Health Care Insurance

A recent US Census department report released in August noted some interesting changes in the health insurance habits of Americans. These include:

• The percentage of Americans without health insurance was 15.3 percent in 2007 is down from 15.8 percent in 2006 - meaning more of the population is covered by medical insurance.
• The number of uninsured was 45.7 million, down from 47.0 million - or 1.3 million less Americans without Health Coverage.
• The number of people with health insurance increased to 253.4 million in 2007 up from 249.8 million in 2006 - thats 3.6 million more Americans with health Insurance.
• The number of people covered by Private Health Insurance was 202.0 million in 2007 unchanged from 2006.
• The number of people covered by Government Health Insurance increased to 83.0 million, up from 80.3 million in 2006 - equal to 2.7 million more people.
• The percentage of people covered by Private Health Insurance was 67.5 percent down 0.2 percent from the pervious year.
• The percentage of people covered by Employment-based Health Insurance decreased by 0.4 percent to 59.3 in 2007.
• The number of people covered by Employment-based Health Insurance , 177.4 million, was not statistically different from 2006.

So, it looks as though there are more people with medical or health insurance but the increase is being covered by the government as Private or Employment Health Insurance schemes decreased slightly.

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Things have changed a lot since the 1970s, when most people in the United States who had health insurance had indemnity insurance. Indemnity insurance is often called fee-for-service or traditional health insurance. This type of coverage generally assumes that the medical provider (usually a doctor or hospital) will be paid a fee for each service provided to the patient—that is, you or a family member covered under the policy.

With fee-for-service insurance, you go to the doctor of your choice, and you submit a claim to the insurance company for reimbursement. Often, your doctor or hospital will submit the claim for you. You will only be reimbursed for “covered” medical expenses; that is, the covered services listed in your plan’s benefits summary.

When a service is covered under your policy, you can expect to be reimbursed for some—but generally not all—of the cost. How much you will receive depends on your policy’s coinsurance and deductibles. You will be responsible for the portion of the bill not reimbursed by the insurance company. Go to the section on Indemnity Insurance for more information on coinsurance and deductibles.

Today, many Americans who have health insurance are enrolled in a managed care plan, such as a health maintenance organization (HMO) or a preferred provider organization (PPO). For more information on HMOs and PPOs, go to the section on managed care.

When we talk about health insurance, we usually mean the kind of insurance that pays medical bills, hospital bills, and typically, prescription drug costs. This type of coverage includes Medicare and Medicaid, two government programs that provide health insurance coverage for certain populations, such as seniors, people with disabilities, and individuals and families with low income. But there are other types of coverage as well, including disability insurance, long-term care insurance, and other coverage that can offer additional financial protection for you and your family. Information on these types of plans is provided later in this guide.

Source: http://www.ahrq.gov/

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Short-term disability is private insurance that replaces some of your income if an injury or illness prevents you from working. While you are away from work it pays you a percentage of your income for a defined period of time.

Some employers provide group policies as part of their benefits packages. If your employer does not offer short-term disability or you want additional coverage you can buy an individual policy from an insurance agent.

State temporary disability insurance (TDI) programs are currently available in six states/territories:

• California
• New York
• New Jersey
• Rhode Island
• Hawaii
• Puerto Rico (Spanish)

For a longer illness lasting six months or more your employer may provide group long-term disability (LTD) insurance. The Federal Citizen Information Center (FCIC) offers an LTD guide that includes information about individual disability income insurance and offers tips and a checklist on buying the right policy for you.

Social Security provides long-term disability benefits based on your salary and the number of years you have worked and contributed to the Social Security system. However, Social Security replaces only a limited portion of your salary, and the qualifications to receive benefits are very strict. To be eligible for Social Security disability benefits, all of these conditions must be met:

• You have been disabled for five full calendar months.
• Your disability is expected to last at least 12 months or end in death.
• You are unable to be gainfully employed at any occupation, not just your occupation at the time your disability began.

Disabilityinfo.gov is the federal government’s web site for disability-related information and services. You may wish to access information about disability benefits, or locate state and local resources.

If you were injured on the job, you should contact your state workers’ compensation office.

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