The Catch 22 In The Health Insurance Malaise
By David Lubega,
Today, many people are glambling with the new Healthcare Act, nicknamed The Obamacare Act. Years ago, when I was in graduate school, I wrote a paper on National Insurance for All Americans. My good professor told me, it was a great paper but wont work in the United States of America. At that time in 1991, 20 million people had no insurance coverage. The health care reform of 1994 was shot down by our friends in Congress. And today we have 30 million people and counting with no insurance coverage. How did we get here? The answer is in the pudding.
Medicare:
Most people dont know about Medicare insurance coverage and what it covers. Medicare is a federal funded insurance where a working person contributes to its existence through social security. You must have worked 40 quarters or 10 years to get it when you are 65 years old. You became disabled or have a minor disabled they can get it too. Medicare has three parts namely Part A that covers hospitalization, part B does cover equipment, transportation. Logistic stuff so to speak. Then part D which was added on to cover prescription drugs and you must enroll in it to get coverage. Private insurance manage this part D coverage. All these have time of enrollment to have coverage. All of them require premium payment but part A and B- premiums can be deducted from your social security check. Medicare covers 80% of the medical bill and you are responsible for the 20%. Now, this is where the catch 22 problem arises. Most people may not have the 20% of the bill to pay. The best way to pay this bill is to buy a supplemental insurance from private insurance of your choice if you can afford it. Again, few can afford it. The other alternative is to apply for Medicaid/Medical to some states. What is Medicaid/Medical?
MEDICAID/MEDICAL:
It is a state insurance coverage sponsored by both the state and the federal government. This one covers 100% of your medical bills for those who are considered to be under the federal poverty standards as provided by the fed. You can be young or older to get coverage. You remember the people with the 20% payment and they have no money to pay. They can apply for this insurance to get coverage. But what about those who have some money but they cant afford to pay for a private insurance coverage? They have say between $1400-$1800 in-come per month. But still they have bills to pay? Most states have what they call spend down .You have to spend that money before you qualify for coverage month to month coverage. Otherwise, you are on your own. One thing I need to mention here is that, the applicant for Medicaid/Medical has to have money in the bank not more than $2000 if you are single, $4000 a couple. People with chronic medical problems I have worked with , complained about this more often until this new healthcare Act came about to cover the so called donor hole. Also, it required insurance not to deny insurance coverage to those with chronic illness. If this law has not stated in your area, it is coming near you. As a concerned person about health issues, I am waiting to see how the healthcare insurance bundling works as part of this healthcare reform. Most important to resolve the issue of catch 22 and get rid of the 30 million uncovered Americans. After all we need to Be Well. Dont we?
Today, many people are glambling with the new Healthcare Act, nicknamed The Obamacare Act. Years ago, when I was in graduate school, I wrote a paper on National Insurance for All Americans. My good professor told me, it was a great paper but wont work in the United States of America. At that time in 1991, 20 million people had no insurance coverage. The health care reform of 1994 was shot down by our friends in Congress. And today we have 30 million people and counting with no insurance coverage. How did we get here? The answer is in the pudding.
Medicare:
Most people dont know about Medicare insurance coverage and what it covers. Medicare is a federal funded insurance where a working person contributes to its existence through social security. You must have worked 40 quarters or 10 years to get it when you are 65 years old. You became disabled or have a minor disabled they can get it too. Medicare has three parts namely Part A that covers hospitalization, part B does cover equipment, transportation. Logistic stuff so to speak. Then part D which was added on to cover prescription drugs and you must enroll in it to get coverage. Private insurance manage this part D coverage. All these have time of enrollment to have coverage. All of them require premium payment but part A and B- premiums can be deducted from your social security check. Medicare covers 80% of the medical bill and you are responsible for the 20%. Now, this is where the catch 22 problem arises. Most people may not have the 20% of the bill to pay. The best way to pay this bill is to buy a supplemental insurance from private insurance of your choice if you can afford it. Again, few can afford it. The other alternative is to apply for Medicaid/Medical to some states. What is Medicaid/Medical?
MEDICAID/MEDICAL:
It is a state insurance coverage sponsored by both the state and the federal government. This one covers 100% of your medical bills for those who are considered to be under the federal poverty standards as provided by the fed. You can be young or older to get coverage. You remember the people with the 20% payment and they have no money to pay. They can apply for this insurance to get coverage. But what about those who have some money but they cant afford to pay for a private insurance coverage? They have say between $1400-$1800 in-come per month. But still they have bills to pay? Most states have what they call spend down .You have to spend that money before you qualify for coverage month to month coverage. Otherwise, you are on your own. One thing I need to mention here is that, the applicant for Medicaid/Medical has to have money in the bank not more than $2000 if you are single, $4000 a couple. People with chronic medical problems I have worked with , complained about this more often until this new healthcare Act came about to cover the so called donor hole. Also, it required insurance not to deny insurance coverage to those with chronic illness. If this law has not stated in your area, it is coming near you. As a concerned person about health issues, I am waiting to see how the healthcare insurance bundling works as part of this healthcare reform. Most important to resolve the issue of catch 22 and get rid of the 30 million uncovered Americans. After all we need to Be Well. Dont we?
Source...