Health Care Insurance

Health Insurance Overview

Health insurance helps protect you from high medical care costs. Many people in the United States get a health insurance policy through their employers. In most cases, the employer helps pay for that insurance. Insurance through employers is often with a managed care plan. These plans contract with health care providers and medical facilities to provide care for members at reduced costs.

You can also purchase health insurance on your own. It usually costs you more than employer-based insurance. People who meet certain requirements can qualify for government health insurance, such as Medicare and Medicaid. If you do not have health insurance, you must pay your medical bills directly or rely on health care providers or organizations that donate care.

Managed care plans

Managed care plans are health insurance plans that contract with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan’s network. How much of your care the plan will pay for depends on the network’s rules.

Restrictive plans generally cost you less. More flexible plans cost more. There are three types of managed care plans:

• Health Maintenance Organizations (HMO) usually only pay for care within the network. You choose a primary care doctor who coordinates most of your care.
• Preferred Provider Organizations (PPO) usually pay more if you get care within the network, but they still pay a portion if you go outside
• Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care

Medicare is the U.S. government’s health insurance program for people age 65 or older. Certain people under age 65 can qualify for Medicare, too, including those with disabilities, permanent kidney failure or amyotrophic lateral sclerosis.

Medicare

Medicare helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.

The Medicare program has four parts:

• Part A is hospital insurance.
• Part B helps pay for medical services that Part A doesn’t cover.
• Part C is called Medicare Advantage. If you have Parts A and B, you can choose this option to receive all of your health care through a provider organization, like an HMO.
• Part D is prescription drug coverage. It helps pay for some medicines.

Medicaid

Medicaid is government health insurance that helps many low-income people in the United States to pay their medical bills. Although the Federal government establishes general guidelines for the program, each state has its own rules. Your state might require you to pay a small part of the cost for some medical services.

You have to meet certain requirements to be eligible for Medicaid. These might involve:

• Your age
• Whether you are pregnant, disabled or blind
• Your income and resources
• Whether or not you are a U.S. citizen or a lawfully admitted immigrant

Prescription Drug Coverage

Medicare prescription drug coverage is insurance that helps people pay for prescription drugs at participating pharmacies. It is available to everyone who has Medicare. It provides protection if you pay high drug costs or have unexpected prescription drug bills. It doesn’t cover all costs. You have to pay part of the cost of prescription drugs. Most people also have to pay a monthly premium and a yearly deductible for the coverage.

Private companies provide Medicare prescription drug coverage. You choose the drug plan you like best. Whether or not you should sign up for the coverage depends on how good your current coverage is. You need to sign up for coverage as soon as you are eligible for Medicare. Otherwise, you might have to pay a penalty.

The Obama-Biden Plan for a Healthy America

Barack Obama Will Make Health Insurance Affordable and Accessible to All

The Obama-Biden plan provides affordable, accessible health care for all Americans, builds on the existing healthcare system, and uses existing providers, doctors and plans to implement the plan.

Obama Will Lower Health Care Costs

The Obama plan will lower health care costs by $2,500 for a typical family by investing in health information technology, prevention and care coordination.

Promote Public Health

Obama and Biden will require coverage of preventive services, including cancer screenings, and will increase state and local preparedness for terrorist attacks and natural disasters.

The Barack-Biden Health Care Plan: Overview

On health care reform, the American people are too often offered two extremes – government-run health care with higher taxes or letting the insurance companies operate without rules. Barack Obama and Joe Biden believe both of these extremes are wrong, and that’s why they’ve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference.

The Obama-Biden plan provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors and plans to implement the plan. Under the Obama-Biden plan, patients will be able to make health care decisions with their doctors, instead of being blocked by insurance company bureaucrats.

Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year.

If you don’t have health insurance, you will have a choice of new, affordable health insurance options.

Make Health Insurance Work for People and Businesses – Not Just Insurance and Drug Companies

• Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.
• Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.
• Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.
• Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors.
• Make employer contributions more fair by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of their employees health care.
• Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.
• Ensure everyone who needs it will receive a tax redit for their premiums.

Reduce Costs and Save a Typical American Family up to $2,500 as reforms phase in:

• Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs and taking on drug companies that block cheaper generic medicines from the market
• Require hospitals to collect and report health care cost and quality data
• Reduce the costs of catastrophic illnesses for employers and their employees.
• Reform the insurance market to increase competition by taking on anticompetitive activity that drives up prices without improving quality of care.

A Commitment to Fiscal Responsibility

Barack Obama will pay for his $50 – $65 billion health care reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.