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JAYNE HURD & MIKE JORDAHL Health Insurance. Who Needs Insurance? Health insurance is not required but at some point everyone will need it.

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Presentation on theme: "JAYNE HURD & MIKE JORDAHL Health Insurance. Who Needs Insurance? Health insurance is not required but at some point everyone will need it."— Presentation transcript:

1 JAYNE HURD & MIKE JORDAHL Health Insurance

2 Who Needs Insurance? Health insurance is not required but at some point everyone will need it

3 Why? You never know when you might be involved in an accident or diagnosed with a serious medical condition. The main reason to have coverage is to have protection against large expenses of serious illness or injury.

4 Indemnity Plan HMOs Can go to doctor of your choice Insurer generally pays 80%, you pay 20%  Coinsurance Vast majority of procedures covered Have deductibles  Amount of expenses paid before insurer pays Out-of-pocket Maximum  Once expenses reach certain amount insurer will pay total bill Health Maintenance Organization Pay a set premium  Payment for insurance Range of benefits  Including preventative care Some require co-pay  Requires insured to pay a certain amount for service before insurer pays  Unlike co-insurance- insured pays certain percentage Different Types

5 PPOs POS Plans Preferred Provider Organization Managed care closest to Indemnity Plan PPO negotiates discounts with doctors and hospitals Allows you to see a doctor anytime Typically make a copayment within your network of doctors  Out of the network insurer only pays portion of bill May have deductibles Can make self-referrals Premiums are generally lower Point of Service Plan Combines HMO and PPO Three Options  Go to primary care physician  Covered under HMO, copayment required  Access care through PPO provider  Copayment and coinsurance are required  Obtain services from an outside provider  Reimbursed according to network rules May have deductibles Continued..

6 Dean Health Plan, Inc. Dean Copay No deductible $30 office visit copay $500 hospital copay Ranges from $150-175 per month Covers any healthcare within Dean system Dean 1000 $2000 family deductible $30 office visit copay 0% coinsurance Max out-of-pocket pay $4000 per family Covers any healthcare within Dean system for the whole family Health Insurance Companies

7 Humana One Enhanced Copay 80% Plan Plans range from $200- 300 per month Deductibles of $1000 or $2500 $35 office visit copay $60 hospital visit copay Coverage for preventative care Prescription coverage included Value 100% Plan-Family Plans range from $190-240 per month Deductibles of $5000-$7500 Coverage for preventative care Diagnostic illness/injury visits are paid at 100% Prescription coverage included Companies Continued..

8 Monthly Annual Family $1,115 Individual $402 Family $13,375 Individual $4,824 Average National Cost

9 25 Year Old Man Anthem Smart Sense Plus Plan Type POS Deductible $5,000 Coinsurance 30% $62.14/month

10 45 Year Old Man Anthem Smart Sense Plus Plan Type POS Deductible $2,500 Coinsurance 30% $135.23/month

11 65 Year Old Man Anthem Smart Sense Plus Plan Type POS Deductible $2,500 Coinsurance 30% $264.33/month

12 As of June 2009, one in six Americans answered a survey saying they were without healthcare. This is about 16.3% of the population. The highest uninsured rates among Hispanics, the young, and those with low income.

13 Two Year Old Colorado Girl Denied Health Insurance for Being Too Skinny Aislin Bates was denied by United Healthcare Golden Rule for being underweight. Aislin is two years old and weighs 22 lbs. but her parents say she is perfectly healthy. Her father was self employed and needed to find insurance. He was astonished about being denied. According to the company 11% of applicants are denied for not meeting certain guidelines.

14 Nevada Seniors Saved $12 million on RX Drugs in 2011 Thousands of Nevada seniors saved millions on prescription drugs Due to health insurance reform passed in 2010 On average, each save $553 More seniors and people with disabilities on Medicare saw significantly lower costs for critical health care  Through discounts on brand-name drugs and free preventive care.

15 Sources "LIFE Foundation | Who Needs Health Insurance?" LIFE Foundation. Web. 29 Feb. 2012.. "LIFE Foundation | What Are the Different Types?" LIFE Foundation. Web. 28 Feb. 2012.. "Co-pay." Investopedia. Web. 28 Feb. 2012.. "Individual & Family Plans." - Dean. Web. 29 Feb. 2012.. "Medical Plans." Individual Insurance Plans from Humana. Web. 29 Feb. 2012.. "Average Insurance Costs For Auto, Home, Renters, and Health." Compuquotes.com. Web. 29 Feb. 2012.. “Get Quotes for Individual & Family Insurance Plans.” ehealthinsurance.com. Web. 1 Mar. 2012. http://www.ehealthinsurance.com/individual-family-health-insurance? action=changeCensus &census.zipCode=53901 "About One in Six U.S. Adults Are Without Health Insurance." Web. 01 Mar. 2012.. "Two-year-old Colorado Girl Denied Health Insurance for Being Too Skinny." DailyFinance.com. Web. 01 Mar. 2012.. http://www.foxreno.com/news/news/local/reid-nevada-seniors-saved-12-million-rx-drugs-2011/nJQb2/


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