Warm Up: Why do you need insurance? What is a co-pay? What is a premium?

Health Insurance: Pays for hospitalization, dental work, surgery, routine medical care, preventative care, mental health care, and medicines. Deductible: Amount you pay before the insurance company pays their portion.

Types of Health Insurance I: Health Maintenance Organization (HMO) plans. An HMO contracts with health care professionals and facilities to create a “provider network”. If you choose HMO insurance, you’ll typically pay just a small co-payment if you visit a doctor or hospital within the network. Co-Pay: Amount consumer pays before seeing health professional. Pay lower premiums and co-pays than other plans This insurance is the least flexible, must use their doctors. No choice in care.

B: Preferred Provider Organization (PPO) plan. PPO’s also enter into agreements with doctors, dentists, hospitals etc. Unlike HMOs, PPO’s will cover some but not all of the cost of care administered by out of the network providers. Low premiums if you use doctors in the network. Choice of doctors is allowed. Wider range of access

C: Point of Service (POS) plan. Offers a combination of the HMO and PPO. Allows out of network physician but at a higher fee. D: Health Service Account (HAS) Combines high deductible PPO plan with the Savings Account. Employees put money into the account before payroll taxes up to a certain limit set by law. Every dollar in the account is tax free. You are basically self-insured. Great for self-employed and people who rarely use medical services, have good health.

What is COBRA? COBRA: Consolidated Omnibus Budget Reconciliation Act 1. Gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time. 2.certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. 3. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.

The Patient Protection and Affordable Care Act. Obamacare The Patient Protection and Affordable Care Act. Obamacare. This law passed in 2010 will make it mandatory that all citizens and legal residents buy health insurance through taxation.

The PPACA does the following: Requires health insurance plans to maintain dependent coverage for children until they turn 26. Bars insurers from denying coverage to children because of pre-existing health problems Taxpayers will fund Medicare to enable coverage of low-income people up to 133 percent of the poverty line. Ex. In 2010, $11,344 was considered the poverty line with the PPACA the amount would be anyone making less than or equal to $15,087. States create health insurance exchanges- supermarkets for individuals and small businesses to buy coverage. Fines employers and businesses with more than 50 workers if insurance if not offered by the company or it their workers get coverage through the state exchanges and receive a tax credit. Increases Medicare payroll tax on couples making more than $250,000 and individuals making more than $300,000.

Adds a new tax of 3.8 percent on income from investments to any investor. Sets up program to create non-profit co-ops. Problems can arise if the co-ops run out of money. They are not regulated like other health care providers. Imposes a tax on so-called Cadillac health plans, employer-sponsored health insurance worth more $10,200 for individual coverage, and $27,500 for a family plan. This will affect many small and large companies that currently offer their employees health insurance. Some people will pay more in premiums and have higher deductibles to help cover cost of the very sick and elderly.

Many more taxes and regulations are set to come on line in the next five to ten years. The bill was over 1500 pages long, voted into law without a lot of debate, no amendments were allowed, and without many reading it. “We have to pass the bill so that you can find out what is in it.” Nancy Pelosi –Speaker of the House, 2010. The Affordable Health Care Act went into effect in November 2013 and has had numerous delays and waivers due to problems with the website, and millions of customers who were given cancellation notices. Not enough healthy people are signing up which is necessary to help insure older and sicker people. Premiums have gone up in some states 100%. Deductibles have also gone up in some cases 100%. Which means people have to pay more up front to offset the people who have low premiums and are sicker. In many states there is only one Healthcare company- no competition means higher prices and lower quality.