The final CMS rule is also going to attempt to improve the integrity of the Advanced Premium Tax Credits (APTC) program. It hopes to do this by “implementing stronger checks” that would take tougher measures to verify anyone applying for Advanced Premium Tax Credits earn the income they claim. The new measure is also going to disqualify any applicant who fails to file taxes or reconcile prior APTCs.
Young adulthood is a period of transition, which for many includes higher education. Higher education is associated with specific risks to wellbeing. Understanding the available data on wellbeing in this group may help inform the future collection of data to inform policy and practice in the sector. This scoping review aimed to identify the availability of data sources on the wellbeing of the Australian young adult population who are attending tertiary education. Using the methods of Arksey and O’Malley, data from three primary sources, i.e., Australian Bureau of Statistics, Australian Institute of Health and Welfare and relevant longitudinal studies, were identified. Data sources were screened and coded, and relevant information was extracted. Key data for eight areas related to wellbeing, namely, family and community, health, education and training, work, economic wellbeing, housing, crime and justice, and culture and leisure sources were identified. Forty individual data sets from 16 surveys and six active longitudinal studies were identified. Two data sets contained seven of the areas of wellbeing, of which one was specific to young adults in tertiary education, while the other survey was not limited to young adults. Both data sets lacked information concerning crime and justice variables, which have recently been identified as being of major concern among Australian university students. We recommend that government policy address the collection of a comprehensive data set encompassing each of the eight areas of wellbeing to inform future policy and practice. Full article
Colombians report little to no confidence in judges, the formal legal system and their rights. And yet they continue to file tutela claims. I conducted research in Colombia between July 2016 and May 2017 to investigate this, interviewing 90 lawyers, judges, government officials and service providers, as well as 93 everyday citizens from various class backgrounds. I also surveyed 310 Colombians who were in the process of filing tutela claims. I concluded that citizens view the tutela as the only mechanism through which they can make claims to things they care about, such as health care. Colombians turn to the courts because they see no other alternative, not because of their robust belief in the courts.
Employers and employees may have some choice in the details of plans, including health savings accounts, deductible, and coinsurance. As of 2015, a trend has emerged for employers to offer high-deductible plans, called consumer-driven healthcare plans which place more costs on employees; some employers will offer multiple plans to their employees.[60]

Obamacare health insurance plans are major medical insurance that provide individual or full family healthcare coverage that meets all the requirements of the Affordable Care Act (ACA), signed by President Obama in 2010. One of the biggest features of Obamacare plans is that they are required to offer 10 "essential health benefits." These benefits include provisions such as maternity care and mental health coverage, that may not be available with other forms of health insurance. Another key feature of Obamacare is that these plans offer strong protections for consumers with pre-existing health conditions such as diabetes or cancer. The ACA requires that health insurers can't turn you down, charge you more or drop your coverage if you have a pre-existing condition.
The compulsory insurance can be supplemented by private "complementary" insurance policies that allow for coverage of some of the treatment categories not covered by the basic insurance or to improve the standard of room and service in case of hospitalisation. This can include complementary medicine, routine dental treatment and private ward hospitalisation, which are not covered by the compulsory insurance.
In 2006, a new system of health insurance came into force in the Netherlands. This new system avoids the two pitfalls of adverse selection and moral hazard associated with traditional forms of health insurance by using a combination of regulation and an insurance equalization pool. Moral hazard is avoided by mandating that insurance companies provide at least one policy which meets a government set minimum standard level of coverage, and all adult residents are obliged by law to purchase this coverage from an insurance company of their choice. All insurance companies receive funds from the equalization pool to help cover the cost of this government-mandated coverage. This pool is run by a regulator which collects salary-based contributions from employers, which make up about 50% of all health care funding, and funding from the government to cover people who cannot afford health care, which makes up an additional 5%.[31]
A contract between an insurance provider (e.g. an insurance company or a government) and an individual or his/her sponsor (e.g. an employer or a community organization). The contract can be renewable (e.g. annually, monthly) or lifelong in the case of private insurance, or be mandatory for all citizens in the case of national plans. The type and amount of health care costs that will be covered by the health insurance provider are specified in writing, in a member contract or "Evidence of Coverage" booklet for private insurance, or in a national health policy for public insurance.

If you are between jobs, self-employed, working part time, looking for family coverage, or don’t get healthcare from an employer, Bright Health’s Individual and Family plans give you the coverage you deserve while saving you hundreds. And, yes, we totally know that finding the right plan is a frustrating process during Open Enrollment, so we do all we can to make buying health insurance as painless as possible.
Deductible and out-of-pocket limit amounts shown below are the costs for individuals. Amounts for families are twice the individual amounts. If members receive services from out-of-network providers, their deductible and out-of-pocket limit will be higher than the amounts listed in the chart below. All plans are available direct with PacificSource and through OregonHealthcare.gov.
We would be willing to take on a significantly higher deductible in a catastrophic plan. Even $20 – $25k a year deductible in order to keep basic premiums low and pay for most things out of pocket. Depending on the landscape when we retire (whether subsidies still exist), we could COBRA until the end of that year and shop for a low premium plan for the following year. And like the good ole doc, we are beefing up our HSA accounts while we can to fill in gaps if we need to until becoming eligible for Medicare. Hoping to preserve them for later on though.
Perhaps the most unconventional idea here is to drop health insurance and join a medical cost sharing group instead. These faith-based expense sharing programs are not insurance. Instead members directly share unforeseen medical expenses. Members make a fixed monthly sharing contribution. The groups have set up different systems to either reimburse members for their expenses or directly pay providers for the eligible expenses other members incur. By paying only for actual expenses and non-profit admin fees, the costs of these programs can be very attractive. This was a very popular option for RVers in 2017. 

HealthCare.com is an independent, advertising-supported website publisher and provides a consumer comparison service. HealthCare.com may earn revenue for leads, clicks, calls and application generated, and may be compensated by its advertisers for sponsored products and services. This compensation may impact how, where and in what order products appear. HealthCare.com does not include all companies or all available products. HealthCare.com is not a broker or agent on the sale of insurance products.

The effectiveness of regenerated chicken bone char (CBC) in fluoride removal was investigated in the present study. Heat treatment was studied as the regeneration method. Results revealed that the CBC regenerated at 673 K yielded the highest fluoride adsorption capacity, hence, 673 K was the best regenerating temperature. The study continued up to five regeneration cycles at the best regenerating temperature; 673 K. The CBC accounted to 16.1 mg F/g CBC as the total adsorption capacity after five regeneration cycles. The recovery percentage of CBC reduced from 79% at the first regeneration to 4% after five regeneration cycles. The hydroxyapatite structure of CBC was not changed during the fluoride adsorption by five regeneration cycles. The ion exchange incorporated with the chemical precipitation occurred during the fluoride adsorption. The repeated regeneration of CBC is possible and it could be used as a low cost defluoridation technique to minimize the wastage of bone char. Full article
Then the choice is clear: You need an ACA plan. ACA plans are the only option that will cover all pre-existing conditions on day 1 without waiting periods. Same with prescriptions. If you have lots of prescriptions you need coverage for then an ACA plan is your best option. Most alternative healthcare options will give you discounts on prescriptions but will not give you a “copay” structure like ACA plans—although many ACA plans do subject you to your plan deductible first. Some ACA alternatives will cover pre-existing conditions after a 12-24 month waiting period.

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!


So we can expect a slight decline in the value of premium subsidies in 2019, on the heels of two consecutive years when average premium subsidy amounts increased significantly. But the cost of your specific health insurance policy could go up or it could go down, depending on whether you receive a premium subsidy (most exchange enrollees do, but everyone who enrolls outside the exchange pays full price), and how much your plan's price is changing.
Young adulthood is a period of transition, which for many includes higher education. Higher education is associated with specific risks to wellbeing. Understanding the available data on wellbeing in this group may help inform the future collection of data to inform policy and practice in the sector. This scoping review aimed to identify the availability of data sources on the wellbeing of the Australian young adult population who are attending tertiary education. Using the methods of Arksey and O’Malley, data from three primary sources, i.e., Australian Bureau of Statistics, Australian Institute of Health and Welfare and relevant longitudinal studies, were identified. Data sources were screened and coded, and relevant information was extracted. Key data for eight areas related to wellbeing, namely, family and community, health, education and training, work, economic wellbeing, housing, crime and justice, and culture and leisure sources were identified. Forty individual data sets from 16 surveys and six active longitudinal studies were identified. Two data sets contained seven of the areas of wellbeing, of which one was specific to young adults in tertiary education, while the other survey was not limited to young adults. Both data sets lacked information concerning crime and justice variables, which have recently been identified as being of major concern among Australian university students. We recommend that government policy address the collection of a comprehensive data set encompassing each of the eight areas of wellbeing to inform future policy and practice. Full article
Obamacare health insurance plans are major medical insurance that provide individual or full family healthcare coverage that meets all the requirements of the Affordable Care Act (ACA), signed by President Obama in 2010. One of the biggest features of Obamacare plans is that they are required to offer 10 "essential health benefits." These benefits include provisions such as maternity care and mental health coverage, that may not be available with other forms of health insurance. Another key feature of Obamacare is that these plans offer strong protections for consumers with pre-existing health conditions such as diabetes or cancer. The ACA requires that health insurers can't turn you down, charge you more or drop your coverage if you have a pre-existing condition.
For starters, the vast majority of the headlines you're seeing are for health insurance that people buy in the individual market. That can be in the health insurance exchange or outside the exchange (i.e., purchased directly from the health insurance company), but it does not include coverage that people get from an employer, nor does it include Medicare, Medicaid, or the Children's Health Insurance Program.

Common chronic illnesses usually treated in primary care may include, for example: hypertension, diabetes, asthma, COPD, depression and anxiety, back pain, arthritis or thyroid dysfunction. Primary care also includes many basic maternal and child health care services, such as family planning services and vaccinations. In the United States, the 2013 National Health Interview Survey found that skin disorders (42.7%), osteoarthritis and joint disorders (33.6%), back problems (23.9%), disorders of lipid metabolism (22.4%), and upper respiratory tract disease (22.1%, excluding asthma) were the most common reasons for accessing a physician.[10]


 An important note about Avera Health in South Dakota. Avera Health declined to renew our contract to offer their ACA plans in 2019. When we inquired as to why, we received this reply on 10/18/18: “RVers… I am sorry, but a narrow network product does not fit well for the members. We want to be able to take care of our members when they have an accident or illness. We do not have any providers or facilities outside of SD and NW Iowa, which makes us not the best fit for RVers.” While we agree that their plans are not a great fit for RVers, it seems it should be left to the members to decide if they are willing to risk traveling with their coverage. Nevertheless, it looks like RVers are not welcome to enroll with Avera Health for 2019.
The ACA’s individual mandate penalty will be set to $0 starting in January 2019. People who are uninsured in 2018 (and not eligible for a penalty exemption) will still have to pay a penalty when they file their 2018 tax return in early 2019. But people who are uninsured in 2019 and beyond will not face a penalty, unless they’re in a state that imposes its own individual mandate.
Coinsurance: Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co-insurance is a percentage of the total cost that insured person may also pay. For example, the member might have to pay 20% of the cost of a surgery over and above a co-payment, while the insurance company pays the other 80%. If there is an upper limit on coinsurance, the policy-holder could end up owing very little, or a great deal, depending on the actual costs of the services they obtain.

The Swiss healthcare system is a combination of public, subsidised private and totally private systems. Insurance premiums vary from insurance company to company, the excess level individually chosen (franchise), the place of residence of the insured person and the degree of supplementary benefit coverage chosen (complementary medicine, routine dental care, semi-private or private ward hospitalisation, etc.).

Thanks for the post. My wife and I have achieved FI and are exploring when we can retire (she is only working part time now). My biggest challenge is that I have a chronic leukemia that requires medication for life (fortunately I am in remission but still need to take medicine daily). What surprised me the most when searching for health plans on the exchanges, was the lack of hospitals and doctors in the plans. I live in Houston and none of the major hospitals in the medical center are in the market place plans. So if I quit my job I would loose access to the specialist that I have seen for almost 7 years now. I’ve thought of moving to a different state where the plans have access to specific local specialists (of course who knows if the plans in other states will eventually drop those doctors). But for now I feel a bit stuck in my job if I want to visit the doctor and have access to the medical facility that I am so familiar and comfortable with.
Can anyone address the elephant in the room: as medical therapeutics change and biologics are available and more appropriate for various conditions it is noteworthy to realize that these costs are often not covered by many government insurers and not eligible for foundations grants (as are sometimes offered in the form of copay cards, or copay assistance). I’m talking 20% out of pocket cost for a biologic can run 1500-2000 out of pocket after insurance. If you happen to get one of these rheumatologic or immunologic diseases, Medicare is NOT going to cut it. Are people folding in these possibilities into their projected costs in retirement. How does the FIRE community think about these things (I mean the medical FIRE community…I don’t think the non-medical FIRE community is even aware of these nuances unless they’re already dealing with a chronic or rare disease under treatment).

There are also some states where insurers that are expanding their existing coverage areas, including Kentucky and Colorado. But that’s not the case everywhere. Some insurers in Washington, for example, are reducing their coverage areas. And in Georgia, Anthem is simultaneously reducing the number of counties where they’ll offer plans, but increasing the number of people who will be eligible for their plans (by exiting numerous rural counties and rejoining almost as many populous counties)
Before the development of medical expense insurance, patients were expected to pay health care costs out of their own pockets, under what is known as the fee-for-service business model. During the middle-to-late 20th century, traditional disability insurance evolved into modern health insurance programs. One major obstacle to this development was that early forms of comprehensive health insurance were enjoined by courts for violating the traditional ban on corporate practice of the professions by for-profit corporations.[55] State legislatures had to intervene and expressly legalize health insurance as an exception to that traditional rule. Today, most comprehensive private health insurance programs cover the cost of routine, preventive, and emergency health care procedures, and most prescription drugs (but this is not always the case).
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.

Hospital and medical expense policies were introduced during the first half of the 20th century. During the 1920s, individual hospitals began offering services to individuals on a pre-paid basis, eventually leading to the development of Blue Cross organizations.[54] The predecessors of today's Health Maintenance Organizations (HMOs) originated beginning in 1929, through the 1930s and on during World War II.[56][57]


As far as the compulsory health insurance is concerned, the insurance companies cannot set any conditions relating to age, sex or state of health for coverage. Although the level of premium can vary from one company to another, they must be identical within the same company for all insured persons of the same age group and region, regardless of sex or state of health. This does not apply to complementary insurance, where premiums are risk-based.

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:
In the late 1990s and early 2000s, health advocacy companies began to appear to help patients deal with the complexities of the healthcare system. The complexity of the healthcare system has resulted in a variety of problems for the American public. A study found that 62 percent of persons declaring bankruptcy in 2007 had unpaid medical expenses of $1000 or more, and in 92% of these cases the medical debts exceeded $5000. Nearly 80 percent who filed for bankruptcy had health insurance.[48] The Medicare and Medicaid programs were estimated to soon account for 50 percent of all national health spending.[49] These factors and many others fueled interest in an overhaul of the health care system in the United States. In 2010 President Obama signed into law the Patient Protection and Affordable Care Act. This Act includes an 'individual mandate' that every American must have medical insurance (or pay a fine). Health policy experts such as David Cutler and Jonathan Gruber, as well as the American medical insurance lobby group America's Health Insurance Plans, argued this provision was required in order to provide "guaranteed issue" and a "community rating," which address unpopular features of America's health insurance system such as premium weightings, exclusions for pre-existing conditions, and the pre-screening of insurance applicants. During 26–28 March, the Supreme Court heard arguments regarding the validity of the Act. The Patient Protection and Affordable Care Act was determined to be constitutional on 28 June 2012. SCOTUS determined that Congress had the authority to apply the individual mandate within its taxing powers.[50]

But for 2019, that uncertainty has not been a factor. The federal government will continue to not fund CSR, but states and insurers already know that. So the cost of CSR is almost universally built into the rates that insurers started filing in the spring of 2019 (in most cases, the cost is being added to silver plan rates, which is beneficial to the majority of consumers and can result in some highly discounted bronze and gold plans for people who qualify for premium subsidies)


Few factors bear as heavily on the well-being of any state’s citizens as their overall quality of health. In evaluating the Best States for health care, access to preventative medical and dental treatment for children and adults alike is a key consideration. Since adoption of the Affordable Care Act of 2010, also known as “Obamacare,” the percentage of Americans without health insurance has reached a record low, falling below 10 percent. The measure has been politically controversial since its inception, and the Republican-run Congress and President Donald Trump have vowed to repeal Obamacare. A rollback of the law's mandate that everyone have coverage – either through employers or public health care programs – or pay a tax penalty passed in late 2017, posing challenges to millions who have found insurance under the law.
Consumers who are unable to afford ACA-compliant coverage can now purchase short-term coverage with a much longer duration. Federal regulation changes finalized this summer and announced this month will make it possible for many buyers to purchase a short-term plan with an initial duration of nearly a year – with renewal options that allow the plan to remain in force for three years.
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