Top 5 Individual Health Insurance Terms

healthy-heartWhen shopping for a new individual health insurance plan, one of the main challenges people face is understanding the sea of acronyms and terminology. Here is a list to help understand some of the most basic individual health insurance terms.

1. Premium

Your premium is the amount you pay to the health insurance company each month (or quarter) to maintain your coverage. When you’re researching plans it’s usually the first cost you see and consider, but it’s important to also factor in the copayments, deductible, coinsurance, and out-of-pocket maximums, described below.

2. Copayment

Your co-pay, or copayment, is a flat dollar amount you will pay your healthcare provider for a covered service. For example, you may have to pay a $30 copayment for each covered visit to a primary care doctor, and $10 for each generic prescription filled. Copayments vary from plan to plan and are sometimes different depending on the type of covered service you receive.

3. Deductible

Your deductible is the amount you must pay for covered services before your health insurance begins to pay. Insurers apply and structure deductibles differently. For example, under one plan, a comprehensive deductible might apply to all services while another plan might have separate deductibles for covered services such as prescription drug coverage. Deductibles can significantly affect the price of your insurance premium. Typically, plans with lower deductibles offer more comprehensive coverage but have higher premium costs.

4. Coinsurance

Coinsurance is a certain percent you must pay each benefit period after you have paid your deductible. This payment is for covered services only. You may still have to pay a copay.

For example, your plan might cover 80 percent of your medical bill. You will have to pay the other 20 percent. The 20 percent is the coinsurance.

5. Out-of-pocket Costs

Cost you must pay. These are your expenses for medical care that aren’t reimbursed by insurance. Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren’t covered. Out-of-pocket costs vary by plan and each plan has a maximum out of pocket (MOOP) cost. Consult your plan for more information.

To read more or find other relevant insurance terms, check out this glossary of terms on medmutual.com.

Medical Care Standards in Space

stephen geri medical careAs the spaceflight industry continues to develop, many civilians are wondering how we can secure the safety and health of space passengers who will witness both physiological and environmental challenges that we do not see here on Earth. Because this is an ever-growing field, medical care standards need to be considered for various types of spaceflight.

According to an article recently published by Medical News Today, Professor in Aeronautics and Astronautics at Stanford University, Scott Hubbard, says “‘Medical constraints are the most important discriminators in determining who in the general population can be a spaceflight participant,” (Experts Consider Medical Care Standards for Civilians in Space). In addition, the article comments on how various types of space flight requires different medical standards. Thus, it is difficult to allocate a general standard of medical care for a wide variety of space vehicles.

stephen geri space flightBoth suborbital and orbital flights should be considered as offering a wide variety of risks and challenges to humans who travel in space. According to the Medical News Today article, “Among the factors to be considered in developing medical care standards for civilian space flights are that suborbital and orbital flights pose different risks and challenges to the human body and will likely require different codes of medical practice, skills, equipment and materials,” (Experts Consider Medical Care Standards for Civilians in Space). This means that motion sickness, pressure suits, and oxygen masks must all be considered in terms of equipment needed for these flights.

Furthermore, professional, medically-trained staff will likely be a factor in determining health precautions when it comes to orbital tourists flights, especially since a majority of the passengers will not be trained in emergency equipment and treatment. Medical News Today states that, “The authors point to the factors that the NASA medical stanstephen geri health care in spacedards address in order to provide the proper level of care for different space missions. They suggest that these should also be considered when establishing medical standards for commercial spaceflight,” (Experts Consider Medical Care Standards for Civilians in Space).

These factors include the type and duration of the mission, the objectives of the mission, providers of health and medical care and what level of training they have received, the pre-flight health status of those on board, medical risk of illness or injury, time required to return back to Earth to receive medical treatment, and the level of accepted medical risk. For more information on the anticipated medical care standards for space travel, please read Medical News Today’s article here.

 

Diabetes Expenses

Recently, more and more American children have been diagnosed with diabetes. So, unsurprisingly, healthcare spending for this metabolic disease has risen, and particularly for those with private health insurance. According to an article published by United Press International, “Spending for employer-insured children with diabetes rose 7 percent between 2011 and 2012, and 9.6 percent between 2012 and 2013,” (Hays, Healthcare Spending for Privately Insured Kids with Diabetes Rises).

stephen geri diabetes

Because the amount of children with diabetes has risen so exponentially, the health care spending for these individuals is doing the same in order for doctors and researchers to fully understand the relationship between actual health outcomes for children with diabetes. According to UPI, “Researchers said one of the main reasons for the spending increase is that branded insulin is administered to children with diabetes more frequently than it is for older Americans with the disease,” (Hays, Healthcare Spending for Privately Insured Kids with Diabetes Rises).

The important thing to monitor now is how this increase in spending contributes to what professionals can learn about managing diabetes and ultimately come to some sort of a cost-effective solution, if not a cure. According to the article, patients with diabetes spent an alarming, “$10,000 more each year than those without the disease,” (Hays, Healthcare Spending for Privately Insured Kids with Diabetes Rises).

From more information on the amount of effort and spending associated with patients who have diabetes, please read UPI’s article here.