American Single-Payor Health Plan Design

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.

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.

The plan takes effect at age 18: children under 18 are covered under their parents’ policies. At that time, the child registers with the national plan; there will be four options for the child’s coverage.

College waiver: Premiums due are waived while the child is enrolled as a full-time student. The waiver can last as long as eight years (until the child’s 26th birthday): at that time the child will enter the regular plan.

Military service waiver: Premiums are waived for active-duty military members; credit is given towards the total premium “nut” for military service at the rate of 10% of per full year of service.

National-service waiver: Premiums are waived for individuals enrolled in a designated national-service program. Credit is given towards the total premium “nut” for national service at the rate of 10% per full year of service to a maximum of 50%.

Individual enrollment: The child can simply enroll in the national plan.

Level One Coverage

Services designated as Level One are required as part of base plans.

Men Aged 26-64: 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, hospice and palliative care.

Women Aged 26-64: 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, hospice and palliative care.

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.

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), liposuction, 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.

 

Doing our homework – sustainable energy

download-25As John and I toss various issues back and forth, we will try to keep at least one foot on the facts. Here are some links to articles related to sustainable energy, and the date they were originally published. Just click on the titles.

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October 17, 2016 –  Scientists accidentally discover efficient process to turn co2 into ethanol

September 28, 2016 – How does carbon capture and storage actually work?

March 15, 2013 – China’s top 6 environmental concerns

October 28, 2016 – Tesla unveiles its solar roof and Powerwall 2

October 29, 2016 – Tesla’s Invisible Solar Panels Are a Big Deal to Suburbanite Homeowners

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