protection you need.

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08/05/2009

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08/05/2009

According to the United States Census Bureau, almost 25% of Charlottesville’s population does not have health insurance.
 
There are a few renowned hospitals in Charlottesville, including Martha Jefferson and the University of Virginia Medical Center. Still, one in four people living in Charlottesville does not have individual health insurance. According to exports, college towns usually have more people who are uninsured.
 
When Brittany Burgess, a resident of Charlottesville, turned 19, she decided to stop getting individual health insurance. She chose not to have insurance because she says she is healthy.
 
“I've never tried looking into getting everything. I'll just deal without it until I really need it,” she said.
 
Charlottesville’s free clinic tends to hundreds of patients every day who do not have insurance. According to Charlottesville Free Clinic Executive Director Erika Viccellio, more than 30% of the youth are uninsured.
 
“A lot of that has to do with trying to find jobs, or they might have beginning jobs that don't offer health insurance,” she said. “They're typically healthy, and they decide not to pay for expensive health insurance.”
 
Another reason for the high number of uninsured, according to Viccellio, is that many students do not leave Charlottesville immediately after they finish school. However, that is not the sole reason.
 
“Charlottesville has more small employers than large employers, and it's hard for small employers to offer health insurance. It's expensive,” she said.
 
Students of the University of Virginia are usually well-insured. In order to enroll, students are required to have health insurance for their first school year; however, they can drop their coverage after that. According to Dr. James Turner of the university’s Student Health, the university’s students are the largest group of insured people in Charlottesville.

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08/05/2009

Karen Ignagni, president and CEO of the insurance industry’s trade group – America's Health Insurance Plans – tactfully responded to House Speaker Nancy Pelosi’s recent comments about insurers.
 
House Speaker Pelosi just recently commented that health insurance providers were the “villains” and they have been “immoral” in the Congress debate regarding the health care system’s overhaul.
 
Karen Ignagni told reporters in a conference call, “For a country that's trying to accomplish what it has failed to do for a century, pass health care reform, the same old Washington politics ... is a major step backward.”
 
“This is the playbook of consultants, not of consensus.”
 
In 1994, the insurance industry helped kill off health care legislation by financing and backing the “Harry and Louise” television advertisements. However, this time around, the health insurance group has taken a nuanced approach toward legislation and reform. Now, it is agreeable to certain ideas with bipartisan support, like doing away with the practice of denying insurance to persons with pre-existing conditions. The trade group has also stayed at the lobbying table as President Obama’s government and Congress work on the matter.
 
Ignagni has carefully stood by that message during the conference call, and has avoided any intimidating statements that the influential group could again turn into negative TV ads if provoked any further.
 
"For our part, we will set the record straight," Ignagni asserted. “The American people wouldn't know it based on the rhetoric that has been used over the past week or so.”
 
Ignagni also denied that the health insurance industry has anything to do with the protest groups turning up at the town hall meetings.
 
“That's not us,” she remarked.
 
Around 25% of population in Charlottesville does not have health insurance, says census.
 
According to the United States Census Bureau, almost 25% of Charlottesville’s population does not have health insurance.
 
There are a few renowned hospitals in Charlottesville, including Martha Jefferson and the University of Virginia Medical Center. Still, one in four people living in Charlottesville does not have individual health insurance. According to exports, college towns usually have more people who are uninsured.
 
When Brittany Burgess, a resident of Charlottesville, turned 19, she decided to stop getting individual health insurance. She chose not to have insurance because she says she is healthy.
 
“I've never tried looking into getting everything. I'll just deal without it until I really need it,” she said.
 
Charlottesville’s free clinic tends to hundreds of patients every day who do not have insurance. According to Charlottesville Free Clinic Executive Director Erika Viccellio, more than 30% of the youth are uninsured.
 
“A lot of that has to do with trying to find jobs, or they might have beginning jobs that don't offer health insurance,” she said. “They're typically healthy, and they decide not to pay for expensive health insurance.”
 
Another reason for the high number of uninsured, according to Viccellio, is that many students do not leave Charlottesville immediately after they finish school. However, that is not the sole reason.
 
“Charlottesville has more small employers than large employers, and it's hard for small employers to offer health insurance. It's expensive,” she said.
 
Students of the University of Virginia are usually well-insured. In order to enroll, students are required to have health insurance for their first school year; however, they can drop their coverage after that. According to Dr. James Turner of the university’s Student Health, the university’s students are the largest group of insured people in Charlottesville.
 

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08/05/2009

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08/05/2009

The health care debate last Wednesday reached its boiling point with the appearance of badgering protesters, the same protesters who had plagued several other Democratic town-hall forums prior to the debate. Democrat party leaders labelled the critics as ‘angry mobs’ trying to ‘destroy President Obama’ while the Republicans accused the Democrats of rejecting public opposition to their proposals.
 
A few Democrats encountered jeers, taunts and even an effigy, as the House members went home for the August recess. Video footages of protests, intended to drown out the health plan debate that were to be the focus in an otherwise relatively quiet news week were seen on television and online.
 
As the political power struggle is getting stronger due to the current situation, each side is questioning whether the pickets being held at gatherings in different locations have been arranged by conservative groups or were ignited by the common people who just wanted to voice their own discontentment and displeasure.
 
Democrats have opted to marginalize the complaints as a fringe movement, prompting House Minority Leader John A. Boehner (R-Ohio) to respond Wednesday, "Democrats are in denial. Instead of acknowledging the widespread anger millions of Americans are feeling this summer toward Democrat-controlled Washington, Washington Democrats are trying to dismiss it as a fabrication."
 
Some political figures attempted to find a middle ground in the midst of the vicious partisanship.
 
"We have to be careful we don't just jump to the conclusion and label every bit of opposition above a certain decibel level as organized and contrived," Senator Robert P. Casey, Jr. (D-Pa.) said Wednesday.
 
This week, Robert Gibbs, the White House spokesman stated that the opposition contains voices that are genuine.
 

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08/05/2009

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08/05/2009

Attorney General Mike Cox and Blue Cross Blue Shield of Michigan reached a tentative agreement last Thursday to lower the health insurance rate of increase from up to 56% to just 22%, effective October 1.
 
The deal would include the company’s non-group and group conversion policies that were bought by individuals 65 years old and below who have no employer-based or government plans. The proposed agreement still needs the backing of state regulators.
 
The deal replaces the earlier proposal of Blue Cross that included a 56% increase for every policy. The company said that they needed the increase because of the economic recession. Cox contested the proposal, which led to rate hearings. The company covers about 200,000 people with its medical insurance.
 
Moreover, the rate increase hearings set for the company’s Medicare supplemental or ‘Medigap’ policies will continue, since these are not part of the tentative agreement.
 
Cox called the tentative deal "a victory for families who are struggling to afford access to health care". He also said that Blue Cross’ rates would be higher if he had not intervened. Cox is a Republican and he will be running for a gubernatorial position in 2010.
 
Blue Cross Blue Shield of Michigan would be allowed to increase their monthly premiums by $47 for non-group policies according to Cox. The original request of the company was as high as $122 monthly.
 
Blue Cross says that the state has a “broken regulatory system” that should be changed to guide the insurance market. According to Andrew Hetzel, the spokesperson of Blue Cross, "Because of financial losses and the prospect of a lengthy rate-setting process, we determined new rates were needed sooner rather than later".
 

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08/05/2009

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08/05/2009

The bill that will merge with H.R. 3200, or the America's Affordable Health Choices Act, has been approved by the House Energy and Commerce Committee with a 31-28 vote.
 
H.R. 3200 is a version that was passed by the House Ways and Means and Education and Labor committees and was approved on August 3. On September 8, it will be voted on by Congress after its summer recess.
 
The passing of H.R. 3200 was not favored by many employers, insurers and the public. Protests have been staged by conservative voters and America's Health Plans at town hall meetings held by members of Congress.
 
The reform on said act has, however, been postponed by the senate until September. The version from the Senate Finance Committee is expected to be more conservative than the version put forth by Congress.
 
“We're still waiting for the Finance Committee to take action. That really is what folks are waiting for now,” said the senior counsel on health policy, Kathryn Wilber, at the American Benefits Council in Washington.
 
H.R. 3200 creates a health insurance program that competes with private insurers. The Senate’s version is expected to widen the options with the inclusion of nonprofit and state-sponsored cooperatives.
 
Advocates of the public plan, the Obama administration and most Democrats, have been taking into consideration the benefits to the citizens who will subscribe to health insurance plans. The pros firmly believe that the public program will give rise to greater competition among insurers.
 
According to Watson Wyatt Worldwide’s senior consultant, Steve Raetzman, the Senate Finance Committee is considering proposals that do not appeal at all to employers, but the hope is that an improved version will eventually receive bipartisan support.
 

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08/05/2009

A report from “The Orlando Sentinel” stated that experts are worried about the fact that more young workers in Florida are working without health insurance coverage because of tight budgets.
 
The young employees, who consist of about 25% of the uninsured in the state, could possibly have many problems in the future.
 
According to the report, "Of the 2.4 million Floridians in that age group, an estimated 915,000 are uninsured, according to U.S. census data. And a national study released Thursday by the private research group Commonwealth Fund pegged the number of uninsured young adults in 2007 at 13.2 million - up from 11 million in 2000. That the youngest segment of the adult population is forgoing regular doctor visits and delaying urgent medical care for lack of insurance worries health experts, who say if the trend persists it could mean a sicker country in the future."
 
The young workers, who usually pay for their own treatments in emergency rooms or in clinics, are actually paying for the medical expenses of older or chronic users of the medical insurance system, according to the “Sentinel” article. However, the health insurance reform bill that is being discussed in the Congress could improve the current situation of the young laborers.
 
The report added, "Under the reform bills in Congress, Medicaid would be expanded to include childless adults who have incomes less than 133 percent of the federal poverty level - or about $14,400 a year; children could remain dependents until age 26; premiums would be capped; and insurers wouldn't be able to exclude people or charge more if they have pre-existing conditions such as asthma or diabetes".
 

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08/05/2009

To win the White House, President Barack Obama and his associates created a wide, grass-roots network of volunteers and supporters, considered to be among the most important assets in American politics. The network’s goal after the election was to restructure itself into a ground-level force to push Obama’s health care reform.
 
But currently, as a crucial congressional break is approaching, Obama’s health care plan is facing stiff opposition. A few member of Obama’s network said the group is still thinking about how to operate. Some also said they are being slowed by several factors, including tension and disenchantment among some essential supporters.
 
In Chester, Va., Obama supporter Beth Kimbriel volunteers 40 hours a week to convince people to give their support to Obama’s health care reform. But with critics of the health plan disseminating what she calls false information, Kimbriel finds it hard to be convincing every time she presents Obama’s position.
 
Also, in Cary, N.C., Murray Silverstone, who said he is eager to pitch in on Obama’s health care battle, wonders why Obama staff people arrived late in his area. It took five weeks for Obama’s supporters to reach his area to restructure the campaign system.
 
"It wasn't clear to us why there was such a delay," said Silverstone, an astronomer who volunteers to work supporting Obama’s campaign amid his research and college teaching.
 
Even with an increasing number of people being sceptical about Obama’s plan, Democrats are still hoping the August break will give them a chance to explain the health care system overhaul to the public. But Republicans are also as determined to use the break to disrupt town hall meetings of the Democrats.

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08/05/2009

When Glenda Krull and Mark Moody couldn’t afford their mortgage and health insurance payments any longer, they knew what they had to do. The couple sold their home.
 
Four year ago, Moody, 60 years old, underwent a liver transplant; it is possible that he will need another one. Every month, Moody pays $1,345 for the best policy he can afford from Premera Blue Cross.
 
Moody is desperate to keep the policy despite the consequences. The expensive premiums of his individual health insurance forced his wife Glenda to have her coverage downgraded, the couple’s retirement savings were slashed, and they were forced to move to a house half the size of their original home.
 
A good insurance policy doesn’t guarantee Americans who have serious illnesses that they will receive the care they require and that they will not go broke.
 
According to a study by researchers from Ohio University and Harvard University, in 2007, about two-thirds of all of the personal bankruptcies that were filed throughout the US were related to medical bills, illnesses or income loss. Of those who filed for bankruptcy, 78% had individual health insurance during the time they got sick.
 
Economist Sara Collins said, “It’s not just the uninsured. It’s people who have insurance that doesn’t protect them [who are increasing the need for reform].” Collins is also a vice-president of the Commonwealth Fund, a New York-based foundation for private health care.
 
For Moody, when health insurance coverage goes beyond the reach of people like him and his wife, it shows that the health care system of the country has gone gravely awry.
 

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08/05/2009

As a way to lower costs, more and more families are opting not to avail themselves of family medical insurance. According to reports, an estimated 50 million Americans have no coverage, and therefore are not protected against possible financial woes in the future, which could lead to bankruptcy. That’s why financial experts are advising families to seek family health insurance policies.
 
When it comes to cost-cutting, families can always find alternative measures instead of dropping medical insurance plans. Many affordable medical plans in the market are suitable for different budgets. Families can seek help from insurance experts when it comes to figuring out confusing insurance language, to help them decide on the plans that will perfectly suit their needs and budget.
 
A good look at available family medical insurance policies can help families make informed decisions. Families can choose from a variety of available policies, from the basic to catastrophic to comprehensive insurance plans.
 
For starters, families should look back at their own medical histories, and the medical services they’ve sought during the previous five years; this will give them an idea of the kind of coverage they may need in the future and what they should be looking to buy.
 
Client Services Director Tom Carolan of BestHealthcareRates.com explains, “Finding the right family medical insurance coverage can be both confusing and overwhelming, but it is a vital part of protecting your family’s future.”
 
“We enjoy walking families through the process of selecting a plan that can give them solid coverage at the price they need, which is why we offer one-on-one consultations for each and every new customer,” he added.

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08/05/2009

The supporters of the recently launched faith-based, pro-health reform campaign clarified that those involved in the campaign are not pushing for a particular health reform plan. But supporters also said they are taking a “moral position” on the health plan issue.
 
“This isn’t a political issue, it is a deeply theological issue, a biblical issue, and a moral issue,” said Jim Wallis, president of Sojourners. “So we are not going to at any time during the debate weigh in on the particulars of policy questions… [We’ll] leave the plumbing to the politicians.”
 
The “40 Days for Health Reform” campaign was launched by Wallis and other religious leaders. The campaign involves religious leaders from across America who will push Congress to submit legislation that will help offer more options for affordable health plans in America.
 
The group also sponsored television ads featuring Catholic leaders, local evangelicals, pastors, and other religious people. The group has been leading prayer rallies and events to reach 100 members of Congress.
 
National Healthcare Sermon Weekend, scheduled at the end of this month, will be observed by Christian, Jewish, and Muslim clergy who will speak about health care reform in congregations nationwide.
 
Some of the events scheduled for September include candlelight vigils and visits to Congress members.
 
Evangelical pastor John Hay, Jr., of the West Morris Street Free Methodist Church in Indianapolis, explained in a teleconference what inspired him to participate in the campaign.
 
“As pastor of an urban core church within walking distance of major hospitals, it seemed like some people in our congregation might as well have lived a 1,000 miles away from those shining institutions,” Hay said.
 
“They often put off a serious health problem until it reaches chronic stages and then make an emergency run,” he said. “This is no way for the most blessed country in the world to treat its most vulnerable citizens.”

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08/05/2009

The Republican Senator Charles Grassley, a key player in the controversy surrounding the health care system overhaul, faced crowds that showed little doubt that they’re unhappy with what's on the table.
 
"It seems to me that people are expressing, not just on health care, but people are just very scared about the direction the country is taking," said Grassley and accentuated that he has not signed off on anything.
 
Grassley, who is a ranking Republican on the Senate Finance Committee, has been bargaining for a compromise health plan to get some Republican votes.
 
"I don't want the government or a bureaucrat working for the government to come between you and your doctor," said Grassley. "I think the stakes are very, very high."
 
The forums arranged by several federal lawmakers have presented challenges for the administration of President Barack Obama as it struggles to win over those who are skeptical about a costly plan for health care system reform.
 
Missouri Senator Claire McCaskill and Pennsylvania Senator Arlen Specter were among those who held raucous town hall meetings on Tuesday. On Wednesday in Harrisburg, Pennsylvania, Specter stated that the health care protesters are "not necessarily representative of America" but should be listened to.
 
"There's more anger out there now than I have ever seen before," the Democrat said. "And I think the anger is caused by so many people having lost their jobs and (being) worried about losing their health insurance."
 
In North Dakota, an angry crowd packed a hall in Casselton to speak to Democratic Senator Byron Dorgan, with just a few signs of support for the health care overhaul plan. A woman was booed by the crowd after saying the reform is important.

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08/05/2009

The U.S. Chamber of Commerce started running its TV ad on Wednesday warning Americans that the health care overhaul would increase the deficit and raise taxes. The TV ad came after President Barack Obama emphasized that his health care plan would not add to the nation’s deficit.
 
"Washington's latest health reform idea: a trillion-dollar health plan and a government-run public option with big tax increases, even on health benefits," says a narrator in the Chamber's ad. "And the federal deficit? The non-partisan Congressional Budget Office says the federal deficit will grow $239 billion."
 
"Inflated taxes, swelling deficits, and expanded government control of your health --- tell Congress let's slow down, and reform health care the right way," the narrator concludes.
 
Changing the nation’s health care system to provide more health-plan options to uninsured Americans is among the top domestic priorities of Obama in his first year in office.
 
The first to accomplish markup of a bill was the Senate Health Committee. Recently, the Senate Health Committee approved a $600 billion measure created by Senator Ted Kennedy, which has a public health plan option. According to the Congressional Budget Office, Kennedy’s bill would cost $1 billion over 10 years.
 
The Republicans believe the President’s "bureaucratic takeover of health care" will affect businesses, increase deficit, and raise taxes.
 
"The creation of a new government-run insurance plan is a step in the wrong direction," the Chamber wrote. "We do not believe that the government plan will be a fair competitor. Because of the increased costs and lack of competition caused by a government plan, employers will not be able to continue offering their current plans, which cover more than 170 million Americans."

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08/05/2009

The Sanford Health Plan intends to join the competitive North Dakota insurance market if approved.
 
Blue Cross Blue Shield of North Dakota is currently the leading health plan provider, controlling over 90 percent of the health plan market and covering over 475,000 people.
 
“I think it’ll be a minor tremor, but I think it’ll shake things up a bit,” said David Middaugh, president of Middaugh & Associates, referring to the possibility of Sanford entering the fray. “They’ll have a presence right away.”
 
Sanford, based in Sioux Falls, South Dakota, has been a health coverage provider since 1998, and has become one of the top private health insurance firms in South Dakota, second to Wellmark, the Blue Cross Blue Shield plan.
 
The Sanford plan is now covering 51,000 people in Minnesota, Iowa and South Dakota, and it hopes to increase enrollees to 100,000 in five years.
 
The Sanford plan is affiliated with Sanford Health, a major health care provider network; it is poised to merge with Fargo-based MeritCare before the year ends. Executives of both health systems look forward to offering their insurance program, with coverage starting January 1, but Sanford is still waiting for regulatory approval.
 
“In North Dakota we have already started getting requests for information about Sanford’s insurance plan,” MeritCare spokesman Darren Huber said. “It’s clear people want additional high-quality options for insurance.”
 
North Dakota insurance commissioner Adam Hamm said his staff is still evaluating Sanford’s application to join the health insurance market in the state.
 
 “They’re a significant player in South Dakota,” Hamm said of Sanford. “They’ve indicated a strong intent to expand in our state. I’m obviously interested in seeing more choice and competition in North Dakota.” 

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08/05/2009

Officials of the Oklahoma Employee Benefits Council were happy to reveal that the state was successful in recent negotiations for HMO contracts that would cover 37,000 employees. The negotiated price was $30 million less than the original contract.
 
The state predicts an average cost increase of 5.86% in vision, dental, and health benefit plans in 2010, as compared to the finance office’s estimate of 12.88%, and Hewitt Associates’ projected an 11.8% average nationwide increase. But according to Brian King, a council spokesman, members of those HMOs will be subject to higher co-pay and out-of-pocket expenses.
 
In a planned statement, Chairman Bryce Fair said, “The council has a difficult balance to achieve, especially with the current economic situation. We’re determined to protect the needs of state employees and their families, while at the same time weighing the financial challenges of state agencies.”
 
Executive Director Philip K. Kraft commented, “Our contract negotiations with the HMOs are an exhaustive effort that requires many hours from the council members and staff. Without this effort, the costs would be significantly higher. We work hard to minimize the impact of rising health care costs on the employees, state agencies and taxpayers.”
 
According to council officials, the increases were lowered by means of “tireless, meticulous negotiations,” as well as the assistance of Gallagher Benefits Consulting Services.
 
Both standard and alternative plans offered by the participating HMOs are in turn offered by the Employee Benefits Council to state employees. Higher premium costs and lower co-pays are featured in standard plans, while lower premium costs and higher co-pays are typical of alternative plans. There will be an overall increase of 3.91% in standard plans and 8.69% on alternative plans.

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08/05/2009

One reason that health insurance is the top priority of many politicians is because 47 million people are not enrolled in health plans, while the government spent $2.3 trillion on health care last year.
 
In 2006, according to the Census Bureau, 59.7% of the population had employer-provided health insurance, 27% availed themselves of government health plans like Medicaid and Medicare, and 15.8% did not have any health insurance at all.
 
These statistics are broken down by economic status and race. People who have higher incomes are more likely to access health care through private health plans while most of those in the low-income bracket had the cheaper health plans funded by the government.
 
In 2008, the cost of health insurance increased by 6.1%. This increase has also caused 0.3% of employers to drop their workers’ health insurance. The number of Americans with government-subsidized health insurance also went down slightly.
 
For a family of four, the average cost of insurance is between $12,000 and $15,000 per year. While that is already expensive for those with low incomes, not enrolling in any health insurance is usually even more expensive.
 
Depending on the state, the average cost of an emergency-room visit alone is between $560 and $1,250, while cancer treatment averages $33,248 and a colonoscopy averages $2,000. The hospital costs of labor and delivery also vary, ranging from $7,000 to $14,000.
 
Moreover, health insurance without maternity coverage can quickly put any woman into debt, as the average OB visit costs $90. In addition, ultrasound and laboratory work cost an average of $300 and $200, respectively. Naturally, complicated pregnancy costs even more, which is why health insurance with maternity coverage is so important.

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08/05/2009

Students who are bound for college and are moving out of their parents’ house, but are still under the umbrella of their parents’ health insurance coverage, need to weigh their options regarding student health insurance cover. There are several options that should be considered to ensure that students remain insured even after moving out of the family home.
 
The first option is to stay on their parents’ health plan by remaining in school and letting it take care of any medical expenses they will incur. Parents can inquire with their agent about the scope of benefits that can be provided to their children. Most health insurance plans provide coverage for children aged 19-25 years old, allowing them to continue using their parents’ policies.
 
The next option would be to use the Consolidated Omnibus Budget Reconciliation Act (COBRA). This helps students retain the student health insurance coverage their parents bought for them. For those over 25 years old still attending school, or those who have decided to stop studying after reaching 18 years old, losing their parents’ health insurance coverage is a likely possibility. However, they might be able to temporarily continue the health coverage their parents carry for them through the utilization of COBRA.
 
Another option for those who will be working soon is to try short-term health insurance coverage. For those who won’t be a student for a short time and therefore won’t be able to use COBRA, considering a short-term health insurance policy may be a wise decision. This will be advantageous for those who are expecting to get insurance through a job and are just looking for coverage that is inexpensive and short term.
 
The last option is to get an individual health insurance plan that will keep you permanently protected.

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08/05/2009

Health insurance options used to be limited as the health insurance industry was dominated by only a small number of companies. Back then, the insurance companies had the power in their hands. Today, there are more insurance companies from which consumers can choose. Legal protection has also been given to the consumer. Recent laws ensure fairness when it comes to costs and the quality of service.
 
Looking at the health plans available today, one can also see that there is more flexibility given to the consumer. Before, the coverage plans that were offered were the same no matter what company was offering it. However, today there are more options available to the consumer. They can now choose a plan that is able to meet their specific needs.
 
The flexibility enjoyed by consumers significantly affects the cost of their health insurance coverage. For example, they can opt to have a high deductible so that they can have low monthly payments. They can also choose a plan that focuses on emergency care and care for illnesses instead of a plan that focuses on general care.
 
For people who used to find it difficult to pay for health insurance, the legal protection measures that have been enacted in the past ten years have given them a wider and more varied set of health insurance options. Many states have programs available that provide health insurance options at a very low cost.
 
The health insurance system has seen many improvements. These are the result of the increase in the number of health insurance providers, as well as the enactment of legal protection. To choose a health insurance plan that is perfect for your needs, you only need to spend some time on research.

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08/05/2009

Years ago, the kinds of health insurance plans available were very limited. Today, there are a lot to choose from. It is not always easy to choose the perfect health insurance plan, so it is very important to know your needs. You can choose from either a managed care plan or an indemnity plan. As both have unique benefits, you must decide what is best for you and your family.
 
Indemnity plans offer a lot of benefits. One of these is being able to choose any doctor you want. Normally, an indemnity plan will pay a percentage of your expenses. It usually does not cover services such as preventive exams. A Preferred Provider Organization (PPO) is another kind of health insurance that is similar to indemnity health plans. Going to a doctor that is within the PPO’s system will get you discounts.
 
Health Maintenance Organization (HMO) health insurance plans are also available. Through these health plans, you pay a monthly fee to receive health care benefits. Also, you must go to a doctor that is within the plan’s system or else your care will not be paid for. A number of HMO’s may also require co-payments for visiting a doctor.
 
You may find it difficult to choose a health plan because of the wide variety that is currently available. What you must keep in mind is that your health needs must be met by your health insurance plan at a reasonable price. It is very important for you to find a health plan that will answer your family’s specific needs. And, of course, it must also be within your budget.

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08/05/2009

Getting a health insurance policy will protect you from the expensive costs of health care. However, having a health insurance policy is not just protection from these costs; it can also be protection from serious illnesses.
 
Health insurance costs have been rising partly because of the advancements in health care. Modern medical technology has given us more options for treatment. Many illnesses that were difficult to cure before can be effectively treated by doctors today. However, getting these treatments is expensive. This is where your individual health insurance policy comes in.
 
You don’t have to worry about treatment expenses, including anything from a diagnostic test to specific forms of treatment, when you have a health insurance policy. You are also not limited by the amount of money you have available. This is why it is so important to have a comprehensive health insurance policy.
 
With a health insurance policy, it is also easier to maintain your health. Many policies focus on preventative care, not only coverage for catastrophic and emergency health situations. Preventive care can help you avoid more serious medical conditions.
 
Purchasing a health insurance policy is just like making any other significant purchase. You need to take the time to assess the details of each policy. Also, you need to consider the expenses that you will incur when you decide to get a specific health plan. Taking these steps will ensure that you get a health plan that is right for you.
 
It is a very wise decision to invest in a health insurance policy. Not only will you enjoy the medical benefits, but you will have the security of knowing that a policy is there to cover you in case something unexpected happens.

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08/05/2009

The health insurance industry can appear very intimidating and unfriendly. You might be wondering what qualities a health insurance provider should have. You might also be unsure about how to understand the language of your policy. Choosing a health insurance provider is not easy. However, you only need to educate yourself to know what to do.
 
There are a number of things to look at when choosing a health insurance provider. First, a health insurance provider should have stable monthly premiums. A provider whose premiums change every month should be avoided. Unstable premiums make it difficult to manage your expenses; in addition, it is very possible that the provider is shady.
 
Efficient claims processing is another thing to look for. You would not want to receive collection notices asking you to pay your medical bills because your provider has delayed payments. Also, you don’t want to have to follow up your claim several times before they process it. It is time to look for a new provider if your current provider has claims processing and customer service that is very poor.
 
When requesting quotes, ensure that your provider gives you several options. A provider should not bully you into purchasing a specific policy or health plan. Consider talking to an independent agent rather than a company agent. An independent agent will normally show you quotes from different providers.
 
During your health insurance comparisons, evaluate each provider’s network of facilities and doctors. Avoid providers with a limited network. Most doctors know details about the health insurance providers located in your area. There must be a reason why they did not choose to work with certain companies.

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08/05/2009

Because there are many health insurance companies that you can choose from, it can be challenging to find the health insurance that best suits you. First find out what type of coverage will meet your needs. After figuring this out, start looking at companies that offer that type of coverage and start comparing their rates. An online quote for health insurance can be obtained from numerous sites on the internet. When you do go to the internet for an online health insurance quote, make sure to fill the forms out correctly.
 
Another way to get a health insurance quote is to talk to an insurance agent. An agent will help you with your decision and with finding the right plan for you. They can present several plans from different companies. After that, you can easily compare the features of each plan. This will save you the difficult task of talking to people from many different companies about health insurance quotes.
 
If talking with an insurance agent is not what you have in mind, you can visit websites that will allow you to review insurance plans. These websites can also give you quotes. Some websites may ask for your personal information. They use this to provide you with health insurance quotes from a variety of health insurance providers. This only takes a short while and you can comfortably compare the plans and rates on your computer.
 
It is very important to get several health insurance quotes and compare them. Doing so will help you choose the insurance plan that is perfect for your needs and budget.

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08/05/2009

Although a number of health issues affect people despite their age, gender, or geographic location, there are some health issues that usually only affect a specific group of people. An example of this is men’s health issues.
 
Prostate cancer occurs when there is abnormal growth in this male sex gland. Normal sexual functions, as well as bladder control, are impeded when a man’s prostate has a tumor. One of the disease’s symptoms is manifested by urination problems.
 
Heart disease is usually caused by atherosclerosis, which happens when fatty substances amass on the inner walls of an artery. Together with stringy tissue and calcium, the fatty substance will harden and block the artery.
 
Another health issue for men is high blood pressure, or hypertension. There are various factors that lead to hypertension. These include one’s hormonal levels, the state of one’s nervous system, kidneys, and blood vessels, and the salt and water in one’s body.
 
One of the major diseases affecting American men is lung disease. Its symptoms include cyanosis, wheezing, swelling, chest pain, and breathing difficulties.
 
There are many things men should do to stay healthy. It is important to be physically active and to eat a balanced diet. It is also wise for men to get screening exams for diabetes, depression, cholesterol, blood pressure, cancer, and obesity.
 
The health issues that plague men are not just significant to them, but to the people who care for them as well. To be able to receive preventive care and to maintain good health, it is important for a man to get an individual health insurance plan that is right for his needs.

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08/05/2009

The health care insurance industry in the U.S. is quite complicated. There are so many health plans available that many Americans find it difficult to select the best one.
 
Every year, ‘U.S. News & World Report’ collects and publishes the rankings of the country’s top health insurance plans. In spite of this, there is no insurance plan that can be considered the absolute best. Rankings of health insurance plans can be a helpful starting point, but rankings should not be the single source of information when you are looking for the best plan.
 
Rankings have a number of problems and disadvantages. For one, the rankings can become useless when a listed plan has already become unavailable. If it still is available, it is possible that the benefits included in the plan have changed as well.
 
Also, rankings are usually not based on data; instead, they are most often based on surveys. Rankings are therefore more subjective. The results are influenced more by the opinions of consumers than by the coverage provided by the plan itself.
 
The main reason why rankings shouldn’t be taken at face value is that each person has different insurance needs. The highest ranked plan may be ideal for one person but completely inappropriate for another.
 
Instead of consulting rankings, consider carefully the benefits that you need when choosing your plan. For example, if you do not have a pre-existing health condition, you can choose a plan that has low premiums. On the other hand, you may want a plan that covers prescription drugs, has benefits related to mental health, and has low deductibles.

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08/05/2009

Preferred Provider Organization (PPO) plans, sometimes referred to as participating provider organization plans, are health care programs managed by an insurance company. Medical doctors, clinics and hospitals, and other health care providers are contracted by the insurance company to assist its insured members with their medical needs.
 
Under a PPO plan, the insured pays a fee at the time of every medical service. However, with this type of plan, a member is provided with a substantial discount by the professional partners of the insurance company.
 
Before the insurance company starts paying for the insured’s medical fees, the insurance company collects a yearly deductible. The company typically pays 80% of the insured’s medical cost for the in-network physician. The patient is responsible for the remaining cost not covered by the insurance company. The patient also has the option to request an out-of-network physician or medical service provider. The deductible for these services may be more expensive than PPO physicians and the insurance will cover less of the cost. In order for people with PPO plans to get cheaper rates, it is best if they use the doctors, hospitals, and other medical providers in their plan’s network.
 
PPO plans also provide prescription services at a discounted rate. PPO plans cover most health care services, and PPO premiums are lower than those for individual health insurance. Moreover, insured members have more health care options with PPOs, since they are part of a wide network of medical providers.

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08/05/2009

Free or discounted fees for doctors' visits and prescriptions are not the only things your health plan can offer. Today, many insurance companies also offer improved coverage for mental health conditions, disease management programs, infertility, and much more. Sometimes these benefits may not be well explained by your insurer.
 
Disease management programs are health programs designed to help health insurance plan members with chronic health conditions, such as asthma and diabetes. For diabetic members, your health plan may offer benefits, such as counseling sessions on proper diet, nurse consultations, and drug monitoring. However, because most insurance companies sell plans to employers, many workers are not aware that these benefits exist.
 
Your health insurance may also include coverage for those trying to conceive. Since the cost of reproductive technology, such as in vitro fertilization (IVF), is very high, many insurers do not include such benefits in the package. However 14 states, including New Jersey and New York, have passed a bill requiring insurance companies to provide some level of coverage for infertility treatment. In most states, legislation includes IVF in the coverage.
 
For people who are diabetic and who need to lose weight, some insurance companies also reimburse a portion of a health club membership and other programs that promote weight loss to manage diabetes. For people with heart disease who are smoking, some health plans also offer support programs that may help them kick the bad habit.
 
You may also enjoy coverage for alternative medicines and therapies, such as massage, acupuncture, and herbal medicine. Today, a growing number of insurance companies now include such treatments in their health plans.
 
It is unlikely that your health plan is trumpeting information about state-mandated coverage. It is up to you to get the details.
 

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08/05/2009

Although the majority of Americans avail themselves of subsidized health care coverage through their employers (group/business health insurance), some people who do not have access to this kind of insurance just purchase their own independently (individual health insurance). However, the challenge is when the person has what is called a “high risk” medical condition, like cancer, central nervous system issues, cardiovascular conditions and other diseases that require frequent and costly treatments. Aside from treatment costs, these conditions also often last longer and can result in complications that become another responsibility of the insurance company. Since the law allows insurers to reject the applications of individuals with serious pre-existing health issues, most insurance companies do.
 
The most common health care option for “high risk” individuals is high-risk health insurance. High-risk health insurance provides almost the same coverage options as those offered by individual health insurance. Both typically are comprehensive and have diverse options. In many states, a Preferred Provider Organization (PPO) plan is one of the most popular types of high-risk insurance plans. Health Maintenance Organization plans are also available in many areas.
 
Today, individual states provide this type of health plan through high-risk insurance pools. The coverage is funded by the state but the insured has to pay a premium, which is often quite expensive, to the state insurance agency.
 
High-risk insurance provides broad health coverage and even pays for prescription drugs. Mental health and maternity are also often covered by high-risk insurance. The main disadvantage of purchasing high-risk insurance, however, is costly premiums which are determined by the insured’s pre-existing health conditions, location, and age.

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08/05/2009

In most states, the majority of insurance companies deny people with pre-existing health conditions health insurance coverage. Some people get medical insurance either through their employer or as a dependent on someone else’s health insurance plan.
 
Currently, 31 states run high risk pools, which are designed to help those who cannot get health coverage due to pre-existing health conditions. In many states, the health coverage offered by high risk pools is similar to what individual health insurance offers. Most pools provide comprehensive medical plans covering extensive disease-specific benefits. Many high risk pools also include disease management programs for people with chronic diseases. Typically, enrollees are provided with an option of choosing a PPO, HMO or indemnity plan.
 
Like other insurance options, high risk pool coverage has limitations in terms of benefits. This type of insurance also requires higher deductibles, co-payments, and out-of-pocket costs. In most states, high risk pool coverage usually imposes a so-called ‘pre-existing condition exclusion’ period of up to 12 months. Only after this period has ended will the insurance company start paying insurance claims.
 
High risk pool insurance is usually more costly than regular individual health insurance. Enrollees in high risk pools usually pay 150% to 200% more in premiums than the standard rate charged by insurance providers for individual insurance policies. This is mainly because the people enrolled in this type of coverage have illnesses that require frequent and expensive treatments.
 
Although costly, this can be the best option for those who are unable to purchase an individual policy because of existing health problems. Generally, the health care cost of being uninsured will be a lot greater than the cost of high risk pool premiums.

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08/05/2009

When one looks for a health insurance plan, one may have difficulty choosing between a Health Maintenance Organization (HMO) and a Preferred Provider Organization (PPO). The common ground on which HMOs and PPOs stand is the concept of a primary care physician (PCP), who represents the first contact for the medical care of a member. But what actual differences are there between HMOs and PPOs?
 
An HMO requires a patient to select a PCP from the HMO network. This PCP will be the one responsible for the maintenance of the patient’s health. This physician will also be the one to refer the patient to other physicians within the same HMO network for specialist care, should the need arise. A patient may not see a specialist without being referred by his or her PCP.
 
In a PPO, on the other hand, a patient may get medical care from any medical provider, even if the provider is not a member of the PPO network.
 
The advantages of an HMO are the premiums, which are usually lower, and the absence of deductibles to meet. Another advantage is that there is only one PCP responsible for the patient’s overall health maintenance. The benefit of this lies in the fact that the PCP will be very familiar with the medical background of the patient.
 
On the other hand, the advantage of a PPO is that a patient is not bound to a single doctor. Also, a patient does not need to be referred by his or her PCP should he or she wish to see a specialist.

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08/05/2009

In response to consumers’ demands, the insurance industry has created linked, or ‘hybrid’, health insurance policies. These policies offer health benefits provided by annuity or life insurance and traditional long-term health plans. Hybrid policies also guarantee that the insured’s long-term health coverage that has not been used can be used by beneficiaries.
 
Hybrid health insurance functions in many ways. One type of hybrid health insurance that links a life insurance policy to long-term care insurance requires the insured to deposit a premium into a policy to create a pool of money for health care benefits.
 
Another type of hybrid insurance policy works like a fixed annuity that does not have a premium rider. Instead, a part of the internal return is used to pay for the health coverage. Insurance companies typically provide a payout of up to 300% of the aggregate value of a policy for up to three years after the value of the account is depleted. For example, a policy owner, who has a $100,000 annuity and has chosen a two-year benefit factor and aggregate coverage limit of 300%, would immediately create a pool of money worth $200,000 to cover long-term care expenses and another $200,000 of life insurance benefits. This only takes effect after the initial policy value, which is $100,000, is depleted. But, if the policy holder is healthy and does not need health care, the unused benefits will be paid out as a lump sum to the policy holder or to any named beneficiary.
 
The cost of these new policies differs from one person to another depending on the person’s health condition, age, gender, benefits requested, and premiums.
 

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08/05/2009

There are many health care plans available to consumers depending on their needs and budget. Even though many health plans seem to offer the same thing, the coverage and benefits they offer are very unique.
 
Preferred Provider Organizations (PPOs) are one of the popular health insurance options today. Although PPOs basically work like HMOs, or Health Maintenance Organizations, the two provide different benefits.
 
Even though their networking methods work in much the same way, PPOs have a wider network. They also impose a smaller fine for services acquired outside the network. For a higher cost, PPOs allow their members to choose their preferred providers. HMOs, however, do not cover out-of-network services.
 
Point of Service (POS) plans integrate the formulas utilized by PPOs and HMOs. In this type of plan, members shoulder a co-payment when utilizing the services of providers that belong to the network. However, there are no deductibles. POS plans function like a PPO regarding out-of-network services. POS plans allow their members to seek services from providers outside their network. However, customers must initially pay deductibles and coinsurance.
 
PPOs don’t have one single plan. The differences in coverage and benefits are due to the differences in the needs of customers. Some of the factors people might want to consider include the cost of monthly premiums, the coinsurance they need to pay even if they don’t seek out-of-network services, and the size of the annual deductible.
 
There are still other factors to consider before choosing the appropriate plan. Perhaps the best thing to keep in mind is that the benefits you receive will depend on the amount you pay.

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08/05/2009

Heath insurance for freelance writers and independent contractors can be very expensive. As a result, no matter how tempting the freelancer lifestyle may be, many people still stick to a nine-to-five job because of the employer subsidized health plans.
 
Finding a health plan for an independent worker requires some research. As when making any other major decision, a careful assessment of the options available is necessary.
 
There are several routes freelancers can take when getting a health plan. Joining a group, like a guild, may offer some affordable medical insurance options. Some states consider one individual who works independently as a “group”. This means that, in those states, independent workers may just be charged a group or discounted rate without the additional fees of joining a guild or group.
 
The Editorial Freelancer Association, for example, provides health plans to its members. Discount health plans and dental HMOs are also available to members. Some health insurance providers offer plans that are targeted to freelance writers for as low as $333 per month for each member. Other options include the National Association for the Self Employed, AvantGuild, and the Author’s Guild, all of which provide discounted insurance for published writers in selected states.
 
Another option for freelance writers is COBRA, a program run by the federal government. COBRA offers a subsidy to individuals who have just lost their jobs and who wish to continue the health plans subsidized by their previous employer. Should an editor or writer leave their full-time job and become a full-time freelancer, the COBRA subsidy may be a good option. COBRA offers 18-36 months of coverage, depending on various factors.

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08/05/2009

Many people feel that group health insurance is better than individual health insurance because the former usually costs less and provides more benefits than the latter.
 
However, many people cannot get group health plans because they work for a small company that does not provide them with group health insurance, they are self-employed, or they have run out of COBRA benefits. Thus, their only option is to purchase individual health insurance.
 
Individual health plans are offered by many insurance companies; however, people who are over 50 years old, especially those with medical problems, are often declined by insurance companies.
 
Before enrolling in an individual health plan, it is important to consider how much of your physician and hospital bills the insurance will cover, how much you will have to pay in premiums, and how much you have to pay before the plan starts to pay for your medical expenses.
 
Enrolling in an individual health plan provides you with several options, such as fee-for-service policies and managed care plans.
 
Also called indemnity insurance, a fee-for-service insurance plan is a traditional type of health insurance that pays a portion of every medical service you access, such as hospital stays and physician visits. With this type of plan, although you pay for the rest of the expenses, you can go to the hospital and doctor of your choice.
 
A managed health plan, on the other hand, is insurance provided by a group such as a Preferred Provider Organization (PPO) or Health Maintenance Organization (HMO). Insurers that offer managed health plans contract with hospitals and physicians, which make up the "network" of the plan. With this type of individual insurance, the insured are advised to patronize the physicians and hospitals that are part of their plan's network.
 
Other types of individual health insurance are Open Enrollment in Managed Care Plans and Association-Based Health Insurance.
 
 

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08/05/2009

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08/05/2009

Several states in the U.S., particularly Massachusetts, are working on enacting or have enacted laws that require the residents of the state to get individual health insurance. Usually called insurance mandates, these laws are passed in an attempt to reform the U.S. health care system.
 
Expanding a state’s risk pool is the concept behind these insurance mandates. The result of this would be reduced costs for all the state’s residents.
 
Risk pools work based on the idea that a state has low-risk and healthy residents who will counterbalance the high expenses brought about by the pool’s high-risk and less healthy members. When low-risk and healthy individuals are insured, the members of the pool will then assume a larger part of the expenses of the pool’s high-risk members.
 
There are instances when the members of the pool start to find it very hard to pay for their premiums. This is usually called a “death spiral” by the insurance industry. To lessen the probability of a “death spiral” occurring, insurance mandates are issued so that everyone will be forced to purchase insurance, thus diversifying the members of the risk pool and lowering individual costs.
 
There are some problems with insurance mandates. For one, there will be low-risk and healthy individuals who would prefer not to buy insurance as they are hardly ever sick. The state would then need to create penalties for those who fail to comply with the mandate. Another problem is that there are some people who cannot afford health insurance. The state must then work on subsidizing or lowering insurance premiums.
 

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08/05/2009

Just like individual health insurance, the purpose of life insurance is the same: to provide financial aid. Life insurance policy holders also pay premiums: monthly, quarterly, or annually. Policies can run for one year up to a full lifetime. In health insurance, the policy holder receives the benefits in the form of discounts, reimbursements, etc. In life insurance, the policy holder’s beneficiaries will be paid a specified amount upon the death of the policy holder.
 
Life insurance started in ancient Rome. Burial clubs collected money from the poor to pay for the funerals of their members. Starting in the Middle Ages, labor guilds, religious and fraternal organizations, and mutual life insurance companies took over the life insurance business. Mutual life insurance companies are owned by its members, just like credit unions. Edmond Halley, an astronomer in the 17th century, developed the very first actuarial tables that were used to calculate insurance risks according to mortality statistics. As a rule of thumb, higher risks result in higher premiums.
 
Risk calculation determines how much a premium will cost, or whether an applicant will be given a policy at all. Everything from the applicant’s full medical history, hobbies and lifestyle, driving record, travel history, and credit history will be taken into consideration by insurance actuaries when determining the actual cost of the applicant’s premium.
 
Some of the major factors that affect the cost of life insurance premiums include age, gender, and pre-existing medical conditions. Men and older people are likely to pay higher premiums. People with “dangerous” hobbies, such as scuba diving and skydiving, also pay more for life insurance policies.
 
It is possible for life insurance claims to be denied. For example, most life insurance policies do not provide coverage for suicide. Fraudulent claims will be fully investigated.

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08/05/2009

Many people consider buying long-term care (LTC) health insurance. However, there are a number of factors that need to be considered.
 
LTC coverage may not be affordable or necessary. Before purchasing LTC insurance, it is best to consider your family status. Incurring out-of-pocket costs for long-term care may be a financial risk worth considering, because this type of health plan may not be affordable. Ideal candidates for this type of coverage are those who can afford to pay high premiums, and can also handle increasing fees.
 
The affordability of LTC plans is also determined by your general financial picture. Your net worth is one reliable measure, but this should exclude your home and even your savings and the investments and pension you expect after you retire. People who have less than $500,000 in investments might also not be able to afford this type of coverage.
 
It is also necessary to calculate the insurance costs as a percentage of your calculated retirement income. You might not be able to afford the insurance plan if the premiums consume more than 10 percent of your income.
 
Individuals with investments worth $1 million, and couples with $1.5 million worth of investments, may be able to afford this coverage.
 
You may also consider your family health history. Although not a perfect predictor, many inherit their parents’ or grandparents' health patterns.
 
It is also wise to understand the features and disadvantages of long-term care policies. Although insurance of this type is aggressively sold, many people who purchase it do not understand what they are getting. Make the most of your hard-earned money. Know every aspect of the health plan you are interested in before purchasing.
 

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08/05/2009


For most people, going to college is a big adjustment in their lives. There are new things to learn, new people to meet, and more experiences to enjoy. Most young people look forward to graduating, while having fun in the process. However, there are also important things to consider, such as tuition fees and other expenses.
 
With all the hassles that college life brings, it is easy to neglect one’s health. Although young people are considered healthier than the rest of the population, there are studies showing that college students are also prone to accidents and health problems just like anyone else. In the US, about 1.7 million students are uninsured, meaning their medical expenses are paid with money from their pockets. This fact is aggravated by another finding which shows that some uninsured students do not seek medical help, due to the high costs of consultations and treatments. This kind of scenario could result in numbers of students dropping out of school due to illness or to get work to pay their medical bills.
 
In response to this problem, some colleges have begun to force students to acquire some form of medical coverage, while others offer affordable medical packages. Student health insurance plans are more flexible and have fewer requirements than traditional individual plans. In addition, some plans offered by colleges can be extended even after one’s graduation.
 
Medical insurance plans are also important to students covered by other people’s policies. Insured students are commonly covered under their parents’ policies which are offered by their parents’ employers. It is important to check the eligibility of students under their parent’s medical coverage; the coverage might be terminated due to certain factors, such as when a student reaches a certain age or has married.
 
For college students, health insurance is important in safeguarding their health, reducing future expenses, and improving their chances of graduating.

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08/05/2009

Different types of alternative medicine, also known as CAM (Complementary and Alternative Medicine), are becoming more popular with people living in the U.S. All health-related practices and therapies that are not considered as traditional medicine are classified as CAM. Examples of CAM include treatments such as energy healing, acupuncture, biologic therapies, body and mind mediations, massage and chiropractic therapies, and spiritual healing and prayer.
 
According to the Center for Disease Control, in 2004, around 36% of the people living in the United States had undergone alternative therapy. Nowadays, a lot of people think that combining CAM therapies with traditional medicine provides better possibilities for healing. The term “alternative” is used to refer to therapies that are used in place of traditional medicine therapies. On the other hand, the term “complementary” is used to refer to therapies that are used together with traditional medicine therapies.
 
Insurance for alternative therapy is now being offered by a number of insurance companies in the United States. CAM therapies such as massage therapy, chiropractic care, and acupuncture are covered by this type of insurance. Many job-based group health insurance plans cover this option as an answer to the requests of employees.
 
CAM therapies are used by an increasing number of people in the U.S. As a result, CAM is now one of the health care industry’s fastest-developing segments. However, many insurance companies still think twice about providing coverage for CAM, in spite of increasing public demand.
 
It is important to take into account that for some states, this kind of insurance coverage is not considered as an insurance product.

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08/05/2009

Bipolar disorder is manifested through a person’s alternating moods, from extreme elation to deep depression. In truth, this disorder is more complicated than was previously perceived. It is an illness that influences the behavior, feelings, thoughts, perceptions, and physical condition of the individual who has the illness.
 
It is important for a person experiencing the symptoms of this depressive disorder to seek help right away. The person suffering from this illness should be examined and treated immediately to ensure his/her safety and wellbeing. A medical practitioner would be able to outline the proper treatment and medication for your condition.
 
Bipolar Disorder is a lifelong illness. If untreated, this disorder will make it difficult to live a fruitful and productive life, due to the recurring manic and depressive incidents it will produce. Having the proper treatment for this disorder would help you continue living your life on your own terms, preventing the disruptions caused by extreme mood swings. Medication is not enough to cure it. A combination of educating yourself about the illness, seeking help from doctors and therapists, a reliable support group, making healthy decisions, and sticking to the right treatment plan will help you keep the mood swings under control.
 
Finding the right treatment is vital. Your primary doctor is a good place to start seeking advice for therapists appropriate for your condition. You can also try to make a list of therapists that your medical insurance or health plan will allow you to see, if your policy has some restrictions. When you have found the right therapist for you, an accurate diagnosis would be your next goal. Knowing what you are up against will help you prepare mentally and physically for the treatment you need.
 

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08/05/2009

Sleep is vital for everyone because it is the body’s opportunity to energize and repair itself after a tough or tiring day. Sleep is essential for making us feel refreshed in the morning and for staying mentally and physically alert during our daily activities.
 
Almost everyone has encountered sleep problems at some time. This may lead to daytime sleepiness, which will greatly affect one’s performance in work, school and community life. Sleepiness not only reduces an individual’s productivity but can also cause other problems such as accidents, irritability and slow mental processing. You may be physically present at your meeting but your mind seems to wander because of an irresistible urge to sleep.
 
Difficulty sleeping may be caused by stress brought about by tough deadlines, failing relationships, or increasing debt. It may also be caused by poor bedtime habits or a change in time zone. You may get back to your regular sleeping pattern after the stressful ordeal has passed or after your body has adjusted its natural clock. However, if you are still having trouble getting the right amount of sleep on a regular basis, then you may be suffering from a sleep disorder. You can tell the difference if you are just having an occasional sleepless night or a sleep disorder by addressing the symptoms.
 
Some of the common sleep disorders include insomnia, narcolepsy, sleep apnea, restless legs syndrome, and sleep paralysis. Some of the sleep disorders, such as insomnia, can be treated through a change in lifestyle, but some of them require medication and can be potentially dangerous. You can seek medical help through your health plan or your preferred Health Maintenance Organization.
 

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08/05/2009


Having problems getting back on track and communicating with people around you after a traumatic ordeal? You might be suffering from Post-Traumatic Stress Disorder (PTSD). PTSD is an illness where a person feels that there is no hope and she/he will not be able to live a normal life again after surviving a harrowing and life changing experience. These people should bear in mind that help is available and that recovery from this illness is possible. All you have to do is be open to the idea of seeking treatment, joining a strong support group, and sticking to the recovery plan.
 
Having PTSD is not easy and overcoming it is definitely not a walk in the park. But, to get your life back in order, you will need courage to face the truth. Seek help immediately. The earlier the disorder is diagnosed and treated, the earlier you will be able to live normally again. It is not a sign of weakness to admit that you have PTSD, and the only option to defeat it is to get professional help and guidance.
 
An expert and well-informed approach to crisis intervention and management can help individuals and their families with PTSD, in a way that promotes healing and growth. There are several managed health plans that support PTSD treatment facilities to provide an environment that gives plenty of privacy and comfort. Some medical insurance companies also cover mental health services that may also include consultation with a therapist. Coordinate with your health insurance agent to get information on your policy coverage.
 


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08/05/2009

Depression is an illness that affects millions of people around the globe. In the United States alone, the number of adults who suffer from depression is estimated at 33 to 35 million. The good news is that it can be successfully managed, if not always completely cured. One only needs to reach out to medical professionals, family, or even just friends. Some health plans have also adapted higher deductibles and co-payments for prescription drugs.
 
Everyone, regardless of age, gender, economic status, or race, may be affected by depression. However, studies show that women are more prone to the illness and experience episodes of depression twice as often as do men.
 
As to what causes depression, no specific cause has yet been singled out. However, there is a consensus that it is caused by a mixture of environmental, genetic, psychosocial, and biochemical factors.
 
Major depressive disorder (MDD), commonly known as depression, is diagnosed when a patient manifests a depressed mood or loss of interest and if this manifestation is accompanied by at least four symptoms. Symptoms include difficulty in concentrating, fatigue, feeling of worthlessness or guilt for no reason, irritability, difficulty in sleeping, and hopelessness.
 
As no one can deny the importance of the mind and body connection, a person who suffers from depression may find it helpful to adopt a lifestyle that is good not only for the mind, but also for the body. This lifestyle entails maintaining proper hygiene, having a well-balanced diet, managing anxiety under the supervision of a health professional, setting realistic goals in order to avoid disappointment, and, of course, having a social network or close and intimate relationships.

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08/05/2009

Diabetes is the medical condition wherein a person has a very high level of blood sugar. It is necessary and normal to have sufficient sugar in one’s blood; however, too much sugar in one’s blood can be dangerous and can lead to diabetes. Gestational diabetes, Type 2, and Type 1 are two of the types of diabetes.
 
Almost 21 million Americans, adults and children alike, struggle with diabetes. Many of these 21 million Americans do not have health insurance. Thus, they have significantly limited options for treatment and they are at great risk in case of illness. People who have diabetes but do not have medical insurance should know the risks of remaining uninsured.
 
Not only is diabetes itself harmful, but it can also lead to other illnesses. These include kidney failure, heart disease, blindness, stroke, and amputation of the lower limbs.
 
For diabetics, visits to the doctor, medication, and other medical treatments are the benefits of having health insurance. These are necessary in order to control a person’s diabetes as well as other medical issues that will arise from it. Diabetes is usually an illness that lasts a lifetime. Health care for diabetics is ongoing and the best solution for financing one’s medical expenses is getting health insurance.
 
When selecting a health insurance plan that will answer your needs, it is important to look at a number of things. For one, find a policy that will cover all the necessary treatments for diabetes. Also, make sure that the policy will cover treatments for the medical conditions that are linked to diabetes. Finally, make sure that your health insurance plan will cover a substantial amount of the costs of your pharmaceutical needs.

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08/05/2009

Health insurance can be split into two general groups: managed care and traditional. There are four main types of plans within these groups, namely, traditional enmity plans (fee-for-service plans), Preferred Provider Organizations (PPO), Point-Of-Service Plans (POS), and Health Maintenance Organizations (HMOs).
 
For many years, up to the 1960s and ‘70s, traditional enmity (fee-for-service) plans were the common coverage. These plans are like car insurance – the policyholder pays a particular amount of his or her medical expenses (deductible), and after that, the insurance company covers the majority (around 80%) of the bill. Over all, fee-for-service plans offer flexibility to policyholders, wherein they can freely consult and choose their doctors and hospitals without getting permission from the insurance company. However, these plans also involve higher out-of-pocket costs, higher premiums, and more paperwork.
 
Managed care has boomed recently, together with the advancement of medical technology. Of all the types of managed care coverage, Health Maintenance Organizations (HMOs) are the least flexible, but they are also the least expensive. In exchange for minimal paperwork and low premiums, HMOs require policyholders to see only their prescribed network of doctors. Meanwhile, Preferred Provider Organizations (PPO) offer a bit more flexibility. PPOs also have their own network of health providers. Policyholders are given financial incentives to stay within the network, but they are not completely restricted to it. The third type of managed care is the Point-Of-Service plans (POS). These plans are like a combination of a PPO and an HMO plan, because of the Primary Care Physician (PCP) feature. Policyholders choose their PCP from the POS’ doctor network.
 
In summary, no health insurance type can be considered the absolute best - it all depends on a person’s preferences and needs.

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08/05/2009

Depending on the coverage needed, there are different kinds of travel insurance: trip protection, car rental or luggage protection, and medical coverage.
 
The health and medical insurance policy type of travel insurance provides coverage for medical and dental expenses caused by injury or illness during travel. Under this type is medical evacuation coverage, which is helpful when hospital transfer is necessary. Typically, this is bundled with medical coverage. However, it could also be purchased separately.
 
Another kind of medical coverage is the dismemberment and accidental death policy. This covers the duration of the vacation. Just like the usual life insurance policies, beneficiaries get a certain amount in case the policyholder dies.
 
With regard to medical policies, consumers need to check for issues about pre-existing medical conditions, as well as age limitations. Many policies have increased rates for senior citizens.
 
The second type of travel insurance is trip protection. Under this are cancellation coverage, delay coverage, and trip interruption protection.  With cancellation coverage, your prepaid expenses would be reimbursed if ever your trip were cancelled due to illness or death of a family member.  Delay coverage, on the other hand, takes care of transport delays. If flights are cancelled due to bad weather, delay coverage will shoulder your prepaid hotel expenses.  Last but not least under trip protection, an interruption protection provides coverage for travel company bankruptcy, airline strike, jury duty, or whatever reason that cuts your trip short.
 
As for the third type of travel insurance, luggage and car rental protection provides coverage for rental car accidents and missing/stolen baggage.
If you want to purchase any of these policies, be sure to choose the ones that provide travel assistance aside from the monetary coverage.
 

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08/05/2009

It is very difficult to go through a divorce. There are many things to worry about, and health insurance is one of these. Health insurance coverage issues, such as continuing the policy you had before the divorce, can be very challenging. People who are about to be divorced may be worried about how their health insurance coverage will be affected by the divorce. You must study the options that are available to you. If you are satisfied with your current coverage, find out how you can maintain it. If not, you can look for another health insurance plan whose rate you find reasonable.
 
There are fewer things to worry about when you are insured under a group health insurance plan provided by your employer or when you have individual health insurance. In these cases, your health insurance coverage will not be affected when you get divorced. The bigger problem happens when you are insured under the group health insurance policy of your spouse. When the divorce is finalized, your coverage is terminated as well.
 
In this case, getting COBRA coverage is a good option. With COBRA, you can continue your coverage simply by paying premiums.
 
If COBRA coverage is not a possible option for your use, or if you are not satisfied with your current insurance company, you always have the option to get a health insurance policy from a different insurance company. In some ways, doing this would be beneficial, as you will have a fresh start with a possibly better insurance company. However, getting a completely new policy may be difficult, as there will also be a number of restrictions associated with a new policy.

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08/05/2009

Below the Employee Rate Breakdown in a group or business health insurance proposal, there may be column headings that indicate EE Rate, Total Rate, Dep Rate, ER Cont and EE Cont. Though business health insurance quotes come in various formats, most insurance providers use the same abbreviations. The EE Rate is the employee rate. This is usually placed in the column to the far left, on that same line. This is the rate of the employee’s insurance, regardless of whether they have dependents or not. The Dep Rate column displays the rate for the employee’s requested dependents, such as children. This rate is the total premium for all of the dependents. The premium will not adjust if it is rated as “family”, or even if the member or employee chooses to add more dependents to his or her health plan. An employee’s total premium is displayed in the Total Rate column, which includes the premium for the employee only, and the premium for their dependents. In case that an employee does not enroll any dependents, the result of the EE Rate will be the same as the Total Rate, and the space intended for the Dep Rate will indicate $0.
 
The column labeled EE contribution displays the percentage of the Total Rate which the employee will shoulder. This is derived from the employee and dependent contribution portions or percentages that are applied to compute the health plan quotes. In addition, the column labeled ER contribution shows the percentage of the Total Rate which the employer will shoulder. This amount should be equal to the difference between the Total Rate and the EE Contribution. Each of the columns should show a total amount at the bottom – this shows the combined rates for every employee.
 

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08/05/2009

Typical insurance premiums cost around 8% to 10% of the total payroll amount. The majority of this percentage will go to health insurance coverage. Companies can offer three kinds of health care coverage for their employees: either fee-for-service or the traditional type of coverage, Health Maintenance Organization or HMO, and Preferred Provider Organization or PPO.
 
The traditional health plan or fee-for-service provides employees with the most flexible coverage. As far as this type of coverage is concerned, there are no restrictions when it comes to choice of doctors and hospitals. Because of their flexibility, traditional health plans are usually more expensive.
 
Health Maintenance Organization is the second type of health plan. Basically, HMOs are considered prepaid health plans. Employees covered by an HMO can only seek services from doctors and health providers inside the HMO network.
 
Employees under HMOs also make co-payments worth $5 to $25 every time they go to the doctor’s office or emergency room. Typically, employees also need to select their primary care physicians (PCP) for health monitoring. PCPs also make the necessary referrals if ever their patients need the services of specialists. HMOs are geared towards preventive care.
 
As for the last main type of health insurance coverage, Preferred Provider Organization works as a combination of the traditional and HMO coverage. PPOs also have their own network of doctors and hospitals, just like HMOs. Employees are also required to have primary care physicians and pay small co-payments. However, employees under PPOs are given the option to seek out-of-network services. This option will require employees to pay more than the usual premium amount and to fill out forms.

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08/05/2009
Key Senate Democrats presented a modified health care bill, calling for private insurance companies to compete with insurance options offered by the government. In a letter, Senators Edward Kennedy and Christopher Dodd said their improved bill dramatically decreases the costs of the earlier incomplete proposal.  The two senators stressed that the Congressional Budget Office’s estimate of the proposal’s cost is now down to $611.4 billion over 10 years from $1 trillion. In a press conference, Senator Dodd said the revised plan is closer to the “historic health care reform.” This bill, he added, offers the public options on a health plan that is run by “what functions best for Americans, not by what makes enormous profits.”The revised bill also calls for a $750 annual fee for each full-time worker and $375 for each part-time worker at large companies not subsidizing health coverage for their employees. Small companies with only 20 employees would be exempt from penalties. It is estimated that the fee would raise $52 billion in 10 years. This would be used to subsidize those who cannot afford to pay for medical insurance. The government’s budget would be coming from higher taxes and trimmed Medicaid and Medicare spending. The two senators also emphasized that the legislation aims to reduce the number of employers who want to drop their workers’ health coverage next year due to high health care costs.  The bill also urges private insurance companies to provide medical coverage to any applicant at a lower cost, especially to those with pre-existing medical conditions. The revised proposal is also projected to advance President Barack Obama’s proposal that aims to cover an estimated 47 million people who lack health coverage.

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08/05/2009
A recent survey commissioned by health insurance company CIGNA has found that when it comes to health care costs women are far more likely to search for bargains, such as by using healthcare comparison sites, than men are.Kurt Weimer, who leads the companies division for individuals along with small businesses, says: “From our perspective, women have always been sort of the key decision maker in health care selection. It’s moved to the next level… Not only are they making that health care decision, now they’re looking at the economics.”The survey found that out of the 1,000 people questioned only 15% of men compare the costs of medical treatments and doctors in comparison to 20% of women. The survey also found that 79% of Women were more likely to buy the generic own brand range of medications, whereas only 69% of men would look to a generic range as opposed to the well known, and more expensive brands.Weimer goes on to say that the recession has forced mothers to take on the role of “Chief financial officer” as well as “Chief medical officer”, pointing out “If you’re like all of us, you’re looking at how to make ends meet.”Executive director of the National Association of Mothers Centers (motherscenter.org) believes that women might be feeling the pressure of the recession and downturn in the economy more so than men because they make “the bulk of the buying decisions for the family”.

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08/05/2009
U.S. Health and Human Services Secretary Kathleen Sebelius disclosed Monday that local and government organizations could now avail themselves of outreach grants to enroll more children in health care insurance plans.The outreach program aims to cover 4 million children who do not have health care plans and keep 7 million children insured under the Children’s Insurance Programs and Medicaid. Sebelius said that the project prioritizes residents of “historically under-served” or rural areas.“These grants arrived just in time, when we need them the most,” Sebelius added, referring to recent news on the country’s unemployment rate, which has reached 9.5%. Sebelius also stressed that when the unemployment rate is high, the rate of uninsured individuals also rises. This is because the majority of Americans are enrolled in group health insurance plans, which are employer-provided health plans. “When parents lose their jobs, they and their children also lose health coverage,” Sebelius added.The grants, made through the Children's Health Insurance Program Reauthorization Act signed by President Barack Obama and which was released in February, will be initially funded by the federal government. The outreach program will last until 2013 and will be providing a total of $100 million worth of grants.To get the most qualified applicants, Cindy Mann, director of the Center for Medicaid and State Operations, advised using innovative methods, such as technology-driven or even localized and community-based initiatives. “We should think of ways that can really help us reach all qualified children in order for them to enroll with less red tape,” Mann said.Local governments, community-based or non-profit organizations, schools, and religious groups are welcome to apply. Eligible candidates may submit their applications at grants.gov until early August.

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08/05/2009
Rep. Chris Murphy of the 5th Congressional District of Connecticut says that America’s current health care system is sick. "I like to say we've got a disease in our health care system that's very difficult to diagnose. So the solution to that disease is going to be equally complex."Murphy stressed the need for reforms to cover the uninsured and fix the problems in the current health care system. According to the Congressman, the reforms will be centered on freedom of choice.Addressing those with individual and business health insurance, Murphy discussed the availability of choices: "If you like what you have, you get to keep it. If you're an individual or a small business that doesn't like what's available, we're going to give you options."Murphy currently works in the Health subcommittee of the House of Representatives, as well as in two other House committees, writing the health reform legislation. Also writing the reform packages are two committees from the Senate.According to Murphy, bills are often bogged down because of the number of House committees that work on the actual legislation. "We're trying in the House to have all three committees write a similar bill''Despite the complex legislation, Murphy is sure that Congress will be prepared to vote on the health care reform before July ends.The reform will require some changes in the American way of life. Everybody will be required to avail themselves of health insurance. Companies will also be compelled to either offer coverage to their employees or pay costs instead.As for the insurance industry, the reform will pave the way for a basic insurance package that will be available to all American citizens.

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08/05/2009

Connecticut state attorney general Richard Blumenthal is pushing for the rejection of Connecticut insurance companies’ request for a health care rate increase of 30% by October this year.
In response to Anthem Blue Cross Blue Shield’s request for a rate increase of 22%–30%, Blumenthal commented, “This request is legally or factually unjustified by anything this company has submitted.”
In Anthem’s submitted increase request, the premium for the $250-deductible Century Preferred PPO, one of Anthem’s popular health plans, will increase by $62 monthly, from $264 to $326.
Sarah Yeager, the company’s director of corporate communications, said that increased claim costs have exceeded the insurance premium enough for the company to demand for higher rates.
A spokesperson of Anthem Blue Cross Blue Shield also said that the finances and rates of the company are regularly evaluated to ensure that the premium fees can cover claim expenses and costs.
The company, which filed its request on June 9, agreed to waive the 30-day deadline for the state Insurance Department to continue its evaluation. Based on state law, the changes in the company’s rates would have been automatically instated on Thursday without the department’s implied disapproval. The changes in rates could affect 56,000 insured Connecticut residents. According to the Insurance Department’s records, the population covered by the company comprises 4% of the 1.4 million residents of Connecticut.
An increase of this magnitude, Blumenthal said, is clearly against the statutory standard. “The current economic condition and the October 1 implementation also make it necessary for the state to reject this request.”
Insurance rate increases and the insurance companies’ compliance with regulations and laws involving insurance business are regulated by the state Insurance Department.

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08/05/2009

Last Monday, Connecticut Senator Christopher J. Dodd asked Anthem Blue Cross to review its proposed rate increase. The proposal constitutes an increase of 23% on the average, while in Connecticut the proposed rate increase is 32% for individual health insurance plans.
 
Last Wednesday, Anthem Blue Cross and Blue Shield asked the Connecticut Insurance Department to approve the increases. Once approved, the majority of the 56,000 residents below 65 years of age who bought health and medical insurance from Anthem will be affected.
 
The proposed increases will not affect Anthem’s group and business health insurance policies. However, some employers complained about recent premium increases.

In a letter addressed to David R. Fusco, Anthem’s president in Connecticut, Senator Dodd stated that Anthem’s proposed individual policy rate increase “runs counter to the goal of providing all Americans with quality, affordable health care,” especially now that the insurance industry is taking part in federal efforts to reform America’s health care system.
 
Considering that 322,000 residents are uninsured, the senator said, "Should these new rates kick in, there is no question that additional Connecticut families will join the ranks of the uninsured."
 
Back in January, Dodd started a “listening tour” to hear what constituents think about health care reform. And according to the senator, Fusco was “kind enough” to attend the kickoff.
 
In Monday’s letter, Dodd requested that Fusco "reconsider the proposed rate increases in Connecticut and instead join me once again in my efforts and those of the Senate and the House to enact comprehensive health reform legislation this year."
In response, Anthem expressed its appreciation for the senator’s concerns, but stated, “Our proposed rate increase is a reflection of increasing health care costs." The company explained that some of its policies will not be affected by the increase. However, those policies would require buyers to shoulder more of the health expenses.  

 
 

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08/05/2009

A survey released last Wednesday revealed that only a little less than half of the American population believes that their health plans would cover their cancer treatment costs in full, while around two-thirds have the false notion that Medicare will not cover anything.
 
Out of the 1,000 adults who participated in the survey, 70% stated that they were “very concerned” about shouldering cancer treatment costs if they ever had cancer, while 59% fear putting their families in financial trouble.
 
Released by the Community Oncology Alliance, the survey implies that Americans are worried and at the same time misinformed about the country’s health care system, as well as the modifications that might take place after Congress and the White House finish working on the overhaul.
 
According to Dr. Patrick Cobb, president of the Community Oncology Alliance and a managing associate of Hematology-Oncology Centers of the Northern Rockies in Billings, Montana, it is right for people to fear the costs of cancer treatment since cancer is the second leading cause of death in America.
 
When it comes to health insurance comparisons, only a small number of private insurance plans provide full coverage for cancer treatment. These plans could have premiums of $5,000 or more.
 
Cobb further explained, "Monthly out-of-pocket costs for cancer care and treatment, not covered by private insurance plans or Medicare, can easily run to $1,000 or more. For many cancer patients, the costs of diagnostic imaging, surgery and expensive cancer medications, especially in the first few months of treatment, can add up to well beyond $2,500 per month."
 
As part of the proposed health care reform, President Obama has begun to push for a government-managed insurance option that will be offered along with the traditional private and employer-sponsored insurance.

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08/05/2009

Insurance companies are seeing an increase in short-term health insurance applications this year.
 
Texas insurance company Blue Cross and Blue Shield expects an increase of 33% in individual short-term health insurance applications in the first half of the year.
 
Margaret Jarvis, spokesperson for Blue Cross and Blue Shield, Texas, said sales of individual health plans, whether short-term or long-term, in the first half of last year, were at a record high for the company. Sales of both types of individual insurance, Jarvis said, increased by over 30%.
The increasing interest in getting individual health care plans, in general, and in short-term insurance plans, in particular, is evident in the recent launching of more short-term individual policies by big health insurance companies. Shifting from group health insurance to temporary individual health coverage indicates the growing number of unemployed people in the U.S.
Recently, the Golden Rule subsidiary of United Healthcare in Texas launched two new short-term health plans that are specifically designed to cater to the health care needs of the unemployed not qualified for the subsidized health plans under the Consolidated Omnibus Budget Reconciliation Act (COBRA) or those who cannot afford it.
COBRA is a federal program that offers up to nine months of subsidy to those who wish to continue their health insurance after losing their job. COBRA, however, can also be very expensive for those who do not meet the primary requirements.
Another insurance company, Humana, opened a new short-term insurance plan in April for Arizona, Colorado, Alabama, Ohio, Nebraska, Wisconsin and Michigan.
Richard Collins, CEO of United Healthcare Golden Rule, said temporary health plans are necessary especially now, when the economy is not yet stable.

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08/05/2009

Due to the soaring cost of health care, small businesses in Utah are now ready to embrace a health care reform, including the government-run insurance option, just to offer health care subsidy to their workers and earn a profit.
 
A recent survey reveals only 40% of the 300 randomly chosen businesses provide health care insurance to their employees, and 79% of those are struggling to subsidize their workers’ health plans. In addition, 88% of the companies that dropped their employees’ health coverage say they cannot afford to shoulder the costs anymore.
 
“What comes through loud and clear is the health crisis is huge, it’s crushing, and something needs to be done right away,” said John Arensmeyer, CEO and founder of Small Business Majority.
 
Small business owners in Utah believe a comprehensive reform on health care is an economic necessity, and that controlling the costs should be the top priority of the reform.
 
“The problem is that the cost of the health insurance is rising,” said Betsy Burton, a small bookshop owner, whose health plan cost increased by more than 20% last year. “At that rate, it is really difficult to make a profit in a business like this, with a low profit margin,” she said.
 
While almost 50% of business leaders in Utah consider themselves as Republicans and identify themselves as having conservative political views, small businesses in the state are now ready to embrace a bold health care system reform.
 
The struggle of small businesses with the rising cost of health care and their eagerness to do something to solve the problem is not really surprising, said Judi Hilman, executive director of the Utah Health Policy Project. "It is because small businesses are the first that experience the current problems in our system," she explained.

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08/05/2009

As the U.S. government continues to work on reforming the country’s health care system, business groups fear that many small companies throughout Southeast Valley would be forced to shut down.
 
The senate proposal for the bill on health care reform would compel employers to provide business health insurance for their workers. Otherwise, they need to contribute a fee worth 8% of their payrolls for a government-managed insurance plan.
 
Via Homes president, Trudy Licano, said that "A lot of times legislation is meant to help people, but this could shut doors. There's going to be a pretty huge impact on us. Some businesses just can't afford it."
 
Under the said bill, employers who will provide insurance for their workers would be required to cover 72.5% of the premium cost for full-time employees and 65% for family policies. Companies are also required to insure their part-time workers. However, some businesses would be exempted depending on their size, which has yet to be determined.
 
Mary Ann Miller, president and CEO of Tempe Chamber of Commerce, explained the possible effect of the proposed health bill to the business sector: "I think that most businesses would love to be able to provide health insurance to its employees, and do so wherever they can. But mandating such coverage will only drive up costs for businesses of all sizes during tough economic times."
 
Last month’s proposed bill was described by the U.S. Chamber of Commerce as "a dangerous proposal."
 
According to Jack Alspaugh of the Arizona Small Business Association, companies with less than 50 employees will find it difficult to balance efforts between providing coverage to their employees and maintaining their payrolls.
 
The Senate and House members are still working out the details of the bill, which President Obama wants to sign by fall.

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08/05/2009

Brian Urban, an insurance broker, refused to believe a caller who told him a story about an owner of a small business in Nebraska who couldn’t afford health plan premiums because it would require him to pay around $24,000 to $40,000 annually.
 
Urban said, “Just the size of the numbers was far out of what the market would dictate even for someone with some severe medical conditions. And according to the story, these were healthy individuals.”
 
The Nebraska health insurance market is a familiar territory for Urban since he is the CEO of Corporate Resource Group, as well as the legislative chairman in Nebraska for the National Association of Health Underwriters.
 
33-year-old Larry Harbour was the man who complained about the high cost of premiums. As the owner of LB Custom Chrome and Detail in Nebraska, he tried his best to find affordable insurance coverage. In a phone call, Urban offered to get Harbour affordable premiums.
 
Harbour, who was happy to hear Urban’s offer, described the search for health insurance as “very confusing.” “It's very tough to understand unless you have someone, so to speak, holding your hand and walking you through the process.”
 
Urban’s phone call was the first of many geared toward helping Harbour find affordable business health insurance coverage. “According to the story, he was uninsured, and I don't find that acceptable. It's my job to make sure that as many people are insured as possible,” Urban said.
 
Urban also made a comment about how confusing premiums affect the health insurance debate. “We're not opposed to reform. It's just that we want to make sure we're dealing with real-life facts and numbers and that reform is focused on the areas it's truly needed.”

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08/05/2009

Despite the continuing support for President Obama’s health care reform, some of the major players in the debate are beginning to worry about the overhaul’s success. They fear it won’t be sufficient to solve the problem of runaway medical costs.
 
Some even believe that the deals the White House made with drug makers and hospitals to keep the negotiations alive could make the problem worse.
 
On Monday, there will be a closed-door meeting between labor leaders and Obama. They will discuss aggressive measures to keep health care costs from escalating. Terry O’Sullivan, head of the Laborers' International Union of North America, expressed his support of the plan to have everyone covered by medical insurance, and at the same time his concerns about the reform.
 
"We are certainly for expansion of coverage. We think every American ought to have health insurance. But if that doesn't come with making sure there is real prevention, if we're not talking about really controlling healthcare costs, this is going to be a train wreck."
 
On the other hand, business groups are urging the current administration and its allies in Congress to tackle the cost issues by making changes to the way doctors, hospitals and providers are paid.
 
According to Steve Wojcik, the National Business Group on Health’s vice-president for public policy, “Going into health reform, there was a lot of talk from the president on how controlling costs had to be on a par with expanding coverage. The priority on controlling costs seems to have fallen by the wayside."
 
Consistent survey results point to the public’s biggest health care concern: rising cost of medical bills and health plan premiums. At the core of his campaign for health care reform, Obama insists that his health care reform will provide relief.

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08/05/2009

Health insurance costs in Alabama have increased by 95% since 2000, according to the Health Care Status report.
 
The report reveals that the number of small businesses or companies providing health coverage benefits to workers dropped by two percent since 2000. Currently, only 48% of small employers in Alabama offer health benefits to workers.
 
The soaring costs of health insurance have affected individuals as well. According to the report, 28% of middle-class families spend at least 10% of their total income on health care.
 
A related study found that the limited options offered by health insurance companies is an issue related to these rising costs. According to the study, BlueCross-BlueShield controls an 83% share of Alabama’s health insurance market. Roughly, 13.6% of Alabamians are uninsured.
 
Options for health insurance are even more limited for individuals with pre-existing conditions. In Alabama, the costs of health insurance vary based on health status and demographic factors. Coverage can also exclude some pre-existing conditions or even be completely denied.
 
The report also says that 16% of people in Alabama do not visit a doctor due to the high costs. Moreover, families and businesses in Alabama pay a hidden health tax of about $600 each year on premiums to subsidize the costs of the uninsured.
 
Currently, approximately 2.9 million people in Alabama avail themselves of health plans through their jobs. Subsidized by their employers, these people have an average family premium of $12,230.
 
Based on the Health Care Status Quo report, the need for health care reform in Alabama and across the U.S. is clear.

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08/05/2009

Health Net Inc. suffered a major disappointment when the U.S. Department of Defense awarded its $2.8 billion annual military Tricare contract to Aetna Inc, another Health Maintenance Organization (HMO).
 
Estimated to be worth around $17 billion, the contract includes five one-year options along with a 10-month base period. The contract will provide service to millions of personnel in the military, National Guard and Reserves, dependents, and retirees in 20 Midwest and East Coast states.
 
The Tricare military health care program involves 900 of Health Net’s 2,500 employees. The devastating news had a negative effect on the company’s stock, which fell by around 15%. However, it managed to close at $145.13, down only 3%.
 
In a press statement, Health Net Federal Services president Steve Tough expressed the company’s disappointment about the decision of the Department of Defense.
 
“We anticipate that a debriefing will be conducted within the next couple of weeks. We will consider the information provided at the debriefing, and within two weeks following, we will determine whether we will accept or challenge the award decision.”
 
Another health care provider that lost a government contract is Humana Inc. After an extensive bidding attempt, the company lost its $3.73 billion annual contract that covers 10 southern states. The contract was awarded to California PacifiCare’s parent company, United Health Group Inc.
 
TriWest Healthcare Alliance Corp. was the only company to retain its $2.9 billion annual contract. It provides services to military personnel located in 21 Western states.
 
In 1988, Health Net won a pilot contract to provide service to military personnel, retirees, and dependents in Hawaii and California. Aetna got the contract in 1993 and, after three years, Health Net won it back. 

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08/05/2009

House democrats unveiled an extensive plan for a bold reform of the nation’s health care system. Contained in the 1,018-page bill are provisions on regulating the health insurance market, formation of a new health insurance option run by the government, and other steps for implementing universal health coverage.
 
The bill sets out initiatives for reducing health care costs, which are expected to rise to $2.5 trillion this year. In addition, the cost of the legislation, which is estimated at $1 trillion, will be offset with a new tax to be imposed on wealthy Americans.
 
The proposal, which is considered one of the most liberal in revamping the system, was criticized by Republicans and 30 leading business groups, although many of these also showed support for some aspects.
 
If implemented, employers will either provide medical insurance to their workers or pay the government a fee based on their payroll. Small businesses with an income below $250,000 will be exempt from paying the fees. Also included in the plan are regulations prohibiting insurance companies from denying Americans with pre-existing medical conditions. This is to ensure more affordable options for everyone. 
 
All low income Americans will also become eligible for Medicaid, and private insurance companies will be offering a standard universal benefit package designed by the government.
 
The Congressional Budget Office (CBO) estimates that 97% of Americans, including legal immigrants, will have health coverage by 2019. Furthermore, the CBO estimates that nearly 162 million people will have continued employer-provided insurance and 30 million people will avail themselves of health coverage through the new health insurance exchange. Nine million of those who would avail themselves of the new exchange are expected to choose the new health program run by the government. 

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08/05/2009

After Wal-Mart pledged support for the proposal that requires employers to contribute to their workers’ health insurance costs, the National Retail Federation is asking its members to oppose Wal-Mart’s stance on the issue.
 
In a letter issued by NRF chief executive Tracy Mullin, group members are urged to “Come out swinging.” He added that, “To truly lead on the health care debate, it is imperative that businesses, associations and politicians take a stand where it counts and not shy away from deal-breakers like employer mandates.”
 
The letter shows the different views of companies toward the health care reform, which aims to cover the uninsured.
 
Different companies have allowed trade groups like the National Retail Federation, the largest trade group in the industry, and the Chamber of Commerce, the biggest business lobbying organization in the country, to spearhead the opposition to the health care plans in congress. Wal-Mart isn’t part of the NRF.
 
In a June letter to the senators in the drafting committees, the NRF said that it would prompt its members to oppose politicians who support an employer mandate. Meanwhile, the Service Employees International Union, Wal-Mart, and the Center for American Progress sent their own letter to the White House, voicing their support for a company mandate that will urge employers to provide health benefits like group health insurance to their employees. 
 
The letter was signed by Michael Duke, president and CEO of Wal-Mart, Andrew Stern, president of SEIU, and John Podesta, president of the Center for American Progress.
 
The NRF is not alone in expressing opposition to Wal-Mart’s stance. In its letter to the White House, the United Food and Commercial Workers Union raised questions about Wal-Mart’s position. 

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08/05/2009

This news bit goes out to parents and professionals alike. It’s time we stop using that “toothache excuse” for school and office absences, the American Association for Dental Research (AADR) says. In the Oral Health Care Within Health Care Reform policy statement issued by the association on July 14, 2009, it was stressed that the need to attend to one’s oral and dental aches is urgent, as poor oral care can result in other serious problems—health-related and not.
 
According to the AADR, U.S. employees take 164 million hours off from work in a year, only to attend to a toothache or a gum irritation. Similarly, children are absent from school for 51 million hours a year, to be free from dental pain. The association has concluded that these periodontal diseases create the same full-body inflammatory response as other internal ailments would, yet they receive much less attention. The AADR claims that many Americans—more than 80 million, to be exact—have applied for medical insurance, but not for dental insurance.
 
In line with this, the association recalled what the U.S. Surgeon General mentioned in 2000. Back then, the Surgeon General called upon everyone to recognize the importance of oral health measures. He even proposed that lawmakers "build an effective health infrastructure that meets the oral health needs of all Americans and integrates oral health effectively into overall health.”
 
Today, the AADR recommends that continued information dissemination regarding accessible and affordable oral health insurance must be conducted among Americans, if that would mean better oral health and, in turn, general health, as well.

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08/05/2009

The White House and the Democrats in Congress who are working hard on the health care bills to beat President Obama’s deadline, are trying to keep legislation costs to $1 trillion for 10 years. But would that be enough?
 
There is no doubt that $1 trillion would cover a lot of uninsured people. However, it will not be enough to meet the goals that the advocates initially wanted. Congress is currently working on proposals that include a $1.042 trillion bill that will be presented by Democratic leaders in the House on Tuesday. The proposals intend to provide subsidies to a smaller number of moderate-income families. They will also prevent most workers from abandoning the health plans provided by their employers.
 
According to the Congressional Budget Office, the estimated number of uninsured people will go down to 15-20 million after 10 years. As of now, around 50 million people are uninsured.
 
Last Monday, Senate GOP leader Mitch McConnell stated that "One of the major concerns that Americans have about health care reform is the price tag. Every proposal we've seen would cost a fortune by any standard."
 
In defense of the health care reform, President Obama says that the overhaul is a crucial investment toward fixing the nation’s dysfunctional health care system. Straightening the rough edges of the current health care system would prevent financial problems in the future.
 
Lawmakers are still trying to figure out how to finance the overhaul. According to Obama, fixing the health care system will not increase the country’s financial deficit, and to offset such a deficit there will be a need to either raise taxes or cut national spending.

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08/05/2009

Aetna expressed its support and concern for the welfare of college students in terms of health care. Head of Aetna Student Health Kate Begley said, “At Aetna, we work closely with campus health and counseling centers, as well as community and travel service providers, to offer students access to convenient care at an affordable price, no matter where they are located.”
 
Most parents find summer the ideal time to ensure the academic and financial preparedness of college students for life on campus. This is also the time when vital decisions are made. What is often overlooked, however, is student health insurance. Aetna encourages parents to view a student’s health insurance options as one of the important considerations when they prepare their children for college education.
 
Kate Begley further said that they “support the efforts of colleges and universities to ensure students have access to affordable, quality health care.” Aetna also gave tips to parents who are in the process of selecting a student health insurance plan. These tips include weighing the option of carrying a dependent on one’s plan against the benefits of a school plan; identifying a health-care contact on campus by reviewing the school’s website and visiting the campus health center; and understanding the health insurance requirements of the school.
 
"Choosing a student health insurance plan that is right for your child is a personal decision and one that should be examined carefully, particularly in today's uncertain economy," added Begley. "Evaluating the true cost, meaning the premium plus out-of-pocket expenses, of a family plan versus a student health plan is critical to understanding which plan is most cost-effective and will best serve the needs of your college student."

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08/05/2009

A considerable amount of the American family’s budget is spent on medical insurance. The USA government alone allocates over $2.2 trillion yearly or $8,000 per person on health plans to ensure healthy workers and a productive economy. It is projected that the amount the government spends on the health care system will increase to more than $4 trillion by 2017 if no program for the reform of the system is enacted.
 
President Obama has initiated ways to modernize the system of health care in America. The Recovery Act of 2009 includes a provision for the citizens who have recently lost their jobs, which will provide a tax credit that will continue their health insurance contribution through COBRA. He also signed a law that supports health plan coverage for children through the Children’s Health Insurance Program (CHIP). The president has also pushed for the computerization of health records in the United States in five years in order to make the system more efficient and more accurate. The government will save much money if the paper-based records, which are time-consuming and expensive, are replaced with a computer system that will deliver speedy results with minimal or no errors.
 
The government also seeks to uplift the research and development of the current health system. The Recovery Act has also allocated $1.1 billion for comparative research that details data on the effectiveness of a medical treatment or procedure. This will aid the doctors in proper diagnosis and treatment of their patients. Programs on wellness will also be promoted in the country because almost one-third of illnesses are attributed to poor lifestyle choices. This will reduce the risks of acquiring diseases, such as hypertension, cardiovascular ailments, and cancer.

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08/05/2009

Aside from mortarboards, graduating college students have other things to think about.
 
A report from the National Association of Colleges and Employers estimated that this year, at least a million alumni pulled out from their parents’ health insurance coverage after graduating. Because of financial shortages, former college students are having a hard time getting replacement insurance policies.
 
According to Jon Gabel, graduates should go for health insurance plans offered by employers. The senior fellow from the University of Chicago’s Opinion Research Center—Health Policy and Evaluation Department also added that it is the most affordable health plan for fresh graduates.
 
But the thing is, landing a job in today’s struggling job market is difficult. NACE says that around 2.5 million fresh graduates are unemployed. Samantha Whiteside, a 24-year-old graduate of health and fitness from Virginia Polytechnic University, is one of them.
 
After graduating last year, she had a promising career outlook after getting a job in an outpatient rehabilitation center around March. She worked as a technician as well as a wellness instructor for seniors with mental illness. Her employer promised that she would get health insurance benefits after three months. However, she was fired three days before her fourth month began.
 
“I've never been in this situation before," she said. "I know everybody's been saying that the economy's bad … but I never thought it would happen to me."
 
She is currently working as a part-time swimming instructor. Marla Whiteside, her mother, got her an individual health insurance plan for $96 per month. Even though the plan would only cover 70% of hospital bills, it’s better than having no coverage at all.
 
According to Cheryl Fish-Parcham from Families USA, graduates should not be part of the uninsured population.
 

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08/05/2009

President Barack Obama continues to push for the overhaul of the U.S. health care system. He says that this matter cannot be delayed because it would affect “the stability of our entire economy.”
 
In Obama’s weekly Internet and radio address, he urged the Representatives from the two parties to work on laws that will decrease costs and regulate the “unwarranted giveaways to [health] insurance companies in Medicare and Medicaid,” while keeping the Americans’ health care options intact.
 
Obama added, “This is what the debate in Congress is all about: Whether we’ll keep talking and tinkering and letting this problem fester as more families and businesses go under, and more Americans lose their coverage, or whether we’ll seize this opportunity.”
 
Obama is ramping up this health insurance reform campaign, as he is set to hold two legislation events for the press this week. He will gather the Representatives to the White House for deliberations, and will hold a primetime press conference on July 22. The House and Senate are hard set to meet Obama’s August deadline, as he urges them to act on legislation before the coming congressional recess.
 
According to Obama’s recent statements, he will deny support on legislation that would add to the deficit.
 
“I don’t believe that government can or should run health care,” Obama remarked. “But I also don’t think insurance companies should have free rein to do as they please.”
 
Obama wants a final bill in about two months time, by October. Certain members of both parties criticize Obama’s action timetable for this health care overhaul campaign as “too ambitious.”
 
Jon Kyl, Arizona Senator, commented in the Republican weekly address on radio: “Something this important needs to be done right, rather than done quickly.”

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08/05/2009

Michigan state employees have already dropped their health benefits, Gov. Jennifer Granholm said today while giving a cold shoulder to House Speaker Andy Dillon’s plan to pool some 400,000 public employees covered by individual health plans to help the state save money.
 
Last week, Dillon, D-Redford Township, claimed this bold health care reform will help the state save as much as $900 million per year.  Dillon further said this plan would provide insurance for retirees and local employees who would be covered by a single health plan that would provide extensive health plan options for individuals, depending on the premiums they can afford.
 
“Show me the money. I do not know where the savings come from,” Granholm told the reporters. She further said she had not seen the details of Dillon’s proposal.  “I haven’t seen the legislation and I have a million questions about it,” she added.
 
The proposal evidently does not work for Granholm. She said it will never resolve the state’s financial problems. She doubted that bigger pools of workers will help the state save money, noting that the state currently has 55,000 employees that belong to big insurance pools.
 
She further added that she believe that Dillon was wrong to say that state employees pay less for health insurance and receive better benefits than those in private sectors. Granholm then cited last year’s House Fiscal Agency report that reveals that state employees have lower wages and receive fewer benefits than private sector employees.
 
In a prepared statement, Dillon replied to Granholm, saying, “Change is never easy—there will always be countless reasons not to change. But one thing is clear: business as usual isn’t working.”
 
He suggested lowering government expenses to prevent layoffs, and decreasing college scholarships. “We need leaders like Governor Grandholm, Senate Majority Leader Mike Bishop and others to work together in the days ahead so we can turn Michigan around,” Dillon said.

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08/05/2009

UnitedHealth Group plans to acquire Health Net’s subsidiaries in the Northeast for $510 million.
 
Announced by the two companies on Monday, the acquisition will strengthen UnitedHealth’s networks in New York, New Jersey, and Connecticut. Based in Minnetonka, the health plan and medical insurance provider generates the most revenue among health insurers in the nation.
 
Jay Gellert, chief executive of Health Net in Los Angeles, expressed his confidence about the deal. "For our members, this offers a very, very good alternative. We have confidence [UnitedHealth] will do first-rate by our members."
 
Health Net will continue its operations in Arizona and in western United States. The deal, which needs regulatory approval, is expected to be completed within a year.
 
New York, New Jersey, and Connecticut have around 578,000 Health Net members combined. 437,000 of them are risked-based commercial members and 35,000 are self-insured commercial members. Another 55,000 are Medicare Advantage members, while the remaining 51,000 are Medicaid members. Operations in those areas are expected to generate $2.7 billion in revenue.
 
Jeff Alterm, UnitedHealth chief executive in the Northeast, talks about the company’s reputation in the region. "We have a long, successful history of serving people in the Northeast and are committed to responding to local market needs while also providing people with access to the innovative health care products, programs and technology applications of a company with a national scale."
 
Health Net’s Medicaid and Medicare businesses, along with the commercial membership renewal, will cost UnitedHealth around $60 million. Once the deal is closed, UnitedHealth will pay Health Net another $290 million. The remaining $160 million will be paid within a span of two years.

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08/05/2009

These days, young adults are learning about individual health insurance the hard way.
 
Sarah Posekany, a 27-year-old nursing student, was forced to file for bankruptcy. She underwent colon surgery and she was uninsured. Posekany is still in debt and she owes a medical bill of thousands of dollars.
 
"It's not fair," Posekany said. "We should learn how to be a strong nation and take care of everybody."
 
Katie Miletti is a 24-year-old college student. Although she survived cancer as a child, she still has to deal with her treatment’s side effects. She was removed from her mother’s policy, as she was already too old. For one month, she was left uninsured. She later qualified for Medicaid, a federal-state program for health insurance.
 
"Everyone should have health insurance," she said. "I don't think it should matter what your health problems are, how rich you are, or what your income is."
 
Called “the young invincibles” by the insurance industry, these young adults think that they will never get hurt or sick.
 
Nick Bernstein felt that way once, too. Bernstein became a waiter to pay off his college loans. He also planned to get a wine-production graduate degree. He filled his leisure time with snowboarding and backpacking.
 
While snowboarding last April 1, Bernstein had an accident, which left his collarbone broken.
 
At first, he wasn’t sure if he had insurance at all. Fortunately, his stepfather’s health plan was still able to cover a part of his $27,000 medical bill. However, this coverage might stop before he gets well. He was diagnosed with a staph infection. As he is incapable of working now, he still has to find a way to get insurance before his 25th birthday, as he will be dropped from the policy of his stepfather.

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08/05/2009

Expensive premium costs are the main reason being cited by millions of US citizens as to why they cannot avail themselves of individual health insurance policies, according to a recent study published in “Health Day News” last Tuesday.
 
Approximately three out four people want to buy a policy but are not able to get one because the cost of the premium is prohibitive, based on a report by the Commonwealth Fund, which is a foundation that financially supports an independent research on health insurance reform. Around 57 percent admitted that finding coverage they could afford is bordering on very hard to downright impossible.
 
A survey conducted for the report also cited that 47 percent of the respondents said that finding the plan with the coverage they needed was difficult or impossible. Another 36 percent stated that they were charged additional rates or their application was denied due to a pre-existing condition. Some companies had their condition excluded from their coverage altogether.
 
The report, called ‘Failure to Protect: Why the Individual Insurance Market is Not a Viable Option for Most US Families, compared the experiences of adults in the working-age bracket who have employer- and individual-based private health insurance.
 
In the report, it was also found that people who acquired health insurance individually pay more money on deductibles and premiums than those with group or business health care coverage.
 
Among US adults who have individual insurance, the survey showed that 64 percent spend more or less $3,000 on premiums annually, while only 20 percent of people who have employer-based insurance are spending that much.

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08/05/2009

Lawmakers in Connecticut are moving forward with their plans to establish universal health care, as there has been no federal legislation on the issue. This move follows Massachusetts’ pioneering law.
 
Currently, President Barack Obama’s administration and the Democrats in Congress are struggling to rally support for a plan to provide health care for a large number of Americans. Connecticut is part of a small minority of states that are planning to create universal health care independently. The state is aiming to improve the system that has caused more than 40 million Americans to be left uninsured.
 
On Monday, Republican Connecticut governor Jodi Rell’s veto was overridden by the state legislature, which is controlled by Democrats. A board composed of nine members will be created to develop a system for universal health care in the state. On January 1, 2011, this board will be giving lawmakers recommendations for the health care plan. Called SustiNet, the plan will cover almost all of the 3.5 million residents of Connecticut, including the 350,000 residents of the state who do not have coverage.
 
In 2006, Massachusetts enacted a law that made health coverage compulsory. It was the first state to do so in the U.S., and it brought health coverage within the reach of people who cannot afford it by providing subsidies and by reforming the industry. Maine and Vermont are also in the process of advancing their health care reforms.
 
Connecticut will be building a system around a health insurance pool that includes employees of the state and Medicaid participants. The pool would eventually be expanded to include private employers and residents who require individual health insurance.

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08/05/2009

According to health officials and doctors, adult vaccinations and the issues surrounding them are some of the numerous problems that haunt legislators as Congress continues to work on the health care reform.
 
In a survey released by health officials, only a small number of adults are aware that they can avail themselves of vaccines against meningitis, tetanus, whooping cough, pneumonia, and shingles.
 
Experts however believe that demand and awareness are just tiny bits of the whole problem. According to Dr. William Schaffner from Vanderbilt University in Tennessee and the National Foundation for Infectious Diseases, the health care system is a hindrance to vaccination. Not all medical insurance and health plans provided by companies cover vaccinations, doctors are paid only minimally for administering them, and nobody can ensure the availability of vaccines.
 
In a news conference, Schaffner said, "They system is cumbersome almost to the point of not being able to get the vaccine."
 
Schaffner, along with vaccine experts, is hoping for Congress to tackle vaccination issues in the health care reform legislation. He said, "More than $10 billion a year is spent in direct medical costs and indirect costs" to treat pneumonia, meningitis and influenza. “These diseases can be prevented through vaccination.”
 
A survey of 22,000 U.S. adults released by Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention indicates that most adults in the U.S. don’t get the necessary vaccines.
 
Dr. Anne Schuchat further stated in the news conference that, "About half of adults had received a tetanus shot within the past 10 years." People should get tetanus vaccines every 10 years.

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08/05/2009

Robert Reich, the labor secretary during the Clinton administration, spoke to healthcare executives on Thursday in San Francisco. Reich said that Obama must “start knocking heads” on the health reform issue if he wants a bill from Congress by this fall.
 
He also said that the president has learned from Bill Clinton’s mistakes. Unlike Clinton’s reform proposals in the 1990s, Obama did not send Congress a bill that he knew would not be passed at all.
 
Reich also said that Obama should have begun working on the issue two weeks in advance. Obama is now at risk of Congress adjourning and leaving the bill unsettled. With this, the opponents of the package will have time to plan their attacks. Reich was the speaker at the Leadership Summit that was sponsored by the American Hospital Association and Health Forum.
 
Even so, Reich said that “you will see an Obama bill.” He added that “Obama will play his cards” when a Senate and House joint committee works on the legislation. Reich is now a professor at the University of California, Berkeley. He is a regular commentator on political policy and economic issues.
 
Reich also said that the president will be adamant in adding standards to the insurance of medical malpractice. He also said that Obama as well as Obama’s allies are now more interested with HMO-style pre-paid health care and the accountable care provided by integrated systems such as the Cleveland Clinic or the Mayo Clinic. Obama and his allies are becoming aware that offering coverage to those who are uninsured is only a piece of the health reform puzzle.

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08/05/2009

President Barack Obama currently travels the country to promote health care reform. Obama brought his campaign for the health care revamp to a public forum on Thursday near the Midwestern city of Cleveland, Ohio.
 
With the increasing number of Americans getting skeptical about his overhaul plan on the American health care system, and with the growing costs of health plans, the president has become more determined to gain support for his health care reform campaign.
 
“We can rescue our economy,” Obama said. “We can rebuild it stronger than before. We can achieve quality, affordable health care for every single American. That is what we are called upon to do. That is what we will do, with your help, Ohio.”
 
The president seeks major and bold changes in the nation’s medical care system that costs $2.4 trillion. The United States is the major industrialized nation that does not have a comprehensive health care system.
 
The president emphasized that changing the nation’s health care system can no longer wait. “We spend one of every six of our dollars on health care in America, and that is on track to double in the next three decades,” said the president.
 
But the Congress’ top Democratic lawmakers have left their plans to meet Obama’s deadline for voting on his reform. Senate Majority Leader Harry Reid said senators will not vote on Obama’s plan before their recess in August, as the president had wanted. Reid said more work is still necessary to come up with the right plan.
 
Obama stressed that there is a sense of urgency about the issue, saying “I have no problem, if I think people are really working through all these issues in making sure that we get it right. But I do not want a delay just because of politics.”

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08/05/2009

This week, President Barack Obama will be in North Carolina and Virginia to promote health care reform. During the recess next month, the president will be keeping Congress under pressure. The fact that 47 million people are uninsured in America is only one of the arguments that support health care reform. Another argument, which many people are unaware of, is the fact that 25 million people in the U.S. are underinsured.
 
John Stewardson wakes up very early in the morning and goes to work at the 602 union located in Washington, D.C. He’s home before noon as he needs to prepare lunch for Linda, his wife who is a cancer survivor.
 
"I'm just going to have to take medicine for the rest of my life," Linda said.
 
Last summer, she was diagnosed with a tumor in her brain; she is currently in remission. Now, the financial health of her family is at stake, as their group health insurance only paid $150,000 for the treatment. Their savings were demolished by the cost of the treatments, both for the cancer itself and for the side effects.
 
"It's like she fell out a cancer tree and hit every branch on the way down," said John Stewardson.
 
The family is around $100,000 in debt.
 
At the Senate, Sen. Chris Dodd is working to make health choices affordable. He is supporting the government’s insurance plan that would eliminate caps on health plans.
 
"The underinsured are a critical group," said Dodd. "In some cases, fifty-three percent don't know they're underinsured. So they either have huge co-pay if a problem happens or the deductibles are so high they might as well not have insurance."
 
John’s union only offered him one plan. After this reached its cap, they were left uninsured. Every day, John calls Medicare and his union to ask for additional coverage. So far, John has had no luck.

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08/05/2009

July is nearly over and everybody is still having disagreements about the real progress of the health care reform legislation. According to Speaker Nancy Pelosi and White House officials on Sunday, legislation is progressing, however, their fiscally conservative allies are still less optimistic and the Republicans continue to oppose it.
 
On CNN’s “State of the Union,” Pelosi said, “When I take this bill to the floor, it will win. We will move forward, it will happen.”
 
North Dakota senator and budget committee chairman Kent Conrad expressed his opinion that a bill that only carries votes from Democrats is impossible and undesirable. “Look, there are not the votes for Democrats to do this just on our side of the aisle,” he said on ABC’s “This Week.”
 
Senate minority leader Mitch McConnell also stated on CNN’s “State of the Union” that, “The only thing bipartisan about the measures so far is the opposition to them.”
 
The White House originally wanted the legislation to be completed before Congress takes a break in August. Robert Gibbs, spokesman for the White House tried to be positive about the missed deadline: “We are enthusiastic about the progress that’s been made. We think we’re on the road to getting comprehensive health care reform by this fall.”
 
He also stated that even though committees from the House and Senate are considering different versions, 80% of the contents of a final version have already been agreed upon.
 
In a statement on CBS’s “Face the Nation,” Obama’s senior advisor, David Axelrod, similarly described the progress of the bill. “Now, we are at that final twenty percent. We are trying to work through those details.”
 
Health care reform has been at the top of Obama’s plans since he assumed the presidency. He wants every American citizen to have medical insurance as well as other health plans.

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08/05/2009

President Barack Obama and other Democrats in Congress are pursuing a new health insurance plan. According to nonpartisan budget experts, this health plan would work with private insurance companies without forcing them to shut their doors.
 
Good news for Democratic ears, the Congressional Budget Office’s estimate comes as officials pushed for progress on the health care reform before the recess in August.
 
Democrats had a meeting on Monday afternoon with their allies in the House, and, according to House Speaker Nancy Pelosi, a floor vote may still be pushed through in the coming days. Meanwhile, negotiations between a small number of Republican and Democratic lawmakers resumed in order to find a compromise.
 
Democratic dissension has slowed the progress of legislative work from the President’s strict timetable.
 
Two weeks ago, Budget Office Director Douglas Elmendorf infuriated congressional Democrats and the White House with his statement in Congress about the House bill’s inability to control health care costs due to lack of mechanisms.
 
In order to disprove allegations that their proposal would make way for a federal takeover of the commercial and private health insurance industry, Democrats are now backing a suggestion from the budget office for a government insurance option that will not harm private insurance companies.
 
Given the unclear projections about how an actual reformed health care system would work, the controversy has yet to have an end in sight.
 
Poll results show that Americans favor a public coverage option as a component of the health care system reform. However, both employer groups and the insurance industry fear that a government-run insurance option will destroy private insurers.

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08/05/2009

President Obama might face another hurdle in his push for universal health care. This time, it’s not from lawmakers but from a recent paper on economics, which argues that health insurance makes people fat.
 
Authors Jay Bhattacharya and Kate Bundorf from Stanford University, Neeraj Sood from the RAND Corporation, and Noemi Pace from University College London all stated that Americans with either public or private health and medical insurance coverage have a higher tendency to become obese. According to weight-gain estimates in the paper, “private insurance increases body mass index by 1.3 points and public insurance increases body mass index by 2.1 points.”
 
Even before the paper came out, economists already mentioned that fat people are a burden on taxpayers.
 
According to a study that came out today, overall obesity-related health-care treatment costs have doubled in the last 10 years to $147 billion. The costs have even outgrown the obesity rates, which “only” climbed by 37% for the same period.
 
The new evidence supports the authors’ argument that health insurance is not just a simple transition of financial wealth from thin taxpayers to fat ones, but instead a “true economic subsidy for obesity.” The study suggests that obesity is literally encouraged by health care coverage. Knowing that insurance coverage provides protection against expenses caused by some weight-related issues, people tend to take weight gain for granted.
 
Even if the study only gathered weak evidence about more-generous coverage encouraging more people to gain weight, there is “strong” statistical evidence pointing to health or medical insurance coverage boosting obesity and body mass index.
 
The question now is how the universal health care system, which is still a work in progress, would affect the obesity rates of Americans in the near future.

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08/05/2009

Evaluating health plans can be tough, especially when it comes to provider networks and managed-care plans like HMOs and PPOs. A major factor to consider when choosing an insurance plan is the out-of-network service coverage.
 
Any kind of medical care sought outside the network arranged by your managed-care plan is categorized as non-network services. Even though most networks try to include all sorts of providers - from family doctors to pediatricians - not all types of specialists can be included. Things could become tricky especially when the type of service you are looking for is not covered by the network.
 
HMO members pay for out-of-network services by themselves since HMOs don’t cover out-of-network services. Since PPO plans cost more than HMO plans, members can get partial coverage for out-of-network services as long as the services required were eligible and pre-approved by the insurer.
 
For example, a PPO member’s visit to a doctor who is part of the network will be shouldered by the insurance company. The member only needs to make a co-payment. However, seeking the services of a doctor who is not part of the network could be covered only up to 80%. The plan holder would have to pay for the remaining 20% out of his own pocket.
 
Obviously, it would be wise for managed-health-care plan holders to avoid out-of-network treatments. Luckily, many managed-health-care providers are responsive to the plight of their customers when it comes to out-of-pocket expenses. Some providers have managed to deflect the expenses by creating a payment plan, since they are willing to do anything to keep their customers in the network.
 

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08/05/2009

The health insurance system is full of complexities. The more choice that you have in terms of doctors, hospitals, and treatments, the more costly it will be it. And if you choose a cheaper premium over an expensive one, your freedom to choose is compromised. Before deciding to purchase a plan that should be perfect for your needs, you should be aware of the different kinds of medical insurance plans that are available and the benefits that they offer.
 
Nowadays, Preferred Provider Organizations (PPOs) are the most popular type of health plan. Within this year alone, around 158 million Americans were enrolled in PPOs. Here are some of the reasons why PPOs have become popular as a health insurance option.
 
In the PPO system, doctors, hospitals, and other health providers agree on a deal with insurance companies to provide substantial discounts to plan members. Health insurance firms benefit from discounts given by health care providers. In return, the providers get to bill more patients.
 
In this way, the plan holder benefits from discounted rates from the doctor’s office, while the doctor, on the other hand, benefits from a guaranteed pool of patients, and finally, the insurance provider benefits from the premiums purchased by a larger group of customers. This system is similar to the “you scratch my back and I'll scratch yours" concept.
 
PPOs have some advantages over other health insurance options. Unlike other health care organizations, PPOs don’t require the members to retain primary care physicians (PCP). It means that members can consult specialists even without referrals. PPO plan holders also have the freedom to choose any provider–even those that are outside the provider network.
 
PPOs have a lot more to offer their customers. But what makes them very popular to a lot of people is the balance between cost and freedom.

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08/05/2009

Purchasing the right travel insurance is not an easy choice to make. Despite the many different risks they may face when travelling, some people refuse to take out travel health plans because they think that not all trips are worth insuring. But no matter what type of trip you’re taking, it is always best to purchase travel insurance before going on a vacation.
 
Individual health insurance carriers, travel insurance specialists, credit card companies, and travel agents are just some of the establishments that offer travel insurance. Before purchasing travel insurance, it is a must for consumers to check what vacation-related incidents are already covered by their health and auto insurance. This is very important because purchasing extra insurance without first noting the risks already covered by primary insurance could just be a waste of money.
 
Flight insurance policies could cost as little as $10; they provide coverage in case of death as a result of a plane crash. Typical comprehensive policies cost around 3% to 8% of the overall cost of the trip. One of the best features of travel insurance is its flexibility. Consumers can choose just the kind of coverage they feel they need.
 
So, what are the things to note before purchasing travel insurance? It’s just a matter of finding the balance between coverage and price, need versus budget. Try to shop around, like when you’re looking for typical insurance coverage. Expensive premiums don’t always offer the best coverage. Sometimes, there are cheaper premiums that offer the exact coverage needed. Take note of the policies offered by travel agencies. Most of the time, they cost more than regular travel insurance.

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08/05/2009


Health Maintenance Organization (HMO) is an umbrella term referring to any organized health plan aside from those offered by traditional health insurance firms. It is a prepaid health plan that requires a member to pay a monthly premium in exchange for comprehensive health care. Some of the basic services offered by HMOs are doctor’s visits, emergency care, hospital stays, laboratory tests, x-rays, surgery, and therapy.
 
HMO members are given access to primary care providers. These primary care providers will examine you and assess your condition before referring you to a specialist. HMOs also ensure lower medical expenses.
 
Because of the fixed monthly premium, an HMO ensures that its members are provided with basic health care before their conditions deteriorate. Examples of the preventive care HMOs provide are office visits, well-baby checkups, immunizations, physicals, and mammograms.
 
Many people prefer HMOs to other health plans because of their efficient service. Claim forms are not required for hospital stays or hospital visits; members use cards instead.
 
If you plan to choose an HMO, you have to consider many factors. First, you have to think about the kinds of services that you will need in the future. If you have special needs, it is important to take note of them. If you already have a health care provider, consider the benefits to know if you need to switch to another provider.
 
When it comes to the actual provider, reputation and reliability are very important. The quality of service that HMOs provide should tell you what provider to choose. You can also talk to acquaintances enrolled in the particular HMO you are considering and ask them what they think of the services that are provided.

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08/05/2009

There are still many students who do not have student health insurance, primarily because of poverty. Not all students are fully covered by scholarships and loans; they struggle just to finish their college education. These students are in need of affordable health insurance to protect them when the need for health care arises.
 
Some lucky students have parents who pay for their health insurance, but others do not. Regardless of whether a student is supported financially by parents or not, having health insurance is really a necessity. These days, living without insurance, especially insurance that covers the medical basics, is like courting financial disaster. This calls for affordable student health insurance.
 
In the light of the current financial uncertainties in our modern society, insurance companies have come up with some affordable solutions to really fulfill the need for individual health insurance in the education community. Thus, students can now focus on their studies and not worry about what will happen if or when sickness strikes them.
 
There are many things to consider when buying medical insurance. For instance, a student should want to know exactly what his or her plan covers. He or she should find out if the plan allows selecting a physician of his or her own choice. Other considerations include: the cost of the annual payments for the plan, reimbursements and the length of time these take, and even the company’s customer service (i.e., if the company offers 24-hour customer service). These considerations tip the balance in favor of going online to find affordable student health insurance. The websites of insurance companies provide complete, up-to-date information on the services they offer.

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08/05/2009

PPO stands for Preferred Provider Organization. It is a care system that provides members with health benefits and medical coverage within a structured, medical professional network and facility. This care system is typically sponsored by employers or insurance companies to help subsidize the medical costs that members would otherwise have to carry themselves.
 
The organization selects the doctors, health care providers and hospitals in the network that provide members with medical assistance and health care coverage. While a PPO encourages its members to avail themselves of the services of the doctors and hospitals within the network, it also allows members to visit medical services that are outside of the network. A PPO covers more of the medical costs of a patient if an in-network, health service provider is visited.
 
In a PPO, the member costs involved are determined by a member’s specific needs. Thus, a PPO member pays only for the medical expense incurred from the actual medical services that were rendered. This contrasts the health maintenance organization (HMO) for which a member pays a monthly coverage. Like an HMO, however, a co-payment is often required in a PPO. This refers to the amount paid at the time of treatment to cut the medical costs. This amount is not fixed and depends on the particular medical treatment received.
 
The major advantage of a PPO is that is offers more choices than other health care insurance systems. If a patient has a medical need that, for some reason, cannot be addressed by health care providers within the network, he or she may avail him or herself of the services of those outside the network while still having a certain degree of their cost covered.

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08/05/2009

People like many things, such as pets, jewelry, and seafood, but these things are not always safe. For those who have allergies, coming into contact with these things can result in discomfort and pain.
 
An allergy is a reaction of a person’s immune system to an object that is usually not harmful to human beings. People who have allergies are usually allergic to many things. These can include pollen, pets, insect bites, food, dust mites, mold, and medications. Allergies are believed to be acquired through one’s environment and through one’s genes. When an allergic reaction happens, the person’s immune system generates a "false alarm." Sneezing, a runny nose, itching, rashes, swelling, and asthma are some of the common symptoms of an allergic reaction.
 
An allergy exam will identify a person’s allergies. This involves a thorough documentation of a person’s medical history. The person will also be screened for allergy-related disorders. His/her body will also be assessed as to how it responds to various allergens. An allergy exam also includes blood and skin tests.
 
Allergies can be treated in different ways. Decongestants are used to lessen swelling. They are also used to bring back blood to the blood vessels in a person’s nose. Metered-dose inhalers are used to expand bronchial tubes. Sneezing and itching are treated with antihistamines. Getting allergy shots will lower a person’s body’s capacity to produce an allergic reaction. There are also alternative treatments that are done to treat allergies.
 
A person’s individual health insurance plan can be affected if he or she has allergies. Coverage for medication is usually limited in most plans. Only a small number of plans, mainly HMOs, provide coverage for preventive care.

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08/05/2009

Health care is an ever-growing need, and with the cost of insurance premiums it is very important to consider every option available to you related to your health. Health insurance really is vital and careful comparisons can and should be made when choosing the best health plans offered in the market.
 
The use of alternative medicines is sometimes relied upon these days as a back up to health plans by some people.  Since the start of civilization, man has been using herbs to solve health issues. From simple colds and digestive issues to depression, many medicinal herbs have been proven effective against a wide range of diseases. The good thing about these alternative medicines, aside from being cheap, is that they can be grown in your own backyard.
 
Oregano is one of the most popular medicinal herbs in the world. Aside from enhancing immunity to disease, this herb can provide relief from cold and flu. When placed in hot water, the vapors produced by this plant contain antibacterial and antiviral properties. It also serves as a good decongestant.
 
Rosemary on the other hand is a popular brain tonic used in Chinese traditional medicine. Its volatile oils help increase brain activity and alertness. This plant also helps digestion and boosts the immune system.
 
Another popular alternative medicine is St. John’s wort. Researchers from the Center for Complementary Medicine in Munich concluded that the herb’s extract provides a more effective treatment against depression symptoms than any antidepressant. According to the studies, St. John’s wort actually worked better than the placebos given. It provides the basic medical effects of tricyclics and SSRIs with fewer side effects.
 
The best option is to be covered by a comprehensive health insurance policy, but having medicinal plants in your own backyard can also be helpful when treating minor illnesses.

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08/05/2009

The growing demands of the public are continuing to push the insurance industry into providing wider coverage. More and more people are willing to spend on health and medical insurance policies. In addition, as far as expanding coverage is concerned, insurance companies are starting to consider alternative treatments and medicines.
 
As a consumer, you want to get the most out of your insurance plan. If you’re planning to apply for coverage, you must first understand the issues related to health plans and alternative treatments.
 
Back in 2006, 18 major Health Maintenance Organizations (HMOs) and insurance providers, including Medicare, Prudential, Aetna, and Kaiser Permanente, participated in a survey, which listed 14 companies that covered 11 out of 34 alternative treatments. Massage therapy, chiropractic treatments, and acupuncture are some of the most common alternative treatments covered by insurance. However, coverage is limited to discounts and fewer sessions.
 
The health care systems of the West emphasize the use of drugs for treating mental illness. But with concerns about the use of drugs like tricyclics or SSRIs (selective serotonin reuptake inhibitors), alternative medicines like St. John’s wort could be an option. Scientists from the Center for Complementary Medicine in Munich discovered and concluded that the herbal extract of St. John’s wort may be far more effective than any antidepressant.
 
If you want to avail yourself of these alternative treatments and medications, you must first find out a few basic facts about your insurance policy. The first thing you might want to know is whether the insurance plan provides coverage for alternative treatments and medications, and, if it does, to what extent.
 
Before getting treatment, you might also want to ask a particular practitioner whether he or she accepts health insurance and if there are additional costs involved. This basic information will help you choose the best insurance for your money.

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08/05/2009

Although acupuncture seems to relieve pain, many insurance companies still consider similar therapies, including herbal supplements and massage, to be outside the medical mainstream. They are still considered as complementary and alternative medicine (CAM). However, some insurance companies do offer coverage for selected alternative medicines and therapies on a case-by-case basis.
 
The easiest way to get insurance companies to cover your alternative therapies is by making a good case that a certain alternative treatment is necessary for you. The best way to do this is to ask for a prescription from your doctor. This should include the length and frequency of your treatment. Among the frequently covered alternative therapies are massage therapy, chiropractic care, herbal remedies, acupuncture, mind-body stress management, and homeopathy.
 
For some insurers, covering alternative medicine is a good way to save money. For instance, common treatments for chronic back pain are more expensive than alternative therapies, such as acupuncture and biofeedback. Also, some people sometimes find these conventional treatments less effective. Acupuncture therapy only costs $200, while medication costs around $600 and surgery costs $10,000, but getting frequent alternative therapies may also cost more than the conventional treatments.
 
If your medical insurance does not cover your alternative therapies, you may be able to find affordable alternative treatments by alternative medicine college interns, who often offer therapies at discounted rates. The Pacific College of Oriental Medicine, for instance, has treatment centers located in New York, Chicago, and San Diego that offer herbal medicine consultations and acupuncture therapies for only $10 to $60. You may also save money on your alternative therapies through your Health Savings Account’s pretax money or Flexible Spending Arrangement.

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08/05/2009

Some people nearing retirement age dream of spending the remaining years of their lives in a community full of camaraderie and friendship, which is also a place that provides various social, cultural, and fitness activities. Others grab the chance to stay in a smaller house that is easier to maintain and provides the luxury of seclusion, while at the same time feeling the comfort of being surrounded by fellow senior residents. Both scenarios provide the elderly with a sense of independence.
 
Senior citizens are provided with six housing options for their retirement, namely, Independent Living, Assisted Living, Board and Care, Nursing Homes (Skilled Nursing Facilities), Congregate Housing, and Continuing-Care Retirement Communities (CCRCs). Among these housing options, Independent Living is the best choice for those who want freedom and versatility. It provides a residence in a compact, easy-to-maintain, private apartment or house within a community composed of fellow senior citizens.
 
True to its name, Independent Living allows the elderly to maintain their own residence and enjoy their daily routine without custodial or medical assistance. However, the senior citizens are allowed to bring in their preferred custodial or medical assistance from outside the community once it becomes necessary.
 
Independent Living for senior citizens includes community services, such as laundry and cleaning. There are also some community activities offered, namely, outings, golf, and other social events. The residents are free to decide what will be in their daily schedules, and since the residents are generally in good physical and emotional health, it will be up to them to arrange for their own medical insurance, such as Medicare, which provides health insurance coverage to people who are 65 years old and above. Medicare operates a single-payer health care system.

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08/05/2009

Medicare is a social program provided and administered by the U.S. government. It grants health insurance benefits to senior citizens, and other people who meet certain criteria. If a citizen is granted Medicare health insurance, he or she is also granted other rights pertaining to it. Some of these are the right to partake in the decisions that affect health care; the right to understand, identify and freely choose all treatment options; the right to appeal the decision to deny a member certain services; the right to get medical services in cases of emergency; the right to file grievances and complaints; the right to a timely and fast appeal resolution; the right to privacy regarding personal medical information; the right to be treated fairly and without discrimination.
 
In general, the rights most often executed by patients are the right for a speedy appeal of a decision and the right to appeal a health care resolution that is not acceptable to a policyholder’s satisfaction. No matter what type of Medicare plan a person has, he or she has the right to make an appeal regarding the decisions of his or her insurance company or of Medicare.
 
Whenever a policyholder feels that services and benefits available to him or her are ending before they should, he or she can make a Fast-Track appeal. This is available if the policyholder is released from a skilled nursing care facility, a hospital, a rehabilitation facility, an agency for home health care, or a hospice.

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08/05/2009


Large group health insurance is also called corporate group health insurance. A company will be categorized under and qualified for this type of insurance if its number of employees grows beyond the limit of companies classified as “mid-size.” Each of the insurance companies has eligibility requirements on how many employees a company must have in order for it to qualify for large group health insurance. This is the highest category for group health insurance, so usually there is no limit to the number of members or employees accepted.
 
In addition to better flexibility, corporate group health insurance has many similarities to mid-size group health insurance policies. In most health insurance providers’ portfolios, one would usually see a greater selection of plan options under the large group category. Large group health insurance policies are not the guaranteed issue type, as is the case with mid-size group health insurance. However, large companies or groups usually do not have many “high risk” employees or members. Thus, it is less likely that the group concerned would be denied insurance coverage for this reason.
 
Additional benefits are offered to large groups that are not available to smaller group sizes. This is because the insurance providers or companies assume the cost of these benefits, with the risks covered and absorbed by the total premium usually charged to large groups.
 
When searching for a large group health insurance policy, the concerned party must study the available options offered by the insurance companies in their state. There may be significant differences regarding the premiums charged and the benefits provided. Additionally, it is also important to know employees’ needs and wants pertaining to health insurance. If the group’s size is large enough, the insurance company might provide them with additional benefits.

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08/05/2009

Some insurance providers call Mid-size Group Health Insurance “mid-market” health insurance. Compared to small group health insurance, Mid-Size Group Health Insurance presents more plan choices. Depending on the insurance company, the number of required members or employees needed to qualify for this category may vary. Usually, if a certain company goes over the 50-member maximum count for small group health insurance, it will be offered with the next level benefits, and this will fall into the mid-sized category. More plans are offered under this category, and some of these plans have better benefits than the ones presented to smaller groups.
 
Not being a guaranteed issue is one distinguishing feature of Mid-Size Group Health Insurance. Therefore, a mid-sized company that has many employees with health problems may be refused insurance. Consequently, an insurance provider may request a claims history report from the concerned company’s previous health insurance provider. They may also issue a health survey that will query how many employees have particular medical conditions, such as diabetes, pregnancy, cancer, or other health conditions with great claim payouts. The group or company will be evaluated as one entity, and not per employee.
 
In searching for insurance providers that offer Mid-Size Group Health Insurance, the interested party has to consider several of the available options. Additionally, the concerned party should ask for both composite and age-rate quotes. A composite-rated Mid-Size Group Health Insurance provides a flat rate, which will be paid by each of the employees. This way, if the company lets its employees pay for a share of the insurance costs, bookkeeping would be simplified. An insurance that is age-rated has premiums rated in relation to the age of the employee. This is rated per employee.

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08/05/2009

Every state has its own regulations that determine how small a business should be in order to fall under the classification of a “small business.” Businesses that fall under the small-business category are qualified for small group health insurance. In order to be classified as a small business, a company usually has to have from 2 to 50 members or employees. In some situations, insurance companies may promote small group health insurance policies to a solo and self-employed individual. These one-person groups are not eligible for particular guarantees or policies that pertain to groups with more members.
 
Health insurance is state-regulated; thus, the laws that regulate small group health insurance may vary considerable. However, there are still some common procedures being followed in most U.S. states. Further information about state-specific laws can be gathered from a state’s State Department of Insurance or a duly accredited small business health insurance broker.
 
One of the main advantages of being categorized as a “small group” is that the company’s coverage of health insurance is assured by the health insurance provider. Therefore, if a company qualifies and meets the requirements of being classified as a “small group,” the insurance provider must grant and approve the application, regardless of past and present health conditions of all the company’s employees. This is called guaranteed issue coverage. The insurance provider may still ask the employees some health questions, but this is only performed to rate the premium for the group health plan.
 
There are particular eligibility requirements in order to qualify for a small group health insurance plan. The company needs to prove that it is a legitimate and legal entity. The tax payer identification number, business tax returns, payroll records, business license, and other documents are needed for this.

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08/05/2009

Most of the universities and colleges in the U.S. require their full-time students to have a student health insurance plan. After taking time to carefully research all of his or her student health insurance choices, the concerned student should now be comfortable with a decision regarding which health care policy would best suit their needs. The next step, of course, is to file an application for enrollment in the desired health insurance plan.
 
If the student has chosen the student health insurance being offered by the university or college where he or she is studying, they may not need to apply. Most universities and colleges automatically enlist their full-time students in their student health insurance plan, if the student does not show proof of private health-plan coverage first.
 
Meanwhile, if the student has chosen a private student health insurance policy or individual health plan instead, he or she must submit an application, together with the premium payment. Most insurance companies require the premium payment upon application. The premium is fully refundable, of course, if the application is declined.
 
In the process of applying for a private health insurance plan, the applicant is asked a series of health-related questions. This will determine his or her eligibility and qualification for coverage, and also the risk factor. If the applicant is presently undergoing treatment for a serious injury or illness, the application may be declined. It is also of utmost importance to disclose all requested information honestly.
 
The applicant will also be asked to choose the effective date of coverage. Most insurance policies can be made effective immediately after application, but sometimes the processing can take weeks, so it is best to file the application early.
 

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08/05/2009



Medicare has greatly improved its services and health plans; however, there are still many eligible persons who find it difficult to pay for their share of expenses, especially for prescription drugs, and even for their Medicare premium. Individuals, who only rely on their Social Security benefits, or those with a relatively low income, may not be capable of paying all the costs. For this reason, they can avail themselves of the following assistance programs: Supplemental Security Income Benefits (SSI), Medicaid, Medicare Savings Programs, and others.
 
Supplemental Security Income Benefits (SSI) is a benefit provided by the Social Security Administration office to individuals with limited income, or to those who are blind, disabled, or are aged 65 years and above. SSI benefits are given every month to cover a member’s basic needs.
 
Medicaid is a program jointly administered by the State and Federal governments. Persons who qualify for this usually have all their health care costs covered in full. Income level qualifications for this program vary depending on the state.
 
Medicare Savings Programs are state-level Medicare programs designed to assist citizens in paying for their Medicare premiums, coinsurance percentages, and deductibles. A person must have Medicare Part A to qualify for this.
 
Additionally, individuals with limited income may avail themselves of Medical Prescription drug assistance. If eligible, he or she will get financial assistance for the premium every month, the annual deductible, and some selected medication plans. For queries regarding qualifications for this program, concerned persons may contact their Social Security Administration office.

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08/05/2009

Medical insurance companies are usually wary of providing coverage to athletes who want to get health insurance. This is true despite the fact that the very active lifestyle of athletes results in their good health. Compared to other people, athletes eat well, exercise regularly, and get a lot of rest. Although this kind of lifestyle could be beneficial for an athlete’s long-term health, athletes are not immune to getting injuries.
 
For an athlete to improve his performance, he usually goes through strenuous training. However, when an athlete exerts himself too much in training, he is bound to experience its negative effects. While pushing one’s limits can mean triumph for an athlete, overdoing one’s training can lead to serious injuries and a visit to the hospital.
 
Every year, two million adults experience injuries that are sports-related. Sciatica, concussions, bone fractures, anterior knee pain, medial epicondylitis, rotator cuff injury, and lateral epicondylitis are just some of the injuries commonly sustained by athletes.
 
Many people are finding that getting preventative health care is becoming more difficult with the rising cost of health care in the U.S. This is even worse for athletes who need to regularly see health care professionals, as they strain their bodies with exercise on a regular basis. To supplement an athlete’s fitness and nutritional needs, regular visits to the doctor are essential in maintaining good health.
 
Athletes who have a health plan can optimize their training by regularly meeting with a physical therapist or a doctor who has experience in working with athletes. If an athlete has an accident, he has a number of options to choose from to get physical therapy. If an athlete has appropriate access to health care, he will find it easier to maintain his health and to prevent expensive and possibly irreversible injuries.

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08/05/2009

The Health Insurance Portability and Accountability Act (HIPAA) was enacted by Congress in 1996 to provide privacy and health coverage for patients. The recording and electronic exchange of health information prompted the need to secure the privacy of patients. Prior to the enactment of HIPAA, there was a scarcity of laws to protect the privacy of patients when their health and medical files were stored in computers instead of the traditional paper charts.
 
HIPAA has two main titles: Title I and Title II. Title I deals with individual health insurance and group or business health insurance. It works to ensure the availability of insurance for every citizen. Title II, on the other hand, provides a list of rules and penalties regarding the national health care system. It is well-known for the "Administrative Simplification" guidelines.
 
The rules were drafted by the Department of Health and Human Services. They are meant to ensure the security and efficiency of electronic health data during exchanges throughout the country’s health care system.
 
HIPAA helps provide insurance coverage to as many people as possible. However, there are limits to what it can do. HIPAA cannot coerce employers to pay or offer insurance coverage for their employees. And because of that, it cannot guarantee coverage for everyone in the workforce. It also cannot force employers to provide their employees with the same health insurance coverage and benefits that were provided by their previous employers.
 
Even though HIPAA assists in the availability of insurance to everybody, it cannot regulate how insurance companies charge group or business health insurance coverage. It also cannot force business health plans to provide specific benefits.
 
HIPAA has been helping Americans for almost 12 years now. People should understand the basic provisions and limitations of the Act to be able to maximize the benefits they receive.

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08/05/2009

Unlike Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) health plans, many indemnity policies provide the insured with an option to choose their preferred doctors and hospitals when needing health care services. Sometimes, this type of insurance is more expensive than PPO and HMO provided plans, but the payoff means more options for the insured.
 
Some important points to consider when choosing an indemnity policy for a health plan is the deductible, which refers to the amount of money one has to pay before the health coverage is provided. Moreover, some insurance plans require a co-payment, a portion of the remaining fees one has to pay after paying the deductible. For example, if the eligible fees are $1,000 and the deductible is $200, then what’s left is $800. The co-payment is a percentage of what is left from the eligible charges. If the insurance company requires a co-payment of 20%, then the co-payment of $1,000 eligible charges with a $200 deductible would be $160.
 
In addition, many indemnity health plans do not cover preventative health care services. These services, including annual check-up exams and other doctor visits, are health services that may prevent diseases or illnesses.
 
Unlike other types of health insurance, the good thing about indemnity health insurance policies is that most of these policies provide the insured with the freedom to use the services of his or her chosen doctor. Some policies also allow the insured to go to his or her preferred hospital.
 
Indemnity health insurance policies also vary in terms of benefits, depending on the rate, the insurance provider, etc. Some insurers offer indemnity plans covering more benefits, but charge high premiums, while some offer the same coverage but with high deductibles. The challenge is to get affordable insurance that covers what type of health care one really needs.

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08/05/2009

The adolescent years can be very difficult for young people who are going through this stage. Feeling melancholic or short-tempered is quite normal, and having an emotional high once in a while is natural for teenagers who are constantly bombarded with different kinds of educational demands and activities. However, if these strong emotions don’t go away or become so intense that you’re unable to handle them, you might be experiencing teenage depression. But you don’t need to keep on suffering this way. Help is just around the corner, and all you need to do is seek it out. Always remember that you are stronger than your depression.
 
An important thing to know is that you’re never alone in this battle. Depression is more common in teenagers than you might think, and the solution for this problem is within your reach. No matter what you may feel and believe, a lot of people are concerned about you. You just have to have the courage to speak up about it, because that’s the first step in overcoming depression.
 
Although depression is not your fault, there are steps that you can take to steer your emotions towards feeling better. Keep your body healthy. If you are stressed, don’t hesitate to ask for help from your parents or a trusted adult. Although it may seem as if you and your parents don’t always see eye to eye, their love and concern for you will drive them to seek therapists and specialists that will give optimal treatment for your condition. If you don’t have student health insurance, your parents’ medical insurance will come in handy for the necessary arrangements. Also, it is best to form your own strong support group that will help and encourage you every step of the way to regaining good health.

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08/05/2009

In the health insurance industry a benefit waiting period refers to the time before health insurance coverage commences. There are different kinds of waiting periods with corresponding rules for how they work within the framework of certain kinds of health insurance plans. In general, some of the typical waiting periods are employer waiting periods and affiliation periods.
 
The employer waiting period is the most common type of waiting period. This is applicable to business group plans. Newly hired employees must wait for a certain period before becoming eligible for health insurance coverage. The waiting period, which is usually three months, is enforced by employers to prevent new employees from filing large claims and then leaving the company quickly. Employer waiting periods have fewer restrictions. However, it is better to have a “back-up” health care plan since the new benefits are not yet in effect.
 
The employer waiting period runs concurrently with a pre-existing condition exclusion period. They both begin on the same date. It means that employees are spared from a longer waiting time.
 
Meanwhile, an affiliation period is set by a Health Maintenance Organization. With specific guidelines, this waiting period usually lasts less than two months. But for late enrollees, the affiliation period could stretch up to three months.
 
Affiliation periods are regulated by HIPAA or Health Insurance Portability and Accountability Act. While waiting for coverage to commence, you don’t need to pay premiums since HMOs are not providing the benefits yet. One of the benefits of enrolling in an HMO plan that imposes an affiliation period is the absence of pre-existing condition exclusions. HMOs can’t deny coverage for pre-existing conditions.
 
Benefit waiting periods act as gaps in your insurance coverage. By understanding how they work, you will be able to decide whether you need an additional health plans as a backup.

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08/05/2009

Most of the primary universities and four-year colleges in the U.S. require their full-time students to have a student health insurance plan. A student has several available options in choosing the best health plan for him or her. Obviously, in order to determine which is best, he or she must make certain enquiries and be knowledgeable regarding the various student health plans being offered.
 
In researching the different options for student medical insurance, it would certainly be helpful to be familiar with the health care coverage that one should expect. Although the coverage of services and benefits vary depending on the insurance company, there are particular benefits that ought to be a part of all health insurance policies. Given that health insurance policies are regulated by the state, the state in which a student is attending college may impose particular requirements on all insurance companies. If the state has specific mandates, a student should clearly see these on the leaflet or brochure of the medical insurance policy he or she is considering.
 
Here is a list of some benefits that are commonly covered by most student medical insurance policies. The amount of the deductible and limits of coinsurance vary significantly, so those items are not addressed here.
 
Preventive health care (usually with maximums)
Visits and consultations with a physician
Hospital room and board
Outpatient prescription drugs (usually with maximums)
Inpatient prescription medication
Outpatient surgical procedures
Registered nurse fees
Anesthesiology
Ambulance
Durable medical equipment
Hospital intensive care
Lab and radiology
Psychotherapy (some states mandate this, usually with maximums)
Radiation and chemotherapy
Physiotherapy (usually with maximums)
 

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08/05/2009

Around 51% of the immigrants in the United States are not enrolled in any health insurance plan. Getting health care coverage may be particularly difficult for an immigrant, considering that many immigrants are not working at companies that offer group/business health insurance.
 
There are only a few options for insurance coverage for immigrants. Usually, immigrants are not eligible for federal insurance like Medicaid. Although Medicaid provides subsidies to people with low income, poor immigrants are still not qualified to receive public benefits like Medicaid because of the Personal Responsibility and Work Opportunity Reconciliation Act (PROWRA). Immigrants may only avail themselves of a subsidy after five years of residence in the U.S. Undocumented non-citizens are not eligible for Medicaid.
 
Similarly, although there are many subsidized health programs for children in the U.S., like State Children’s Health Insurance Program (SCHIP), the children of immigrants who have not been in the U.S. for at least five years are restricted from receiving health care assistance due to PROWRA. They may still be ineligible for an extended period due to economic requirements. Moreover, unrecorded non-citizens do not qualify for SCHIP.
 
The easiest way for immigrants to get access to health coverage is through private individual health plans. The cost of this type of insurance is, however, higher than many other health plans.
 
Nonetheless, in a nation where health care costs are soaring at a very alarming rate, it is a necessity for every U.S. resident, whether an immigrant or one who was born in the U.S., to purchase an insurance plan that greatly lessens the burden of medical costs.

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08/05/2009

Cancer health insurance is designed to help reduce expenses for cancer care. However, it is not intended to replace group/business or individual health insurance policies. Rather, cancer insurance is meant to complement health plans that are already in place by dealing with extra expenses not covered by your existing policy.
 
To be eligible for cancer insurance, an individual should not have an existing cancerous condition. People who have been diagnosed and treated for cancer are in most cases ineligible for such a policy.
 
There are a wide variety of cancer insurance policies, so it is necessary to read the documentation carefully and understand it thoroughly before buying one. The coverage differs based on its provider, although most plans cover both medical and non-medical expenses. You should read it and compare it with your existing policy to check if there are certain benefits that overlap. You also need to be aware of the limitations of the policy beforehand.
 
To know if you really need a specific health insurance plan, like cancer insurance, you should determine the extent of your cancer risk. If you have a strong family history of cancer, it would be wise for you to consider including this kind of insurance in your coverage. However, if you only have an average risk of having cancer, a better option might be to upgrade the coverage of your existing insurance policy. This will help you save money and increase your range of benefits. Lastly, before signing anything, make sure that you have completed a comparison check of all the plans available to decide which policy is best for you.
 

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08/05/2009

Health insurance has always been a necessity, especially for seniors. Many older people even consider purchasing supplemental health plans to cover medical expenses that their insurance plan may not cover.
 
Medicare, a federal health insurance developed for seniors through the Social Security Act of 1965, is the most popular option among the elderly. To qualify for Medicare health insurance, the applicant must have worked for 10 years. If the person does not meet this requirement, he or she is required to pay a monthly premium.
 
Medicare covers diverse health care services, although some services are subject to extra costs. Services that are often not covered by this type of insurance include in-patient hospital deductibles and other fees.
 
Usually, to ensure that most of their medical expenses will be covered, many seniors enroll in secondary health insurance plans to supplement their Medicare health plan. A Medigap policy, an individually purchased health insurance policy, is a widely used option as a supplemental health plan for seniors. Since only a few prescription drugs are covered by Medicare, many seniors also choose to enroll in Elderly Pharmaceutical Insurance Coverage or the EPIC Program, which subsidizes prescription drugs costs. This insurance covers almost all prescription drugs. The insurance’s deductible plan is also applicable to seniors who earn over $20,000 per year.
 
Medicare coverage used to be limited to hospital care, physician and outpatient care. But in 2003, through the Medicare Prescription Drug Improvement and Modernization Act, Medicare started providing coverage for the cost of prescription drugs.
 
Seniors may also enroll in other Medicare Advantage Plans, such as Medicare Medical Savings Account Plans, Preferred Provider Organizations, Private Fee-For-Service Plans, Health Maintenance Organizations, and Medicare Special Needs Plans.

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08/05/2009

Medicare offers various options aside from the Medicare Supplemental Insurance. The original, or default, Medicare plan is a fee-for-service plan. This means that it offers a certain amount of flexibility to its policyholders, with different types of prescription medication coverage and health care services. Policyholders can also avail themselves of the services of doctors or hospitals of their choosing, as long as these health care providers accept payment from Medicare for the services they render.
 
There are other choices that can either replace or augment the original Medicare plan, including Medicare Special Need Plans, Medicare PFFS (Private Fee-for-Service) plans, Medicare PPO (Preferred Provider Organization) Plans, Medicare HMO (Health Maintenance Organization) Plans, PACE (Programs of All-inclusive Care for the Elderly), and others.
 
Policyholders are advised not to make any alterations to their current coverage if they are covered by a trade union, employer, TRICARE, the Department of Veteran Affairs, a special program or plan, or Medicare supplemental policy until they consult with a benefits administrator or a licensed insurance provider.
 
Before a person decides on which Medicare coverage to choose, he or she must consider the plan’s benefits, cost, choice of hospitals and doctors, the location of medical facilities, and other important matters. If needed, assistance can be received in order to get advice regarding prescription medication coverage and health care policy is best for a particular person’s needs. Persons with queries can call Medicare’s hotline at 1800-633-4227 to talk with a service representative, or they can visit www.medicare.gov. Medicare personnel will respond via email with the requested information in approximately three weeks.

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08/05/2009

The current financial crisis has created many “in-betweens”— average people who need immediate health insurance coverage for short and limited periods of time. To answer the needs of the “in-betweens,” private insurance companies have designed short-term medical insurance policies. This quick fix is perfect for consumers who seek insurance coverage for one to six months just to avoid getting into a difficult financial situation.
 
Through short-term health policies, healthy individuals are able to benefit immediately from family or individual health insurance. Coverage can start after 24 hours of processing. Once a consumer determines the total coverage period required the insurance provider can opt to allow a plan holder to make a one-time payment depending on the period of coverage.
 
Most of the time, these types of policies include a range of deductibles and premiums. They are promoted as 35% cheaper than regular private health plans. Some of the most common services covered by short-term policies are outpatient and in-patient treatment, as well as surgery. Plan holders can also select their preferred doctor or medical facility without limitations. However, using the services of in-network providers can lead to financial incentives.
 
As for the drawbacks, short-term medical insurance won’t cover everything. It could be perfect for healthy consumers who need to be temporarily insured; however, short-term plans don’t cover preventive care and routine office visits. Pre-existing medical conditions are also not included in the coverage. In addition, short-term medical insurance is not available nationwide.
 
So if you need temporary insurance coverage while waiting for new insurance to kick in, you can choose between different short-term major medical plans. However, before choosing any type of insurance, practice responsible consumerism. It is always best to know your needs and analyze the benefits of your possible insurance choice before enrolling in a plan.

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08/05/2009

One of the most important decisions for families is selecting the appropriate family health plan. Before modern health plans were offered, there was only one kind of service, which is now known as the fee-for-service option. Today, there are many plans to choose from. Before choosing a health insurance plan, it is best to make health insurance comparisons to know fully what are the available options. Basically, there are two major issues that people must address when choosing a health insurance plan: the needs and the budget.
 
Firstly, people must realize that health plans do not cover everything. It is crucial to know the needs that must be addressed to avoid spending on plans that offer irrelevant services. After considering the type of plan to purchase, the next logical step is to fully understand the benefits offered, as well as the plan’s guidelines.
 
So where do budget and needs meet? As we all know, a teenager and a baby boomer have different needs. It’s a good thing that every health insurance plan employs different ways to cover different kinds of situations. After understanding the type of coverage needed, the next thing that needs to be considered is affordability. As a rule of thumb, the more comprehensive the insurance plan, the more expensive it will be. Often, consumers base the type of coverage they purchase on their financial status.
 
Of course, monetary issues are important because health insurance is just one of the basic needs that families must address. Families also have to pay for the children’s education and everyday needs. That is why it is very important to consider all the factors before purchasing a health plan: in order to find a plan where price and coverage meet.

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08/05/2009

Recently, there has been a steady increase in health insurance premiums. Many insurance options have been affected by this. However, you can choose options without the increased costs by planning and researching carefully.
 
As health insurance premiums are becoming more expensive, you will want to get the most out of what you pay. To do this, you must ensure that your health plans only meet your heath care needs. Everyone has different health care needs so it is possible that you might have chosen the wrong plan if you pay high premiums for a plan that covers options that you do not need. When this happens, it would be best to reassess your needs.
 
For a person who is generally healthy and who doesn’t visit the office of his health care provider that often, an individual health insurance plan that features a high deductible or a high co-payment could be the right choice. This is an example of spending your money wisely when it comes to insurance. It is important to make sure that you are only paying for the services that you need.
 
A health insurance plan that focuses on affordable medications would be advisable for those who have health conditions that need constant medication, such as asthma or allergies. It is vital that you figure out the health insurance options that matter to you. This will help you maximize your health insurance premiums.
 
Even though there has been a rise in health insurance premiums, it is still possible to not spend too much. You can do this by making wise choices, and by ensuring that the options you are paying for are what you really need. A little bit of research will help keep your expenses down.

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08/05/2009

Often, people with small businesses do not have health insurance plans. It is important for them to find health coverage through a self-employed health insurance plan. What they need is an affordable, quick and easy health plan.
 
Being hurt or struck by a sickness is tragic not only to one’s family but also to one’s finances. Although sicknesses and accidents may come anytime— sometimes, when they are least expected—one can be prepared for them by having a health plan. As an owner of a small business, a person can get health coverage through a variety of plans. He or she may consider looking into plans that are like discount cards, a family plan that can cover him or her as a business owner, or group health insurance plans for the self-employed. Also, individual health care plans may be an option.
 
It is not difficult to look into different health insurance policies available; one can secure online quotes in no time. Eye care, dental and ER services may be obtained along with quotes for health coverage. Knowing the type of insurance to look for is important. Some plans offer discount cards that can be used in transactions with anyone who accepts them. These types of plans are ‘down-to-earth’. However, there are other, more typical insurance plans, which may require one to wait in order to be covered for any pre-existing condition.
 
There are many different types of health insurance policies for the self-employed. Quotes for these can be easily organized online.

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08/05/2009

The health maintenance organization (HMO) dental insurance plan is the type of insurance that requires some type of prepayment from a patient. The patient, in turn, is provided with dental care from providers within the network. Of course, if the patient wishes to use the service of a dentist outside the network, he or she will have to pay the entire bill, which is known as a capitation dental insurance plan.
 
A dentist within the network receives his or her payment once a month by the insurance provider, and this payment is usually fixed. This is one of the differences between an HMO and preferred provider organization (PPO) dental insurance plan. A dentist who is within the network may agree to lower the cost for the patient provided that the insurance company refers other patients to the dentist so that he or she may have more clients, and therefore a greater income.
 
An HMO dental insurance plan covers the following services: basic dental services. This includes cleaning, dental exams and X-rays, and other procedures such as dental crowns, dentures and bridgework. These procedures, however, are slightly less common. Furthermore, part of the cost of these procedures is shouldered by the patient. Nevertheless, the costs of the basic dental services are not shouldered by the patient.
 
The advantages of an HMO dental plan lie in the absolute entitlement of an eligible patient to dental care. This means that despite the lack of full compensation, the patient will still be treated. There are a number of companies that provide a variety of dental plans. These may help patients weigh the coverage he or she needs against the amount of money he or she is willing to pay for dental care.

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08/05/2009

Understanding how loved ones fall into drug addiction may be hard for you to grasp. Watching them fall into the vicious cycle over and over again even after swearing that they will never do it again is a very difficult and painful experience. However, we have to recognize the fact that drug abuse is not an issue of moral limitations and flawed resolve, but a cruel cycle that affects the brain and causes the person to fall deeper and deeper into the quicksand of addiction.
 
The damage drug abuse and addiction can cause might snowball from one disaster to another and can lead to death. It would take a great amount of courage and resilience to recover from drug abuse and addiction. The first step towards a full recovery is admitting that you have a drug problem. Being ashamed and trying to do the healing process alone will not help you. A strong support group goes a long way in providing you with the strength to battle the internal conflict.
 
Drug addiction is a very tricky disorder. Relapses often happen, even if you thought you were fully recovered, which might be very exasperating and discouraging. But don’t lose hope. There are various drug treatments that can help lead you towards recovery. Being sober is only one of the initial steps you need to make. You’ll need trained health professionals to outline a recovery program for you and there are rehabilitation centers that offer a wide range of programs with the most appropriate treatment for you. The treatment cost should not be a problem if you are familiar with what services your medical insurance covers. Other financial concerns can be discussed with the management and will provide choices that match your arrangement.
 

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08/05/2009

Until today, people had very few long-term, health care insurance options. Most commonly, people would have traditional policies, which offered a certain amount of health benefits. But, the traditional, long-term health care policies weren’t really enough and, with the soaring health care costs, self-ensuring is also a risky move. Depending on family may also be an alternative, but it is still not a viable option.
 
While the traditional long-term-care health plans were a great help for some, many still wanted guaranteed benefits in the event that the health plan was never used. Thus, the insurance industry came up with traditional health plans that had a “return of premium” rider. With this type of policy, the health insurance company, over a period of time, would return part of the premiums to the owner of the policy if the health benefits were never used.
 
The insurance industry has designed health insurance described as “linked or hybrid” policies. These health plans provide the benefits offered by an annuity or life insurance agreement and the traditional, long-term care insurance plans. With this type of policy, the insured is guaranteed that if he or she remains healthy and does not use the health care, the benefits can be used by his or her beneficiaries. Some hybrid insurance policies do not have a “premium rider”. Instead, a part of the internal return is used in paying for the long-term care benefits. The cost of the long-term care benefits is based on the amount of coverage chosen upon the purchase of the term. Usually, the insurers of some hybrid health plans provide a payout of 200% or 300% of the aggregate insurance value up to three years after the value of the annuity account is depleted.
 

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08/05/2009

With so many different health insurance plans to choose from and so many people without any health insurance at all, prescription drugs can be expensive and difficult for many Americans to obtain.  Many people who require daily medication face financial hardship while struggling to afford their prescriptions; some even find themselves having to choose between the drugs they need and paying their bills.  No one should have to make decisions like this.  There are many options available for those who need help with the cost of their prescription medications.
Several programs help patients obtain prescriptions for free or at a discount, regardless of their health insurance coverage.  The Janssen Ortho Patient Assistance Foundation offers free prescriptions donated by a group of companies to patients who meet qualification guidelines.  The Partnership for Prescription Assistance is a clearing house that helps patients locate the best discount or free prescription programs available and assists with applications and enrollment.  Together Rx Access works directly with several pharmaceutical companies to provide discounts on many different medications.  For people aged 65 and over who qualify for Medicare, the optional Part D plan provides coverage for prescriptions.  Many states also have programs to help qualifying patients receive help with the cost of prescriptions.
Most health plans offer some form of prescription drug coverage.  If you decide to use your insurance to help with the cost of medications be sure that you understand the particular rules set out by your policy terms.  Many insurers cover only a select group of drugs, while others require co-pays for prescriptions.  These out-of-pocket expenses can vary depending on the kind of medication.  Some plans restrict or exclude medications that are not prescribed by a network provider or those not deemed medically necessary.  Consult your policy before making a decision.
Independent prescription plans are an increasingly attractive option for many people.  These programs give consumers discount cards to use when buying prescriptions.  If your health insurance does not cover a medication you have been prescribed or does not offer prescription coverage at all, purchasing one of these plans could be a good alternative to paying for medications out of pocket.  There is usually an annual fee for participation in a plan, and plans can be offered through a variety of sources including pharmaceutical companies, drug stores or pharmacies, insurance companies, and non-profit organizations.  There is a lot of variation between plans, but they are generally structured in tiers and charge fees based on a sliding scale of factors.  Discounts also vary, but generic drugs are usually much cheaper than name-brand medications.  It is very important to carefully research several different prescription plans before making a decision.  Consider what medications you need, whether you can substitute generics for name brands, and how often you purchase your prescriptions.  You may even need to participate in more than one plan if you take many different prescriptions.
Prescription medication can be expensive, especially if you require daily treatments to keep you healthy.  Consider one of these options to help you get the prescriptions you need without breaking the bank. 

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08/05/2009

Many Americans suffer from some form of mental health issue such as depression, anxiety or stress.  The stigma that was once so firmly attached to these disorders has significantly lifted and many health insurers now provide comprehensive coverage for substance-abuse treatment, therapy, in-patient care and other mental-health services.
Insurance coverage for mental-health services varies from provider to provider and across states.  Some states have laws outlining a minimum standard of care for mental issues or substance-abuse treatment, though many plans offer much more coverage than state minimums.  Coverage for mental health or substance abuse is typically not as comprehensive as other medical services and may require higher deductibles or co-pays.  The Mental Health Parity Act of 1996 mandates that insurance plans that offer mental health services set dollar amount limits for this coverage equal to those of other kinds of medical care.  The law does not, however, require all health insurance carriers to offer coverage for mental-health treatment.  Many states have parity laws, as well, so check with your state’s insurance department to find out about regulations in your area.
There are potentially very many professionals involved in mental-health treatment:  primary-care physicians, physician assistants, clinical psychologists, psychiatrists, social workers, substance-abuse counselors, therapists, nurses, etc.  It is important to explore all of your options before seeking treatment and to coordinate care with specialists through both your primary-care doctor and your insurance company.  Before you seek treatment for a mental health issue, contact your insurance carrier and request a written outline of the services covered by your plan.  Find out if you will need a referral from your primary-care physician, and if there are any restrictions on the kind of care you are eligible for or the providers you have access to.  Be sure to ask about any out-of-pocket fees you may incur while seeking treatment, whether you are required to use in-network providers, and other options available to you through your insurance plan.
Some companies offer employee assistance programs (EAP).  These services can be a part of a larger health insurance package or can be entirely separate programs.  Visits to therapists or counselors are usually free, though the number of times you can see a provider may be limited.  EAPs cover preventative and diagnostic services; many provide assistance with substance abuse, stress, depression, family and marriage counseling.  If your employer offers an EAP, you can rest assured that any information you share with a mental-health professional is completely confidential and your employer never receives any information about your treatment.
Both Medicare and Medicaid cover mental-health and substance-abuse services.  If you are eligible for either of these programs, check with your plan representative or caseworker for more information and help locating an approved provider or treatment facility.
Certain states offer public mental-health services such as state-funded clinics where payment is calculated on a sliding scale based on your income level or what you can afford to pay.  Many of these facilities also offer financial assistance to patients who qualify.
 

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08/05/2009

As unemployment rates continue to climb, more Americans who were previously insured through an employer or union suddenly find themselves without health coverage.  For these people, short term health insurance is an affordable option that can provide a much-needed temporary safety net.  A product of the Congressional Omnibus Budget Reconciliation Act of 1985—COBRA—is one of these options.
The idea behind COBRA health coverage is fairly simple.  The plan allows workers who have been laid-off to continue to purchase health insurance from their former employer for a set period of time following their dismissal.  The term of a COBRA policy is generally 18 to 36 months, and the plan is meant to protect workers while they search for another job or consider alternative options for health care coverage.  Employers are required by federal law to provide information about COBRA plans to laid-off workers, but COBRA is not always a good fit.  In fact, the majority of laid-off workers choose to forego COBRA coverage altogether in favor of more viable options.
While COBRA coverage is intended to provide care for healthy people who have recently lost their jobs and to act as added security in an unsteady job market, it can be cost-prohibitive for newly laid-off workers who have lost their source of income, and may be impossible to obtain for those with serious medical conditions or health risk factors.  COBRA policy premiums are more expensive, as workers who purchase the policy are required to take on the added cost of the portion of the premium that their employer once paid.  So workers are paying more for the same coverage.  For people with serious medical concerns the cost of care and treatment, even with a COBRA plan, could put coverage completely out of reach.  Furthermore, COBRA is not always offered by employers.  For example, when a company chooses to drop group medical coverage for existing employees or has filed for bankruptcy, it is not required to extend COBRA to laid-off workers.
Recent federal legislation tied to President Obama’s economic stimulus package has provided some relief for workers considering COBRA.  Under Obama’s plan, laid-off workers who purchase COBRA coverage can receive government subsidies for up to nine months that cover about 65 percent of COBRA premiums.  The subsidies are offered to workers who involuntarily lost their jobs between September 1, 2008 and December 31, 2009.  This has made COBRA health plans a much more realistic option for many unemployed people.  There are restrictions, however:  Individuals with annual income over $125,000 and married couples with annual income over $250,000 are not eligible for the program. 
Even with this help from the federal government, COBRA may not be the most affordable health insurance coverage available for laid-off workers.  It certainly pays to do some research into alternatives such as short-term major medical plans, state-sponsored programs, or a spouse or partner’s employer-sponsored coverage.  Researching these other options before necessity sets in is wise, as it allows workers the luxury of time and the opportunity to consider all factors before making an informed choice.            
 

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08/05/2009

Health insurance plans are about as unique as the people who purchase them.  With so many options to choose from it is hard to know which is the right fit.  Being informed about your choices is the first step to deciding wisely.
Health Management Organizations (HMO):  These plans are characterized by a range of services provided through a network of doctors, hospitals, labs and clinics who agree to treat members at predetermined rates.  Members need to arrange all care with specialists through their primary care physician—who acts as sort of an overseer of treatment.  Patient choice is often restricted under HMOs, as those who wish to use out of network providers or services may face additional costs; in some cases, patients are required to pay total expenses out of pocket.  HMO premiums are usually very low and plans cover most routine preventative procedures like mammograms, vision exams, immunizations, and physicals.
Preferred Provider Organization, PPO, is another kind of managed care plan that allows members to visit any in-network doctors without a referral from a primary care physician.  Though members do not need to see a primary care doctor and are free to see a specialist of their choice, there is generally better coverage for in-network providers.  PPOs sometimes require co-pays for office visits, and most plans require members to pay the annual deductible in full before coverage begins.  These policies also oblige members to obtain approval before receiving any major medical treatment or services.
Point of Service, or POS, are managed care plans with varying benefit levels based on where care is obtained—in the plan network or out of it.  Most POS plans combine benefits from HMOs and PPOs.  Patients are required to name a primary care physician, but are free to seek out of network care for greater personal expense if they choose.  Some POS plans may ask patients to cover office visit co-pays, an annual deductible or coinsurance out of pocket.  Coinsurance is the percentage of the total cost of care that a patient has to assume once the insurance company has paid their share.  For example, if an employer health plan covers 80% of the total allowable cost of treatment then an employee with that plan would have to come up with the additional 20% of the cost from their personal financial accounts.  
A health savings account, or HSA, is a personal savings plan with tax benefits.  Used in conjunction with policies that have high deductibles, these low premium plans provide an account that can be accessed at any time with the withdrawn funds going to pay for qualifying medical care.  Additional funds can be deposited tax-free, and funds remain in the accounts from year to year.  Funds can also be invested according to the account owner’s discretion.  Interest and dividends build up without tax penalties.  In fact, the only time penalties are assessed is when the withdrawn funds are used to pay for things other than medical care.
With so many options it is always a good idea to take your time and carefully consider risks and benefits before committing to a policy.

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08/05/2009

eHealth Insurance is a top Web site for people searching for the best health insurance. It is a certified, health-insurance company that caters to persons, families and small companies that want to purchase health insurance. They have about 800,000 policy-holders throughout the US, and they offer a wide-ranging selection of health insurance plans from the major health insurance companies in the country. To top that off, they also deliver exceptional customer service. With their well-informed and professional representatives, easy-to-follow online tools, and pioneering Web site, people will discover that getting health insurance doesn’t have to be expensive and difficult.
 
The easy access to eHealth Insurance helps people get the health insurance they want, and at the same time understand what they need. Just by supplying the zip code and basic information about the applicant, he/she can receive free quotations, figure out the plan appropriate for him/her, and gather enough data to make the correct decision on which health insurance to buy. There are certified insurance agents that will accommodate those who are in need of clarification and further explanations regarding their policy.
 
After the online application has been submitted for the plan or coverage, eHealth will work with the insurance company that the applicant has chosen, to speed up the approval process. eHealth Insurance will still continue forwarding the applicant’s concerns and questions to the health insurance company to ensure that any small glitch or query will not be left unnoticed. This ongoing service also helps the applicant with any future needs from the health insurance department. 
 
eHealth Insurance offers a wide range of options in health insurance products that applicants can choose from.
 
They have individual and family health insurance, which can benefit singles or families that weren’t able to acquire health insurance coverage through their employer. This kind of health plan is the most appropriate for individuals and families. They also offer Small Business Health Insurance, which is good for companies and/or organizations that have two to fifty employees. eHealth also offers short-term health insurance, which is good for temporary coverage. This is applicable to those who are between jobs or are fresh graduates, since the term of the policy is not that long, and therefore not that pricey. They also have offer student health insurance, which is good for full-time college students living far from home who are no longer covered by their parents’ policy. eHealth offers affordable dental insurance. They also have dental discount cards, which are another option for standard dental coverage. This is not considered an insurance plan, but it can give the applicant discounts to any dentist in the local area on several dental procedures. Lastly, eHealth Insurance offers health savings accounts.  
 

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08/05/2009

In the current health insurance system, Americans who are in employment pay for their portion of employer-sponsored coverage with pre-tax dollars that are automatically withheld from the workers’ paychecks.  For those who do not have access to employer-sponsored health insurance and must pay for policies on their own, they almost always use after-tax dollars to pay premiums.  This creates an unfair tax benefit for workers who take advantage of medical insurance through an employer and makes private health plans unaffordable for many working Americans.  One proposed solution to this problem is state-sponsored health insurance exchanges.
Statewide health insurance exchanges are a way to make healthcare more affordable for a wider audience of working people as federal lawmakers debate tax code reforms that would improve access to health insurance for more Americans.  Like the stock market, these exchanges would include all different kinds of insurers and provide a single market for all different kinds of insurance plans—traditional indemnity policies, HMOs, health savings accounts, PPOs and other options.  Exchanges could also include federal insurance programs like Medicare and Medicaid, thus protecting low income families and those with special medical needs.  Instead of offering health insurance from a single source, employers would designate the exchange as their preferred “plan” and pay their contributions directly to the exchange.  Workers would then be free to choose any of the participating plans in the exchange, thereby offering the opportunity to find coverage that best fits their circumstances.
Supporters of health insurance exchanges insist the system would save small businesses significant administrative costs as processes like enrollment, claims services and premium payments would be centralized and simplified.  This would allow businesses who have never been able to provide health insurance for employees the chance to extend this coverage to workers.  Furthermore, because employers would make fixed payments to the exchange rather than to individual companies, the possibility of coverage non-renewal, group coverage cancellations, and ballooning premiums are eliminated. 
Employees would benefit financially because all contributions to the exchange would come before taxes.  This would level the field for workers who currently have to provide their own insurance with after-tax dollars.  Because coverage would never be tied to a particular employer, people would have the freedom to carry a health plan from job to job without penalty or lapse in coverage.  Continuity of care and policy portability have been hailed as some of the most attractive options with statewide health insurance exchanges.
Statewide health insurance exchanges would ease the financial burden for many working individuals and families without requiring extensive intervention from the federal government.  The system would be a relatively easy transition from the existing model, a quick solution to the healthcare crisis, and would create significant improvement in access to healthcare for millions of working Americans whose employers do not currently offer group health insurance or for those who simply cannot afford personal insurance on their own.  If the federal government fails to enact widespread tax reform to remedy the predicament of healthcare coverage for working Americans, health insurance exchanges could be the answer.

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08/05/2009

Family planning, the process of delaying or accommodating pregnancy, is a growing concern for both health insurance companies and reproductive health advocates.  The main focus on both sides of the issue is what defines comprehensive care.  Traditionally, insurance companies have distinguished family planning care as providing customers access to contraception.  However, through activism and legislation, that definition is gradually expanding to encompass a wider range of preventative services.
In the current health insurance market, many states require private insurers who offer prescription drug coverage as part of their comprehensive health plans to include the full range of FDA-approved contraceptives.  This covers pills and injections as well as devices like birth control patches, rings and IUDs.  It is important to note, however, that 19 of the 27 states with these laws in place allow certain employers—like religious organizations or churches—to withdraw coverage for contraceptives for employees.  Furthermore, many health insurance plans do not offer equal coverage for these drugs; women may have to pay more out of pocket for birth control prescriptions than for other medications.
Perhaps the biggest complaint against private insurance companies is that the scope of coverage for family planning services is generally narrow and doesn’t include counseling, education, or many clinical procedures like contraceptive device implantation.  This often leads women to choose a method of contraception based solely on cost rather than suitability. 
While most private health insurance plans cover contraceptives on some level, all state-sponsored public plans are required by law to provide comprehensive family planning coverage.  These plans pay the full cost of prescriptions and many clinical services, allowing a large number of women, and especially the poor, greater access to care.  Yet these public health plans are not without their own problems. 
In many states the regular income levels for Medicaid eligibility are very low.  This excludes a large number of poor women simply because they are not “poor enough.”  Care is generally offered to women who already have young children, which does not help women who wish to avoid a first pregnancy.  Some states do offer Medicaid waivers that expand income limits and include women who do not already have children.  These waivers have proven moderately effective in reaching a greater portion of the population, but the area that remains lacking for Medicaid programs is provider reimbursement.  Delayed or incomplete payments negatively impact doctors and clinics, threatening the financial stability of these providers and their ability to care for patients.  Timely reimbursement would also encourage private physicians to work with Medicaid, thereby giving even more women access to quality family planning resources.
Family planning is a very personal issue that involves obtaining detailed information about a woman’s sexual history and reproduction objectives.  Services such as counseling, community outreach, education, language assistance and interpretation, and care that is sensitive to cultural differences are all integral to the process.  These services make up a more complete picture of family planning and reproductive care, and should be increasingly present as part of overall comprehensive health insurance packages, whether from private or public insurers. 

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08/05/2009

Business or group health coverage is defined as any type of employer-sponsored medical insurance for business owners, employees and their dependents.  The majority of Americans with health insurance have this type of medical coverage.
General requirements in most states identify at least two workers as a business and therefore eligible for group medical coverage.  However, some states set a lower threshold and a few even allow “business groups of one” which make it possible for sole proprietors to buy health insurance at group rates.  If you own your own business, check with your state’s insurance department to determine the particular regulations in your area.
With group health coverage, employers and employees split monthly premiums based on percentages.  Though there is variation across plans, in most groups employers cover the bigger portion of the premium, typically at least 50 percent.  There are different laws, benefits, coverage options and costs associated with small and large businesses.  Small businesses are generally defined as companies with less than 50 employees; large businesses have more than 50 employees. 
Whether a business is classified as small or large, group coverage has the same basic structure.  The employer chooses the plan that best fits the company’s needs and workers can either accept enrollment or seek other alternatives for health insurance.  Most group health plans are underwritten by a health insurance company, though some very large businesses can choose to self-insure health care coverage for employees.  This means that instead of paying premiums to an insurance company, the business sets aside funds to cover the cost of employee health care and therefore assumes all risks associated with benefits and claims.  A self-insured plan could drastically influence the quality of care you receive if you develop a serious medical condition or are significantly injured so it is wise to find out how your employer’s group policy is funded.  Regardless of the type of underwriting your employer chooses, however, all group health insurance is subject to state regulation.
With small group coverage, no employee can be turned down for insurance regardless of their medical history.  Plans must be renewed by the underwriting company each year provided the business complies with all the terms of the policy agreement; premiums are paid on time, there has been no fraudulent claims activity and no breach of contract.  This kind of coverage protects employees of small firms who might not otherwise have access to health insurance plans.
For large businesses, the rules are slightly more restrictive.  Large group plans can deny coverage based on employees’ medical histories and can exclude certain pre-existing conditions from the coverage offered.  In fact, whole companies can be rejected based on past-claims history, though once a policy is issued to the business every employee of that business must be included in the coverage.  Policies have to be renewed by the underwriter every year as long as the business complies with all the terms of the contract.
Companies that provide group health insurance for their workers are able to attract new employees, retain quality personnel and reap tax benefits.  No matter what the size of your company is, offering a group plan makes sense.
 

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08/05/2009

AIDS, or Acquired Immunodeficiency Syndrome, is a human immune system disease caused by the human immunodeficiency virus (HIV). This disease progressively makes the immune system ineffective, leaving a person susceptible to tumors and infections. HIV is transmitted through direct contact of a mucous membrane with a bodily fluid, such as semen or vaginal fluid, containing HIV. The transmission can be transmitted through blood transfusion, sex and contaminated needles.
 
Since 2007, AIDS has affected 33.2 million people worldwide and it has killed more than two million people, including an estimated 330,000 children. And while this virus progressively makes your immune system weak, being infected with HIV weakens your body’s capability of fighting against other disease-causing bacteria and viruses.
 
AIDS and HIV have no cure but treatments can slow down the course of the disease. People with HIV or AIDS should undergo the Antiretroviral treatment that reduces both the morbidity of HIV infection. However, aside from being expensive, these drugs are not available in many countries.
 
If diagnosed with AIDS, getting a health plan or being enrolled in a health program is indeed necessary.
 
There are some programs that provide assistance to people with AIDS. The AIDS Health Insurance Program (AHIP) is designed for those with AIDS or any HIV-related disease but not eligible for Medicaid and cannot afford an insurance. The AHIP pays for your health insurance premiums but excludes deductibles and co-payments.
 
To qualify, you must be ineligible for Medicaid and should have an insurance plan during the time of application. Monthly income should also not be higher than $2,096 for a household of two or $1,559 if single.
 
If your income disqualifies you from the AHIP program, you may also apply for the ADAP Plus Insurance Continuation Program (APIC). APIC, which started in 2000, is administered by the AIDS Drug Assistance Program of the New York State Department of Health. The program assists in paying health plan premiums of people with HIV. Individuals with an annual gross income of $44,000; a family of two with up to $59, 200; and a family of three or more with $74,400 may qualify. For individuals and families, the resource limit is about $25,000. If you are not qualified for AHIP but think you can qualify for APIC program, call Client Advocacy Helpline at 212/367-1125 from 2:00 to 5:30 p.m. weekdays.
 
Unlike Medicaid, AHIP does not count assets in determining eligibility. However, AHIP examines the income generated by the assets of the applicant. When determining eligibility, the income of the applicant’s assets is added to his or her monthly income.
 
Applicants should show proofs for eligibility. These include: birth certificate, naturalization certificate, green card or passport for proof of citizenship; SSI/SSD award letter, unemployment benefits statement or pay stub for proof of income; letter of diagnosis from doctor or M11Q form for medical documentation; and insurance premium or COBRA statement for verification of health insurance; and insurance card.
 
If diagnosed with AIDS or HIV, you should apply immediately or before your current health plan coverage ends. If you lose your health policy, AHIP will require you to purchase a new insurance.
 
To qualify, you must be able to complete the Medicaid application process. A relative or a friend can also apply for you and give you all your required AHIP documentation.
 

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08/05/2009

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08/05/2009

Many health insurers decline coverage for experimental medical treatments simply because there is not enough evidence of success to warrant deeming them medically necessary.  Because these treatments and medications cannot be established as effective for a large group of patients, the cost of covering them is not justifiable.  Yet for many patients, these investigative treatments and cutting-edge medications represent real hope for improved health.  If you have been denied coverage by your health insurer, request a written statement of exactly why your desired treatment has been rejected.  This will give you a starting point for working with your company and your doctors to get coverage for the treatment you seek.
When seeking experimental or investigative treatment, you are your own best advocate.  The first step is to establish that the treatment is indeed medically necessary in your particular case.  To do this, gather evidence to support positive outcomes resulting from the procedure or medication.  It is important to collect scientific or anecdotal support explaining that the treatment has been effective for others with your condition. However, it is more important to establish that you have personally exhausted all other options.  If you can show that traditional treatments or medications have not worked for you or have ceased working, this can go a long way to convincing your health insurance carrier to consider alternatives.  Furthermore, if you have been able to pay for your desired experimental treatment out of pocket or have participated in a clinical trial and have had positive results, showing documented proof of this can lend further credence to your case.
Educate yourself in the terms and language of your health insurance policy.  Read your policy carefully to determine how your insurer defines experimental treatment.  If the terms of your policy are vague, this ambiguity can work in your favor.  Your particular therapy may not be categorized as experimental, even if your claim has been denied.  If your health plan includes coverage for prescription medications, find out if your state has laws regulating off-label uses of approved drugs.  In many states, health insurance providers who offer prescription drug coverage are required to pay for any and all uses of the medications included in their plans, even if the treatments are non-traditional and as long as those uses can be proven to be effective or are supported by the scientific literature.
As a last resort, plead your case in terms of economic common sense.  Would it be more cost efficient for your insurer to pay for experimental treatment or a traditional course of therapy?  Could the investigational treatment be cheaper than not treating your condition at all?  Will the experimental treatment prevent a more serious, and potentially more expensive, condition from developing?  Work with your primary-care physician or specialist to determine the answers to these questions and take them to your insurer for consideration.
When you want experimental or investigational treatment for a medical condition, it is important to educate yourself, advocate for your health and work with trusted healthcare providers to help you get the coverage you need.

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08/05/2009

Mental health refers to how we feel, think, and act while coping with life. It also determines the way we handle stress, make choices, and how we relate to others. Everyone gets anxious, sad or worried sometimes. But, people with a mental disorder find it hard to control these feelings, and often these feelings interfere with their daily lives.  Fortunately, these disorders—schizophrenia, phobias, depression, bipolar disorder and many others—can often be treated. Therapy and medicines can improve the lives of those with mental disorders.
In the U.S., having a mental illness is very common; one in five families has a member with a mental illness. And, with the rising number of people with these disorders, getting mental health insurance has quickly become a hard-fought issue.  As of 2003, many states have passed laws that require insurers to offer mental health coverage, although a few may offer minimal coverage. Some states also have laws that regulate insurance parity to ensure that mental health coverage is as strong as physical health coverage. Lawmakers are still working on the national bill to improve health parity, hoping to regulate the mental health coverage offerings of insurance companies.
So, what are the necessary benefits one must be aware of in getting mental health insurance?  Until now, many mental health plans offer policy holders a limited amount of doctor visits and the deductible amount. But, before shopping for mental health insurance, it is best to first check the state laws to know what your rights are. In most cases, the coverage for mental illnesses requires a higher deductible and co-payments compared with the physical health insurance. If this is the case, try looking for cheaper options. If you have other insurance provided by your employer, an MSA, or a medical savings account may be the best choice for you.
People working for small businesses, with 50 or less workers, can access an MSA.  An MSA is also available to self-employed individuals, provided they have a high-deductible health plan.
Medical savings accounts can be used in mental health treatments along with your high-deductible health insurance plan, provided that it is your only health insurance. You may pay as much as $1,600 or more annually for every individual, and as much as $3,200 per family.  MSA can be used in paying your health care costs, provided that you are not in between jobs and do not have an income. The amounts you deposit into your MSA are tax-exempt, and you can also claim the amount you didn’t spend.
A Flexible Spending Account (FSA) is also another option for mental health coverage. An FSA works the same as an MSA except that these can be used even without a high-deductible insurance plan.  Workers whose employers offer a high-deductible plan are qualified to get an FSA. The disadvantage of this option, however, is that unused money cannot be withdrawn for non-medical expenses.
As the number of people diagnosed with mental illness increases, the need for mental health plans also increases. It is necessary to stay informed of new laws and health insurance company policies. 

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08/05/2009

Although not required, health plans for workers in small businesses are often provided by their employer. In good business practices, providing a health plan is usually used as an incentive to hire the best people.
 
A business with two to 50 employees is considered a small business. Many small business employers offer health plans through group health insurance plans that use organized medical networks such as Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Point of Service (POS) and the new Health Savings Accounts.  Each of these options has different characteristics that may affect your new health insurance choice.
 
Many employers get HMO plans because they have low premiums. PPO and POS plans usually cost slightly more but are more flexible, allowing workers to use their own doctor and medical care choices. The HAS plans, the newest option in the market, provides employers and workers with a way to save money through tax-free expenses.
 
A certain group of small industries can also join together to form a bigger group which acts as a “purchasing group” for health insurance. There are many Alliances or pools of small businesses types, some are even statewide. To form a pool of small businesses, check with your state insurance commissioner or your Chamber of Commerce. Although this is a great idea in many states, in some cases this may also not work best for you, depending on where you live.
How to lower the cost of my health insurance plan?
 
Lowering the cost of these health plans is always a concern for employers. Changing the deductible affects the premium employers have to pay every month. Additional coverage also affects the cost of the plan. Some small businesses include additional options, such as vision, dental and alternative medicines, which add more costs. Increasing the options and health benefits, increases the premiums. Moreover, health insurance plans provide two maximum limits that affect the premium price: the maximum limit over a person’s lifetime and the maximum limit for each claim. The higher limits also mean higher premiums.
 
When looking for more efficient but affordable health insurance for small businesses, there are certain points a business owner should consider. It always helps if you understand the types of medical networks used in group or business health plans, and the amount of the deductible you choose when setting up the health policy, as this also greatly affects how much you will pay for the premium. It also helps a lot to compare your final two options’ annual premiums and the approximate amount your workers will have to pay out-of-pocket, yearly. Check whether both you and your workers can afford the cost of the health plan. Considering the total costs of the policies, including the estimated out-of-pocket expenses of your employees, and the services offered by the policies will probably help you make a good decision on which type of group health insurance you will choose.  If you think you will be spending too much, having your small business become a member of small business alliance in your state may also help to access affordable health insurance policies.
 

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08/05/2009

About 50 million Americans are without health insurance.

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08/05/2009

Although California ranks second in terms of the highest number of uninsured children in the U.S., California is still one of the top states in the Agency for Healthcare Research and Quality list. It offers exceptional home health care and pain management quality.
 
Individual Health Insurance policies in California have different rules. One can be denied from getting health insurance because of pre-existing conditions, unless he or she is eligible for HIPAA. HIPAA eligible individuals cannot be denied individual health insurance and cannot be provided with pre-existing condition exclusion periods. They also do not have limitations on their health care insurance costs.
 
According to the California Department of Insurance, people with individual or group insurance that have no breaks in coverage for more than two months, must receive credible coverage from the new insurance company for their previous health insurance. Moreover, in California, individual health insurance cannot be cancelled if the policy holder gets sick. 
 
California also offers the Major Risk Medical Insurance Program that covers individuals for 36 months, who cannot afford individual health insurance policies because of a pre-existing health condition. But, after the given period, individuals who accessed the Major Risk Medical Insurance Program will be guaranteed an individual health insurance policy. This health insurance must cover all the policy holder’s medical needs for their pre-existing health condition, but with limits on their treatment costs.
 
The state also offers the Medi-Cal program to assist those with limited income.  Moreover, families with children who are 18-years-old or younger and who do not have health insurance may also purchase health insurance policies through the state’s Healthy Families insurance program. Eligible middle-income mothers and infants can also access affordable health plans through Access for Infants and Mothers.
 
Moreover, individuals, even those with a pre-existing health problem who apply for a group health insurance plan, cannot be denied. This means that if you change jobs, you cannot be denied group health insurance at your new job. You will also not be charged any extra fees, as long as you meet certain requirements.
 
In addition, small businesses with a small group of employees cannot be turned down by insurance companies.  But, if one in the group has a disease or has pre-existing condition, the insurer may charge a higher premium for the health coverage of the group. Small businesses with two to 50 employees or any business of any size may also purchase cheaper health plans through a statewide alliance or trade association.  The California Department of Insurance has the list of associations one may join for the purpose of purchasing cheaper health plans.
Pregnant women, who had group insurance for three months and suddenly lose it for certain reasons, may also get health coverage through some state programs.
Self-employed individuals in California cannot enjoy the health benefits provided by group health insurance, although they are allowed to join certain associations that may assist them in paying for health coverage.
 

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08/05/2009


Aside from skin cancer, prostate cancer is the major disease that affects many men in the United States. Erectile dysfunction and difficulty in urination are the symptoms of prostate cancer.
 
One of the most important risk factors that concern the development of the disease is age. Research show 70 percent of those diagnosed with prostate cancer are 65 years old and above. Research from the American Cancer Society also reveals that most of those diagnosed with this disease are African-American men. Genetic factors are also considered a risk factor. The number of relatives diagnosed with prostate cancer may correlate with one’s chance of developing the disease.
 
Health Insurance’s role in detection of Prostate Cancer
 
Since prostate cancer has affected hundreds of thousands of Americans, many researches have been done on prostate cancer. These researches reveal that men covered by health insurance are less likely to die from this disease. But this does not mean that men with health policies do not develop prostate cancer. The difference is just that these insured men diagnosed with prostate cancer have access to medical care, had examinations that detect the disease early, and had early treatments.
 
When purchasing a health insurance plan, make sure that the policy you are getting offers prostate cancer preventive care, and options for prostate cancer treatment.
 
Studies show that men over 50 years old, those whose family has a history of prostate cancer, and those who are considered “high risk” are advised to have an annual exam to detect prostate cancer. Detection of prostate cancer at an early stage enables one to have early treatments to prevent the spread of cancer. Preventive detection examinations for prostate cancer are: digital rectal exam and blood test called prostate specific antigen testing. Many insurance companies offer policies covering these preventive exams. Moreover, many states also require insurers to provide coverage on prostate cancer treatments.
 
Talking to a health care professional may help you see whether your health care policy offers coverage for preventative exams on prostate cancer. If it does not, it helps to purchase a health plan that does.
 
Treating Prostate Cancer
 
There are two popular ways in treating prostate cancer: radiation therapy and surgery. Many health insurance plans cover both; if not, however, at least to some degree. Coverage differs depending on the plan, thus, if purchasing a new health plan, make sure to talk to a health insurance representative to understand the coverage of your plan and the payments.
 
If undetected, prostate cancer is a threat to your health. Since early detection and preventive care is a life saver when it comes to any disease, a comprehensive health insurance plan is indeed necessary.
 
Insurance companies offer many options. Even if you already have the traditional health care plan through PPO or HMO, it may be of help for you to explore the benefits you can get from new health care options, including the High Deductible Health Plan. This plan, along with Health Savings Account or a Health Reimbursement Arrangement, offers a traditional medical coverage that is tax free. This helps saving funds for future medical expenses. Like any health plan, getting this type of plan also has advantages and disadvantages. Thus, talking to a health care professional before purchasing one is necessary.
 

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08/05/2009

For the purposes of this article, four types of health insurance have been identified.  A high deductible heath plan is private insurance with lower monthly or annual premiums than other types of insurance, but consumers pay greater out of pocket expenses for care.  A consumer-directed health plan, also known as a health savings account, combines a high deductible plan with a special, tax-free account that can be used to pay for medical expenses.  Private insurance is a plan provided by an employer, a trade union, or purchased directly by the customer and includes managed care plans like HMOs, but does not include military insurance.  Public health insurance includes state or federally funded programs like Medicare, Medicaid, and State Children’s Health Insurance Plans (SCHIP). 
A 2007 US Census Bureau survey reported that both the percentage and actual number of uninsured people decreased slightly between 2006 and 2007.  Despite this promising trend, the number of people who receive health insurance through public programs increased during that same period, from 80 million in 2006 to 83 million in 2007.  This could be due to any number of factors including turnover in the workforce as baby boomers retire or the current economic recession and subsequent job loss.
Of people under the age of 65, 43 million are uninsured.  This represents slightly less than16 percent of the population.  In this same age group, more than 67 percent of people who have health coverage own policies issued by private insurance companies.  Of this 67 percent with private health insurance, 17 percent are enrolled in a high deductible health plan.  Five percent of people with private medical insurance are enrolled in consumer-directed health plans.  Those enrolled in individual health insurance plans are more likely to have a plan with a high deductible than those who have group health insurance through an employer or trade union.  Citizenship has a significant impact on access to medical insurance, as foreign-born residents of the US are about two and a half times more likely to be uninsured than those born here.
Thanks to increased awareness of and access to state health plans for children, only about nine percent of children under the age of 18 are uninsured.  More than 60 percent of children are covered by private health insurance, while nearly 33 percent are covered under a public health plan backed by state or federal government.  Economic status clearly plays a role in a child’s access to health insurance, as children living at or below the poverty level are more likely than other children to go without medical insurance, either through a private or public plan.
Economic factors also affect the population at large.  Income level has been shown to directly correlate to rates of medical coverage.  About 25 percent of citizens with annual income of less than $25,000 do not have any health insurance, while the more affluent are likely to have at least some kind of health coverage.  The plan quality and percentage of the population increases in relation to income levels.     
 
 

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08/05/2009

In the U.S., breast cancer is a major cause of cancer-related death in women, second only to lung cancer. The percentage of breast cancer occurrences is high, with one in every eight women suffering from the disease. However, only one in 28 breast cancer patients die from it. Because breast cancer, like any other type of cancer, is one of the most costly diseases that require frequent treatments, having a solid health insurance plan helps you access the medical care necessary for overcoming this disease. Solid health insurance provides a better chance of fighting breast cancer, with access to treatments and early detection exams.
Breast cancer results from an uncontrolled growth of cells in the breast. These abnormal cells may also spread to nearby tissues and organs. The growths the cells form are called tumors.  Tumors can be benign or malignant. While benign tumors do not spread and are harmless, malignant ones invade nearby organs.
Both men and women can have breast cancer. Breast cancer may be cured if detected at an early stage. The best way to detect this disease early is through mammograms and breast exams. Women below 40 years old are advised to have a mammogram every three years, while women who are 40 years old and above should have this type of exam every year. Although breast cancer can be prevented, some uncontrollable risk factors may cause the development of the disease. The most important risk factor is having a family history of breast cancer or any type of cancer. Some lifestyle-related factors including not breastfeeding and having children at the risk age (30 years old) or beyond may also trigger the development of the disease.
Since breast cancer is a disease that affects many women, it is necessary for women to make sure that their health plan covers mammograms and other medical treatments and exams that may be necessary if diagnosed with breast cancer. Make sure that you purchase the right policy—one which covers chemotherapy, breast cancer reconstructive procedures, mastectomy, and doctor appointments.  By law, if a woman’s policy includes coverage of a mastectomy, it must also provide coverage for reconstructive surgery as well.
Insurance for Breast Cancer Patients
Individuals with cancer, whether it be breast or lungs, are considered “high risk” to health insurance providers. With different and more comprehensive medical needs, one insurance option for breast cancer patients is the high risk insurance, which is almost the same as individual health insurance, but generally covers comprehensive medical plans with a wide range of deductible options. A Preferred Provider Organization plan is the most common coverage option for “high risk” individuals.  The Health Maintenance Organization plans are also available in many states.
Women’s Health and Cancer Rights Act
Signed into law in 1998, the Women’s Health and Cancer Rights Act was designed to assist breast cancer patients who, after a mastectomy, choose to have reconstructive surgery.
Under this law, HMOs and other insurance providers that provide coverage for mastectomy procedures must also cover breast reconstructive surgery after the mastectomy.  Breast reconstruction includes the reconstruction or augmentation of the affected breast to provide a similar appearance with the other breast, breast prosthesis, and treatment or therapy for complications that may arise after surgery. 

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08/05/2009

Health insurance is a guarantee that whenever a person contracts a disease or suffers an accident he/she won’t have to pay the full payment for his/her medical expenses. Health insurance aids people in protecting themselves against costly or unexpected medical expenses. The mechanics of health insurance is that a person pays for an insurance policy that states what kinds of accidents or diseases the insurance company is willing to cover. If the person agrees to the coverage of the policy then the insurance company and the person have a binding contract. These can be purchased through private insurance companies or government-funded insurance programs. It can be acquired individually or by a group. Both ways aim to provide the individual with a less costly means of getting medical treatment.
Health insurance companies determine the kind of coverage a person or group might need. They determine this by looking at the age of the person, the kind of lifestyle he/she has, the kind of work they do, and the current state or physical health they are in. After going through these processes the health insurance company will determine how much the person would have to pay for his/her first premium.
The health insurance policy has several factors:
Premium: This is how much the insured (or if the individual is insured under his/her company, the employer will pay for this) would have to pay to acquire medical coverage. Deductible: This is how much the insured must pay from his/her account before the health insurer pays its share. For example, a policy-holder might have to pay a $500 deductible per year, before any of their health care is covered by the health insurer. It may take several doctor's visits or prescription refills before the insured person reaches the deductible and the insurance company starts to pay for care. Co-payment: This is the amount that the insured person must pay for from his own pocket before the insurance company pays for the patient’s visit to his doctor. Co-insurance: This requires the insured to pay a certain percentage of the total payment, which is agreed beforehand in the health insurance policy. Exclusions: This explains that not all treatments or services are covered by the policy. The insured person must also pay the full cost of non-covered services. Coverage limits: In some health insurance policies the health insurance company will only pay up to a certain amount. In case of extra charges, the insured person would be required to pay for that from his own pocket. In addition, some insurance company plans have lifetime or annual coverage maximums. If the insured reaches this limit he/she would have to pay for the rest of the expenses from his/her own pocket.

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08/05/2009


In the United States, a big portion of the immigrant population is uninsured. Approximately 50% of the non-citizens do not have health insurance. Purchasing a health policy can be difficult for immigrants, considering the fact that most of immigrants do not have high-paying jobs or work that provide them with health insurance packages. There are a few choices for immigrants to have access to cheaper health care. But it is necessary to take note that immigrants may not be eligible for health care programs administered by the government.
 
Though Medicaid helps assist people with low income, many uninsured non-citizens with low income are still not qualified for Medicaid in some cases due to some restrictions. The Personal and Work Opportunity Reconciliation Act (PRWORA) restricts legal immigrants from getting health benefits like Medicaid. Under this law, non-citizens who are living in the United States for not more than five years are not qualified for federal health care programs. Even after five years of stay, they can still be ineligible for these programs if they do not meet the income requirement. Immigrants who are undocumented are also not eligible for Medicaid.
 
Moreover, children immigrants cannot avail themselves of the health care benefits the State Children’s Health Insurance Program (SCHIP) offers. In the same case with Medicaid, PROWRA restricts immigrants from getting SCHIP benefits in the first five years of their stay in the US. They may still not qualify for the SCHIP for an extended period because of economic factors.
 
Because of these restrictions, it is easier for immigrants to purchase private health insurance only if they have sufficient income. Immigrants with higher income may find private health plan the best option if their employer does not provide them with health insurance benefits.
 
So, what are the options for immigrants?
 
Legal immigrants in the US can choose to buy group plans to save money. Group plans use some medical networks such as Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and the new Health Savings Accounts (HSA).
 
When choosing an HMO, you need to live in close proximity to where you are required to visit your primary care physician. An HMO plan is usually less expensive. Similarly, the PPOs and POSs use a medical network but offer a wider geographic area. Although PPO and POS encourage you to use health care within the network, with these plans, you may also be allowed to use out-of-network physicians. PPO and POS plans, however, are slightly expensive than HMO plans.
The Health Savings Accounts work similarly but it only requires a high deductible health plan and charges lower premiums. The money you saved with lower monthly payments is deposited into your Health Savings Account which you can use for your medical fees. For more information about the possible health plans you can get, talk to health care experts.
 
It is very important for all residents in the US, whether born there or immigrated, to have the means to pay for health care. In this country where health care costs are soaring at an alarming rate, getting a solid or comprehensive health plan helps a lot in reducing the burden of these costs.

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08/05/2009

Medical care costs can be quite daunting. That is why there is health insurance, to help you alleviate any pain or sickness you might have without breaking the bank. Health insurance policies are available in most companies. Generally, employees acquire this as soon as they become part of the company. Most employers avail their employees with health insurance policies, which are often structured as a managed care plan. These plans benefit employees with health care treatment and medical facilities at low costs.
 
Health insurance policies can also be acquired through the government, like Medicare and Medicaid. If you are able to meet the requirements of the government, these policies can be made available to you.
 
For further understanding about health insurance policies here are a few details:
 
What health insurance covers
 
A health insurance policy is a written agreement between the insurance company and you, in which you can access certain benefits, such as drugs, tests and treatment services. The insurance company agrees to handle the cost of certain benefits that are in your policy. These are called "covered services."
 
The insurance company also lists in your policy the forms of services that are not available to you. In an event that you suffer from a sickness or accident that is not covered by your policy you have to pay for the medical care that you acquire.
 
What a medical necessity is
 
A medical necessity is different from a medical benefit. A medical necessity is what a doctor will deem as necessary. A medical benefit is something covered in your insurance policy. There might be incidents that your doctor might decide that you require medical care that is not available in your insurance policy.
 
The insurance company will decide what drugs, services or tests they will avail to you. They base this on what kind of medical care each patient needs. This might mean that the drug, test or service that you require is not available in your policy.
 
What you should do
 
You should ask your doctor to study your insurance coverage carefully so that he/she can give you the treatment that is most appropriate for your coverage. Since there are so many insurance plans it is wise to study the details of each plan. When you have studied your insurance policy, you can help your doctor by suggesting medical care that is appropriated to your plan. Here are a few tips to better understand your policy:
Read and learn your insurance policy. It's wiser to know what your insurance company will pay for before you get tested, receive a service or fill a prescription. Your insurance company will have to approve the kind of care that you need before your doctor can give it to you. Forward your queries to your insurance company and ask a representative to clarify it with you. Always be mindful that your insurance company, not your doctor, decides what will be paid and what will not.

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08/05/2009

Today’s economic downturn has affected many aspects of people’s lives. Even purchasing a healthcare insurance plan became troublesome when it comes to finding the best plan at an affordable price. But despite this dilemma there are still ways for you to purchase a health insurance policy that will cover your basic needs at no burdensome cost. Here are a few ways to acquire the health plan:
 
Exhaust all options in your employer plan
 
If you acquired your insurance policy through your employer, study your coverage yearly when your company offers open enrollment.
 
Explore your options with your policy. Find out what it doesn’t cover and what it does. Determine what kind of service or treatment it offers and see if you can add more to it without breaking the bank. Study your deductibles, co-payments, lifetime maximum benefits, limits on out-of-pocket expenses and lifetime maximum benefits and prescription coverage.
Determine if your medical needs have altered. A plan with a lower co-payment but a higher premium is more advisable for people with health problems.
You can pay for health-care expenses with your own money by using a flexible spending account with pretax dollars, which means that the US government will pay for a third of the tab.
You can adjust the price of your premium through employee incentives, like quitting smoking, losing weight and exercising regularly. People with a healthy lifestyle have lower premiums.  
Less costly ways to purchase a health insurance plan
 
The health savings account is another way to pay for medical expenses from your own pocket. You can get an HSA through an employer if you purchase a high-deductible health insurance.
 
$2,900 is the maximum contribution of the HAS to individuals, while $5,800 is for adults. Your contribution is either deductible or pretax, even if it’s not itemized, and withdrawals and earnings for medical expenses are tax-free.
In this plan your money is invested, and what you don't spend will move over to the following year. If you change jobs you can take the account with you.
Use HealthDecisions.org, eHealthInsurance.com or HSA Insider to look for insurance that qualifies as highly deductible under IRS regulations.
The maximum age to make contributions is 65; afterwards taxable withdrawals for any purpose are permitted.  
For those who have a hard time coursing through the economic slump
 
Do not let insurance coverage lapse if you’re between jobs. If you’ve neglected to attend to your insurance policy and you’ve been without coverage for 63 days some provisions of the federal law will not apply to your policy.
 
The Consolidated Omnibus Budget Reconciliation Act, COBRA, of 1985, permits you to retain group coverage after the end of your job, for 18 months, but you will pay the entire premium. You should know about your rights under the state and federal law.
 
You can keep on contributing to your flex account under COBRA, giving you more chance to use the money.
You can use your HSA to pay COBRA or other health insurance premiums if you're receiving unemployment compensation.
Under certain circumstances, you can make penalty-free withdrawals from an IRA to pay premiums if you're unemployed.  

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08/05/2009

As health-care costs continue to rise and more Americans than ever are going without individual health insurance, health-care reformers and politicians alike are seeking new ways to address consumer trepidation.  A controversial new proposal aims to link rates for medical insurance to lifestyle choices such as diet, exercise and smoking.
According to a recent study conducted by the University of California, the average yearly cost of treating people for health issues related to smoking is about $72 billion.  A survey from the Centers for Disease Control found that another $75 billion is spent caring for people with medical conditions arising from obesity.  The cost of treating and managing these conditions contributes significantly to an overall increase in health insurance premiums for all insured people.  Some experts even suggest that poor lifestyle choices raise prices so much that they are a causative factor in making medical insurance unattainable for more than 50 million Americans.
Supporters of this plan suggest that people who make good decisions about their health, exercising regularly, maintaining a healthy weight, avoiding alcohol and drugs, and refraining from smoking, should benefit financially in the form of lower health insurance premiums.  They feel that people who are responsible and proactive about their health should not have to bear the burden of other peoples’ poor decisions.  Proponents often point to existing insurance discounts for preventative or safety measures, auto insurers give premium breaks to owners of vehicles with alarm systems, airbags, or theft recovery devices; homeowners can get insurance discounts if their residences are equipped with burglar alarms, smoke detectors, or sprinkler systems.  It has also been suggested that rewarding good lifestyle choices would not only encourage more people to take better care of their health, but would also increase competition in the insurance industry. This would have the added benefit of forcing health insurance companies to be more innovative in the benefits they offer consumers without compromising the quality of their coverage. 
Surprisingly, many health care insurers advocate these initiatives and cite numerous studies that seem to suggest that poor lifestyle choices decrease a person’s overall health, require more medical intervention and therefore increase the cost of health care for all Americans.  In fact, several health insurers have traditionally backed higher taxes on everything from cigarettes to junk food.
On the other side of the argument, controversy arises from the opposition who feel that the government does not have the right to interfere in individual choice.  They believe people should be able to live their lives as they see fit and should not be punished for their lifestyle preferences.  Furthermore, detractors worry that these types of incentives would create prejudice against certain groups, such as smokers or the obese.  Furthermore, opponents fear that those who struggle with addiction would not only be unfairly categorized, but would also find it more difficult to obtain treatment if they needed it.
Though a highly controversial proposal, rewarding healthy behavior is one example of how consumers are willing to at least explore different possibilities in an effort to make the cost of health insurance more affordable to the millions of Americans currently living without medical coverage.
 

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08/05/2009

Like accidents and calamities, a failing health condition is something that one does not wish to encounter. However, life does not always deal a fair hand and if one does encounter health problems and you need to be prepared. For those employed by companies, this may not be much of a concern, as companies have Health Maintenance Organizations (HMOs) for their employees. For the self-employed, whether voluntarily or not, individual health insurance is the option.
 
Individual health insurance is a health insurance type available to individuals, not to groups and organizations. Given the fast increase in the unemployment rate because of the current economic slump, many citizens seek cost-effective health insurance plans. The good news is that the variety and the affordability of the options available are rather pleasantly surprising, especially to those laid-off workers who seek an alternative to the costly Congressional Omnibus Budget Reconciliation Act of 1985 (COBRA) coverage. COBRA is a federal law which allows an 18-month extension of benefits to laid-off workers should they intend to continue buying the health coverage from their employer-sponsored plans within a defined period.
 
Applying for an individual health insurance is not without its drawbacks, however. In applying for an individual health insurance, one will typically be accepted if he or she is healthy and without any pre-existing medical condition. This, nevertheless, is to the advantage of an individual without any pre-existing medical condition, since individual policies are usually inexpensive.
 
Among the few organizations with data based on a national source is eHealthInsurance. The data of the organization best reflects purchasing patterns and prices in the individual health insurance market.

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08/05/2009

The food that we eat greatly affects our energy level, mood, the way we think, and how we relate to other people. Carefully choosing the right kinds of food may prove to be a challenge because of the wide variety of great tasting meals that surround us. More often, we eat more than what our bodies can actually burn. We consume excessive amounts of sugar, calories and fat, daily, which may lead to obesity and other health illnesses such as diabetes, hypertension and cardiovascular ailments.
 
Healthy eating does not mean being unrealistically strict about what we should eat. There is no need to deprive ourselves of the food that we love. We have to remember that food nourishes our bodies and energizes us. Maintaining a balanced diet means consuming the right proportions of carbohydrates, fats, proteins, fibers, vitamins and minerals. The food serving size will depend on your age, gender and level of physical activities. Increasing water intake is also a vital part of a healthy diet because it helps clean our systems of harmful toxins and waste products.
 
Choosing a healthy eating lifestyle also means widening our food choices by trying food that we don’t normally eat, including vegetables, fruits and whole grains. You can still enjoy the food that you love as long as you consume them in moderation. A nutritious diet and an active lifestyle will help reduce the risk of serious diseases such as cancer. It is also best to have a regular annual exam through your preferred Health Maintenance Organization to ensure that you are on the right track.
 

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08/05/2009

Finding a good broker is important when choosing the right health insurance coverage for your employees. A broker can present a number of health plans from different insurance providers. A vast number of options will enable you to make a comprehensive comparison of health insurance offers.
 
Rates of deductibles and co-insurance are valuable factors to consider when choosing a health insurance plan. A policy that requires a co-payment of more than 25% of the total cost of procedures is not a good insurance plan. A good health insurance plan should offer a range of services, as well as coverage for pre-existing medical conditions and long-term illnesses. Coverage should be at least $1 million. And, to further evaluate maximum reimbursement for health care procedures, check with local doctors to learn their rates.
 
The next thing to check is the insurers themselves. Standard and Poor’s website contains a lot of helpful information about the financial health of different insurance companies. An insurer’s claim payment history is also important to know. Nobody wants an insurer with a bad record when it comes to paying claims. Normally, a broker can help you out in this area.
 
If your business is a small one, your state’s department of insurance can help you to find health providers that provide coverage specifically for small businesses in your area. Another option would be consulting association plans or health purchasing alliances. Health purchasing alliances enable small business owners to avail themselves of group health insurance coverage at a lower price.
 
Whether you own a small or large business, the only way to get the best insurance deal is to do your homework.

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08/05/2009

The mental and emotional health of an individual plays an important role in a person’s success, whether in his personal life or professional career. People who are healthy, both mentally and physically, lead a fruitful and productive existence with other people in their community. They are able to face whatever challenges are hurled their way, build relationships, and contribute constructively to the group they are affiliated with. These mentally healthy people consider the problems they face as part of their day-to-day living and as a means to improve one’s character.
 
However, not all of us give much importance to our mental and emotional health. In fact, most of us take our emotional well-being for granted, only recognizing its importance when problems begin to arise and reach the point of deep depression. To prevent this, it is wise for individuals to make sure that they have health plans in place that cover not only physical health insurance, but also to support their mental and emotional needs.
 
In order to care for our psychological well-being, we should take the time to build and exercise on the areas where we need improvement. As with maintaining our physical health, we should also invest our energy in developing our mental health to make it stronger and increase its immunity from an emotional breakdown.
 
Being mentally and emotionally healthy, however, does not mean that a person will never encounter rough times and emotionally draining experiences. The true test in having a good and stable psychological well-being is the ability to face all the disappointments, loss, anger, and many other kinds of emotions, but still have the resiliency of being able to bounce back and learn from the experience.

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08/05/2009

The loss of group health insurance may not be a question of whether or not it will happen, but of when it will happen. When it does, as in any other undesirable situation, one must know what to do. Otherwise lack of information might add insult to injury. While there may be instances when this scenario is inevitable, the good news is that there are a number of health insurance options to be explored in case of the loss of group health insurance.
 
Each year, many adults under the age of 65 lose their health insurance coverage for varying reasons. These reasons include the death of a spouse, divorce, retirement from a job before reaching the age of 65, a decrease in working hours, and, of course, separation from the job. If any of these causes a person to lose their group health insurance, there are steps to counter the problem.
 
A person who has just lost their insurance may opt to find out if they can get COBRA benefits. COBRA stands for Consolidated Omnibus Budget Reconciliation Act, a federal law enacted in 1985 that can help them keep their insurance longer. Furthermore, because of the new provisions added to the law, a person’s cost for this continuing coverage under COBRA may not be prohibitive.
 
A person who is changing jobs may want to know about the Health Insurance Portability and Accountability Act of 1996, or HIPAA. This provides protection of one’s right to have insurance when moving from one group plan to another, as well as from a group to an individual plan.

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08/05/2009

As the green movement continues to sweep the nation—consumers are snapping up everything from hybrid cars to all-natural cleaning products—there is an increasing market for non-traditional medical treatments.  More and more Americans are seeking alternatives to conventional medicine to help prevent and treat various conditions.  This customer demand, along with the emergence of scientific evidence that supports the effectiveness of alternative medicine, has fuelled a shift in how many health insurance companies provide coverage for these services.  Progress has been slow, but is certainly leaps and bounds from where it was just a few years ago.
Alternative medicine is an approach to health that encompasses factors like herbal remedies, ancient cultural healing methods, and non-invasive or natural treatments.  The most common alternative therapies covered by health plans are chiropractic care, massage, and acupuncture.  Naturopathic medicine—treatments that include things like nutrition and diet, use of herbs, and holistic healing—is also covered by some plans.  Some health plans even cover things like guided meditation, homeopathic treatments, herbal supplements, and mind-body stress management.
Although traditional health insurers are broadening their coverage for natural or alternative therapies, there is still quite a wide gap between coverage for these types of treatments and more conventional medical intervention.  In health plans that offer coverage for alternative medicine, insureds usually incur some out of pocket expense for treatment—though usually at a much lower cost than if they had to pay without medical coverage at all—or are limited in the number of sessions insurance will cover.  If you are interested in exploring alternative or natural therapies, check with your health insurance carrier to see if they provide coverage and what the terms of such coverage are.
When you contact your insurance company, you should ask the following questions to ensure you have as much information as possible before making a decision:
-Is pre-approval, authorization, or a referral from my primary care physician required for alternative care? -What kinds of treatments are covered? -Will I incur any out of pocket expenses like co-pays, coinsurance, or charges for additional services or products like supplements, tests and supplies? -Do I have to choose a natural healthcare provider from a network? -What are the limits of coverage?  Are there caps on per-visit dollar amounts or number of visits?  Are certain medical conditions excluded from coverage?
If your health plan offers limited or non-existent coverage for alternative medical treatments, you may be able to increase or add this coverage by exploring options in your existing policy.  For example, some plans allow customers to use alternative therapies if they agree to pay a higher deductible.  There are also policy amendments, called riders, that some health insurance plans offer to customers that provide extra coverage for things like homeopathic remedies.  You may also be able to work with a provider in your insurance company’s network to arrange for non-traditional treatments.
It may take some investigative work, but if you desire alternative, natural or non-traditional medical therapies, there are options for this kind of coverage from many health insurance plans.  

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07/28/2009

President Obama might face another hurdle in his push for universal health care. This time, it’s not from lawmakers but from a recent paper on economics, which argues that health insurance makes people fat.


Authors Jay Bhattacharya and Kate Bundorf from Stanford University, Neeraj Sood from the RAND Corporation, and Noemi Pace from University College London all stated that Americans with either public or private health and medical insurance coverage have a higher tendency to become obese. According to weight-gain estimates in the paper, “private insurance increases body mass index by 1.3 points and public insurance increases body mass index by 2.1 points.”


Even before the paper came out, economists already mentioned that fat people are a burden on taxpayers.


According to a study that came out today, overall obesity-related health-care treatment costs have doubled in the last 10 years to $147 billion. The costs have even outgrown the obesity rates, which “only” climbed by 37% for the same period.


The new evidence supports the authors’ argument that health insurance is not just a simple transition of financial wealth from thin taxpayers to fat ones, but instead a “true economic subsidy for obesity.” The study suggests that obesity is literally encouraged by health care coverage. Knowing that insurance coverage provides protection against expenses caused by some weight-related issues, people tend to take weight gain for granted.


Even if the study only gathered weak evidence about more-generous coverage encouraging more people to gain weight, there is “strong” statistical evidence pointing to health or medical insurance coverage boosting obesity and body mass index.


The question now is how the universal health care system, which is still a work in progress, would affect the obesity rates of Americans in the near future.


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07/28/2009

President Barack Obama and other Democrats in Congress are pursuing a new health insurance plan. According to nonpartisan budget experts, this health plan would work with private insurance companies without forcing them to shut their doors.


Good news for Democratic ears, the Congressional Budget Office’s estimate comes as officials pushed for progress on the health care reform before the recess in August.


Democrats had a meeting on Monday afternoon with their allies in the House, and, according to House Speaker Nancy Pelosi, a floor vote may still be pushed through in the coming days. Meanwhile, negotiations between a small number of Republican and Democratic lawmakers resumed in order to find a compromise.


Democratic dissension has slowed the progress of legislative work from the President’s strict timetable.


Two weeks ago, Budget Office Director Douglas Elmendorf infuriated congressional Democrats and the White House with his statement in Congress about the House bill’s inability to control health care costs due to lack of mechanisms.


In order to disprove allegations that their proposal would make way for a federal takeover of the commercial and private health insurance industry, Democrats are now backing a suggestion from the budget office for a government insurance option that will not harm private insurance companies.


Given the unclear projections about how an actual reformed health care system would work, the controversy has yet to have an end in sight.


Poll results show that Americans favor a public coverage option as a component of the health care system reform. However, both employer groups and the insurance industry fear that a government-run insurance option will destroy private insurers.


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07/28/2009

July is nearly over and everybody is still having disagreements about the real progress of the health care reform legislation. According to Speaker Nancy Pelosi and White House officials on Sunday, legislation is progressing, however, their fiscally conservative allies are still less optimistic and the Republicans continue to oppose it.


On CNN’s “State of the Union,” Pelosi said, “When I take this bill to the floor, it will win. We will move forward, it will happen.”


North Dakota senator and budget committee chairman Kent Conrad expressed his opinion that a bill that only carries votes from Democrats is impossible and undesirable. “Look, there are not the votes for Democrats to do this just on our side of the aisle,” he said on ABC’s “This Week.”


Senate minority leader Mitch McConnell also stated on CNN’s “State of the Union” that, “The only thing bipartisan about the measures so far is the opposition to them.”


The White House originally wanted the legislation to be completed before Congress takes a break in August. Robert Gibbs, spokesman for the White House tried to be positive about the missed deadline: “We are enthusiastic about the progress that’s been made. We think we’re on the road to getting comprehensive health care reform by this fall.”


He also stated that even though committees from the House and Senate are considering different versions, 80% of the contents of a final version have already been agreed upon.


In a statement on CBS’s “Face the Nation,” Obama’s senior advisor, David Axelrod, similarly described the progress of the bill. “Now, we are at that final twenty percent. We are trying to work through those details.”


Health care reform has been at the top of Obama’s plans since he assumed the presidency. He wants every American citizen to have medical insurance as well as other health plans.


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07/28/2009

This week, President Barack Obama will be in North Carolina and Virginia to promote health care reform. During the recess next month, the president will be keeping Congress under pressure. The fact that 47 million people are uninsured in America is only one of the arguments that support health care reform. Another argument, which many people are unaware of, is the fact that 25 million people in the U.S. are underinsured.


John Stewardson wakes up very early in the morning and goes to work at the 602 union located in Washington, D.C. He’s home before noon as he needs to prepare lunch for Linda, his wife who is a cancer survivor.


"I'm just going to have to take medicine for the rest of my life," Linda said.


Last summer, she was diagnosed with a tumor in her brain; she is currently in remission. Now, the financial health of her family is at stake, as their group health insurance only paid $150,000 for the treatment. Their savings were demolished by the cost of the treatments, both for the cancer itself and for the side effects.


"It's like she fell out a cancer tree and hit every branch on the way down," said John Stewardson.


The family is around $100,000 in debt.


At the Senate, Sen. Chris Dodd is working to make health choices affordable. He is supporting the government’s insurance plan that would eliminate caps on health plans.


"The underinsured are a critical group," said Dodd. "In some cases, fifty-three percent don't know they're underinsured. So they either have huge co-pay if a problem happens or the deductibles are so high they might as well not have insurance."


John’s union only offered him one plan. After this reached its cap, they were left uninsured. Every day, John calls Medicare and his union to ask for additional coverage. So far, John has had no luck.


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07/28/2009

President Barack Obama currently travels the country to promote health care reform. Obama brought his campaign for the health care revamp to a public forum on Thursday near the Midwestern city of Cleveland, Ohio.


With the increasing number of Americans getting skeptical about his overhaul plan on the American health care system, and with the growing costs of health plans, the president has become more determined to gain support for his health care reform campaign.


“We can rescue our economy,” Obama said. “We can rebuild it stronger than before. We can achieve quality, affordable health care for every single American. That is what we are called upon to do. That is what we will do, with your help, Ohio.”


The president seeks major and bold changes in the nation’s medical care system that costs $2.4 trillion. The United States is the major industrialized nation that does not have a comprehensive health care system.


The president emphasized that changing the nation’s health care system can no longer wait. “We spend one of every six of our dollars on health care in America, and that is on track to double in the next three decades,” said the president.


But the Congress’ top Democratic lawmakers have left their plans to meet Obama’s deadline for voting on his reform. Senate Majority Leader Harry Reid said senators will not vote on Obama’s plan before their recess in August, as the president had wanted. Reid said more work is still necessary to come up with the right plan.


Obama stressed that there is a sense of urgency about the issue, saying “I have no problem, if I think people are really working through all these issues in making sure that we get it right. But I do not want a delay just because of politics.”


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07/28/2009

Robert Reich, the labor secretary during the Clinton administration, spoke to healthcare executives on Thursday in San Francisco. Reich said that Obama must “start knocking heads” on the health reform issue if he wants a bill from Congress by this fall.


He also said that the president has learned from Bill Clinton’s mistakes. Unlike Clinton’s reform proposals in the 1990s, Obama did not send Congress a bill that he knew would not be passed at all.


Reich also said that Obama should have begun working on the issue two weeks in advance. Obama is now at risk of Congress adjourning and leaving the bill unsettled. With this, the opponents of the package will have time to plan their attacks. Reich was the speaker at the Leadership Summit that was sponsored by the American Hospital Association and Health Forum.


Even so, Reich said that “you will see an Obama bill.” He added that “Obama will play his cards” when a Senate and House joint committee works on the legislation. Reich is now a professor at the University of California, Berkeley. He is a regular commentator on political policy and economic issues.


Reich also said that the president will be adamant in adding standards to the insurance of medical malpractice. He also said that Obama as well as Obama’s allies are now more interested with HMO-style pre-paid health care and the accountable care provided by integrated systems such as the Cleveland Clinic or the Mayo Clinic. Obama and his allies are becoming aware that offering coverage to those who are uninsured is only a piece of the health reform puzzle.


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07/28/2009

According to health officials and doctors, adult vaccinations and the issues surrounding them are some of the numerous problems that haunt legislators as Congress continues to work on the health care reform.


In a survey released by health officials, only a small number of adults are aware that they can avail themselves of vaccines against meningitis, tetanus, whooping cough, pneumonia, and shingles.


Experts however believe that demand and awareness are just tiny bits of the whole problem. According to Dr. William Schaffner from Vanderbilt University in Tennessee and the National Foundation for Infectious Diseases, the health care system is a hindrance to vaccination. Not all medical insurance and health plans provided by companies cover vaccinations, doctors are paid only minimally for administering them, and nobody can ensure the availability of vaccines.


In a news conference, Schaffner said, "They system is cumbersome almost to the point of not being able to get the vaccine."


Schaffner, along with vaccine experts, is hoping for Congress to tackle vaccination issues in the health care reform legislation. He said, "More than $10 billion a year is spent in direct medical costs and indirect costs" to treat pneumonia, meningitis and influenza. “These diseases can be prevented through vaccination.”


A survey of 22,000 U.S. adults released by Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention indicates that most adults in the U.S. don’t get the necessary vaccines.


Dr. Anne Schuchat further stated in the news conference that, "About half of adults had received a tetanus shot within the past 10 years." People should get tetanus vaccines every 10 years.


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07/28/2009

Lawmakers in Connecticut are moving forward with their plans to establish universal health care, as there has been no federal legislation on the issue. This move follows Massachusetts’ pioneering law.


Currently, President Barack Obama’s administration and the Democrats in Congress are struggling to rally support for a plan to provide health care for a large number of Americans. Connecticut is part of a small minority of states that are planning to create universal health care independently. The state is aiming to improve the system that has caused more than 40 million Americans to be left uninsured.


On Monday, Republican Connecticut governor Jodi Rell’s veto was overridden by the state legislature, which is controlled by Democrats. A board composed of nine members will be created to develop a system for universal health care in the state. On January 1, 2011, this board will be giving lawmakers recommendations for the health care plan. Called SustiNet, the plan will cover almost all of the 3.5 million residents of Connecticut, including the 350,000 residents of the state who do not have coverage.


In 2006, Massachusetts enacted a law that made health coverage compulsory. It was the first state to do so in the U.S., and it brought health coverage within the reach of people who cannot afford it by providing subsidies and by reforming the industry. Maine and Vermont are also in the process of advancing their health care reforms.


Connecticut will be building a system around a health insurance pool that includes employees of the state and Medicaid participants. The pool would eventually be expanded to include private employers and residents who require individual health insurance.


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07/28/2009

Expensive premium costs are the main reason being cited by millions of US citizens as to why they cannot avail themselves of individual health insurance policies, according to a recent study published in “Health Day News” last Tuesday.


Approximately three out four people want to buy a policy but are not able to get one because the cost of the premium is prohibitive, based on a report by the Commonwealth Fund, which is a foundation that financially supports an independent research on health insurance reform. Around 57 percent admitted that finding coverage they could afford is bordering on very hard to downright impossible.


A survey conducted for the report also cited that 47 percent of the respondents said that finding the plan with the coverage they needed was difficult or impossible. Another 36 percent stated that they were charged additional rates or their application was denied due to a pre-existing condition. Some companies had their condition excluded from their coverage altogether.


The report, called ‘Failure to Protect: Why the Individual Insurance Market is Not a Viable Option for Most US Families, compared the experiences of adults in the working-age bracket who have employer- and individual-based private health insurance.


In the report, it was also found that people who acquired health insurance individually pay more money on deductibles and premiums than those with group or business health care coverage.


Among US adults who have individual insurance, the survey showed that 64 percent spend more or less $3,000 on premiums annually, while only 20 percent of people who have employer-based insurance are spending that much.


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07/28/2009

These days, young adults are learning about individual health insurance the hard way.


Sarah Posekany, a 27-year-old nursing student, was forced to file for bankruptcy. She underwent colon surgery and she was uninsured. Posekany is still in debt and she owes a medical bill of thousands of dollars.


"It's not fair," Posekany said. "We should learn how to be a strong nation and take care of everybody."


Katie Miletti is a 24-year-old college student. Although she survived cancer as a child, she still has to deal with her treatment’s side effects. She was removed from her mother’s policy, as she was already too old. For one month, she was left uninsured. She later qualified for Medicaid, a federal-state program for health insurance.


"Everyone should have health insurance," she said. "I don't think it should matter what your health problems are, how rich you are, or what your income is."


Called “the young invincibles” by the insurance industry, these young adults think that they will never get hurt or sick.


Nick Bernstein felt that way once, too. Bernstein became a waiter to pay off his college loans. He also planned to get a wine-production graduate degree. He filled his leisure time with snowboarding and backpacking.


While snowboarding last April 1, Bernstein had an accident, which left his collarbone broken.


At first, he wasn’t sure if he had insurance at all. Fortunately, his stepfather’s health plan was still able to cover a part of his $27,000 medical bill. However, this coverage might stop before he gets well. He was diagnosed with a staph infection. As he is incapable of working now, he still has to find a way to get insurance before his 25th birthday, as he will be dropped from the policy of his stepfather.


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07/28/2009

UnitedHealth Group plans to acquire Health Net’s subsidiaries in the Northeast for $510 million.


Announced by the two companies on Monday, the acquisition will strengthen UnitedHealth’s networks in New York, New Jersey, and Connecticut. Based in Minnetonka, the health plan and medical insurance provider generates the most revenue among health insurers in the nation.


Jay Gellert, chief executive of Health Net in Los Angeles, expressed his confidence about the deal. "For our members, this offers a very, very good alternative. We have confidence [UnitedHealth] will do first-rate by our members."


Health Net will continue its operations in Arizona and in western United States. The deal, which needs regulatory approval, is expected to be completed within a year.


New York, New Jersey, and Connecticut have around 578,000 Health Net members combined. 437,000 of them are risked-based commercial members and 35,000 are self-insured commercial members. Another 55,000 are Medicare Advantage members, while the remaining 51,000 are Medicaid members. Operations in those areas are expected to generate $2.7 billion in revenue.


Jeff Alterm, UnitedHealth chief executive in the Northeast, talks about the company’s reputation in the region. "We have a long, successful history of serving people in the Northeast and are committed to responding to local market needs while also providing people with access to the innovative health care products, programs and technology applications of a company with a national scale."


Health Net’s Medicaid and Medicare businesses, along with the commercial membership renewal, will cost UnitedHealth around $60 million. Once the deal is closed, UnitedHealth will pay Health Net another $290 million. The remaining $160 million will be paid within a span of two years.


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07/28/2009

Michigan state employees have already dropped their health benefits, Gov. Jennifer Granholm said today while giving a cold shoulder to House Speaker Andy Dillon’s plan to pool some 400,000 public employees covered by individual health plans to help the state save money.


Last week, Dillon, D-Redford Township, claimed this bold health care reform will help the state save as much as $900 million per year. Dillon further said this plan would provide insurance for retirees and local employees who would be covered by a single health plan that would provide extensive health plan options for individuals, depending on the premiums they can afford.


“Show me the money. I do not know where the savings come from,” Granholm told the reporters. She further said she had not seen the details of Dillon’s proposal. “I haven’t seen the legislation and I have a million questions about it,” she added.


The proposal evidently does not work for Granholm. She said it will never resolve the state’s financial problems. She doubted that bigger pools of workers will help the state save money, noting that the state currently has 55,000 employees that belong to big insurance pools.


She further added that she believe that Dillon was wrong to say that state employees pay less for health insurance and receive better benefits than those in private sectors. Granholm then cited last year’s House Fiscal Agency report that reveals that state employees have lower wages and receive fewer benefits than private sector employees.


In a prepared statement, Dillon replied to Granholm, saying, “Change is never easy—there will always be countless reasons not to change. But one thing is clear: business as usual isn’t working.”


He suggested lowering government expenses to prevent layoffs, and decreasing college scholarships. “We need leaders like Governor Grandholm, Senate Majority Leader Mike Bishop and others to work together in the days ahead so we can turn Michigan around,” Dillon said.


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07/28/2009

President Barack Obama continues to push for the overhaul of the U.S. health care system. He says that this matter cannot be delayed because it would affect “the stability of our entire economy.”


In Obama’s weekly Internet and radio address, he urged the Representatives from the two parties to work on laws that will decrease costs and regulate the “unwarranted giveaways to [health] insurance companies in Medicare and Medicaid,” while keeping the Americans’ health care options intact.


Obama added, “This is what the debate in Congress is all about: Whether we’ll keep talking and tinkering and letting this problem fester as more families and businesses go under, and more Americans lose their coverage, or whether we’ll seize this opportunity.”


Obama is ramping up this health insurance reform campaign, as he is set to hold two legislation events for the press this week. He will gather the Representatives to the White House for deliberations, and will hold a primetime press conference on July 22. The House and Senate are hard set to meet Obama’s August deadline, as he urges them to act on legislation before the coming congressional recess.


According to Obama’s recent statements, he will deny support on legislation that would add to the deficit.


“I don’t believe that government can or should run health care,” Obama remarked. “But I also don’t think insurance companies should have free rein to do as they please.”


Obama wants a final bill in about two months time, by October. Certain members of both parties criticize Obama’s action timetable for this health care overhaul campaign as “too ambitious.”


Jon Kyl, Arizona Senator, commented in the Republican weekly address on radio: “Something this important needs to be done right, rather than done quickly.”


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07/28/2009

Aside from mortarboards, graduating college students have other things to think about.


A report from the National Association of Colleges and Employers estimated that this year, at least a million alumni pulled out from their parents’ health insurance coverage after graduating. Because of financial shortages, former college students are having a hard time getting replacement insurance policies.


According to Jon Gabel, graduates should go for health insurance plans offered by employers. The senior fellow from the University of Chicago’s Opinion Research Center—Health Policy and Evaluation Department also added that it is the most affordable health plan for fresh graduates.


But the thing is, landing a job in today’s struggling job market is difficult. NACE says that around 2.5 million fresh graduates are unemployed. Samantha Whiteside, a 24-year-old graduate of health and fitness from Virginia Polytechnic University, is one of them.


After graduating last year, she had a promising career outlook after getting a job in an outpatient rehabilitation center around March. She worked as a technician as well as a wellness instructor for seniors with mental illness. Her employer promised that she would get health insurance benefits after three months. However, she was fired three days before her fourth month began.


“I've never been in this situation before," she said. "I know everybody's been saying that the economy's bad … but I never thought it would happen to me."


She is currently working as a part-time swimming instructor. Marla Whiteside, her mother, got her an individual health insurance plan for $96 per month. Even though the plan would only cover 70% of hospital bills, it’s better than having no coverage at all.


According to Cheryl Fish-Parcham from Families USA, graduates should not be part of the uninsured population.


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07/28/2009

A considerable amount of the American family’s budget is spent on medical insurance. The USA government alone allocates over $2.2 trillion yearly or $8,000 per person on health plans to ensure healthy workers and a productive economy. It is projected that the amount the government spends on the health care system will increase to more than $4 trillion by 2017 if no program for the reform of the system is enacted.


President Obama has initiated ways to modernize the system of health care in America. The Recovery Act of 2009 includes a provision for the citizens who have recently lost their jobs, which will provide a tax credit that will continue their health insurance contribution through COBRA. He also signed a law that supports health plan coverage for children through the Children’s Health Insurance Program (CHIP). The president has also pushed for the computerization of health records in the United States in five years in order to make the system more efficient and more accurate. The government will save much money if the paper-based records, which are time-consuming and expensive, are replaced with a computer system that will deliver speedy results with minimal or no errors.


The government also seeks to uplift the research and development of the current health system. The Recovery Act has also allocated $1.1 billion for comparative research that details data on the effectiveness of a medical treatment or procedure. This will aid the doctors in proper diagnosis and treatment of their patients. Programs on wellness will also be promoted in the country because almost one-third of illnesses are attributed to poor lifestyle choices. This will reduce the risks of acquiring diseases, such as hypertension, cardiovascular ailments, and cancer.


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07/28/2009

Aetna expressed its support and concern for the welfare of college students in terms of health care. Head of Aetna Student Health Kate Begley said, “At Aetna, we work closely with campus health and counseling centers, as well as community and travel service providers, to offer students access to convenient care at an affordable price, no matter where they are located.”


Most parents find summer the ideal time to ensure the academic and financial preparedness of college students for life on campus. This is also the time when vital decisions are made. What is often overlooked, however, is student health insurance. Aetna encourages parents to view a student’s health insurance options as one of the important considerations when they prepare their children for college education.


Kate Begley further said that they “support the efforts of colleges and universities to ensure students have access to affordable, quality health care.” Aetna also gave tips to parents who are in the process of selecting a student health insurance plan. These tips include weighing the option of carrying a dependent on one’s plan against the benefits of a school plan; identifying a health-care contact on campus by reviewing the school’s website and visiting the campus health center; and understanding the health insurance requirements of the school.


"Choosing a student health insurance plan that is right for your child is a personal decision and one that should be examined carefully, particularly in today's uncertain economy," added Begley. "Evaluating the true cost, meaning the premium plus out-of-pocket expenses, of a family plan versus a student health plan is critical to understanding which plan is most cost-effective and will best serve the needs of your college student."


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07/28/2009

The White House and the Democrats in Congress who are working hard on the health care bills to beat President Obama’s deadline, are trying to keep legislation costs to $1 trillion for 10 years. But would that be enough?


There is no doubt that $1 trillion would cover a lot of uninsured people. However, it will not be enough to meet the goals that the advocates initially wanted. Congress is currently working on proposals that include a $1.042 trillion bill that will be presented by Democratic leaders in the House on Tuesday. The proposals intend to provide subsidies to a smaller number of moderate-income families. They will also prevent most workers from abandoning the health plans provided by their employers.


According to the Congressional Budget Office, the estimated number of uninsured people will go down to 15-20 million after 10 years. As of now, around 50 million people are uninsured.


Last Monday, Senate GOP leader Mitch McConnell stated that "One of the major concerns that Americans have about health care reform is the price tag. Every proposal we've seen would cost a fortune by any standard."


In defense of the health care reform, President Obama says that the overhaul is a crucial investment toward fixing the nation’s dysfunctional health care system. Straightening the rough edges of the current health care system would prevent financial problems in the future.


Lawmakers are still trying to figure out how to finance the overhaul. According to Obama, fixing the health care system will not increase the country’s financial deficit, and to offset such a deficit there will be a need to either raise taxes or cut national spending.


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07/28/2009

This news bit goes out to parents and professionals alike. It’s time we stop using that “toothache excuse” for school and office absences, the American Association for Dental Research (AADR) says. In the Oral Health Care Within Health Care Reform policy statement issued by the association on July 14, 2009, it was stressed that the need to attend to one’s oral and dental aches is urgent, as poor oral care can result in other serious problems—health-related and not.


According to the AADR, U.S. employees take 164 million hours off from work in a year, only to attend to a toothache or a gum irritation. Similarly, children are absent from school for 51 million hours a year, to be free from dental pain. The association has concluded that these periodontal diseases create the same full-body inflammatory response as other internal ailments would, yet they receive much less attention. The AADR claims that many Americans—more than 80 million, to be exact—have applied for medical insurance, but not for dental insurance.


In line with this, the association recalled what the U.S. Surgeon General mentioned in 2000. Back then, the Surgeon General called upon everyone to recognize the importance of oral health measures. He even proposed that lawmakers \"build an effective health infrastructure that meets the oral health needs of all Americans and integrates oral health effectively into overall health.”


Today, the AADR recommends that continued information dissemination regarding accessible and affordable oral health insurance must be conducted among Americans, if that would mean better oral health and, in turn, general health, as well.


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07/28/2009

After Wal-Mart pledged support for the proposal that requires employers to contribute to their workers’ health insurance costs, the National Retail Federation is asking its members to oppose Wal-Mart’s stance on the issue.


In a letter issued by NRF chief executive Tracy Mullin, group members are urged to “Come out swinging.” He added that, “To truly lead on the health care debate, it is imperative that businesses, associations and politicians take a stand where it counts and not shy away from deal-breakers like employer mandates.”


The letter shows the different views of companies toward the health care reform, which aims to cover the uninsured.


Different companies have allowed trade groups like the National Retail Federation, the largest trade group in the industry, and the Chamber of Commerce, the biggest business lobbying organization in the country, to spearhead the opposition to the health care plans in congress. Wal-Mart isn’t part of the NRF.


In a June letter to the senators in the drafting committees, the NRF said that it would prompt its members to oppose politicians who support an employer mandate. Meanwhile, the Service Employees International Union, Wal-Mart, and the Center for American Progress sent their own letter to the White House, voicing their support for a company mandate that will urge employers to provide health benefits like group health insurance to their employees.


The letter was signed by Michael Duke, president and CEO of Wal-Mart, Andrew Stern, president of SEIU, and John Podesta, president of the Center for American Progress.


The NRF is not alone in expressing opposition to Wal-Mart’s stance. In its letter to the White House, the United Food and Commercial Workers Union raised questions about Wal-Mart’s position.


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07/28/2009

House democrats unveiled an extensive plan for a bold reform of the nation’s health care system. Contained in the 1,018-page bill are provisions on regulating the health insurance market, formation of a new health insurance option run by the government, and other steps for implementing universal health coverage.


The bill sets out initiatives for reducing health care costs, which are expected to rise to $2.5 trillion this year. In addition, the cost of the legislation, which is estimated at $1 trillion, will be offset with a new tax to be imposed on wealthy Americans.


The proposal, which is considered one of the most liberal in revamping the system, was criticized by Republicans and 30 leading business groups, although many of these also showed support for some aspects.


If implemented, employers will either provide medical insurance to their workers or pay the government a fee based on their payroll. Small businesses with an income below $250,000 will be exempt from paying the fees. Also included in the plan are regulations prohibiting insurance companies from denying Americans with pre-existing medical conditions. This is to ensure more affordable options for everyone.


All low income Americans will also become eligible for Medicaid, and private insurance companies will be offering a standard universal benefit package designed by the government.


The Congressional Budget Office (CBO) estimates that 97% of Americans, including legal immigrants, will have health coverage by 2019. Furthermore, the CBO estimates that nearly 162 million people will have continued employer-provided insurance and 30 million people will avail themselves of health coverage through the new health insurance exchange. Nine million of those who would avail themselves of the new exchange are expected to choose the new health program run by the government.


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07/28/2009

Health Net Inc. suffered a major disappointment when the U.S. Department of Defense awarded its $2.8 billion annual military Tricare contract to Aetna Inc, another Health Maintenance Organization (HMO).


Estimated to be worth around $17 billion, the contract includes five one-year options along with a 10-month base period. The contract will provide service to millions of personnel in the military, National Guard and Reserves, dependents, and retirees in 20 Midwest and East Coast states.


The Tricare military health care program involves 900 of Health Net’s 2,500 employees. The devastating news had a negative effect on the company’s stock, which fell by around 15%. However, it managed to close at $145.13, down only 3%.


In a press statement, Health Net Federal Services president Steve Tough expressed the company’s disappointment about the decision of the Department of Defense.


“We anticipate that a debriefing will be conducted within the next couple of weeks. We will consider the information provided at the debriefing, and within two weeks following, we will determine whether we will accept or challenge the award decision.”


Another health care provider that lost a government contract is Humana Inc. After an extensive bidding attempt, the company lost its $3.73 billion annual contract that covers 10 southern states. The contract was awarded to California PacifiCare’s parent company, United Health Group Inc.


TriWest Healthcare Alliance Corp. was the only company to retain its $2.9 billion annual contract. It provides services to military personnel located in 21 Western states.


In 1988, Health Net won a pilot contract to provide service to military personnel, retirees, and dependents in Hawaii and California. Aetna got the contract in 1993 and, after three years, Health Net won it back.


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07/28/2009

Health insurance costs in Alabama have increased by 95% since 2000, according to the Health Care Status report.


The report reveals that the number of small businesses or companies providing health coverage benefits to workers dropped by two percent since 2000. Currently, only 48% of small employers in Alabama offer health benefits to workers.


The soaring costs of health insurance have affected individuals as well. According to the report, 28% of middle-class families spend at least 10% of their total income on health care.


A related study found that the limited options offered by health insurance companies is an issue related to these rising costs. According to the study, BlueCross-BlueShield controls an 83% share of Alabama’s health insurance market. Roughly, 13.6% of Alabamians are uninsured.


Options for health insurance are even more limited for individuals with pre-existing conditions. In Alabama, the costs of health insurance vary based on health status and demographic factors. Coverage can also exclude some pre-existing conditions or even be completely denied.


The report also says that 16% of people in Alabama do not visit a doctor due to the high costs. Moreover, families and businesses in Alabama pay a hidden health tax of about $600 each year on premiums to subsidize the costs of the uninsured.


Currently, approximately 2.9 million people in Alabama avail themselves of health plans through their jobs. Subsidized by their employers, these people have an average family premium of $12,230.


Based on the Health Care Status Quo report, the need for health care reform in Alabama and across the U.S. is clear.


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07/13/2009

Despite the continuing support for President Obama’s health care reform, some of the major players in the debate are beginning to worry about the overhaul’s success. They fear it won’t be sufficient to solve the problem of runaway medical costs.


Some even believe that the deals the White House made with drug makers and hospitals to keep the negotiations alive could make the problem worse.


On Monday, there will be a closed-door meeting between labor leaders and Obama. They will discuss aggressive measures to keep health care costs from escalating. Terry O’Sullivan, head of the Laborers' International Union of North America, expressed his support of the plan to have everyone covered by medical insurance, and at the same time his concerns about the reform.


"We are certainly for expansion of coverage. We think every American ought to have health insurance. But if that doesn't come with making sure there is real prevention, if we're not talking about really controlling healthcare costs, this is going to be a train wreck."


On the other hand, business groups are urging the current administration and its allies in Congress to tackle the cost issues by making changes to the way doctors, hospitals and providers are paid.


According to Steve Wojcik, the National Business Group on Health’s vice-president for public policy, “Going into health reform, there was a lot of talk from the president on how controlling costs had to be on a par with expanding coverage. The priority on controlling costs seems to have fallen by the wayside."


Consistent survey results point to the public’s biggest health care concern: rising cost of medical bills and health plan premiums. At the core of his campaign for health care reform, Obama insists that his health care reform will provide relief.


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07/13/2009

Brian Urban, an insurance broker, refused to believe a caller who told him a story about an owner of a small business in Nebraska who couldn’t afford health plan premiums because it would require him to pay around $24,000 to $40,000 annually.


Urban said, “Just the size of the numbers was far out of what the market would dictate even for someone with some severe medical conditions. And according to the story, these were healthy individuals.”


The Nebraska health insurance market is a familiar territory for Urban since he is the CEO of Corporate Resource Group, as well as the legislative chairman in Nebraska for the National Association of Health Underwriters.


33-year-old Larry Harbour was the man who complained about the high cost of premiums. As the owner of LB Custom Chrome and Detail in Nebraska, he tried his best to find affordable insurance coverage. In a phone call, Urban offered to get Harbour affordable premiums.


Harbour, who was happy to hear Urban’s offer, described the search for health insurance as “very confusing.” “It's very tough to understand unless you have someone, so to speak, holding your hand and walking you through the process.”


Urban’s phone call was the first of many geared toward helping Harbour find affordable business health insurance coverage. “According to the story, he was uninsured, and I don't find that acceptable. It's my job to make sure that as many people are insured as possible,” Urban said.


Urban also made a comment about how confusing premiums affect the health insurance debate. “We're not opposed to reform. It's just that we want to make sure we're dealing with real-life facts and numbers and that reform is focused on the areas it's truly needed.”


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07/13/2009

As the U.S. government continues to work on reforming the country’s health care system, business groups fear that many small companies throughout Southeast Valley would be forced to shut down.


The senate proposal for the bill on health care reform would compel employers to provide business health insurance for their workers. Otherwise, they need to contribute a fee worth 8% of their payrolls for a government-managed insurance plan.


Via Homes president, Trudy Licano, said that "A lot of times legislation is meant to help people, but this could shut doors. There's going to be a pretty huge impact on us. Some businesses just can't afford it."


Under the said bill, employers who will provide insurance for their workers would be required to cover 72.5% of the premium cost for full-time employees and 65% for family policies. Companies are also required to insure their part-time workers. However, some businesses would be exempted depending on their size, which has yet to be determined.


Mary Ann Miller, president and CEO of Tempe Chamber of Commerce, explained the possible effect of the proposed health bill to the business sector: "I think that most businesses would love to be able to provide health insurance to its employees, and do so wherever they can. But mandating such coverage will only drive up costs for businesses of all sizes during tough economic times."


Last month’s proposed bill was described by the U.S. Chamber of Commerce as "a dangerous proposal."


According to Jack Alspaugh of the Arizona Small Business Association, companies with less than 50 employees will find it difficult to balance efforts between providing coverage to their employees and maintaining their payrolls.


The Senate and House members are still working out the details of the bill, which President Obama wants to sign by fall.


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07/13/2009

Due to the soaring cost of health care, small businesses in Utah are now ready to embrace a health care reform, including the government-run insurance option, just to offer health care subsidy to their workers and earn a profit.


A recent survey reveals only 40% of the 300 randomly chosen businesses provide health care insurance to their employees, and 79% of those are struggling to subsidize their workers’ health plans. In addition, 88% of the companies that dropped their employees’ health coverage say they cannot afford to shoulder the costs anymore.


“What comes through loud and clear is the health crisis is huge, it’s crushing, and something needs to be done right away,” said John Arensmeyer, CEO and founder of Small Business Majority.


Small business owners in Utah believe a comprehensive reform on health care is an economic necessity, and that controlling the costs should be the top priority of the reform.


“The problem is that the cost of the health insurance is rising,” said Betsy Burton, a small bookshop owner, whose health plan cost increased by more than 20% last year. “At that rate, it is really difficult to make a profit in a business like this, with a low profit margin,” she said.


While almost 50% of business leaders in Utah consider themselves as Republicans and identify themselves as having conservative political views, small businesses in the state are now ready to embrace a bold health care system reform.


The struggle of small businesses with the rising cost of health care and their eagerness to do something to solve the problem is not really surprising, said Judi Hilman, executive director of the Utah Health Policy Project. "It is because small businesses are the first that experience the current problems in our system," she explained.


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07/13/2009

Insurance companies are seeing an increase in short-term health insurance applications this year.


Texas insurance company Blue Cross and Blue Shield expects an increase of 33% in individual short-term health insurance applications in the first half of the year.


Margaret Jarvis, spokesperson for Blue Cross and Blue Shield, Texas, said sales of individual health plans, whether short-term or long-term, in the first half of last year, were at a record high for the company. Sales of both types of individual insurance, Jarvis said, increased by over 30%.


The increasing interest in getting individual health care plans, in general, and in short-term insurance plans, in particular, is evident in the recent launching of more short-term individual policies by big health insurance companies. Shifting from group health insurance to temporary individual health coverage indicates the growing number of unemployed people in the U.S.


Recently, the Golden Rule subsidiary of United Healthcare in Texas launched two new short-term health plans that are specifically designed to cater to the health care needs of the unemployed not qualified for the subsidized health plans under the Consolidated Omnibus Budget Reconciliation Act (COBRA) or those who cannot afford it.


COBRA is a federal program that offers up to nine months of subsidy to those who wish to continue their health insurance after losing their job. COBRA, however, can also be very expensive for those who do not meet the primary requirements.


Another insurance company, Humana, opened a new short-term insurance plan in April for Arizona, Colorado, Alabama, Ohio, Nebraska, Wisconsin and Michigan.


Richard Collins, CEO of United Healthcare Golden Rule, said temporary health plans are necessary especially now, when the economy is not yet stable.


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07/13/2009

A survey released last Wednesday revealed that only a little less than half of the American population believes that their health plans would cover their cancer treatment costs in full, while around two-thirds have the false notion that Medicare will not cover anything.


Out of the 1,000 adults who participated in the survey, 70% stated that they were “very concerned” about shouldering cancer treatment costs if they ever had cancer, while 59% fear putting their families in financial trouble.


Released by the Community Oncology Alliance, the survey implies that Americans are worried and at the same time misinformed about the country’s health care system, as well as the modifications that might take place after Congress and the White House finish working on the overhaul.


According to Dr. Patrick Cobb, president of the Community Oncology Alliance and a managing associate of Hematology-Oncology Centers of the Northern Rockies in Billings, Montana, it is right for people to fear the costs of cancer treatment since cancer is the second leading cause of death in America.


When it comes to health insurance comparisons, only a small number of private insurance plans provide full coverage for cancer treatment. These plans could have premiums of $5,000 or more.


Cobb further explained, "Monthly out-of-pocket costs for cancer care and treatment, not covered by private insurance plans or Medicare, can easily run to $1,000 or more. For many cancer patients, the costs of diagnostic imaging, surgery and expensive cancer medications, especially in the first few months of treatment, can add up to well beyond $2,500 per month."


As part of the proposed health care reform, President Obama has begun to push for a government-managed insurance option that will be offered along with the traditional private and employer-sponsored insurance.


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07/13/2009

Last Monday, Connecticut Senator Christopher J. Dodd asked Anthem Blue Cross to review its proposed rate increase. The proposal constitutes an increase of 23% on the average, while in Connecticut the proposed rate increase is 32% for individual health insurance plans.


Last Wednesday, Anthem Blue Cross and Blue Shield asked the Connecticut Insurance Department to approve the increases. Once approved, the majority of the 56,000 residents below 65 years of age who bought health and medical insurance from Anthem will be affected.


The proposed increases will not affect Anthem’s group and business health insurance policies. However, some employers complained about recent premium increases.


In a letter addressed to David R. Fusco, Anthem’s president in Connecticut, Senator Dodd stated that Anthem’s proposed individual policy rate increase “runs counter to the goal of providing all Americans with quality, affordable health care,” especially now that the insurance industry is taking part in federal efforts to reform America’s health care system.


Considering that 322,000 residents are uninsured, the senator said, "Should these new rates kick in, there is no question that additional Connecticut families will join the ranks of the uninsured."


Back in January, Dodd started a “listening tour” to hear what constituents think about health care reform. And according to the senator, Fusco was “kind enough” to attend the kickoff.


In Monday’s letter, Dodd requested that Fusco "reconsider the proposed rate increases in Connecticut and instead join me once again in my efforts and those of the Senate and the House to enact comprehensive health reform legislation this year."


In response, Anthem expressed its appreciation for the senator’s concerns, but stated, “Our proposed rate increase is a reflection of increasing health care costs." The company explained that some of its policies will not be affected by the increase. However, those policies would require buyers to shoulder more of the health expenses.


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07/13/2009

Connecticut state attorney general Richard Blumenthal is pushing for the rejection of Connecticut insurance companies’ request for a health care rate increase of 30% by October this year.


In response to Anthem Blue Cross Blue Shield’s request for a rate increase of 22%–30%, Blumenthal commented, “This request is legally or factually unjustified by anything this company has submitted.”


In Anthem’s submitted increase request, the premium for the $250-deductible Century Preferred PPO, one of Anthem’s popular health plans, will increase by $62 monthly, from $264 to $326.


Sarah Yeager, the company’s director of corporate communications, said that increased claim costs have exceeded the insurance premium enough for the company to demand for higher rates.


A spokesperson of Anthem Blue Cross Blue Shield also said that the finances and rates of the company are regularly evaluated to ensure that the premium fees can cover claim expenses and costs.


The company, which filed its request on June 9, agreed to waive the 30-day deadline for the state Insurance Department to continue its evaluation. Based on state law, the changes in the company’s rates would have been automatically instated on Thursday without the department’s implied disapproval. The changes in rates could affect 56,000 insured Connecticut residents. According to the Insurance Department’s records, the population covered by the company comprises 4% of the 1.4 million residents of Connecticut.


An increase of this magnitude, Blumenthal said, is clearly against the statutory standard. “The current economic condition and the October 1 implementation also make it necessary for the state to reject this request.”


Insurance rate increases and the insurance companies’ compliance with regulations and laws involving insurance business are regulated by the state Insurance Department.


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07/13/2009

Rep. Chris Murphy of the 5th Congressional District of Connecticut says that America’s current health care system is sick. "I like to say we've got a disease in our health care system that's very difficult to diagnose. So the solution to that disease is going to be equally complex."


Murphy stressed the need for reforms to cover the uninsured and fix the problems in the current health care system. According to the Congressman, the reforms will be centered on freedom of choice.


Addressing those with individual and business health insurance, Murphy discussed the availability of choices: "If you like what you have, you get to keep it. If you're an individual or a small business that doesn't like what's available, we're going to give you options."


Murphy currently works in the Health subcommittee of the House of Representatives, as well as in two other House committees, writing the health reform legislation. Also writing the reform packages are two committees from the Senate.


According to Murphy, bills are often bogged down because of the number of House committees that work on the actual legislation. "We're trying in the House to have all three committees write a similar bill''


Despite the complex legislation, Murphy is sure that Congress will be prepared to vote on the health care reform before July ends.


The reform will require some changes in the American way of life. Everybody will be required to avail themselves of health insurance. Companies will also be compelled to either offer coverage to their employees or pay costs instead.


As for the insurance industry, the reform will pave the way for a basic insurance package that will be available to all American citizens.


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07/13/2009

U.S. Health and Human Services Secretary Kathleen Sebelius disclosed Monday that local and government organizations could now avail themselves of outreach grants to enroll more children in health care insurance plans.


The outreach program aims to cover 4 million children who do not have health care plans and keep 7 million children insured under the Children’s Insurance Programs and Medicaid. Sebelius said that the project prioritizes residents of “historically under-served” or rural areas.


“These grants arrived just in time, when we need them the most,” Sebelius added, referring to recent news on the country’s unemployment rate, which has reached 9.5%. Sebelius also stressed that when the unemployment rate is high, the rate of uninsured individuals also rises. This is because the majority of Americans are enrolled in group health insurance plans, which are employer-provided health plans. “When parents lose their jobs, they and their children also lose health coverage,” Sebelius added.


The grants, made through the Children\'s Health Insurance Program Reauthorization Act signed by President Barack Obama and which was released in February, will be initially funded by the federal government. The outreach program will last until 2013 and will be providing a total of $100 million worth of grants.


To get the most qualified applicants, Cindy Mann, director of the Center for Medicaid and State Operations, advised using innovative methods, such as technology-driven or even localized and community-based initiatives. “We should think of ways that can really help us reach all qualified children in order for them to enroll with less red tape,” Mann said.


Local governments, community-based or non-profit organizations, schools, and religious groups are welcome to apply. Eligible candidates may submit their applications at grants.gov until early August.


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07/13/2009

A recent survey commissioned by health insurance company CIGNA has found that when it comes to health care costs women are far more likely to search for bargains, such as by using healthcare comparison sites, than men are.


Kurt Weimer, who leads the companies division for individuals along with small businesses, says: “From our perspective, women have always been sort of the key decision maker in health care selection. It’s moved to the next level… Not only are they making that health care decision, now they’re looking at the economics.”


The survey found that out of the 1,000 people questioned only 15% of men compare the costs of medical treatments and doctors in comparison to 20% of women. The survey also found that 79% of women were more likely to buy the generic own brand range of medications, whereas only 69% of men would look to a generic range as opposed to the well known, and more expensive brands.


Weimer goes on to say that the recession has forced mothers to take on the role of “Chief financial officer” as well as “Chief medical officer”, pointing out “If you’re like all of us, you’re looking at how to make ends meet.”


Executive director of the National Association of Mothers Centers (motherscenter.org) believes that women might be feeling the pressure of the recession and downturn in the economy more so than men because they make “the bulk of the buying decisions for the family”.


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07/13/2009

Key Senate Democrats presented a modified health care bill, calling for private insurance companies to compete with insurance options offered by the government.


In a letter, Senators Edward Kennedy and Christopher Dodd said their improved bill dramatically decreases the costs of the earlier incomplete proposal. The two senators stressed that the Congressional Budget Office’s estimate of the proposal’s cost is now down to $611.4 billion over 10 years from $1 trillion.


In a press conference, Senator Dodd said the revised plan is closer to the “historic health care reform.” This bill, he added, offers the public options on a health plan that is run by “what functions best for Americans, not by what makes enormous profits.”


The revised bill also calls for a $750 annual fee for each full-time worker and $375 for each part-time worker at large companies not subsidizing health coverage for their employees. Small companies with only 20 employees would be exempt from penalties. It is estimated that the fee would raise $52 billion in 10 years. This would be used to subsidize those who cannot afford to pay for medical insurance. The government’s budget would be coming from higher taxes and trimmed Medicaid and Medicare spending.


The two senators also emphasized that the legislation aims to reduce the number of employers who want to drop their workers’ health coverage next year due to high health care costs.


The bill also urges private insurance companies to provide medical coverage to any applicant at a lower cost, especially to those with pre-existing medical conditions. The revised proposal is also projected to advance President Barack Obama’s proposal that aims to cover an estimated 47 million people who lack health coverage.


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07/13/2009

Key Senate Democrats unveiled last Thursday a health care revamp bill that imposes a fine of more than $1,000 for Americans who refuse to avail themselves of affordable health coverage. The bill aims to fulfill the top domestic priority of President Barack Obama.


In a statement, Obama supported the legislation saying that it “reflects many of the principles I’ve laid out, such as reforms that will prohibit insurance companies from refusing coverage for people with pre-existing conditions and the concept of insurance exchanges where individuals can find affordable coverage if they lose their jobs, move or get sick."


In the proposed health care system, it would be an obligation for citizens to be covered by health insurance as it is necessary for motorists to get auto insurance coverage now. The government would also subsidize health insurance for the poor and even for middle-class families. However, those who decline to apply for health care coverage would face penalties.


As estimated by the Congressional Budget Office, the said penalties can raise $36 billion in 10 years. The penalty system is patterned after the method used in Massachusetts, which imposes an annual penalty of about $1,000 per individual who declines to get medical coverage. Federal legislation also dictates for the fines to be higher on families.


Data from a survey by the Kaiser Family Foundation show that in 2008, employer-paid health care family plans averaged at $12,680 while individual plans were at $4,704. It is estimated that the cost of the revised federal health plan will be less than this.


The penalties will be set at half the price of basic medical coverage. Called “shared responsibility payments,” the penalty aims to urge people to avail themselves of a health plan while they are still healthy and not wait until they get sick. Penalties shall be collected through the income tax system.


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07/13/2009

Key Democratic senators are pushing for a government-managed insurance policy to provide alternatives that will compete with private health plans. This proposal, which aims to help President Obama’s health care reform, will also require large companies that do not provide insurance to their employees to pay an annual fee of $750 per worker.


Democratic Senators Edward M. Kennedy of Massachusetts and Christopher Dodd of Connecticut said that the modified proposal would be cheaper compared to its previous version. The revised proposal aims to cover up to 97 percent of the American population.


Two weeks ago, the Congressional Budget Office estimated the cost of the previous proposal at $1 trillion over 10 years. The revised proposal on the other hand will cost around $611.4 billion. This modification on the actual cost of the proposal also “virtually eliminates” the earlier prediction that many companies would be forced to drop health insurance coverage for their employees.


On Wednesday, the two senators wrote to the members of the Senate Health, Education, Labor and Pensions Committee in anticipation of the return from vacation of lawmakers to the Capitol.


As early as next week, the Health Committee could finish its version of the bill. A party-line vote is virtually guaranteed because of the proposed government-run health insurance alternative.


On the other end, the Senate Finance Committee is working separately towards a companion measure that aims to achieve a bipartisan concession.


At the end of the month, the three House committees working on the legislation are expected to arrive at a vote that is sure to include the proposed insurance option from the government.


Obama is pressing for Congress to pass legislation within the year.


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07/13/2009

WASHINGTON – From the very start, President Obama’s administration has been working hard to sell health care reform to the middle class as part of the solution to increasing medical costs, and not just as something costly for the benefit of the poor.


But with the way legislation is being shaped by Congress, the most important issue yet to be addressed is whether the extent of the benefits for the middle class will be sufficient to gather their support.


Back in the 1990s, President Bill Clinton’s health insurance regulations failed because of the “Harry and Louise” ads. The insurance industry used these ads to suggest that Clinton’s health plan was “a bad deal” for the middle class. Even though recent polls suggest some public discontent with the way Obama is handling the issue, the President is yet to go down the same road as Clinton.


According to Len Nichols, New America Foundation’s health policy program director, the middle class’ decision will decide the fate of this year’s health care debates. "It will come down to Obama's portrayal of the benefits of the new world," and his solutions to the rising cost of insurance premiums." All this is complicated. All this is hard to show.”


Obama is selling a different payoff to Americans who are going to shoulder most of the bill that will cover the uninsured. Even though the portrayed payoff is generally appealing, quantifying it would be more difficult to do as compared to the subsidies needed to help cover the poor. The President wants the public to underwrite the cost of legislation and look forward to smaller premium increases in the future and guaranteed coverage.


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07/13/2009

The purpose of health insurance is to provide medical and financial protection. But according to estimates, three-quarters of those who filed for personal bankruptcy due to medical problems were actually insured.


As Washington pushes to cover almost every American in the proposed health insurance reform, many health-policy experts agree that having everyone insured will not fix the rough edges of the system. With many people already covered, a medical crisis would definitely mean financial calamity.


Lawrence Yurdin, a computer security specialist, filed for bankruptcy even though he had medical insurance. The 64-year-old’s Aetna policy indicated up to $150,000 worth of coverage per year. However, almost his treatments at a hospital in Austin, Texas, were not covered by his policy. Last December, Yurdin and his wife filed for bankruptcy with $200,000 worth of medical bills to pay.


Lawmakers are struggling with legislation details that would create minimum insurance coverage standards. With the expensive price tag, lawmakers could lean toward less comprehensive coverage for some policy holders.


However, patient advocates stress the necessity of laying down basic levels of insurance coverage to protect individuals like Yurdin from bankruptcy. They also want new federal rules that would prevent some insurance firms from selling worthless and incomprehensive policies.


According to Elizabeth Warren, a law professor from Harvard who studies medical bankruptcies, “Underinsurance is the great hidden risk of the American health care system. People do not realize they are one diagnosis away from financial collapse.”


Republican senator Charles E. Grassley from the Senate Finance Committee points out the same thing as he emphasizes the need to make “meaningful” insurance policies more accessible and affordable. “Until that happens,” Grassley continued, “any presentation of limited-benefit plans ought to be completely straightforward, and not misleading in any way.”


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07/13/2009

Standard Insurance Company (“The Standard”) recently signed a partnership agreement with Health Advocate, one of the leading health advocacy and assistance companies, in a bid to simplify healthcare plans and services. The Standard, a subsidiary of StanCorp Financial Group, Inc., announced today its new offering—the Health Advocacy Solution—in collaboration with Personal Health Advocates.


Luce Giroux, Second Vice President of Product Management at The Standard, said that the Health Advocacy Solution would help increase worker productivity by reducing the employees’ stress in navigating the healthcare system. “The Health Advocacy Solution offers direct access to our Personal Health Advocates who will provide more efficient ways of solving healthcare-related issues.”


Giroux said the Health Advocates are mostly nurses or well-trained assistants who will help workers navigate the usually complex healthcare system. They will help locate doctors, explain and clarify billing statements and negotiate fees, explain benefits plans and healthcare-related terminology, and even give assistance on issues related to prescription drugs. Moreover, the Health Advocates, backed by medical doctors and other health experts, also extend their help to their client’s spouse, parents, parents-in-law, and dependent children.


Regardless of industry, groups with at least 10 employees can avail themselves of the Health Advocacy Solution at a discounted rate, in addition to The Standard’s other health insurance plans and services.


David Rocchino, Chief Sales Officer of Health Advocate, Inc., also expressed his gratitude for The Standard’s partnership with his company. “We are indeed very pleased to be part of The Standard’s offering. Our advocacy complements their services and programs… This new service can help clients save time and money,” he added.


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07/13/2009

President Obama will visit northern Virginia on Wednesday to hold another town-hall meeting as he continues to push for the overhaul of the country’s healthcare system.


Those who want to participate in the event are encouraged by the White House to send questions and video responses online. People can visit the White House’s official Web site or connect through social networking sites like Facebook (http://facebook.com/Whitehouse) and Twitter (#WHHCQ).


According to Sheryl Gay Stolberg of “The New York Times,” Obama’s administration has created a multi-pronged strategy to help the president promote his health plan to the public. The strategy aims to persuade government officials outside of Congress, like state governors, to help by acting as Obama’s emissaries. However, the strategy contains many potential risks, like funding problems, which will be tackled by lawmakers when they return to Capitol Hill next week from recess.


“If Mr. Obama waits too long to exert his presidential muscle to forge consensus on Capitol Hill,” Ms. Stolberg warns, “his moment of opportunity could pass. He could also lose control of the final outcome if lawmakers cut backroom deals he dislikes, for example, by deciding to pay for the expansion by taxing employee health benefits, a move that worries Mr. Obama’s political advisers because it could cause the president to break a campaign promise.”


According to senior adviser to the president, David Axelrod, the administration wants “as many people as possible” to take part in the nationwide discussion about the healthcare reform.


Dan Balz and Shailagh Murray of the “Washington Post” analyze the administration’s plans. Just like healthcare, the energy and immigration bills will also face tough opposition in the Senate.


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07/13/2009

For small-business owners, maintaining their workers’ health insurance is becoming increasingly difficult with the soaring costs and a weak economy.


Pedro Alfonso, owner of the small telecommunications firm Dynamic Concepts Inc. said subsidizing the health plans of his 85 employees now entails out-of-pocket costs. Alfonso says that before, his company could afford 70% of its workers’ insurance premiums. Now, however, it can only pay 35%.


Alfonso, 61, said that rising health costs is hard for workers. “But it’s also hard on us,” he added.


Small companies, such as Alfonso’s, are among those which the non-partisan Congressional Budget Office (CBO) is concerned about. With higher health costs, 15 million people employed in small companies may lose their health plan benefits or may voluntarily drop their health insurance. Moreover, about 10% of small-business employers are now contemplating dropping their workers’ health coverage next year due to the sky-high health care costs.


Based on an incomplete bill in the Senate Health, Education, Labor and Pensions Committee, employees working in small companies are more vulnerable, especially if their company is paying for high premiums.


Policy analyst at the Heritage Foundation, Greg D’Angelo, agrees that the current insurance system does not work for owners of small companies. “The number of people who will lose their health-plan benefits depends on what the lawmakers are still negotiating,” he added.


Based on CBO estimates, over 10 million people who receive low wages would choose to terminate their current, high-cost insurance plans. With the government’s proposed health care overhaul, workers at small firms will most likely buy cheaper insurance in the open market.


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07/13/2009

Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), the federal economic recovery plan offers a subsidy for employees who wish to continue their health insurance after job loss. As long as they are qualified for a new health insurance plan, the subsidy will pay 65% of their insurance premium for nine months.


COBRA offers continuing group/business health insurance for workers who lost their jobs. Signed into law in February 2009, this new subsidy covers involuntary job loss between September 1, 2008 and December 31, 2009, and applies to those who were terminated for any cause as long as it was not because of gross misconduct, as set in the IRS guidelines. Workers cut in large layoffs may also avail themselves of the subsidy.


In a notice, the IRS explains, “If the company would have terminated the employee’s services and the employee had knowledge that he/she would be terminated, the retirement is involuntary.”


Moreover, although COBRA mostly covers offices with at least 20 workers, smaller companies or groups that are under state mini-Cobra plans may also avail themselves of the subsidy. If the employee worked in a company that pays for COBRA premiums, he/she is only required to pay 35% of the total health plan for up to nine months.


nce qualified, a laid-off employee can use the Health Coverage Tax Credit, which shoulders 80% of health premiums for retirees that receive financial support from Pension Benefit Corporation. This also covers workers who lost their jobs due to technical modernization or deferral trade policies.


Workers who do not qualify for the subsidy are those who have a gross income of more than $125,000 a year or $250,000 for joint filers.


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07/13/2009

Despite the strain of soaring costs, the government is continuing to head towards a huge health care overhaul, which, it is feared, will lead to sky-high costs for everyone. Americans are supportive of President Barrack Obama’s proposed health insurance reform plan yet many are worried about its impact.


In a forum held last week at the White House, which was broadcasted live on the ABC television network, President Obama presented his health insurance reform plan to the public. Obama confidently answered questions on his proposed insurance reform, including questions relating to how people can keep their existing individual insurance plans.


A fact check on the President’s speech and his answers to questions show that he is eager to pursue his reform but that he sometimes glosses over details in his explanation of how he plans to make the reform successful.


The president campaigned for his health care plan and informed the audience that the costs of health care have increased three times faster than wages in the United States. Some studies, however, like the one prepared by Family USA, a group that is advocating for reforms in health care, reveal that heath care insurance costs have actually increased five times faster than wages in the US, as reported in October 2008.


The president said, “If you are happy with your current [health care] insurance plan and happy with your doctor, we don’t want you to have to change.” However, some speculate that the president’s plan cannot change the fact that private companies have the freedom to choose the health care plans of their employees.


Moreover, it has been found that Americans find it important for President Obama to offer a reform on health care without adding to the national deficit. But the price tag for this health care proposal is pegged to be between $1.3 and $1.6 trillion, which means it will clearly need more revenue for it not to add to the deficit.


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07/13/2009

Most health insurance providers in Guam will start covering ambulance services as the Guam Fire Department starts to charge fees for the use of ambulances on July 1.


According to Bri Hosei Habin, Health Care Management Division chief at Moylan\'s NetCare Life & Health Insurance program, various health insurance plans provide different levels of coverage for ambulance services. This means that a subscriber must pay ambulance fees or make a co-payment if he does not meet his health insurance deductible.


Based on Public Law 29-02, the Guam Fire Department will charge $95 for non-emergency ambulance services and $195 per transport for emergency ambulance services.


The bills for the services rendered will be mailed to health insurance providers while those uninsured will be charged directly, Edward Cruz, Fire Chief Aide, said during a press conference.


Cruz said that beginning July 1, the Guam Fire Department will issue ambulance invoices and bill health insurance providers.


Invoices for non-emergency purposes will cover the transport only while the fees for emergency services will include equipment and supplies used to provide medical care, such as a defibrillator, masks and oxygen, Cruz added.


Cruz also said that the funds from the ambulance services will be utilized to train personnel and maintain medical equipment.


Calvo's Select Care program health plan administrator, Frank Campillo, said that most ambulance services in the country’s mainland are offered by private companies. He further added that ambulance services are given by most health insurance companies in the island but that the Guam Fire Department did not charge for this before and will only start charging for them now.


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01/30/2009

Courtesy of Assurant Health


Short Term Medical Insurance - For individuals and families in brief periods of transition.


Short Term Medical Insurance, also known as temporary health insurance, protects you and your family from large medical bills that can result from an unexpected illness or injury. It’s protection and coverage you can rely on – no matter if you’re in between permanent coverage or in a life transition. And, if you’re uncertain about how long you’ll need coverage, Short Term Medical Insurance is ideal since you can pay on a month-to-month basis.


Short Term Medical Insurance is appropriate for:


People in Transition or others who may be in-between permanent health insurance plans like those offered by most employers.


Examples of people who might purchase Short Term Medical insurance: people between job, people seeking a less expensive alternative to COBRA, employed people who need coverage while waiting for their new employer’s group coverage to begin, temporary or seasonal employees, and recent college graduates.


Individual Medical Insurance - Permanent Health Insurance for Individuals and Families.


For individuals and families in need of coverage for 6 months or more. Individual Medical insurance is designed to provide people with the permanent protection they need from the financial hardship that can come from just one unforeseen illness or injury. Individual Medical Insurance also allows you the flexibility to choose the right plan for you – from the most cost-effective to the most comprehensive.


Permanent Health Insurance is appropriate for:


Individuals and Families whose need for health insurance is expected to last greater than six months.


Examples of people who might purchase Individual Medical insurance: self-employed individuals and their families, individuals working at companies that do not provide health insurance, individuals who are not satisfied with their employer’s health insurance, and retirees not yet eligible for Medicare.


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10/03/2008

Maybe you've changed jobs, or started a new job, and the health coverage doesn't take effect right away. Or, you've finished college, and are no longer covered under your parents' plan. Perhaps you may be between jobs, and don't know when you will get another job with health benefits.


Even a minor gap in insurance coverage can be cause for worry, because medical bills paid out-of-pocket can be financially devastating.


If this is the case, then short-term medical insurance may be appropriate. When you leave a job, you can choose to continue your coverage under the COBRA act of 1985, or get temporary coverage as your state laws dictate. Or, you can elect to purchase a short-term medical plan.


Weigh the pros and cons, and decide which choice is best for your situation.


Short-term medical insurance is best for those who are in good health, and have no pre-existing conditions. One of the biggest appeals of a short-term plan is its low premium. Depending on the policy, benefits can be up to $2 million per person. However, most policies have a limit on how long they last. The majority last for 12 months, although some insurers have plans with coverage up to 36 months. Short-term insurance can be bought in one-month increments, making it easy to drop the benefits at the end of any given month.


Surgery, hospitalization, emergency room visits, diagnostic tests, prescription drugs, follow-up visits, and limited mental health care are included under most short-term health policies, but under limits and conditions.


Because of its low cost, short-term health insurance does not usually cover routine preventative care such as physical exams, immunizations, and PAP tests. A good rule to remember with short-term health coverage is that it doesn't pay unless you've actually suffered an illness or injury for the first time during the policy period.


Most companies offer a 30-day guarantee period, and will refund 100% of your premium within this time if you decide that you don't want the policy . To get your money back during this window, however, you must not have filed any claims.


With some short-term medical plans, your deductible will apply on a per-injury or per-illness basis. After you've paid the deductible, most insurers will pay up to 50 or 80% of the next $5,000 of medical bills before 100% coverage takes effect, up to the plan maximum.


A short-term health insurance policy works like an "indemnity" plan that gives you the choice to go to any doctor or specialist you like. However, most plans do require pre-authorization, requiring that you obtain approval from your insurer before you are hospitalized (except for emergency treatment). If you don't get pre-authorization, your insurance company won't reimburse you.


If you aren't one of the 170 million Americans covered under an employer plan, short-term health insurance may be an appealing, less expensive alternative. We offer short-term medical from Assurant Health and you can begin the application process at our homepage.


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09/16/2008

Since being enacted in July of 1965, Medicare has become an important part of American life. According to the Center for Medicare Advocacy, approximately 44.8 million people are expected to be enrolled in Medicare in 2008, up from 43.1 million in 2006. Medicare not only provides healthcare coverage for people aged 65 and older, but also people under the age of 65 with certain disabilities, and people with End-Stage Renal Disease.


While Medicare with its many benefits and parts may seem confusing at first glance, there is a vast amount of information readily available to help you make an informed decision about which plan best meets your healthcare needs. The four major parts that make up Medicare are Part A, B, C, and D.


Medicare Part A covers inpatient hospital services and skilled nursing facility stays. Its benefits also cover some short-term home health care and hospice care, providing certain conditions are met. Part A and Part B Medicare are often referred to as the "Original Medicare". There is no fee for Part A Medicare.


Medicare Part B covers outpatient services such as doctor's visits, lab tests, hospital treatments that are not inpatient, and other basic medical care including preventative services. Part B usually will pay 80% of a service covered by the program and you will be responsible to pay the other 20% along with a yearly deductible amount and a monthly fee.


Medicare Part C or Medicare Advantage plans include both hospital and outpatient services, similar to Part A and Part B, but are provided by private insurance companies that have been approved by Medicare. Most plans will provide you with a list of doctors that are approved by the plan. Usually Medicare Advantage plans require you to see a doctor on their list, or your medical service may not be covered. Additional costs such as copayments, coinsurance, or deductibles are often part of the Medicare Advantage plans. Costs can vary greatly depending on the plan. Prescription drug coverage and dental or vision care may be included in Medicare Advantage Plans at an additional cost.


Medicare Part D is also known as the Medicare Prescription Drug Plan. These plans are optional and are also provided by private insurance companies. Each prescription drug plan will have different costs and will cover different prescription drugs. It is very important to be careful when choosing a Prescription Drug Plan to be sure the prescriptions you are currently using are on the plan you choose and a pharmacy you want to use is also included in the plan. Medicare Part D may not only lower your current prescription drug costs, but it may help protect you against higher costs in the future.


Medicare Supplemental coverage or Medigap plans are provided by private insurance companies. They pay for health expenses that Medicare doesn't cover, such as co-payments. There is an additional cost for these supplemental plans and costs vary depending on the plan you choose.


The first step in choosing any healthcare plan is determining what healthcare benefits you want and need. The coverage you choose will not only affect your current, but also your future health care. Medicare has been a life saver for many older Americans over the years, providing access to affordable healthcare to more older Americans than ever before.


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10/03/2008

As children, we never dreamed of the day that our country would be faced by such a health insurance crisis. According to Income, Poverty, and Health Insurance Coverage in the United States, the number of uninsured Americans would increase to a record high of 47 million people in 2006. That is over 13 percent of the population. As a nation, we cannot say that we didn't see it coming. Healthcare costs were on the rise; unemployment was on the rise too. The cost and development of new technology would continue to increase as would gas and transportation costs. All of these had a major impact on the healthcare industry.


Some American simply claim they cannot handle the increasing cost of healthcare. Meanwhile, some employers do not even afford coverage to employees. And for those that do, many Americans continue to lose their coverage as companies downsize and turnover employees. So all the while, those who may in fact need the healthcare coverage most are stuck standing out in the rain.


No one has to be stuck in that position. Since 2006, healthcare has taken a turn in the opposite direction. America has seen over a 1% increase in health insurance coverage. This is not to say that we will see the same healthcare costs that we became accustomed to only 2 decades ago, but healthcare is becoming somewhat affordable again. And as cost of insurance improves, most of us will continue to hope that we will see a correlation in the extent of coverage as well.


Healthcare is a hot topic of discussion, especially during this election year. Some believe that it is up to the government to take action to get America out of yet another crisis. But regardless of what the government plans on or objects to doing, it is important that individuals take note of their own healthcare situation. After all, it is the individuals who will actually be impacted by these circumstances.


Purchasing insurance coverage is now simpler than ever. Today, we see more individual healthcare companies on the rise, opening new doors and opportunities for those without coverage. Companies like these are making it nearly impossible to not have healthcare coverage or insurance. Health insurance is readily available through a simple search online or by directly contacting health insurance providers regarding personal health insurance.


Imagine your child lying there ill and you not being able to do anything about it. It is up to you to protect your family. And if you don't, who will?


Ultimately, that choice is left up to the individual level. Yet in the long run, those without insurance coverage may find themselves further in debt than if they taken advantage of these opportunities in the first place. And these will be the Americans left standing in the rain.


Source: C. DeNavas-Walt, B.D. Proctor, and J. Smith. Income, Poverty, and Health Insurance Coverage in the United States: 2007. U.S. Census Bureau. August 2008.


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09/16/2008

Although traditional methods of purchasing and maintaining insurance aren't likely to disappear anytime soon, the option to purchase policies online is the fastest growing method of distribution for insurance product, and appears unlikely to lose popularity any time soon. Too many customers are calling for innovative products that take less time and add less inconvenience to their already hectic lives, and insurance companies are answering that call by selling their products online.


Benefits to Consumers


As consumers became comfortable purchasing products on the Internet in the 1990's, insurance companies began to offer policies online. As technology and information sharing grew more and more reliable, online aggregators began to collect information on policy prices. These aggregators allow consumers to compare the costs and coverage between companies. Although many consumers purchase insurance online, an even greater number research online before purchasing more traditionally through an agent. Comparison shopping benefits consumers by providing them with more variety of choice in coverage and price. This availability of information to consumers in almost instant, and thus increases competition between insurance companies to provide a quality product at a competitive price.


For most online insurance purchasers, ease of comparison shopping, personal convenience, and savings are the top reasons for using online services. Before online comparisons for insurance premiums were available, shoppers got on the phone or in the car and spoke to an agent. This made comparison shopping take longer and added agent pressure tactics and inconvenience to the cost of purchasing insurance. Purchasing online takes away the salesperson pressure, and allows customers to take time and review the differences in coverage as well as in price. Further, the only appointment online shoppers have to make is with their laptops!


For those who crave a little human contact, or have questions, over 80% of sites offering online purchasing have links to contact an agent available, and the ability to contact an agent or representative to insure there are no unforeseen gaps in coverage or to get answers to questions consumers might have is another service online insurers offer their customers. Agents are trained to help consumers find the policy that covers them comprehensively, and to answer questions about the product.


Purchasing online insurance is certainly easier and more convenient, but is it really cheaper? Purchasing insurance online saves consumers an average of $600.00 per year, but insurers insist that the policies are not cheaper online. Insurance companies point out that the online format allows for more comparison shopping, which is what generally saves the consumer money.


Benefits to Insurance Companies


Insurance companies save money on commissions when consumers purchase policies directly from the company, because they don't have to pay the agents. Further, as policies purchased online generally require less paperwork and man hours to process, companies save time and money in this way as well.


Insurance consumers like online product. This benefits companies because policy holders use insurers that offer product that benefits them and cater to their lifestyle. Some companies are beginning to allow policies and proof of insurance to be printed offline, which makes the company seem greener to environmentally conscious consumers. Other companies donate to environmental causes out of online sales in an effort to support the growing interest in green lifestyles of many of their purchasers.


Future of Online Insurance Sales is Bright


Recent research shows that 21 percent of all new customer insurance sales occur online, according to the Insurance Information Institute's online discussion (http://www.iii.org/media/hottopics/insurance/distribution/?table_sort_782813=5). This is a significant amount of purchasing power.


This trend seems to be growing quickly. The Insurance Information Institute also reports a 37 percent increase in online sales from 2006-2007. The increases are expected to continue. The largest anticipated increase is in the auto insurance industry, where Celent estimates online sales will increase from 70 percent of sales in 2007 to 90 percent by 2011. J.D. Power and Associates reports that 39 percent of purchasers switched insurance companies, up from 33% in the 2007 study.


Free quotes, less pressure, more choices, and added convenience have made shopping for insurance online a commonly used method of purchasing car insurance today, and the trend is becoming more popular daily. Policies are available for everything from auto insurance and life insurance to individual health insurance, and consumers are appreciative of the added conveniences this type of service offers. According to J.D. Power's most recent survey, consumers will likely continue to make the switch into 2009.


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