In the current economic climate a lot of people have lost their jobs or are in fear of losing them. Saving for retirement is down and predicting when the economy will turn around is anyone’s guess. In these times we must watch how every dollar in the budget is spent. It’s more important than ever to get the medical insurance coverage needed to protect the family’s finances but also equally important not to pay for insurnace coverage that isn’t needed.
There are many health insurance plans to evaluate so how do you determine which one is best for you?
One option to help reduce the varied choices is to use HealthMarkets to find the best plan for you. It’s important to look at the premium quotes from various health plans. Look past just the stated cost of the health plan and decide which benefits in are the most important for you.
The insurance plan which is the lowest price may not give you the level of protection you need if you become ill or are injured. An insurance plan which covers a large range of services will probably cost more, but can actually save you money in the long run when comparing it to a basic plan. This is because you will pay a larger share of the medical costs.
Do you need maternity benefits, do you require a big range of doctors and hospitals and will you need a referral to see a specialist doctor? Check the out of pocket maximum set for a 12 month period. Which prescription drugs does the plan cover, do you have to buy generic drugs or does it cover the brand name products? Does the insurance plan have incentives for healthy lifestyle habits, such as covering the fees for prostate screening, check-ups, immunizations and screening for cancer.
By focusing on the benefits you need when looking for health insurance, you’ll be able to find the best plan for you and your budget.
Health Care Reform: an Opportunity for Insurance Industry Participation in Sierra Leone’s Medical Care System
Throughout the world, total state control and management of industries, services, markets and the means of production are gradually becoming a relic of the past. This model as practiced in the Sierra Leone healthcare system has empirically been proven to have served only to stifle innovation, growth, productivity and quality output with a resultant decline in overall living and healthcare standards of the citizenry. The current state of the hospitals and health centers glaringly highlights the systemic problems endemic in the entire government owned, managed, financed and operated health care system.
The continued operation of such a decadent and dilapidated delivery and financing system, lacking in even the basics of a modern healthcare infrastructure continues relegating Sierra Leone to the very bottom of the human development index.
The transformation thus of the medical healthcare delivery and financing system into a private insurance or a national insurance based system offers opportunities not only for insurers to develop market-based medical insurance plans and policies but also serves to effectuate the Ministry of Health & Sanitation’s desired policy goals, as espoused in the 2002 National Health Policy Paper.
Both policy and regulatory officials, healthcare providers, the insurance industry and other stakeholders must be engaged to effectuate implementation of fundamental systemic reforms if the country is to avert an even greater catastrophe.
Under the proposed privatization plan, the Ministry of Health & Sanitation will be transformed from ownership and management of hospitals, clinics, and employer of last resort for all physicians, nurses and ancillary healthcare providers into a health agency with only policy and regulatory functions.
The goal will be for the health agency to serve as a policy and regulatory watch dog mandated with ensuring that adequate and quality medical care is provided at the various private hospitals, clinics and pharmacies that will inevitably be established with the break-up of the current government owned facilities.
With the break-up and subsequent purchase or leases of these hospitals, clinics, health centers and other facilities, investors and entrepreneurs in an effort to realize maximum returns on investments, will economically be compelled to upgrade quality and standard of care, introduce state of the art equipment and technologies and engender a type of market forces competition which will inure only to the betterment of health consumers in the country.
A much needed infusion of capital into the health care industry by such a privatization plan will clearly spur additional economic activities in ancillary industries, as the dynamic forces of privatization and market mechanism forces of demand and supply will ensure competition for the healthcare pie.
Divestiture of Government Ownership:
The dismantling of the current mammoth and highly inefficient government owned healthcare delivery and financing entity must from a public policy perspective be designed and restructured to ensure governmental ownership and management divestiture from hospitals and other health care facilities.
Under such a scenario the government’s current enormous but woefully mismanaged capital outlay for health services will be substantially decreased as inefficiencies of corruption, salaries of providers, infrastructure maintenance, costs of medications and diagnostic equipments and other overhead operating costs will no longer be recurrent expenditures from the nation’s depleting coffers.
A system based entirely on a private market-based national health insurance plan with private enterprise and market competition at its core appears the most logical reform policy route to ensure a future sound, efficient and profitable health care infrastructure.
Health Insurance Plans:
The cog which the proposed new system must revolve around is a nationwide network of affordable health insurance plans creatively designed to ensure a greater pool participation of a majority of the population. In such a system health insurance companies and provider organizations will be established to market various health plans, with minimum services and premiums based on market conditions. The responsibility for monitoring compliance by the various plans would fall under the ambit of both the Ministry of Health and Sanitation and the Sierra Leone Insurance Commission.
A major plank in this proposed health care delivery and financing privatization hinges on the enactment of health insurance legislation providing for employers to provide health care for their employees and dependants as part of a standard benefits package with concomitant tax incentives and governmental subsidies to ensure compliance. With such legislation the virtual free socialized medical care system, the costs of which have been borne exclusively by the government will now be based on a multi-payer system in which government, employees and employers will all participate.
With the system as currently structured however, only the government has a financial interest and stake and when other programs conflict with the financing of health care, politicians have only been too willing to sacrifice the health of their citizens on he alter of their greed and personal aggrandizement.
It is envisaged that health insurance providers will introduce concepts and plans, such as Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO), through alliances of health providers and insurance companies and marketed to employers, labor unions, governmental ministries and corporations on an annual premium basis.
The competition engendered by such health organizations for the medical insurance pie will subsequently result in competitive rates, coverage, deductibles, co-payments and premiums to make health care costs affordable for all.
As unemployment and underemployment are perennial problems in the Sierra Leonean economy, the provision of health care benefits to this category of the population must remain the responsibility of government. Medical services provided to this category of citizens in a private enterprise environment must be reimbursed by the government on a negotiated and pre-determined fee schedule or an insurance mechanism established in which government negotiates with providers and carriers for the provision of services.
As an example a fund established by levying taxes on the private health care providers, envisaged to emerge with such privatization, could be instituted and utilized to pay for these indigent services.
Further, since the hospitals, medical clinics and other medical facilities will be operated as businesses, either for profit or as non-profit organizations, the market forces of demand and supply will certainly ensure that patient quality care, improvements in diagnostic technologies, competent personnel and a general responsiveness to the demands of the clients will drive the new marketplace. The lethargic and inefficient atmosphere witnessed at most government hospitals today with customer service virtually non existent would be a philosophy of the past.
The economic viability of healthcare businesses will depend largely on the clientele they can attract and maintain utilizing the above yardstick. Providers of lousy health care plans and services will inevitably loose business to competitors as every year participants will have an opportunity to change health insurance plans.
Since a large population of Sierra Leone resides in rural areas, the proposed privatization plan will ensure the expansion of health care facilities into areas currently inadequately serviced. This plan will ensure that clinics and doctors put up shop in every part of the country in order to tap into the healthcare services available in these rural areas.
Challenges to Insurance Companies:
Designing an insurance system and plan to cater to the needs of the rural population who often are self employed in farming and mining activities posses a challenge to insurers in Sierra Leone, who in the past have been largely passive and unimaginative in policy design to meet the challenges and risks confronting the nation’s socio-economic landscape.
Proactive and creative underwriting of risks must be undertaking by underwriters, actuaries and marketing specialists to design, tailor and price health insurance coverage to meet the diverse needs of the insuring public. For example, the creation of pools by occupational categories could be one method by which insured’s, engaged in similar trades could be encouraged to form co-operatives for purposes of obtaining health insurance coverage at affordable rates for themselves and dependants. Premium payments through the pooling together of the co-operatives commodities can be an alternative payment method for the medical services. Health insurance companies could possibly establish subsidiary or ancillary companies solely for the handling of payments made by cash crops.
The current system under which nearly all doctors and related health care providers are employed by the government while at the same time owning private practices would be changed with a concomitant government savings on salaries, productivity and other fringe benefits. As privatization takes over in the hospitals, physicians, nurses and other providers will no longer be on the government’s payroll but will rather be independent contractors with their own practices.
Whilst a micro version of the proposed reform has mushroomed in an ad hoc manner over the years with some large companies and corporations contracting with individual physicians and clinics for the provision of health care to their employees and dependants, the kind of systemic and structural overhaul needed to forestall a total collapse of the system and extend similar services to all could only be realized by a comprehensive approach along lines of reforms proposed in this policy paper.
By: Kortor Kamara
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The Obama plan is designed to give the federal government more control over health care decisions and dollars, a major difference from the current decentralized system of employer-based insurance and state-based insurance regulation. Here in Ohio, health insurers have been effectively held in check by the Ohio Department of Insurance. This, however, is not the case in many other states.
The Obama Plan
Many parts of the Obama plan resemble initiatives from the Clinton health plan of 1994 and the Kerry Health plan of 2004.
Essentially, Obama’s health care plan is divided into three sections:
1. Modernizing the US health care system to lower costs and improve quality
2. Promoting prevention and strengthening public health
3. Quality, portable and affordable health coverage for every person
The $2500 in savings will come from health care reform, using some of the following initiatives:
*Making health insurance universal, which may reduce spending on uncompensated care.
*Improving management and prevention of chronic conditions.
*Increasing insurance industry competition and reducing underwriting costs and profits.
*Providing reinsurance for catastrophic coverage, which will reduce insurance premiums.
Shifting Cost Burden
While all of these ideas are feasible, the underlying theme seems to be simply shifting some of the cost burden from the private sector to the government. And of course, much more control of our health dollars and decisions would come from Washington D.C and not Anthem or UnitedHealthCare.
The Obama plan will actually compete directly with Ohio private health insurance companies in a “National Health Insurance Exchange.” The federal government (not health insurance carriers) would determine the quality of health benefits that Americans would receive. And these new rules would apply to both the new national health plan and all participating private health plans.
Preventative Coverage Would Be Emphasized
Obama’s health care plan will encourage “healthy lifestyles” with specific emphasis on wellness. Employer wellness programs will be increased, and cafeterias and vending machines in the workplace may see healthier food.
School-based health screening programs may increase along with increased support for physical education.
For Ohio individuals and families, the Obama plan would require preventative services on many federally-supported health programs such as Medicare, Medicaid and SCHIP. One benefit may be possible discounts to on health insurance premiums for enrollment in wellness and prevention programs.
Currently, some Ohio individual health insurance policies offer a similar discount, such as Anthem’s Lumenos Health Incentive Account (HIA).
Ohio Group Health Insurance
Employer-based health insurance would radically change under the Obama plan. Here in Ohio, both small and large employers are able to choose among many different health plans for their employees. The Obama plan would force employers to offer a specific level of health benefits to their employees or pay a tax to finance a national health program. Currently, the amount of provided health benefits and the size of the tax have not been specifically discussed.
Perhaps the best and most economical health insurance plan for Ohio residents would be a concept already in place…HSAs (Health Savings Accounts). Thus, instead of imposing a top-down change on the health care system, it would seem to be prudent to transfer direct control of health care dollars to individuals and families. This would allow Americans to choose their own health plans and benefits, while making health insurance companies compete directly for consumer’s dollars by providing a real value to patients.
All of this could be accomplished by specific tax and regulatory changes designed to utilize the power of free-market competition. Health care spending could be reduced, preventative treatment could be emphasized and portability could be promoted. Reforming the tax treatment of health insurance and aiding employers that help their employees buy health insurance would help quite a bit.
For now, Ohio health insurance rates are remarkably low compared to many other states. There are many reputable health insurance companies that offer a wide array of policies, including Health Savings Accounts. That shouldn’t change much for the next two years. In 2011, things might change…hopefully, for the better.
For additional information on Ohio health insurance plans, or an instant Ohio health insurance quote, please visit http://www.ohioquotes.com
By: Ed Harris
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All Pennsylvania residents will be able to visit www.EasyToInsureME.com enter their zip code and compare all of the Pennsylvania health insurance plans side by side in the Easy To Insure ME quote engine. When the Pennsylvania resident has chosen a health insurance plan they can apply online or print an application for immediate health insurance coverage. If the Pennsylvania resident is not ready to buy yet they can choose up to 4 plans to compare and print the Pennsylvania health insurance comparison.
Free Pennsylvania health insurance consultations will be done over the phone between the hours of 9 a.m. to 9 p.m. Feel free to call Chad Levin the owner of Easy To Insure ME at 215 944 3079. Or email them at firstname.lastname@example.org
Thank you for your trust and confidence Pennsylvania.
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By: Pennsylvania Health Insurance
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Health Care Costs due to Managed Health Care
The current health care system in America is inaccessible to approximately 47 million poor and lower middle class people. In order to address the growing health care insurance crisis in the U.S. that resulted in health care cost growth in the 1970s and 1980s, health maintenance organizations (HMOs) sprung up. These were initially as non-profit groups designed to separate unnecessary tests and treatments from those that the patient required in an effort to keep costs down. Managed care organizations began screening requested procedures by physicians to pre-authorize what the HMO would or would not cover. However, the number of people who are the riskiest to insure-diabetics, cancer, etc.-continues to rise. Many South Carolina managed care industry experts say the cost of cheap health insurance is still high because of the existing pool of insured people who use the health care system more than an average amount.
The other battle that is ongoing in South Carolina involves the health insurance companies and hospitals, the latter which cannot turn anyone away from care by law. However, as the number of South Carolinians who cannot afford cheap health insurance increases, hospital emergency rooms are handling the majority of the load. More people have to turn to hospitals as their primary health care givers given a lack of adequate or non-existant health insurance coverage.
Cheap Health Insurance Plans Through the Workplace
Most cheap medical insurance policies in South Carolina are usually written through group coverage offered at work by your employer through a private South Carolina cheap health insurance company. This is usually the more cost effective way to purchase cheap health insurance now available since a large number of employees allows South Carolina companies to reduce their insurance premiums. Similar to buying in bulk, the more health insurance plans a business can purchase for its employees the less expensive the insurance is per employee. In South Carolina, like the rest of the nation, the number of companies that can provide cheap health insurance for their employees is declining.
Personal Health Insurance Plans
Health insurance plans can be purchased by individuals and families from virtually every insurance provider in South Carolina. Trying to purchase health insurance on an individual basis can be more expensive if the person already has a health problem, known as a pre-existing condition. Many companies will not cover people with pre-existing conditions if they have no continuation of coverage-renewing health insurance coverage after only a prescribed short period of time-picked up from an earlier cheap health insurance policy.
South Carolina Health Insurance Pool
The South Carolina Health Insurance Pool is a state health insurance plan designed to provide coverage for those that either do not have or have lost medical coverage at no fault of their own and are uninsurable. The pool was created by the General Assembly to help people who couldn’t get health insurance coverage from any other source, including people with certain disabilities. Blue Cross and Blue Shield of South Carolina currently administers the pool.
Coverage is available to a person who has been a state resident for at least 30 days and meets the following criteria:
They were turned down for private health insurance coverage for health reasons;
They were accepted for private health insurance, but have pre-existing illnesses or conditions excluded from coverage, for a period exceeding 12 months;
They are paying health insurance premiums for comparable coverage which are more than 150 percent of the premium levels charged by the pool;
In certain situations, other individuals whose last health insurance coverage was an employer based group health plan may be eligible for coverage.
No matter what your age, there are also several federally sponsored programs to help you if can’t afford the premiums for individual health insurance, providing you meet their eligibility guidelines.
Medicare, a health insurance program for people age 65 or older, certain younger people with disabilities, and people with end-stage renal disease.
Medicaid, a program for the poorest individuals and low-income families with children.
The Children’s Health Insurance Program (CHIP), a plan that provides health care to children whose parents make too much to qualify for Medicaid, but earn too little to afford individual health insurance.
Types of Cheap Health Insurance Coverage
Cheap health insurance plans generally fall into one of two categories: indemnity plans and managed care plans (HMOs, PPOs or POS plans). An indemnity plan allows you to choose your own doctors and pays for your medical expenses totally, in part, or up to a specified amount. Managed care plans generally provide broader coverage within a specified network of health-care providers.
Although you can purchase cheap health insurance plans that cover specific areas of health care (surgical, hospital, physician expense plans) most plans cover varying degrees of health care in a number of different areas. This health insurance coverage, known as major medical insurance, offers extremely broad coverage with a very high maximum benefit that’s designed to protect you against losses from catastrophic illness or injury.
When comparing cheap medical insurance plans, check to see if they provide additional benefits that you may need, including prescription drugs, preventive care, mental health benefits, maternity care, and vision care. A comparison of various health insurance policies and rates through many South Carolina health insurance companies can be obtained at www.insurances.sc.
Cheap Health Insurance Recipient Costs
With most cheap health insurance policies available in South Carolina, the way to control cost is to cut down on the out-of-pocket expenses. Since most health care insurance policies require you to make a co-payment (the amount you pay a health care provider with every visit), anything involving a lot of time spent in the doctor or dentist’s office can become expensive. Most also require a deductible (costs you must cover out of your pocket for any major expense before your cheap health insurance policy picks up the remaining costs). You may also have coinsurance, the percentage of cheap medical insurance cost you will still have to pay after you reach your deductibles.
Another thing to consider is COBRA health insurance. This law allows employees who leave a job the ability to stay on that South Carolina company’s employee health insurance for up to 18 months although they have to pay the full amount of the coverage. Check the COBRA benefits to see if purchasing a less expensive individual health insurance plan may be in your best interest.
How to Buy Cheap Health Insurance
If you need to purchase individual health insurance, it can be expensive. Unlike group plans, in which the costs and risks associated with health care are spread among many people; individual health policies are “medically underwritten” to take into account your personal health history. Any “pre-existing” condition such as heart disease, diabetes, and even pregnancy, can nix your chances of acceptance or boost your premiums.
To determine the acceptability of a particular applicant, a health insurance underwriter can require information regarding the following:
The individual’s age: Age determines rates and whether coverage will be issued at all.
The individual’s gender: at younger ages, males have a lower rate of illness and injury than females. That changes by age sixty.
The individual’s health history and physical condition: Someone who has had a previous condition that can contribute to a future illness/injury is not considered an ideal risk. In response to a less than ideal medical history, modified coverage may be offered depending on the individual’s health, higher than normal premiums may be issued, or the person may be denied coverage altogether.
The individual’s occupation and hobbies: Some occupations such as construction workers have higher insurance rates, along with people who enjoy dangerous activities such as skydiving or bungee jumping. At times certain occupations are considered so hazardous that insurance companies will not cover them at all.
Your first step in getting cheap health insurance coverage is to understand exactly what you need. Think carefully about what coverage you must have. Do you need health insurance for your whole family, or just yourself? Do you want to choose your providers? If you’re over 65, do you need insurance to fill the gaps in Medicare? Do you need – and can you afford – long-term disability and/or long term care coverage? Even if you begin by soliciting cheap health insurance quotes you must still know exactly what you want in terms of health insurance coverage so you will be comparing apples to apples when weighing any cheap health insurance premium quote.
After that, contact a South Carolina insurance agent in your area. Ideally, you can start with an independent South Carolina insurance agent who is familiar with the insurance companies that do business in your area. This agent is also not bound to write coverage for any particular health insurance company so he or she can give you an honest appraisal of various health insurance policies.
When you’ve found the right coverage, you’ll give information to your agent to complete the necessary forms. Be honest. It’s important to disclose your medical history thoroughly and accurately. Report all of your health problems to your agent. If any of your health information is misstated or incomplete, the company might refuse to pay your claims and could cancel your policy.
About the Author:
The cost of caring for “disease” continues to rise faster than inflation according to an article this month in Newsweek magazine. It said “over 47 million Americans don’t have health insurance at all”. Those with low-cost health insurance usually get these from employers, but with costs rising, it is obvious that the health insurance situation in Florida is getting worse.
Taking care of employees is the primary concern of a good employer. But that has been perceived as “expensive” by some companies as it means providing the employee with vacations, bonuses, incentive pay, and of course, health insurance coverage. In the future, Florida businesses may be able to offer low-cost health insurance to residents who are willing to make a few changes in lifestyle.
The New England Journal of Medicine published a major study on health insurance recently that said low cost insurance rates may be made available to those willing to go through a certified “health risk assessment”. These health risk managers look at your lifestyle, and your current state of health, and certify that the person is “healthy” and a “low-risk” which can qualify the applicant for lower insurance rates. The only other way to get low-cost health insurance in Florida is to get it from your employer as part of their group health insurance plan.
There are many health insurance consultants out there who can help Floridians find low-cost insurance, such as Florida Health Insurance Web – www.FloridaHealthInsuranceWeb.com – insurance consultant, Morgan Moran said, “Change a few things about your lifestyle, and lower rates could be available”. The insurance industry believes, most people would change a few things to get lower insurance rates, and assure living a longer happier life. These changes may include a better diet, more exercise, and less high risk behavior like “skydiving” or “bungee jumping”. Until now, insurance plans rarely took behavior into account.
Many Floridians are looking for a quick fix. If they can take a pill or have a stint plugged into their heart they would, rather than change their lifestyle, after all, it does sound easier. The New England Journal confirmed what other research showed– that angioplasties and stints don’t prolong life and don’t even prevent heart attacks, yet $30 billion was spent on those last year. Mutual of Omaha found that almost 76% percent of people eligible for angioplasty or heart bypass surgery were able to “safely avoid it by making the comprehensive lifestyle changes”, saving almost $30,000 per person. It is plain to see that changing lifestyle is more cost effective than surgery.
Low-Cost Insurance Consultation
In an effort to find affordable health insurance rates, many are turning to health insurance consultants for help. In a phone interview, consultant Morgan Moran said, “The best way to find affordable, low-cost health insurance is to have an employer-sponsored group health insurance plan.” Group health insurance plans are the most affordable, low cost health insurance plans out there, aside from state-sponsored health insurance plans. If you can obtain health insurance from your employer, you will pay even less for your health insurance than you would if you purchased a group health insurance plan on your own.
Most employers have certain requirements an employee must meet before he or she can be a part of the employer-sponsored group health insurance plan. These requirements range from the number of hours the employee works, to the employee’s status, i.e., whether the employee works full-time or part-time. Employers sometimes have time requirements as well. This means the employee must be with the company for a certain amount of time before he or she is considered eligible for the employer-sponsored group health insurance plan.
Employer-sponsored group health insurance plans are usually the most affordable, low cost health insurance plans for a variety of reasons. If you have an employer-sponsored group health insurance plan, the health insurance premiums are either divided between you and your employer, or paid completely by your employer. This means one of two things. Either you are required to pay half of the health insurance premiums plus a low cost co-payment or you are only required to pay an affordable co-payment.
Employer-sponsored group health insurance plans like this have become even more affordable and low cost when you factor in your spouse and children. Rather than purchase individual health insurance policies for each of your family members, or pay out-of-pocket for health care costs, you can add your spouse and your children to your employer-sponsored group health insurance plan.
Rates on health insurance policies change daily, and vary from carrier to carrier so it’s a good idea to speak to a consultant like Moran. Their fees are paid by the carrier without passing the cost along to the consumer. Find out more at www.FloridaHealthInsuranceWeb.com
By: Zane Durant
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