Hello, all. My friend Terry and I have been working on a proposed single-payor health insurance plan. This plan is designed to cover all Americans, from cradle to grave, soup to nuts, whatever you want to call it. This is a work in progress at this point; stay tuned for future updates. We welcome any feedback or constructive criticism.
General Plan Provisions
The plan year runs January 1 to December 31. Each year, there will be an open-enrollment period running from January 1 to February 28: during this time, individuals may opt to change their coverage without incurring a waiting period. After open enrollment, there will be a 90-day waiting period for plan changes. There are no referral or authorization requirements; any licensed medical provider (including MDs, DOs, APRNs, PAs, chiropractors and physical therapists) may provide services under this plan.
Level One Coverage
Services designated as Level One are required as part of base plans.
Men Aged 18-64: Covered services include: Doctor visits, inpatient and outpatient hospital services, emergency services, laboratory services, diagnostic testing, prescription drugs, mental health/rehab services, vision and dental checkups, screening colonoscopy after age 50
Women Aged 18-64: Covered services include: Doctor visits, inpatient and outpatient hospital services, emergency services, laboratory services, diagnostic testing, prescription drugs, mental health/rehab services, vision and dental checkups, maternity services, annual gynecological exams, screening mammograms after age 40, screening colonoscopy after age 50
Family Coverage: Covered services include: Doctor visits, inpatient and outpatient hospital services, emergency services, laboratory services, prescription drugs, mental health/rehab services, maternity services, annual gynecological exams, screening mammograms after age 40, screening colonoscopy after age 50, pediatric services including vision and dental, childhood immunizations, sports exams up to age 18
Age 65+: Additional services covered include nursing-home services, Alzheimer's treatment, hospice/palliative care (available before age 66 with doctor's certification)
Level Two Coverage
Services designated as Level Two can be purchased as riders to a base plan. There is a 90-day waiting period before coverage purchased under these riders takes effect if not purchased during the open enrollment period.
These services include: dental services, orthodontics, eyeglasses, hearing aids, infertility treatment, bariatric (weight-loss) surgery, smoking-cessation treatment, LASIK and similar vision services.
Level Three Coverage
Services designated as Level 3 are optional; individuals may purchase these coverages as riders to the base plans. There is a 90-day waiting period before coverage purchased under these riders takes effect if not purchased during the open enrollment period.
These services include: cosmetic surgery (non-reconstructive), Botox and similar procedures, Viagra, Rogaine, hair transplantation, cosmetic dental procedures.
Non-Covered Services
Services not covered under the plan include:
Massage therapy, naturopathy, religious practitioners (Christian Scientists), homeopathy, acupuncture, acupressure, hypnotherapy, biofeedback.
We have considered a variety of funding mechanisms; we are leaning towards having each person contribute towards a "nut", an amount which would be intended to cover expected health expenses over one's working lifetime; credits would be given against this for national service, military service, and possibly other categories of exemptions.
Again, this is a work in progress, and we welcome any and all constructive criticism. Thanks in advance.
General Plan Provisions
The plan year runs January 1 to December 31. Each year, there will be an open-enrollment period running from January 1 to February 28: during this time, individuals may opt to change their coverage without incurring a waiting period. After open enrollment, there will be a 90-day waiting period for plan changes. There are no referral or authorization requirements; any licensed medical provider (including MDs, DOs, APRNs, PAs, chiropractors and physical therapists) may provide services under this plan.
Level One Coverage
Services designated as Level One are required as part of base plans.
Men Aged 18-64: Covered services include: Doctor visits, inpatient and outpatient hospital services, emergency services, laboratory services, diagnostic testing, prescription drugs, mental health/rehab services, vision and dental checkups, screening colonoscopy after age 50
Women Aged 18-64: Covered services include: Doctor visits, inpatient and outpatient hospital services, emergency services, laboratory services, diagnostic testing, prescription drugs, mental health/rehab services, vision and dental checkups, maternity services, annual gynecological exams, screening mammograms after age 40, screening colonoscopy after age 50
Family Coverage: Covered services include: Doctor visits, inpatient and outpatient hospital services, emergency services, laboratory services, prescription drugs, mental health/rehab services, maternity services, annual gynecological exams, screening mammograms after age 40, screening colonoscopy after age 50, pediatric services including vision and dental, childhood immunizations, sports exams up to age 18
Age 65+: Additional services covered include nursing-home services, Alzheimer's treatment, hospice/palliative care (available before age 66 with doctor's certification)
Level Two Coverage
Services designated as Level Two can be purchased as riders to a base plan. There is a 90-day waiting period before coverage purchased under these riders takes effect if not purchased during the open enrollment period.
These services include: dental services, orthodontics, eyeglasses, hearing aids, infertility treatment, bariatric (weight-loss) surgery, smoking-cessation treatment, LASIK and similar vision services.
Level Three Coverage
Services designated as Level 3 are optional; individuals may purchase these coverages as riders to the base plans. There is a 90-day waiting period before coverage purchased under these riders takes effect if not purchased during the open enrollment period.
These services include: cosmetic surgery (non-reconstructive), Botox and similar procedures, Viagra, Rogaine, hair transplantation, cosmetic dental procedures.
Non-Covered Services
Services not covered under the plan include:
Massage therapy, naturopathy, religious practitioners (Christian Scientists), homeopathy, acupuncture, acupressure, hypnotherapy, biofeedback.
We have considered a variety of funding mechanisms; we are leaning towards having each person contribute towards a "nut", an amount which would be intended to cover expected health expenses over one's working lifetime; credits would be given against this for national service, military service, and possibly other categories of exemptions.
Again, this is a work in progress, and we welcome any and all constructive criticism. Thanks in advance.
via International Skeptics Forum http://ift.tt/2qpI0DF
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