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At least 289 records · Page 16Linked to original sources
PubMed1975

[Medical insurance estimation of risks].

The purpose of insurance medicine is to make a prognostic estimate of medical risk-factors in persons who apply for life, health, or accident insurance. Established risk-groups with a calculated average mortality and morbidity form the basis for premium rates and insurance terms. In most cases the applicant is accepted for insurance after a self-assessment of his health. Only around one per cent of the applications are refused, but there are cases in which the premium is raised, temporarily or permanently. It is often a matter of rough estimate, since the knowlege of the long-term prognosis for many diseases is incomplete. The insurance companies' rules for estimate of risk are revised at intervals of three or four years. The estimate of risk as regards life insurance has been gradually liberalised, while the medical conditions for health insurance have become stricter owing to an increase in the claims rate.

Coronary Disease↗
PubMed1990

Medicare program; inpatient hospital deductible and coinsurance and skilled nursing facility coinsurance for 1990--HCFA. Notice.

This notice announces that the inpatient hospital deductible for calendar year 1990 under Medicare's hospital insurance program (part A) remains the same as announced on September 29, 1989 at 54 FR 40205. However, the repeal of the Medicare Catastrophic Coverage Act of 1988 by the Medicare Catastrophic Coverage Repeal Act of 1989 restored 1988 part A coverage and cost-sharing rules, including the benefit period provisions, coinsurance charges, and the three-day prior hospitalization requirement for skilled nursing facility (SNF) care. Because the Part A catastrophic benefits under the Medicare Catastrophic Coverage Act of 1988 were in effect in 1989, the Medicare Catastrophic Coverage Repeal Act of 1989 included several provisions that apply to beneficiaries who were inpatients of hospitals or SNFs both at the end of 1989 and the beginning of 1990.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1993

Retiree health benefits.

Some 80% of elderly Medicare beneficiaries have private supplemental insurance. Approximately 50% of these have some form of medigap of privately purchased coverage. Those holding private coverage tend to be younger, more highly educated, and white. Women are more likely to hold medigap type plans, and men are more likely to have employment related coverage. The extent of multiple coverage is relatively rare. One estimate puts multiple coverage at about 20% of those with private supplemental coverage. Contrary to conventional wisdom, those with multiple coverage are not the very old and poorly educated. Rather, they tend to be younger and more highly educated. Also, women are more likely to have both employer-sponsored and medigap coverage, maybe because of the uncertainty about whether a wife will continue to have employer-sponsored post-retirement coverage after her husband has died. Medigap-type health insurance is heavy on first dollar coverage; the Medicare deductibles and copayments are covered. Provisions of OBRA 1990 will homogenize this coverage even more. Employer-sponsored health benefits are common. Some 8.4 million elderly Medicare beneficiaries have employer-sponsored coverage. A large but undetermined number of early retirees also have coverage. These recipients have generally been the workers in very large firms. However, the future will not look like the past. Two thirds of current workers are promised health benefits upon retirement. The benefits provided under these plans are both broad and deep. The nature of benefit coordination between these plans and Medicare can reduce the size of the apparent benefits. The carve-out method of coordination is the most common and can result in sizable out-of-pocket payments by the beneficiary. However, it is not obvious that employer-sponsored plans have been designed to exploit this opportunity. There is little information on the conditions under which a worker is vested for health benefits. The sketchy evidence that does exist suggests that a worker must retire from the firm and have had time in service about equal to that required for the firm's pension plan. Firms apparently can change their retiree benefit plans if they have explicitly retained the right to do so. There are sound economic reasons to suggest that many firms would honor their commitments, even in the absence of legal requirements. Supplemental retiree coverage leads to additional use of health services, particularly by those in poorer health and particularly by those with plans that feature first-dollar coverage. The increased use of services as a result of supplemental coverage also increases Medicare's costs.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMedDate not supplied

[Evaluation of noise-induced injury: consideration of a group of exposed cement workers].

The study covered 1334 workers employed in 12 cement factories located in southern Italy. They were submitted to audiometric screening consisting of a questionnaire containing questions on past otologic complaints, metabolic diseases, use of ototoxic drugs and past occupational or non-occupational exposure to noise, plus otoscopic examination and full audiometric examination. The results revealed a statistically significant relationship between duration of exposure to noise and elevation in the hearing threshold. The highest noise levels were found in the "crude/baked mills" department; however, the highest frequency of occupational hearing loss was observed in the "mine and crushing installations", maintenance and "hodmen" departments. On the question of assessment of the audiometric tracings for preventive and insurance purposes, attention is drawn to the fact that there is a need for a method that will enable an evaluation for prevention to be transformed into an evaluation for insurance. This method should in any case allow for deduction of the portion of hearing loss regarding presbycusis and socioacusis and take due account of the 3 KHz frequency. The attention of industry and public administration is drawn to the urgent need for prevention programs to protect against noise-induced hearing loss in both occupational and non-occupational settings.

Adult↗
PubMed1980

National health insurance: another alternative.

The author proposes a national health insurance plan that would encourage the use of preventive medicine and involve a graduated voucher arrangement. The program would provide a limited amount of free care, copayment beyond the amount covered by vouchers, and catastrophic coverage beyond the copayment level. The maximum price of medical procedures would be set by the government, and would be varied to encourage provider relocation and innovative provider arrangements such as health maintenance organizations.

Deductibles and Coinsurance↗