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Health Insurance. Jayne Hurd & Mike Jordahl. Who Needs Insurance?. Health insurance is not required but at some point everyone will need it. Why?. You never know when you might be involved in an accident or diagnosed with a serious medical condition.

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health insurance

Health Insurance

Jayne Hurd & Mike Jordahl

who needs insurance
Who Needs Insurance?

Health insurance is not required but at some point everyone will need it

slide3
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.

different types
Different Types

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
continued
Continued..

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
health insurance companies
Health Insurance Companies

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

companies continued
Companies Continued..

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

average national cost
Average National Cost

Monthly

Annual

Family

$1,115

Individual

$402

Family

$13,375

Individual

$4,824

25 year old man

Anthem Smart Sense Plus

Plan Type

POS

Deductible

$5,000

Coinsurance

30%

$62.14/month

25 Year Old Man
45 year old man

Anthem Smart Sense Plus

Plan Type

POS

Deductible

$2,500

Coinsurance

30%

$135.23/month

45 Year Old Man
65 year old man

Anthem Smart Sense Plus

Plan Type

POS

Deductible

$2,500

Coinsurance

30%

$264.33/month

65 Year Old Man
slide12
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.

slide13

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.

Two Year Old Colorado Girl Denied Health Insurance for Being Too Skinny

slide14

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.

Nevada Seniors Saved $12 million on RX Drugs in 2011

sources
Sources

"LIFE Foundation | Who Needs Health Insurance?" LIFE Foundation. Web. 29 Feb. 2012. <http://www.lifehappens.org/who-needs-health-insurance/>.

"LIFE Foundation | What Are the Different Types?" LIFE Foundation. Web. 28 Feb. 2012. <http://www.lifehappens.org/what-are-the-different-types-of-health-insurance/>.

"Co-pay." Investopedia. Web. 28 Feb. 2012. <http://www.investopedia.com/terms/c/copay.asp>.

"Individual & Family Plans." - Dean. Web. 29 Feb. 2012. <http://www.deancare.com/insurance/find-plan/individual-family/>.

"Medical Plans." Individual Insurance Plans from Humana. Web. 29 Feb. 2012. <http://www.humana.com/individual_insurance/insurance_products/humanaone_medical_plans.aspx>.

"Average Insurance Costs For Auto, Home, Renters, and Health." Compuquotes.com. Web. 29 Feb. 2012. <http://www.compuquotes.com/average-costs-of-insurance.html>.

“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. <http://www.gallup.com/poll/121820/one-six-adults-without-health-insurance.aspx>.

"Two-year-old Colorado Girl Denied Health Insurance for Being Too Skinny." DailyFinance.com. Web. 01 Mar. 2012. <http://www.dailyfinance.com/2009/10/20/two-year-old-colorado-girl-denied-health-insurance-for-being-too/>.

http://www.foxreno.com/news/news/local/reid-nevada-seniors-saved-12-million-rx-drugs-2011/nJQb2/