Friday, January 14, 2011

How Much Do Americans Have to Pay for Health Insurance?

Coming from the UK I sort of find it hard to imagine having to pay out for your own health care . . . but how much does the average American in reasonable health have to pay for insurance, and what happens if you don't have it?
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Health care insurance rates in the US are very complicated. you can be part of a Health Maintainence Organization, the rates for this insurance are the cheapest but the levels of care can be lower. You have to see your designated primary care clinic before you can go to a specialist. The main goal of this form of insurance is to keep health care cost low while maintaining health. Then there are PPOs that means the insurance company has a list of preferred providers for each specialty and you can choose who to see off the list. This is more expensive than an HMO but not as expensive as traditional US health insurance. There is more choice but also more cost. Finally, there is traditional health insurance where you pay the highest premiums but you pick whoever you want to see and go to them. Unlimited choice highest cost. Usually the employer has one or more health care insurance plans available for the employees and makes a contribution to the insurance. The amount of employer contribution is sometimes set by company policy but other times is a negotiable benefit. There are plans for the poor, unemployed, disabled and retired. These are Medicaid for the indigent and Medicare for the disabled and retired population. The government pays for medicaid out of taxes, and everyone working pays a payroll deduction towards medicare. There are also many persons who are employed, making above the indigent level, but not enough to cover health insurance or they are part time and not eligible for company benefits. This is the problem area for US healthcare. This part of the population often ends up losing their prperty etc in order to pay medical bills. Additionally, as most health insurance only pays for 80% of "allowable" claims there are many health care cost not covered. I am taking a medication which is given IV over a period of 8 hours. At first I took it daily, then weeekly and now I am taking it once a month. It cost $5,000.00 US dollars per day for the treatment. Medicare my primary insurance does not allow for any of the expense. My secondary insurance will cover 80% and after I pay $3000.00 per year it picks up 100%. I am lucky! I am covered by Medicare due to a permanent disability which prevents me from going to work, as well as I am covered by insurance through the US military as I am retired from the Army and a disabled veteran. I am supposed to get free healthcare at the military hospitals, but they are overtasked with the injured soldiers returning from Iraq etc. To give you a hint, the average family of 4 will pay over $400.00 per month on thop of the employer contribution for a PPO insurance plan.
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