Essential Health Insurance Information You Ought To Know

Lately, healthy insurance has taken a prominent place in the front of national debate. While it's not certain what will actually happen, many people are going to experience a change in their health plan. Some may get a much better plan, some may not. And several people may get some benefits where before they had none. In this article, you'll learn a few basic things that you should know about your own health plan, so you'll be more informed in the future.

The big question you should ask right away is if your plan is considered "managed care" or not. If it is, you will likely be saving some money, but those savings will come at a price. Generally speaking, these kinds of plans are more restrictive in both the doctors you can see, and the procedures and treatments they can give you for your ailments. If you know this going in, it can save you some trouble down the road.

Another thing you'll need to find out is if you have the option of seeing a doctor outside of your group. Some managed care plans allow you to see a specialist, for example, who isn't in your group, but they require that you get a referral from your primary physician. Generally, if you do see a doctor outside your group, it is going to cost a bit more.

Another thing to be sure of is the approval process. Many plans require additional approval for prescribed treatments, even if they are suggested by your primary physician. If you go ahead with a treatment that hasn't been approved by your plan, then you may end up having to pay for the whole thing by yourself. This can get quite expensive, so be careful.

The last thing you'll need to be aware of is what kind of prescription drugs are available on your plan. Many plans only cover generic drugs, and it's important to know this. Some new drugs that are popular don't yet have a generic version. If your doctor prescribes you a non generic brand without knowing whether your insurance covers it or not, you will either have to pay for everything yourself, or go back to your doctor for another prescription. It can save you a lot of time and money if you know this ahead of time.

Long gone are the days of having comprehensive health insurance that covers everything. That's why you need to know what you're covered for, and what you aren't. That way you can be sure to maximize the benefits from your plan, and minimize the cost.

Get Better Tennessee Health Insurance On Your Own

With greater numbers of residents in need of health insurance in Tennessee, more people are braving the unknown and shopping for health plans on their own. As of 2009, Tennessee statistics showed that 810,600 non-elderly adults and 134,200 children were not covered by health insurance.

Many people may be seeking coverage for themselves and/or their family for the very first time after a lifetime of enjoying group coverage through work. Even though the stakes are very high, many people simply don't know the differences in policies or even how to find reliable agents and brokers to help them compare plans.

Will the plan with the lowest premium price protect you from devastating medical debt? Are all agents who sell Tennessee health insurance plans equally qualified to help you find the best coverage for your needs? It may not be as simple as we'd like to believe because most bankruptcies filed in this country due to medical debt are actually filed by people who thought they were covered by health insurance.

Learn To Compare Tennessee Health Insurance Companies

As you may remember, Tennessee was recently host to a major health insurance scandal that left many policyholders holding unpaid claims when they discovered their insurer was not financially solvent. You can check with the Tennessee Department of Commerce & Insurance, or the National Association of Insurance Commissioners regarding an agent's or a broker's license status.

In addition, you can use independent rating organizations like A.M. Best, Moody's, and Standard & Poors to assess how financially sound an insurer is, but that's just the beginning. With literally hundreds of different choices in health insurance for Tennessee on the market, how can you even tell where to start to get the best deal on coverage?

Compare Tennessee Health Insurance Plans And Agents

One shortcut to finding the best coverage to fit your needs is to learn to evaluate heath insurance agents and brokers. Agents and brokers who have worked with Tennessee insurance plans for many years already know which insurers offer the most popular plans and have the best reputations. The trick is to find reliable experts you can trust.

Not all insurance salespeople are equal. Some agents only offer a handful of plan choices because they primarily focus on other types of insurance. That's probably only going to become a greater problem now that health insurance commissions are being reduced. Agents and brokers who have been in the business for years are more likely to have more information both about insurance companies and the plans they offer. With literally hundreds of variations in coverage available, finding an agent with more knowledge about different health plans means you'll get better advice.

In addition to finding agents and brokers who have developed expertise specifically in Tennessee Health Insurance, you'll also need to look for independent agents. Independent agents are not motivated to sell certain policies to earn higher commissions. They earn a commission regardless of which insurer has the right coverage for you because they work with a variety of insurers. In contrast, some agents can only show you plans from a single insurance company. Even if that is a big name company, your choice of plans is still drastically limited when you work with such an agent.

Your need for an agent you can count on doesn't end when you buy the plan. If underwriting makes a counter offer that raises your premium or excludes coverage for a pre-existing condition, you'll need an agent who is willing to negotiate with the insurer as your advocate. If you are aware of a pre-existing condition, a good agent can help you explain it on the application in the most favorable light. Experienced agents also know which insurers have the most relaxed underwriting practices of accepting pre-existing conditions.

Since many insurers raise premium rates annually, you'll also want to find an agent or broker who offers free annual plan comparisons. Let your agent shop for insurance for you every year to be sure you continue to get the best rates and coverage in the years to come. That can help you save on premiums year after year. While your health remains good, it's simple to switch health insurance for Tennessee whenever you get a notice that your premiums are being raised.

Once you know what to look for in an agent or broker, you'll have a better chance of finding the best deal on health insurance in Tennessee. Knowledgeable agents educate their clients, and can warn you when limits on coverage are less obvious. When you find agents and brokers who want your business for a lifetime, you'll get better service and greater savings.

Get More From California Health Insurance Coverage At Work

Even if you still have health insurance in California as a job benefit, your coverage is probably shrinking right before your eyes. According to the nonprofit Commonwealth Fund, California employers were hit by a 39 percent increase in the cost of providing family health coverage in just six years (from 2003 to 2009).

It cost employers, on average, $12,631 to provide California health insurance as a company benefit last year. Yet, employers in 27 other states were faced with even larger rate hikes. Before you feel sorry for the employers, consider who's really paying for the escalating price of U.S. health care.

Companies typically chip in for approximately 75 percent of their employees' premiums, but the higher premiums rise, the more employees have to handle on their own. As expected, workers are paying for more and more of their health care, even with group plans.

With huge increases in the deductibles for California insurance plans, employees have to choose whether to fund their own health care or go without preventive care or, worse still, delay care they really need. How many times have we missed the early warning signs of a treatable disease with our increasing reliance on high-deductible health insurance? It's ultimately the employee and his family that pay most dearly for the lack of health care.

How To Fight Skyrocketing California Health Insurance Premiums

Employees at smaller companies tend to be hurt more. On average, individual deductibles jumped by 83 percent between 2003 and 2009. That left workers with deductibles averaging over a thousand dollars a year ($1,283).

Family-plan deductibles only rose by 68 percent during the same period, but that still left families with deductibles of $2,652. The cost of a single broken arm typically costs almost that much.

When you're stuck with a high-deductible California health insurance plan, it might make sense to add a little protection of your own. Accident health insurance plans won't help a bit if you get sick, but they can replace a high deductible of $2,000 with a mere $100 deductible if you're accidentally injured.

Even if your boss won't chip in, individual accident coverage is as low as $22 a month for $5,000 in medical coverage. Family accident plans start at $35 a month for the same amount of coverage.

These accident plans are usually clear about coverage, unlike typical California health insurance policies. Check out what the plan excludes, such as coverage for adults playing professional sports, and what the refund policy is before you buy.

Health Insurance In California Needs Reform

The nation's new health care laws are projected to slow the rising costs of health insurance for California if only by adding oversight. State and federal officials to have been empowered to evaluate and possibly reject rate hikes from insurance companies.

Other measures have also been added that could curb unnecessary, but expensive, waste in health care, such as incentives to boost coordination between primary care physicians and specialists. Not only can that improve patient care, but it can also cut duplicative lab tests, x-rays, etc.

New health care laws are still on the ropes while courts try the legality of requiring most of us to maintain minimal health insurance coverage. Court cases trying the constitutionality of withholding treatment from patients in hospitals until patients die from neglect don't seem to be as popular. Yet, statistically in a myriad of situations ranging from cancer to gunshot wounds, people who are admitted to hospitals without health insurance die more frequently in hospitals across the nation much more often than people in the adjacent rooms who are protected by health insurance.

Maybe adding a little extra protection, even if it is coming our of your own pocket, is a worthwhile investment until the cost of wasting human life is considered higher than the cost of providing medical services.

US Healthcare Industry Growing on the back of Healthcare IT Segment

According to our latest research report “US Healthcare Sector Forecast to 2012”, the healthcare industry, in spite of the regressive effects of the recent economic downturn, will grow at a considerably high pace in the coming years. Supported by all the verticals of the industry such as, hospital services and pharmaceuticals, the US Healthcare industry is expected to grow at a CAGR of around 6% during 2010-2013. Majority of the revolutions in the industry will be brought about by the numerous applications being developed in the Healthcare IT (HIT) segment.

The report projects the main driving factors behind the largest healthcare industry in world through prudent and in-depth analysis of its every aspect. As evident from the recent developments and the steps taken by the US regulatory authorities, the industry is on the path of recovery through regulations for saving operation costs of all the industry verticals. For instance, the industry recognized the uneconomical and cumbersome nature of paper-based health records, which needed to be replaced with a more efficient system. Besides, several other factors have been discussed in detail to provide a comprehensive picture of the industry.

For providing a wholesome picture of the US Healthcare, developments in the hospital sector, pharmaceutical sector, medical device sector, and healthcare insurance sector have been diligently covered in the report. The descriptive analysis in each of the segments provides a detail outlook of the past, current, and expected future patterns in the respective sectors.

Moreover, all the analysis and market projections in our report, “US Healthcare Sector Forecast to 2012”, has been made on the basis of reliable data. Additionally, the report covers the major players in the numerous segments of the healthcare industry. We have also discussed the various regulatory reforms in the industry and their impacts on the future of all the segments comprising the industry. The report would be able to provide the necessary information to the clients, enabling them to understand the progress of the US Healthcare industry.

Fixing American Healthcare -- Here Is What Needs To Be Done

To many Americans the healthcare system is broken and in major need of overhaul. The good news is that the Affordable Healthcare Act of 2010 addresses many of America's healthcare problems. The bad news is that significant parts of the new healthcare law will phase in over the next three years rather than immediately, with all legislated changes scheduled to be implemented by 2014. Additional bad news is that significant problems with the American healthcare system are not covered in the Affordable Care Act of 2010.

In the year 1900 agriculture represented two thirds of the American economy. Today agriculture accounts for less than 3% of the U.S. economy. There have been huge advances based on research, technology, farm management and agricultural practices. Farms on average are much larger. In 1900 no one could have comprehended or predicted the changes that would happen in agriculture. The same level of change is needed in healthcare, but it needs to be accomplished in 10 years or less. President Kennedy challenged America to put a person on the moon within a decade and we did it. The same type of challenge and mobilization is needed in healthcare reform now.

Republicans fought passage of the law every step of the way and Democrats avoided many key provisions in the hope of getting a few Republicans in the Senate to support the bill in order to get it passed into law. The result is a less than perfect partial solution to a large-scale set of problems.

The Affordable Healthcare Act of 2010 is primarily health insurance reform legislation. The passage of this legislation was highly controversial. The new healthcare law addresses many issues that required attention for decades. There are parts of the law that can and should be improved on and there are many healthcare issues that still need to be addressed, especially dealing with the quality and cost of healthcare.

The Key Problems with the American Healthcare System

Following is a summary of many of the key problems facing the American healthcare system

1 – Healthcare costs represent over 17% of the American GNP and they are increasing significantly every year. On a per capita basis the U.S. pays significantly more for healthcare than any other country and it is hurting our economic competitiveness in world markets. Although America pays more for healthcare than other countries, our overall health and life expectancy is lower than many other countries. This alone is cause for concern and a wake-up call for action.

2 - Healthcare is too costly for businesses and consumers. For many employers and their employees, annual increases in health insurance costs have averaged 15% - 25% and more over the last few years due to actual increases in medical costs as well as insurance companies increasing premiums in anticipation of the healthcare legislation. The Affordable Healthcare Act partially addresses cost issues according to the non-partisan Congressional Budget office and most Congressional Democrats, yet Congressional Republicans say otherwise.

3 - Most people have an opinion about the new healthcare law and many strongly support or oppose it, yet few people know what the law includes and why they should support or oppose the law.

4 – While Republicans are trying to repeal the new healthcare law, there is no chance they will be successful. They cannot get 60 votes in the Senate to support repeal the healthcare law and if they could President Obama would certainly veto repeal.

5 - Hundreds of thousands of people work in insurance companies administering healthcare, however none of them actually provides healthcare services. This is a huge overhead cost to the healthcare system.

6 - Countless people work in doctors' offices and hospitals handling medical records, billing, patient scheduling, insurance forms and other paperwork using inefficient, error prone paper and partially automated processes.

7 – The U.S. has the best healthcare in the world for those that can afford it, yet millions of Americans get little or no healthcare.

8 - Americans spend billions of dollars every year on a myriad of diet plans, yet the average weight of Americans increases every year, resulting in epidemic levels of diabetes, coronary and other diseases and medical conditions. Millions more continue to smoke, use dangerous illegal drugs and follow unhealthy lifestyles. All of this is driving up healthcare costs.

9 - Medication developed and manufactured by American pharmaceutical companies is priced significantly lower in other countries than in the U.S.

10 – Healthcare quality is a very significant problem. Medical errors made by medical professionals including doctors, nurses and others are one of the leading causes of death and injury in the U.S. every year. In many cases, medical and cleanliness best practices are established but not followed.

11 – Medical malpractice insurance costs are too high due to medical errors, however if you or a family member is injured or dies due to medical errors, are you ready to have your right to legal recourse limited?

12 – With the exception of health insurance, Americans can buy almost anything across state lines. We travel extensively and often require healthcare away from our home state and we may need to travel out of state to get appropriate healthcare. Why not create competition by enabling health insurance companies to sell health insurance nationwide.

13 – There are too many health insurance options, making the selection of health insurance very costly. Why not simplify the policy choices and enable consumers to purchase health insurance online, significantly reducing health insurance sales costs?

14 -Millions of unmarried heterosexual couples in long-term relationships can't include their partner in their health insurance plan.

15 - Countless families have been wiped out financially due to serious illnesses either not covered or insufficiently covered by medical insurance, or because they could not get health insurance.

16 – Pharmaceutical advertising adds considerably to the cost of drugs. Advertising also significantly increases usage of pharmaceuticals as consumers learn about and push their doctors to prescribe medications that sometimes are not needed or appropriate.

17 – There have been wonderful improvements in medical diagnostic, operating room and other medical equipment in recent years, as well as important advances in pharmaceutical drugs. These advances are very costly and are at times being used beyond their appropriate need. Valid and unnecessary use of advanced medical tests and pharmaceutical products is helping to drive healthcare costs higher.

18 - In employee surveys (employee satisfaction surveys, employee opinion surveys and employee benefits surveys) employees are asked their opinions about and satisfaction with employee benefits they receive from their employer. Most employees across many industries are saying their health insurance costs are escalating much too quickly while their coverage is being cut back. Some employees are commenting in their survey responses that they are opting out of healthcare insurance because they can't afford it.

Concluding Thoughts

The Affordable Healthcare Act addresses some of the above and other problems, however there is much the new law does not address, or that is inadequately addressed.

Congress still has much to do regarding healthcare. Are they up to the challenge, or will Republicans continue to obstruct progress? Will Democrats support important issues that Republicans want to include in any new or revised healthcare legislation?

Today, as this article is being written, former Republican Senate Majority Leader Bill Frist came out openly supporting the Affordable Healthcare Act, openly challenging current Republican Congressional leaders and members. Bill Frist is a highly accomplished medical doctor. His strong preference is to keep the Affordable Healthcare Act and to enhance it to further address cost, quality, and other key issues. Hopefully Republicans in Congress will get Bill Frist's message.

Beyond the Affordable Healthcare Act of 2010, the American Recovery and Reinvestment Act of 2009 includes significant money in support of improving and streamlining the healthcare system including $25.8 billion for health information technology investments and incentive payments along with $10 billion for health research and construction of National Institutes of Health facilities.

As Americans are learning more about the actual provisions of the new healthcare law, the polls indicate they are becoming more supportive of it. Unfortunately millions of Americans were against the Affordable Healthcare Act due to misinformation and lies about the new law that was continuously spewed by Republican politicians and lobbyists.

The Challenge

- Are there new models of healthcare that will provide better healthcare at significantly lower cost?

- Should the Cleveland and Mayo Clinics serve as a model for providing healthcare excellence?

- Would a single payer approach to healthcare insurance bend the healthcare cost curve significantly downward?

- Should hospitals and doctors be paid at least partially based on keeping patients healthy rather than being paid only for treating medical problems?

- Should healthcare professionals practice more preventive medicine and less reactive medicine?

- Can Americans become more responsible for their own health, improving their diet, increasing exercise, losing weight, avoiding illegal drugs and excessive alcohol, and going to and listening to their doctor when they need to?

- Can doctors, nurses and other medical professionals learn and follow best practices in order to significantly lower medical errors?

- When will Americans be able to purchase health insurance across state lines?

- Will medical records be automated as called for in the Affordable Healthcare Act?

- Should pharmaceutical companies stop relying on Americans to subsidize costly development of new drugs by paying significantly higher prices for the same drugs sold in other countries at much lower prices?

- Should pharmaceutical companies stop advertising their drugs to the population overall, instead educating doctors about drugs and relying on doctors to prescribe appropriate medicines?

- Should there be a single carefully regulated and administered website that provides consumers with information about the performance of hospitals and doctors?

- When will unmarried heterosexual couples in long-term relationships be able to include their partner on their health insurance plan?

- Are too many costly diagnostic tests being performed and too many drugs being prescribed?

- On average, are doctors spending enough time with patients?

- When will American citizens have more influence with Congress than special interest groups and industry lobbyists?

- Will Congress finally do what needs to be done for the good of Americans rather than for their own partisan gain?