7'2 Health Insurance

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7.2 Health Insurance
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Health Insurance Premiums

• Health insurance protects you from financial
  hardship covers some health-related expenses
• If no insurance is offered _at_ your job, you can
  buy health insurance, individually, but it is
  usually expensive!!
• If insurance is offered _at_ your job, it is usually
  group health insurance.

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Basic Health Coverage

• Hospitalization hospital room, meds, lab tests,
  x-rays, operating room
• Surgical fees of doctors who do/help with
  surgery
• Medical fees of non-surgery doctors, other med
  bills, physical therapy

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Major Medical Insurance

• Add onto group plan for addl premium
• Helps with expenses due to major illness/injury
• Dental and/or vision may be added on

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Example 1

• Lela Wendts employer offers a health insurance
  plan that covers Lela, her husband and their
  child. The total monthly premium is 285, of
  which the employer pays 26. How much does Lela
  pay for the health insurance for one year?

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Example 2

• An employer provides dental health insurance to
  employees. The monthly premium cost per employee
  is 36. If the employees pay 65 of the premium,
  what is the total annual premium paid by an
  employee for the dental insurance?

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Health Insurance Benefits Coinsurance

• Insurance comp pays for only part of expenses
  you also have to pay some
• Deductible part of bills you must pay before
  insurance pays
• Coinsurance - you pay after deductible is met
• Copay fixed amt you pay _at_ each visit

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2 Categories of Health Insurance

• Network must see a pre-approved list of doctors
• HMO (Health Maintenance Organization)
• PPO (Preferred Provider Organization)

• Not Network can see any doctor you want
• Indemnity

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Equations

• Total bill covered amt uncovered amt
• (covered amt deductible) (coinsurance rate)
  coinsurance amt
• Uncovered amt deductible coinsurance amt
  patient must pay

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Example 3

• Jolene Ridgeway underwent surgery for an injury.
  The hospital portion of the bill was 5298, of
  which only 4875 was covered by Jolenes group
  medical insurance policy. In addition, the
  coinsurance amount of the bill was 18 the
  remaining deductible she had for the year was
  300. How much of the hospital bill must Jolene
  pay?

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Wrap It Up