Medical Insurance and Different Types of Coverage Essay

In 2010, under the Obama administration, the Affordable Care Act (ACA) or what is known as Obamacare was implemented. This act was intended to provide citizens in the United States with insurance if they could not afford it beforehand. Also under ACA, a standard of coverage and the management of insurers was put into place (“Obamacare Summary” 2016). But as with everything else in life, Obamacare had its downsides. One of them being, healthy people ended up paying more for their health insurance than those

“But insurers in many counties are offering such a dizzying array of health insurance plans with so many subtle differences that consumers have struggled to determine which plan is best for them” (Pear, 2015). One of the attractive features of affordable coverage is the low monthly premium. With these attractive numbers, some people might even choose to give up their employer coverage to save the extra money. Naturally, consumers would most likely be fond with the low premiums rather than the quality of the plan. However, low premium is only worth the price that is paid for. The high deductibles lie within these low cost plans could cost the patients a fortune when they receiving the care. As this happen, the Affordable Care Act is no longer serve its purpose in helping to increase the quality and affordability of health insurance as well as reducing the cost of healthcare. Instead, the Obama Care only succeeds in reducing uninsured rate of the population. The lack of understanding about the healthcare coverage could become financially burden to the consumers’ family if they choose to use the plan.

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Last year the average cost of an insurance policy for a family of four was $20,728.00 according to the Milliman Medical Index (2012 Milliman Medical Index, figure 1). The median household income for 2012 was $51,017.00 according to Steve Hargreaves for CNN Money (2013, para. 1). This means the average American spends almost 40.62 percent of health

Health insurance comes as second nature to many of us. We grab that blue and white card and put it in our wallet and forget about it until we are sick or injured. When this happens, there it is, cushioning our fall like the extra padding it provided to cushion our wallets. This is not the case with everyone, however. Many Americans have no cushion to fall back on, no blue and white card to show the emergency room when they have an unexpected health concern. No HMO with a convenient co-pay amount when their son or daughter develops an ear infection.

With 50 million uninsured Americans in 2010, the Affordable Care Act (ACA) aimed to insure nearly everyone with “minimum essential” health insurance coverage. The ACA provides that all Americans and individuals lawfully present in the United States be provided health insurance regardless of their health or financial situation. It strengthens existing forms of health insurance coverage, while building a new health insurance market for individuals and families who do not have employer coverage or another form of “minimum essential coverage” such as Medicare or Medicaid. In addition, the ACA imposes fees or assessments on health insurance providers. The fees meant to be absorbed by insurance providers will impact premiums for all individuals covered under fully insured or self-funded plans and policies.

Health insurance in the United States is not a single nationwide system and is much more diverse in terms of production methods (Ridic, Gleason & Ridic, 2012). Health insurance is either purchased privately or provided to some public groups from the government, mainly Medicare and Medicaid (Ridic, Gleason & Ridic, 2012). Medicare is a nationally run program for aged and disabled individuals (Ridic, Gleason & Ridic, 2012). Medicaid provides coverage economically disadvantaged groups (Ridic, Gleason & Ridic, 2012). The Affordable Care Act of 2012, established a shared responsibility between the government, employers and individuals ensuring all Americans have access to affordable health insurance (The Commonwealth Fund, 2016). For private

The Affordable Care Act, signed into law on March 23, 2010, consists of 10 titles which provide Americans with health benefits. Sometimes this is referred to as “Obamacare” or the Patient Protection Act. The basis of the ACA is to assure that Americans can afford quality health insurance, without discrimination, while making purchasing insurance competitive for buyers, while also eliminating the uninsured (U.S. Department of Health and Human Services [HHS], 2015a). This allows the consumer to take control of their health care while making informed choices. By providing affordable health care, this will help reduce wasteful spending that does not improve the quality of health care, which could generate an annual savings of around $140 billion after a five-year period (Sahni, Chigurupati, Kocher, & Cutler, 2015). All American’s were required to be insured either by purchasing private insurance, by their employer, or

The number of Americans who do not have health insurance has grown rapidly over the years. The high cost of premiums implemented by insurance companies is regarded as one of the leading causes of this problem. Some people are not financially competent to purchase the insurance they need due to these prices. However, the PPACA health care reform assures to make health insurance coverage available to people who are legal residents of the US. Proof of insurance coverage is compulsory of all Americans while insurers are free to charge what they want. Coverage is universal under the new law, and it demands that all Americans obtain coverage. As of this year millions of

Understandably, physicians and hospitals are concerned about the inability to collect the remaining 40 percent from these patients. Even patients who have insurance are becoming responsible for an enormous portion of their medical fees. Among the Americans who receive health coverage through their employers, more than 40 percent have a deductible of at least $1,000. According to the Kaiser family Foundation, only about 10 percent of Americans had a deductible of this size in 2006.

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For many Americans the cost of health care is something they cannot easily afford, however these individuals make too much to obtain Medicaid. Usually these Americans are young and generally healthy individuals that do not need access to medical services regularly. Until the ACA passed in 2010, many of these healthy individuals were not covered by an insurance policy. Under our new laws regarding mandatory coverage, these hard working, healthy taxpayers are forced to maintain insurance

Mr. Smith has straight Medicare insurance, he is eligible for 100 days of in-patient rehabilitation in hospital or skilled nursing home after his hip replacement. Giving him enough time to recover. Thus, individual’s recovery with managed care is impacted by the limited days allowed by the insurance personnel. That affects the recovery and also the safety of the person after discharge from the nursing home. Eventually affecting the facility’s reputation and also limiting financial reimbursement to the facility.

This week’s key takeaways were Chapter 8, Understanding Health Insurance, was a bit of a refresher for me as I have worked in the healthcare industry for over 8 years and have a great understanding of how health insurance terminology and how it works. What made chapter 8 interesting is the timeline of health insurance in the U.S. as well uncertainty and risk involved with health insurance as it is something most of us don’t consider with our health insurance. Chapter 9, Health Economics in a Health Policy Context and how supply and demand work with healthcare. When you hear supply, and demand you usually associate with products or goods but not generally with services.

Have a look at your out-of-pocket expenses for your coverage and deductibles, for yourself and your family to make sure you are certainly not paying an amount that you just cannot afford.