How Health Insurance Works

When I consider purchasing an individual health insurance plan for myself or my family, do I have any financial obligations beyond the monthly premium and annual deductible? Answers: It depends on the plan, but some plans have the following cost-sharing elements that you should be aware of. Co-Payments: Some plans include a co-payment, which is typically a specific flat fee you pay for each medical service, such as for an office visit. After the co-payment is made, the insurance company typically pays the remainder of the covered medical charges. Deductibles: Some plans include a deductible, which typically refers to the amount of money you must pay each year before your health insurance plan starts to pay for covered medical expenses. Coinsurance: Some plans include coinsurance. Coinsurance is a cost sharing requirement that makes you responsible for paying a certain percentage of any costs. The insurance company pays the remaining percentage of the covered medical expenses after your insurance deductible is met. Out-of-pocket limit: Some plans include an out-of-pocket limit. Typically, the out-of-pocket limit is the maximum amount you will pay out of your own pocket for covered medical expenses in a given year. The out-of-pocket limit typically includes deductibles and coinsurance. But, out-of-pocket limits don’t typically apply to co-payments. Lifetime maximum: Most plans include a lifetime maximum. Typically the lifetime maximum is the amount your insurance plan
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Health Care? – Our Congress is Privatized Without life, the pursuit of happiness and liberty is impossible. They Dump the Sick to Satisfy Investors Insurance Exec Turned Whistleblower Wendell Potter Speaks Out Against Healthcare Industry: Wendell Potter The “Private” sector once again fails. Trillions in waste, fraud and fines but idiot American Government Haters cling to Corporate Media anti-government pro-corporate propaganda. —————————————————————————– With 1300 private insurance companies and thousands of different health benefit programs designed to maximize profits, private health insurance companies spend an incredible 30 percent of each health care dollar on administration and billing, exorbitant CEO compensation packages, advertising, lobbying, and campaign contributions. Aren’t we all delighted to know our health care dollars are now circulating all over the Halls of Congress, paying outrageous sums of money to lobbyists, making sure we do not do the right thing for the American people? Public programs such as Medicare and Medicaid and the Veterans’ Administration are administered for far, far less than private health insurance. Let me conclude by saying that I understand that the power of the insurance companies and the drug companies, the medical company suppliers–the medical equipment suppliers–is so significant, so powerful that we are not going to pass a single-payer, Medicare-for-all program. But at the very least

Latest Health Insurance In Usa News

Walmart Health Screening Stations Touted As Part Of 'Self-Service Revolution'
While shopping at the Alexandria, Va., Walmart location, Aleisha Butler, 24, takes a moment to utilize the SoloHealth Station, an interactive, self-service health care kiosk (Photo by Jack Gruber/USA Today). He tests his eyesight, weighs himself and …
Read more on Kaiser Family Foundation

US STOCKS-M&A deals lift Wall Street shares nearer a record high
On the downside, health insurance stocks tumbled, led by a 6.4 percent drop in Humana Inc to $ 73.01. The company said the government's proposed 2014 payment rates for Medicare Advantage participants were lower than expected and would hurt its profit …
Read more on Reuters

Health Reform & Seniors (04/08/2010 Web chat)

How does the health insurance reform legislation affect seniors? Sr Officials highlight some of the immediate benefits of health reform for America’s seniors before answering questions from the public. * HHS Secretary Kathleen Sebelius * Kathy Grennee, Assistant Secretary for Aging * Marilyn Tavenner, Principal Deputy Administrator for the Centers for Medicare and Medicaid Services (CMS) More info at We allow comments according to our comment policy US Department of Health& Human Services
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Health Insurance Plan Reimbursement from Auto Wreck Settlement

Health Insurance Plan Reimbursement from Auto Wreck Settlement

When you signed up for health insurance at work did they tell you that if you get a in car wreck, you will have to pay your own medical expenses? Burt True, a lawyer with True & Associates, discusses insurance subrogation. Subrogation is when your health insurance plan claims they get paid back for the medical expenses they paid before you get paid for your injuries. Missouri (and other states) prohibit the assignment of personal-injury claims. In a recent case, Scroggins v. Red Lobster (2010), a woman agreed to a settlement with Red Lobster after she fell there. But, her employer, St. John’s Hospital in Springfield, claimed that its health insurance plan gets paid back out of her settlement. The court said, “Missouri courts have never allowed a provider to be reimbursed for medical expenses that the insured recovers in a settlement from a liable third party under a lien theory, and we declined to do so now.” But, your health insurance plan does not stop there. They want a way around state law. So they go to the feds. They get qualified under a federal law called ERISA. ERISA stands for Employee Retirement Income Security Act. Since federal law trumps state law, the health insurance plan claims it can still get paid back even though state law prevents this. Now it gets complicated. ERISA does preempt state law, but there are exceptions listed in the federal law. One exception is state insurance law. But then there is an exception to the exception called the Deemer Clause

American Health Care System-With Leon “The Senior Citizen”-Doctor DILDO Wants YOU!

It’s a lost cause! or 972-420-1293
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Health Reform & Seniors #2 (04/22/2010 Web chat)

AARP President Jennie Chin Hansen and other health experts from HHS took your questions in a live online chat about how reform will benefit Seniors. We allow comments according to our comment policy US Department of Health& Human Services