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Health Insurance: Pays for hospitalization, dental work, surgery, routine medical care, preventative care, mental health care, and medicines.

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Presentation on theme: "Health Insurance: Pays for hospitalization, dental work, surgery, routine medical care, preventative care, mental health care, and medicines."— Presentation transcript:

1 Health Insurance: Pays for hospitalization, dental work, surgery, routine medical care, preventative care, mental health care, and medicines.

2 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. Pay lower premiums and co-pays than other plans This insurance is the least flexible, must use their doctors. No choice in care.

3 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

4 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 uses medical services, have good health.

5 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.

6 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.

7 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.

8 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, The Supreme Court upheld that the Affordable Health Care Act is constitutional under the Necessary and Proper Clause because under Article I, Congress has the power to tax.


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