HEALTH INSURANCE IS NOT HEALTH ASSURANCE:

It is unfortunate that we have come to such a time as this. As of July 1, 2007, Massachusetts is the first and only state to require, by force of law, health insurance of every resident. Not only is it legally mandated but penalties will be visited upon the pockets of those who fail to comply with the law.

It is likely that Massachusetts is the state that is piloting this new health care approach and that it will ultimately be coming soon to a medical institution near you.
Ironically, it is the people who are at present trying to live according to principles of physical, mental and moral excellence that will suffer. These are people who are making lifestyle choices that are like deposits in a quality of life bank. Although, it probably has not entered into the thinking of most of us, there are people who are living and have lived their entire lives without a health care crisis. Paying for something they don’t need or may never need is not so much the problem as paying for something that is within their power to prevent.

Neither home owner’s insurance nor automobile insurance can protect you from loss of or damage to your asset. These products simply minimize or completely cover the cost of expenses to repair or replace it. This is especially helpful in unexpected, undesirable circumstances beyond your control. Loss of or damage to your health may be undesirable but it is not entirely unpredictable or beyond one’s power of control.

Some people, who have insurance policies to cover their tangible assets, invest additional money and even time and effort to increase or maintain the value of these assets long before any unwelcome events. Physical health is one of the most grossly undervalued assets and it receives such investments many times only AFTER loss or damage. Health insurance seems to stifle the conviction to make any investment beyond a monthly premium.

So what about the people who cherish and protect their health as sacredly as their characters. Being in the minority, they are probably considered insignificant complainers. With everyone else, they too will be “persuaded” by the tip of a financial blade to purchase this product (health insurance) whether they need it or like it or not. But decisions for the sake of the majority does not prove that this is anything more than a big band-aid.

Of very little mention in the discussion about health care are the benefits to be awarded the healthy. Maybe most of us are assuming that everyone is unhealthy. Is it the national consensus and presumption that everyone needs health care or at some later point in time will be needing health care ? Is everyone bound to get sick and need drug medication, surgery or radiation ?

Perhaps many in our nation need to know that there are people who do not believe that disease just randomly shoots into a crowd and kills people. Yes, there are those who believe that for the most part, many diseases are self-inflicted wounds and those who believe this are choosing lifestyles which do not lay the foundation for disease.

There are people in America who choose not to use the flesh of animals as food and therefore do not have the diseased blood of these creatures circulating throughout their bodies. There are many who do not eat between meals. Even more interesting is the fact that there are people who limit themselves to 2 meals per day and have their heaviest meal in the morning instead of just before bed. They use only fruits, grains, nuts and vegetables as part of their dietary regimen while excluding refined or processed foods.

These people even exercise everyday and drink plenty of water. Some choose not to drink fluids with their meals because they know fluid with food will interrupt digestion as the stomach must absorb the liquid before it can continue with digestion. They drink only water or occasionally fruit or vegetable juices either sometime before a meal or at least 2 hours afterward.

There are people who take advantage of the sunlight because they know that it raises or lowers blood pressure, blood sugar and blood cholesterol according to the body’s need and has many other beneficial effects. They are not afraid of skin cancer because they have not been consuming hydrogenated oils which promote the development of free radical cells that become cancerous when exposed to the radiation of the sun’s rays.

Some people in our nation are temperate and choose to dispense entirely with everything hurtful and use in moderation even the good things. They make a point of getting fresh air and as much rest as possible.
I don’t think these people are going to live very long in this country without ultimately facing persecution because they are even going around sharing vital health information with other people so that their lives can be improved as well. They promote a higher quality of life for everyone. The last person who did this consistently and showed how it could be done got Himself nailed to a cross.

There really are people in America who live healthy, disease free lives and who are choosing to leave the treasures of health as an inheritance to their children. Instead of diseases that “run in the family”, they are passing on lifestyle habits that exempt their children from the responsibility-assassinating, death sentence of genetic predisposition. Many of them trust in God and not Gov. to help them. They pay for any unforeseen medical expenses (accidents) out of their own pockets.

Now that health insurance is required by law in Massachusetts and the caring disposition of our legislators is so evidently manifest, how will the decision-makers reward those who have no need and may never have need of drug medication, surgery or radiation ? Will they grant them unlimited, free, noclause accident insurance in recognition of their faithfulness to the laws of health ? It is highly unlikely. It is not current lawmaker “policy”.

The health care crisis in this country has nourished many industries. While it tantalizes some with the promise of omnipotent health insurance it establishes for others perpetual wealth assurance based upon the near certain unwillingness of many to take charge of their health. Through medical vocabulary intimidation and willful ignorance with some, many are convinced that only doctors (not themselves) are qualified to address their health issues.

300 million people having responsibility for their health, making health-complementary lifestyle choices and living healthier lives is HEALTH ASSURANCE and REAL HEALTH INSURANCE. With health assurance a person becomes eligible for wealth assurance benefits. He or she can save tons of money that might otherwise evaporate at the command of chronic or acute illness. It is no longer necessary for anyone to look for their finances in the obituary column each day because of medical expenses. Health Assurance minimizes your risk of owning a graveyard plot in the ultimate wealth cemetery – A NURSING HOME.(2009 Tyrone Keels)

Frequently Asked Questions About Health Insurance

Most people get health insurance through their employers or organizations to which they belong. This is called group insurance.
Some people do not have access to group insurance. They may choose to purchase their own individual health insurance directlyfrom an insurance company. Many Americans get health insurancethrough government programs that operate at the national, State,and local levels.

Examples include Medicare, Medicaid, andprograms run by the Department of Veterans Affairs and Department of Defense.

Group Insurance:Group health insurance is typically offered by employers. Or, if you are a member of a union, professional association, or other group,you may be able to get group coverage through that organization.
Some employers allow employees to choose between several plans,including both indemnity insurance and managed care. Otheremployers offer only one plan. Some group plans offer dental and/or vision benefits as well as medical benefits. So it is important to compare plans to find the one that offers the benefits you need most. Once you enroll in a health insurance plan, you usually cannot change to another plan until the next open season, usually set once a year.

When group health insurance is an employee benefit, your employer usually pays a portion or all of the premiums. This means your costs for health insurance premiums will be lower than they would be if you paid the entire premium alone.
When you get group insurance through membership in an organization, you usually will benefit from being a member of a large group. You may pay less for premiums than an individual would pay.

However, the organization often does not pay a share of the premium, meaning you may be responsible for paying the entire premium yourself.
 

Individual Insurance: If you are self-employed or your employer does not offer health
insurance, you may not have access to group insurance.

You may,however, be able to purchase individual coverage directly from an insurance company. When you buy your own health insurance, you will be responsible for paying the entire premium rather than sharing the cost with an employer. You should shop around to find a plan that fits your needs at a price that you are willing to pay.

Most self-employed workers are able to deduct their health insurance premiums from their Federal taxable income, providing them with an important tax saving. Most States also offer similar tax preferences. If you are self-employed and buy individual health insurance, you should consult a tax advisor to find out if you are eligible for this deduction.Insurance plans differ greatly from one company to another and,within an insurance company, from one plan or product to another.
Some plans have multiple products (options) from which you can choose; read carefully through the “fine print” to be sure you understand the various choices.

3. Which type of health insurance is right for you?

Whether you are eligible for group insurance or choosing an individual plan, you should carefully compare costs and coverage.Be sure to compare:
  1. Premiums.
  2. Coverage/benefits.
  3. Access to doctors, hospitals, and other providers.
  4. Access to after hours and emergency care.
  5. Out-of-pocket costs (coinsurance, copays, anddeductibles).
  6. Exclusions and limitations.

Even if you do not get to choose your health plan—for example, if your employer offers only one plan—you still need to understand your coverage. What kind of services are covered by the plan? What steps do you need to take to get the care you and your family
members need? When do you need prior approval to ensure coverage for care (for example, elective hospitalization for scheduledsurgery)? How are benefits paid; do you have to submit a claim?
Make sure you understand how your plan works. Don’t wait until you need emergency care to ask questions.

The major difference between indemnity (nonnetworkbased coverage) and managed care
plans (network-based coverage) concerns choice of doctors, hospitals, and other providers; out-of-pocket costs for covered
services; and how bills are paid.
Be sure to check on the physicians and hospitals that are included in the plan.

Indemnity Insurance:This type of coverage offers more flexibility in choosing doctors and hospitals. Usually, you can choose any doctor you wish, and you can change doctors at any time. Although you usually will not need a referral to see a specialist or go for x-rays or tests, you may need paperwork, such as your medical records, from your primary care physician.

 Be sure to ask your doctor if there’s any paperwork that you will need to take with you.
If you have indemnity insurance, your plan only pays part of your medical bills. You are responsible for the rest. Your out-of-pocket costs are likely to be higher for certain services than with some managed care plans.

 Usually, you will need to spend a certain amount each year before your plan begins to pay benefits. This amount is called a deductible.

Deductibles are the amount of the covered expenses you must pay each year before your plan starts to reimburse you. Deductibles might range from $100 to $300 per year per covered person or $500or more per year for a family.
If you have an indemnity plan, you may have more paperwork to do.Some doctors will submit the claim for you. Once the doctor receives payment from the insurance company, he or she will bill you for thedifference.

 With other doctors, you will have to pay the entire bill and file a claim with your insurance company to be reimbursed.
Indemnity insurance pays a portion of the bill—usually 80 percent,after the deductible has been met, although this may vary. You pay the remainder, usually 20 percent of the total bill. This is called coinsurance.
Indemnity policies typically have an out-of-pocket maximum. This means that once your expenses reach a certain amount in a given calendar year, the fee for covered benefits typically will be paid in full by your insurance plan.

 If your doctor bills you for more than the reasonable and customary charge, you possibly may have to pay a portion of the bill. If you have Medicare coverage, there are limits on
how much a physician may charge you above the usual amount.
There also may be lifetime limits on benefits paid under the policy.Most experts recommend that you look for a policy with a lifetime limit of at least $1 million. Anything less may not be sufficient.

Managed Care:More than half of all Americans who have health insurance are enrolled in a managed care plan. Managed care plans usually cover a wide range of health services. With these plans, costs are lower when patients use the doctors and other providers who participate in the plan (network providers).
In most cases, you will not have to fill out any insurance forms or submit any claims to the insurance company when you usein-network providers. Usually, you will pay a copay(typically $10to $20 for an office visit) each time you go to the doctor or hospital or fill a prescription.

Your copay may vary depending on whether you see your primary care doctor or a specialist and whether you receive a generic or brand name prescription drug. Most managed care plans have a list of drugs that they cover, called a formulary.

 Your copay for prescription drugs will probably depend on whether you are getting a generic drug, a brand name formulary drug, or a brand name drug not on the plan’s formulary.
For example, the copay might be $10 for a generic drug, $25 for a formulary drug, and $40 for a brand name non-formulary drug. Be sure to check the formulary of the plan you are considering to make sure it will cover any routine prescription drugs that you and your
family members take.
Some managed care plans have a mail-order pharmacy option. This means that you send your doctor’s prescription for routine maintenance drugs (for example, blood pressure medicine, drugs to control blood sugar, and other drugs used on a regular basis) to the
mail order pharmacy.

 In most cases, you will receive a 3-month supply of your medication by return mail. You still pay a copay, but your cost may be lower than it would be at a local retail pharmacy.
If you choose to enroll in a managed care plan instead of an indemnity plan, you may have lower out-of-pocket expenses for health care, as long as you see doctors who are part of the plan (innetworkproviders).
There are three main types of managed care plans:
• Health maintenance organizations (HMOs).
• Preferred provider organizations (PPOs).
• Point-of-service plans (POS).
All three types of managed care plans have contracts with doctors,hospitals, and other providers. They have agreed on certain fees with these providers. As long as you get your care from a plan provider, you typically will be responsible only for any cost-sharingyour plan requires.

Health Maintenance Organizations:HMOs have long been known for a focus on prevention and wellness. Traditionally, HMOs required that you receive most of your care from one primary care physician who is aware of your total health picture. If you belong to an HMO, usually you must receive all of your medical care from network providers, except inemergencies.

 HMOs usually have flat copayments rather than deductibles and co-insurance and no lifetime limits on coverage.
After you enroll in an HMO, you typically will need to select a primary care physician who will be responsible for coordinating all of your care. Primary care physicians may be family practice doctors, internists, pediatricians, obstetricians-gynecologists, or general practitioners.
If you become ill, your primary care doctor will see you first, unless it is an emergency. Your primary care doctor will give you a referral if he or she thinks you need to see a specialist. Usually, your HMO will not provide coverage for a specialist unless you have this referral.
In most cases, you must see a specialist who participates in your HMO.

 Sometimes, in special circumstances, HMO patients may be referred to providers outside the HMO network and still receive coverage.
If you need to be admitted to the hospital and it is not an emergency, you may have to obtain precertification from your plan.
In most cases, your physician or hospital will take care of this for you. Non-emergency hospital care may not be covered without precertification. In case of an emergency admission, you or a family member, your doctor, or your hospital will need to contact your
plan within a certain timeframe (usually within 48 hours of admission) to obtain written confirmation of coverage for the hospital stay.

Today, some HMOs do not follow this “primary care model.” So, if you are considering a traditional HMO, it is important to compare the features and requirements among the various HMO plans that are available to you.

For PPOs, this coinsurance may be different than the coinsurance charged for in-network providers. Also, you may have to pay the total cost of care right away and then file a claim with your insurance company to get the allowable reimbursement for out-ofplan care.

When shopping for health insurance you are probably most interested in saving money while also getting the right coverage. There is no denying that these details are essential to the process, but you don’t want to forget about the company that you are going to be getting involved with.

If you do not trust a health insurance company you should not consider doing business with them. This never ends well, and will only make things difficult on you as you move forward to seek medical attention in the future.

Finding a health insurance company you can trust can be an easy process. The first step is reading reviews of each company. Find out what other people like and don’t like about each provider. You don’t want to rely totally on this information, but you should definitely take it to heart. To go along with this, don’t forget to ask others what health insurance company they do business with. This is a good way to collect first hand information.

You can also personally speak with a health insurance company to ask questions before buying. This will give you a good idea of what is being offered, and what type of customer service experience you can expect to run into in the future.

Overall, you want to buy from a health insurance company you trust. If you trust the company you are buying from you will feel good about your decision and will know your coverage will be there when you need it in the future.