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Regulating Private Healthcare Plans

Regulating Private Healthcare Plans

If you’re looking for some healthcare plans with the least hassle and faster service and guaranteed approval, Private healthcare plans are always ready for you. You name it, they’ll have it for you. As long as you can pay the premiums, they’ll be more than willing to assist you in having yourself enrolled with all your concerns assessed and addressed and will do everything to convince you that they are the best. That is how they do it to have clients enrolled on their program. As the healthcare is becoming a priority of the state, more and more people are now looking for healthcare insurance that they can avail to be able to experience the privileges that await them on the fulfillment of the Affordable Healthcare Act. This is also an opportunity to all companies that offers private healthcare plans in which more people would not only want to have it but would already be a necessity or a need to have. With this to happen, regulation should be done in order to monitor insurance companies on their policies and avoid abuse on the people with high cost premiums and amount of deductibles.

The government has worked on having the health insurance market place or HIX which stands for health insurance exchange. HIX serves as means by the government to be able to monitor private healthcare plans in relation to the cost of premiums, benefits, and all policies governing a particular plan. Though this is yet to be established, it is seen to be fulfilled by January 1, 2014. All private healthcare plans under the HIX are assured to be accredited under the federal law and follows rules and regulation on being in the health care industry. With this regulatory operation, individuals can easily searched for reliable private healthcare plans that are assured to be real, credible and offers policy without having to suspect any abuse in the part of the insurer.

President Obama promoted the concept of a health insurance exchange as a key component of his health reform initiative. Obama stated that it should be “… a market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that’s best for them, in the same way that Members of Congress and their families can. None of these plans should deny coverage on the basis of a preexisting condition, and all of these plans should include an affordable basic benefit package that includes prevention, and protection against catastrophic costs. There are those who strongly believe that Americans should have the choice of a public health insurance option operating alongside private healthcare plans. The belief is that it will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.” However, the public health insurance option was ultimately dropped from the reform legislation; the insurance sold on the health insurance exchanges in the United States will, therefore, now be exclusively from the private insurers.

Private-Health-CareWith the HIX implemented, insurers are likely to obey rules set by the government. Major requirements must be fulfilled in order to prevent possible abuse of the different insurance companies such as: *

  • Guaranteed issue: Insurers will not be permitted to refuse to insure any individuals. Private healthcare plans must be given to anyone who ask of it whether they are healthy or with pre-existing conditions. With that, you can expect that by year 2014, you are now capable to have yourself or someone even with illness be insured. It may be costly, but it will give you an advantage that having to pay all medical services by out-of-pocket money.
    • Limit to price variations: prices will vary based on four factors and not beyond a total factor of approximately 10. No matter how great your private healthcare plan could offer, premiums in the individual private healthcare plans could not exceed ~4.5 times the cost of the lowest cost premium plan. Pricing factors such as AGE (3:1) and Smoking status (1:5:1) should not exceed the limit for price variations. This is to prevent people to pay too much due to possible risks. Pricing variation will be allowed by area (within a state) and family composition (“tier”) as well
    • Plans will be offered in four comparable tiers ranging from bronze to platinum with limited out of pocket expenses. Within the exchanges, private healthcare plans are to be offered in four tiers designated from lowest premium to highest premium: bronze, silver, gold, and platinum. Proponents of the health reform believe that allowing comparable plans to compete for consumer business in one convenient location will drive prices down. Having a centralized location increases consumer knowledge of the market and allows for greater conformation to perfect competition.
    • Strict regulations on rescission or unmaking of a contract between parties. With the implementation of the Affordable Healthcare Act, any health insurance company are no longer allowed to cancel any transaction of any individual enrolled in a particular private healthcare plan due to severe illness or manifestation of pre-existing illness.
    • Lifetime and annual limits eliminated. This effectively eliminates the ceiling on financial risk for individuals in the individual exchanges.

Many people are becoming a victim of fraud and abusive health insurance companies. As the healthcare services are very much needed, people who avail healthcare insurances should be protected. With the affordable healthcare act, we can look forward to a better life having to worry less on matters regarding to health. However, as the act has been work upon, many insurers are in doubt of the true benefits of the act. Business is business as to what they would say and having all things said, there is an outlook in which people would no longer take health insurance until they got sick. With that taken into consideration, debates and discussion are still going on. Let’s just hope that by the year 2014, the result we be a balanced operation which all sides would benefit. As for you, better check out on the latest updates on healthcare because the affordable healthcare care act is a work in progress and before you know it, you might be already missing some of the privileges that you could already have.


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