The resulting programme is profession-based: all people working are required to pay a portion of their income to a not-for-profit health insurance fund, which mutualises the risk of illness, and which reimburses medical expenses at varying rates. Children and spouses of insured people are eligible for benefits, as well. Each fund is free to manage its own budget, and used to reimburse medical expenses at the rate it saw fit, however following a number of reforms in recent years, the majority of funds provide the same level of reimbursement and benefits.
Accident insurance was first offered in the United States by the Franklin Health Assurance Company of Massachusetts. This firm, founded in 1850, offered insurance against injuries arising from railroad and steamboat accidents. Sixty organizations were offering accident insurance in the U.S. by 1866, but the industry consolidated rapidly soon thereafter. While there were earlier experiments, the origins of sickness coverage in the U.S. effectively date from 1890. The first employer-sponsored group disability policy was issued in 1911.
Since 1994, this web site has been a guide for consumers seeking straightforward explanations about the workings of individual health insurance – also known as medical insurance. Within this site, you’ll find hundreds of articles loaded with straightforward explanations about health insurance – and the health law – all written by a team of respected health insurance experts.
The private health system in Australia operates on a "community rating" basis, whereby premiums do not vary solely because of a person's previous medical history, current state of health, or (generally speaking) their age (but see Lifetime Health Cover below). Balancing this are waiting periods, in particular for pre-existing conditions (usually referred to within the industry as PEA, which stands for "pre-existing ailment"). Funds are entitled to impose a waiting period of up to 12 months on benefits for any medical condition the signs and symptoms of which existed during the six months ending on the day the person first took out insurance. They are also entitled to impose a 12-month waiting period for benefits for treatment relating to an obstetric condition, and a 2-month waiting period for all other benefits when a person first takes out private insurance. Funds have the discretion to reduce or remove such waiting periods in individual cases. They are also free not to impose them to begin with, but this would place such a fund at risk of "adverse selection", attracting a disproportionate number of members from other funds, or from the pool of intending members who might otherwise have joined other funds. It would also attract people with existing medical conditions, who might not otherwise have taken out insurance at all because of the denial of benefits for 12 months due to the PEA Rule. The benefits paid out for these conditions would create pressure on premiums for all the fund's members, causing some to drop their membership, which would lead to further rises in premiums, and a vicious cycle of higher premiums-leaving members would ensue.
In-Network Provider: (U.S. term) A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or co-payments, or additional benefits, to a plan member to see an in-network provider. Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the "usual and customary" charges the insurer pays to out-of-network providers.
If you suffer an injury or illness, individual health insurance can help pay for the cost of health care. Health insurance can also help pay for a wide range of medical services including medical emergencies, routine doctor's appointments, preventative care, prescription drugs, and inpatient/outpatient treatment. You'll typically pay a monthly premium, plus a deductible or copayment.
A high deductible health insurance plan has higher deductibles and lower premiums than most other health insurance plans. This means you pay a smaller fixed amount every month, but it will take a longer time for insurance to kick in and begin cost-sharing (meaning you will pay your percentage of coinsurance for every bill). You might benefit from this plan if you don’t require many doctor’s visits or other healthcare benefits. Look at quotes for high deductible health insurance plans to figure out if this plan is right for you.
Given the premium increases that took effect in most areas for 2018, it’s essential for anyone who is eligible for premium tax credits – or who might be eligible with an income fluctuation later in the year – to enroll through the exchange if and when they have a special enrollment period. Don’t sign up for an off-exchange plan and miss out on the possibility of much more affordable premiums via a tax credit.
Most aspects of private health insurance in Australia are regulated by the Private Health Insurance Act 2007. Complaints and reporting of the private health industry is carried out by an independent government agency, the Private Health Insurance Ombudsman. The ombudsman publishes an annual report that outlines the number and nature of complaints per health fund compared to their market share 
healthy, sound, wholesome, robust, hale, well mean enjoying or indicative of good health. healthy implies full strength and vigor as well as freedom from signs of disease. a healthy family sound emphasizes the absence of disease, weakness, or malfunction. a sound heart wholesome implies appearance and behavior indicating soundness and balance. a face with a wholesome glow robust implies the opposite of all that is delicate or sickly. a lively, robust little boy hale applies particularly to robustness in old age. still hale at the age of eighty well implies merely freedom from disease or illness. she has never been a well person
Medicare Levy Surcharge: People whose taxable income is greater than a specified amount (in the 2011/12 financial year $80,000 for singles and $168,000 for couples) and who do not have an adequate level of private hospital cover must pay a 1% surcharge on top of the standard 1.5% Medicare Levy. The rationale is that if the people in this income group are forced to pay more money one way or another, most would choose to purchase hospital insurance with it, with the possibility of a benefit in the event that they need private hospital treatment – rather than pay it in the form of extra tax as well as having to meet their own private hospital costs.
Much in the same manner ought that oligarchy to be established which is next in order: but as to that which is most opposite to a pure democracy, and approaches nearest to a dynasty and a tyranny, as it is of all others the worst, so it requires the greatest care and caution to preserve it: for as bodies of sound and healthy constitutions and ships which are well manned and well found for sailing can bear many injuries without perishing, while a diseased body or a leaky ship with an indifferent crew cannot support the [1321a] least shock; so the worst-established governments want most looking after.
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As a small business owner, you can shop for group health insurance for your employees at any time of the year and browse a variety of insurers and coverages through eHealth. You'll need at least one employee to qualify for a small business plan and you'll contribute toward employee premiums. As of 2016, per the Affordable Care Act, businesses with 50 or more full-time employees must offer affordable health insurance or pay a tax penalty.
syn: healthy, healthful, wholesome refer to physical, mental, or moral health and well-being. healthy most often applies to what possesses health, but may apply to what promotes health: a healthy child; a healthy climate. healthful is usu. applied to something conducive to physical health: a healthful diet. wholesome, connoting freshness and purity, applies to something that is physically or morally beneficial: wholesome food; wholesome entertainment.
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Lifestyle choices are contributing factors to poor health in many cases. These include smoking cigarettes, and can also include a poor diet, whether it is overeating or an overly constrictive diet. Inactivity can also contribute to health issues and also a lack of sleep, excessive alcohol consumption, and neglect of oral hygiene (Moffett2013).There are also genetic disorders that are inherited by the person and can vary in how much they affect the person and when they surface (Moffett, 2013).