January 1, 2010

Over 20 million U.S. residents have no health insurance coverage. The problem is certainly a serious national crisis but perhaps not as hopeless as some believe. Some significant portion of these uninsured can reasonably resolve their situation by learning more about their options and taking appropriate financial steps to improve their own situation. This short report is meant to summarize those options and highlight the assistance available through Freedom Benefits Association. It is our belief that better understanding of the current health care system and the options already available is the obvious first step toward a solution to the national health care crisis.

About a quarter of the uninsured residents are not U.S. citizens and many have recently immigrated to the U.S.  These individuals have the best chance of finding quality affordable coverage; see the article titled "Health Insurance for U.S. Immigrants" at http://www.medsave.com/inbound-immigrant-insurance-features-and-benefits.htm.   It is relatively easy to learn about and enroll in this low cost medical insurance.

Of course education and planning will not help everyone. Other published reports indicate that a significant portion of uninsured patients offered financial assistance by a hospital declined to even apply for such assistance even when offered by hospital employees or social workers at the time of admission. Other indications clearly show that Americans are willing to modify their current behaviors and spending patterns to a relatively small extent in order to address their health care issues. In other words, even if workable solutions are available in the current system, there is little evidence that all uninsured Americans will take the steps necessary to utilize them. Those social behavior issues are beyond the scope of this article. This article focuses on those Americans with a "will do what it takes" attitude toward addressing their health care issues.

First it is important to recognize that all Americans have access to health care right now under our current system. Disregarding problems of access due to individual issues like language, mental illness or physical location, our health care system is designed to make sure that no one dies on the sidewalk outside of a hospital. The available service might not always be the same level of care as we would choose if money were no object, but this system, nevertheless, provides the highest level of medical care known in the history of the world. For purposes of discussion, this article breaks down the suitability of health plans into four very general economic groups that are discussed throughout this article:

Poor - those without significant income or assets. For example, those who could not come up with $1000 cash to address a serious personal or health issue would fall in this general category.

Low Income - those whose health care needs are in direct economic competition with other basic living expenses.

Middle Income - those whose health care is paid primarily through payroll deductions and employer contributions. Some out-of-pocket health care needs are in direct economic competition with other basic living expenses.

Higher Income - those whose health care is primarily provided by an employer or entity without any significant direct action needed on their part.

It is important to recognize that the very large majority of Americans without health coverage fall into the Low and Middle Income categories. Individuals in the Low Income category are most likely to be in a chronic problem - often going for years without health coverage or treatment that would have been selected by those with better access to health care. This is considered the more serious segment of the uninsured problem. The largest group of uninsured Americans fall into the Middle Income category but most of these Americans are temporarily without health coverage due to changing life circumstances including job changes, divorce, education transitions (high school or college graduations, for example), starting their own business, etc. These people generally have a greater ability to make changes that will give better access to health care. When we hear a quote like "46 million Americans have no health coverage" it actually turns out that in any given point in time more than half of them are in that situation only on a temporary basis.

In a nutshell, our health care system works like this: poor people are given free health care though a number of local and state-administered programs. Low income people must spend down their income and assets to be in the poor category in order to access health care benefits but frequently make reasonable decisions not to do so. Middle income people are covered by managed care health plans that attempt to mold purchase decisions by meshing "what's available" in our health care system with "what's affordable" based on the dollars already allocated. Higher income people enjoy the health care they choose, mostly paid by an employer, with little overall impact on their other life decisions or financial lives.

All Americans are eligible for one or more of the following types of health insurance plans:

Welfare systems - local hospitals, charities, state and federal governments provide billions of dollars of health care through a wide number of programs for the poor. Assess is primarily based on income and assets. Increasingly, organizations that provide social services are providing referrals to these health programs. These programs are best located through a local welfare office or health care clinic. These programs are not available on the Internet. Low income individuals are not likely to use, nor do we recommend, the assistance available through Freedom Benefits Association. The immediate challenge is getting those eligible in contact with the available programs.

High Risk Pools - Each state has one or more health plans that will accept applicants regardless of prior coverage and regardless of health history. These are referred to alternately as "open enrollment" "guaranteed issue" or "state mandate plans". Unfortunately the price of these plan exceeds the amount of disposable income for most low income applicants, and significant lifestyle changes would be necessary for middle income applicants to access health coverage through these programs. For this reason, most eligible people decline to enroll. At this time there is no universal listing of the available plans in this category. Information is available through each state's Insurance Department.  See "High Risk Health Insurance Plans" and "Blue Cross / Blue Shield" for more information.  These health plans can be quite expensive.  The average premium price for applicants to a high risk pool is 150% to 200% of the rate for healthy applicants.   Make sure that you have exhausted the low cost possibilities listed for your state here at MedSave.com before moving to a more expensive insurance. 

Short Term Health Coverage - Those in lifestyle transitions are best covered by short-term health plans that cost a fraction of the amount of other health plans. The low cost makes this popular with low and middle income applicants. This type of health insurance is available in all states except MA, NJ, NY, and VT. These health plans provide the same benefits as longer-term health plans except that they do not provide coverage for ongoing medical conditions. Today most short-term health insurance plans are issued on the Internet. A state-by-state listing is available online at http://www.medsave.com/list-of-low-cost-insurance-and-benefits.html .

CORBRA and HIPAA Plans - Those who must maintain coverage for ongoing medical conditions are guaranteed that right under these two laws known as COBRA and HIPAA. The catch is that you must have prior health coverage and be able to afford the high cost of these health plans. Most uninsured Americans in a low and middle income category with serious pre-existing medical problems do not meet these requirements for participation in these plans. (They were not recently enrolled in a health insurance plan that provides and/or cannot afford the cost of premiums). Information is best accessed through your current or previous health insurance provider. See http://www.COBRAplan.com for more information.

Basic Health Insurance - As the name implies, this is a limited benefit coverage that provides most but not all of the protection needed by the majority of Americans. The cost is significantly less than other health plans. The benefits of this insurance can be combined with other health plans for middle income and higher income applicants, whenever possible, for full protection. In some cases for lower income applicants this may be the only coverage that is affordable; in this case it is better than no coverage at all. Basic health insurance is available in about half of the states. More information is available at www.BasicHealthInsurance.net .

Catastrophic Health Insurance Plans - About a third of the cost of coverage can be chopped off by purchasing insurance only for catastrophic health care costs. The federal government is promoting this approach through a new program called Health Savings Accounts. It you purchase this type of insurance, then you are allowed certain tax breaks in paying for your ordinary out-of-pocket health care costs. More information is available online at www.HealthSavingsAccount-hsa.com. This plan works best as a cost-saving measure for healthy higher income applicants. This new program is still suffering from many start-up woes (see the articles on the Web site), but holds promise for middle income applicants in the future. The commercial marketplace for this coverage is still emerging. Freedom Benefits offers assistance through OnlineAdviser service to help find and enroll in these health plans for a flat fee.

Group Health Insurance - Almost all employers may purchase guaranteed issue health insurance coverage on their full time employees and themselves and all employees' dependents regardless of health history. The eligibility requirement is proof that state wage taxes were paid on these covered employees. These plans are available exclusively to middle income and higher income applicants. Freedom Benefits Association (www.freedombenefits.org) provides advice and support to small businesses enrolling in low cost employee benefit plans.

Preferred Risk Health Plans - Most states allow discounted health plans to be available to those individuals without significant medical history and good current health status. The cost is significantly lower than other health plans, although the savings tend to be greater for younger people than older applicants. These plans are generally designed for those in a higher income category but the lower cost attracts some middle income applicants. This approach may offer greater benefits but no financial savings for applicants over age 50.  See the low cost healthinsurance plans listed for your state here at MedSave.com.  In most states MedSave.com and Celtic Insurance offer prefered risk health insurance plans for individuals and families.




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