Insurance



__**Insurance, what is it??**__ A contract (policy) in which an individual or entity receives financial protection or reimbursement against losses from an insurance company. The company pools clients' risks to make payments more affordable for the insured.

1. HMO 2. PPO 3. Indemnity Health 1. Whole 2. Term
 * Health Insurance **
 * Auto Insurance **
 * Medicaid****Property Insurance**
 * Medicare**
 * Life Insurance[[image:im-insurance-grad05.jpg width="440" height="287" align="right"]]**
 * Cobra**

There are three major types of health insurance-
 * Health:**

__//1.PPO//__ -Preffered Provider Organization -Managed care organization of medical doctors, hospitals, and other health care providers - these people have agreed with an insurer or a third party administrator to provide health care at reduced rates -Coverage: preventive care, routine exams and checkups, hospital and emergency care, prescription drugs, outpatien surgery, and specialist care - good with flexibility of getting care without a network provider, there are more out of pocket costs, reduced prescription costs, covers more medical services with a premium -Disadvantage: after your deductable is met you will be required to pay co-insurance which will be around 30% of the total amount, PPO can charge you alot of out of pocket expenses which you will be charged after deductibles and co-insurance

//__ 2. HMO: __// -Health Maintenance Organization Plan -It is structured like a network -Options for doctors is limited within your own network and you must choose a primary care physician who is in charge of different medical situations -Cheapest plan available -Advantages: HMO plans are inexpensive, monthly flat rate, no upfront costs, no claim forms necessary for you to complete to get insured -Disadvantages: have to choose doctors, specialists and other care providers in your network, may reruire pre-approval for certain services and long waits to see certain specialists

__//4. Indemnity://__ - able to use any medical provider, doctor and hospital. - you or they will send a bill to the insurance company. The insurance company ends up paying part of your medical bill. - with this, you have a deuctible ( amount of covered expenses you have to pay before the insurer starts to give money back) this is what you pay each year before the insurer starts paying


 * Auto Insurance:**

Insurance for an automobile allowing one party to agree to pay for another party’s financial loss from a collision, theft, or storm damage

__7 types of Auto Insurance:__


 * • 1. Liability Insurance
 * • 2. Collision Insurance[[image:http://t0.gstatic.com/images?q=tbn:ANd9GcTmy5VcHk2TRksFG6xJbcwjG2gQlap9MF-H-cfGoc9rI2bYldW5 width="270" height="178" align="right"]]
 * • 3. Comprehensive Insurance
 * • 4. Uninsured Motorist Protection
 * • 5. Medical/ Personal-Injury Protection
 * • 6. No Fault Insurance
 * • 7. Gap Insurance

//__Liability Insurance:__// - This is usually a minimum requirement to have in order to drive your car on throad. - Liability insurance covers property that is damaged in a crash such as other cars or buildings, it also can cover medical bills

//__Collision Insurance:__//

- this can make sure that if an accident occurs, you will be able to get enough money to fix or even replace your car- this isn’t a necessity, but it would be a very good idea especially if you get into an accident with a new car that you can’t afford to fix. - with collision insurance, you receive compensation: when the cost of the damage wont be for the cars value when it was new, but instead what it would be worth at the time of the accident. This could end up saving you a lot of money.

//__Comprehensive Insurance:__// - this deals with things that happen to your car that don’t involve an accident. It may have to deal with weather damage, fire, vandalism or theft. - Comprehensive insurance is pretty expensive but its definitely worth purchasing it along with the collision insurance. This is because even if your car were to be destroyed, with both the comprehensive and collision insurance funds will still be available to cover a remainder of the load.

//__Uninsured Motorist Protection:__// - this can pay for injuries to you and your passengers during an accident - when there is an accident, the other driver is both legally responsible for the accident is considered "uninsured" - an uninsured driver is someone who did not have any insurance, had insurance that didn't meet liability requirements, or whose insurance company denied their claim.

//__Medical/Personal Injury Protection:__// - useful when you obtain large medical bills because of injuries caused to either you or passengers after an accident - this does seem like a good idea to have, however if you have a good health insurance, and with the cost of the medical/personal injury protection, it may be unnecessary.

//__No Fault Insurance:__// - used to cover damages on property or your car - can cover personal injuries as well, no matter whose fault the damage was - very expensive

__//Gap Insurance://__ - used when you are still paying off a loan on a car. - helps pay off the remaining balace if you get into an accident - good idea if you owe more than the value of the car - certain Auto Loan lenders require Gap Insurance until your car is fully paid off and completely yours.

- this is for being covered just incase something were to happen to your home such as any type of damage - you can get policy's for external and/or internal damage for your home - some things to get on your policy would be: fire flood theft lightning - with this type of insurance you can also get protection on important items such as jewelry and silverware
 * Home/Property Insurance:**

-Health insurance for people who are 65 or older. Also people who are under 65 with certain disabilities quailify for medicare. people with End-Stage Renal Disease qualify. -End-Stage Renal Disease: permanent kidney failure, requirring dialysis, or kidney transplant
 * Medicare Insurance:**

//__Plan A: Hospital Insurance__// -Helps cover inpatient care in hospitals, skilled nursing facility, hospice, and home health care -If buying Part A, you must also have Part B and pay monthly premiums. If you have limited income and resources, your state should/may help pay for Part A and/or Part B. -Cover: Inpatient care in hospitals, Inpatient care in a nursing facility, Hospice care services, Home Health Careservices, Inpatient care in a Religious Nonmedical Care Institution

//__Plan B: Medical Insurance__// -Helps cover medical services:- doctors' services-outpatient care-home health services-some preventive services -Pay a premium each month, Pay the standard premium amount, Social Security will contact you if you have to pay more depending on your income - If not signed up for Part B right away, you may have to pay a late enrollment penalty, Some automatically, If you collect benefits from Social Security or the Railroad Retirement Board, you will automatically get both A and B. Medically necessary services: Services that treat/diagnose your medical condition, if only met at specific standards.• Preventative services: Healthcare that can prevent illness. For example, flu shots. media type="youtube" key="19Du4JtiXzI" height="315" width="420"

//__Plan C: Medicare Advantage__// -A plan offered by private companies approved by Medicareû Provides all of part A and B coverage, Offer hearing, dental, health and wellness programs - Mainly Medicare prescription drug coverage -Can charge any cost they like and have different rules for different services - Health Maintenance Organization Plans -Preferred Provider Organization Plans -Private Fee-for-Service Plans - Special Needs Plans - Pay one monthly premium -Can charge out-of-pocket costs:-If plan charges monthly premium-If plan pays any of Plan B premium -If plan had yearly deductable-How much you pay for visits(healthcare) -If you follow plans rules or need extra benefits - Pay one monthly premium -Can charge out-of-pocket costs:-If plan charges monthly premium-If plan pays any of Plan B premium -If plan had yearly deductable-How much you pay for visits(healthcare) -If you follow plans rules or need extra benefits -coverage Always covers emergency and urgent careû Must cover all previous Original Medicare except Hospice Care media type="youtube" key="FsAlXRV1yx0" height="315" width="420" Start at 1:50\

__//Plan D: Medicare Prescription Drug Coverage//__ - Offered to everyone with Medicare - If you don’t join a Medicare drug plan when you are first eligible, you have to pay a late enrollment penalty - You must join a plan run by an insurance company to get Me Drug Coverage - Monthly premium -Yearly deductable -Copayments or Coinsurance -Cost in the coverage gap

-Low income individuals -partially state-funded, so their policies vary by state -it sends payments directly to your health care providers -depending on your state's rules, you may also be asked to pay a small part of the cost (co payment) for some medical services -Eligibility for children is based on the child's status, not the parent's -Covers: doctors and dental care, lab and X ray services, prescriptions, nursing home care, prenatal care
 * Medicaid:**

- Contract that pays a beneficiary iin the time of your death - This is something you buy for the people you leave behind, it covers expenses such as funeral and medical bills. With Life Insurance, you can leave financial support to your family - Two types: Whole Life and Term Life
 * Life Insurance:**

//__Whole Life Insurance__// - policy that stays in affect for the insured’s whole life and requires premiums to be paid every year into the policy. - It is also known as Cash Value Insurance, making you pay more every year resulting it being the more expensive Life Insurance. T - The major disadvantage of whole life insurance is the lack of control that the policy owner has. With whole life, the policy is completely in the hands of the insurance agent.

//__Term Life Insurance__// - policy that stays in affect for a certain term, usually 20-30 years of a person's life - this is much cheaper than the whole life insurance due to the yearly premiums - this insurance is for those who would rather invest their savings in other contracts or securities, besides life insurance



- Consolidated Omnibus Budget Reconciliation Act - any workers and their families who lose their health benefits have the right to choose to continue group health benefits provided by their group health plan for 18 months after job loss - Employers are required to give COBRA - gives certain former employees, retirees, spouses former spouses, and dependent children the right to temporary continue their health coverage at group rates.
 * COBRA**



**vocab** **Co-payments: a payment from an employer that goes toward a type of insurance** **Deductable: the amount that the person insured has to pay** **Covered expenses: an expense that the person being insured will be reimbursed.For example, in most insurances, a doctors appointment is a covered expense** **Claims: a statement to an insurance company that claims/proves what went wrong/what was damages** **Exclusions: things that are not specifically covered by an insurance company** **Premiums: the amount paid for an insurance policy**

**bibliography:**

[] [] [] [] power points created by Fall 2011 Banking Class []