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Insurance. Many people in the US are uninsured – assume all responsibility for health care costs. Many people in the US are uninsured – assume all responsibility.

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Presentation on theme: "Insurance. Many people in the US are uninsured – assume all responsibility for health care costs. Many people in the US are uninsured – assume all responsibility."— Presentation transcript:

1 Insurance

2 Many people in the US are uninsured – assume all responsibility for health care costs. Many people in the US are uninsured – assume all responsibility for health care costs. Insurance decreases out of pocket expenses for health care services. Insurance decreases out of pocket expenses for health care services.

3 Companies purchase health insurance for employees Eligibility depends upon continuous employment Eligibility depends upon continuous employment Employees must work 20 or greater hours per week. Employees must work 20 or greater hours per week. Most companies have a waiting period before insurance benefits are available. Most companies have a waiting period before insurance benefits are available. Pre-existing conditions may be ineligible Pre-existing conditions may be ineligible

4 Health insurance HMO – Health Maintenance Insurance HMO – Health Maintenance Insurance A type of managed care medical insurance A type of managed care medical insurance Specialty treatment is available with referral Specialty treatment is available with referral When a person elects to go to an HMO, these physicians provide all of their care – insured are limited to contracted physicians for care. When a person elects to go to an HMO, these physicians provide all of their care – insured are limited to contracted physicians for care. Out of pocket expenses are set. Out of pocket expenses are set. Specialty care must be submitted to HMO for approval – may be denied. Specialty care must be submitted to HMO for approval – may be denied.

5 Health insurance PPO - Preferred Provider Organization PPO - Preferred Provider Organization Physicians contract services for a set fee and is listed as a preferred provider. Physicians contract services for a set fee and is listed as a preferred provider. The insured person chooses from preferred providers. The insured person chooses from preferred providers. The insurance company pays a set amount and the insured pays a set amount called the co-payment. The insurance company pays a set amount and the insured pays a set amount called the co-payment. Referrals are made to specialists on the list. Referrals are made to specialists on the list.

6 Health insurance Cancer Insurance Cancer Insurance Specific insurance for the treatment of cancers. Specific insurance for the treatment of cancers. Additional to basic health care insurance. Additional to basic health care insurance.

7 Disability Insurance Provides income upon disability – short or long term. Provides income upon disability – short or long term. Various waiting periods are available before benefits begin. Various waiting periods are available before benefits begin.

8 Vision Insurance may pay a portion of an eye exam and part of a pair of glasses or contact lenses. may pay a portion of an eye exam and part of a pair of glasses or contact lenses.

9 Dental Insurance covers a portion of teeth cleaning, fillings, x-rays, orthodontics and oral surgery covers a portion of teeth cleaning, fillings, x-rays, orthodontics and oral surgery

10 Life Insurance Provides financial payment to a beneficiary in the event of death. Provides financial payment to a beneficiary in the event of death. Benefit can vary, depending on the needs of the family and individual. Benefit can vary, depending on the needs of the family and individual. Employers often offer life insurance to their employees in the amount of the employee's annual salary. Employers often offer life insurance to their employees in the amount of the employee's annual salary. Individual policies can be purchased Individual policies can be purchased

11 Types of Life Insurance Term Life Insurance – specific amount of money will be paid to a beneficiary. Term Life Insurance – specific amount of money will be paid to a beneficiary. Whole Life Insurance – a policy that allows the holder of the policy to draw on the insurance as a pension as well as having money go to a beneficiary at the time of death Whole Life Insurance – a policy that allows the holder of the policy to draw on the insurance as a pension as well as having money go to a beneficiary at the time of death


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