Health Insurance – Is it Only For the Old and the Sick?

It has become alarming that a growing number of fit and healthy people today actually think that they have nothing to do with health insurance. They exercise regularly, do not smoke or take alcohol, eat nothing but nutritious diet, and lead a healthy stress-free lifestyle. Some even convert to vegetarianism, practice yoga meditation, reiki, chi gong and other Eastern practices thought to prevent diseases and increase longevity. So who needs health insurance anyway?

Sadly though, a number of these health buffs, some in the prime of their lives, suddenly get sick and die. You have probably heard of this athlete who, while jogging, just suddenly keeled over and fell dead in his running shoes. This just disproves that being healthy means being invincible to all diseases and sickness. There will always be a “chink in your armor” that infections and dread diseases can penetrate.

Is health insurance only for the old and the sick?

If health is wealth, then it cannot be emphasized enough that having a health insurance is definitely one of the best investment you can ever have. The famous pro-gun slogan “It is better to have it and not need it than to need it and not have it” can very well hold true for health insurance.

Health insurance has become one of the hot issues that often spark debates and controversies. Each individual has his or her own opinion as to who should get medical insurance. As was stated above, the healthy and the strong believe they don’t need health insurance anymore. The sober truth is nobody is born with a crystal ball to gaze into their future. Nobody can foretell the time and circumstance when they will get sick and require medical attention.

Another problem is that uninsured healthy people have the tendency to miss health checkups and regular physicals that provide advance detection of dread diseases, abnormalities and malignancies that could be silently spreading in their system. This can lead to disastrous consequences.

What are the benefits of health insurance?

This popular type of insurance safeguards you and your family from sudden medical emergencies that could lead to financial crisis. A well-chosen health insurance plan can provide some financial security and save you from a lot of worries if and when urgent medical care should arise.

This insurance makes cash available to pay for the various medical expenses and health care requirements covered by the policy. It also covers disability expenses and long-time health care requirements like in-house nurses and caregivers. This means you get immediate and complete health care as compared to uninsured individuals.

How does health insurance maintain your health?

One misconception about this type of insurance is that it is ONLY a way of settling medical bills in case you became sick or got injured. While this is true, it is only a part of the many benefits of health insurance and not the whole. This type of insurance not only insures your health; it ensures it.

Keeping you in perfect health not only helps keep the cost of health care at a minimum. It can make health insurance premiums low and within reach of everyone. Health insurance providers like Blue Cross Blue Shield know the value of keeping you healthy. They are also aware that keeping you in good shape eventually saves them a lot of money.

Health insurance companies have various ways to make you aware of the benefits of staying healthy. One of them is through educating the public by means of available online materials and information. They make the public the public aware that smoking kills, that obesity leads to heart complications, that wearing protective gear lessens the damage of accidents or that stressful living leads to a shorter life span.

Health Insurance – Health Savings Account – HSA

Health insurance is a critical part of our health care system. For those that are lucky enough to have health insurance, they know that it shouldn’t be taken for granted. For a large number of the unfortunate who don’t have health insurance for their families, do so at great risks.

Health insurance has long been a popular political subject for our country. There are many that fill health insurance should be socialized. There are just as many feel it should be kept private. While both parties may have sound arguments, we have to accept what is available to us. So, unless you’re a government employee, or one of the dwindling corporate employees still receiving health insurance, you need to go out there and get it on your own.

There are a number of health insurance choices that should suit your specific needs. A Health Maintenance Organization, or more commonly called HMO, is one popular health insurance choice. HMOs are one of the most common forms of health insurance provided by employers. They allow you to visit a pre-selected hospital, doctors, or clinics, without restriction. This may or may not be totally covered by your employer, but usually comes at a fixed monthly cost.

The Preferred Provider Organization, or the PPO, is similar to the HMO concept. With the PPO, you are not forced to get a little dig their doctor or hospital. When you do, however, you receive a discount for doing so. This system works on the reimbursement, philosophy. Essentially, you are reimbursed by your insurance company after services are rendered. Sometimes, they will bill your insurer at the time of service.

Indemnity health insurance plans are eight other top and plan that has become quite popular these days. One reason is, you are able to choose any position or hospital you choose. The drawback to this of course is that it comes at a premium. In addition to higher costs ease typically require a larger deductible. For the hypochondriac this may not be the best choice. Those that like to make lots of visits to hospitals might find other plans more suitable. But for those that have to be on their deathbed to see a doctor, this may be an appropriate plan.

The Health Savings Account, HSA, has some similarities to the indemnity health insurance plans. As the Health Savings Account is probably most suitable to the individual that doesn’t require a lot health care, or checkups. These individuals, which most commonly are men, may find the Health Savings Account to be a good choice for them.

Health Savings Accounts are a way to both have a way to save and pay for medical expenses. Any contributions that are made to the Health Savings Account that go unused for medical purposes are retained in a savings account. This savings account can hold many popular investments, such as mutual funds. So, getting back to the individual that avoids medical care, this individual gifts for both best of both worlds. They get the protection of the much-needed health insurance. This provides protection against large medical or accident issues. But, if these funds go unused, they get the benefit of putting the money away for retirement. Any after-tax dollars that are contributed to the Health Savings Account can be detected, up to $2900 for 2008.

Choosing a health insurance plan may seem like a very confusing process. There is no open and shut method of choosing the best health insurance. Each individual is different, with different health needs. The most important step here is to get some form of health insurance. Go in without adequate health insurance puts you and your family at tremendous risks. And those risks just aren’t worth the possible consequences.

Financing to Support Coordination of Behavioral Health and Primary Care Services

In October 2003, the Health Resources and Services Administration issued Program Information Notice (PIN) 2004-05 regarding Medicaid Reimbursement for Behavioral Health Services. The PIN requires Medicaid agencies to reimburse Federally Qualified Health Centers and Regional Health Centers for behavioral health services provided by a physician, physician assistant, nurse practitioner, clinical psychologist, or clinical social worker, whether or not those services are included in the state Medicaid plan. The PIN clarifies that “FQHC/RHC providers must be practicing within the scope of their practice under the state law.”

What might PIN 2004-05 mean for the Medicaid population? Categorically eligible Medicaid beneficiaries (e.g., TANF, aged/blind/disabled) may or may not be able to easily gain access to public mental health services, depending on definitions of target populations and medical necessity, which vary from state to state.

In states with public mental health systems that focus on populations with serious mental illness and serious emotional disturbance, PIN 2004-05 creates an opportunity for other Medicaid populations, with higher physical health and lower behavioral health risks, to obtain behavioral health services through a CHC. This is consistent with the HRSA initiative to reduce health disparities and create behavioral health capacity in CHCs. PIN 2004-05 helps to assure that safety net populations are served.

But what does PIN 2004-05 mean in terms of financing and the behavioral health services now provided to populations with serious mental illness? The answer varies from state to state because of differing Medicaid models. This variability requires every community partnership between a CHC and a CMHC to assess their specific financing and policy environment in order to identify a business model that will support integration activities. Such partnerships must develop policy direction that addresses the need for greater access to behavioral health services for the Medicaid population, without disadvantaging any populations now served by the public mental health system.

Learning from Pilot Sites:

“Depression in Primary Care: Linking Clinical and System Strategies” is a Robert Wood Johnson Foundation national program to increase the effectiveness of depression treatment in primary care settings. The program charged its eight demonstration sites with addressing financial and structural issues as well as implementing clinical models. A special issue of Administration and Policy in Mental Health and Mental Health Services Research contains a series of resulting papers, some of which speak directly to the financial and policy barriers in the system.

The pilots reveal the commitment of sites around the country that continue to patch together funding because they believe in the integration approach. For example, in Washington State there is a partnership between the CMHC and the Federally Qualified Health Center, where the CMHC’s clinicians in the FQHC sites are financed by an annual golf tournament – hardly a sustainable model. The IMPACT trials, Depression in Primary Care project, state Medicaid pilot sites, and an Aetna project all identify similar components for financing:

– Screening

– Care management

– Psychiatric consultation

These are close to the components identified in the report of the President’s New Freedom Commission on Mental Health, which emphasized that there must be a relationship between mental health and general health. However, these service components are currently missing from public and private sector billing codes and financing policy. The challenge – for federal, state and private payors – will be to align financial/policy incentives to support clinical integration, which research demonstrates is effective in achieving positive outcomes.

Barbara Mauer is a nationally known expert in behavioral health and primary care integration. She has more than 15 years of experience in this field and is a managing consultant for MCPP Healthcare Consulting in Seattle as well as a National Council senior consultant. She offers consulting services to public and private sector health and human service organizations on integration as well as strategic planning, quality improvement, and project management. Mauer has authored many papers and books on behavioral health and primary care integration.

Health Insurance Plan – The Easy Way to Getting Health Insurance

Even though more and more people are realizing that they need health insurance many are apprehensive about getting a health insurance plan for them. This is because there are too many choices that leads to confusion as to which plan will serve the health needs of them and their family. By learning some basics about health insurance, one can easily get a health insurance plan that is right for their needs.

Most of the health insurance plans are got by going through the employer. These days most companies provide health insurance to its employees through a group plan. As most of the employees will be covered through a group, the premium for health insurance comes down. Many of these plans are designed not only to cover the employee but also the family members of the employee. Although this increases the premium paid out, the plan covers the entire family thereby increasing the benefits of the plan. To go by this route through the employer, one needs to check with the department of human resources in the company and check the policy of the company towards health insurance. Every employee should be able to begin an individual health insurance plan through the group scheme at any point of time during the tenure with the company.

If you are in between jobs and were previously covered by your employer in the earlier job, the COBRA law entitles you health insurance coverage continued from the coverage you had on the earlier job. This law is passed by the government to protect your health interests and will provide you health insurance although the premium might be increased from what it was earlier. If the insurance coverage was extended to the entire family, the law will permit the continuance of the full coverage for a particular period.

However, there are many millions of people in America who are not covered through a group health plan provided by an employer. For such people, the insurance companies offer individual plans. The people under this are mostly those who are self-employed or people who are not provide with health insurance by the employer or those who do not qualify for aid from the government health insurance like Medicaid or Medicare. However, these individual plans are dearer in comparison to the premium paid in the group insurance plans. These plans can also cover other family members by paying extra premium. Getting an individual plan is quite easy as most of the insurance companies provide these plans. One can search through the internet also for more information on these plans. Some sites might help you get a comparison in terms of pricing and other details between various plans.

Another avenue that needs to be remembered is federal health aid. People above 65 years or those with some kind of disabilities as mentioned in the guidelines of the government can apply for Medicare. Income based insurance program provided by the government is Medicaid. One must remember that health insurance is very important and whatever avenue is chosen to achieve this is not important. The only thing is that to get the maximum benefit at the lowest costs one should properly research and find the best options one has towards getting health insurance