Employer-sponsored group health insurance plans first emerged in the 1940s as a way for employers to attract employees when wartime legislation mandated flattened wages. This was a popular tax-free benefit which employers continued to offer after the war’s end, but it failed to address the needs of retirees and other non-working adults. Federal efforts to provide coverage to those groups led to the Social Security Amendments of 1965, which laid the foundation for Medicare and Medicaid. These government-sponsored health plans continue to provide care to those left out of employer-sponsored group health insurance plans. As national health expenditures have climbed past 15 percent of gross domestic product (GDP), the Affordable Care Act of 2010 substituted a nationwide mandate that each taxpayer join a group plan for the sort of single-payer solution that has faced stiff opposition since the 1930s.
ATRIO Health Plans was established by Oregon physicians in 2004. Since then, ATRIO has grown to serve thousands of members in Douglas, Josephine, Jackson, Klamath, Marion and Polk counties. We offer Medicare Advantage health insurance, and are proud to have achieved our membership growth through financially sound underwriting practices that result in competitively priced plans with comprehensive coverage.
Access to health care may vary across countries, communities, and individuals, largely influenced by social and economic conditions as well as the health policies in place. Countries and jurisdictions have different policies and plans in relation to the personal and population-based health care goals within their societies. Healthcare systems are organizations established to meet the health needs of targeted populations. Their exact configuration varies between national and subnational entities. In some countries and jurisdictions, health care planning is distributed among market participants, whereas in others, planning occurs more centrally among governments or other coordinating bodies. In all cases, according to the World Health Organization (WHO), a well-functioning healthcare system requires a robust financing mechanism; a well-trained and adequately paid workforce; reliable information on which to base decisions and policies; and well maintained health facilities and logistics to deliver quality medicines and technologies.[1]
Private health care has continued parallel to the NHS, paid for largely by private insurance, but it is used by less than 8% of the population, and generally as a top-up to NHS services. There are many treatments that the private sector does not provide. For example, health insurance on pregnancy is generally not covered or covered with restricting clauses. Typical exclusions for Bupa schemes (and many other insurers) include:
The Select PPO may be paired with a health care Flexible Spending Account (FSA) that can be used for qualified medical expenses during the plan year. During Open Enrollment, the employee chooses an amount to contribute in 2019 and then makes voluntary pre-tax contributions up to annual IRS limits. The funds in a health care Flexible Spending Account do not roll over from year to year; if funds are not used, they are forfeited. Vanderbilt does not contribute to health care FSA accounts.
Sepsis, a syndrome characterized by systemic inflammation during infection, continues to be one of the most common causes of patient mortality in hospitals across the United States. While standardized treatment protocols have been implemented, a wide variability in clinical outcomes persists across racial groups. Specifically, black and Hispanic populations are frequently associated with higher rates of morbidity and mortality in sepsis compared to the white population. While this is often attributed to systemic bias against minority groups, a growing body of literature has found patient, community, and hospital-based factors to be driving racial differences. In this article, we provide a focused review on some of the factors driving racial disparities in sepsis. We also suggest potential interventions aimed at reducing health disparities in the prevention, early identification, and clinical management of sepsis. Full article
Access to health care may vary across countries, communities, and individuals, largely influenced by social and economic conditions as well as the health policies in place. Countries and jurisdictions have different policies and plans in relation to the personal and population-based health care goals within their societies. Healthcare systems are organizations established to meet the health needs of targeted populations. Their exact configuration varies between national and subnational entities. In some countries and jurisdictions, health care planning is distributed among market participants, whereas in others, planning occurs more centrally among governments or other coordinating bodies. In all cases, according to the World Health Organization (WHO), a well-functioning healthcare system requires a robust financing mechanism; a well-trained and adequately paid workforce; reliable information on which to base decisions and policies; and well maintained health facilities and logistics to deliver quality medicines and technologies.[1]
That's the market that was most in need of reform before the Affordable Care Act, and it's the market segment that was most heavily affected by the ACA (the small group health insurance market also saw some significant reforms, but not as much as the individual market). Not surprisingly, it's also been the market that has seen the most change over the last several years and has been in the spotlight each year when rate changes are announced.
In-Network Provider: (U.S. term) A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or co-payments, or additional benefits, to a plan member to see an in-network provider. Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the "usual and customary" charges the insurer pays to out-of-network providers.
Vanderbilt University is committed to providing high-quality benefits to serve the diverse and changing needs of faculty and staff. To help faculty and staff make the best decision for themselves and their families, the 2019 health plan options and changes are outlined below. At the end of this article, links to additional tools and information, as well as dates and locations for benefits discussion forums, are provided.
We’re still on my wife’s employer plan so 2018 will be fine. We’ll need to figure out healthcare once she retires, though. I think the best option for us would be a regular plan. We are relatively healthy, but we go to the doctor a few times every year. The catastrophic plan would be a better fit for someone with no chronic condition at all. Healthcare is a mess here in the US.
Background: Aim of study was to assess impact of deformable registration of diagnostic MRI to planning CT upon gross tumour volume (GTV) delineation of oropharyngeal carcinoma in routine practice. Methods: 22 consecutive patients with oropharyngeal squamous cell carcinoma treated with definitive (chemo)radiotherapy between 2015 and 2016, for whom primary GTV delineation had been performed by a single radiation oncologist using deformable registration of diagnostic MRI to planning CT, were identified. Separate GTVs were delineated as part of routine clinical practice (all diagnostic imaging available side-by-side for each delineation) using: CT (GTVCT), MRI (GTVMR), and CT and MRI (GTVCTMR). Volumetric and positional metric analyses were undertaken using contour comparison metrics (Dice conformity index, centre of gravity distance, mean distance to conformity). Results: Median GTV volumes were 13.7 cm3 (range 3.5–41.7), 15.9 cm3 (range 1.6–38.3), 19.9 cm3 (range 5.5–44.5) for GTVCT, GTVMR and GTVCTMR respectively. There was no significant difference in GTVCT and GTVMR volumes; GTVCTMR was found to be significantly larger than both GTVMR and GTVCT. Based on positional metrics, GTVCT and GTVMR were the least similar (mean Dice similarity coefficient (DSC) 0.71, 0.84, 0.82 for GTVCT–GTVMR, GTVCTMR–GTVCT and GTVCTMR–GTVMR respectively). Conclusions: These data suggest a complementary role of MRI to CT to reduce the risk of geographical misses, although they highlight the potential for larger target volumes and hence toxicity. Full article
One caution for any of you looking for cheap coverage – make sure the drug coverage is adequate. My best friend’s 77 year old husband was recently diagnosed with stage IV thyroid cancer (after full thyroidectomy and iodine treatment 11 years ago!) and his drug plan (he’s Medicare) won’t cover Tier 4 drugs at all, which is the only thing his doctor can offer. So he’s making his final arrangements because he’s going to die. I don’t know if this drug was going to just buy him some time or put him in remission or what, it’s new as of early 2018, but it’s heartbreaking to think he has no choices (other than suicide) because they cannot afford treatment. This drug costs, get this, $16,000 a month!!! That’s not a typo.
Humana group medical plans are offered by Humana Medical Plan, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico, Inc. License # 00235-0008, Humana Wisconsin Health Organization Insurance Corporation, or Humana Health Plan of Texas, Inc. or insured by Humana Health Insurance Company of Florida, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Insurance Company, Humana Insurance Company of Kentucky, or Humana Insurance of Puerto Rico, Inc. License # 00187-0009, or administered by Humana Insurance Company or Humana Health Plan, Inc. For Arizona residents, plans are offered by Humana Health Plan, Inc. or insured by Humana Insurance Company. Administered by Humana Insurance Company.
Humana individual dental plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc.CompBenefits of Georgia, Inc ., Humana Health Benefit Plan of Louisiana, Inc., or DentiCare, Inc. (DBA CompBenefits). Discount plans are offered by HumanaDental Insurance Company, Humana Insurance Company, or Texas Dental Plans, Inc. For Arizona residents: Insured by Humana Insurance Company . For Texas residents: Insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits).
If you suffer an injury or illness, individual health insurance can help pay for the cost of health care. Health insurance can also help pay for a wide range of medical services including medical emergencies, routine doctor's appointments, preventative care, prescription drugs, and inpatient/outpatient treatment. You'll typically pay a monthly premium, plus a deductible or copayment.
Keep in mind, however, that if your state department of insurance publishes rates in advance of open enrollment, they’ll be the full-price premiums. If you’re eligible for premium subsidies, you’ll end up with lower prices when you eventually enroll. And premium subsidy eligibility extends well into the middle class. A family of four will qualify for subsidies with an income above $100,000 in 2019. So don’t assume you won’t get premium subsidies until you check to make sure!
Minimum Essential Coverage (MEC) is the least amount of coverage that is required by Obamacare for an individual to be considered “compliant” and to avoid having to pay the Individual Mandate penalty if it were to be enforced. All ACA Marketplace plans and most major medical health insurance plans are considered MEC. Since the individual mandate tax penalty is gone as of January 1, 2019 it is unlikely that stand-alone MEC plans will have a significant roll in 2019.
No individual applying for health coverage through the individual marketplace will be discouraged from applying for benefits, turned down for coverage or charged more premium because of health status, medical condition, mental illness claims experience, medical history, genetic information or health disability. In addition, no individual will be denied coverage based on race, color, religion, national origin, sex, sexual orientation, marital status, personal appearance, political affiliation or source of income.
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