Managing ResourcesManaging Resources

Personal FinancePersonal FinanceUnit 5Unit 5

Health InsuranceHealth Insurance

Hospital Expense InsuranceHospital Expense Insurance

A.A. HOSPITAL EXPENSE HOSPITAL EXPENSE INSURANCE—INSURANCE—pays for all or pays for all or part of your hospital billpart of your hospital bill

1.1. Room, meals, laboratory Room, meals, laboratory tests, x-rays, nurses’ tests, x-rays, nurses’

care, care, medicine, anesthesiamedicine, anesthesia2.2. Protects against the high Protects against the high

cost of hospitalizationcost of hospitalization3.3. Usually has a deductible Usually has a deductible

and may have limitsand may have limits4.4. Blue Cross is an exampleBlue Cross is an example

Surgical Expense InsuranceSurgical Expense Insurance

Pays part of all of the surgeon’s Pays part of all of the surgeon’s feesfees1.1. Certain amount covered for Certain amount covered for different types of operationsdifferent types of operations2.2. Frequently bought in Frequently bought in combination with hospital combination with hospital insuranceinsurance3.3. Blue Shield is an exampleBlue Shield is an example

Medical Expense InsuranceMedical Expense Insurance

Covers fees charged by doctors Covers fees charged by doctors for services other than surgeryfor services other than surgery

--office visits, tests--office visits, tests

Major Medical InsuranceMajor Medical Insurance

picks up where other health picks up where other health insurance ends to cover big insurance ends to cover big expenses (serious illness or expenses (serious illness or injuries)injuries)

--usually pay a deductible and --usually pay a deductible and co-insurance (policyholder co-insurance (policyholder expected to pay a certain expected to pay a certain percentage)percentage)

Comprehensive Medical Comprehensive Medical InsuranceInsurance combines hospital, surgical, combines hospital, surgical,

medical and major medicalmedical and major medical --usually a group plan--usually a group plan

Sources of Health InsuranceSources of Health Insurance

A.A. INDIVIDUAL POLICY—INDIVIDUAL POLICY—purchases from an insurance agentpurchases from an insurance agent----usually expensive but can be tailored for individual usually expensive but can be tailored for individual

needsneedsB.B. GROUP HEALTH INSURANCE—GROUP HEALTH INSURANCE—insurances made available insurances made available

through an employer, union, or other organization to their through an employer, union, or other organization to their membersmembers--employers may pay all or part of the cost of the insurance for --employers may pay all or part of the cost of the insurance for their employeestheir employees

C.C. HMOHMO (Health Maintenance Organization)—normally consist of a (Health Maintenance Organization)—normally consist of a staffed medical clinic organized to serve its members staffed medical clinic organized to serve its members --fixed monthly fee--fixed monthly fee

D.D. GOVERNMENT INSURANCEGOVERNMENT INSURANCE1.1. Worker’s Compensation—provide medical and survivor Worker’s Compensation—provide medical and survivor

benefits for person injured, disabled or killed on the jobbenefits for person injured, disabled or killed on the job--pays for all necessary medical expenses and 2/3 of --pays for all necessary medical expenses and 2/3 of normal wage while unable to worknormal wage while unable to work

2.2. Medicare—coverage for people over 65Medicare—coverage for people over 653.3. Medicaid—pays for health care for the poor, blind, Medicaid—pays for health care for the poor, blind, disabled, elderly and dependent childrendisabled, elderly and dependent children

What Determines Cost of What Determines Cost of Health InsuranceHealth Insurance

A.A. EXTENT OF COVERAGEEXTENT OF COVERAGEB.B. NUMBER OF CLAIMS NUMBER OF CLAIMS

FILED BY FILED BY POLICYHOLDERSPOLICYHOLDERS

C.C. AGE OF POLICYHOLDERAGE OF POLICYHOLDERD.D. NUMBER OF NUMBER OF

DEPENDENTSDEPENDENTS