Choosing Smart Health Insurance

Do you feel it is important to have health insurance? It may be that most of us would answer no.

In fact, if a member of our family who is ill and must be treated in our hospital had felt the importance of having this insurance. Because the illness much less severe illness, but the body must suffer, bag, too miserable.

Life Insurance and Health Insurance is required primarily for self-employed and informal workers who do not have health insurance from a company or government agency.

A self-employed if stricken ill or disabled because of an accident will have a lot of financial losses because they have to bear the cost of treatment and can not work for a living.

Others as if someone working in a company or government employee, they usually get health insurance that will cover the cost if the hospital and paid fixed monthly salaries.

The most important thing is, before determining what health insurance products, from which the insurance company, it is advisable to compare different products, types of products from several insurance companies.

Do not rush to buy insurance products without a clear understanding of rights and obligations if we take an insurance product. Here are some tips you can use as a consideration:

• Determine the benefits of whatever protection we need, for example hospitalization benefit and critical illness, because this is what causes us to spend large sums of money, because the period is difficult to predict. Or, provide outpatient benefits if in the last 1-2 years we often went back and forth to the doctor. Usually, health insurance is also attached to life insurance.
• Look for information of insurance products as needed, by collecting brochures from various companies or websites to find information on insurance companies,
• Ask your agent in detail about the product as a whole until details of the calculation of the allocation of funds we pay for anything,
• Do not believe all health insurance agents say, because they are not necessarily well understood by the products they offer,
• Ask for an illustration made health insurance product benefits, the premium must be paid and the allocation of premiums paid wherever
• Learn the contents of the illustrations in the house with a relaxed and thoroughly, do not rush to conclusions, ask a better idea if there is not yet clear
• Compare products from the various health insurance companies, which provide the greatest benefit with the least expensive premiums, but also find out whether the company info bona fide or not
• Do not just BASED on the best insurance award from a magazine, but you should really know how to calculate the insurance costs
• Determine the insurance product after all you really understand
• After determining and deciding to buy a health insurance product, we will accept the insurance policy that contains a binding agreement between the customer and the insurance company. Learn more policy content, customers are usually given a 14-day opportunity to cancel the policy.

Remember, do not be fooled by an insurance product "Do not buy Life Insurance and Health Insurance Unit Link associated with investment". Trust unit-linked products very expensive the cut, you better take health insurance and pure and invest money into Mutual Funds separately.

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TRICK RISK THROUGH HEALTH INSURANCE

Before determining what insurance is selected, the first step of his seyogia do is determine the needs. Of the three types of insurance above, determine the appropriate level of preference your condition. In general, in developed countries the first priority is to follow the health insurance. The reason, because when you are sick, the cost may not be less. If only you worked at a company and the company is providing facilities of health costs, its value may not suit your needs.

Especially if you have a certain lifestyle. If you are experiencing hospitalization, for example, you may want to be treated with first-class facilities, and facilities provided the company only second-class facilities. To menyiasatinya, you can follow the health insurance program that benefits tailored to your needs.

In reality, most people simply did not have any health facility. So when sick, all should bear their own costs. For circles like this, of course, health insurance ought to be an absolute thing, because no one knows when the risk of pain to come even if you maintain good health. Therefore, health insurance can be considered to have.

The question is, what kind of health insurance are eligible to choose? now, other than a direct quote from health insurance companies, quite a lot of health insurance offered through penyelengara credit card (issuer). So, the card holder is offered "benefits" of health insurance and the premiums langsug charged to card holders via credit card.

There's nothing wrong with such a pattern of supply, however, you should look at what benefits the insurance company gdiberikan yan. Then, if the insurance company that works with the credit card issuer is bona fide and have experience. Not until, when you are sick and make a claim, proved even more difficult process.

So, to choose the health insurance companies, at least there are two things to note, namely bonafiditas and recordnya tracks, and then compared with the benefits offered premiums charged to you. In addition, you also must consider that the hospital worked with the company's health insurance. More and more hospitals are working together, the more is the bona fide insurance company. Useless you have health insurance when the house was magic in your neighborhood - sebgai example - do not have cooperation with the health insurance you have.

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Health Insurance Needs It So

Health care costs today than just the doctor alone has cost a pretty expensive (to pay the doctor added with the purchase of drugs), especially if you should seek treatment and stay in the hospital. Medical costs are increasingly rising resulted in the family burden becomes very heavy if one of the family members attacked the disease.


Meanwhile, the unexpected, such as illness or accident is a common occurrence even if the timing is not predictable. Because it badly needed a plan to solve this problem or the problem carefully and wisely.

Unexpected Deal ready

Here's a true story that we write as an illustration. The husband, wife, call it Dicki and Dina had a baby who is very pretty with the name Alia.

Dicki and Dina are couples who live in the Jakarta metropolitan city that requires them to work together in order to meet all the needs of daily life. The couple lived in a housing on the outskirts of Jakarta.

Some time ago, the fruit of their heart disease that required to stay in the hospital because they have to undergo some tests and treatments internsif enough. Without realizing their child's stay in hospital for 1 week.

So they want to complete payment of their hospital bills surprised, why it costs so expensive? Up to Rp. 12 million? They were preparing an emergency fund but the amount is insufficient to pay all the hospital bills, so in order to pay the hospital bills they have to withdraw funds in their future.

This kind of thing we often hear. Not only must take the future savings, but instead there is a need to borrow them first to relatives because this form of expenditure is always ignored. How you can overcome problems like this? There are ways that our opinion can help you at least do not anticipate this in terms of financial availability for the things that are not unexpected. First to prepare an unexpected funds that you need to fill again when it is used and both with have health insurance. Both alternatives have advantages and disadvantages.

Unexpected funds and insurance

The first option is to spend the unexpected that you must specify the amount yourself. Of several books related to family finances in our opinion you should meyiapkan unexpected tactical funds ranging from 2 to 6 months of living expenses per month.

When the family monthly expenditure of Rp 5 million, then at least you have to set aside in savings of between Rp 10 million to Rp 30 million. Because of this requirement is the need for the unexpected, where events can occur at any time, the placement of a product that high levels of liquidity into our suggestions. For example, in the form of savings in which the decision can be made at any ATM with the current ease almost all banks offer these advantages.

You've set the size and has put in savings, if in the next month you should use it for unexpected needs such as repairing the house as much as Rp 2 million, then you should add back the amount of its original value. For example, USD 10 million is prepared to fund unforeseen circumstances. When you have used up USD 2 million then you should have budgeted funds to add back the total funds to $ unexpected. 10 million back.

Usefulness of these funds for a variety of unexpected expenses not only because of hurt, but for other needs such as, a leaky house repairs, car crash and others. The limitations of these alternatives to prepare for the unexpected burden of family health are funds available so that you depend with funds set aside for the unexpected.

Sometimes funds are not prepared enough to keep the rising cost of medical treatment, whether it is only to the doctor and to stay in the hospital. The advantages in this way is that you can determine the amount of money should you spend or you set aside. If not unlikely event of an unwanted or unexpected so that you have funds set aside to remain intact in number.

Alternatively you can do is to buy family health insurance. With this program you transfer the risk of the unexpected (illness) to a third party (insurance company) at a cost that should you spend each year in the form of annual premium which has no cash value or be lost or burned when not in use in the current year.

Health Insurance

Indonesian society in general have not seen the insurance especially health insurance as a necessity. Another case with American or European society that has seen health insurance as a necessity. Not only higher costs for medical care in the U.S. or Europe, but if no insurance it will be very difficult for them to get the best treatment is desired.

In general about health insurance is similar to the general asurasi where premiums are paid for one year can not be returned or burnt again during the year despite no claims. Some insurance companies give a refund of premiums paid when no klain for 1 year, although a small amount.

In Indonesia there are two categories, namely health insurance, health insurance, collective (group) and individual health insurance. Individual insurance usually diperutukan for families in which only a maximum of 5 individual members, father, mother of 3 children funds. Premiums must be paid relatively higher than the collective health insurance.

Meanwhile, the collective number of individuals who participate are usually older and premiums are paid less because of the risk of claims on the average by all individuals in the group. The greater the number of groups or members within a set of lower premiums to be paid.

Insurance Benefits

Health insurance is a type of insurance that maintain the availability of funds if the individual or family member stricken with the disease. All the needs of the doctor to have to stay in the hospital with a variety of needs such as, the cost of medicines in the hospital until the operation of all these things covered by insurance companies. In general, type of treatment or programs that are available are the benefits of outpatient (Outpatient), hospitalization benefits (Inpatient), labor benefits and dental benefits.

In general, outpatient benefits (Outpatient) are borne by insurance companies are:
* GP Consultations
* Providing referrals to doctors when necessary spesilis
* Consultation to a specialist
* The purchase of medicines in accordance with the list of drugs
* Supporting the diagnostic survey

In outpatient benefits have maximum limits the use of funds each year. Of the total cost of expenditures for outpatient care, in general at every insurance company requires the insured to pay 20 percent.

Labor benefits associated with the birth of a child, from the cost of normal delivery, delivery with additional tools and S-caesacea operations. For the benefits waiting period persalian there are usually up to 280 days. Each insurance company has a waiting period that limits vary.

As for the benefits of dental care consisting of prevention, basic dental care, dental care complex and the installation of dentures. For all treatments insurance companies typically limit the amount of the total cost that can be used per year. In the dental benefits are an obligation for the insured to pay 20 percent of the cost of treatment (same as outpatient benefits).

The third benefit of treatment as above, namely outpatient, labor and dental benefits are additional options you can take by following the basic program of inpatient benefits. So you can not just take advantage of outpatient only, labor only, or dental treatment without following the basic program of hospitalization benefits.

For the benefit of hospitalization which are the basic benefits that should be taken first, hospitalization benefits coverage in general is almost the same from the existing insurance companies. Benefits include:
* Cost of accommodation space
* Cost-ICU room accommodation
* Consult a doctor
* Consult a specialist
* Cost of surgery, complex, major, intermediate and minor
* Other costs hospitals include: the cost of drugs, lab tests and diagnostic
* Treat the road 30 days before and after hospitalization
* Treatment at home
* Local ambulance service
* Treat emergency road accidents
* Treat dental emergency road accidents
* Compensation of death

The amount of coverage is dependent with the program you take, many insurance companies use the name or type of program is different. For inpatient premium amount to be paid annual visits of the high cost of accommodation in the hospital room you choose, for example, you choose accommodation costs with the cost Rp. 200.000 the following benefits following the prescribed program options. For the three additional programs, the premium must be paid for outpatient consultations based on the selected general practitioners, labor costs based on the desired natural childbirth and dental care in terms of basic care.

Insurance Claims

In case there are claims that wearing the insurance company reimbursement system (reimbursement) or the system provider. With the replacement system, the insured must spend the money to pay medical expenses which you can then claim (request a replacement) to the insurance company.

In this case the completeness of the letters of administration becomes necessary. Sometimes issues arise in the claims process is not complete because the required conditions. The length of disbursement tertantung claim with the insurance company generally ranges from 7 working days.

As for your provider's system does not spend a dime, you're only equipped health insurance membership card in order to obtain needed medical services. Surely in a hospital or clinic you have chosen previously.

With the replacement of the system you can go to any hospital. While the system provider, you must specify a hospital choices you want based on the hospital list in collaboration with the insurance company.

Perhaps the question arises, how much premium should we spend to have health insurance? Once again, the amount of premium or fees should you spend each year depends on the program you choose. Like the example above where you select the program inpatient accommodation costs Rp.200, 000, then the premiums will be calculated based on the cost of accommodation and age of the insured. The younger the age of the insured, the burden will be more affordable premiums.

Importance of Insurance

After learning the basics or general health insurance, shows that health insurance becomes very important for a family plan. Why?

First, the health insurance program, for sure you know the burden of expenditure that must spend a year to pay the premium without having to fear when one family member became ill.

Second, by choosing a health insurance program with the system provider, if one family member became ill then you do not have to bother with issues of money, because it was covered by an insurance company and you do not need to spend any money for hospitalization. With your outpatient required to spend 20 percent of the total cost.

As for shortcomings in terms of health insurance is still quite expensive for our society. Actually said it was relatively expensive, therefore we strongly recommend that you plan your family finances, so you can see the family's financial goals by priority.

When you participate with insurance companies that use the system provider, you can only choose a partner hospital of the insurance company. So who should be seen in this case is how many hospitals or clinics owned by a partner insurance company. The easiest option is to determine the nearest hospital to home and of course with the best quality.

So from this description we do hope you can see the importance of preparing or planning a fund unexpected or your health insurance program that protects families from financial hardship when the plague struck. Begin immediately. The younger you are the easier to follow and premiums must be paid also relatively cheaper. Hopefully useful.

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Health Insurance

For many of us, our health insurance benefits are the most important employee benefit. This may be especially true considering an estimated 47 million Americans -- many of them working Americans -- lack basic health insurance according to an August 2007 report published by the U.S. Census.

Before you have a medical emergency, it's important to know how to understand the basics of your health insurance benefits. Some of the basic features include:

Premiums. You want to know how much your monthly insurance premium is and whether your employer pays a part of it. Monthly premiums can easily reach $100 for single persons and two or three times that amount for families.

Employers often obtain health insurance for their employees with a group policy. By spreading the risk among more insureds, group insurance plans are often able to obtain more affordable premiums.

Deductibles. A deductible is the amount you pay the physician before your insurer pays its share of your medical bill. Generally, the larger your deductible is, the smaller your premium. You may wish to consider increasing your deductible in exchange for a lower premium. Higher deductibles are a common way for insurers to make insureds share in the cost of health care.

Copayments. A copayment is the amount you pay when you visit a doctor. Like a deductible, a copayment is a means of sharing the costs of health care to discourage excessive use of benefits. Copayments are often in the range of $5 to $25 -- not too much but high enough to discourage frivolous use of your benefits.

Out-of-pocket expenses. Out-of-pocket expenses are the costs you have to pay, in total, before an insurer pays for any remaining amounts. Amounts you pay as deductibles are included in your out-of-pocket expenses, which are kept as a running total. Most health insurance plans also have a yearly maximum for out-of-pocket expenses that you have to pay. Once you have reached your maximum for the period, you're usually done paying for that period.

Coverage of services. When it comes to the coverage of medical services, some employer-sponsored health plans are simply more generous than others in the scope of services that they cover. You should be aware of any procedures or medical disorders that your health insurance plan does and does not cover.

Ancillary care. A good health insurance plan pays for visits to a doctor. However, a more comprehensive plan also provides benefits coverage for such ancillary care as pharmacy and vision. Dental insurance is often offered as a separate benefit but it may also be included in a comprehensive health insurance plan as a policy rider.

Health insurers often contract with a network of doctors to provide health care for insureds. These networks are often managed care networks, which include health maintenance organizations (HMOs). HMOs focus on providing preventive care by encouraging early diagnosis (when treatment is cheaper). HMOs actively use copayments, deductibles and out-of-pocket expense caps to manage health care costs.

With managed care, you select a doctor from a roster of physicians in your area. This physician is called your primary care physician. You use your primary care physician as a gateway for your health care, obtaining a referral from him or her to obtain specialized medical care. This gateway approach is another way that managed-care networks seek to control health care inflation, which has easily outpaced general inflation over the past decade.
Health care critics argue that the gateway process penalizes consumers by slowing down the time it takes to receive timely health care for specialized needs. In spite of these criticisms, HMOs and other managed-care networks have become the dominant system for providing health care in the U.S.

Another type of health care insurance is fee-for-service health care. Fee-for-service care is more expensive than HMOs since it is a pay-for-what-you-get insurance system. Fee-for-service health care plans use a network of physicians called preferred provider organizations (PPOs). An advantage of fee-for-service health insurance is that you have more latitude in choosing a doctor.

A major issue in health care today is declining reimbursement rates, particularly with respect to Medicare reimbursements. Health insurers often use a contracted reimbursement system to pay physicians and rely on a similar system to be reimbursed by Medicare. For example, an insurer might reimburse a doctor or hospital $10,000 for a kidney dialysis, or $5,000 for a birth given by Caesarean section. However, if Medicare is reimbursing at lower rates, the health insurer eats the difference and is forced to increase insurance rates.

When you receive health insurance, you often have an open-enrollment period. Open enrollment is generally a once-a-year period that lets you modify your insurance coverage. If you give birth to a child or have a change in your marital status, you are allowed another opportunity to modify your health insurance coverage.

If you and a spouse have your own health insurance plans with the other spouse as a beneficiary, you should see how each spouse's plan affects the other. Health insurers use coordination of benefits to determine which insurer pays for which services and to prevent from paying twice for the same procedure or visit.

If you anticipate paying health care costs each year that your employer does not reimburse, you may wish to set up a health care reimbursement account. These accounts let you make before-tax contributions to fund the account during the year, potentially saving you hundreds or thousands of dollars in taxes. Health care reimbursement accounts are also called cafeteria or Section 125 plans after the section of tax code that governs their use.

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Avoid losing your health care coverage

Follow these three steps to make sure you have health insurance when you need it most.

NEW YORK (CNNMoney.com) -- Thousands of Americans have found themselves with a cancelled health insurance policy or a denied claim, just when they need it most.

In California for example, insurers paid out about $19 million in fines for dropping policyholders, and the attorney general is investigating reports that insurers are denying claims at rates close to 40%.

Follow these tips to avoid any lapse in your coverage.

1. Know the process. Rescission is a term used when an insurance company cancels a policyholder's coverage on grounds that the company was misled on your application. For example, forgotting to mention that you were hospitalized for chest pains could be grounds for cancelling your coverage, should you later develop a heart condition and make claims to your insurance company.

Health Net, an insurer in California, was recently fined $1 million because employees there were offered bonuses if they found a reason to cancel policies. Generally insurance companies have two years to go back and find discrepancies in your insurance application according to Amir Mostafaie of eHealthInsurance.com.

2. Appeal the cancellation. There are steps you can take if your policy has been cancelled. First, find out why you've been dropped. Get in touch with your insurance company. Next, call your state health insurance department and describe your situation. The folks there can act as intermediaries between you and the insurance company.

But if you don't seem to be getting anywhere, simply apply with a different carrier. Your relationship with the insurance company is already sullied, so go with a different company.

And when you fill out these applications, it's natural to forget some dates, or the names of doctors. You can always make a note at the bottom saying the dates were estimated, according to eHealthinsurance.com.

3. Appeal denied claims. If your claim is denied, make sure you find out what the appeals process is. Every plan should have a clear appeals process that you must follow. And don't delay. Sometimes you only have 60 days to start the process. Make sure you collect any paperwork you already have, such as bills, physician information or physician referrals, and keep a log of every telephone call you make.

If your attempts to deal with the insurance company informally are not successful, you will have to file a formal appeal. You'll probably have to submit an appeal in writing.

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Open Wide: A Dental Exam on Health Reform

When the 5-year-old boy opened wide for dentist Lindsey Robinson in April, she found cavities in the back corners of his mouth. But his parents, who had no insurance, didn't bring him back for fillings.
The boy returned in September with a toothache. Untreated, one cavity ''got into the nerve and developed an abscess,'' says Robinson, who practices in Grass Valley, Calif. She had to remove the tooth. "The parents felt horrible putting it off,'' she says.

This recession has led many adults to postpone trips to the dentist, both for themselves and their children. "In tough economic times, you're concerned about your job and your expenses,'' says Bill Prentice, director of the American Dental Association's Washington office. "People are putting off dental care. Patients aren't coming back for checkups as they should.''

During the ferocious debate on health reform, meanwhile, dental care has largely been shunted to the sidelines. It's treated as separate -- and unequal-- to general medical care, says Oral Health America, an advocacy and education organization that has called for dental coverage for all Americans.

The American Dental Association has also pushed for inclusion of dental care in reform legislation. In addition, the group seeks better pay for dentists who treat patients covered by Medicaid, the government insurance program for the poor and disabled. Currently, many state Medicaid programs don't cover dentists' costs of seeing these patients.

California, mired in a budget crisis, has even removed dental coverage for adults on Medicaid, Robinson notes.

Dental care represents about 5% of overall health care spending. But the out-of-pocket expenses can add up, especially for the more than 100 million Americans who have no dental coverage -- more than twice the number who lack health insurance. Kids without dental insurance are much more likely to have no regular dental care than those with coverage. And untreated tooth decay in children can cause pain, difficulty concentrating on learning, loss of school days, and difficulty in eating and sleeping. Tooth decay is the most common chronic disease of children, says the Centers for Disease Control and Prevention.

Untreated tooth problems afflict millions of adults as well. Adult dental procedures typically are much less expensive than those in general medical care, but some still can run into the thousands of dollars, which leads many to forgo treatment. In 2005, 25 million adults did not receive dental care because they couldn't afford it, according to a report by Delta Dental Plans Association.

Families who have private dental insurance generally get at least some coverage for cleanings, fillings and X-rays, as well as twice-a-year checkups.

People without coverage can get short-term relief with lower-cost care at a community health center, a county health department, or a clinic at a dental school.General dentists in private practice averaged $206,000 in income in 2007, according to the American Dental Association, though the group says the economic downturn has squeezed that pay.

Robinson, a pediatric dentist, works in a rural area in Northern California where the recession has struck hard. Like other dentists, Robinson says she's flexible on payments if a family can't immediately pay the entire cost of a visit. "I'm certainly willing to work with people,'' Robinson says.

About 20% of her pediatric patients have no coverage at all, she says.

"There are so many kids with giant holes in their mouth,'' she says. ''They have advanced disease. Many need a great deal of treatment.''

Robinson sees the reform debate in Washington as vitally important as millions more Americans may gain health insurance. Preventive dental care and treatment should be covered for those newly insured people, she says.
Like other oral health advocates, she wants to put teeth in health care reform. "It's important that dentistry has a seat at the table,'' Robinson says.

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A Good Argument for Not Buying Health Insurance

This post is really targeted to the self-employed and non-insured among you. (You lucky still-employed workers with health benefits, you're excused for now.) I just want to offer this interesting op-ed piece by Chicago-based health care writer J. Duncan Moore, Jr. as food for thought, because he gives good reasons for why it's not worth having health insurance -- and how it's possible to profit without it.
I have individual coverage by Anthem Blue Cross, who, without any notice, just upped my monthly premium 21 percent. To afford the payments, I moved from a $2,500 deductible to a $5,000 deductible last year. A month after that move, Blue Cross upped my premium 15 percent. My "who needs this crap" attitude was stoked after reading Moore's point of view.

After losing his job and seeing his $447-a-month COBRA coverage about to expire, Moore decided not to get an individual plan. His reasoning: he's a healthy person who eats right, sleeps enough and has no family history of major diseases. So, Moore decides, "Why shouldn't I create my own network and find providers who would give me a discount for paying cash?" Putting his plan into practice, he went to his doctor for a checkup. His visit was billed at $100 but discounted to $65, and routine cholesterol tests were marked down from $195 to $110. "I wrote two checks on the spot. There was no paperwork, no correspondence, no phone calls, no arguing about deductibles or co-pays, for me or for the doctor's office. And the doctor got his money immediately."

This is where he tips into a part of U.S. health care that is changing and needs to change: patients knowing the price of medical treatments upfront. " Most doctors don't like to cite a price in advance, but as the U.S. health system moves toward asking patients to pay a greater share of the bill, doctors are going to have to become more responsive to their patients' cost sensitivities."

I wish I had known that earlier. When my doctor told me I needed to do the standard blood work for cholesterol levels, STDs, etc., I went to the lab without a second thought. How much could a couple of pricks of my thumbs to put traces of my blood into five vials really cost? Turns out it cost $1,400. My Blue Cross plan covered a little under $300 of it. The lab is obviously used to this kind of sticker-shock from patients because it immediately offered me a monthly installment plan. The $1,100 I owe is split into 12-month payments of $90.95. How much could I have saved if I had asked the cost beforehand and whether it was negotiable?

My friend who is experiencing a strange gastrointestinal condition isn't going to have sticker shock. She needs a MRI but instead of going immediately with her doctor's choice, she's calling hospitals all over the Bay Area to find out what they charge and whether they offer discounts. One interesting note: She discovered the hospitals charge different rates based on what health care plan a person has -- one hospital receptionist told her she would be charged more if she had Aetna instead of Blue Cross. Unfortunately, the receptionist clammed up when my friend asked by how much.

Moore's reasoning for not having health insurance may not make sense for everyone, and woe to him if he's ever hit by a car or falls off a ladder. But, as he puts it, "Even if I bought a policy, there are no guarantees that the insurance company would pay, that it wouldn't try to weasel out of the obligation." He cites a guy who was pre-approved for pricey back surgery by his health plan -- which immediately back-peddled when they got the $148,000 bill. Only a newspaper article about it and public outrage got them to pay.

To me, Moore's reasoning about skipping health insurance the way it's structured right now for individuals makes sense. Regardless of how you feel about Obama's attempts to change U.S. health care (I must admit I favor a government option). But no matter how health care changes, one thing is for sure: we patients need to be as consumer-savvy and price-conscious when we're in the doctor's office or hospital as we are at the grocery store and shopping mall.

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The Annual Deductible of a Health Insurance Policy

What Exactly is the Annual Deductible?

By definition, the annual deductible of a health insurance plan is the dollar amount you must pay each plan year before the insurance carrier will help you pay for your health care costs.

Now, some health care procedures, like office visits, preventative care and generic drug prescriptions, may have a set co-pay. For anything that has a set co-pay, the amount of that co-pay does not count towards your deductible. Now you may not be happy about that, but you must understand that these co-pay amounts are lower than you would pay without the coverage.

How Does the Annual Deductible Work?

Say your policy has an annual deductible of $1,000. By its definition as noted above, you would be responsible for paying for $1,000 worth of health care expenses (excluding co-pays as mentioned above) for the calendar year. Once you have paid for health care services that total $1,000, the insurance company steps up and contributes to any additional costs as outlined by your policy.

In a typical PPO plan, this usually means that you will have to pay for a percentage of the cost. The insurance company negotiates how much the service will cost with the service provider. You pay your percentage and the insurance company pays the balance.

Annual deductibles are either based on the individual or on the family if more than one person is covered by the policy. The individual deductible applies to each covered person separately. In the case of an individual deductible, each member must meet the annual deductible before the insurance company contributes to the costs of that individual.

Family deductibles apply to all covered members of a family. Depending on the guidelines, meeting the deductible can be shared by two or more family members.

This leads us to one of the most common family deductible formats, the two member max.

The Two Member Max Clause:

If your policy covers more than one person, you may see a footnote on the annual deductible that says "2 member max". Effectively then, two of the people covered on the policy must each meet the deductible before the insurance company will help pay for the health care costs of all covered members.

What is just one person meets the deductible? If one person meets the deductible then the insurance company will contribute to that person's health care costs and not any of the other covered members. And, this person's future expenses do not count towards any other member's deductible. A second member must also meet the deductible before the insurance company will contribute to their health care expenses.

If there are more than two people covered under the policy, once two of the members have reached the deductible, the insurance company will contribute to all members' health care costs.

Don't let your annual deductible take you by surprise. Know what it is and how it is structured.

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Secrets to Lowering Healthcare Insurance Payments

Stay Fit

Comparison Shop

Do The Math

You must be healthy to get the cheapest premium. health care insurers will ask about your medical history before offering you an insurance policy. If you don't meet the insurance carrier's underwriting criteria you may have your premium increased or you may not be offered an insurance policy at all.

This may or may not be fair. However, this is the way that insurance works and in order to get the cheapest rate for the best policy, we must deal with the system that is currently in place. healthcare insurance companies are concerned about your chances of getting ill in the future. Your current healthcare status and your health care history greatly impact the probability of your having high or low medical expenses in the future.

Many factors that impact your Health and longevity are outside your control. But there are many that are within your control. Do what you can to make sure that you and your family stay healthy.

Of course there are many other benefits of living a longer healthier life. So if you smoke, please stop. If you don't have a regular exercise routine, please consider one.

Improving your level of health not only improves your odds of living a longer life, it improves your odds of avoiding a financial catastrophe. If you develop a medical condition that causes you to lose your job, you lose income. When you lose your job, you will probably be offered COBRA. COBRA Health insurance is usually more expensive than other plans, but this may be the only plan available; Health insurance companies may not want to insure you unless they are forced to do so. This raises your expenses. After your COBRA eligibility runs out you may be faced with buying a state-mandated policy that will cover your pre-existing condition that you can't afford or going without coverage. You may be both unemployable and uninsurable at this point. Any significant medical bill will ruin you.

Ccompare multiple plans

Many people fail to price shop and benefit shop. They will often take their COBRA option when they lose their job without looking at other alternatives. When their COBRA eligibility ends, they may take an individual policy from the same insurer without looking at other companies offerings. Shopping around for insurance is a key to lowering your costs.

Do The Math

Would you put a dollar on a bet where you could only get a dollar back if you won? How about betting me a dollar and only having the potential of getting 90 cents back? You're too smart to make a bet like that, but many people are making bad decisions about their medical insurance because they have never done the math are look askance at higher deductible plans.

A high deductible healthcare insurance policy may be your best option. However, you need to compare prices AND benefits to determine if this is the case for you. When comparing two Health insurance policies that have different deductibles but otherwise the same, determine your annual premium for both policies and compare them with the annual deductible. Make sure that the higher premium you might pay for the lower deductible policy is justified.

Getting the best policy possible at the most competitive price means being able to comparison shop for health insurance intelligently. You can't price shop and benefit shop very well if your choices are limited or nonexistent, so do what you can to stay healthy and to keep your family healthy. You can't look at many options intelligently unless you Do The Math and make sure that any extra premiums you pay for a low deductible policy are justified.

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Florida Health Insurance: a Health Protection Scheme

If you are a resident of Florida and have not purchased a health insurance plan because of the high cost; then it is the right time to shop for Florida health insurance in tune with your budget and requirement. In Florida, all health insurance plans are regulated by State’s own Department of Insurance. As a result, it does not matter if you buy from your local agent or directly from the health insurance company, you will pay the same premium per month for the same plan.

Health insurance, in layman’s term is a monetary coverage provided by an insurance company to an individual in exchange for a premium. Today, various companies have come up with cost-effective health insurance plans, which are ideal for children up to the age of 19, pregnant women, self employed individuals, and families to meet their healthcare expenses. In Florida, you can gather quotes from the insurance companies and compare them when purchasing your health insurance plan. Indeed, you will get the best price and coverage you need for your health through a single health insurance policy.

As far as coverage is concerned, Florida health insurance covers all your medical expenses such as cost of medicines, prescriptions, doctor visits, and hospital stays. But the coverage and rates of premiums are determined only on the basis of your current health condition. At the same time, you can find a host of health insurance plans including affordable Florida group health insurance, Florida group insurance, temporary health insurance Florida, Florida individual health insurance and small business health insurance Florida in varied rates and premiums.

Health insurance protects your most important asset, yours and your family’s health. It is better to have health insurance with less benefits or a higher deductible than not to have health insurance at all. It is advisable to search for Florida health insurance quotes online, since there is every possibility of getting the coverage you are actually looking for. Plus, you will have an online representative who will shop for the cheapest plan for you at each visit. When comparing health insurance quotes in Florida, it is advisable to take the advantage of the Internet, you will surely get the best deal.

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3 Health Insurance Misconceptions

Misconception #1:

Co-insurance

Co-Insurance levels should be given careful analysis when buying insurance. A health insurance plan premium with an 80/20 or 20% co-insurance level is much higher typically than is a 50/50 or a 50% plan. Co-insurance or shared costs between the insured and the insurance company normally have stop losses or Maximum Out-Of-Pocket amounts to protect you against a catastrophic event. Make sure there is, and you know what the stop loss is on the plan you are looking at. Let's further examine and break down co-insurance.

Example:

Health insurance plan A has a $2,000 deductible and is an 80/20 plan. (Meaning you co-insure 20% after your deductible of $2,000) Let’s say your stop loss (maximum out of pocket) is $3,000, (which means you're total out of pocket would be $5,000 on this plan and the plan costs $380 per month for a family of 5.

On the other hand health insurance plan B has a $5,000 deductible but is a 100% plan. (Meaning you have no co-insurance after your deductible of $5,000) Your stop loss (maximum out of pocket) is zero after your deductible and this plan costs you $290 per month.

Both plans have 100% coverage after your stop loss, (maximum out of pocket) has been met.

Your stop loss (maximum out of pocket) for plan A would be $5,000 per year. ($2,000 deductible + $3,000 co-insurance).

Your stop loss (maximum out of pocket) for the plan B would be $5,000 per year as well. ($5,000 deductible + $0 co-insurance).

Your total risk "potential loss" or exposure would be $5,000 in any given year on either plan.

So in this example, on plan A you would be paying an extra $1,080 per year for the exact same out of pocket catastrophic exposure compared to plan B.

Wouldn’t it make more sense financially to select plan B as opposed to plan A? When it comes to choosing a health plan these are the things most people overlook, or fail to understand. When you choose Colorado Health Solutions to represent you, we will inform and educate you of these types of things to make sure you select the right plan at a price you can afford.


Misconception #2:

Deductibles

Health insurance companies will charge you a "fool's premium" for a very low deductible. By "fool's premium" we mean that to lower your deductible from say $2,000 to $500, they will charge you an additional $2,880 a year. So unless you manage to have a catastrophic event in the first 6 months of your plan, you will always be the loser. Look carefully at the cost for different deductibles and ask yourself a couple questions:

How much does it cost for the next lowest and the next highest deductible?

How many months will it take before you have lost the advantage of the lower deductible by paying the difference in premiums?

Of course you could wind up in the hospital next month and call me up with an "I told you so". However, 99% of you will never reach your deductible. There is normally a trade off between costs and benefits and typically it's represented graphically by a curve of "diminishing returns".


Misconception #3:

Co-pays

A $20 doctor office co-pay is much more expensive than a $40 doctor office co-pay! How you ask? Let’s take a closer look.

Let's assume that the premium associated with a $20 co-pay is an additional $174 per month in premium for a family of 4 when compared to a $40 co-pay. (This is a real scenario)

In this scenario you would be paying an additional premium of $174 per month ($2,088 per year) to protect yourself against a "potential loss" or exposure of $20 each time you visited the doctor’s office. To come out even with the $20 co-pay you'd have to visit the doctor about 105 times a year to come out even! Don't pay a "fools premium" for benefits that are offset by increased premiums. It pays to do a little math when looking at cost versus benefits when purchasing health insurance. Again we can help you decipher this and choose the right plan.

We hope this will help you now or sometime in the future, what I tell my clients is this...You already pay enough for your health insurance, don't pay more than you have to!

Health insurance carriers are coming out with new more affordable plans all the time, how will you know if one is right for you? Would your agent call you if there was one better suited for your needs? Most likely not! Most agents/brokers will only talk to you if there is something in it for them! We here at Colorado Health Solutions have a completely different attitude and approach, if there is something that becomes available best suited for you and your family we will let you know!

There has been a new major medical plan that was just released that is on average 20-40% less than many of the other carriers. If you'd like to get a quote on this plan to either get health insurance or lower your premiums just visit our website today, we'd be happy to help. Again, don't pay more than you have to when it comes to your health insurance!

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To Insure Your Health

Health Savings Accounts (HSA) are becoming more popular as the cost of health insurance continues to increase.

An HSA is a special bank account that is set up in conjuctions with the enrollment in a high deductible health plan (HDHP).

You, your employee or an eligible family member can make tax free contributions to the HSA. The HSA will earn interest that is not taxed and any withdrawals to pay for qualified medical expenses are also not taxed. Any funds remaining in the account at the end of each year is carried over to the next year.

The contribution to an HSA each year is limited to the amount of the HDHP deductible or $2,650 for individuals and $5,250 for families, whichever is less. You or your employee may not contribute to an HSA once you or your eomployee becomes eligible for and enrolled in Medicare. Your or your eomployee can make withdrawals to pay for qualified medical expenses by check or debit card just as you would with any other bank account.

Your employee owns the HSA so that your employee can keep the account even if he changes health insurance plans or jobs. However, if the owner of the account is not enrolled in an HDHP, he can no longer make contributions to the account.

An HDHP is a health insurance plan that has a high deductible of, at least, $1,000 for individuals and $2,000 for families, adjusted each year for the cost of living. Despite the high deductibles most HDHPs will cover preventative care in full. To be enrolled in an HDHP, the enrollee cannot be covered by any other health insurance coverage, including under a spouse's plan, that is not a HDHP.

An HSA provides a method for you or your employees to reduce health insurance costs by enrolling in a less expensive HDHP as long as you or your employees are willing to finance, through the HsA, the medical expenses that are incurred, up to the amount of the deductible.

You should consult with a tax advisor to determine eligibility requirements and tax advantages before you decide to participate in an HSA.

If you and your employees decide that an HSA is a good alternative to the more traditional health insurance plans, The United State Federation of Small Businesses (USFSB) can offer you, from selected carriers, this less costly option.

Another way USFSB can help you reduce your costs for medical services is through the use of a Medical Discount Card. It is important to note that this is not insurance. The Medical Discount Card can be used, at participating health care providers, to obtain reduced cost for the services that are rendered as long as you are prepared to pay for the services at that time.

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Why Buy health Insurance?

Your health history is a good predictor of whether or not you might have healthcare problems in the near future. If you've always been healthy, you've got a better chance of not needing medical care in the next year when compared to someone who has a history of being sick all the time.

However, many people who have diabetes, high blood pressure or even heart attacks had unblemished health histories for decades. Then they got sick and maybe stayed sick or even died.

Your good healthcare history isn't a very good predictor of future injury. Anyone can trip on a child's toy and fall down a flight of stairs or have an accident while exercising.

Will Your Car Cover Policy Pay Your health costs?

Your automobile Issurance plan offers limited Insurance for your health bills. Your auto Issurance plan might pay for the health care expenses of those you may injure in an accident. Because of the fact that you can't hold yourself legally liable for your own health care expenses, this Insurance is often inadequate when it comes to your medical costs. Even insurance policies with "no fault" Insurance typically limit this Issurance to a few thousand dollars per accident.

Will Your Employer's Assurance Cover You?

if you are hurt on the job, there is a good chance that your employer's workmen's compensation or liability Insurance will pay your medical bills. But it is the rare disease or sicknesses that will be covered by an job's liability policy.

Of course when your employer provides health Cover for you, many more situations are likely to be covered.

Will A Hospital Treat You Even if You posess No Assurance?

In many situations you can receive medical services from a hospital whether or not you have health Insurance. There are big drawbacks. One is the limitation on the medical care and another is the potential destruction of your credit.

Most hospitals will treat uninsured patients who walk through their doors in the aftermath of heart attack. Most hospitals will treat those who are in need of immediate health care in emergency situations. However, once the crisis is over, they are likely to stop medical care unless you can pay for it.

If a hospital does treat you when you don’t own health care Insurance the treatment won't be free. You will be billed and when you can't pay for your treatment, the event and its cost may hang over your head like a dark cloud for years and years.

Can The Government Pay Your health care bills?

In some cases Social Security or Medicaid will cover your health expenses. However few people qualify. You will find that only particular diseases and disorders qualify for payments from Social Security. Medicaid only covers those who posess very low assets and income.

A car Insurance policy or some other liability plan or the government might cover your medical care costs in some situations. However, only a good health insurance policy will give you the peace of mind of knowing that a disease or car crash isn't likely to ruin your creditworthiness.

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CPS Health Insurance Definitions

CPS Health Insurance Definitions

The Census Bureau broadly classifies health insurance coverage as either Private (non-government) coverage or Government-sponsored coverage.

Private Health Insurance
Private health insurance is coverage by a health plan provided through an employer or union or purchased by an individual from a private health insurance company.

Employment-based plans
Employment-based health insurance is coverage offered through one's own employment or a relative's. It may be offered by an employer or by a union.

Own Employment-based plans
Own employment-based health insurance is coverage offered through one's own employment and only the policyholder is covered by the plan.

Direct-purchase plans
Direct-purchase health insurance is coverage though a plan purchased by an individual from a private company.

Government Health Insurance

Government health insurance includes plans funded by governments as the federal, state, or local level. The major categories of government health insurance are medicare, medicaid, the State Children's Health Insurance Program (SCHIP), military health care, state plans, and the Indian Health Service.

Medicare
Medicare is the Federal program which helps pay health care costs for people 65 and older and for certain people under 65 with long-term disabilities.

Medicaid
Medicaid is a program administered at the state level, which provides medical assistance to the needy. Families with dependent children, the aged, blind, and disabled who are in financial need are eligible for Medicaid. It may be known by different names in different states.

SCHIP
SCHIP, the State Children's Health Insurance Program, is a program administered at the state level, providing health care to low-income children whose parents do not qualify for Medicaid. SCHIP may be known by different names in different states.

Military health care
Military health care includes TRICARE and CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), as well as care provided by the Department of Veterans Affairs (VA).

TRICARE
TRICARE is a military health care program for active duty and retired members of the uniformed services, their families, and survivors.

CHAMPVA
CHAMPVA is a medical program through which the Department of Veterans Affairs helps pay the cost of medical services for eligible veterans, veteran's dependents, and survivors of veterans.

VA
The Department of Veterans Affairs provides medical assistance to eligible veterans of the Armed Forces.

State-specific plan
Some states have their own health insurance programs for low-income uninsured individuals. These health plans may be known by different names in different states.

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Overview of Medicare Supplemental Insurance

Background information on Medigap insurance plans that supplement Medicare and the benefits those plans cover.

Medicare has several gaps and doesn't pay for all of the health care services you may need. If you are in the Original Medicare Plan, you may want to buy Medicare supplemental insurance, also called Medigap insurance. This is health insurance that helps pay for some of your costs in the Original Medicare program and for some care it doesn't cover.

Medigap insurance is sold by private insurance companies. By law, companies can offer only 12 standard Medigap insurance plans, plans, named A through L. Each plan has a different set of benefits. (Beginning in 2006, Medigap Plans H, I, and J, cannot be sold with prescription-drug benefits, although people who already had those policies can keep them.)

You are advised to study all the Medigap plans before deciding which is best for you. No matter which insurance company offers a particular plan, all plans with the same letter cover the same benefits. For instance, all Plan C policies have the same benefits no matter which company sells the plan. However, the premiums can vary.

All 12 Medigap policies cover basic benefits, but each has additional benefits that vary according to the plan. Briefly, Plan A is the most basic plan. Plans B-L offer everything in Plan A and provide even more coverage. Plans K-L offer similar services as Plans A-J, but the cost-sharing for the basic benefits is at different levels.

None of the standard Medigap plans cover:
• Long-term care to help you bathe, dress, eat, or use the bathroom
• Vision or dental care
• Hearing aids
• Private-duty nursing
• Prescription drugs

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History and evolution of healt insurance

History and evolution of healt insurance

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Health care – a global concern: Part 1 - Sun Life Financial

Around the globe, there is widespread concern in both developed and developing nations around health and the affordability of health care, especially in retirement.

May 21, 2009 - The population is aging. Rapidly. Global numbers for life expectancy rose from 47 years in 1950 - 1955 to 65 years in 2000 - 2005. And the numbers are expected to rise to 75 years in 2045 - 2050.1 This bulge in the demographics, especially in developed nations, will test and impact government social policies and health-care systems around the world. The population seems to be taking note.

Asia and health care

A Sun Life survey conducted in Asia found that people are thinking about health more than ever before. This is especially true in Hong Kong and China where both personal and parental health are serious concerns. In Hong Kong, 77% of those surveyed indicated they think more about health than 5 years ago.

What are we thinking about? For many of us, we’re thinking about the cost of health care. In the Philippines and Indonesia, 54% of respondents first associate health care with expense.2 And a November 2008 Gallup poll revealed the Chinese population worries more about having enough money to pay medical costs than they do about having enough for retirement, their children's education or to maintain their standard of living.

Across the globe, faith in government health-care systems is low.3 In Asia, personal savings are considered the most important source of financing for health-care treatment. Confidence in ability to pay for health care in Indonesia, India and Philippines is 24%, 19% and 19% respectively. China and Hong Kong are less confident in being able to pay for health care – only 5% and 6% say they are "very confident".

North Americans and health care

North Americans aren’t immune to health-care concerns. Almost half of U.S. adults are "very" to "extremely" worried about having to pay more for health care or health insurance. Only 8% are not worried at all. Those ages 45 to 64 years old are most worried (56%), but 37% of those ages 18 to 34 have concerns as well.

Their concerns appear valid. According to the Centre for Retirement Research’s March 2009 National Retirement Risk Index, when health-care costs are included in the calculations, the percentage of households in America considered "at risk" increases from 44% to 61%. "At risk" is defined as unable to maintain their standard of living in retirement. Previous analysis of health-care costs did not consider potential expenses for long-term care towards the end of life.

Unfortunately, long-term health-care costs may be the reality for many. According to our U.S. Unretirement Index3, 77% of Americans aged 40-49 who plan to work past traditional retirement age are doing so to receive health-care benefits. Yet half of the boomers in the U.S. who have retired early have done so for health reasons. The majority live in lower-income, less-prepared households – the people who most need the income and benefits that come with prolonged employment.

Canadians, too, have very real concerns about health-care costs. According to Statistics Canada, by 2012, half of the workforce will be 55 or older and almost a quarter of them will be more than 60 years old. For Canadians, as for the rest of the world, increased longevity means their parents are living longer, too. Many baby boomers expect to pay long-term health-care bills for both their parents and for themselves. Few retirees and entrepreneurs have a benefits package or sufficient savings that allow them to do this.

A global challenge

Older populations around the world face different standards of living. According to the World Health Organization’s 2008 World Health Report, annual government spending on health worldwide varies from just $20 US to more than $6,000 US per person. More than 100 million people a year fall below the poverty line because of personal health expenditures, and as many as 5.6 billion people have to pay for more than half of their health expenditures themselves.

Covering long-term health-care expenses in retirement introduces potential challenge for individuals and governments around the world. Longevity is sure to challenge health-care systems to find better and cost-effective treatments for chronic health problems, and to build health-care systems capable of handling the load.

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California Health Insurance

In 2007, 87% of Californians had some form of health insurance. Services in California range from private offerings: HMOs, PPOs to public programs: Medi-Cal, Medicare, and Healthy Families (SCHIP).

At times, it is difficult to navigate the complex health insurance system. California developed a solution to assist people across the State and is one of the only States to have an Office devoted to giving people tips and resources to get the best care possible. California's Office of the Patient Advocate was established July 2000 to publish a yearly Health Care Quality Report Card on the Top HMOs, PPOs, and Medical Groups and to create and distribute helpful tips and resources to give Californians the tools needed to get the best care.

Additionally, California has a Help Center that assists Californians when they have problems with their health insurance. The Help Center is run by the Department of Managed Health Care, the government department that oversees and regulates HMOs and some PPOs. The number to call is 1.888.466.2219, they have staff on hand to help you through the process of filing a complaint, or just figuring out what to do next.

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United States

The United States mixed economy health care system relies heavily on private (for profit) and not-for-profit health insurance, which is the primary source of coverage for most Americans. According to the United States Census Bureau, approximately 84% of Americans have health insurance; some 60% obtain it through an employer, while about 9% purchase it directly.[38] Various government agencies provide coverage to about 27% of Americans (there is some overlap in these figures).

Public programs provide the primary source of coverage for most seniors citizens and for low-income children and families who meet certain eligibility requirements. The primary public programs are Medicare, a federal social insurance program for seniors and certain disabled individuals, Medicaid, funded jointly by the federal government and states but administered at the state level, which covers certain very low income children and their families, and SCHIP, also a federal-state partnership that serves certain children and families who do not qualify for Medicaid but who cannot afford private coverage. Other public programs include military health benefits provided through TRICARE and the Veterans Health Administration and benefits provided through the Indian Health Service. Some states have additional programs for low-income individuals.

In 2006, there were 47 million people in the United States (16% of the population) who were without health insurance for at least part of that year.[39] About 37% of the uninsured live in households with an income over $50,000.

In 2004, U.S. health insurers directly employed almost 470,000 people at an average salary of $61,409. (As of the fourth quarter of 2007, the total U.S. labor force stood at 153.6 million, of whom 146.3 million were employed. Employment related to all forms of insurance totaled 2.3 million. Mean annual earnings for full-time civilian workers as of June 2006 were $41,231; median earnings were $33,634.) The insurance industry also represents a significant lobbying group in the United States. For 2008 insurance was the 8th among industries in political contributions to members of Congress, giving $28,654,121, of which 51% was given to Democrats and 49% to Republicans, with the top recipient of insurance industry contributions being Senator John McCain (R-AZ). The leading contributor from the insurance industry — as measured by total political contributions — was AFLAC, Inc., which contributed $907,150 in 2007.

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United Kingdom

The UK's National Health Service (NHS) is a publicly funded healthcare system that provides coverage to everyone normally resident in the UK. It is not strictly an insurance system because (a) there are no premiums collected, (b) costs are not charged at the patient level and (c) costs are not pre-paid from a pool. However, it does achieve the main aim of insurance which is to spread financial risk arising from ill-health. The costs of running the NHS (est. £104 billion in 2007-8) are met directly from general taxation. The NHS provides the majority of health care in the UK, including primary care, in-patient care, long-term health care, ophthalmology and dentistry.

Private health care has continued parallel to the NHS, paid for largely by private insurance, but it is used by less than 8% of the population, and generally as a top-up to NHS services. There are many treatments that the private sector does not provide. For example, health insurance on pregnancy is generally not covered or covered with restricting clauses. One of the major insurers, BUPA, excludes many forms of treatment and care that most people will need during their lifetime or specialist care most of which are freely available from the NHS. These include:

ageing, menopause and puberty; AIDS/HIV; allergies or allergic disorders; birth control, conception, sexual problems and sex changes; chronic conditions; complications from excluded or restricted conditions/ treatment; convalescence, rehabilitation and general nursing care ; cosmetic, reconstructive or weight loss treatment; deafness; dental/oral treatment (such as fillings, gum disease, jaw shrinkage, etc); dialysis; drugs and dressings for out-patient or take-home use† ; experimental drugs and treatment; eyesight; HRT and bone densitometry; learning difficulties, behavioural and developmental problems; overseas treatment and repatriation; physical aids and devices; pre-existing or special conditions; pregnancy and childbirth; screening and preventive treatment; sleep problems and disorders; speech disorders; temporary relief of symptoms. († = except in exceptional circumstances)

BUPA's competitors include, among others, AXA, Aviva, Groupama Healthcare and Pru Health.

Recently the private sector has been used to increase NHS capacity despite a large proportion of the British public opposing such involvement. According to the World Health Organization, government funding covered 86% of overall health care expenditures in the UK as of 2004, with private expenditures covering the remaining 14%.

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