Linda from Florida says "my insurance is too hard to understand". Linda you are not alone, studies show that more than 40 percent of the American population that currently has some sort of health plan does not fully understand the rules and or benefits of their plan. The length and wording in a plan document can often be intimidating and hard to understand.
There are a few basic health care terms you need to know: Coinsurance- most insurance plans do not pay 100 percent of all your medical bills. Coinsurance is the amount you must pay for your medical bills, typical 10 to 30 percent. Coinsurance is not the same as a copayment, a copayment is the amount you are responsible for each time you see a physician or receive a prescription medication. The amount can be anywhere from $10 to $25 dollars, and upward of $30 to $50 for a specialists, depending on your insurance.
According to a recent study of the dually eligible population, nearly 9 million seniors and younger people with disabilities who are covered by Medicare qualify for dual eligibility- meaning 9 million people could be getting help from Medicare and Medicaid. Dual eligible's often have health care coverage where Medicare is the primary payer for physician and hospital services, and Medicare Part D as the primary payer for most prescription drugs, and a state-administered Medicaid program is responsible for Medicare copayments, Part B premiums, and a variety of additional services not covered by Medicare. It might sound a bit confusing to the member but participating in these plans not only saves the member money but by having these additional services members will most significantly gain an advantage of having long-term care.
Should you be one of the millions of Americans turning 65 in the next little while your health insurance will be completely different as you qualify for the social insurance program called Medicare. Medicare is entirely funded at the federal level and focuses primarily on the older population- 65 and older, however this plan also covers people under age 65 with certain disabilities, and people of all ages with end stage renal disease. The Medicare program provides a Medicare Part A which pays for hospital bills, Medicare Part B which covers medical insurance bills, and Medicare Part D which covers prescription drugs.
With all the policy changes going on in Washington pertaining to health care, one thing most policymakers do agree on is that the population today could greatly benefit from an integrated, coordinated approach to health and social service delivery; In the past members generally faced significant fragmentation in their health care coverage. Medicare is the primary payer for hospital services and physicians, and often a separate plan- Medicare Part D is the primary payer for most prescription drugs. A state-administered Medicaid program is responsible for Medicare Part B premiums, and copayments. For those members who also qualify for full Medicaid coverage, services not covered by Medicare such as dental, vision, therapies, behavioral health services, and certain drugs are taken care of. Members are at such an advantage when they have Medicare dual enrollment: great quality nursing home care, good long-term care, more availability of physicians and specialists, and lets not forget the prescription drug programs which encourages members to use their benefits so they can stay up with their medication regimen, all the while saving the member money.
Getting to know what health benefits you qualify for really does not need to be complicated or a lengthy process, in fact the process is quite simple; with a quick phone call, a health advocate at Altegra Health will determine your eligibility, if you qualify these advocates will assist you through the application process and get you enrolled in these programs; all designed to enhance the quality of your life and reduce, and sometimes even eliminate the financial burden of other out-of-pocket expenses.
There are a few basic health care terms you need to know: Coinsurance- most insurance plans do not pay 100 percent of all your medical bills. Coinsurance is the amount you must pay for your medical bills, typical 10 to 30 percent. Coinsurance is not the same as a copayment, a copayment is the amount you are responsible for each time you see a physician or receive a prescription medication. The amount can be anywhere from $10 to $25 dollars, and upward of $30 to $50 for a specialists, depending on your insurance.
According to a recent study of the dually eligible population, nearly 9 million seniors and younger people with disabilities who are covered by Medicare qualify for dual eligibility- meaning 9 million people could be getting help from Medicare and Medicaid. Dual eligible's often have health care coverage where Medicare is the primary payer for physician and hospital services, and Medicare Part D as the primary payer for most prescription drugs, and a state-administered Medicaid program is responsible for Medicare copayments, Part B premiums, and a variety of additional services not covered by Medicare. It might sound a bit confusing to the member but participating in these plans not only saves the member money but by having these additional services members will most significantly gain an advantage of having long-term care.
Should you be one of the millions of Americans turning 65 in the next little while your health insurance will be completely different as you qualify for the social insurance program called Medicare. Medicare is entirely funded at the federal level and focuses primarily on the older population- 65 and older, however this plan also covers people under age 65 with certain disabilities, and people of all ages with end stage renal disease. The Medicare program provides a Medicare Part A which pays for hospital bills, Medicare Part B which covers medical insurance bills, and Medicare Part D which covers prescription drugs.
With all the policy changes going on in Washington pertaining to health care, one thing most policymakers do agree on is that the population today could greatly benefit from an integrated, coordinated approach to health and social service delivery; In the past members generally faced significant fragmentation in their health care coverage. Medicare is the primary payer for hospital services and physicians, and often a separate plan- Medicare Part D is the primary payer for most prescription drugs. A state-administered Medicaid program is responsible for Medicare Part B premiums, and copayments. For those members who also qualify for full Medicaid coverage, services not covered by Medicare such as dental, vision, therapies, behavioral health services, and certain drugs are taken care of. Members are at such an advantage when they have Medicare dual enrollment: great quality nursing home care, good long-term care, more availability of physicians and specialists, and lets not forget the prescription drug programs which encourages members to use their benefits so they can stay up with their medication regimen, all the while saving the member money.
Getting to know what health benefits you qualify for really does not need to be complicated or a lengthy process, in fact the process is quite simple; with a quick phone call, a health advocate at Altegra Health will determine your eligibility, if you qualify these advocates will assist you through the application process and get you enrolled in these programs; all designed to enhance the quality of your life and reduce, and sometimes even eliminate the financial burden of other out-of-pocket expenses.
About the Author:
As Altegra Health , is the leading health advocate provider in the nation their goal when it comes to Risk Adjustment is to provide a continuous monitoring of risk scores to ensure members are appropriately risk-adjusted and, in turn, qualify for calibrated premiums.
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