Guide to Buying Health Insurance Sourcebook, 1st Ed.

Description

This special edition provides information about understanding the importance and need for health insurance, medical billing, and a detailed study about private and public-health insurance in the United States.

Sujets

• Santé et bien-être
• Santé du quotidien
• Santé au quotidien
• Santé au quotidien
• Fitness
• Medicaid
• Health
• Sourcebook
• Health care reform debate in the United States

Informations

• Publié par: Infobase Publishing
• Date de parution: 01 septembre 2020
• Nombre de lectures: 0
• EAN13: 9780780817838
• Langue: English

Extrait

GUIDE TO BUYING HEALTH INSURANCE SOURCEBOOK
 
First Edition
Health Reference Series Special Edition
GUIDE TO BUYING HEALTH INSURANCE SOURCEBOOK
 
First Edition
 
 
 
 

615 Griswold St., Ste. 520 Detroit, MI 48226
Bibliographic Note
Because this page cannot legibly accommodate all the copyright notices, the Bibliographic Note portion of the Preface constitutes an extension of the copyright notice.
 
* * *
OMNIGRAPHICS
Kevin Hayes, Managing Editor
* * *
Copyright © 2020 Omnigraphics
ISBN 978-0-7808-1782-1
E-ISBN 978-0-7808-1783-8
 
 

Library of Congress Cataloging-in-Publication Data
Names: Hayes, Kevin (Editor of health information), editor.
Title: Guide to buying health insurance sourcebook / edited by Kevin Hayes.
Description: First edition. | Detroit, MI: Omnigraphics, [2020] | Series: Health reference series: special edition | Summary: “Provides basic health information for understanding the importance and need for health insurance, a detailed study about private and public-health insurance in the United States, including key factors for choosing a private plan, Medicare, Medicaid, and CHIP coverage. Includes a glossary of related terms and directory of related resources”-- Provided by publisher.
Identifiers: LCCN 2020020555 (print) | LCCN 2020020556 (ebook) | ISBN 9780780817821 (library binding) | ISBN 9780780817838 (ebook)
Subjects: LCSH: Health insurance--United States.
Classification: LCC HG9396 .G85 2020 (print) | LCC HG9396 (ebook) | DDC 368.38/200973--dc23
LC record available at https://lccn.loc.gov/2020020555
LC ebook record available at https://lccn.loc.gov/2020020556
 
 
Electronic or mechanical reproduction, including photography, recording, or any other information storage and retrieval system for the purpose of resale is strictly prohibited without permission in writing from the publisher.
The information in this publication was compiled from the sources cited and from other sources considered reliable. While every possible effort has been made to ensure reliability, the publisher will not assume liability for damages caused by inaccuracies in the data, and makes no warranty, express or implied, on the accuracy of the information contained herein.

This book is printed on acid-free paper meeting the ANSI Z39.48 Standard. The infinity symbol that appears above indicates that the paper in this book meets that standard.
 
Printed in the United States
TABLE OF CONTENTS
Preface
Part 1: Understanding the Importance and Need of Health Insurance
Chapter 1—Rising Healthcare Costs in the United States
Section 1.1—Key Drivers of Rising Healthcare Cost
Section 1.2—The Effect of Healthcare Cost Growth on the U.S. Economy
Chapter 2—Role of Insurance in Improving Access and Equity in Healthcare
Chapter 3—National Healthcare Expenditures: An Overview
Section 3.1—Components of Healthcare Spending
Section 3.2—How Much Is Healthcare Spending Projected to Grow?
Chapter 4—The U.S. Healthcare Coverage in Comparison to Other Advanced or Emerging Economies
Chapter 5—Qualifying Health Coverage (Minimum Essential Coverage)
Chapter 6—Healthcare Coverage and Your Federal Taxes
Section 6.1—Premium Tax Credits for Individuals and Families
Section 6.2—Affordable Care Act Tax Provisions for Large Employers
Section 6.3—Small Business Healthcare Tax Credit
Chapter 7—Health Insurance: Trends and Stats
Section 7.1—State-by-State Health Insurance Coverage
Section 7.2—How Many Americans Are Uninsured?
Chapter 8—Health Insurance and Healthcare Quality
Chapter 9—Health Insurance Fraud, Abuse, and Wastage
Section 9.1—Preventing Medicare Fraud and Abuse
Section 9.2—Common Healthcare Fraud
Section 9.3—Beware of “Open Enrollment” Scams
Section 9.4—Protect Yourself from Marketplace Fraud
Part 2: Private Health Insurance
Chapter 10—Private Health Insurance: Premiums and Federal Policy
Chapter 11—Situations When You Might Need Private Health Insurance
Chapter 12—Key Factors for Choosing a Plan
Section 12.1—Financial Factors: Premiums, Deductibles, Out- of- Pocket Costs, and Maximum Annual Limit
Section 12.2—Choice of Providers and Services
Chapter 13—Types of Health Plans and How They Compare
Chapter 14—Types of Employer Group Plans
Section 14.1—Large Group Plans
Section 14.2—Small Group Plans
Chapter 15—Health Reimbursement Agreements
Chapter 16—COBRA Requirements and Benefits
Chapter 17—Self-Insurance and Stop-Loss Plans
Chapter 18—Where to Buy Private Health Insurance
Section 18.1—The Health Insurance Marketplace
Section 18.2—Outside the Marketplace
Chapter 19—Open Enrollment and Special Enrollment Periods
Chapter 20—Essential Health Benefits
Chapter 21—Additional Health Benefits
Section 21.1—Home Healthcare
Section 21.2—Dental and Vision Coverage for Adults
Section 21.3—Telehealth
Section 21.4—Long-Term Care
Section 21.5—Infertility Treatment
Section 21.6—Birth Control Coverage
Section 21.7—Breastfeeding Coverage
Section 21.8—Off-Label Prescription Drugs and Clinical Trials
Chapter 22—Multiple Insurance Plans: Coordination of Benefits
Chapter 23—Tips to Make the Most of Your Health Benefits
Part 3: Publicly Sponsored Health Insurance
Chapter 24—Patient Protection and Affordable Care Act
Section 24.1—Patient Protection and Affordable Care Act: Benefits and Coverage
Section 24.2—Supreme Court Ruling on Obama Care
Chapter 25—Insurance Programs under Affordable Care Act
Section 25.1—The Four Metal Categories
Section 25.2—Catastrophic Level Health Plans
Chapter 26—Immigration Status and the Marketplace
Chapter 27—Medicare Health Coverage
Section 27.1—Medicare Savings Programs
Section 27.2—Medicare Coverage and Your Medicare Coverage Choices
Section 27.3—Part A and Part B Coverage
Section 27.4—Programs of All-Inclusive Care for the Elderly (PACE)
Section 27.5—Extra Help with Medicare Prescription Drug Plan Costs
Section 27.6—Medicare and TRICARE
Chapter 28—How Medicare Works with Other Insurance
Chapter 29—What Is Medicare Supplement Insurance (Medigap)?
Chapter 30—Medicaid and CHIP
Section 30.1—Medicaid and CHIP Coverage
Section 30.2—Medicaid Expansion and What It Means for You
Section 30.3—Medicaid Cost Sharing
Section 30.4—The Children’s Health Insurance Program
Section 30.5—CHIP Cost Sharing
Section 30.6—Using Your New Medicaid or CHIP Coverage
Section 30.7—Canceling a Marketplace Plan When You Get Medicaid or CHIP
Section 30.8—Enrollment Rules
Chapter 31—Coverage Options for People with Disability
Section 31.1—SSDI and Medicare Coverage
Section 31.2—SSI Disability and Medicaid Coverage
Chapter 32—How to Apply for Health Coverage Exemptions
Part 4: Navigating Health Insurance
Chapter 33—Roadmap from Coverage to Care
Chapter 34—Understanding the Billing Cycle
Section 34.1—Medical Coding and Billing Process
Section 34.2—Identifying Billing Errors and Disputing Charges
Chapter 35—Surprise Medical Billing or Out-of-Network Payment
Section 35.1—What Consumers Need to Know about Surprise Billing
Section 35.2—Balance Billing Protection Act
Chapter 36—Health Insurance Claims and Appeals
Section 36.1—How Claims Are Processed
Section 36.2—How to Appeal an Insurance Company Decision
Section 36.3—How to Appeal a Marketplace Decision
Chapter 37—Filing a Complaint (Grievance)
Chapter 38—Health Insurance Rights and Protections
Section 38.1—Workers’ Right to Health Plan Information
Section 38.2—Grandfathered Health Plans
Section 38.3—Protecting the Privacy and Security of Your Health Information
Section 38.4—Your Rights under HIPPA
Chapter 39—Coverage for Preexisting Conditions
Section 39.1—All about Preexisting Diseases and Conditions in Health Insurance
Section 39.2—Preexisting Conditions Coverage: Frequently Asked Questions
Chapter 40—Flexibility for Workplace Health Plans in Response to COVID-
Section 40.1—Marketplace Coverage and Coronavirus
Section 40.2—New IRS Rules for Flexible Spending Accounts in Respose to COVID-
Part 5: Healthcare Reforms in the United States
Chapter 41—Improving Access to Healthcare
Chapter 42—Single-Payer Healthcare System
Chapter 43—Strategic Plans to Reform, Strengthen, and Modernize the Nation’s Healthcare System
Section 43.1—Affordable Healthcare: Balancing Spending on Premiums, Deductibles, and Out-of-Pocket Costs
Section 43.2—Promoting Health, Wellness, and Disease Prevention
Section 43.3—Strengthening Economic and Social Well-Being of Americans across the Lifespan
Section 43.4—Fostering Sound, Sustained Advances in the Sciences
Chapter 44—Reforming America’s Healthcare System through Choice and Competition
Section 44.1—Federal and State Level Barriers to Market Competition
Section 44.2—Price Transparency Requirements to Increase Competition and Lower Costs
Section 44.3—Reducing Costs with Generic Drugs
Chapter 45—Cutting Back on Healthcare Administrative Spending
Part 6: Additional Help and Information
Chapter 46—Glossary of Terms Related to Health Insurance
Chapter 47—Directory of Organizations
PREFACE
About This Book
Any program that helps in the payment of medical expenses is commonly termed as “health insurance,” and there are various categories of health insurance existing in the United States. The main categories include private and public coverage. Social welfare programs, such as Medicaid, provide assistance to people who are unable to afford health coverage. According to the 2018 statistics provided by the United States Census Bureau, around 91.5 percent had health insurance coverage, and over 27.5 million people were uninsured. The uninsured rate increased from 7.9 percent to 8.5 percent in the year 2018 when compared to 2017. In 2018, private health insurance coverage continued to be more prevalent than public coverage, covering 67.3 percent of the population and 34.4 percent of the population, respectively.
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