Presentation on theme: "Choose a Healthcare Plan Taylor Bohl, Mia Feldmann, Jaclyn Saltzman, Cara Venegoni."— Presentation transcript:
Choose a Healthcare Plan Taylor Bohl, Mia Feldmann, Jaclyn Saltzman, Cara Venegoni
INDIVIDUAL HEALTH INSURANCE You get it when: - the employer does not offer health plans - you are self-employed - you are unemployed
Gives more flexibility, you can choose the coverage that works best for you from any insurance company It is generally more expensive than group policies Consider higher deductibles or high co- payments to keep premiums down
Most colleges require students to be insured You can purchase student insurance, a basic policy, for a low price through the school Offers are often extended to recent graduates as well
GOVERNMENT- SPONSORED HEALTH INSURANCE Federal and State governments establish programs that provide health insurance for certain qualifying groups of Americans
MEDICARE Designed to provide low cost medical insurance for older Americans To qualify, must be 65 or older and have certain disabilities During working years, you contribute to the Medicare plan automatically by payroll deduction and employer matches contributions
The payroll taxes help pay for the current Medicare recipients. Recipients pay a portion as well When you reach the federal retirement age, 65, the contributions of younger works and their employers will help support your Medicare costs
MEDIGAP Used to fill some of the gaps in Medicare coverage A supplemental insurance Sold by private insurance companies, not the government
MEDICAID Americans with low incomes or disabilities, regardless of age, may qualify. Helps insure the people without the means to pay for health insurance can receive health insurance Supported by both federal and state governments, run by states
People who qualify for welfare assistance probably qualify for free treatment through this program Coverage varies state to state All are based on federal guidelines
WORKERS COMPENSATION A state required insurance program where employers contribute to pay for work related injuries, illnesses or death Injured workers generally receive 2/3s of their salary while disabled. Incase of work-related death, the program provides cash benefits to the family
Run by the States so coverage varies state to state Even if you have other health insurance, you will be covered for work-related claims by workers compensation if you are employed.
HOW TO SHOP FOR HEALTH INSURANCE Compare carefully Read policies, not just brochures Ask your insurance agent, or your companys benefit coordinator what each plan covers Health insurance is only as good as the company that provides it
Objective in buying any insurance is not to cover every possible expense but to protect yourself from expenses that are too high for you to pay on your own Health insurance is a trade off The greater the coverage the higher the premiums
Decide what is most important to you QUESTIONS TO ASK: do you need coverage for your family, or just yourself? Are there any major life cycle changes in the near future? Do you need coverage for any chronic illness or disabilities?
Would you prefer to pay for preventive care and check ups or pay a higher premium for this care? How much can you afford? Is your doctor in the plan? How comfortable are you with having a limited selection of health care providers?
INSURANCE PROVIDER CONCERNS Physical Exams Care by Specialist Hospitalization Vision Rehab Plans limits and exclusions Policy for going outside the plan for care Prevented care Prescription drugs Dental Physical Therapy Number of doctors and specialists participating in the plan Emergency procedures
GROUP HEALTH INSURANCE Large employers unions and professional organizations often offer group plans to members or employees Companies sometimes pay part or all of the premium as a benefit Premiums are lower for group insurance and the plans are less expensive
EMPLOYER SPONSORED PLANS During special period of the year, open enrollment, you can enroll in employers plan Part time workers usually do not get health insurance
COBRA Consolidated Omnibus Budget Reconciliation Act COBRA requires the employers to offer to continue health insurance for 18 months after a job is left. Must notify employer within 60 days of leaving, if you do this must pay the entire premium
PRE EXISTING CONDITIONS Medical Condition diagnose or treated before you join a new plan Your new insurance may not cover the expenses for that condition until waiting for a period of a month or more, no more that 12 months, in 12 months the plan must cover it.