Book Opener

Health InsurancelllllBasic health insurance often includes the following benefits:Inpatient and outpatient hospital carePhysician careSurgeryPrescription drugsDental and vision careMajor medical coverage pays for expenses beyond those covered bya basic plan, including long-term hospitalization and the cost of catastrophicillness.Insurance PlansHealth insurance companies offer a variety of health insurance plansto make some degree of health insurance coverage available to mostpeople. The type of coverage people carry depends on the their individualsituations.Group Plans Many people get their health insurance through a groupinsurance plan where they work. Insurance companies can offer lowerpremiums to large groups, and many employers pay part of the premiumfor each employee. See Figure 35.4 for a listing of basic features that alltypes of health insurance should offer.A federal law known as the Consolidated Omnibus Budget ReconciliationAct (COBRA) allows employees to keep their group insurancefor a specific period of time after being laid off. Under COBRA,Figure 35.4A health insurance plan should:Health Insurance Must Havesl Offer basic coverage for hospital and doctor bills.l Provide at least 120 days’ hospital room and board in full.l Provide at least a $1 million lifetime maximum for each family member.l Pay at least 80 percent for out-of-hospital expenses after a yearly deductible of$500 per person or $1,000 per family.l Impose no unreasonable exclusions.l Limit your out-of-pocket expenses to no more than $3,000 to $5,000 a year,excluding dental, vision care, and prescription costs.Helmet LawsBicycling is a great wayto exercise outdoors,but like any sport, thereis a chance of injury.Concerned about thepossibility of headinjuries to cyclists, somestates have passedmandatory helmetlaws. There are manyarguments for andagainst these laws. Doyou think there is aneed for mandatoryhelmet laws?Get InvolvedFind out which stateshave mandatory helmetlaws. Write your congresspersona lettertelling him or her howyou feel about helmetlegislation for yourstate.HEALTH INSURANCEAlthough health insurance plans vary greatly,all plans should have the same basic features.Would you add anything to this list ofmust haves?Chapter 35: Insurance Protection 759