Definition Health insurance is insurance against the risk of incurring health care related expenses. It indemnifies the insured for the related financial loss. It is important to note that health insurance is a form of short term insurance. Disability, critical illness and long-term care insurance are all subclasses of health insurance. When an individual buys health insurance, he/she enters into a contract (policy) with the insurance company so that for a monthly premium, the insurance company will provide cover for medical expenses incurred. The level of cover and the health care providers allowed will range between different products. Coverage will include visits to doctors or hospitals, prescriptions, cost of medical examinations or immunisations, as well as other medical expenses. The payment from the insurance company can either be made directly to the policyholder or to the health care provider concerned. As a way of limiting moral hazard, most insurance companies will include features to contracts such as deductibles, co-payments, co-insurance and other out-of-pocket payments. A deductible is the fixed amount that the insured must pay out of their own pockets each year before the health insurance company starts to pay for the medical benefits. It is calculated yearly and expressed as an annual amount. When the deductible is met, the following out-of-pocket costs are incurred: co-payment and/or coinsurance. A co-payment is a specified amount that the insured must pay the healthcare provider at every visit. A coinsurance is a percentage of the total medical bill that the insured must pay for a healthcare service. As a way of protecting the insured against extreme out-of-pocket costs, some policies include an out-of-pock... ... middle of paper ... ...t quickly to have a competitive advantage. Also, said companies may not employ actuaries on a full-time basis. For example, some companies may only employ the assistance of an actuary on a consulting basis for some large scale projects. Alternatively, an actuary might be hired to fill a ‘multifaceted’ role at a company that may include a combination of roles such as marketing, client management or financial duties in addition to traditional analytical work. The best area for non-traditional work opportunities lays with smaller organisations such as small/new biotech firms and health IT companies. These companies are looking for professionals that are agile with little or no training. Moreover, actuaries with strong analytical skills and extensive experience in the health care industry are also commonly sought by healthcare executives. (Society of Actuaries, 2010)
Healthcare is a complicated thing, but there are lots of things that need to be addressed. There is controversy about whether healthcare is a right, responsibility, or a privilege. This essay is going to explain examples of each. The word right can be defined simply as “something to which one has a just claim” (merriam-webster.com). According to the online legal dictionary, the word privilege is defined as “a special benefit, exemption from a duty, or immunity from penalty, given to a particular person, a group or a class of people”. Google dictionary describes responsibility as “The state or fact of being accountable or to blame for something”, or “The state or fact of having a duty to deal with something.”
A risk classification is how much risk you are in when you buy insurance. For example if you were to buy health insurance, but you have a heart condition your insurance will cost a lot more. The insurance company can determine this in many different ways, for health insurance you will typically take a physical before you get insured. Another situation where risk comes to play in insurance would be car
When good claims go bad, “ beneficiaries who aren’t covered; services that payers say aren’t reasonable and necessary; provided services that weren’t covered; duplicate bills ...
Another downfall to HMO coverage is selective-contracting. This is a process where hospitals deny treatment to patients because their...
They also include employer-sponsored group health plans, government and church-sponsored health plans, and multiemployer health plans (hhs). There are exceptions—a group health plan with less than fifty50 participants that is administered solely by the employer that established and maintains the plan is not a covered entity (hhs). Two types of government-funded programs are not health plans: (1) those whose principal purpose is not providing or paying the cost of health care, such as the food stamps program; and (2) those programs whose principal activity is directly providing health care, such as a community health center,5 or the making of grants to fund the direct provision of healthcare (hhs). Certain types of insurance entities are also not health plans, including entities providing only workers’ compensation, automobile insurance, and property and casualty insurance (hhs). If an insurance entity has separable lines of business, one of which is a health plan, the HIPAA regulations apply to the entity with respect to the health plan line of business
Have you ever went without health insurance between jobs, or while working part time or because you just couldn?t afford it? No having health insurance is a big risk in a time where medical costs are sky high, Prescription drug prices are outrageous and when your paying your family doctor $50 for a office visit. Fifty dollars represents a full 8 hours of work for many Americans.
Healthcare can then be described as an activity or act geared to maintain health. This could be through provision of medical services or any other services that aims at maintaining good health. Healthcare is not necessarily provided when a person becomes sick or loses health but is progressive and should always be provided as a preventive measure. Healthcare system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of the targeted populations. Therefore, we can say that these are systems put in place to meet healthcare needs of a particular population. There are several systems worldwide and in this case, we are going to focus on the US Health care system.
From the hospital perspective mandating the health insurance will reduce the problem of Free riders into the Hospital and if a person who is insured visits the hospital for the treatment the cost of his medical treatment will not be totally absorbed by the hospital if the person is unable to pay for the treatment and the amount will be shared between the hospital and the insurance company.
Later, another panel member argued that the purpose of health insurance is not to insure everyone. It should be provided to only cover catastrophic health conditions. Today, not only does health insurance cover catastrophic events, but also there are limits on the amount of out-of-pocket health care costs for essential health care (The White House, 2016). Also, most out-of-pocket costs have been eliminated for preventative care (The White House,
Health Insurance is essential to your Personal Well Being and your Health. For a large proportion of uninsured people, health insurance can and is most often a matter of choice. Uninsured Americans normally tend to delay and even go without doctors' visits, prescription medications, and other effective treatments, even if they know they have a serious or life-threatening condition. Institute of Science and Technology (Institute 2009). 20 to 30 percent of uninsured children are more likely to need certain shots, prescription medications, asthma care, basic dental care and other things that we would consider a must have.
It is the individual responsibility to cover their healthcare expensed, as a result, people use their own funds or savings to pay their healthcare cost.
Universal Healthcare by definition means healthcare for all. That would also mean that an insured persons rates would not be increased to cover the uninsured. Universal Healthcare is moral and just obligation. By promoting the health of our citizens we then promote our infrastructure as well.
Health insurance provides benefits for sickness, injury, surgery, and prescription medication. There are a variety of plans with different
The United States passed bill that health insurance should be mandatory in the year 2014. Under the Patient Protection Affordable Care Act, each person is required to have at least a minimum level of health insurance failure to, the individual will face a penalty. The mandatory health insurance issue has faced reactions from both sides with some people supporting while others opposing. It is mandatory for every individual to purchase a health insurance depending on their earnings. The health care insurance is mandatory for all US citizens, and all legal residents in America. It is considered as an individual responsibility requirement, and those without this insurance are subject to a tax penalty of $750 per year up to a maximum of three times that amount ($2,250) per family. However, there are exemptions for financial hardships, incarcerated persons, religious objections, and undocumented immigrants. Mandatory health insurance is important, and should be applied in all states because, everyone gets ill and at one time, they have to visit a health care facility for medical services. In addition, it protects the health future of families, and protects people from unexpected high medical costs because they are covered.
“Part super-hero. Part fortune-teller. Part trusted advisor (“Be an Actuary.”).” An actuary is all this, they are crucial apart of the world of business. Actuaries work in both the public and private sectors of business. They are manly in the administrative part of the work place. They are in every large corporation and in even some of the smaller companies. Actuaries are most often in insurance companies and large corporations; though they are even in so financial planning businesses (“Be an Actuary.”). They are also the people that run financial calculations for both individuals and businesses (Hezzelwood). With being such an important part of business actuarial science is a very good field to go into. Forbes has ranked actuarial science as the best job in 2013 (Smith). Actuarial science is constantly ranked one of the top jobs to have in America (“Be an Actuary.”). There are many things that factor into making actuarial science the best job in America.