Health Insurance Policy

A Health insurance policy is a contract between an insurance company and an individual. The contract can be renewable annually or monthly. The type and amount of health care costs that will be covered by the health plan are specified in advance, in the member contract or Evidence of Coverage booklet. The individual policy-holder's payment obligations may take several forms[7]: Premium: The amount the policy-holder pays to the health plan each month to purchase health coverage. Deductible: The amount that the policy-holder must pay out-of-pocket before the health plan pays its share. For example, a policy-holder might have to pay a $500 deductible per year, before any of their health care is covered by the health plan. It may take several doctor's visits or prescription refills before the policy-holder reaches the deductible and the health plan starts to pay for care. Copayment: The amount that the policy-holder must pay out of pocket before the health plan pays for a particular visit or service. For example, a policy-holder might pay a $45 copayment for a doctor's visit, or to obtain a prescription. A copayment must be paid each time a particular service is obtained. Coinsurance: Instead of paying a fixed amount up front (a copayment), the policy-holder must pay a percentage of the total cost. For example, the member might have to pay 20% of the cost of a surgery, while the health plan pays the other 80%. Because there is no upper limit on coinsurance, the policy-holder can end up owing very little, or a significant amount, depending on the actual costs of the services they obtain. Exclusions: Not all services are covered. The policy-holder is generally expected to pay the full cost of non-covered services out of their own pocket. Coverage limits: Some health plans only pay for health care up to a certain dollar amount. The policy-holder may be expected to pay any charges in excess of the health plan's maximum payment for a specific service. In addition, some plans have annual or lifetime coverage maximums. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs. Out-of-pocket maximums: Similar to coverage limits, except that in this case, the member's payment obligation ends when they reach the out-of-pocket maximum, and the health plan pays all further covered costs. Out-of-pocket maximums can be limited to a specific benefit category (such as prescription drugs) or can apply to all coverage provided during a specific benefit year. Prescription drug plans are a form of insurance offered through many employer benefit plans in the US, where the patient pays a copayment and the prescription drug insurance pays the rest. Some health care providers will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company doesn't pay, as the insurance company pays according to "reasonable" or "customary" charges, which may be less than the provider's usual fee. Health insurance companies also often have a network of providers who agree to accept the reasonable and customary fee and waive the remainder. It will generally cost the patient less to use an in-network provider. Health plan vs. health insurance Historically, HMOs tended to use the term "health plan", while commercial insurance companies used the term "health insurance". A health plan can also refer to a subscription-based medical care arrangement offered through health maintenance organization,HMO, PPO, or POS plan. These plans are similar to pre-paid dental, pre-paid legal, and pre-paid vision plans. Pre-paid health plans typically pay for a fixed number of services (for instance, $300 in preventive care, a certain number of days of hospice care or care in a skilled nursing facility, a fixed number of home health visits, a fixed number of spinal manipulation charges, etc.) The services offered are usually at the discretion of a utilization review nurse who is often contracted through the managed care entity providing the subscription health plan. This determination may be made either prior to or after hospital admission (concurrent utilization review). Inherent problems with insurance Insurance systems must typically deal with two inherent challenges: adverse selection, which affects any voluntary system, and ex-post moral hazard, which affects any insurance system in which a third party bears major responsibility for payment, whether that is an employer or the government. Some national systems with compulsory insurance utilize systems such as risk equalization and community rating to overcome these inherent problems.

American Gold Eagle

The American Gold Eagle is an official gold bullion coin of the United States. Over the years, the gold Eagle from the US mint have become the USA’s most popular bullion coin, and our biggest gold coin seller by far. Each 1-ounce gold Eagle contains a full 31.1 grams of pure gold, with an additional alloy of silver and copper, bringing the total weight up to about 33.9 grams. Coins Offered in 1/10 oz, 1/4 oz, 1/2 oz, and 1 oz denominations. U.S. government guarantees them to contain the stated amount of actual gold weight in troy ounces. By law, the gold must come from sources in America, with an additional alloy of silver and copper to produce a more wear-resistant coin of .9167. It authorized by the United States Congress and backed by the United States Mint for weight and content. The market value of the coins is generally about equal to the market value of their gold content, not their face value. Gold Eagles from the U.S. Mint are the most popular gold bullion coin in this country, and now make up over 80% of the U.S. physical gold bullion market. This bullion product has been a tremendous success for the U.S. Mint.; their actual selling prices vary daily based on the current spot price of gold. The face values are proportional to the weights. The one-ounce gold Eagle has a $50 nominal face value, is 91.67% fine gold, and weighs 1.0909 troy ounces. The most popular size bullion coin issued 20 coins per Treasury tube. The half-ounce gold Eagle has a $25 nominal face value, is 91.67% fine gold, and weighs .5455 troy ounce. The least popular size bullion coin, and often the lowest mintage, it is issued 40 coins per Treasury tube. The quarter-ounce gold Eagle has a $10 nominal face value, is 91.67% fine gold, and weighs .2727 troy ounce. About the size of a nickel, it is popular in jewelry. It issued 40 coins per Treasury tube. The tenth-ounce gold Eagle is a $5 face value coin, 91.67% fine gold (22 karat), and weighs .1091 troy ounce. Smaller than a dime, it is a popular small gift item. It issued 50 coins to a Treasury tube. The obverse design features a rendition of Augustus Saint-Gaudens' full-length figure of Lady Liberty with flowing hair, holding a torch in her right hand and an olive branch in her left, with the Capitol building in the left background. The reverse design, by sculptor Miley Busiek, features a male eagle carrying an olive branch flying above a nest containing a female eagle and her hatchlings.