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04/12/2010
Nevada’s insurance division has recently launched a campaign against deceitful medical insurance plans while persuading consumers to ’check before writing a check’.
The Nevada Division of Insurance along with The Nevada Surplus Lines Association targets the confusion that sometimes envelop health insurance and health insurance scams aimed at individual consumers as well as small firm owners across Nevada. They launched the ’Question the Company and their Plan‘ 2010 Public Education Campaign, which playfully discusses to consumers the importance of gaining complete information before buying a particular policy linked to health insurance plans or ’checking before writing a check’.
The campaign was launched Sunday throughout the state including website banners and upgrades to www.nvinsurancealert.com and television spots to provide consumers and insurance agents information regarding their concerns. The viewers are about to see various amusing ads of pitchman ‘Herm Sleaster’, who promotes the plan that will provide consumers the “fruitcake, a pooch and health insurance coverage for only $29.95 a month…not including some tax”.
The television spots expose the ‘not far from the truth’ re-enactment of how a pitch for a fraudulent health plan might look . It also aims to remind consumers that some of the medical insurance plans sold are invalid, strongly reinforcing that it is always best to use a reputable Health Insurance provider.
The 2010 campaign urges consumers to increase their level of awareness regarding the possible effects of deceitful fraudulent health insurance products and plans or illegal insurance companies.
Author: Van Kelsey
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04/08/2010
Democratic US Representative Bob Etheridge believes that the healthcare law will see an increase in support as the public’s awareness regarding its benefits widens.
He said that Republicans falsely viewed the healthcare law for considering it a ‘government takeover’ of the healthcare industry, reports Rob Christensen.
"It's not true", said Etheridge on Wednesday when he met with reporters and editors of The News and Observer. "We are putting together a framework that operates in the private sector".
According to Etheridge, the bills supporters have to explain how the healthcare law’s benefits everybody, including those suffering from pre-existing health conditions like cancer, those who have gone through heart attack, or pregnant women. Under the newly established law, those individuals would be provided with medical insurance in the easiest way possible.
“We have to push back", he said. "We have to tell the truth. It's hard to get the truth out. It's a lot easier to be against something".
Etheridge said the criticisms aimed at the healthcare law are like those aimed at other social bills.
"If you go back and read about what happened in Medicare in the sixties and Social Security in the thirties a lot of the same words were being used", said Etheridge, adding that doing nothing will not improve the system and also make it worst.
Etheridge voted for the bill despite the majority of people in his district being opposed to the measure. Etheridge believes public opinion on the healthcare law will be more favorable by this November once people actually see it working.
Author: Warren Blumberg
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04/06/2010
The medical journal Lancet, in its most recent lead editorial, has applauded the US Health Care Reform Bill for extending health care access and for aiming to reduce the gap between health outcomes and expenditure.
According to the editors, the winners are the 32 million uninsured US citizens who were previously too poor or too sick to obtain medical insurance, but will now have coverage starting in 2014. It is also said that by 2019, the coverage will extend to 95% of the population.
The new bill pushes insurers to take in all applicants regardless of their health status. While the increase in coverage will promote the private health industry, the journal stresses that Medicaid and Medicare – the insurance program for low income and elderly citizens, which currently cover 28% of Americans – “will have a catastrophic additional operational and financial burden for which solutions are not clearly defined within the current bill.”
The editorial stated that the suggested cost-saving options, like the initiative to pay for the quality and not the quantity of care (known as pay-for-performance instead of the fee-for-service), and also the proposal to reprimand medical institutions for high rates of readmission, are “welcome but will probably not reduce health-care costs.”
Preventive health care, which includes healthier eating and more exercises, are the key to success of the new bill. The editors wrote, “Preventive behavioral changes, necessary for the well being of the entire society, are not only the most difficult to bring about but are also those that, if unaddressed, will have a heavy toll on the cost of the country's health care.”
“The success of the health-care reform bill will greatly depend on its acceptance by the public,” they added.
Author: Avery Smith
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03/30/2010
The new healthcare reform will allow young people to be covered under the medical insurance plan of their parents until aged 26, a provision a healthcare policy expert and GW professor says will greatly help college students.
At present, young individuals over 22 years old are unable to receive healthcare through the insurance plan of their parents, placing a large burden on many college students – both in the graduate and the undergraduate level – to find coverage amid the increasing tuition cost.
“Private health insurance that the parents have will now include dependents up to the age of 26, so generally speaking students and young adults who've graduated from school may still be eligible for coverage under their parents' policy”, said health policy professor Leighton Ku of the School of Public Health and Health Services. “So that's really great for students”.
He said majority of students at the George Washington University are in favour of this part of the health insurance legislation, adding that most students are usually misinformed or uninformed of the bill’s effects.
This provision may also influence 10% of GW students who acquire health insurance from the Student Health Services, claimed Dr. Isabel Goldenberg, director of SHS. Students may now be covered by their parents’ health insurance, making the SHS insurance unnecessary.
According to Goldenberg, students must evaluate all their healthcare options before calling off their SHS plan, as the dependent’s age extension will only take effect after a few months.
“Students should review their family's policy if they are under age 26 and compare cost, benefits and access to health care to make an informed decision about the best coverage”, she said.
Author: Van Kelsey
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03/26/2010
US President Barack Obama is now promoting the historic healthcare reform, as a recent survey shows that Americans are split over the sweeping bill he signed into law last Tuesday.
Obama promoted the reform during his speech before an audience in Iowa on Thursday. During the speech he stated that the new medical insurance reform bill is now the country’s law.
On Thursday, the US Senate also authorized changes to the new rule, sending them out to the House of Representatives. Several minority Republicans attempted to stall these changes through a succession of amendments; however, all were rejected.
A number of Democrats in the House called for the changes in exchange for the approval of the original healthcare reform bill.
The Republicans are firmly against this new law. In a survey conducted by Quinnipiac University, results indicate that Americans are generally divided over the issue, with almost 50% of the respondents saying that they do not approve of the new legislation, while around 40% claim they approve.
Congressional Democrats have also been the target of acts of vandalism and threats following the vote over the healthcare bill.
Democrat Nancy Pelosi, a speaker for the House of Representatives, and Republican Minority Leader John Boehner stated that those measures do not have a place in US politics.
Steny Hoyer, the House Majority Leader, said that at least ten members of the Congress have received some threats to themselves or their families over the last couple of days.
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03/24/2010
Illinois will not be trying to impede the implementation of the new healthcare reform bill passed by Congress.
Governor Pat Quinn claims he welcomes the new reforms, unlike several other American states. “We aren't going to be dragging our feet, whinning and complaining,” he explained. “We [want] this to be a reality...we want to save money for families and businesses.”
The Illinois governor said that the residents of the state will benefit in several ways. “It's going to eliminate things like pre-existing conditions as a basis of denial or exclusion... it will lead to more equal pricing and price stability, we'll get more for our insurance premiums that we're getting today.”
Quinn went on to say, “Unwarranted rescissions in insurance policies will be prohibited and it will help families in Illinois with their financial security.” According to him, the major cause of bankruptcy in families is unexpected medical expenses.
Quinn added that the new reforms should also require free wellness programs to be set up by health insurance companies, to help promote health and hopefully reduce health related problems.
When implemented, the reform will expand Medicaid. Quinn does not believe that adding participants to the health care rolls will add to the state’s deficit; however, he says that cost estimates are yet to be completed.
The governor admits that the new reforms are not flawless and still have a long way to go; nevertheless, he looks forward to working with US President Barack Obama on their implementation.
By: Van Kelsey
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03/23/2010
Sandy Praeger, the insurance commissioner of Kansas, has spoken out to help clarify the confusion that surrounds the new healthcare reform.
Among the things consumers will immediately notice include health insurance firms not being able to set a lifetime or annual cap on the cost they should pay out in covering health care.
The federal government will provide states billions of dollars to aid in lowering the premiums for individuals with pre-existing health conditions, since insurance firms can no longer reject coverage based on the health history of a person.
Children up to 26 years old will be covered by the health plans of their parents. Individuals who are on Medicaid will be eligible to get drug discounts and more people will be entitled for health care as the requirements ease up.
Some parts of the healthcare plan claim that all routine medical examinations, such as immunizations, will be administered for free. Consumers will no longer need to have a co-pay for preventative visits to doctors.
In covering the national healthcare program’s cost, everyone will have to acquire medical insurance. While several individuals are dismayed by this requirement, authorities said that it is vital for the plan to work.
“If they can't exclude you from a pre-existing condition, you just wait until you're sick to buy the coverage so you really need to have a requirement that everyone has to have the coverage,” said Praeger, speaking to KCTV 5 News.
Officials still do not know the exact cost for consumers each year; however, they hope that the competition as well as adding 32 million uninsured individuals to the health plans will, maintain the low cost.
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03/22/2010
US President Barack Obama has said he will issue an executive order once the health insurance reform bill is passed, which will reaffirm the longstanding restrictions regarding the utilization of the federal government’s funds for abortion.
This announcement seems to have appeased the conservative Democrats headed by Michigan Representative Bart Stupak, who allegedly claim that they will now back the healthcare reform given the votes to pass.
According to President Obama, the bill as written preserves current law; however, the executive order offers additional protection to ensure that the situation is maintained and imposed, and that the restrictions of the health care legislation over the public abortion funding cannot be avoided.
The House of Representatives is set to vote on the health care reform, with about 216 votes needed for its passage.
The $940 billion package is projected to extend the medical insurance coverage of around 32 million individuals by 2019. It will also make insurance more affordable by offering health care’s highest middle class tax cut in history, cutting down costs for numerous families as well as small business owners, who are presently rated out of coverage.
The bill also establishes a new competitive health insurance industry, giving millions of Americans the same insurance alternatives that the members of the Congress will have. It is also expected to end discrimination against people with pre-existing health conditions.
According to the non-partisan Congressional Budget Office, the health care plan will reduce the federal deficit by around $138 billion within 10 years and will amount to around $940 billion in costs over the course of a decade.
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03/19/2010
US President Barack Obama has delayed his trip to Australia and Indonesia to work with legislators on having the health care bill approved.
White House spokesperson Robert Gibbs stated on reports that the president will reschedule his travel for June.
“The president greatly regrets the delay,” he said.
According to Gibbs, Obama has spoken to President Susilo Bambang Yudhoyono of Indonesia and will talk to Prime Minister Kevin Rudd of Australia; and both leaders understand the significance of the health care reform and Obama’s wish to see it through.
“The president believes right now the place for him to be is in Washington seeing this through,” Gibbs explained.
In the past days, he said that Obama has appealed to “more than two dozen” lawmakers to help assure votes for passage. On Sunday, the House is aiming for a possible vote on the sweeping reform, which would provide health care coverage to over 30 million Americans and enforce new rules on the health insurance industry. The president will carry on with his outreach in order to secure 216 House votes, said the press secretary.
He also disclosed that Obama had an influence in persuading Catholic nuns to back the health care bill. Gibbs, who pertained to the nun’s support as “very, very important,” said that Obama had recently convened with Sister Carol Keehan, the Catholic Health Association president.
The president was set to leave on Sunday morning for his first overseas trip this year. Obama and his aides did not want to wait till the last minute to call on to Australia and Indonesia and say “we’re not coming,” said Gibbs.
“That would cause some problems...in just common sense and manners,” he added.
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03/18/2010
Press Secretary Robert Gibbs explained on Tuesday that the White House would not mind to see the House employ a legislative approach that would let the Democrats vote on changes to the health care bill of the Senate, but not on the bill itself.
"There are I'm sure those that are going to want to make this about the legislative process rather than the heart-wrenching stories of people like Natoma Canfield," Gibbs said. Canfield is a woman from Ohio who was diagnosed with leukaemia after she dropped her health insurance for the plan had become very expensive.
The process being discussed is referred to as ‘deem and pass.’ It allows the House to pass changes and forward them to the Senate, while considering the original bill to have been ratified.
According to Republican critics, the idea is more like a ‘demon pass’ or a devilish effort to evade recorded votes concerning the Senate bill’s more controversial matters, such as special deals with certain states and abortion language.
"The majority plans to force the toxic Senate bill through the House under some controversial trick," Republican House Minority Leader John Boehner said. "There is no way to hide from this vote."
Gibbs said that Republicans made use of the ‘deem and pass’ in times of congressional majorities.
‘Deem and pass’ is also included in the ‘budget reconciliation’ process, which has also been the subject of debate of different political parties.
Through ‘deem and pass,’ Senate Democrats would be allowed to sign off in a final health care reform bill by keeping away from a Republican filibuster.
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03/16/2010
Hill Physicians Medical Group, Northern California’s largest Independent Practice Association (IPA), and the Physicians Integrated Medical Group are under negotiations regarding a merger, said both groups on Monday.
Brisbane-based PIMG represents around 500 doctors practicing in San Mateo County and San Francisco; while the San Ramon-based Hill, headed by CEO Steve McDermott, constitutes around 3,000 physicians in Northern California situated mostly in the Sacramento region, the Bay Area, and the Central Valley.
The merger received a unanimous approval from PIMG’s board of directors, which recommended this move last week to its IPA members, they said.
Plans involve the suspension of PIMG’s independent operations by midyear, “enabling a smooth transition of physicians and members”, explained PIMG Chief Executive James Rodriguez in a statement.
“This orderly transition will enable each of our patients the opportunity to remain with their primary care physician and positions our physicians to realize the benefits that come with being part of a nationally recognized, geographically broad medical group”, he said. “I believe it is likely that most of PIMG’s primary care and specialty physicians will make the move to Hill Physicians Medical Group”.
According to Rodriguez, around one-third of IPA’s doctors in Brisbane already have medical group affiliation with Hill; thus, expanding the association is natural. Of its 500 physicians, PIMG considers 300 to be the group’s core members.
PIMG, which was established in 1995 to offer care to San Francisco Health Plan members, also provides PPO and HMO coverage to patients through Aetna, PacifiCare, Health Net, Blue Shields of California, and Anthem Blue Cross, as stated in its website.
Meanwhile, Hill is already the largest IPA in the region, constituting 3,000 physicians on health plan contracting as well as other business transactions, and providing around 300,000 HMO enrollees.
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03/15/2010
Congresswoman Nancy Pelosi of San Francisco, spent most of the past weekend promoting healthcare reform and denying allegations that the Democratic Party lacks the necessary votes to pass it.
The Democratic leader, during a break in a dedication ceremony at San Francisco’s Chinatown, said it’s more crucial than ever for some type of healthcare reform to be passed in the near future.
“It’s very clear that the status quo is not acceptable. Too many people in our country do not have health insurance,” she stated.
However, Republican Congressman John Boehner of Ohio, who appeared on CNN’s State of the Union Program, disagreed with Pelosi, saying:
“The only bi-partisanship that’s going on in this town right now with regard to health care is the bi-partisan opposition to what they’re attempting to do.”
He went on to say that the Democrats don’t have enough votes to pass the health insurance bill through; because if they did, then the deal would have been completed months ago.
Pelosi said that the Democrats will continue to push for the bill to go through, though she did not give further details on what would make up the bill once the vote takes place.
According to newly elected Republican Senator Scott Brown of Massachusetts, the debate over the matter has been a waste of time. He said the present reform needs to be scrapped and then start over again.
An “entire year has gone to waste” as the Democrats take on what he defines as a “destructive” effort, Brown explained.
Author: Van Kelsey
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03/12/2010
The House of Representatives are unlikely to set a vote by March 18 on the medical insurance reform, said White House spokesperson Robert Gibbs on Thursday, adding that the Congressional Democrats are carrying out actions to consolidate position within their own party.
According to him, it may take several days after March 18 before the House could finish the bill. Last week, Gibbs told reporters he thought the House was scheduled for voting on the legislation by the 18th, when President Barack Obama departs for overseas trips to Australia and Indonesia.
Prior to Gibbs’ statement, Senate Majority Leader Harry Reid told the media that the Congressional Democrats are “not going to set any arbitrary deadlines,” because of issues still to be discussed in order to advance the reform.
The White House was urging for an early vote on the health insurance bill. Obama said during a rally in St. Louis, Missouri, on Wednesday that “the time to talk is over. It's time to vote”.
Reid officially informed the Republicans that the Democrats “plan to use the regular budget reconciliation process that the Republican caucus has used many times”.
Reconciliation only needs a simple majority to press forward a contentious budget reform, as the Democrats are lacking just a single vote for a filibuster-proof supermajority in the Senate.
The Democrats are now taking actions to secure their needed votes, particularly in the House, where several politically-vulnerable Democrats fear that the bill may bring damage to them in an election year.
House Speaker Nancy Pelosi met with the House Democrats on Thursday to address, ‘member-by-member,” the issues they raise.
“We have a pretty good idea of where we are going,” Pelosi said.
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03/11/2010
The US Senate passed a $140 billion jobs bill on Wednesday that would extend the deadline of the unemployment insurance until the end of 2010 as well as extending some tax breaks which will soon expire.
The bill passed the Senate with a 62-36 vote and will now advance to the House for voting. The majority of the 15 million unemployed Americans would like the White House to act more to produce jobs, and this jobs bill does not include new major initiatives. Nevertheless, it does include a $15 billion job creation effort however; some Americans believe that more needs to be done.
In December alone, a $154 billion job creation bill passed the House, and a number of Republicans are worried of adding additional money to the deficit.
The new bill will extend the COBRA health insurance benefits, as well as unemployment insurance benefits for those without work, till the end of 2010.
Under the new jobs bill, tax credits that had expired by the end of 2009 will be extended until the end of December this year, there will also be a deduction for teachers’ education expenses and a research and development benefit for businesses.
Unemployment has been steadily increasing over the past few months. In Utah for example the unemployment rate in December was 6.7%, up from six percent in August.
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03/10/2010
Major business groups announced on Tuesday a multimillion-dollar advertising campaign to oppose President Barack Obama’s healthcare bill as it draws nearer in a make-or-break voting in the House.
The ad buy, amounting from $4 million to $10 million, is set to start on nationwide cable outlets Wednesday. Later this week, the campaign will shift to around 17 states home to conservative and moderate Democrats. Their votes are vital to the president’s endgame for passing the bill to overhaul the health insurance industry and expand coverage.
The ad comes as Obama builds up momentum in his last healthcare drive. However, congressional Democrats still lack votes to pass the bill, and they are encouraging several of the same legislators targeted by business groups.
Health insurance firms, criticized by Obama regarding a recent wave of premium increases, help in paying for the ads, claimed US Chamber of Commerce’s top lobbyist Bruce Josten, who coordinates the campaign.
“Health care costs will go even higher under this bill, making things even more difficult for business,” he said. “We are trying to tell Congress to stop with this bill and start over, and get it moving in a direction that makes it more affordable.”
Jeri Kubicki, an expert in employee benefits with manufacturing groups, said that employers are holding up the hiring of new employees due to concerns that the passage of the bill would increase their costs.
The ad’s script says: “Health care costs will go even higher, making a bad economy worse.” It advises the public to tell their lawyers: “Stop this health care bill we can't afford to pay.”
The president’s health plan would not demand companies to grant coverage to their employees; however, it would increase the fees of firms, whose employees would get taxpayer-subsidized policies with the new medical insurance market.
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03/09/2010
In an unexpected turnaround, Blue Care Network in Southfield, Michigan, has ended its plan to purchase Physicians Health Plan of Mid-Michigan for 45 million dollars from Lansing-based Sparrow Health System.
Ever since, Attorney General Mike Cox of Michigan and competing health plans have objected that the merger would lessen competition and result to higher costs of health care.
Officials from Sparrow and Blue Cross argued that the acquisition would raise the benefits of both plans’ subscribers by cutting down administrative costs and enhancing services.
Sparrow and Blue Cross believed that the deal would be given regulatory clearance last year. However, a joint statement of the two companies concluded that the deal would not be granted clearance without litigation.
Blue Care President Kevin Klobucar said that unless they could get a federal clearance over a short time, which they have been warned impossible, “a prolonged period of uncertainty would be extremely difficult for client employers, health plan members and employees at both organizations”.
“It was not a desire of either organization to continue to focus our time and resources to litigate this matter”, he further exclaimed.
In a statement, CEO of Physicians Health Plan, Scott Wilkerson, said that PHP intends to continue serving its members.
“Despite this outcome, we are pleased that PHP has operated on a business-as-usual mindset throughout this lengthy regulatory process”, he stated.
According to him, the customer-focused strategy of the company has allowed them to continue to offer “high-quality, cost-effective care that people have come to expect from our award-winning health plan”.
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03/08/2010
As the debate on national healthcare advances in Washington, Illinois residents are experiencing an abrupt increase in medical insurance costs.
Insurance companies in Illinois are increasing their premiums by up to 60% – during a time when they are also enjoying their profits at maximum, according to Senator Dick Durbin, an advocate of President Barack Obama’s healthcare reform bill.
“For those who say go slow, I can tell them this -- the health insurance companies aren't going slow when it comes to raising premiums”, said the Illinois senator at a press conference on Sunday.
According to him, passing the healthcare reform bill would help in changing the existing system, which permits medical insurance to earn while the patients suffer.
”Families are facing skyrocketing costs”, said Durbin. “Emergency rooms are overflowing. Health centers are struggling to meet the increasing demand. Yet insurance companies continue to raise premiums for hardworking families and, consequently, their profit margins”.
Over the past ten years, insurance premiums throughout the country have increased by 131%, while the wages have increased by only 38%, explained the senator. The cost crunch implies that an average of around 11,000 workers in America lose their insurance coverage each day; while the top ten health insurance firms, on the other hand, saw their profits increase by 250% over the last ten years.
Durbin said in a statement that the profits of insurance companies are “the only thing rising faster than insurance company premiums”.
President Obama’s bill will eliminate the unexplained and unprecedented increase in premiums and end the abuses of insurance companies, he claimed.
“It’s what Americans deserve, and we’re too close to let this opportunity pass us by”, said Durbin.
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03/05/2010
A report from Families USA – a non-profit consumer healthcare advocacy organisation – says that failure to pass the reform on healthcare this year would result to around 300,000 premature deaths across the country in the next ten years. Ron Pollack, the organisation’s executive director, explains that the report also considered the conditions from the past fifteen years and discovered numerous needless deaths.
“Approximately 295,000 people died due to a lack of health coverage”, says Pollack. “In Iowa, about 1,600 people between the ages of 25 and 64 died due to a lack of health insurance coverage”. He claims that the organisation has also estimated figures for the next decade if there is no healthcare reform.
In Iowa, the organisation approximates that around “1,500 people will die in the next decade due to a lack of health care coverage, if health reform fails”. Pollack says that on average, it would amount to about “three (Iowans) dying per week over the next 10 years”.
The Families USA executive director states this is mainly because under-insured or uninsured people are less probable to have regular medical check-ups; hence, they are not screened for possible diseases and get no pre-emptive care. Majority of individuals with no health insurance delay treatment though they are already in pain, simply hoping it would go away. Pollack stresses that this situation needs to change.
According to him, numerous people will die unnecessarily and prematurely in the next ten years because “our terribly flawed health care system excludes these ordinary Americans”.
He says that failure to enact the healthcare reform and not doing anything to make healthcare affordable would result to a “huge and terrible cost” and Americans may continuously “pay in tragic, unnecessary deaths” for the next several years.
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03/04/2010
President Barack Obama on Wednesday signed into law the Temporary Extension Act of 2010 (HR 4691), just hours after it was passed in the Senate with a 78–19 vote.
The bill’s main purpose is the extension of health care subsidies and unemployment benefits for unemployed individuals. However, through March 31, 2010, it also extends a federal tax credit, allowing the government to subsidize around 65% of the cost of Consolidated Omnibus Budget Reconciliation Act (CORBRA) premiums. The new law also refined the treatment of COBRA continuation, which results from the reduction of hours consequent to employment termination.
COBRA was initially approved as a part of the American Recovery and Reinvestment Act of 2009, PL 111-5. The provision states that group health plans must consider an eligible individual as having his/her premium fully paid provided that the person pays 35% of the COBRA continuation coverage premium. Those eligible persons may receive the subsidy for over fifteen months, and 65% of the subsidy is reimbursed on the employer by taking credit on their tax returns.
Eligible individuals are those who have been unwillingly terminated from their jobs between August 31, 2008 and April 1, 2010. The bill extended the eligible period’s closing date from February 28, 2010 to March 31, 2010.
The newly signed bill also added particular rules for those individuals who lost their health insurance coverage due to a reduction in their working hours. Under the provision, if a person failed to make COBRA continuation coverage election after his/her working hours have been reduced, followed by an involuntary termination from employment, it will be regarded as qualification for COBRA continuation coverage.
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03/03/2010
The supervisors in Cerro Gordo County in Iowa, US, agreed on Tuesday that individuals employed after July 10th will not be entitled to the health insurance offered to early retirees.
The health insurance of employees taking an early retirement – those aged 58 with 30 years of service or aged 62 with 20 years of service – has been paid by the county until they were eligible for Medicare under a scheme that was launched in 1998.
The insurance policy only included the employees. If they wanted their family to be covered, they needed to pay an extra amount.
According to County Administrative Officer Tom Drzycimski, after 1 July, the insurance coverage would still be accessible to retirees and current employees hired before July 10th, provided that they conform to the minimum eligibility requirements.
He stated that the Government Accounting Standards Board is now requiring local governments to pay for future financial liabilities such as the early retirement program’s insurance policies.
“In order to limit our obligations over time, the county decided to discontinue the program”, Drzycimski further explained.
In a related issue, he told the county supervisors that elected officials, their deputies, and non-bargaining workers will experience an increase of 4.9% in insurance premiums for their family. Cerro Gordo County would continue to pay the employees’ premium on single-coverage.
Employees in the county with family insurance policies will see an increase in their contribution from $234 to $245.60 per month.
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03/02/2010
President Obama is currently exploring four heath care plan proposals, according to a letter he sent to congressional leaders today.
Discussed at the bipartisan health summit last week, the GOP ideas include proposals to expand the use of fraud investigators disguised in patients' clothing to help uncover wasteful behaviour and abuse in federal programs like Medicaid, as proposed by Republican Senator Tom Coburn. Obama has stated he is also open to more ambitious pilot programs to change the rules governing malpractice lawsuits within the medical profession, a longtime GOP issue.
Among the ideas to be added to President Obama's $950 billion plan which were discussed last week also include a proposal by Republican Senator Chuck Grassley, calling for higher Medicaid reimbursements for doctors, and a proposal by Republican Senator John Barrasso to look into the expansion of health savings accounts.
"After decades of trying, we're closer than we've ever been to making health insurance reform a reality," Obama's letter stated. "I look forward to working with you to complete what would be a truly historic achievement."
Obama will discuss an updated version of the plan on Wednesday at the White House, however he stated that other Republican proposals will not be included, nor will proposals that republicans have attacked in recent weeks, such as maintaining Medicare Advantage benefits from Florida residents, and exempting the state of Nebraska from Medicaid costs.
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03/01/2010
House Majority Leader Steny Hoyer promised on CBS’s ‘Face the Nation’ on Sunday that the health care reform would push forward after the historic bipartisan healthcare summit on Thursday with US President Barack Obama.
“We're going to move ahead”, he said in the interview with Bob Schieffer. According to him, the reform on health plans is essential as it will bring down health costs. “We think it will improve the health of America”.
The House’s number two Democrat described Thursday’s summit as ‘extraordinary’.
“I can't remember a similar meeting held by any president, certainly in the 30 years I've been in Congress”, he said. “It was a civil and substantive discussion. I think the American public got the impression that very serious debate and discussion and there were differences”.
However, Hoyer avoided questions on whether there had been enough votes in the House of Democrats to pass the outlined health plans. Although a reform package was approved in the chamber in November, several analysts believe that it may be difficult to acquire the votes next time.
“I don't think we have the votes in terms of a specific proposal because there's not a specific proposal on the table yet”, Hoyer added.
He said he believes that a specific proposal would be set forth within the next two weeks, and then the Democrats would start counting the votes for the bill.
The House Majority leader appeared on the ‘Face the Nation’ program together with Senate Democrat Kent Conrad of North Dakota, as well as Republicans Representative Marsha Blackburn of Tennessee and Senator Tom Coburn of Oklahoma.
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02/25/2010
Congressional Democrats, still holding slight hope for the televised bipartisan summit on medical care, are ready to try a more comprehensive bill in the next few weeks without even one Republican vote.
A bipartisan cooperation appears to be highly unlikely, said the members of the two parties on Wednesday. The insurance reform procedures the Republicans might endorse need Democratic-backed measures that the GOP greatly opposes, like government subsidies to allow low-income Americans to purchase health coverage.
Senator John Cornyn of Texas said that the White House’s health reform program “displaces Texas' priorities with Washington's priorities”.
According to Senate Minority Leader Mitch McConnell of Kentucky, with Democrats reluctant to start from scratch, “I think it's nearly impossible to imagine a scenario under which we could reach an agreement”.
With these remarks, Democratic leaders say that they are hoping to convince House Democrats to take back their objections and support a health bill passed by the Senate last December. In return, the Senate Democrats would be compelled to agree to make several changes under the Senate budget reconciliation policy, which stops GOP delaying strategies.
On Wednesday, the Democrats easily closed on one of the more famous health care concern, as the House had voted 406-19 against the exemption of the health insurance industry from federal antitrust error. Independent experts greatly agree that the change would have the least effect, partly due to the regulatory role the states are already playing.
“In Texas alone, we have seen insurance industry premiums increase by 104 percent since 2000. It's time to open markets and block closed-door collusion”, said Central Texas Representative Lloyd Doggett on Wednesday.
Author: Van Kelsey
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02/24/2010
California lawmakers said on Tuesday that they were surprised by the attempt of Anthem Blue Cross to raise individual insurance premiums by around 39% during a time when the policyholders are striving to pay for health coverage.
A hearing was opened by the Assembly Health Committee to look into the proposal of the largest for-profit health insurance provider in California.
The increase is to take effect on 1 May and will likely affect over 700,000 individual insurance policyholders in the state.
The hearing came in amid an intense national debate on healthcare reform and a day prior to the congressional committee is set to question WellPoint Inc. – Anthem’s parent company.
“How are Californians supposed to afford health insurance with these rate increases?” asked Democratic Assemblyman Dave Jones from Sacramento, California, upon starting the hearing. “What level of profit is enough?”
Jones, who is the committee’s chairman, said that the state could not wait for the federal government to take action.
California has an obligation to protect its businesses and consumers from “outrageous rate increases”, he explained.
According to Anthem, it needs to boost premiums partly because healthier, younger individuals have been abandoning health insurance coverage since the recession, passing it on a group of policyholders who are older and much more in need of healthcare services.
The most recent increase would total to 25%; however, for those who have acquired individual policies, it could reach to 39%.
The firm’s 7.3 million remaining policyholders in California are within employer-sponsored schemes and will not be affected, said Anthem’s spokeswoman Kristin Binns.
Author: Mark Kelsey
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02/23/2010
On Monday, US Representative Leonard Lance of New Jersey disclosed a legislation he has written that will assure that preventative services, like mammograms, cannot be refused coverage by health insurance providers or group health plans as an effect of federal rule.
At the Summit news conference, authorities connected with the North Jersey and Central/South Jersey Affiliates of Susan G. Komen for the Cure declared their support for Lance’s bill, entitled "Safeguarding Access to Preventative Services Act of 2010."
The bill came as a response to the declaration made by the US Preventive Services Task Force which stated that women should only receive a mammogram whey they reach the age of 50, a proposal Lance and cancer groups have strongly rejected.
Lance said that, “While we don't know the cause or cure for cancer, we do know that early detection is still the best protection. My bill would make sure that women can't be denied coverage for the preventative screenings they need despite the misguided federal guidelines."
Those who joined Lance at the news conference include Dr. Jan A. Huston of the Medical Advisory Council of Susan G. Komen for the Cure North Jersey, Deborah Q. Belfatto of Komen North Jersey Affiliate, Lisa Berkower of Komen North Jersey Race for the Cure, and Nancy Healey of Komen Central and South Jersey Affiliate.
Barbara Waters, Advocacy for the North Jersey Affiliate of Susan G. Komen for the Cure’s co-chair, said: “Breast cancer continues to be the most commonly diagnosed cancer in women. It is important that we continue to work to increase awareness and maintain access to life-saving screening measures."
Moreover, the legislation would forbid the US Secretary of Health and Human Services from employing any proposal of the US Preventive Services Task Force to decline coverage for a service or an item by health insurance providers or group health plans.
Author: Avery Smith
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02/22/2010
In Lake County, California, several months after the Board of Supervisors’ approval to give eligible employees a one-time stipend worth $700 from a health insurance assistance holiday, the supervisors have also recently accepted the payment. All of them have pledged to give their respective shares to charity.
In November and December, Lake County accepted a “premium holiday” from its respective insurance carriers, which was approved last year by the board to be returned to employees through a one-time stipend.
Presently, the decision lies with the board on whether to accept the reimbursement for the members, who also contribute into the county’s medical insurance plan.
Supervisor Denise Rushing has raised concern on how the board could cast their vote on an issue that would aid its members financially. However, County Counsel Anita Grant stressed that this process can be compared with the board’s vote for salary increases.
Supervisor Rob Brown stated that the board has the option not to accept it. However, he also proposed that they can also accept it and give it to community groups.
Board Chair Anthony Farrington noted that the only manner in which he can cast his vote on it is if a regulation can specifically identify where he would be giving the money. He also inquired whether the auditor-controller of the country could write the check for him so that it will be given directly to Hospice Services of Lake County and Clear Lake High Sober Grad.
Supervisor Jeff Smith also said that it would be disappointing if the ordinance was not approved. “I think it's a good way to get some money out there in the community,” he added.
Brown decided to advance the decree to February 23, which was seconded by Comstock. It was approved 4-1 on its initial reading, with only Farrington rejecting it.
Author: Van Kelsey
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02/19/2010
On Thursday, majority Democrats stated that they will back an initiative that would compel health insurance providers to offer justification for sizeable rate increases, and to be more receptive regarding factors that can lead to cuts in rates.
House Commerce Committee Chairwoman Representative Janet Petersen said that action on the initiative could be reached in the coming week. She contended that immediate action was necessary to tackle this disturbing trend in the insurance industry.
She said, "We really do not have a full picture of what is impacting Iowans' health care costs. This is a good first step in having more accountability.”
The initiative was influenced by the announcement of Wellmark Blue Cross Blue Shield of its plan to increase the rates of medical insurance for approximately 80,000 Iowans by 18%.
Under this new initiative, the Insurance Commissioner of Iowa would be obliged to make an itemized report regarding health expenditures, including health care expenses, data on rate increases, and factors associated with medical insurance costs.
Moreover, Senator Becky Schmitz said that she will advance the initiative in the Senate.
She said, "As lawmakers, it's our job to ensure that the insurance rate hikes are justified, and that the insurance companies aren't taking advantage of small businesses and families."
Des Moines Wellmark spokesman Rob Schweers said that the company is open with the details of the increase of insurance rate. He reiterated that the increase was essential so that they can meet the demands on health care.
Senate Majority Leader Michael Gronstal also said that he will support the initiative, which will give state regulators the power to collect more information on the issue.
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02/18/2010
Consumers in a minimum of four states who purchase their own medical insurance are being burdened with 15% or more premium increases. It is said that consumers in others states might also experience the same predicament.
WellPoint Inc.’s subsidiary Anthem Blue Cross has been criticized by politicians and regulators for the past week because it has notified its individual policy holders, numbering to 800,000, in California that it is planning to increase rates by possibly 39% on March 1.
The Indianapolis-based WellPoint stressed that it must increase its rates because the low economy has caused fewer people to remain in California’s individual insurance market. Added to this, a great number also have critical health problems. The company said that their healthcare costs have risen because the fees of healthcare providers have also increased and diagnostic tests have been commonly used.
In Oregon, various insurers were allowed to implement a 15% increase this year. This came after a 25% increase had been assigned last year to customers who buy individual health insurance, instead of acquiring the coverage through their respective employers.
Moreover, premiums are more unstable for individual policies in comparison with those purchased by large groups and employers. And as more individuals become unemployed, the healthy ones have opted not to have health insurance, reducing the number of premiums acquired by insurers.
The National Association of Insurance Commissioners’ Sandy Praeger said on Friday that increases of 20% to 30% will be observed on individual health plans in the near future. She noted that most states do not have the legal power to reduce or block the rate of increases on health insurance.
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02/17/2010
Georgia Governor Sonny Perdue has recently announced that Representative Matt Ramsey, a floor leader for the governor in the House, has instituted House Bill 1184. This legislation is set to increase access to medical insurance.
“This legislation will open up the individual insurance market and allows consumers to find the plan that best fits their needs,” the governor said. “It will also help those that are uninsured find a plan that works for them.”
It is said that the legislation will permit families and individuals to purchase health plans that were already approved for sale in other US states. Insurers who are licensed to operate in Georgia, but who also have other products that are marketed in other states, will be allowed to vend those policies in Georgia too.
Added to this, permitting the acquisition of medical insurance across state lines will enable reasonably priced health insurance to become more accessible. It will also increase the kind of health plans that can be offered to Georgians.
Representative Ramsey stated, “This legislation empowers Georgians to find a health insurance plan that meets the needs of their family.”
Governor Perdue initially publicized this proposal on health insurance in January. He made use of the Georgia Chamber of Commerce’s Eggs and Issues breakfast to inform his constituents regarding this measure on health care reform.
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02/16/2010
The IRS said that it will help Michiganians who were forced to purchase medical insurance after losing their employment because of foreign competition or because their retirement benefits and pensions were terminated.
Den Black, who is representing retirees of bankrupt car supplier Delphi Automotive LLP, said: "It has literally made the difference for people who were bankrupt or foreclosed upon, where they have a chance to survive economically."
Those employees lost their life and health insurance coverage last year and will have reduced pensions now that the US government’s pension insurance provider, Pension Benefit Guaranty Corp., has absorbed the responsibility to continue the health plan.
The IRS is implementing some measures to publicize the Health Coverage Tax Credit, which aims to refund 80% of premiums on health care and can help in settling the majority of the premiums every month thereafter. This credit covers individuals whose employment loss is verified by the Trade Adjustment Assistance Act, and those aged 55 and above whose pension arrangements have been assumed by the pension board.
The tax credit can be claimed by employees as a form of refund by completing IRS Form 8885 and the proper documents accompanied by a federal tax return. They can also sign up with the IRS so that IRS can charge them 20% of premium on health insurance, with the IRS completing the required payment every month.
Luis D. Garcia, the spokesman of IRS in Detroit, said that 40,300 employees in Michigan are qualified for the program. He added that, "Having this kind of help with your health insurance premium can be a game-changer for people, and really increase their quality of life."
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02/15/2010
Jayme Martinez, who belongs to a legal group connected to the University of Nevada‘s Boyd Law School in Las Vegas, is helping prepare a legislation that can assure boxers that they have health insurance coverage upon entering the ring.
Martinez was greatly inspired by the medical condition of Filipino boxer Z ‘The Dream’ Gorres, who had a brain injury and suffered from partial paralysis after fighting in November 2009 at the House of Blues in Mandalay Bay. Gorres’ medical expenses at the University Medical Center (UMC) reached approximately $600,000, but his medical insurance only managed to cover $50,000 of the medical costs.
Martinez said that the boxer’s condition pushes them to help boxers in securing health insurance.
She, together with law teacher Robert Correales and law students Ryan Devine and Jonathan Winn, met with Gorres and asked the boxer whether there is an urgency to increase the health insurance of boxers. Gorres said boxers need help.
Gorres’ medical expenses will be partially shouldered by the taxpayers of Southern Nevada because the current state legislation only requires boxing promoters to assign $50,000 worth of medical insurance for every boxer before a fight.
Dr. Benito Calderon, who monitors Gorres’ medical condition, befriended the boxer after the bout that transformed his life. After Gorres was released from the UMC, Calderon has been helping the fighter in his rehabilitation.
Moreover, Martinez has been working to promote boxers’ safety because her husband also trains young boxers. She has also started researching on the injuries of boxers in Nevada, with the goal of determining the amount of health insurance that should be given to them.
Author: Warren Blumberg
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02/12/2010
On February 1, Congressman Joe Sestak of Pennsylvania held a town hall-style conference at Eastern Univeristy with local residents, students and faculty. He is currently the 7th district’s representative, and is eyeing to defeat Senator Arlen Specter to become the official candidate of the Democratic Party in the senatorial elections in 2010.
He opened the meeting by emphasizing his priorities, which include establishing more jobs, promoting “accountable leadership”, and passing the House healthcare. He reiterated the need to pass the bill, which has now become controversial. Concerns regarding healthcare reform were the major topics during the meeting.
Sestak stressed his support for compulsory individual health insurance, saying that when uninsured people get ill, taxpayers generally shoulder the bill. When asked how he can aid college students in paying for their mandatory medical insurance, he said the House’s healthcare bill would permit youths to be covered by the insurance of their parents until they are 27 years old.
He emphasized the need to initiate measures to stop individuals with pre-existing medical conditions from being excluded in getting health care, and assured that there will be equality in gender in terms of insurance prices. He also stressed that he will help small businesses to keep healthcare costs at manageable levels.
Meanwhile, Sestak trails Senator Specter in terms of voter polls party support and recognition. Specter has been a prominent figure in the politics of Pennsylvania since he was elected in 1965. This is his first time running as senator since changing affiliations from Republican to a Democrat in April. The primary voting will be held on May 18.
Author: Mark Kelsey
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02/12/2010
The healthcare legislation might have been suspended in Congress; however, the $80-billion employment legislation’s draft that was just released by the Senate has several provisions on healthcare.
While Majority Leader Harry Reid is preparing to propose the legislation’s final version before the month ends, experts are already inquiring whether this jobs legislation is another form of health-care reform. Last December the House passed it’s own version of a jobs bill that amounted to $154 Billion.
The provisions being considered by the Senate employment legislation include a Medicare physician compensation fix which will last for seven months. This will prevent scheduled Medicare reimbursement cuts to physicians, and delay a possible 21% payment cut to doctors.
People who are newly unemployed would receive an extension of three months to their individual health insurance to aid them to continue purchasing insurance coverage through their former employers.
An upward alteration in the computation of Medicare Advantage compensation rates for 2011 will also be included.
Moreover, the provisions propose payment extensions of one year for Medicare programs like ambulance add-on fees, Medicare Part B treatment caps, improved payments for services on mental health, and extensions related to the Long Term Acute Care Hospital Moratorium, which is scheduled to expire in December 2010.
The majority of these provisions are only temporary. They are aimed at maintaining programs until lawmakers can settle concerns through healthcare legislation towards the end of the year.
It is expected that Senator Reid will attempt to bring the final legislation to a vote for the succeeding two weeks.
Author: Avery Smith
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02/11/2010
Key Senate Democrats unveiled last Thursday a health care revamp bill that imposes a fine of more than $1,000 for Americans who refuse to avail themselves of affordable health coverage. The bill aims to fulfill the top domestic priority of President Barack Obama. In a statement, Obama supported the legislation saying that it “reflects many of the principles I’ve laid out, such as reforms that will prohibit insurance companies from refusing coverage for people with pre-existing conditions and the concept of insurance exchanges where individuals can find affordable coverage if they lose their jobs, move or get sick."In the proposed health care system, it would be an obligation for citizens to be covered by health insurance as it is necessary for motorists to get auto insurance coverage now. The government would also subsidize health insurance for the poor and even for middle-class families. However, those who decline to apply for health care coverage would face penalties. As estimated by the Congressional Budget Office, the said penalties can raise $36 billion in 10 years. The penalty system is patterned after the method used in Massachusetts, which imposes an annual penalty of about $1,000 per individual who declines to get medical coverage. Federal legislation also dictates for the fines to be higher on families. Data from a survey by the Kaiser Family Foundation show that in 2008, employer-paid health care family plans averaged at $12,680 while individual plans were at $4,704. It is estimated that the cost of the revised federal health plan will be less than this.The penalties will be set at half the price of basic medical coverage. Called “shared responsibility payments,” the penalty aims to urge people to avail themselves of a health plan while they are still healthy and not wait until they get sick. Penalties shall be collected through the income tax system. Author: Warren Blumberg
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02/11/2010
Key Democratic senators are pushing for a government-managed insurance policy to provide alternatives that will compete with private health plans. This proposal, which aims to help President Obama’s health care reform, will also require large companies that do not provide insurance to their employees to pay an annual fee of $750 per worker. Democratic Senators Edward M. Kennedy of Massachusetts and Christopher Dodd of Connecticut said that the modified proposal would be cheaper compared to its previous version. The revised proposal aims to cover up to 97 percent of the American population.Two weeks ago, the Congressional Budget Office estimated the cost of the previous proposal at $1 trillion over 10 years. The revised proposal on the other hand will cost around $611.4 billion. This modification on the actual cost of the proposal also “virtually eliminates” the earlier prediction that many companies would be forced to drop health insurance coverage for their employees.On Wednesday, the two senators wrote to the members of the Senate Health, Education, Labor and Pensions Committee in anticipation of the return from vacation of lawmakers to the Capitol.As early as next week, the Health Committee could finish its version of the bill. A party-line vote is virtually guaranteed because of the proposed government-run health insurance alternative.On the other end, the Senate Finance Committee is working separately towards a companion measure that aims to achieve a bipartisan concession. At the end of the month, the three House committees working on the legislation are expected to arrive at a vote that is sure to include the proposed insurance option from the government. Obama is pressing for Congress to pass legislation within the year. Author: Van Kelsey
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02/11/2010
WASHINGTON – From the very start, President Obama’s administration has been working hard to sell health care reform to the middle class as part of the solution to increasing medical costs, and not just as something costly for the benefit of the poor.But with the way legislation is being shaped by Congress, the most important issue yet to be addressed is whether the extent of the benefits for the middle class will be sufficient to gather their support.Back in the 1990s, President Bill Clinton’s health insurance regulations failed because of the “Harry and Louise” ads. The insurance industry used these ads to suggest that Clinton’s health plan was “a bad deal” for the middle class. Even though recent polls suggest some public discontent with the way Obama is handling the issue, the President is yet to go down the same road as Clinton.According to Len Nichols, New America Foundation’s health policy program director, the middle class’ decision will decide the fate of this year’s health care debates. "It will come down to Obama's portrayal of the benefits of the new world," and his solutions to the rising cost of insurance premiums. "All this is complicated. All this is hard to show.”Obama is selling a different payoff to Americans who are going to shoulder most of the bill that will cover the uninsured. Even though the portrayed payoff is generally appealing, quantifying it would be more difficult to do as compared to the subsidies needed to help cover the poor. The President wants the public to underwrite the cost of legislation and look forward to smaller premium increases in the future and guaranteed coverage. Author: Mark Kelsey
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02/11/2010
The purpose of health insurance is to provide medical and financial protection. But according to estimates, three-quarters of those who filed for personal bankruptcy due to medical problems were actually insured.As Washington pushes to cover almost every American in the proposed health insurance reform, many health-policy experts agree that having everyone insured will not fix the rough edges of the system. With many people already covered, a medical crisis would definitely mean financial calamity.Lawrence Yurdin, a computer security specialist, filed for bankruptcy even though he had medical insurance. The 64-year-old’s Aetna policy indicated up to $150,000 worth of coverage per year. However, almost his treatments at a hospital in Austin, Texas, were not covered by his policy. Last December, Yurdin and his wife filed for bankruptcy with $200,000 worth of medical bills to pay.Lawmakers are struggling with legislation details that would create minimum insurance coverage standards. With the expensive price tag, lawmakers could lean toward less comprehensive coverage for some policy holders.However, patient advocates stress the necessity of laying down basic levels of insurance coverage to protect individuals like Yurdin from bankruptcy. They also want new federal rules that would prevent some insurance firms from selling worthless and incomprehensive policies.According to Elizabeth Warren, a law professor from Harvard who studies medical bankruptcies, “Underinsurance is the great hidden risk of the American health care system. People do not realize they are one diagnosis away from financial collapse.”Republican senator Charles E. Grassley from the Senate Finance Committee points out the same thing as he emphasizes the need to make “meaningful” insurance policies more accessible and affordable. “Until that happens,” Grassley continued, “any presentation of limited-benefit plans ought to be completely straightforward, and not misleading in any way.” Author: Warren Blumberg
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02/11/2010
Standard Insurance Company (“The Standard”) recently signed a partnership agreement with Health Advocate, one of the leading health advocacy and assistance companies, in a bid to simplify healthcare plans and services. The Standard, a subsidiary of StanCorp Financial Group, Inc., announced today its new offering—the Health Advocacy Solution—in collaboration with Personal Health Advocates.Luce Giroux, Second Vice President of Product Management at The Standard, said that the Health Advocacy Solution would help increase worker productivity by reducing the employees’ stress in navigating the healthcare system. “The Health Advocacy Solution offers direct access to our Personal Health Advocates who will provide more efficient ways of solving healthcare-related issues.” Giroux said the Health Advocates are mostly nurses or well-trained assistants who will help workers navigate the usually complex healthcare system. They will help locate doctors, explain and clarify billing statements and negotiate fees, explain benefits plans and healthcare-related terminology, and even give assistance on issues related to prescription drugs. Moreover, the Health Advocates, backed by medical doctors and other health experts, also extend their help to their client’s spouse, parents, parents-in-law, and dependent children. Regardless of industry, groups with at least 10 employees can avail themselves of the Health Advocacy Solution at a discounted rate, in addition to The Standard’s other health insurance plans and services. David Rocchino, Chief Sales Officer of Health Advocate, Inc., also expressed his gratitude for The Standard’s partnership with his company. “We are indeed very pleased to be part of The Standard’s offering. Our advocacy complements their services and programs… This new service can help clients save time and money,” he added. Author: Van Kelsey
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02/11/2010
President Obama will visit northern Virginia on Wednesday to hold another town-hall meeting as he continues to push for the overhaul of the country’s healthcare system. Those who want to participate in the event are encouraged by the White House to send questions and video responses online. People can visit the White House’s official Web site or connect through social networking sites like Facebook (http://facebook.com/Whitehouse) and Twitter (#WHHCQ). According to Sheryl Gay Stolberg of “The New York Times,” Obama’s administration has created a multi-pronged strategy to help the president promote his health plan to the public. The strategy aims to persuade government officials outside of Congress, like state governors, to help by acting as Obama’s emissaries. However, the strategy contains many potential risks, like funding problems, which will be tackled by lawmakers when they return to Capitol Hill next week from recess. “If Mr. Obama waits too long to exert his presidential muscle to forge consensus on Capitol Hill,” Ms. Stolberg warns, “his moment of opportunity could pass. He could also lose control of the final outcome if lawmakers cut backroom deals he dislikes, for example, by deciding to pay for the expansion by taxing employee health benefits, a move that worries Mr. Obama’s political advisers because it could cause the president to break a campaign promise.” According to senior adviser to the president, David Axelrod, the administration wants “as many people as possible” to take part in the nationwide discussion about the healthcare reform.Dan Balz and Shailagh Murray of the “Washington Post” analyze the administration’s plans. Just like healthcare, the energy and immigration bills will also face tough opposition in the Senate. Author: Avery Smith
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02/11/2010
Despite the strain of soaring costs, the government is continuing to head towards a huge health care overhaul, which, it is feared, will lead to sky-high costs for everyone. Americans are supportive of President Barrack Obama’s proposed health insurance reform plan yet many are worried about its impact.In a forum held last week at the White House, which was broadcasted live on the ABC television network, President Obama presented his health insurance reform plan to the public. Obama confidently answered questions on his proposed insurance reform, including questions relating to how people can keep their existing individual insurance plans.A fact check on the President’s speech and his answers to questions show that he is eager to pursue his reform but that he sometimes glosses over details in his explanation of how he plans to make the reform successful.The president campaigned for his health care plan and informed the audience that the costs of health care have increased three times faster than wages in the United States. Some studies, however, like the one prepared by Family USA, a group that is advocating for reforms in health care, reveal that heath care insurance costs have actually increased five times faster than wages in the US, as reported in October 2008.The president said, “If you are happy with your current [health care] insurance plan and happy with your doctor, we don’t want you to have to change.” However, some speculate that the president’s plan cannot change the fact that private companies have the freedom to choose the health care plans of their employees.Moreover, it has been found that Americans find it important for President Obama to offer a reform on health care without adding to the national deficit. But the price tag for this health care proposal is pegged to be between $1.3 and $1.6 trillion, which means it will clearly need more revenue for it not to add to the deficit. Author: Warren Blumberg
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02/11/2010
Most health insurance providers in Guam will start covering ambulance services as the Guam Fire Department starts to charge fees for the use of ambulances on July 1.According to Bri Hosei Habin, Health Care Management Division chief at Moylan's NetCare Life & Health Insurance program, various health insurance plans provide different levels of coverage for ambulance services. This means that a subscriber must pay ambulance fees or make a co-payment if he does not meet his health insurance deductible.Based on Public Law 29-02, the Guam Fire Department will charge $95 for non-emergency ambulance services and $195 per transport for emergency ambulance services.The bills for the services rendered will be mailed to health insurance providers while those uninsured will be charged directly, Edward Cruz, Fire Chief Aide, said during a press conference.Cruz said that beginning July 1, the Guam Fire Department will issue ambulance invoices and bill health insurance providers.Invoices for non-emergency purposes will cover the transport only while the fees for emergency services will include equipment and supplies used to provide medical care, such as a defibrillator, masks and oxygen, Cruz added.Cruz also said that the funds from the ambulance services will be utilized to train personnel and maintain medical equipment.Calvo's Select Care program health plan administrator, Frank Campillo, said that most ambulance services in the country’s mainland are offered by private companies. He further added that ambulance services are given by most health insurance companies in the island but that the Guam Fire Department did not charge for this before and will only start charging for them now. Author: Avery Smith
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02/11/2010
For small-business owners, maintaining their workers’ health insurance is becoming increasingly difficult with the soaring costs and a weak economy.Pedro Alfonso, owner of the small telecommunications firm Dynamic Concepts Inc. said subsidizing the health plans of his 85 employees now entails out-of-pocket costs. Alfonso says that before, his company could afford 70% of its workers’ insurance premiums. Now, however, it can only pay 35%.Alfonso, 61, said that rising health costs is hard for workers. “But it’s also hard on us,” he added.Small companies, such as Alfonso’s, are among those which the non-partisan Congressional Budget Office (CBO) is concerned about. With higher health costs, 15 million people employed in small companies may lose their health plan benefits or may voluntarily drop their health insurance. Moreover, about 10% of small-business employers are now contemplating dropping their workers’ health coverage next year due to the sky-high health care costs. Based on an incomplete bill in the Senate Health, Education, Labor and Pensions Committee, employees working in small companies are more vulnerable, especially if their company is paying for high premiums. Policy analyst at the Heritage Foundation, Greg D’Angelo, agrees that the current insurance system does not work for owners of small companies. “The number of people who will lose their health-plan benefits depends on what the lawmakers are still negotiating,” he added.Based on CBO estimates, over 10 million people who receive low wages would choose to terminate their current, high-cost insurance plans. With the government’s proposed health care overhaul, workers at small firms will most likely buy cheaper insurance in the open market. Author: Mark Kelsey
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02/11/2010
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), the federal economic recovery plan offers a subsidy for employees who wish to continue their health insurance after job loss. As long as they are qualified for a new health insurance plan, the subsidy will pay 65% of their insurance premium for nine months.COBRA offers continuing group/business health insurance for workers who lost their jobs. Signed into law in February 2009, this new subsidy covers involuntary job loss between September 1, 2008 and December 31, 2009, and applies to those who were terminated for any cause as long as it was not because of gross misconduct, as set in the IRS guidelines. Workers cut in large layoffs may also avail themselves of the subsidy.In a notice, the IRS explains, “If the company would have terminated the employee’s services and the employee had knowledge that he/she would be terminated, the retirement is involuntary.” Moreover, although COBRA mostly covers offices with at least 20 workers, smaller companies or groups that are under state mini-Cobra plans may also avail themselves of the subsidy. If the employee worked in a company that pays for COBRA premiums, he/she is only required to pay 35% of the total health plan for up to nine months.Once qualified, a laid-off employee can use the Health Coverage Tax Credit, which shoulders 80% of health premiums for retirees that receive financial support from Pension Benefit Corporation. This also covers workers who lost their jobs due to technical modernization or deferral trade policies. Workers who do not qualify for the subsidy are those who have a gross income of more than $125,000 a year or $250,000 for joint filers. Author: Van Kelsey
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02/09/2010
A proposed health insurance plan for the
employees of Fair Lawn Borough, New Jersey could take effect on April 1.
Borough Manager Joanne Kwasniewski, in a letter
addressed to borough workers, said that the agreement between Insurance Design
Administrators (IDA) and the borough relating to a self-insurance program will
be laid out for approval through via resolution at the council meeting on
February 9.
Borough authorities recognized the proposed
change to a self-insurance program at the council’s meeting on January 25 while
trying to control concerns between the local unions regarding changes to their
health benefits.
The present union contracts allow the borough
to change the medical insurance scheme; however, the borough must offer
"equivalent or better coverage" in any program of insurance.
Kwasniewski said, "I want to emphasize
again that the exact same benefits that are provided in the Horizon (Blue Cross
and Blue Shield) plan will be the benefits provided under the borough’s self
insurance program."
Mayor Joe Tedeschi said that the borough’s
present insurer, Horizon Blue Cross and Blue Shield, has planned to raise its
rate in 2010 by 25%. This influenced the borough to consider a self-financed
insurance plan. Tedeschi has projected that the borough can save $1 million
under the new insurance plan.
Robert Ventrella of IDA mentioned in an
interview that if his company’s arrangement with the borough will be
formalized, IDA would then proceed to cover about 350 borough employees under
the specifications of the borough.
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02/08/2010
HealthNow New York is spreading out its local
third-party administrator based in Pennsylvania to cover national operation. It
hopes to take advantage of the growing trend of employers in self-insuring
their corresponding healthcare costs, although they are in need of someone to
administer their health plans.
The Buffalo, New York-based parent company of
Blue-Cross BlueShield of Western New York is establishing a new company,
HealthNow Administrative Services, to offer outsourcing and administrative
services covering self-financed benefit plans.
HealthNow already acquired Philadelphia-based
Brokerage Concepts in 2006. During that time, it was already serving 900,000 participants
and 5,000 clients.
The company noted that the new company will
handle clients in the mid-Atlantic states and New England, while Brokerage
Concepts will continue to operate in Pennsylvania.
It has also started trading employee benefit
services and products across the US. It aims to develop a business which can
cover the whole country.
HealthNow Chief Executive Officer Alphonso
O’Neil-White said, “We believe there’s a significant market out there.”
The company has already opened a client and
sales administration department in Dallas to serve the Southwest. Additional
staffs are also deployed in Phoenix, Louisville and Boston to aid with
countrywide services and marketing. O’Neil-White cited Arizona, Kentucky, Texas
and California as among the states that are attractive. This development in HealthNow’s operations
focuses on broadening its services and products to stay competitive,
particularly with national insurers.
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02/07/2010
This week, the House of Representatives is
planning to cast their vote on – and probably pass – a bill which aims to
remove the antitrust protection of health insurers. This is considered as
Congress’ initial step in its desire to overhaul the health care system of the
US.
Independent experts said that the plan to
eliminate the 65-year-old exemption will not affect consumers that much. Center
for Studying Health System Change’s Paul Ginsburg stated, “I don’t think this
will have much effect. This is strictly political posturing.”
This action of the House is done to
reactivate the stalled efforts of Congress on medical care. The health plans
were greatly affected when Republican Scott Brown won the senatorial race in
Massachusetts, once occupied by Democratic Senator Edward Kennedy.
Dialogues on health care reforms have been
initiated by the Senate and House Democratic leaders; however, not much
progress has been achieved.
Boston University’s Austin Frakt said, “The
market power of insurers has been blamed for increased health insurance
premiums." He also said that the rising costs emanate from the money which
goes through insurance associations to providers of health care, such as
hospitals and doctors.
Ginsburg has also mentioned that insurers are
now prohibited from conspiring to merge and from increasing their prices.
Moreover, the bill will have a hard time in
the Senate. Leaders of the House note that putting an end to the antitrust
exemption will help consumers. They are also hoping that the health care
initiative will benefit freshmen Democrats, who will be judged in the elections
in November.
Click here to view this article
02/04/2010
Lawmakers in Missouri are closing in on their
goal to ensure that medical insurance providers offer coverage for autistic
children. On Wednesday, the Senate and House committees voted to pass legislations
that would ensure coverage for treatment and diagnosis for persons up to 21
years old.
Gov. Jay Nixon has expressed his concern on
this medical issue in his State of the State speech wherein he said that,
"Children with autism shouldn't have to wait for their parents to come up
with the cash or for insurance companies to grow a conscience."
Rep. Kevin Wilson, chairman of the House
Health Insurance Committee, mentioned that an undisputed bipartisan backing for
autism legislation is prevalent in the committee. The committee also modified
bills that were previously submitted to form a new legislation which contained
a ranked approach to insurance coverage. If approved, this new legislation
would give younger children more benefits in comparison with young adults and
teenagers.
Rep. Dwight Scharnhorst is hoping that he can
negotiate some changes to the new legislation when it will be submitted to the
conference committee. "They're out there struggling and in need, and we've
got a lot of little people that we want to make sure that they have the
opportunity to have a value of life comparable to anyone else and hopefully an
improvement," he said.
It is thought that one in every 110 children
in the United States have some form of Autism Spectrum Disorder.
Click here to view this article
02/03/2010
Democratic Senator Jim Brochin of Baltimore
County has sponsored a bill that will allow individuals aged 25 to 29 to be
covered by their parents’ medical insurance. However, members of insurance industry have confided to the Senate Finance Committee that this
expansion could cause employers to stop coverage and insurance providers to
increase their rates.
The bill will compel insurance providers in
group and individual markets to lengthen the age of eligibility of dependents
for medical insurance to 30 years old. On the other hand, it will exempt small
companies that have 50 or less workers.
A fiscal expert has projected that the bill
will cost Maryland $3.8 million in 2011, and by 2015, the cost will reach $24
million. This is due to the fact that eligibility keeps on growing as well as
medical costs rising.
Brochin refuted these claims in a hearing on
Wednesday. He insisted that people who are in their mid to late 20s are generally quite healthy.
Maryland Chamber of Commerce’s Ron Winehold
said that his organization did not object the expansion of eligibility of
dependents to 25 years because the General Assembly approved it in 2007.
However, he commented that increasing the age to 30 is not feasible.
Prior to 2007, children could be covered by
their parents’ medical insurance until they the age of 19 and in the case of college
students, they were eligible until they were 23. The 2007 legislation has
permitted dependents to be covered until they are 25, whether they are students
or not.
Click here to view this article
02/02/2010
On Tuesday, Republican lawmakers have
proposed a constitutional amendment that they said was targeted at impeding any
kind of federal mandate that would require Kansans to purchase medical
insurance. They said that the initiative was imperative due to the possibility
of passing a Democratic health reform in Congress, which requires medical
insurance coverage.
Senator Mary Pilcher-Cook said, “We can
provide health-care reform in our state without forcing citizens to take
certain actions, and we can provide good health care in Kansas without putting
citizens at risk of being sent to jail.”
The “Kansas Health Care Freedom Amendment” is
outlined after a proposition by the American Legislative Exchange Council
(ALEC).
Christi Herrera, ALEC’s Health and Human
Services Task Force director, insisted that health care option is still an
issue in civil liberties.
The Kansas Republican legislators supporting
the amendment include House members Todd Tiahrt, Lynn Jenkins, and Jerry Moran
as well as approximately 15 state lawmakers. Representatives Brenda Landwehr,
Peggy Mast, and Pilcher-Cook were the ones who introduced the amendment.
Glenda Overstreet of NAACP has labeled the
measure as “disingenuous.” She also said that without the reform on health
care, insurance providers will continue dropping coverage relating to
pre-existing conditions. In addition, she said that 300,000 Kansans who have no
insurance will not be given a chance to be covered.
The proposal will be discussed on Tuesday. If
it can pass the scrutiny of the Senate and the House, it will be included in
the November election to be decided by Kansas voters.
Click here to view this article
02/01/2010
Legislators in Missouri have enforced an
order to stop the operations of various companies that have promised health
plans, though in reality they have left thousands of dollars’ worth of unpaid
medical expenses to a lot of consumers.
The order from the Missouri Department of
Insurance’s consumer affairs division, which was filed on Monday, insisted that
12 individuals and 14 companies must answer the charges of defrauding Missouri
consumers. The companies were ordered to be present at the February 17 hearing
to answer the allegations. They could receive a fine of $250,000 as well as
cease-and-desist orders.
The charges stemmed from the complaints of
around 150 consumers who have purchased services from these companies that were
promoted as insurance, utilizing the terms “Group Health Plan,” “dependent coverage,” and “PPO.”
Moreover, some of these companies have promised low-cost medical insurance.
Missouri has started administrative
enforcement measures against the following companies: Beema-Pakistan Assurance
Ltd. a/k/a Beema-Pakistan Co. Ltd.; Serve America Assurance Ltd. a/k/a Serve
America Assurance Ltd. Co. a/k/a Serve America Assurance; Professional Benefits
Consultants a/k/a PBC Direct a/k/a Professional Benefit Consultants of Del.
Inc.; National Alliance of Associations; Affinity Group Benefits Association
Inc.; Peak Membership Alliance; Spencer & Associates LLC; Real Benefits
Association; Americans for Affordable Healthcare Inc.; and Smart Data Solutions
LLC, among others.
Missouri Department of Insurance Director
John Huff further said, “State law provides severe punishment for any company
selling unauthorized health plans in Missouri.”
Click here to view this article
01/31/2010
The American Cancer Society said that the
medical bills of cancer patients who depend on oral chemotherapy for treatment
accumulates much faster than cancer patients who receive intravenous
chemotherapy as treatment.
The American Cancer Society’s Dana
Dzwonkowski mentioned that under various health plans, expenses can reach as
high as $9,000 each month for a treatment such oral chemotherapy. This
treatment, in most instances, belongs to the pharmacy benefits of a patient,
and it is not subjected to the stipulations of a plan on health insurance, she
added.
Relative to this, Representatives John
Kefalas and Randy Fischer have affixed their signatures on House Bill 1202,
with the conviction that this can help the financial problems of patients
undergoing oral chemotherapy. The American Cancer Society further said that
patients who undergo such treatment comprise 15 to 20 percent of all patients
with cancer.
The bill is set to require all medical
insurance plans that cover intravenous chemotherapy medication to offer
coverage for oral chemotherapy medication under a similar patient cost.
Kefalas said that the bill “creates greater
equity, and it helps cancer patients because a lot of times insurance plans
don’t cover oral chemotherapy.”
Moreover, Fischer stated that he signed the
legislation because he is convinced that chemotherapy must be covered by
insurance schemes, despite the kind of technology utilized.
Dzwonkowski said that, “There are a lot more
situations now where oral chemo-therapy is the only kind of chemotherapy that
can treat some kinds of cancer.” She added that oral cancer medicines are very
expensive, and only two of these generic drugs are available in the market.
Click here to view this article
01/30/2010
The rising cost of health insurance prevents employers from availing
this benefit for their employees. Despite the fact that it can attract many
applications from the brightest and the best in the industry, it can require a
very large budget from a company.
The health insurance cost is the main obstacle in providing the
workforce a health plan. However, there are many options available where people
can obtain health insurance plans that are affordable. One option is by creating
or joining a health insurance co-op to reduce the costs of the total health
plan package. Small businesses employ this type of health insurance to achieve
a win-win situation for both employers and employees.
Group health insurance can be far more reasonably priced than many
employers believe.
The Consumer-directed Group Insurance Plan is preferred by many
different sized companies. This health insurance plan provides low monthly fees
for both the employers and the employees.
The Health Savings Account Plans and the Cafeteria Plans are two of the
most popular consumer-directed plans being availed by businesses.
The Comprehensive Group Health Insurance, on the other hand, gives
consumers the options to manage a health insurance group. This plan creates a
network of specialists, doctors, medical professionals, and hospitals for an affordable
and discounted medical plan. The employers and employees will benefit from this
plan because of its low premium fees, coinsurance and copayments.
The Preferred Provider Organization (PRO), Health Maintenance
Organization (HMO) and Point of Service (POS) are the most affordable
comprehensive group health plans that are availed by employers for their
workers.
Click here to view this article
01/30/2010
The dwindling economy of America has put a strain on people as they
struggle to keep themselves insured.
With companies putting emphasis on cost efficiency schemes, layoffs have
become a common practice. This has
caused an increase in the unemployment rate and those without jobs find
themselves in a position without medical insurance or a health care plan. But one option has been put in place to
assist unemployed individuals without medical coverage.
COBRA (Consolidated Omnibus Budget Reconciliation Act) is a law allowing
those who have been laid-off to purchase health coverage for 18 to 36 months.
COBRA acts as a safety net and allows laid-off employees to continue their
health plans as they seek new health insurance coverage through state-sponsored
or private market plans or a sponsored plan from a spouse or a new employer.
The economic stimulus package signed by President Barack Obama has
allowed Congress to reduce the cost coverage of COBRA. However, COBRA could still be expensive
for most individuals and in some instances may not be a good option for some.
COBRA could be expensive compared with a regular sponsorship from an
employer. In some states, there
are less expensive, short-term medical insurance policies offered, allowing an
individual to save up to 35 percent more than other private plans.
Workers from companies that have cancelled their health coverage are
also not entitled to the terms under COBRA. These workers may purchase insurance from state-sponsored or
private plans.
To fully consider COBRA, research is
necessary. One must also be aware
of all insurance options, including the costs of policies. The fact remains that an
individual should always be covered and options for coverage should remain
accessible
Click here to view this article
01/30/2010
Companies interested
in purchasing group health insurance are advised to carefully weigh their
options to ensure that health plans are tailored according to the needs of the
employees.
In searching for the
right group health insurance, it is important to understand the needs and
preferences of an employee with regards to healthcare plans. Research is
necessary in order to know about the different policy types and coverage
needed.
It is also important
to verify with the department of insurance if a company engaged in
business/group health insurance is licensed. Companies must stay away from small, unlicensed business
insurance companies even if they offer a good deal.
Another way to
determine a good group health insurance program is to check the company ratings.
Standard & Poor’s, Moody’s, and A.M. Best Company are examples of firms
that review and rate insurance companies based on credit obligations and
financial credit. Some of these firms even offer information on companies that
offer health plans for employees.
Referrals from other
companies that utilize the services of a group/business health insurance
company would greatly help in choosing the right program for employees. This
could provide insight on the service quality as well as the contact information
of a specific insurance company.
To examine the website
of a group health insurance company is also a must. Details such as products
and services, investor information, claims, customer services, and press
releases, could help in determining how the health insurance company works.
Oftentimes, the chosen
“best deal” is not exactly a good deal when reviewed properly. Thus, it is
important to keep in mind that a good group health insurance plan is
cost-effective and of high quality.
Click here to view this article
01/30/2010
When it comes
to researching health insurance plans, any person would be tempted to only
glance over the jargon and the fine print. But this method would not be
beneficial when a person is comparing the different types of health insurance.
One has to spend time carefully analyzing the various alternatives that are available. This could help
the individual save a lot of money when seeking the best insurance deal.
Health insurance comparisons are not hard to
do, especially these days. It is not necessary to call a lot of people on the
telephone since information gathered over the Internet is easily accessible. Information
about the majority of insurance companies can be found as easily as clicking a
mouse button. Aside from this, searching for information is not limited to
regular office hours only. Don’t just visit the website of a specific insurance
company – utilize comparison sites that contain a broad range of information on
health plans and their providers.
Spending enough time when dealing with health
insurance comparisons is a wise decision to make since everyone has different
needs. The health plans that the various companies offer might be similar in
their structure, their rates could be significantly different and some health
plans may have options that are not necessary to the applicant. Effective
health insurance comparisons will help the applicant decide on what health
plans will provide them greatest benefits.
Click here to view this article
01/30/2010
The population of elderly people
is rapidly increasing and this means providing a better and more efficient medical
insurance plan for them.
Americans have put pressure on
the government to implement improved health care insurance packages that should
provide complete services to people including senior citizens.
However, the cost of the health
care package for older people has skyrocketed, with Medicare benefit payments
totaling $374 billion in 2006. The total cost accounts for 12 percent of
federal government expenditure and 20 percent of the total health care spending
in the country.
The elderly now amounts to 13
percent of the population but they use up more than one-third of the country’s
health care services, including out-of-pocket expenditures and supplemental
insurance policies. Over the next decade, an 8-percent increase in spending
will be seen annually.
Elderly patients are no always aware
of cost in terms of their medical care consumption, including their use of
prescription drugs. Studies show that elderly people would lessen their medical
insurance consumption if cost sharing was to increase. When prices of drug co-payment go up,
elderly people’s drug consumption is reduced as well. The research also suggests that the demand for any kind of
drugs is price sensitive.
Therefore lower consumption of essential
drugs, as a result of a high price tag, may lead to a person becoming more
ill. This event may maximize his
or her need for hospitalization, leading up to more costs.
It is, therefore, important to
remember that the most adequate health insurance plan would have health status
linked to cost sharing.
Click here to view this article
01/30/2010
A lot of people are allergic to something, whether it be an object or an
environmental condition. Though these allergies can be prevented, there are
certain instances wherein people come into contact with some of these things,
thus, resulting to pain and discomfort.
An allergic reaction is usually triggered by something that is not
usually harmful to other humans. This reaction is connected to the person’s
immune system and caused by a variety of things including pollen, pets,
medication and dust.
According to experts, being allergic to something is generally inherited
from the parents but it can also be caused by other factors such as changes in
the environment. Some of the most common manifestations of allergy are
sneezing, itching, swelling, and rashes.
For a doctor to identify the type of allergy a person is suffering from,
he or she should undergo a rigorous allergy exam. This would entail the
methodical documentation of one’s medical history. The person will be screened
of the different kinds of allergy-related symptoms and assessed by the doctor
in terms of how the body reacts to certain allergens.
The coverage of a person's HMO might be affected depending on the
allergy. Most medications for
allergies are not covered by the person’s insurance. However, there are other health plans that include
allergy-related illnesses in their premiums.
Click here to view this article
01/30/2010
Traveling is a great way to unwind and free your self from
the confines of everyday living.
No one wants their special trips to be ruined by any worry, which is why
it pays to be extra cautious when it comes to safety and health. After all, one
travels to reach places and relax. With this, medical insurance has to be
considered.
Before going on a journey, make sure to ask your health care
provider about their coverage policy when it comes to trips. Your policy might
only be applicable in your state alone and may not be valid if used for
emergency room care, doctor visits, or medications outside your state. If your
trip is within the U.S. only, take note of the providers, facilities, services,
and facilities in the area in case of emergency, like sudden illness.
Undergoing medical treatment outside the US can be
costly. Even one’s arrival can
carry risks. For instance, if a
foreign government denies your passport because of your health condition, you
may spend up to $50,000 just for medical evacuation.
American health plans are often not accepted abroad. Services of US programs like Medicare
and Medicaid are strictly to be used within the country. They also do not cover for expenses
obtained outside the U.S. If your current health plan does not provide coverage
for medical expenses outside the country, then you might consider purchasing a
major medical plan or a short term health plan.
Some companies even offer health insurance designed for
overseas travel.
Click here to view this article
01/30/2010
A health insurance exchange is a venue to purchase an organized health
insurance set up, may it be governmental or quasi governmental, to assist
insurers in terms of dealing with
the policy in a cost-efficient way, to allow consumer protections, and to aid
in the expansion of insurance to more individuals. These exchanges are not insurers per se, but they are
responsible for contacting private insurers in order to present a public plan
option to cover specific individuals like those without coverage from employers
or those given coverage by small employers.
This exchange allows accountability and transparency in insurance
coverage. This also assists in
enrollment and delivery of subsidies, and takes part in spreading risk and containing
costs. But this can also increase
premium rates, force an exchange clearance, and allow cherry-picking among
customers because of restriction in terms of eligibility and a small market
share.
However, insurance exchanges promote efficiency in the markets. Since most health insurance markets are
not organized, these exchanges could make them more structured when it comes to
seeking requirements or coverage.
The health reform initiative of the U.S. government emphasizes the
importance of a health insurance exchange. Health plan issues can be addressed as individuals will be
given the option to choose the right health plan. Prices and benefits will also be laid down for people to
assess. Health insurance will not
be denied despite a preexisting medical condition, benefit packages will be
made affordable, and those affected by catastrophes will be fully covered.
With a health insurance exchange, individuals will definitely experience
a proper health care coverage.
Click here to view this article
01/30/2010
There are 46 million Americans without health insurance. The number may come as a surprise, but
it is true.
While the Congress continues to debate over America’s Affordable Health
Choices Act of 2009, the Congressional Budget Office has revealed that
implementing this proposed law will cost the government $1 trillion. By 2019,
the federal deficit will reach $239 billion. At this cost, it is important for the issue to be analyzed
carefully.
Health care is different from a health insurance. Health care is a basic right applicable
to everyone living in the US, including illegal settlers. It is stated in the
1968 federal law that patients in need of hospital attention “must be given a
minimum level of treatment,” including those who are unable to pay.
Health insurance does not have a financial guarantee. According to the
New York Times, three-quarters of American people with health insurance filed
for bankruptcy because of medical problems.
Despite the increasing number of uninsured Americans, the Congressional
Budget Office believes that this problem is only temporary. Many individuals may have lost their
health plans because of the lay-off, but they will regain it again once hired.
In fact, in 2007, the Census Bureau reported that 253.4 million or 85 percent
of Americans were able to obtain health insurance. The Census Bureau also revealed that 10 percent of the 46
million uninsured people are not American citizens at all.
Meanwhile, it was also discovered that the 18.3 million people who had the
chance to avail of health insurance chose not to get it.
Click here to view this article
01/30/2010
More and more Americans are foregoing individual health
insurance even if health care costs are getting more expensive. Because of
this, health care reformers, as well as politicians, have been looking for ways
to address the anxiety of consumers. There is even a proposal to link the rates
of medical plans to lifestyle choices like exercise, smoking, and dieting.
A study, recently conducted by The University of California,
shows that on the average, $72 billion is being spent for treating medical
conditions associated with smoking. A separate survey, done by the Centers for
Disease Control, shows that for health issues linked to obesity, $75 billion is
being spent. The cost for the treatment and management of the said conditions
contributes to the increase in the price of the premium paid by individuals who
are covered by a medical insurance. According to some experts, unhealthy
lifestyle choices contribute to the increase in the price of a premium so much
that they have become causative factors in making health plans unattainable for
roughly 50 million Americans.
Those supporting this plan propose that people with healthy
lifestyle choices (like those who exercise regularly, maintain an ideal weight,
avoid drugs and alcohol, and refrain from smoking) should not be burdened with expensive
health insurance premiums. Rather,
they should benefit from cheaper ones.
Even if this is a controversial proposal, rewarding a person
for his or her healthy lifestyle is an example of how people are willing to
give extra effort to lower the cost of health insurance so that more Americans,
who currently do not have medical coverage, would be able to afford it.
Click here to view this article
01/30/2010
Due to the economic crisis, a lot of companies have implemented different
tactics to reduce expenditures and increase profit. Some made adjustments in their
company’s marketing tactics while others, in production. However, most companies
resorted to lay off, or simply removing employees from their job posts.
When one speaks of job loss, everything else follows. A simple employee
will be ripped off the benefits he or she has received while working. One of
the most important benefits is that of the HMO. The government thought of a plan
to reduce the burden of those who lost their jobs and came up with COBRA or the
Consolidated Omnibus Budget Reconciliation Act. Under this, the government should subsidize almost 65% of
those who wish to continue to avail of a health plan, even after being fired
from their jobs.
This system will allow the people who lost their jobs between September
1, 2008 and December 31, 2009 to continue their group/business health insurance
as they wish, provided that the cause of the termination fulfilled the
guidelines of the IRS.
In addition, COBRA does not only cater to employees from large companies. Those from small businesses can also be
part of the said government program. If an employee comes from a company that has
acquired COBRA premiums, the person will only be required to pay the remaining
35% of his or her health plan for nine months. Once the person is deemed
qualified to be part of the program, he or she can use his or her Health
Coverage Tax Credit to shoulder a portion of the insurance premium.
Click here to view this article
01/30/2010
Insurance first gained popularity during the revolutionary era.
Eventually, people began to realize the importance of securing oneself from accidents
or disasters.
When availing of hospital services, people felt the burden of rising
medical bills. Consequently, the cost of training for medical practice became
more expensive along with medical equipment and technology. Hospitals needed to
augment the medical fees charged among patients. Moreover, doctors needed to
address demands on new therapeutic means and agents. Researches on effective
medicinal cure for acute illnesses added to the cost of maintaining a health
service center.
Soon enough, Texas' Baylor Hospital came up with an idea of spreading
the cost
of a patient's health expense over a connected group in 1929. The idea
gained approval from hospital administrators and doctors. The "Blue
Cross" health insurance program was supported primarily by teachers, and soon
became popular among three million Americans.
The effectiveness of the "Blue Cross" health insurance concept
had caught the attention of private insurance companies, which later on began
offering customized health care program with additional medical benefits and
nursing care.
The State saw the plight of some uninsured employees when faced with sudden
accidents or disasters. Since then, it has offered the option of tax exemption to
companies with a condition of providing customary health insurance plan among
their employees.
The legislation of Medicare in 1960 offered medical insurance for senior
citizens and added new health care features for employees. The acceptance of
health insurance in the United States eased the cost for availing professional
medical services. Group health insurance plan has continued to provide
consolidated health assistance solutions.
Current U.S. President Barack Obama supports the national health insurance
exchange proposal, which highlights lower insurance premium dues and wider
standardized health care assistance.
Click here to view this article
01/30/2010
Health insurance statistics shows that 57 percent of US citizens avail
of health plans as employee benefits from their companies and employers. The
government provides health care coverage to 29 percent of Americans through
Medicaid or Medicare.
Self-employed people, on the other hand, usually turn to private
providers that offer individual health plans.
Availing of individual health insurance is basically more difficult than
getting a group plan. With this option, policies are handed out individually resulting
in a close scrutiny of insurance companies to an applicant’s medical history.
Since health insurance companies are profit-oriented institutions, they
expect to benefit more from consumers through the monthly premium, than through
paying of medical bills.
If someone has had a pre-existing medical condition prior to its
application for an individual health plan, the insurance company will not likely
approve the application, the reason why most apply for insurance before having
medical problems.
Moreover, it is important for a person to disclose his complete medical
history once applying for health plan coverage. Otherwise, he may fall in the
prey of ‘rescission--’ a practice in the industry where an insurance company
may claim that it has received an undisclosed medical condition, problem, or
inconsistency about their client.
So, people must beware of agents who suggest deleting a part of the
applicant’s medical history. These people usually don’t help, as they only aim
to close the deal.
Lastly, it is important to avail of health insurance for the family as
well. Statistics shows that 60 percent of family bankruptcies were due to unpaid
medical bills. Also, there are about 137,000 Americans who died because of lack
of health insurance.
Click here to view this article
01/30/2010
Most people think of healthcare as having those bottles of pills
prescribed by their doctors, and this makes prescription drugs account for over
$230 billion of the health care expenses in the country.
Amid the rising costs of many products in the market, one should
consider the best value drugs to be able to afford the necessary medications at
a reasonable cost. It would help one to compare the prices of medicines on the
Internet to find out which options to choose from.
One of the more practical ways to cut one’s health care budget is by
choosing a medical insurance plan that covers prescription drug benefits.
Some insurance providers offer prescription drug benefits depending on
the coverage, whether one is eligible for a brand-named drug or a generic drug,
or whether the drug is included in the provider’s list.
The price of the prescription drug benefits is normally included in the
medical premiums of the insured. The copayment will also depend on the type of
medical insurance program, or what kind of drug is available, whether it is
branded or generic.
The types of available drugs vary from the costs included in the health
insurance coverage. Generic drugs are often the cheapest and brand-named ones are
usually double the price of the generic. Brand-named drugs that are not
included in the list of the insurer cost more than the usual ones.
Also, some insurance plans have prescription drug benefit that allows
the insured the option for services such as mail-order prescription. It would
just require a prescription that was written for a three-month supply of the
needed medication.
Click here to view this article
01/30/2010
Lack of health insurance has been a countrywide problem in America,
causing the local, the state and the federal governments to respond. The number of uninsured individuals
will continue to grow unless the health insurance coverage undergoes a
change. To solve this, three
options for reform have to be taken into consideration.
First, there exists an option for employers to pay the health insurance
of workers. These employer
mandates are costly yet they can increase the number of insured
individuals. This scheme involves
the “pay or play” option. Employers
could “pay” the state to provide the necessary insurance to their employees or “play”
by paying for the insurance themselves.
Part time employees or smaller firms are not included according to the
legislation. This option, however,
can cause an employee’s status to shift from full time to part time.
Another option is to expand the Medicaid coverage for those who cannot
afford insurance plans. This
option, funded by the federal government, could increase employment and allow a
shift in employment status from part time to full time. One initiative from this option is the
State Children’s Health Insurance Program established by the Congress in 1997
that extends Medicaid to children in families who previously failed to qualify.
Tax credits, meanwhile, would allow individuals with low-income tax to
earn a federal tax credit. Under
this measure, a certain amount of money would be allotted for an individual or
a family. This may not be as
costly as the two previous provisions yet it is the least effective.
One has to weigh what these measures can offer to create that needed
change and give individuals better health plans. They may affect those uninsured, but they too can be costly
to the federal government.
Click here to view this article
01/30/2010
Being covered under medical insurance is important, especially for the
elderly. Some senior citizens even want to purchase additional health plans
just to cover other medical expenses that are not covered by their existing health
plan.
Medicare is the most common medical insurance for the elderly. Medicare
is a federal health plan specially designed for seniors under the Social
Security Act of 1965. Any applicant who wishes to have a Medicare health plan
should have worked for at least 10 years to become eligible. If the applicant
doesn't meet this requirement, he needs to pay for a health insurance premium.
The coverage of Medicare is expansive, although there are some services
such as in-patient hospital deductibles that have separate fees. Seniors
usually avail of secondary health insurance plans, apart from their existing
Medicare health plan, to ensure that their health-related expenses get covered.
One of the most popular options when purchasing supplemental health plans is
Medigap, an individual health insurance policy for seniors.
Another important reason why seniors need a health plan is medication.
Seniors need a lot of medicines, and since Medicare only covers limited
prescription drugs, most of them opt to avail of the Elderly Pharmaceutical
Insurance Coverage. The EPIC Program subsidizes the cost of prescription drugs,
and the good news is that it covers most prescription drugs. Their deductible
plan can also be availed by seniors who earn $20,000 annually.
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01/30/2010
Medicare Advantage offers additional benefits of hearing, vision, dental
and fitness. It includes the Medicare program Part A (Hospital coverage), Part B
(Medical coverage), as well as Part D (Prescription drug program).
Medicare Advantage can be availed through most plans such as Health
Maintenance Organizations (HMOs), Medicare Special Needs Plans, Preferred
Provider Organizations (PPOs), Medical Savings Account Plans (MSAs) and Private
Free-for-Service Plans.
Medicare Advantage offers services including all coverage in the
original Medicare plan plus the assistance on prescription drugs. Medicare
Advantage is best for employees seeking additional benefits in routine dental
check up and eye lens upgrade. Medicare Plan C also covers wider health
services in various hospitals in the country.
The state includes Part C in the premium of every employee or insured
person. Medicare Advantage offers flexible payment program for out-of-pocket
expenses compared to original Medicare. Unlike HMO that limits the options for
covered hospitals and doctors, Medicare Advantage allows more freedom in
availing special health care.
Medicare Advantage program is available for Private Fee-for-Service
(PFFS) Plan, which allows people to avail of the services through a
Medicare-approved health professional or hospital. If the insured person avails
of out-of-network services, additional charges will apply.
Medical Savings Account offers more flexible terms as it allows the
insured person to select more affordable health service fee. Prescription drugs
are covered in PFFS, while MSA requires membership to Medicare Prescription
Drug plan to avail medicine assistance.
Medicare MSA program features a bank account, which allows the insured
person to deposit certain percentage of money. At some cases, out-of-pocket
fees are needed. Special Needs Plan offers maximum coverage for senior citizens
needing nursing care, and extended health assistance. It covers all
prescription drug expenses.
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01/30/2010
Even though a
lot of people living in the United States are aware of Medicare being the federal
health insurance program that provides health plans for those over 65, they are
probably not familiar with the term “Medigap”. This stands for Medicare
Supplement Insurance, and it was designed to take care of the parts of the
healthcare coverage that have not been covered by Medicare. Medigap is ideal
for people who have medical costs that are not covered by Medicare.
Why is it a good idea to purchase Medigap for
health plans? Medicare handles two parts; Hospital insurance falls under Part
A. This helps pay for some home hospice and health care, as well as inpatient
care inside a skilled nursing establishment or hospital following confinement. Medical
insurance, on the other hand, falls under Part B. This helps pay heavy-duty
medical equipment, outpatient hospital care, physician’s fees, and other
supplies and services that are not handled by Part A.
Since some health plan expenses are not paid
by Medicare, it is advisable to get extra insurance to cover the costs like the
Part B yearly deductible, and hospital co-payments that are out-of-pocket.
Medigap can take care of the payments for co-insurance, co-payments, and the
deductibles that are not handled by either Part A or B of Medicare.
To avail of Medigap insurance, the applicant
must have signed up for both Parts A and B of Medicare health plans. If the
applicant has already signed up for a supervised care plan like a PPO
(Preferred Provider Organisation) or an HMO (Health Maintenance Organisation),
they cannot anymore avail of Medigap.
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01/30/2010
Mental Health Insurance provides mental health coverage for the insured
person and his or her children. It offers services such as counseling for children,
adolescents and adults. It has professional clinical psychology intervention,
medication, inpatient, respite care, office visits and day hospital services.
Mental Health Insurance cares for over-all family mental health with
long term assistance and guidance. It has flexible insurance payment terms and
can be modified for the person to have the freedom to pick his or her preferred
hospital and/or doctor. Managed care companies usually encourage insured
members to choose mental health professionals within their network.
If
the child of the insured member prefers a clinical psychologist outside the
accredited list, the HMO (Health Maintenance Organisation) will ask the insured
member to pay for the health expenses. Most companies offer alternatives on
mental health insurance plan, which allow partial or a maximum of 80% coverage on
mental health expense.
The mental health insurance plan works similarly as with the Medicare
program. Mental health insurance specializes in child and adolescent psychiatry
along with clinical intervention. Insured members similarly need to inquire about
yearly deductibles. Insured members may also ask for policies concerning
utilization review.
The utilization review is done by professional clinical psychologists
and nurses. It informs the managed care company or mental health provider about
the required treatment.
Parents may also request a special review in case of a child’s sudden
behavioral change. The preferred psychiatrist will coordinate with the
utilization reviewer and administer the needed treatment.
Mental Health Providers have an open customer relations program that
eases the needed counseling. Payment terms are flexible and customized
according to each client's needs.
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01/30/2010
Availing of professional health services often calls for wise selection.
Health Maintenance Organizations (HMO) and Preferred Provider Organizations
(PPO) may limit options for accredited hospitals and doctors.
Some insured persons prefer to avail of private or family doctor
services, and may encounter queries on coverage plans. A wise choice for health
insurance plan is the flexibility of out-of-network health assistance.
All health services availed from non-accredited hospitals and doctors
are called non-network services. Some private specialists are not yet enlisted
among HMOs and PPOs network. HMO charges insured persons for full payment,
while PPO charges a certain percentage.
PPO plans have higher premiums, yet it allows the flexibility of a
co-payment, covering a maximum of 80% in health expenses. The insured person
needs to pay for the remaining 20% of the total health expense. Most insured
persons decide to seek professional medical services inside HMO network, as it offers
maximum coverage and faster benefit claims process. As a result, most health
insurance providers arrange payment modes to accommodate insured persons who need
special health assistance outside of the network.
Private specialists update their accreditation documents to accommodate more
insured patients. On the other hand, managed-health-care providers are creating
new means to address the changing health needs of the citizens. Special Needs
Plan coordinates with nursing facilities to widen convenience in extended
health care service. Private family clinics and pediatrics are encouraged to
complete accreditation documents to accommodate families with children needing
medical assistance.
Professional dentists are also invited to coordinate
with Medicare Advantage arrangements. An effective health insurance provider
allows maximum coverage for medical and health care services, along with
flexibility of options and payment modes
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01/30/2010
In the United States, there are many types of health insurances that
cater to different needs and preferences. One of the most common health
insurance is the PPO or Preferred Provider Organization.
PPO, also referred to as preferred provider option, is a group of
health care providers who work with an insurance company or a third-party
administration to provide inexpensive health care to a policy-holder. In a
Preferred Provider Organization (PPO), an individual subscribes to a specific policy
that allows them to receive discounted charges from “preferred” health care
providers of PPO.
Preferred Provider Organization (PPO) features a utilization review
wherein the policy-holder or the third-party administration reviews the medical
records of the treatments provided to check if it was given as a treatment for
a specific condition, or just being used to get higher reimbursement. In addition, PPO also has
pre-certification requirement. This requires non-emergency admissions and some
outpatient surgeries to be pre-approved by the policy-holder, and have
undergone “utilization review” beforehand.
PPOs earn profit by implementing an access charge to a particular
insurance company for using their network. The organization negotiates with
health care providers in terms of establishing fee schedules. In addition, they
also supervise disputes between the providers and the policy-holders.
Moreover, PPOs also create an agreement with each other to establish a
stronger position within a particular area. Theorically speaking, this set-up
is advantageous for both the insurer and the providers. The policy-holders
remain to receive discounted medical expenses when they contract the services
of a “preferred provider”. In turn, there will be a significant increase in the
provider’s business since all insurers take advantage of the “preferred”
provider’s services.
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01/30/2010
Family planning has been an ongoing concern of both HMOs and advocates
of reproductive health. Both parties sometimes disagree regarding their
coverage, or their terms, when it comes to the issue of family planning. This
growing issue concerns the definition or boundary of the insurance’s
comprehensive care.
Insurance companies include in their family planning coverage the use of
contraceptives or access to it. However, there are groups and organizations
that are not in favor of their terms and coverage, such as churches and
religious sects.
Through different kinds of legislations, the boundaries of family
planning have been expanded, and insurance terms now cover a wider scope when
it comes to preventive measures.
Today, states require HMOs to provide their clients with a complete list
of all the contraceptives that are FDA-approved. The list includes all pills,
injectables, patches, IUDs and other types of contraceptives. Nonetheless, even
though insurance companies cover these contraceptives, employers in most states
who wish to have these scratched off their coverage are allowed to do it so. This
allows the insurance clients to have more flexible terms, and provides a wider
variety of choices for their employees’ benefits. In addition, only about 19 states
allow this kind of setup, and so it would be beneficial for religious sects to
inquire about their own federal rule beforehand.
It is important to note that state-sponsored health plans are required
to provide the people with a complete coverage on family planning as this
allows the poor to have a greater access when it comes to health care.
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01/30/2010
As one prepares to go to college, parents will usually have basic things
on the checklist including, laptop, allowances, groceries and other things, but
one should never forget to include health insurance.
Students will be more secure knowing they have medical insurance
especially those who are more prone to catching illnesses like medicine
students who are exposed to infectious diseases, or those who are likely to get
injured from strenuous activities like athletes.
In selecting the most appropriate health insurance, it is important to
check out the available options and compare it with others. Information is the
best way to decide on the best coverage for anyone.
It would also help one sort out the best coverage by considering what
the maximum value would be that one would be covered for; if there is any
deductible; its cost and how it varies with different deductibles.
Deductibles should be one of the priorities when deciding on an
insurance plan. A physician’s professional courtesy does not always cover the
deductible and it’s something one cannot rely on.
Knowing whether there are any restrictions on which physicians to use, and
what is beyond the insurance’s coverage are also some things to consider.
There are many insurance providers that accommodate students, and
college student health insurance plans can be obtained in all states from a
host of providers. Also, health insurance coverage differs by state.
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01/30/2010
During the last century, a number of individuals who suffered cancer,
stroke or heart attack died early. Their families mourned their death while
medical insurance companies made the insurance payments.
Nowadays, doctors are now making advances to prevent people from dying.
However, the downside to this is that people who suffered these conditions can
no longer go back to their old life. According to experts, the last 20 years
offered major advancements in science and technology. This led to major changes
in people’s lives and financial plans.
Insurance companies believe that an individual’s health and
income-earning ability are the most important assets one can have. Anyone is
vulnerable and may suffer from cancer, stroke or heart attack anytime. Given
that scenario, it is necessary to think of the things that should be taken care
of right away including medical insurance plans. In the event of a stroke
instead of death, one must plan carefully and take care of things that need to
be addressed.
Almost 50% of all bankruptcies in the United States are due to critical
illnesses. Once an individual is diagnosed with a critical disease, these
people often end up using all their sick and vacation leaves and their credit
cards leading to disability.
More or less, 70% of those who file for bankruptcy had medical
insurance when the disease began; however, health insurance coverage gets lost
since the insured is no longer able to pay their monthly COBRA premiums.
Thus, it is important to have a health care plan to help people
safeguard their health and protect their future.
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01/30/2010
Americans have long been battling for their right to a proper and
secured health care insurance, and women are deemed to need this privilege more
since their health could be at risk during pregnancy and even before and after
conception.
According to studies, there are as many as 1.94 million unplanned
pregnancies each year that is why the government has funded family planning in
the US to prevent the number of unplanned pregnancies from rising.
These services have helped alleviate the numbers of unplanned pregnancies
and abortion among women of different ages and economic status in the US every
year.
More importantly, women who are under these family planning programs by
the government are also entitled to health insurance programs that are publicly
funded.
Through these public-supported insurance programs, women are eligible to
receive prenatal, delivery and postpartum services that are supported by the
medical insurance program.
Since the past several years, the number of women enrolled to publicly-funded
medical insurance program has risen. Hence, early pregnancy rates among
teenaged women have dropped.
Encouraging pregnancy prevention among young women also helps them
improve their health and well being.
Moreover, publicly funded health services have a broader coverage
wherein women can avail of breast exams, diabetes and hypertension screening,
and other tests for chronic illnesses. They are also evaluated in order to
identify whether there is a need for counseling in relation to mental health or
substance abuse.
Other important services that women can avail
of in publicly-funded family planning centers nationwide include pelvic exam,
Pap test, and even HIV testing and counseling
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01/30/2010
Getting sick is becoming more and
more costly. With the medical fees you need to pay for hospitalization, and
medicine, on top of the receding economy, getting sick is not an option.
People say that quality medical
assistance in the USA is now becoming a burden, and it seems to be true. The
price of quality health care is ten times higher compared to what it was some
few years ago.
In this situation, having a
health insurance plan is the best option. Not only because it can spare you
from expensive medical treatments, it could also give you protection just when
you need it the most. Financially speaking, it is best to be prepared at all
times.
So how do health plans work? The
insurance company shoulders the medical expenses of their insured members if
the said member becomes ill. The policy provided by the medical insurance
company contains a list of accidents or causes of illnesses they cover. In
return, the insured member pays for a monthly premium for the said coverage.
Medical insurance are provided by both government \agencies and private
insurance companies.
Health plans cover everything
under the policy, ranging from basic physician check-ups to advance medical
treatments like surgery. Some companies even cover medications and prescribed
drugs, thereby reducing their costs and making them more affordable. Even
visits to the dentist are covered by health insurance plans. So only for the
price of the monthly premium, a person can get his health and his life covered.
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01/30/2010
Because the
rates of prescription medication for health plans are going up, people have
started to look for some cheaper alternatives. Prescription plans offer a resolve for the
expensive prescriptions. Discounts and plans can be dramatically different.
A lot of plans offer discount cards to the
customers, and then the customers present the cards whenever they buy any
prescriptions. A yearly fee is usually charged to compensate for the health
plans, and the cards can be obtained from non-profit groups, insurance
companies, chain drug stores, and drug companies.
It is difficult to make generalizations about
the various health plans since fees are normally tiered. These fees use
discounts in varied ways that depend on the preference of the member who is
buying generic medicines or pills with brand names. One medicine may have a
discount as big as 30%, but a generic form of that same medicine may be sold at
half the price despite showing up on a similar drug organization card. If ever
the doctor gives a prescription that involves a number of manufacturers, the
individual may realize that obtaining discounts from the prescriptions may
require more than one card.
It might be a challenge to find out about all
the details regarding some health plans since prescription plans are so varied
and there are a lot of them out there. It is advisable to take some time in
analyzing the discounts that are associated with the health plans, what
medicines the health plans take care off, and what expenses may incur when
these health plans are used.
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01/30/2010
A growing number of Americans are
not covered by a basic health insurance program. This calls for immediate
action to address the basic health needs of 45.8 million citizens.
This reality prompted Democrats
and Republicans to legislate reforms on health care, requiring adjustments on
inexpensive health insurance plans. Many analysts across the country offered
suggestions such as the "single payer" program and the "pay or
play" program.
Uninsured persons can benefit
from the proposed "single payer" program. Under this, the state will
pay or subsidize the insurance premium. On the other hand, employers may choose
the "pay or play" program. Employers may choose to provide customary
health insurance plan or pay bigger taxes instead. The tax will be used to
subsidize health care programs for the uninsured.
One of the arguments raised by
many employers is the high regulatory tax. Company owners candidly explained
the difficulty of recovering revenues since the recession began. Most companies
may struggle to provide medical insurance assistance.
The State places strict
regulations on health insurance policies. The State also places limitations on
the rating rules of health insurance providers. It also prohibits ungrounded
repudiation. The State health reform program also enforces restrictions on the
selection of medical providers.
Under the health insurance reform
act, premiums are given a limit. Insurance companies cannot increase dues in
excess of the stipulated rate. The law requires health insurance providers to
ensure the availability of medical facilities and the ease of benefit claims.
The State also obliges health insurance companies to provide discounted rates to
senior citizens.
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01/30/2010
According to a report
recently released by the Government Accounting Office, nearly 1.7 million
college students are not insured. This is sad news because young Americans are
also among those who are most likely to have medical emergencies.
The report also showed
that back in 2005, the uncompensated, non-injury-related medical expenses
reached between $120 million to $255 million. Recent reports even show that
around two-thirds of uninsured young adults do not seek treatment because of
its high cost.
Fortunately, colleges are
willing to change these figures and recently, many colleges have done something
about this, such as requiring proof of health insurance prior to enrollment.
While some colleges ask
students for proof of health insurance when enrolling, there are also numerous
colleges that offer coverage options through student health insurance.
According to GAO, around 60% of colleges offer these health plans to students.
Student health insurance is offered by 82% of four-year public colleges while
71% of four-year private colleges offer the said plans.
The eligibility
requirements for availing student health plans are less restrictive compared to
individual plans. If a student opts to take advantage of the student health
insurance offered by his school, he should be qualified for coverage once he
enrolls as a full-time student. There are even student health insurances that
allow the insured to extend it even after graduation.
Student health insurance
comes with different benefits and at different costs, so it is important to
check the policy’s benefits first.
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01/30/2010
Acupuncture has
the uncanny ability to remedy pain yet a lot of insurance companies still
prefer treatments involving massage and herbal supplements for their health plans.
This method of treatment is referred to as CAM or Complementary and Alternative
Medicine and there are several insurance companies that provide coverage for a
number of alternative therapies and medicines depending on the situation.
The quickest way
for an insurance company to incorporate alternative treatments in their health plan
is to formulate an excellent situation that requires a person to undergo
alternative therapy. The ideal way to go about this is to get a prescription
from the physician. Information on the frequency and length of the therapy is
necessary. Some examples of alternative treatments include homeopathy, stress
management for the body and mind, acupuncture, herbal remedies, chiropractic
care, and massage treatment.
A number of
insurers could save a lot of money if alternative medication becomes part of
their health plans. Alternative
treatments like biofeedback and acupuncture are cheaper compared to the usual
therapy for chronic back pain. To add to this, a handful of individuals
believe that usual therapies are not as efficient as the alternative ones. A
session of acupuncture, for example, costs around $200, but conventional
treatment could go as high as $600. Surgery could take away an amount close to
$10,000, but going through alternative treatments again and again could take
away just as much money as usual therapies would.
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01/30/2010
Most people take travel insurance for granted. Some think that having
individual health insurance will suffice in case something happens while they
are on a trip. Truth of the matter is one should get travel insurance since
there are certain health plans that have limited coverage.
If you are planning trips to local destinations, one might not need to
purchase travel insurance anymore. However, if the trip is international, it
would be smart to purchase travel insurance since most insurance companies do
not have networks outside of the country.
Travel insurances cover illnesses, accidents, deaths and the like. The
good thing about this type of insurance is that it also covers losses during
one’s travel, such as baggage and personal belongings. Since there are also a
lot of types of travel insurance, one should choose the best type of travel
insurance he or she needs.
One of these is emergency medical assistance. This assistance will cover
medical expenses that are not usually covered by one’s individual health
insurance.
The terms of travel insurances are flexible and are varied to cater to the
needs of the traveling individual. One can choose single trip insurances or
those that are extended over a certain period of time.
Prices of travel insurances depend on different factors, such as the age
of the person, the type of coverage, and the amount of the whole trip.
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01/30/2010
A lot of insurance companies nowadays are offering different kinds of
health plans to suit the needs of different people. Depending on what the
person wishes to avail of, all health care providers have flexible terms and
provisions that are deemed beneficial for everyone who wish to have their own
insurance.
Since there are a lot of offerings in the insurance industry, people
sometimes get confused as to what type of insurance they will avail. Perhaps,
one of the simplest options when it comes to getting insurance coverage is term
life insurance.
Some may not be familiar with this type of insurance. It would be best
for people to familiarize themselves with all types of insurance for them to be
able to pick the best insurance for themselves and their families.
This type of insurance is only applicable for a certain duration or
term. The time period of the insurance coverage will depend on what the person
chooses.
Although both permanent life insurance and term life insurance serve the
same purpose—that is, to provide benefits to the dependents of the insured upon
his or her death—there is a big difference between the two. Permanent life
insurance encompasses both insurance and investment. On the other hand, term
life insurance only includes life coverage. The latter is the best option for
those who are young and healthy since they will be able to avail of a much
higher death privilege at a much lower premium.
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01/30/2010
The US health reform created a big buzz among Americans. This issue has
produced several debates in Congress, which includes one on the cost of health
insurance.
The cost of health insurance depends on the age, health condition,
income, and job status of an American.
People should be resourceful when searching for the most suitable health
plan for themselves. One may acquire online health insurance quotes from the
internet to find the best health plan that will cater to their needs.
It is also part of an employee’s benefits. Majority of companies give
health insurance to their workers. Most Americans with health insurance availed
of it through their companies.
If a company does not offer this benefit, or if you are self-employed,
you can avail of health insurance by purchasing it yourself.
There are also health plans given by state governments. Medicare and
Medicaid, for example, are government health insurance that are available to
people 65 years old and above, disabled, or those with minimal and no income.
The cost of health care insurance will depend on different things, such
as the income that you earn in a month.
Health insurance also covers premiums. These are monthly fees that are
paid by the insurance holders.
If your health insurance is provided by your company, the premium is
paid by your employer. Most of the time, it is deducted from your salary. If
you purchased your own insurance, the entire fee is your responsibility.
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01/30/2010
It is crucial
to obtain a dependable health insurance policy, especially if the person finds
out that he or she has breast cancer. It is necessary for an individual to
receive the fundamental Health Plans to keep this disease at bay.
A lot of
clinics offer mammograms and breast tests on a regular basis. This gives individuals a better chance
of overcoming breast cancer, especially if they are enrolled in an excellent
HMO.
Despite of gender
or age, every human being is a likely candidate for breast cancer. The earliest
detection of breast cancer is very important because the possibility of getting
rid of the cancer is a lot higher at this point. Clinics that conduct breast
examinations and mammograms on a regular basis, as part of their Health Plans, produce
the best methods of detecting breast cancer. These tests should be performed
regularly to make sure that the cancer cells are discovered at the earliest
possible time.
A lot of women
are susceptible to breast cancer. Women have to make sure that they are
enrolled under Health Plans that could offer examinations such as mammograms
and vital medical attention needed in the event of a breast cancer diagnosis.
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01/30/2010
Every human
being goes through a low phase at one point in their lives. Young individuals
who are entering the stage of adolescence are likely to experience a difficult
period because of their emotional state.
It is normal to
feel melancholic or to experience a short fuse while going through this phase. Going through an emotional high from
time to time is also considered natural among teenagers. These feelings are
usually caused by constant pressure triggered by various forms of activities
and educational requirements. And if
these intense feelings continue to stay with the teenager or if the emotions
become uncontrollable, it might lead to a case of teenage depression.
The good news
is that a young person does not have to carry this burden alone. The teenager
has to search for help and keep in mind that one can control his or her
depression.
The most
important thing is for the person to be aware that s/he is not alone during
this stage of conflict. Teenage depression happens to a lot more teenagers than
expected, and the solution to this issue can easily be accessed.
In spite of
what an individual feels or believes in, it is a fact that many people are
concerned about the well-being of a teenager. The young person just has to be
brave enough to express his/her feelings and share his/her experiences because being
vocal is the initial and most important step to get over depression.
Depression
should not be blamed on oneself, but there are methods, such as maintaining one’s
health, and health plans that can assist an individual in controlling his/her that
would eventually make him/her feel better.
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01/30/2010
Diabetes is a medical condition wherein the body does not have the
capacity to produce enough insulin. This results to an increase in the level of
blood sugar. Insulin is a type of hormone produced by the pancreas and it is
needed in converting sugar to energy. There are a lot of risks involved in
having diabetes. Complications arise because of this disease. These include
kidney failure, strokes, amputation, and heart diseases.
The absence of a health plan for diabetic patients puts them all the
more at risk. Their treatment options become limited, making them candidates
for complications.
It is indeed important for diabetics to get covered. Different medical
insurance companies provide ways for diabetes patients to manage their disease
through doctor visits, insulin, and the necessary medical treatments.
Furthermore, since diabetes is a lifelong illness, long term health plans are
the best choice for paying medical expenses.
There are things that should be considered by diabetics if they want to
purchase medical insurance to cover their medical needs. The policy should
cover almost all possible medical treatments and medicines needed in diabetes,
including insulin shots. The policy should also cover prescription medicines.
Get a health plan that has wide coverage.
Purchasing a health plan when diagnosed with the disease may be
difficult. However, there are laws that protect people with pre-existing health
conditions, such as The Health Insurance Portability and Accountability Act. It
is stipulated under this law that employers are required to shoulder the
medical expenses of their employees who already have pre-existing conditions.
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01/30/2010
There is a growing
concern in the public regarding the rising costs of health care. Experts offer
no easy answers, but can only give straightforward explanations. Experts say that this situation occurs
because insurance companies are working around highly-regulated and fixed
operating margins.
In addition, an
increase in the premium payments for health plans are the expenses passed to
the insurance company by hospitals, doctors and other medical expenses. Other
factors, such as the use of new medical technologies, inflation, and social
problems, affect the rising cost of health care in the United States.
There are many ways
through which people can reduce their medical expenses. One way to reduce
medical expenses is to look for an alternative health-care provider that offers
inexpensive services. Some health plans provide discounts to patients when
consulting a “preferred” doctor.
Another way is to make
sure that one’s health plan covers most, if not all, areas of medical care.
Look for insurance companies that offer comprehensive yet inexpensive
health-care programs. In addition, it would be better to have a higher
deductible with low premium plans.
Some insurance
companies offer discounts to those who pay their premiums yearly. This greatly
reduces the costs one has to take care of every month. Moreover, it would be
helpful to review the policies of one’s health plan and check for any changes
or improvements. This would also help in deciding whether the current plan is
still suited to one’s current needs and preferences.
There is no easy way
to reduce health care costs. However, proper planning and healthy living can
prevent these additional costs.
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01/30/2010
Cost is an important word when it comes to health insurance or benefits.
There is a need to reduce it without compromising the quality of care. However,
this is only possible if the right system is in place.
One option is for an individual’s health care needs to be coursed
through Health Maintenance Organizations or HMOs, the solution to costly health
plans. The HMO model involves a copayment cost share scheme, in which one would
pay a general payment upon the use of a service.
The coverage of a PPO (Preferred Provider Organization) is considered to
be the least expensive of all. Under the PPO, a discount could be obtained
instead of paying the regular rate. But unlike the HMO, a copay is not involved
in this program. However, it does have a deductible and a coinsurance
feature.
A POS or a point of service plan, meanwhile, is quite similar with HMO
or PPO. However, it could be more costly if a patient decides to move away from
some of its features. If a patient, for example, decides to stay in the network
of providers and seek a referral for the services of a specialist, a copayment
is applicable. But once the patient uses an out of network provider without
seeking a referral, a higher amount will be tagged.
An HSA or a Health Savings Account, on the other hand, offers different
ways for health care to be paid. It allows individuals to pay current health
care expenses and at the same time save for future health expenses, tax-free. However,
individuals must be covered by the High Deductible Health Plan (HDHP) to obtain
HSA.
Click here to view this article
01/30/2010
There are three
different types of managed health-care plans available. One plan offers an
inexpensive plan but has a limited choice of health care providers, while
another plan offers more flexibility but at a higher premium.
The answer to this
dilemma is Point-of-Service (POS). POS is a healthcare plan that combines the
flexibility and inexpensiveness of the two other managed health plans (PPO and
HMO). Just like HMOs, POS offers members a list of affiliate health-care providers
and they can designate a primary-care physician. The PCP takes care of
everything with regard to the health care of a patient. However, the insured is
not required to elect a PCP.
In addition, it also
includes the flexibility of a PPO. POS health plans allow members to seek
medical advice complete with their benefits from any doctor, even if the said
doctor is not affiliated with the network.
Moreover, there is no
need for pre-approval when consulting with a preferred doctor. However, a
referral is needed when consulting a non-network doctor. The insured would need
to shoulder around 40% of the total cost incurred when consulting a non-network
health care provider.
One should also keep
in mind that the medical costs incurred when checked by a PCP is less than the
costs when checked by in-house health care providers.
The POS health plan is
gaining popularity among those in search of inexpensive health care coverage
because of the combined benefits of HMO and PPO. POS is great for companies
that have employees that work at several places. This health plan gives the
impression that inexpensive and fuss-free medical care is possible.
Click here to view this article
01/30/2010
Health savings
accounts (HSA) and individual health insurance help in saving money on medical
expenses. HSA also earns interest and is tax-free.
HSA is available to
those who have an eligible health-care insurance plan, which means that one’s
health plan has a high deductible. An individual can discuss HSA with his
employer, insurance companies, banks or credit unions.
People with individual
health insurance can use HSA for specific medical expenses, or HSA qualifying
expenses. There are a number of medical expenses that are covered, such as
expenses for chiropractors, orthodontists, dentists, eyeglasses and
prescription medicines.
One can also use HSA
for purchasing over-the-counter medicines such as antacids and aspirin. In addition, HSA can also be used for
paying medical expenses incurred anywhere, even in other countries.
People who have saved
money on their HSA won’t have to worry about losing it since it works just like
an ordinary savings account. If the owner wasn’t able to use the money by the
end of the year, it will carry over to the next year.
In the event that the
owner lost their individual health insurance, one can still use their HSA
despite not having a high-deductible health plan. However, one can no longer
contribute money to the HSA. The
savings in the HSA can be used as payment for the health insurance’s monthly
premiums while one receives unemployment benefits provided by the state or the
federal government.
With regard to the HSA
savings contribution, a single individual can pay a maximum of $2,850/year
while a family can pay a maximum of $5,650/year.
Click here to view this article
08/05/2009
Among the direct results
of the complexity of a highly civilized society are diverse lawsuits. Dockets
are heaped with various cases, and there are lawsuits that involve Health
Maintenance Organizations or HMO’s.
The Employee Retirement
Income Security Act of 1974 (ERISA) is a federal law that provides the
guidelines or the minimum standards concerning health, retirement and other
welfare benefit plans, as well as life insurance, disability insurance, and
apprenticeship plans. This law also prescribes the limitation of the amount of
damages patients employed by private entities may recover when they file a case
against an HMO.
Texas was the first state
to enact a law that makes it legally possible for a patient to file a lawsuit
against an HMO when the latter fails to apply ordinary care in making decisions
in health care treatment. This Texan law was put into effect in 1997. In 1999,
Georgia and California followed suit. The law in Georgia, however, is slightly
different. An HMO in Georgia may only be sued when there is failure on the part
of the organization to adjust claims in an appropriate and timely manner. The
Californian law, on the other hand, has a wider scope. While it also covers the
failure to use the amount of precaution expected in providing medical care,
such a failure must be proven to have caused serious damage or harm and
resulted in a health care service being denied, delayed, or changed.
There are also other
states that give patients the right to sue their HMO’s. These states are North
Carolina, Oregon, Washington, West Virginia, New Jersey, Maine, and Arizona.
Click here to view this article
08/05/2009
Most of the top
universities and colleges in the U.S. require their full-time students to have
a student health insurance plan. There are several options regarding health
plans from which a student can choose. In order to choose well and make an
informed decision, he or she must be knowledgeable regarding the ins-and-outs
of student health insurance policies. One such important aspect is the
limitations and exclusions of student health insurance plans.
All insurance companies
that offer student health insurance will provide a student with a list of
medical costs that are not included in the policy he or she is acquiring.
Additionally, they will let the client know which of the covered benefits have
limitations and what the limitations are. This information is easily accessible
in the plan brochure and included in the “Exclusions and Limitations” section.
Here is a list of common
exclusions in most student health insurance plans:
Pre-existing conditions
(usually for a certain time period from the date of initial enrollment)
Acne treatment
Treatment of drug or
alcohol addiction
Elective surgeries
Acupuncture
Non-severe mental illness
Self-inflicted injury or
attempted suicide
Elective abortion
Dental and vision
Maternity
Congenital conditions
Additionally, here is a
list of common limitations in most student health insurance plans:
Out-Patient prescription
medications or drugs (usually there is a maximum yearly payable or a particular
drug formulary)
Preventive health care
Repatriation
Prostate screening
Annual physical exams
Psychotherapy
Treatment of diabetes
Mammograms and pap smears
Emergency medical
evacuation
Emergency dental
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08/05/2009
Everyone has felt
emotionally down at some point in their lives. Many people have experienced
depression that manifests itself as having very little energy to perform their
jobs. Some people who are suffering from it prefer to be detached from the
world for no clear reason. The symptoms of depression may vary from one person
to another and it can have a negative impact on your daily routine and it can
also put a strain on your relationships.
Depression is not just a
state of mind and there may be several reasons for it. It can also be caused by
the chemical activities that take place in our brains, which we cannot control.
Chemical imbalances may affect the transmission of impulses to our brains that
may lead to a change in our mood and behavior. Other factors such as genetics,
stress levels, trauma, illnesses and other psychological disorders may cause
depression. A person who has undergone traumatic pain or experiences may also
suffer from depression for a while. Difficulty in work, in school, or peer
pressure may elevate stress levels and may also cause depression.
If you have been feeling
depressed for more than two weeks, then you may be experiencing clinical
depression. If you have a health plan or Health Maintenance Organization, it is
advisable that you seek the help of medical professionals. If you seek your
doctor’s help early, you can prevent your condition from worsening. Overcoming
depression will not happen overnight and it may occur again in the future. With
the help of your doctor, you can manage depression and evolve ways to help you
live a more productive life.
Click here to view this article
08/05/2009
Many types of insurance,
including individual health insurance, life insurance, and casualty and
property insurance are regulated by the state. However, it is the federal
government that regulates job-based group health insurances. In the U.S.,
people who receive health insurance from their employers enjoy the same
protection and rights. A number of federal statutes were issued to establish
these rights.
The Employee Retirement
Income Security Act, more popularly known as ERISA, was enacted by Congress in
1974. All the types of benefits enjoyed by employees are regulated by the act.
Not only does it regulate job-based group health insurance plans but it also
regulates retirement plans and pensions.
With the act, all
employees who have health insurance plans as part of their job benefits have a
right to information about their health plans. Information on the health plan
must be offered to the employees by the administrator of the health plan. This
information includes financial information, rules of the plan, and the
management and operation of the plan.
In 1985, the Consolidated
Omnibus Budget Reconciliation Act (COBRA) was enacted. It required employers
who had more then 20 employees to offer a continuation of the coverage to their
employees who need to leave their health plans because of certain reasons.
The employer must offer
this continuation to the employee (including the employee’s dependents) when
one of these qualifying events occurs to the employee: reduction of working
hours, death, legal separation or divorce, termination of employment, becoming
eligible for Medicare, and when an employee’s dependent child loses
eligibility.
Click here to view this article
08/05/2009
The total premium of a
health insurance policy should be clearly shown on the proposal’s summary page.
With all of the various financial figures that one usually finds in group
health insurance proposals, locating the important numbers can sometimes be
confusing.
Group or business health
insurance proposals are formatted in various ways, but they have some common
points that one can look for. Upon inspection, the group proposal should have a
“Plan Summary” or “Plan Grid” included in it. This part of the proposal should
provide a summary of the available group or business health plans from the
different insurance providers represented in the quote. One segment in this
summary will display the main details of the plan like co-payments,
deductibles, out-of-pocket limits, coinsurance percentages, coverage for
prescription drugs and hospitalization benefits. With the health plan choices
listed in the summary table, there is usually also a total cash amount
connected to each of the health plans. Usually, this amount will correspond to
the total premium for all the individuals and their dependents included in the
quote. This amount may or may not represent the premium cost that the employer
will pay per month. It will also depend on how much of the total premium the
employer intends to shoulder, as percentage of the employee and dependent
premium.
For instance, it is given
that the employer intends to shoulder 75% of the premium for all the members or
employees and dependents. For Health Plan X, which displays a total premium
worth $2,000 on the quote summary, the employer will pay $1,500. The remaining
$500, or 25% of the total, will then be charged to the employees.
Click here to view this article
08/05/2009
Many U.S. residents see
Alzheimer’s as a very alarming disease. But what is even more alarming is the
thought of paying for health care for an Alzheimer’s sufferer with the current
American health care system. However, there are actually health plans for those
who cannot afford the costs associated with Alzheimer’s. These options include
long-term care insurance, Medicare, disability insurance, and Medigap.
Around 42 million
Americans are covered under the Medicare insurance plan. People who are 65
years old and above and people who have qualifying disabilities receive
insurance coverage funded by the government through Medicare. However, many
people still need to supplement their Medicare coverage. Many private insurance
companies offer this supplementary coverage called Medigap.
As supplementary coverage,
Medigap can be combined with an individual’s Medicare coverage. Health
insurance companies throughout the U.S. offer this kind of insurance coverage.
State and federal laws define the coverage of the policies of Medigap. These
policies include details regarding hospital and coinsurance costs that are not
included in the person’s Medicare coverage, as well as deductibles that are
associated with a stay in the hospital.
For those worried about
contracting Alzheimer’s, one of the better options might be disability
insurance. Insurance companies only offer this kind of insurance before the
diagnosis of the disease.
In case a person does not
have disability insurance but is stricken with Alzheimer’s disease, he or she
can qualify for Social Security Disability Income, which is offered by the U.S.
government.
Click here to view this article
08/05/2009
If you are considering
having liposuction, breast enlargement, rhinoplasty, or breast reduction you
are not alone. Plastic surgery has become very common nowadays, so that people
can now have an express treatment done over a coffee break within a busy day.
In 2006, around 11 million plastic surgery procedures were completed in the
United States. However, having an elective surgical procedure can be very
expensive. Only a very small number of individual health insurance policies
provide coverage for these procedures. An example of a covered procedure is
reconstructive surgery or if the cosmetic procedure is necessary for your
health. Usually, coverage of these procedures is only provided for special
cases, and even so, it is possible that not all of the expenses will be covered
by the policy.
Health insurance companies
usually provide coverage for elective procedures under a number of special
circumstances. These special circumstances include being in an accident
(reconstructive surgery), being excessively overweight (liposuction), having a
mastectomy (breast reconstruction), and having problems with one’s respiratory
health (rhinoplasty).
To know whether the
elective procedure that you wish to have is covered by your plan or not and how
much it would cost you if it is not covered, you must consult with your health
insurance provider. However, it might be better for you to get another
insurance plan if the operation you wish to have is just for cosmetic purposes.
Getting a different plan could lessen the cost.
Click here to view this article
08/05/2009
Finding individual health
insurance at an affordable rate is an achievable reality. There are many ways
in which health insurance can be obtained. The rule of thumb to keep in mind is
that the plans that have the most members are more likely to provide more, and
therefore better, savings for their members.
Self-employed individuals
can apply for health insurance plans through the National Association for the
Self-Employed (NASE). NASE is the country’s leading resource for
micro-businesses that brings together a wide range of benefits to assist
entrepreneurs and to contribute to the growth of this important segment of the
US economy. This organization has programs known as the 105 HFR through which
small businesses are given the option to subtract all of their non-insured
medical expenses and premiums from the federal, state and self-employment
taxes.
Also by simply becoming a
member of organizations such as alumni or trade associations, an employee may
secure a cheap, individual health plan. Employees should join an association
that is pertinent to their job description. For instance if the employee is a
journalist their best option is to join the American Society of Journalists and
Authors. Nevertheless, an association does not always have to be job-related in
order to be relevant to an individual. An organization can be relevant to
someone just because he is a single dad.
These associations can
offer affordable, individual health insurance plans because, unlike group
health plans, they are not intensely scrutinized by state regulations. One must
bear in mind that the premiums offered to members will not always be uniform as
is the case for premiums in group health plans.
Click here to view this article
08/05/2009
Medical insurance plans
usually do not include coverage for medical issues that arise during a visit to
foreign countries. However, health issues, such as illnesses and accidents, do
arise. Travelers’ insurance guarantees that the insured need not worry about
any of these possibilities during his/her trip to foreign countries.
Medical insurance
companies offer several plans, including medical travel policies, which can assist
a traveler with his/her medical needs when traveling. The cost of this kind of
insurance policy varies, depending on the medical limits the insured person
chooses and his/her age. Some medical travel insurance policies even cover trip
interruption and evacuation benefits. Some offer one-year coverage while others
offer shorter periods of coverage.
Another type of plan, the
package travel insurance policy, covers more than just the traveler’s medical
needs. It also offers assistance with lost passports, money transfers and some
legal issues. The cost of this plan also varies depending on inclusions, age of
the insured, cost of the trip and the length of the trip.
Travelers may also
consider medical evacuation policies to be important. This type of travel
insurance provides transportation to the closest hospital in the event of
illness or accident. Other medical evacuation policies even cover
transportation back to the United States.
In the event of a
terrorist attack, some evacuation plans also allow the insured to cut short
their vacation, cancel their insurance and receive reimbursement. So when obtaining
travel insurance coverage for acts of terrorism should also be considered.
Since the cost of
travelers insurance is usually 4%–8% of the insured person’s travel cost, it is
best to explore the diverse coverage that insurance companies offer and find
the one that best suits your needs.
Click here to view this article
08/05/2009
Unfortunately, having your
health insurance claim denied is a common occurrence in the U.S. While there is
always hope that your claim was denied due to a misunderstanding, a resolution
of the issue is never easy.
Never assume that the
first “no” answer you receive from your insurance company is final. You are
always legally allowed to appeal the insurer’s decision. If you do choose to
appeal a denied claim, you need to act quickly. Usually, insurers will only
give you 40 days after the denial to start the process of your appeal.
The first thing you should
do is to outline your argument as to why the insurer should honor your claim. Read
your health plan policy document carefully in order to determine exactly which
treatments are included in your coverage and which are not. Insurance companies
usually cover treatments that are explicitly included in the health plan policy.
During your appeal
process, your physician may be able to write a letter of appeal on your behalf.
Many denied claims also get resolved by changing the method by which they are
billed. The billing department of your physician may be able to modify the
method of billing and resubmit it.
You may also seek help
from non-profit organizations, such as the Patient Advocate Foundation. Since
1996 the foundation has assisted more than 21 million people, involved in
disputes with their insurers. It also assists those searching for affordable
treatments who are not insured.
Your physician and
foundations such as Patient Advocate can help you phrase your arguments in a
way that is acceptable to the health insurance companies. The process of appeal
usually takes up to four business days, but for claims of more than $10,000,
the process may take up to 30 days.
Even with repeated
denials, determination always tends to get the best results.
Click here to view this article
08/05/2009
Some companies or
organizations may want to be selective when it comes to deciding which of their
employees should receive health insurance, or they may want to offer different
levels of health insurance through different insurance providers, depending on
employee level or class. For instance, a company may wish to make health
insurance benefits available to their employees at the managerial level.
Placing limits on the number of employees or members that are able to obtain
group health insurance is called “group carve out”. Some common examples of
group carve outs are “management only”, “salary vs. non-salary” and “union vs.
non-union”.
It is the insurance
provider’s right to decide whether it allows carve outs or not. The provider
may also put certain limitations on which kinds of group carve outs it accepts.
The insurance carrier may also require that a carve-out group meets the
standard requirements for minimum participation. In addition they may even
request full, or 100%, participation of all the qualified members or employees
in that carve out group. Some insurance companies may also set a minimum number
of members per carve-out group.
Most of the time carve-out
groups are not included in the state health insurance law that mandates
guaranteed issue for small business or group health plans. Therefore an
insurance company may require each member or employee in a carve-out group to
answer health questionnaires. If a member of that group is categorized as
high-risk, the insurance company may decline their application for insurance
coverage. The options and choices available to group carve outs are often
limited. Additionally, insurance providers may also restrict the carve-out
group’s employer from offering alternative choices or options through other
insurance companies.
Click here to view this article
08/05/2009
Usually an employee must
work for a company for a specified amount of time before he or she becomes
eligible for that company’s group health insurance plan. In the terms of the
health insurance policy, this is called a “waiting period”. If an employer is
going to establish a new group health insurance plan, he or she must select a
preferred waiting period for newly hired employees from several choices or
options. The options available for waiting periods may differ from one
insurance carrier to another, and it can range from one month to one year
following the date of employment.
The waiting period does
not affect or apply to employees who are employed by a company at the time the
group health plan is initially established. However, a company may impose the
waiting period on recently hired employees who do not meet the group health
policy’s selected waiting period.
Most of the time, group
health insurance plans have a “first of the month” effective date for the inclusion
of any new qualified employee. This means that if a company has a waiting
period of one month, a recently hired employee may enroll in the group health
plan on the first day of the month following the date he or she began working
for the company. For instance, if a newly hired employee starts working on
November 18 for a company that has a waiting period of one month, he or she
will then be qualified to enroll in the group health plan on January 1. A
company’s selected waiting period at the time of the group health plan’s
establishment must be applied to all new employees.
Click here to view this article
08/05/2009
Group insurance is one of
the most important benefits a company can offer its employees. In these
difficult days, some workers even choose to stay with a company just to keep
their health insurance coverage. Even businesses with as few as five employees
can offer health care coverage through group health insurance.
Group health insurance is
employer-sponsored health-care coverage issued to a group, such as trade
associations and credit unions, which provides health coverage for group
members and their dependents. With group health insurance, business owners
usually pay at least half of their workers’ health-care monthly premiums.
How does group health
insurance work? When the employee and his/her eligible dependents satisfy the
"deductible," which is the first part of the total eligible costs
that occur within a given year of coverage, the insurance company usually
shoulders 80% of the eligible expenses. Moreover, group health insurance
provides the insured with health coverage regardless of any pre-existing
medical condition.
Group health insurance
usually covers physician fees, nursing services, X-rays and medicines.
Exclusions from the provision of medical benefits under group health insurance
include certain mouth conditions, rest cures, expenses incurred due to
self-inflicted injuries and the medical expenses of a member of another Health
Maintenance Organization (HMO).
If the insured has two insurance plans, one health
plan becomes the primary health insurance which shoulders the insured’s health
care costs until the maximum eligible expense level is reached. Usually a
health plan covers health care costs of up to $5,000. The other plan, which is
the secondary insurance, pays for the expenses not covered by the primary plan
Click here to view this article
08/05/2009
According to a report,
more than 60% of Americans with health insurance get their coverage through a
group health insurance plan sponsored by their employer. These employers make
use of health insurance plans that are specifically designed for small or large
businesses. It is a fact that for many employees, health insurance is the most
valuable benefit that their job offers them. A large percent of the revenues
that health insurance companies earn is made up of the billions of dollars
spent by U.S. companies on their employees’ health insurance.
Recently, for companies in
the U.S., the cost of providing health care insurance for employees has seen a
remarkable increase. This increase is principally due to the increasing costs
of prescription drugs and health care. Many U.S. companies have been forced to
reduce the benefits enjoyed by their employees under their group health
insurance plans because of these continually increasing insurance costs. As a
result when employees need prescription drugs or medical treatment, the
expenses that come out of their own pockets increase as well.
Due to the health
insurance offered by U.S. employers, a large number of Americans are compelled
to stay with their company. This is even more common amongst those employees
who depend on the benefits provided by their employer because they have a
pre-existing medical condition that prevents them from acquiring an individual
health insurance plan. It even comes to a point when such employees are willing
to continue working for a company despite a lower salary, just to enjoy these
benefits.
U.S. companies that offer
these kinds of health care benefits usually have a low rate of staff turnover.
Attracting quality employees and lowering the rate of employee turnover are actually
the two main reasons given by employers for offering such benefits in the first
place.
Click here to view this article
08/05/2009
Access to health insurance
usually requires a steady income. Most insurance plans in the United States are
provided by employers through group insurance plans and as a result unemployed
Americans are frequently at a disadvantage with regards to obtaining affordable
health insurance.
Thanks to some federal
programs and numerous private insurance companies, unemployed Americans and
their families can now get short-term medical insurance. Among the federal
programs that offer subsidies to employees who wish to continue their health
insurance after losing their job is the Consolidated Omnibus Budget
Reconciliation Act of 1986 (COBRA).
COBRA helps pay 65% of the
former worker’s insurance premium for up to nine months. COBRA provisions,
however, only cover those who lost their job involuntarily. It also applies to
those whose employment was terminated for a reason other than gross misconduct.
Workers who are made redundant as a result of a large layoff may also obtain
the subsidy. Applicants must be eligible for employer-provided health insurance
the day before their last date of work.
COBRA is an excellent
choice for those who are able to plan their resignation. However, it can be
very expensive, with an average monthly payment of $700 for families. In 2003
only 7% of laid-off workers could afford COBRA.
For someone who is
expecting to get another job soon or those who just lost their student health
insurance plan, finding other short-term health insurance may be a better
option. A typical short-term insurance policy offers six months of coverage,
although some cover up to one year.
Health coverage of up to $2
million, low monthly premiums and fast approval of applications make short-term
coverage a good option for anybody who is still in the transition process.
Click here to view this article
08/05/2009
According to the American
Pregnancy Association, every year, 13% of pregnant women are not enrolled in
any health plan. In addition, because pregnant women find it difficult to
purchase health plans, many of them either shoulder all the medical expenses of
their pregnancy or receive insufficient pre-natal care.
Pregnant women are
frequently denied health coverage by insurance companies mainly because
pregnancy prior to obtaining insurance is considered a pre-existing condition.
To many insurance companies people with pre-existing medical conditions, such
as cancer, liver and heart disease, are “high risk candidates” who need more
financial assistance. The law allows health insurance providers to decline applicants
who are classified as “high risk”, and many of them do so.
However, pregnant women
who do not have maternity coverage in their health plan or who do not have any
medical insurance at all still have options that can assist them with their
medical expenses. One important option for uninsured pregnant women is
AmeriPlan, an American company that offers discounted maternity coverage. For a
very low monthly fee pregnant women can have access to an array of maternity
and prenatal care services. AmeriPlan also gives as much as a 50% discount at
some health care providers.
Pregnant women with low
incomes may also seek assistance from Medicaid, a health care program funded by
the federal government. Women, Infants and Children (WIC), another
government-funded organization, provides an additional option for uninsured
pregnant women. WIC even provides grants or assistance, such as health care
referrals and even food supplements to low-income pregnant women as well as to
children under five years of age who are found to be at nutritional risk.
Click here to view this article
08/05/2009
A discount health-plan
organization provides its members with access to discounted health care.
Members of discount health plans pay for membership on a monthly or yearly
basis. This type of health plan also provides discounted rates on
medical-related services.
Companies that run or
offer discount plans are not insurance companies. Discount plans are also not
insurance policies that provide broad health coverage.
Many discount plans offer discounts
of up to 40% on medical, vision, hearing and dental services. A discount health
plan is often an attractive option for those who cannot purchase health
insurance due to pre-existing conditions. Discount health plan providers,
unlike insurance companies, do not pay health care providers for their
services.
Before enrolling in a
discount health plan, make sure that the total amount you will pay for your
membership fees annually will not exceed the money you are going to save in
discounts. It is also wise to make sure that there are enough drugstores and
health care providers in your local area and that these providers are
trustworthy. A disadvantage of a discount plan is the fact that there is no
regulatory agency monitoring discount-plan companies. Therefore, verifying whether
the company you are considering is reputable or not is often a challenge. It is
necessary to assess every aspect of the discount plan before choosing to sign
up.
However, if you think you
will spend a lot on prescriptions and health care services over the following
year and if you do not have health insurance, a discount health plan might be
the right solution for you.
Click here to view this article
08/05/2009
As well as the usual
considerations when entering college, prospective enrollees and their parents
should check their insurance policies and providers to ensure that their health
coverage will continue to be comprehensive and uninterrupted.
As colleges stress the
importance of student health insurance they continue to create measures, such
as requiring proof of health coverage, which prospective students must satisfy
before being admitted. This gives students another question to think about
before deciding to enroll in their college of choice, which colleges impose
insurance requirements? From that point on, it’s all about considering
different coverage options.
According to a report from
the Government Accounting Office, 1.7 million college students in the U.S. do
not have health insurance coverage. The report also reveals that students
without coverage spent around $255 million in non-injury-related medical
expenses in 2005.
Aside from requiring
enrollees to provide proof of insurance coverage, many colleges are also
offering coverage options via student health insurance plans. The GAO report
estimated that around 60% of all the colleges in the country provide student
health insurance.
Compared to individual
health insurance plans, the eligibility requirements for student health plans
are less restrictive. If students take advantage of the policies provided by
their respective colleges they should automatically be qualified for coverage
once they register as full-time students.
The only drawback of
student health plans is the variation in benefits and cost. Coverage is very
specific. That is why it is important to examine how any policy would deal with
specific claims before deciding to buy coverage.
Click here to view this article
08/05/2009
The second most common
cause of cancer-related death in women in America is breast cancer; the leading
cause is lung cancer. One out of eight American women will have breast cancer
at sometime in their life. However, only one out of 28 American women will die of
it. If you are diagnosed with breast cancer it is important to have a reliable
health insurance policy, which will help you get the necessary health care.
With the availability of regular breast examinations and mammograms conducted
in clinics, you will have a greater chance of surviving breast cancer if you
have a good health insurance policy.
Everyone, regardless of
age or gender, can develop breast cancer. It is extremely important to detect
breast cancer early as the chances of curing it are then much higher. Regular
mammograms and breast examinations conducted in clinics are the best ways of
detecting breast cancer. These should be done on a regular basis to detect the
cancer as early as possible.
A great number of women
are affected by breast cancer. It is important that all women have health
insurance policies that not only cover mammograms, but also the necessary
medical attention that they will need if they are diagnosed with breast cancer.
Breast reconstruction, mastectomy, chemotherapy and follow-up appointments with
the doctor should all be covered by the policy. By law health insurance
policies that cover mastectomy procedures must also cover breast
reconstruction.
In 1998 the Women’s Health
and Cancer Rights Act was passed. It protects patients with breast cancer who
wish to have breast reconstruction after undergoing a mastectomy. Under this
act insurance companies and other HMOs (Health Maintenance Organizations) who
offer coverage for mastectomies must also offer coverage for breast
reconstruction.
Click here to view this article
08/05/2009
Pre-existing conditions
are medical conditions that a person has before he or she signs up for a health
insurance policy. The term usually has a negative connotation. A pre-existing
condition could make you ineligible for health insurance. If an individual with
a pre-existing condition is eligible for health care coverage, he or she will
probably pay higher premiums than usual.
Individuals with
pre-existing conditions who would like to get health insurance should not worry
as some insurers do offer coverage for people in this situation. However, a
number of restrictions may be applied. Each insurance company that offers
health plans will have a different underwriting procedure.
Pre-existing conditions
come in a variety of forms. Obesity, diabetes, arthritis, depression and
pregnancy are just some of the most common pre-existing conditions. Some
insurance companies have a list of the pre-existing conditions for which they
offer insurance coverage. Each insurance company as well as having its own list
will also have its own standards when it comes to offering insurance for
pre-existing conditions.
Usually an insurance
company will ask a newly insured person to go through a waiting period. It is
only after this period that a person’s pre-existing condition will be covered
by his or her health insurance. A number of individual health insurance
policies will ask the individual to go through a waiting period that is usually
from 12 to 18 months long. Only after this period will the company pay for any
medical expenses that arise from the person’s pre-existing condition.
Fortunately, people with
pre-existing conditions who get health insurance are protected by a number of
laws. One of these is the Health Insurance Portability and Accountability Act
(HIPPA).
Click here to view this article
08/05/2009
A large number of men in
the United States and across the world are affected by prostate cancer.
Erectile dysfunction and difficulty urinating are some of the symptoms of the
disease. Prostate cancer is the most common form of cancer experienced by
American men. It is estimated that in 2007, 218,890 American men will have been
diagnosed with this type of cancer.
Age is one of the
important causative factors for prostate cancer. Around 70 percent of American
men who have been diagnosed with prostate cancer are 65 years old and above.
According to the American Cancer Society, African-American males have a greater
risk of being diagnosed with the disease than White, Asian and Hispanic men.
Another factor that influences the disease is genetics. The risk of having
prostate cancer is directly correlated to the number of relatives a man has who
also developed prostate cancer.
With the abundant research
done on the disease one conclusion is clear, men with individual health insurance
are less likely to die because of prostate cancer.
This does not mean,
however, that men with health insurance will not develop prostate cancer. It
only means that these men can get the health care they need to ameliorate the
adverse effects of the cancer. This is one of the strongest arguments in favor
of men having health insurance. When you are searching for a good health plan,
ensure that the policy will cover prostate treatment as well as preventive
care.
Yearly prostate examinations
are recommended for men who are 50 years old and above, men who have a high
risk of cancer and men who have a family history of prostate cancer. Prostate
examinations will help detect the cancer at an early stage, thus making
treatment more effective.
Click here to view this article
08/05/2009
With the soaring costs of
hospitalization and medicines, health care has become too expensive to bear
personally. Thus, it is necessary to purchase health plans and thereby save
money.
Insurance companies offer a
wide range of options in terms of health insurance plans. The two most common
types of health insurance are reimbursement or indemnity plans and managed care
plans, such as preferred provider organizations (PPO), health maintenance
organizations (HMO) and point of service (POS) plans.
With the indemnity plan the
insured can choose his or her own physician and pay for health care expenses in
full or on an installment basis. Managed care plans offer wider coverage,
involving an arrangement between the insurance company and a selected network
of health care providers, such as hospitals and doctors. Some HMOs require that
a doctor in the network manages the entire health-care needs of the patients,
referring the patients to specialists within the network as and when required.
If you are enrolling in a
medical insurance plan, it is necessary to completely understand the type of
coverage offered by health insurance companies. Insurance companies offer
different types of insurance, such as hospital expense insurance, which covers
expenses for room, board and incidental service costs if the insured is
hospitalized; surgical expense insurance which provides coverage for surgeon’s
fees and other fees associated with surgery, and physician’s expense insurance
which pays for doctors' visits.
Major health insurance
plans provide extensive coverage and benefits designed to protect the insured
from the costs associated with injury or illness. When purchasing a health
plan, one should always examine the policy carefully and read between the
lines. Check for additional benefits, such as preventive care, coverage for
prescription drugs, mental health benefits, vision care, maternity care and
others.
Click here to view this article
08/05/2009
It is very tempting to
just scan through the fine print and the jargon when reading about health
insurance. However, this will surely not help when you are performing health
insurance comparisons. Take the time to study carefully the different options
that are available to you. Doing so can help you save money.
It is not difficult to perform
health insurance comparisons. This is particularly true today. You don’t have
to make a lot of phone calls as with the advent of the internet gathering
information has become much more convenient. There is a huge of amount of
information available online. You can find information on many insurance
companies with just a click of a mouse button. Finding information is also no
longer confined to business hours. As well as visiting individual company
websites, you can also visit websites that have information on a wide range of
health insurance providers and their plans.
You will be spending your
time wisely when you take time to make health insurance comparisons. Health
plans from different companies may be similar, but the prices can differ
significantly. It is also important to take your time when comparing health
insurance plans because each person has different health needs. A plan may have
an option that you don’t need. Comparing health insurance plans will help you
select a plan that features the options that you need.
When making health
insurance comparisons, take the time to read the fine print and to understand
the jargon. It is important to do this before you choose your provider. The
time you spend researching can certainly make a big difference when it comes to
the costs that you will eventually have to pay.
Click here to view this article
08/05/2009
With a multitude of health
care plans available, choosing the appropriate one can be tough and tedious.
That’s why it is important to understand the different considerations before
choosing a health insurance policy.
Some of the health care
providers require you to use treatments and services within their network. If
you already have a personal doctor, you can inquire whether he is included in
the health provider’s network. If you need a new doctor, you can ask your
health provider for a list of doctors within their network.
Specific medical
conditions need specialists. Just like doctors, you must check whether your
specialist is part of your provider’s network. If you don’t have one, and you
feel that you’re going to need a specialist in the future, ask your health care
provider if you need to consult with your primary-care physician before seeing
a specialist.
Pre-existing medical
conditions are also a vital factor to consider when making health insurance comparisons.
Even though this is common sense, some people still forget to ask their
insurance providers about the coverage for pre-existing conditions. Others just
assume that they are covered. For those who join a new group health insurance
plan, the Health Insurance Portability and Accountability Act or HIPAA makes
sure that their pre-existing conditions are covered, provided they have had
insurance for the past 12 months.
By taking into
consideration some of the important factors in choosing the right health
insurance plan, you will have a rough estimate of the cost of your insurance
plan. When it comes to cost, you must take into consideration variables such as
deductibles and co-payments.
Following these tips will help
you find the type of insurance that suits your needs.
Click here to view this article
08/05/2009
Nowadays, it is difficult
to find an affordable health insurance plan. The rising costs of health care as
well as those of health insurance have contributed to this. However, do not let
this discourage you from acquiring insurance or force you to get the first
health insurance plan you see. Remember that you have several options that will
still leave you with health insurance costs that you can afford.
To be able to choose the
health care insurance plan that is right for you, you will need to spend some
time looking at your options critically. Going through this process will help
reduce your health insurance costs. It is also important for you to accurately
assess the kind of health care that you need. People require different kinds of
health care depending on their age and health status.
You will be able to save
money when you get an individual health insurance plan that only covers the
kind of health care that you need. To get reduced health insurance costs, take
your time and research the various options that are available. You will find
that the differences between the prices of similar health plans from different
insurance companies can be astonishing.
These days, it is very
easy for anyone to look for health insurance plans. With the internet, finding
the best choice for you just takes a little bit of effort and time. With many
plans and providers just a click away, you can easily find a plan at an
affordable cost.
Even though costs are
rising, you still have several options that you can choose from. You just need
to do some research and take the time to plan.
Click here to view this article
08/05/2009
The U.S. health-plan
market is run by a complex system of federal state laws and regulations that
are already out of date and therefore counterproductive. One of these laws is
the federal tax code. People receive unlimited tax breaks when purchasing
health plans, if they get their coverage through their employers. Outside the
workplace, Americans pay for health insurance with after-tax dollars. The
solution to this inefficient system is a statewide insurance exchange, which
offers individuals and families the chance to obtain the health insurance of
their choice without losing tax benefits.
By law many health
insurance tax benefits are only available to those who are subsidized by their
employers or are in an employer-based system. Purchasing health plans outside
this system often entails not only inflexible government mandates and high
administrative costs, but also state and federal tax breaks. Losing these tax
breaks can mean an addition of 40 to 50 percent to the total cost of the
purchased health care plan, compared to the cost of obtaining it with an
employer's subsidy.
The solution to this
problem is a single health insurance market, which should be designed to work
well for everyone, not just for employees working for large companies.
A health insurance market
exchange should be designed to work as a market for every type of insurance
plan, including health maintenance organizations, health savings accounts, traditional
health insurance plans and other options that might present themselves in
response to people's demands
In principle a health
insurance exchange should work like a stock exchange, which functions as a
single market for all sorts of stocks and which regulates the costs of selling,
purchasing and trading stocks.
Click here to view this article
08/05/2009
A health plan is
definitely something to consider whenever you are about to have a baby or if
you are going to adopt. To protect the health of your baby, a health plan is
certainly necessary. To provide the new member of your family with the same
coverage as you, the best option is to include your baby in your existing
individual health insurance policy.
If you currently do not
have health insurance coverage, it would be very wise to consider getting a
health insurance policy. This would not only be good for your health care
needs, but for your baby’s needs as well. If you already have a health
insurance policy, another option would be to make its coverage level higher.
Now that you have a child, you must also ensure that you are able to maintain
your health so that you can take care of your child.
If you plan on adding your
baby to your health insurance policy, make sure that your policy will allow you
to do that. If possible, compare the increase in your policy’s premium after
the addition of your baby to your policy with the premium for a new policy.
Choose the one which is the most efficient in terms of cost.
It is also important to
understand the requirements that must be satisfied when adding your baby to
your policy. Doing this will help you stick to the rules set by the company and
thus enable the quick addition of your baby to your policy.
Finally consider your
policy options and the kind of coverage that they include. It is important that
your baby is fully covered. Immunizations, visits to the doctor and others
should be included.
Click here to view this article
08/05/2009
Insuring the safety and
health of one’s child is a top priority for all parents. It is therefore very
important to find a health insurance plan that will meet your child’s needs.
Health insurance will not only help protect your child’s health, but it will
also protect you from expensive medical fees. Frequent visits to the doctor and
check-ups are normal for children. With health insurance, you can have peace of
mind and ensure that your child is being well taken care of.
Parents usually find it
difficult to search for affordable health insurance for their children. It is
not surprising that they only want the best coverage option for their children.
Although the health care needs of a child are a primary concern of every parent,
it is also important to find a plan that will fit the family’s financial
requirements. Fortunately, it is no longer difficult to find appropriate health
insurance for one’s child.
Nowadays, parents have
many options when choosing their child’s health insurance plan. An individual health
insurance plan is one of these options, which parents can get from public and
private entities. A large number of PPOs and HMOs have individual health
insurance plans designed specifically for children. For families with a low
income, federal and state plans, such as the State Children’s Health Insurance
Program, offer individual health insurance custom-made for children.
Parents can also add their
children to their group health insurance plans if their employers provide them
with group health coverage. If you cannot access a group health insurance plan
from your employer, you can look for one through private agencies. A large
number of HMOs and PPOs offer family and group health insurance plans.
Click here to view this article
08/05/2009
College life is exciting
for most students. For some, it will be their chance to live independently from
their parents. Others may see it as an opportunity to set the course of their
future career that will enable them to live the life that they have always
dreamed of.
Maintaining a healthy mind
and body is especially important to students who are attending college because
of the tough academic-related deadlines and rigorous training that they face.
Students who are physically, mentally and emotionally fit perform better in
school than those who are often sick. Thus, it is logical for college
universities to demand that their students have credible student health
insurance or a health plan within their budget.
If you are a foreign
student or a domestic student attending college in the United States, a student
health insurance plan will provide you with medical coverage and protection, in
case of emergency, until you finish your degree. Students can also opt to
remain with their parents’ group health insurance plans. One of the advantages
of obtaining private health insurance is that you can access medical services
above that which your school can offer.
It is best to know the
requirements of the school that you are attending to ensure that your preferred
health service provider meets the minimum requirements of the school. To make
sure that this is accomplished, research and seek advice from professionals to
guide you in choosing a health insurance plan that will suit your needs and
budget.
Click here to view this article
08/05/2009
Every year the United
States has a large number of visitors. People come either as tourists or to
visit their relatives living in the U.S. Others also come as prospective
immigrants on various kinds of visas.
Health care in the U.S.
has become so expensive that in the event visitors get sick or need
hospitalization, it is often difficult to meet the costs. Since no one knows
when they will become ill or have an accident, it is necessary for a visitor to
enroll in a medical insurance plan, even a temporary one, covering his or her
stay in a foreign country. Medical insurance is necessary for visitors who are
staying longer, such as parents of green card holders. Older people, especially
those coming from tropical regions, cannot adapt to the cold climate as well.
The US Department of Health provides free visitor insurance
quotes and information about this topic. Medical health insurance plans usually
provide coverage for hospital stay, surgery, prescription drugs and doctor visits.
Before entering the U.S.
potential visitors should check the websites of medical insurance companies for
benefits, hospital facilities and premiums. Look for insurance companies that
offer affordable and much-needed benefits. Many visitors and new immigrants
recommend nriol.net as a source for good medical insurance agents that give
quick responses to inquiries.
Insurance companies offer
different health plans. Although there are several medical insurance plans for
travelers, these plans can be classified into two categories: Fixed Benefit
Plans and Comprehensive Plans.
Fixed benefits plans
include "Inbound USA", "Inbound Immigrant" and
"Visitors Care." Examples of Comprehensive Benefits plans are
"Diplomat Long Term Insurance", "Visit USA Healthcare Insurance"
and "World Long Term Insurance."
You might think,
especially if your stay is a short one, that traveling to a foreign country
without medical insurance is acceptable. However, although medical insurance
for foreigners may be costly, it provides peace of mind and if you should be
unfortunate and require medical treatment you will be glad that you purchased
medical insurance.
Click here to view this article
08/05/2009
For low-income earners in
the U.S., the rising cost of health care in the country has become a very big
problem. According to the Commonwealth Fund, 96% of families who earn $60,000
or more per year have health insurance that they can use to pay the burdensome
expenses of health care. On the other hand, 53% of families who are considered
to have low incomes are either uninsured or have had a lapse in their coverage.
For families without
insurance, the consequences can be devastating. Unlike persons and families
with insurance, individuals and families without insurance tend to avoid going
to a doctor. Because of high costs these uninsured individuals or families do
not get the urgent or preventative care they need. A lack of access to
preventative care often means that uninsured individuals are diagnosed with
serious diseases when they are already at an advanced stage. In addition a third of families without
insurance find it extremely difficult to pay for their medical bills.
If PPOs and HMOs are too
costly for a family’s budget, there are alternative options. These options
include the Health Savings Account and the Mini Medical Insurance Plan.
A Mini Medical Plan can
cost as little as $50 per month. This would include coverage for prescription
drugs, hospital benefits, a number of visits to a doctor and partial accident
coverage.
Another relatively new and
inexpensive way to get coverage for one’s health needs is the Health Savings
Account (HSA). HSAs work when used together with a health plan called the High
Deductible Health Plan (HDHP). The premium for an HSA is significantly lower
than premiums for PPOs (Preferred Provider Organizations) and HMOs (Health
Maintenance Organizations).
Click here to view this article
08/05/2009
A student who wishes to
obtain formal education abroad must secure a good health insurance policy.
There are two types of health insurance policies a student might consider,
international travel insurance and student insurance in the country where they
plan to study. The type of insurance commonly bought in a student’s home
country before they go abroad is international travel insurance. Student health
insurance, on the other hand, allows a student to pay only a percentage of the
medical expenses at the time when medical services are rendered. This medical
cost is called co-pay.
For an international
student who wishes to pursue full-time study, at least six credit hours in the
United States, he or she must be at least 14 years of age but not older than
65. Such a student must be eligible to enroll or should have enrolled in one of
the required courses. These courses are as follows: a formal university ELS
program, Ph.D., master, bachelor or associate. Also, the student must be a
holder of a J1 or F1 visa. Spouses and unmarried children aged 19 or below may
be included in the health insurance policy.
There is also
pre-existing-condition exclusion for a period of one year, which means that for
a period of one year medical treatment required because of existing health
problems will not be covered by the plan.
For US residents who wish
to study abroad, the terms and conditions of student health insurance policy
are similar, though the amount of coverage may be different, depending on the
country.
Click here to view this article
08/05/2009
Millions of
Americans are totally uninsured, while millions more struggle to fit
ever-increasing health insurance premiums or the high out-of-pocket cost of
covering gaps in their policies into budgets that are already stretched to the
limit. It is clear that most
Americans are ready for a change. The only question is: “What kind of healthcare reform makes
the most sense?”
The current
system of medical insurance in America has several glaring problems. The freedom of choice that makes
American business so unique—supply and demand, consumer-driven competition,
etc.—is virtually non-existent in the health insurance industry. The tax incentives for employers who
offer medical coverage to their workers, along with federal and state insurance
regulations that make policies the property of these employers, limit the free
market system. Patients are taken
almost completely out of the equation and are usually forced to settle for the
coverage their employer has chosen for them. Furthermore, because policies are owned by employers,
employees must leave their insurance when they leave their job. This eliminates portability of coverage
and, in some cases, continuity of care.
Finally, moral and religious objections of patients who participate in
group plans are overlooked. Group
premiums are combined to pay for a wide range of services for all members. This can include things like abortion,
birth control, and stem cell treatments.
If an employee objects to a procedure on a moral or religious basis,
they are powerless to redirect their premium payments away from those services
because their employer controls which insurance policy they are offered and
what types of coverage those plans include. The employee’s only choice is to reject coverage altogether,
which is never an attractive option.
Liberals
who support health insurance reform tend to favor a single-payer, government
sponsored system similar to those in many European countries. These plans would provide universal
coverage to all Americans, regardless of employment or income status. Contributions would be combined into a
single fund that would be used to pay healthcare providers for all services
rendered.
Conservatives
largely oppose the liberal model, believing a single payer system will actually
raise healthcare costs for all Americans.
Some conservatives propose a federal tax credit that would extend to
individuals who purchase their own insurance the same tax breaks enjoyed by
employers who offer group coverage to their workers. Others advocate a plan that would allow people to keep the
same medical coverage no matter where they work, and to take a plan from job to
job. Another faction supports
allowing individuals to purchase health plans from states other than their own
without penalty.
No matter
which reform model they champion, the ultimate goal of activists is to bring
true freedom of choice to health insurance and open a free market system in the
industry. This would make coverage
more affordable for millions of people and would expand a patient’s control
over his or her personal healthcare.
Insurance companies would be forced to offer more competitive rates,
premiums, benefits, and coverage options; thus opening access to essential
health insurance for a multitude of uninsured Americans.
Click here to view this article
08/05/2009
When you
enroll in a group health insurance plan you join a group of other people and
combine your purchasing power in order to obtain healthcare. Since the insurer covers the whole
group rather than individuals, everyone shares the costs. Payments are combined and used to help
offset the cost of care for all members—healthy people essentially pay for
treatment for sick people with the understanding that this same help will be
available to them if or when they need it because they, too, are members of the
group. This system reduces the
risk of personal financial disaster due to healthcare costs that may arise from
injury, illness, or medical condition.
The
following is an example of how a typical group health insurance plan works:
Joe has a medical
health insurance plan through his job with a $1,000 yearly deductible, 15%
patient responsibility after the deductible has been met, a $4,000 out-of-pocket
limit per year, and a $5 million lifetime maximum. At his annual physical, Joe’s doctor tells him he’ll have to
have an operation that is going to cost $100,000. Joe doesn’t panic, though, because the operation is an
approved treatment and will be covered by his medical insurance. With his deductible—the amount Joe must
pay out of pocket before his insurance policy coverage kicks in—Joe must pay
the first $1,000 of the cost of his surgery. After that, Joe’s insurance will kick in with a percentage
of the total cost called coinsurance.
Because his policy has a 15% patient responsibility, after Joe pays his
deductible his insurance company will pay 85% of the remaining cost of the
surgery, or $84,150. Joe must pay
15%, but only until his annual out-of-pocket maximum is reached. The out-of-pocket cap is the maximum
amount a patient will have to pay for healthcare each year. Joe’s out-of-pocket maximum is $4,000,
so Joe will be responsible for his $1,000 deductible as well as an additional
$3,000 to reach his out of pocket cap.
Joe’s insurance company will assume responsibility for the remaining
$11,850. This brings the insurer’s
total contribution to the cost of Joe’s surgery to $96,000. Even if Joe has to go to the hospital
again before the calendar year is up, because his annual maximum and deductible
have been met, his insurance will pay 100 percent of his expenses. Joe’s lifetime maximum is $5 million,
so his insurance will continue to pay his medical bills up to that amount for
the life of his policy, provided Joe pays his premiums on time, and meets his
yearly deductibles, his percentage of coinsurance, and his out-of-pocket
maximums as needed. Joe’s surgery
is a success and he goes to see his doctor for a follow-up appointment. The surgeon’s office charges $250 for a
visit and Joe’s insurance plan requires a co-payment for doctor visits. If Joe’s plan has a $20 co-pay then Joe
is responsible for that amount and his insurance company will cover the
remaining $230 for the cost of the appointment.
Click here to view this article
08/05/2009
When
choosing a health insurance plan it is important to honestly assess your
current health, your risk factors for future conditions, and your budget. Plans vary in terms of services covered
and cost, but remember that the cheapest premium or the greatest number of
covered benefits does not always mean the best value. Obviously, the goal is to choose the plan that will cover the
services you need at an out-of-pocket price you can afford. This is what determines the best
insurance value for your money.
Every
insurance plan will cover doctor and hospital bills, with varying
limitations. Virtually everything
else—prescriptions, vision care, dental care, mental health treatment,
preventative care—may or may not be covered depending on the plan. It is important to make a list of the
services you and your family regularly use. Once you’ve made your list, note the benefits for each
category as laid out by the plan you are researching. For example: prescriptions,
50 percent covered; pediatric care, 100 percent covered; eyeglasses, not
covered; etc. This will help you
identify healthcare plans based on the services you actually need and use, and
will help you determine how comprehensively each plan will meet your particular
needs.
In this
tight economy, we are all concerned about the bottom line. If you are in good health and do not use
any medical services, your out-of-pocket costs will be limited to your monthly
premium. If you regularly use
several medical services, your actual out-of-pocket expenses may be hard to
gauge since you will have to factor in deductibles, co-pays, excess charges,
and payment for treatments that are not covered. The cost for joining a Health Maintenance Organization (HMO)
is fairly easy to estimate as patient fees are fixed and nearly everything is
covered once the premium has been paid; so long as services are rendered by an
approved network provider. For
other types of medical insurance, doing an accurate cost evaluation can be more
difficult because out-of-pocket expenses are based on whether you seek care
within the organization’s network or choose an outside provider or treatment
facility.
Many
insurance plans limit patients’ choice of providers to a list of approved
doctors and specialists. Some
plans require patients to seek approval before getting treatment or using
services. If you have special
needs or are already established with a trusted physician who does not
participate in your new plan, you may want to reconsider changing your
insurance. You will have to pay more out of pocket—sometimes even the total
cost of care—if you want to continue to see your own doctor. Financial inhibitors linked to policy restrictions
include higher out-of-pocket fees like co-payments, deductibles, and increased
patient responsibility for services not covered by the plan.
Before you
make a decision about medical insurance, be sure to educate yourself about all
the benefits, costs, and restrictions of a particular plan to help you
determine the best value for you and your family.
Click here to view this article
08/05/2009
Several democrats are voting against the
health care reform legislation if it does not have an insurance program
commandeered by the government.
They also opposed a health plan of Rep. Henry Waxman, D-California and
four moderate Democrats, which entailed offering small businesses and
individuals a health insurance plan as another option to private insurance, but
they intend to negotiate the health care providers’ rates.
The Democrats, who opposed the plan of Waxman et al., want the public to
be able to pay the same rates that they pay to Medicare, which is lower
compared to private insurers.
A letter sent to House Speaker Nancy Pelosi, Waxman et al. had this to
say about higher reimbursement rates than Medicare rates, “would ensure higher
costs for the public plan, and would do nothing to achieve the goal of ‘keeping
insurance companies honest,’ and their rates down,” The chairmen of two other
committees with jurisdiction over health care reform also received the same
letter.
The letter also opposed the reduction in insurance subsidies for
middle-income Americans, which was in the compromise bill.
“We simply cannot vote for such a proposal,” the letter read.
Outside the Capitol on a Thursday afternoon Rep. Lynn Woolsey, D-Calif.
spoke at a press conference saying that most of the signers support a
single-payer health care system, i.e. Medicare for everyone. They have settled
for something that still falls short of what they are really expecting; they
are no longer willing to compromise more than that,” Woolsey said.
Sounds of the protesters were heard on the Capitol grounds shouting,
“Single-payer now.” The protesters held their rally near the press conference.
Rep. Raul Grijalva, D-Ariz., told the Obama administration and the House
leadership before that they believed in their vision of the health care reform
because of the solid public insurance plan included there.
While the press conference was in motion, Waxman’s committee worked on
the legislation. A health care reform bill has already been passed by two other
House committees, which includes a public plan that the liberal Democrats would
like more. Some of the people on Waxman’s committee and several others balked
at this provision, which pressured Waxman to broker another deal just to get
enough votes to pass the legislation. Waxman’s committee is expected to vote on
this bill on Friday.
House leaders will have a difficult task managing the Democrats’
dissension, when Congress comes back from its August break. The bill has two
versions that the Congress has to mould into one, and one of the two groups of
Democrats (Blue Dogs and Liberal) are going to be disappointed with the final
verdict.
Insurance companies and several business groups do not approve of the
public plan. They argue that the charge on private users is higher compared to
Medicare because Medicare pays below-market rates for their services. If the
government makes a public plan based on the rates of Medicare the problem would
only worsen, which will cause premiums to increase for those businesses that
are covered by private insurers.
Some people are afraid that this might force private insurers out of the
market, which will leave the pubic plan as the people’s only choice.
But Rep. Nydia Velazquez, D-N.Y., stated that a public plan might just
be the thing to nudge private insurers to lower their rates and try to compete.
Click here to view this article
08/05/2009
Health Maintenance
Organizations (HMOs) are a form of managed healthcare insurance. Customers belong to a larger group of
plan participants and pay fixed monthly fees in order to receive care. Providers receive a fixed,
pre-negotiated fee from the insurance company in exchange for their
services. Most HMOs only cover
services provided by a limited network of doctors and facilities.
Many
employers and government agencies use HMOs to offer health insurance for
employees. The overall goal of the
HMO is to keep medical costs low for all members. Insurers accomplish this by contracting with specific
doctors, dentists, clinics, hospitals, and other providers, and insuring large
groups of patients. This allows
the company to negotiate for lower prices based on volume participation. HMOs also lower premiums by identifying
and eliminating certain procedures and treatments they deem medically
unnecessary.
As with any
health plan, there are advantages and disadvantages associated with HMOs.
The cost of
a monthly HMO premium is relatively inexpensive when compared to other types of
health insurance. Premiums are
fixed and co-payments are usually the only required out-of-pocket expense for
patients; some HMOs do not charge co-pays at all. Most HMOs require patients to designate a primary care
physician who acts as a single point of contact for all other care. While some see this aspect of HMOs as a
disadvantage, others find it comforting to know that their care is being
managed by a single provider who has access to their complete medical records
and healthcare history.
Choosing a
primary care physician can be problematic, however, as patients may have to
switch doctors and thus interrupt continuity of care. Patients typically have less control over their own care and
may have to wait to receive treatment if they need specialized care. If a patient wishes to see a specialist,
she must first make an appointment with her primary care physician. If the primary doctor deems the
specialized service medically necessary, he will submit a referral to the
HMO. The HMO either approves or
rejects the proposal and, if the referral is approved, only then is the patient
free to make an appointment with the specialist. If the referral is denied, the patient must then choose to
forego the treatment or will have to pay the total cost of services out of
pocket. Another disadvantage of
HMOs is that they typically limit coverage in an effort to cut costs, focusing
on treating conditions as they arise rather than on preventative care and
long-term health.
When
considering purchasing an HMO plan, think about your particular needs. Do you have a condition which requires
specialized care? Might you need
this kind of treatment in the future?
If you already have a doctor you trust, will you have to find a new
one? Would a change in physician
interrupt your care? Finally,
research the HMO’s reputation in your area and figure out if the cost of the
plan is reasonable for the level of care you will receive as a member.
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08/05/2009
The high price
of health insurance can be intimidating, deterring many people from taking on
the additional expense, especially during these difficult financial times. However, even a minor motor-vehicle accident
resulting in injuries can run up expenses that may seriously drain personal
savings. In the long run, not
having any medical coverage can cost much more than paying a monthly health
insurance premium.
According
to a 2008 survey conducted by the Kaiser Foundation, the average cost of
employer-sponsored health insurance for an individual was about $4,700 per
year; the cost for a family of four was just over $17,700. For those who do not have the benefit
of a health plan through an employer or spouse’s job, the cost of purchasing an
independent individual or family plan can be considerably higher. If you are thinking about buying health
coverage on your own, use these figures as a baseline for your own research.
When it
comes time to comparing plans and prices, be sure to keep in mind the factors
that may affect your final premium.
These include age, gender, health history, location and the type of plan
you select. Because older people
typically require more medical treatments and preventative care, most health
insurance plan premiums jump significantly for consumers over the age of 50. Females can expect to pay more for
health insurance, though the exact reasons for this are unclear. A history of good health translates
into lower premiums, while some pre-existing conditions could exclude you from
coverage altogether. Prices for
health plans vary from state to state, so your residency could also have an
impact on how much you will pay for coverage.
When you
begin your search, check the Internet for online health insurance quotes. Your initial quote will take into
account only your most basic information:
your age, gender and state of residence. This figure is meant as a starting point only and may not
give you a comprehensive picture of your final cost. Once you have made a decision about the kind of plan that
best suits your needs, you will complete an application and receive a more
accurate final quote. The
application will likely include detailed questions about your health history
and any pre-existing medical conditions; some health plans may even require a
doctor’s physical examination or basic medical tests. The number generated by this second quote will be much more
representative of what you can expect your monthly premium to be.
Of course,
if you prefer not to go it alone when purchasing health insurance, you can
always turn to a reputable broker.
These insurance experts will have expert knowledge of the market in your
particular area, as well as personal relationships with several insurers that
will help you make a truly informed decision. You can also visit your state’s insurance department website
for more information about the rules and regulations specific to your location,
or to explore state-sponsored healthcare plans you may qualify for.
Click here to view this article
08/05/2009
Choosing a
primary care doctor or a specialist can be a daunting task, but it is an
undoubtedly important decision and worth taking the time to do the proper way.
First,
check with your insurance carrier for a list of approved providers. If your plan restricts you to seeing
certain medical professionals, you’ll want to know this ahead of time. This will help you narrow your focus to
only those doctors in your plan’s approved network and will save you the
out-of-pocket expense of treating with a non-network provider.
Once you
have a solid list of leads from your insurance company, ask around for
recommendations. Talk to neighbors,
friends and co-workers; see if they have any experience with or knowledge of
any of the physicians on your list.
Next, do a
background check. This is easy to
do online and you can get important information about a doctor’s educational
history, records, licenses, board certifications, and even any disciplinary
action or lawsuits brought by patients.
Your state medical licensing board is a good place to start. You can also consult the Administrators
in Medicine database or the American Medical Association’s Physician Select
website.
Consider
why you need a doctor. Do you have
any family history of serious illness or medical conditions? Do you or a dependent family member
require specialized care for an ongoing health concern? Are you seeking homeopathic or
alternative medicine? What
personal factors would make you most comfortable—is a doctor’s age, gender,
primary language, or years in practice important to you?
When you
have chosen a doctor or two, schedule an interview appointment. This is the best way to get a feel for
a doctor’s personality. Judge a
potential candidate on the factors that are important to you. Did the doctor
answer your questions? Listen to
your concerns? Take his or her
time in the interview to make sure you were satisfied?
Some other
questions you might want to consider:
How far is the doctor’s office from where you live or work? Which hospital does the doctor
use? Where would you go to have
lab tests or x-rays done? Is the
doctor accepting new patients and, if so, how long will you have to wait to get
an appointment? What is the office
staff like? How would you get help
if you needed to speak to someone after hours? How does the doctor handle referrals? Will the office staff take care of
insurance paperwork for you or will you have to file claims and seek
reimbursement on your own? How
many other doctors are in the practice, and will you be able to see your own
doctor every time you visit?
If you
conduct a careful search and educate yourself not only about potential
healthcare providers, but also about the details of your insurance plan, you’ll
find that choosing a quality physician is much less intimidating than it may
have seemed at first.
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08/05/2009
Medicaid is
a federally-sponsored health insurance plan that serves low income individuals
and their families. As the third largest
provider of medical insurance in the US, the program makes it possible to get
health care for those who would otherwise have to go without because of
financial difficulties.
Medicaid
generally covers three types of crucial protection: insurance for low-income families with children and people
with disabilities, long-term care for older Americans and those who are disabled
and supplemental coverage for low-income Medicare beneficiaries to pay for
services not covered by Medicare, including co-pays, deductibles, premiums and
the cost of prescriptions. No
monies are paid directly to Medicaid recipients; all funds associated with care
go instead to the providers offering treatment.
Each state
sets its own guidelines for Medicaid.
States decide on income limits, program benefits, and which services are
covered or excluded. Some states
require patients to pay a nominal fee for doctor visits and other
services. Requirements for
eligibility range from state to state, as well. However, typical factors that influence eligibility include
a patient’s age, disability status, pregnancy, legal blindness, income level
and financial resources such as bank accounts, property, or other assets; and
citizenship or immigration status.
There are special qualification rules for those living in nursing homes
and for disabled children living at home.
The program covers children provided they are US citizens or lawfully
documented immigrants, even if their parents are not. Program specifics vary
greatly from state to state; check with your state’s Medicaid office to find
out the particular regulations for your location.
Income
level is just one factor that determines a person’s eligibility for Medicaid
enrollment. Financial hardship
alone is not enough to qualify someone for coverage and Medicaid does not
provide coverage for all poor persons.
In order to be eligible for the program, applicants must meet income
level limits and fall into one of the following categories:
-Pregnant
women, married or single
-Infant children of women on Medicaid
-Children under age 18
-Disabled children under age 18 being treated in a 24-hour nursing facility who
could be cared for at home with access to money for special services
-People aged 65 and over who are blind or disabled
-Patients who are terminally ill and desire hospice care
-People being treated in 24-hour nursing facilities who could be cared for at
home with access to money for special services
-People leaving welfare programs and in need of medical coverage
-Those who are pregnant, under age 18, over age 65, blind or disabled with very
high existing medical bills they cannot pay.
Once
Medicaid eligibility is determined, coverage is usually retroactive up to three
months prior to the approval date, provided the applicant would have qualified
for Medicaid during that time period.
Program eligibility stops as soon as a participant’s financial
circumstances improve enough to put them over the income limit set by the
state. Each state employs several
qualified caseworkers to help potential applicants determine their Medicaid
eligibility status and benefits according to state regulations.
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08/05/2009
Medicare is
a federal health insurance plan for individuals over the age of 65, or for any
disabled person under the age of 65 and any person with end-stage kidney
disease. There are four basic
parts to the Medicare structure:
Part A, which covers hospital care; Part B, which is traditional medical
insurance and covers doctor visits and other services; Part C, sometimes called
Medicare Advantage and only offered in certain areas of the country; and Part
D, which is optional prescription drug coverage.
Once a
person is eligible for Medicare, there is a seven-month enrollment period. This includes three months before the
applicant’s 65th birthday, the month of the applicant’s birthday and
three months after the applicant’s 65th birthday. Program registration is automatic if
the applicant is already receiving Social Security benefits or railroad
retirement income, or by self-enrollment if neither of these conditions
applies.
Upon
initial enrollment, all Medicare recipients are automatically covered by Part A
for hospital bills. There is no
premium for this part of the program; funds come from Medicare taxes paid
during an individual’s working years.
Part B coverage is optional and pays for doctor visits, outpatient
procedures and other services; a monthly premium is required. To avoid paying more for Part B
coverage one must still be working and enrolled in an employer-sponsored health
insurance plan at the time of Medicare eligibility, or purchase Part B coverage
within eight months of the end of a group policy protection. It is generally wise to sign up for
Part B coverage upon initial Medicare enrollment, regardless of employment
status at the time of eligibility.
Medicare
Part D prescription coverage is also optional and available to all eligible
recipients regardless of income level or health status. Registration is required and coverage
for prescription medications is provided through an approved private insurer. Costs for prescriptions will vary
depending on the plan and there are penalties if Part D enrollment is delayed
upon initial Medicare registration.
The only way to avoid these penalties is to have been covered through an
employer or union at the time of enrollment.
Medigap
coverage, also called Medicare supplemental insurance, is an increasingly
popular option for many Medicare enrollees. This insurance, purchased through a private underwriter,
helps bridge gaps in Medicare coverage.
These policies pay for things like deductibles and co-pays, while some
provide additional services not offered by Medicare. Most states require these plans to be standardized to allow
consumers to compare them more easily.
Applicants have up to six months following Medicare enrollment to
purchase gap insurance without penalty for pre-existing conditions or medical
history. This open enrollment
period happens just once and finding coverage later on could be more difficult,
as some companies deny protection for certain conditions. Those who are still employed or covered
by a spouse’s work policy can save their open enrollment until it is needed.
Contact
your local Social Security office for more information about Medicare, program
eligibility, enrollment procedures and coverage options.
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08/05/2009
Individual
states have regulated private insurance companies since the late 19th
century. State regulation is meant
to make insurance affordable to more people to make sure insurance companies
are financially viable, to protect consumers against fraud, and to ensure
customers receive the benefits they have been promised.
While
states remain the primary regulators of insurance companies and the products
they sell, federal standards are set for employer-sponsored medical plans and
all states must work within this larger framework imposed by the federal
government.
Rules and
policies vary widely from state to state and each state in the US has a unique
set of standards that insurers selling policies there must adhere to. However, there are some common
guidelines that all states impose; most of these involve claims activity. Insurers are always required to be
financially secure enough to pay for claims made against policies. All states require prompt payment of
claims benefits and fair claims practices. Aspects of health insurance that vary by state include
access, rating, and coverage.
As
for-profit organizations, insurance companies—like any other business—seek to
maximize profits while minimizing loss.
Some states regulate this activity with guaranteed-issue laws, which
prohibit insurers from denying group coverage to individual applicants based on
health history or current medical conditions. Some states extend this right to individuals, as well. Guaranteed renewability laws are
another way to combat unfair practices.
Several states have laws that prevent insurers from cancelling group
coverage based on claims or sudden diagnosis of a serious illness. In these states, all group and
individual plans must be renewed annually once issued so long as the company
continues to sell policies in that state.
To stop unfair market practices, some states mandate that insurance
companies must promote all of their coverage options to businesses regardless
of employees’ health or previous claims history. Several states also require companies to guarantee access to
insurance for special populations.
These polices are usually meant to protect infants, disabled children,
and disabled adults who have been covered under a parent or guardian’s policy
since childhood. A few states have
continuation laws, which force small businesses to offer COBRA insurance to
former employees whether or not those companies are subject to the federal
COBRA program.
Rating
practices in some states prohibit or restrict the ability of insurers to charge
higher premiums based on a patient’s current health status, claims history, or
any future risk for illness or injury.
States with
covered benefits legislation often have a wide range of standards governing the
types of medical services and procedures that insurance companies are required
to include in polices sold in the state.
These are sometimes called “mandated benefits.”
Every state
has an insurance department charged with overseeing all policy issuers
marketing products in the state, performing audits, implementing corrective
measures, taking legal action when necessary, and educating the public about
companies operating in the state.
Your state’s department is an excellent source of information about
healthcare coverage regulations in your particular location.
Click here to view this article
08/05/2009
One of the
most common types of managed care health insurance plans are Preferred Provider
Organizations (PPOs). A PPO
supplies medical services for members at discounted prices by providing a
network of approved providers and facilities for patients to choose from. However, PPOs also allow group members
to seek covered care outside of the network for slightly higher fees.
The main
advantage of a PPO over other kinds of managed care health insurance is the flexibility
patients have to manage their own care.
Policyholders do not have to designate a primary care physician or
coordinate referrals for specialized care, nor are they limited to seek
treatment within the plan’s network.
This means that patients can typically choose any doctor, hospital,
clinic, or lab they want. Though
the cost of obtaining care outside of the health plan’s network is slightly
higher, non-network services are still covered and the PPO will pay a portion
of the cost of care. For example,
a PPO might cover 90 percent of the cost of heart surgery if performed by a
doctor in the plan’s network. If a
patient chooses to use a surgeon outside the network, the PPO might pay only 70
percent of the cost. The patient
would then be responsible for the remaining balance. Another advantage of the PPO model is that patients can
refer themselves to specialists at any time, for any reason. With other managed care plans, a
primary care physician must first deem a procedure medically necessary before issuing
a referral for treatment with a specialist. In a Preferred Provider Organization, members are free to
decide if and when they see a specialist without needing approval from another
doctor or the plan.
Perhaps the
biggest disadvantage of PPOs is the cost.
These types of plans usually cost more than other managed care options
because of the increased flexibility the PPO offers. Deductibles and premiums are usually higher as well. Most PPOs require patients to pay a
small amount out of pocket for medical services like doctor visits and
prescriptions, whether care is obtained in-network or out. These co-payments can range from just a
few dollars to more than $30 depending on the service. Furthermore, there is little room for
negotiation in seeking treatment outside of the plan’s network. Even if the care you need is not
offered by a PPO network provider, you will still have to pay more to use an
out-of-network doctor.
As you
consider which health plan is best for you and your family, your budget and
specific medical needs will determine the type of insurance you choose. If specialized care is something you
use frequently, or if you want to have the freedom to manage your own medical
care, a PPO might be your best option.
If you can manage a slightly higher monthly premium and yearly
deductible, a Preferred Provider Organization will provide the flexibility and
expanded choice in coverage that will help you get the care you need.
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08/05/2009
The average
lifespan for an American is about 80 years. Although there is an increasing focus on making better
lifestyle choices like diet, exercise, and preventative care, no one is immune
to the effects of aging. Some kind
of physical or mental incapacity will eventually drive many of us to spend at
least part of our later years in long term care situations.
In 1994
about seven million Americans needed some form of long term care, at an average
cost of $44,000 per person, per year.
By 2000, that number had risen to more than nine million people and
nearly $56,000 per year.
Currently, the cost for long term care hovers around $75,000 per person
annually; and, it has been projected that by 2030 more than 23 million Americans
will need some kind of long term care, at an average cost of up to $300,000 per
person yearly.
So what is
long term care and why is it so expensive? Long term care provides essential medical services either in
the home or in 24-hour nursing facilities for elderly people with conditions
like Alzheimer’s, Parkinson’s, stroke, and those related to the effects of
advanced age like dementia and physical incapacitation. Care is usually tailored to meet a
patient’s particular needs and involves constant monitoring by nurses, doctors,
therapists and aides. There are several
different levels of long term care:
in home care by family and friends, in home care by a professional
caregiver, residence at an assisted living facility, and comprehensive care at
a skilled nursing facility -- also called a nursing home.
While
studies have shown it is more beneficial for patients to remain in their own
homes for as long as possible, the costs for this type of care can add up
quickly. Families are then forced
to make important decisions about the long term care of their loved ones based solely
on financial factors rather than on the course of treatment that would provide
the most benefit for the patient.
Most health
insurance plans do not cover long term care, and Medicare will only pay for
care for a limited time period and under very specific circumstances. Medicaid and plans offered through the
Veteran’s Administration do pay for long term care; but because funds to these
programs are limited, the quality of care is sometimes lacking.
Purchasing
a separate long term care insurance plan, therefore, makes sense. Long term care coverage supports your
independence as you age, gives you more choice in your care, and protects your
loved ones from financial hardship.
Premiums for this type of insurance generally increase as you age;
however, once a policy has been purchased, the price is locked in for the life
of the policy regardless of a patient’s aging or health. Experts recommend people as young as 40
start thinking about long term care insurance. For those who can afford the monthly premiums, this option
ensures a lifetime of protection at a reasonable cost. A price comparison of
long term care insurance plans can be conducted online.
Click here to view this article
08/05/2009
As people
continue to struggle through the recession, there’s increased focus on taking
care of savings and other assets in order to secure the future. One of the best ways to provide a
safety net for your loved ones is by purchasing life insurance. There are two different kinds of life
insurance: term life and whole
life.
Term life
insurance is generally the best fit for the largest number of people. Simply, this is life coverage only,
meaning in the event of the death of the named insured the policy pays face
value to a designated beneficiary.
Term life can be purchased in increments of one to 30 years. Except for the extremely elderly, these
policies are always less costly than whole life insurance.
Term life
insurance has two types of premiums.
Level-term premiums remain constant over the life of the policy and can
be paid in increments; annual renewable premiums increase as the policy holder
ages. Some term policies offer the
option to convert to whole life later on without a medical examination. This can be a good choice for policy
holders who have become seriously ill or have developed a severe medical
condition, but for the average life insurance customer these conversions are generally
not advisable.
Whole life
insurance combines a traditional term policy with an investment piece—typically
bonds and money market accounts or stocks. The investments attached to the policy build cash value over
time which can be borrowed against before the policy term is reached. The two basic elements of whole life
policies are the mortality charge, which is the part of the premium that pays
for coverage, and the reserve, which goes toward the investment portion that
earns interest. As the policy
holder ages the reserve portion of the premium gradually decreases and the
mortality charge increases. Some
whole life companies credit the reserve annually with investment dividends.
Whole life
polices may seem like easy money, but the fact is that they are risky. The value of the policy can fluctuate
along with the markets and usually do not earn as much return on the initial
investment as other more traditional portfolio options like stocks, bonds and
mutual funds. Whole life is also
very expensive and those on a fixed income or limited budget probably cannot
afford to purchase as much coverage as they need.
When
estimating how much life insurance coverage you need, calculate the approximate
amount your spouse or dependents would need to maintain their current lifestyle
in the event of your death.
Factors to consider are any retirement income or pension you would
eventually be eligible for, when that income would begin, and the age of your
dependent children at the time you purchase the policy. Most experts recommend buying coverage
equivalent to at least ten years’ worth of your current salary. People over a certain age and those
with pre-existing medical conditions tend to pay higher premiums so it’s a good
idea to purchase life insurance while you’re relatively young and healthy,
though you should hold off until you have dependents.
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08/05/2009
For those
who cannot afford private health insurance, there are several public health
insurance options available.
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08/05/2009
Short term
health insurance, sometimes called major medical coverage, is a category of
health plans offered by private insurance companies that protect otherwise
healthy people from the possibility of a serious health crisis that could cause
severe financial hardship. Short
term insurance is meant to be just that—temporary—and can be a viable option
for people in transition.
Most short
term policies can only be purchased for a specific, predetermined period of
time, usually up to six months.
Some companies do offer policies with longer terms, though, some up to a
year or more. Coverage ranges, but
is generally focused on treatment in the event of a significant accident or
injury. Plans that offer more comprehensive
coverage are generally much more expensive than catastrophic plans, making them
a less popular option for many customers.
Short term
medical insurance policies often have very strict qualifying standards and
usually do not cover pre-existing medical conditions. These types of temporary polices are not a good fit for
patients who require extensive or long-term care for an illness or injury, or
for those who are looking for a policy that encompasses a variety of services. Short term policies generally do not
cover things like mammograms, physicals, immunizations, pregnancy or
childbirth, dental, or vision care.
All plans also clearly exclude coverage for pre-existing conditions,
defined as an injury or illness that has been diagnosed or treated within the
previous three to five years.
Purchasing a short term plan also negates a patient’s eligibility for
participation in the Health Insurance Portability and Accountability Act
(HIPAA). HIPAA plans cover
treatment for pre-existing medical conditions that would make it difficult for
patients to find other kinds of health insurance. Patients who qualify for HIPAA should not consider short
term medical insurance.
While short
term medical insurance is not meant to be a lasting solution to health coverage
needs, it can be a smart choice for many people. This type of coverage is best suited to those between jobs,
those waiting for insurance from another source such as a new job or spouse’s
plan, for early retirees who are not yet eligible to enroll in Medicare, and
for recent college graduates, discharged military personnel, or the recently
divorced. The application process
is relatively simple and involves a few basic questions about medical history;
coverage usually begins immediately, sometimes within 24 hours of application
approval. Most plans offer
flexible payment options with a wide range of premiums and deductibles to
choose from. Policy holders
typically have the freedom to choose their own doctors and hospitals without
restriction, though sometimes financial incentives are offered—in the form of
lower co-pays and fewer out of pocket expenses—for seeking treatment with
network providers.
Certainly,
short term or major medical policies are not for everyone. Yet for already healthy people looking
for an affordable safety net to protect their assets in the event of a
catastrophic injury or illness these plans are an excellent fit.
Click here to view this article
08/05/2009
If you
choose to enlist the help of a professional insurance agent in deciding on a
health plan, the following are some important questions to ask before
committing to a policy:
1. What kind of agent are you, and what
company or companies do you represent?
Some agents are “captive”, meaning they are only licensed to sell
products from a single company. Other agents are independent, which means they
can represent a variety of companies.
An independent agent usually has more flexibility in helping you find
coverage to suit your needs.
2. What is this plan’s deductible? Does
this amount apply to each individual on the policy or my family as a
whole? Most plans have a per
person/per year deductible, which means each person in your family has his and
her own deductible that has to be met before coverage kicks in. Some plans offer a “worst case
scenario” deductible, which applies if your family is in a serious accident
together or everyone gets sick at the same time. In these cases, the deductible only applies to one or two
people before coverage takes over for the entire family.
3. What is this plan’s patient
responsibility and stop-loss?
Patient responsibility, or coinsurance, is the percentage of the cost of
services that the policyholder is responsible for paying. A stop-loss number sets the maximum
dollar amount that an insured’s coinsurance percentage can be applied to. It
basically works to set a limit on a patient’s out-of-pocket expenses for a
calendar year. Once this stop-loss
number has been reached, the insurance company will pay 100 percent of the cost
of services for the remainder of that year.
4. What is this plan’s yearly maximum
out-of-pocket expense? This will include
things like co-payments, deductibles, coinsurance percentages, and other fees.
5. What is the lifetime maximum benefit,
and does this plan have a per-illness maximum? Most plans have either a $2 or $5 million lifetime maximum,
which is the ultimate amount the insurance company will pay if you or someone
in your family becomes seriously ill.
Per-illness caps are restrictions placed on how much an insurance
company will pay for individual illnesses or serious injuries. Some plans require patients to stay
within these limits in order to qualify for the lifetime maximum benefit.
6. Is this a scheduled plan? Some health insurances stipulate a
scheduled structure—fixed costs for procedures—even if those procedures cost
more than the policy allows. Patients
are responsible for paying any remaining balance out of pocket.
7. Are yearly doctor visits limited? Most quality plans let you visit your
doctor as many times as you want, but some plans restrict how often you can see
a physician in a single year.
8. Does the plan offer prescription drug
coverage?
9. Are there any other fees associated
with this plan? Hidden fees can
add up quickly and may become seriously burdensome if you or one of your
dependents requires long term care, a lengthy hospital stay, or emergency room
care.
Click here to view this article
08/05/2009
Many
Americans over the age of 50 have a difficult time qualifying for health
coverage. Some of these people are
self-employed, have taken early retirement, or have exhausted COBRA coverage following
a lay-off. Because Medicare
benefits do not take effect until age 65, the only option for many of these
“in-betweeners” is to purchase individual health insurance coverage.
While
buying an individual health insurance policy is a viable option for many
people, several problems can arise for those over the age of 50. Some insurance companies require new
applicants aged 50 and older to undergo a physical or series of medical tests
to rule out potential health issues.
Also clients with a pre-existing condition such as cancer or diabetes
may be rejected for coverage based on their medical history.
There are
options available for those over the age of 50 who are looking for health
insurance. Fee-for-service plans
offer the most freedom, but premiums are higher than with any other individual
coverage, making them cost-prohibitive for many people. Managed care is perhaps the most
popular choice for individual health insurance. In managed care, HMOs, PPOs, etc., insurance companies establish
contracts with doctors and hospitals to provide care for plan members at an
agreed-upon rate. These types of
plans typically involve a network of approved providers and plan members are
free to choose facilities and services from the network. Choice can be limited, however, and
patients may have to pay more out of pocket to see a non-network provider. Managed care plans often require small
co-pays for office visits and prescriptions. Open enrollment managed care is another attractive
option. Customers have a one-month
window of opportunity during which the insurance company must let people join
regardless of medical history or pre-existing health conditions. This is an excellent choice for those
who have been excluded from other plans or have been denied coverage based on
their health. Open enrollment
managed care usually does not require a medical exam.
For those
who are members of a trade organization or labor union, association-based
health insurance may be available and offered at discounted group rates.
Some states
have programs called high-risk pools, which are good options for those in poor
health who have been denied coverage elsewhere. This is a last resort kind of plan and in order to qualify
an applicant must have been refused medical coverage by at least two
independent insurers and be unable to find coverage anywhere for less than the
monthly premium offered by the risk pool.
Another option for those who are struggling to get coverage is a
specific disease policy. These
limited plans pay only for care associated with a particular medical condition such
as cardiovascular disease, cancer, diabetes or hypertension. Coverage can be spotty, though, and it
is generally advisable to find a more comprehensive plan if possible.
The process
of comparing and purchasing health insurance can be daunting. Consult with a trusted broker for help
in deciding which plan best suits your needs.
Click here to view this article
08/05/2009
According
to a recent government study, roughly two million American college students are
uninsured and these students account for almost $300 million in uncompensated,
non-injury related health expenses each year. While young men and women are generally considered healthier
than other demographic groups, they are also far more likely to need emergency
medical care. Furthermore, many
uninsured college students simply choose not to seek necessary care or
treatment because the expense is too great. The issue is of such importance that some colleges now
require prospective students to produce proof of adequate medical coverage as a
condition of acceptance. Luckily,
there are several options for these students and their families.
Because so
many colleges and universities require students to have medical insurance, most
schools—both public and private—now offer health plans to new enrollees. In fact, more than half of American
colleges have some sort of medical insurance for students. Eligibility requirements are less
stringent than with private individual plans, coverage begins immediately upon
full-time enrollment, and some plans even extend benefits for several months
beyond graduation. However, there
are huge variations in cost and coverage depending on the school. Some plans cover students only while
they are on campus, and most suspend benefits when students are at home or
travel abroad.
The
majority of college students between ages 18 and 23 who do have medical
insurance are covered under someone else’s plan—usually a parent or
guardian. The benefits of
dependent medical insurance are that there is no interruption of coverage, the
plan terms remain the same even though a student does not reside in the home
full-time, and there are none of the restrictions imposed by school-sponsored
health plans. There are also
drawbacks to this kind of coverage, though. Most employer or union plans require students to be enrolled
full-time, meaning that if a student drops below a certain minimum number of
credit hours coverage could be suspended or terminated. Many of these plans also have age
limits when coverage automatically drops for dependents; this can present a challenge
for students who plan to pursue advanced degrees following their undergraduate
work. Finally, married students
are often excluded from coverage as dependents regardless of age or university
enrollment status.
Other
options include employer-sponsored medical insurance for students who work full
time, private medical insurance plans purchased from an agent or provider, or
state-sponsored plans like Medicaid.
In these cases, students can obtain coverage tailored to their specific
needs and budget. Complications
can arise, though, for those with pre-existing medical conditions—many
companies will deny coverage for these kinds of risk factors. However, different plans have different
guidelines and requirements so it pays to shop around even if coverage has been
refused because of an existing condition.
Many state-sponsored risk plans offer medical insurance for those who
have been denied by a private insurer because of a health condition.
No matter
what, always carefully review the options, restrictions, benefits and costs
thoroughly before committing to a plan.
Click here to view this article
08/05/2009
Sometimes
even the most comprehensive health insurance plans do not provide coverage for
dental and vision care, or severely restrict patient access to these important
services. Purchasing extra
coverage for dental and vision care services can be a smart way to supplement
an existing health insurance policy or obtain essential coverage to help you
and your family stay healthy.
A dental
health maintenance organization (DHMO) is typically the least expensive option
for supplemental dental insurance.
Members of DHMOs are required to choose from an approved list of network
providers and, as long as patients use an in-network provider, most services
are fully covered including cleanings, x-rays, braces, implants, and even some
cosmetic procedures like teeth whitening and veneers. A small co-payment for services is often required, but there
are no limits to the number of times members can see their doctor during a
calendar year.
Dental
indemnity plans give patients complete freedom to choose any provider they
wish. Indemnity insurance will pay
a portion of the fees related to services and the insured individual is
responsible for the remaining balance. These kinds of plans are usually the most expensive option,
but they remain an attractive possibility because of their flexibility.
Preferred Provider
Organizations (PPOs) are less expensive than an indemnity plan, but usually
cost more than a DHMO. Patients
have the option to choose a provider from the PPO’s approved network or to pay
slightly more out of pocket to see an oral healthcare professional outside of
the group’s network.
A scheduled
plan reimburses patients for a set amount of money based on a list, or
schedule, of covered services. For
example, if a policyholder’s dentist charges $50 for a routine cleaning and
insurance pays $25 according to the schedule, the patient is responsible for
the remaining $25. Many scheduled
plans set a maximum calendar year benefit, which means that a patient is
responsible for any and all charges that exceed this amount in a single
year. There are also yearly
deductibles, and some plans require a waiting period before patients are
allowed to seek certain types of care.
Dental
discount plans are not the same as insurance. For an annual membership fee, patients are given a card that
provides access to specially discounted rates on services. All costs are paid out of pocket by
plan members. Usually these
discount plans offer unlimited use within an approved network of providers.
Vision
insurance can help defray the costs of things like annual eye exams, eyeglass
frames and lenses, contacts, and even vision correction procedures like LASIK
surgery.
A vision
benefits package provides services in exchange for an annual premium. There are usually yearly membership
fees, deductibles and patient co-payments, as well. Like dental discount plans, vision discount programs offer
comprehensive, unlimited care at discounted rates. These plans may require an annual membership fee and
deductible.
Both dental
and vision supplemental insurance are relatively inexpensive and are a good
investment if your comprehensive health plan does not offer coverage, or limits
access to these services.
Click here to view this article
08/05/2009
State
Children’s Health Insurance Programs (SCHIP) were established by the federal
government in the late 1990s to provide health insurance to children in
families living at or below the national poverty line who do not qualify for
Medicaid. SCHIPs are meant to
protect children whose working families make too much to be eligible for
Medicaid, but not enough to afford private health insurance. The program is administered by the US
Department of Health and Human Services.
At its
inception in 1997, SCHIPs were the largest expansion of taxpayer-funded health
insurance coverage for children in the US since Medicaid began in the
1960s. Several attempts have been
made recently to expand SCHIP coverage and funding in order to reach an
increasing number of uninsured children, but each measure was met with
opposition by federal lawmakers.
Finally, in February 2009, President Barack Obama signed a bill
extending SCHIP coverage to an additional four million children and pregnant
women. This bill also eliminated the waiting period for legal immigrants to
begin receiving coverage.
Every state
has an SCHIP. Each state has the flexibility to design its own plans and maintain
control over their state-specific eligibility requirements and kinds of
coverage offered while working within broader federal guidelines. States have several options when
structuring SCHIP. The funds can
be used to expand income limits for Medicaid, which opens up public-sponsored
health insurance to more children. An SCHIP can operate as a completely
separate entity -- independent of Medicaid -- or states can create a program
that combines these two approaches.
Eligibility
requirements vary by state, but most states stipulate that uninsured children
in families that earn up to twice the amount of the national poverty level
qualify for SCHIP. Some states set
higher income limits, while a few states have lower limits.
SCHIP
coverage also varies by state, with some states offering more comprehensive
care to program participants than others.
In broadest terms, SCHIP provides necessary well-child care, regular
check-ups, immunizations, dental care, and treatment of illnesses for millions
of children who would otherwise go without medical care. Studies have shown that children
enrolled in SCHIP are nearly two times more likely to see a doctor and get
routine dental care on a consistent basis than children who do not have any
health insurance at all.
SCHIP is
vitally important for the millions of American families struggling to pay for
medical care. In just the first
seven years of SCHIP existence, from 1998 to 2005, the number of uninsured
children dropped by nearly three million; despite the continued growth of child
poverty populations and the significant decline in the number of children whose
families have access to employer-sponsored health insurance. The number of children enrolled in
SCHIPs has steadily increased since the program’s inception, and the latest
legislation amendments should continue these positive results.
As the
current economic recession continues to drag on, SCHIPs provide some relief for
working parents who cannot afford health insurance. At the very least, their children—some of the most
vulnerable victims of the healthcare crisis—can have access to quality medical
and dental care through SCHIP.
Click here to view this article
08/05/2009
PRIMARY
CARE DOCTORS: Some health
insurance plans require patients to use only those doctors included in a
limited network of providers and you’ll have to pay more of your own money to
see someone outside the network.
If you must choose a new doctor, research credentials and background
information through the American Medical Association website.
SPECIALISTS: If you have an existing condition you
are currently being treated for or anticipate you will need specialized care in
the future, find out how the plans you are considering deal with this. Some insurers require a referral from a
primary care doctor in order to approve specialized treatment, while other
plans let you choose your own specialists as you see fit. You should also find out if your plan
requires specialists to be part of a network of approved providers.
MEDICAL
CONDITIONS: Health plans vary in
coverage for pre-existing conditions—some cover them 100 percent, some exclude
them totally, some fall in the middle.
The Health Insurance Portability and Accountability Act (HIPAA)
guarantees coverage for existing medical conditions if you are forced to join a
new plan through an employer or if you were insured for at least 12 consecutive
months by another carrier, regardless of your current health status.
EMERGENCY
CARE AND HOSPITAL STAYS: Find out
what treatment facilities are covered by your plan. You should also find out how your plan defines an emergency
medical situation. Some insurance
plans set restrictions on urgent care, and some require patients to contact
their primary care provider before seeking emergency treatment.
PREVENTATIVE
CARE: Will your plan cover things
like yearly physicals and health screenings? If you have dependent children you will need to know if the
plan pays for things like well-baby visits and immunizations.
PRESCRIPTIONS: If you currently take prescription
medications, or think you might someday need them, consider plans with good
prescription drug coverage already built in. Find out which prescriptions are covered, whether you have
the freedom to choose generic or name brand drugs, and what costs you will
incur out of pocket for your medications.
OBSTETRIC
AND GYNECOLOGICAL CARE: For women,
you will want to find out if your plan covers routine gynecological care. If you are thinking about having
children, find out if your plan covers fertility treatments, prenatal care, and
labor and delivery costs.
ADDITIONAL
SERVICES: Some patients may also
be interested in seeking coverage for things like substance abuse, mental
health, home health services, hospice, experimental medicine, and alternative
or homeopathic treatments. If any
of these areas are of interest to you, be sure to research plans that offer the
type of coverage you want.
COST: Be certain you understand a plan’s fee
structure, premiums, deductibles, co-pays, coinsurance, and lifetime maximums
before you make a decision.
EXCLUSIONS,
RESTRICTIONS, LIMITATIONS: Now
that you have educated yourself about what your plan will pay for, make sure
you ask about anything that will not be covered. These exclusions and restrictions can run up high out-of-pocket
expenses quickly if you are caught off-guard.
Click here to view this article
08/05/2009
A Health Savings
Account (HSA) is a way for people to save money that they can use to pay for
medical expenses. The funds
contributed to these accounts are designated to pay for routine medical care or
can be left to build interest. The
money can either be withdrawn during the year to pay for healthcare, or can be
left alone and used as a savings account for the future. The program was signed into law in
December 2003; and first became available in January 2004.
All HSAs
have two major qualifications:
participants must already be enrolled in a high deductible insurance
plan, and the account is subject to the same regulations as a tax-free trust
made up of a combination of savings and investments.
An HSA only
covers qualifying medical expenses as determined by the IRS. This prevents fraud and helps secure
funds for when people need them most.
The coverage options for an HSA are quite broad and include things like
dental and vision care that many traditional insurance plans do not offer.
The
premiums for an HSA are generally much lower than those of some comprehensive
plans that also require co-pays, as well.
Since the funding for an HSA is theoretically generated from the fact
that money is not being spent on an insurance plan, participants are spared
co-pays and yearly deductibles. Individuals
can also deduct the annual deposits to their HSA from their gross yearly
income, resulting in tax-free savings.
This all generates a comparatively lower out-of-pocket cost for participation
in an HSA than a more traditional healthcare plan.
The policy
of allowing money to stay in the HSA even if it is not being used also
encourages consumers to become educated about their health insurance, and makes
policy purchasers more of a driving force in the process of buying and selling
health insurance. Owners of HSAs
have more incentive to check medical bills carefully, compare the costs of
treatments, and to honestly evaluate their medical needs in order to protect
their savings.
Not
everyone is able to start an HSA; eligibility standards do apply. Patients must first have a high
deductible health plan (HDHP), which means that the annual plan deductible for
an individual must be at least $1,050 with out-of-pocket expenses not exceeding
$5,250 per year. For families, a
policy qualifies as an HDHP if the annual premium is at least $2,100 and
out-of-pocket expenses are no more than $10,500. These HDHPs may not charge co-pays for doctor visits or
prescriptions, but they can be network plans like HMOs or PPOs. An HDHP may have a low deductible
benefit so long as that benefit only applies to preventative care. HDHP family plans only qualify for an
HSA if insurance will not cover any services until the entire plan deductible
is met.
If you set
up an HSA but do not have a qualifying high deductible health plan you can be
penalized by the federal government.
If you think you might qualify for a health savings account or want more
information, consult an insurance professional before taking action.
Click here to view this article
08/05/2009
Due to the current economic state
of the world, hundreds of people are being laid-off. In addition to that, some
employers are reducing or eliminating health benefits, which lead to several people
having no health insurance policy. In order to survive these trying times, here
are a few tips on how to keep your health insurance policy:
1. In the event that you get laid
off, use COBRA (Consolidated Omnibus
Budget Reconciliation). COBRA gives you the opportunity to keep your health plan for 18 months even
when you have lost your employer health coverage. As long as your health plan
is still in existence COBRA can let you use it. You can qualify for some health
insurance that your employer is offering if his/her business is still operating.
Despite it being expensive COBRA is much cheaper than individual or private
health insurance plans.
2. Living healthily will
definitely aid you in times of economic struggle. By living healthily you have
a better chance of avoiding sickness and therefore not having to use your
health insurance policy.
3. Consult your doctor about
discounted fees or certain treatments and drugs that are more affordable.
4. Try to live with lesser
stress. Stress is one of the major killers and you shouldn’t take this lightly.
A stress-free life means lesser trips to the doctor and lesser chances of using
that health insurance policy. So exercise regularly, sleep early and avoid
stressful situations. Also try getting into yoga and other activities that help
the body relieve stress and promote well-being.
5. Quit smoking. Smoking has
always been harmful to your body and it doesn’t take a genius to know that once
you stop smoking the better you will feel. Also, by not smoking you are more
likely to be approved for another health insurance policy/plan. Insurance
companies deem non-smokers as more risk-free so they give them lower premiums.
6. File an application for
Medicaid.
7. Get a Medicare plan, which
caters to those who are 65 years of age or older, and qualify for a certain
requirement.
8. Seek alternative medical treatments, such as herbal remedies and
acupuncture.
9. If your spouse or partner has
a health insurance plan, you can use that to your advantage by applying as a dependent.
The cost might be expensive but at least this will result to lesser coverage
rejections compared to applying for independent or private health insurance
policies.
10. Apply for a lower paying job
because more often than not these companies have a better health insurance.
Health is very important and as our economy is struggling it is much wiser to
opt for a job with lower pay but better health plans, than take a high-paying
job with minimal medical benefits.
Click here to view this article
08/05/2009
Travel can
be exciting, especially when it takes you to far-off places, and no one wants
that thrill ruined by thinking about serious matter like health and
safety. However, it pays to take
precautions and to at least consider the worst-case scenario if you are
planning an extended trip away from home, whether in the US or overseas. This applies especially to medical care
and health insurance.
Before
embarking on your trip, be sure to check with your insurance carrier about
coverage extensions outside your usual area. Your current policy may not cover medical costs incurred out
of state for things like doctor visits, emergency room care or
medications. If you plan to stay
within the US, be sure to have close at hand a list of covered providers,
facilities and services in the area where you will be travelling in the event
of a sudden illness or injury.
Obtaining
medical treatment outside the United States can be expensive, and even simply
arriving at your destination carries risks. If a foreign government was to deny your passport because of
an infection or other condition, medical evacuation can cost upwards of
$50,000. American medical
insurance is usually not accepted overseas; Medicare and Medicaid are strictly
US programs and do not provide coverage for costs sustained while travelling
abroad. If your current medical
policy does not cover care outside the US you may want to consider purchasing a
short term or major medical plan that does.
Along with
short term policies, some companies also offer plans specifically designed to
cover travel abroad. Like short
term or major medical coverage, these can be purchased in increments of time
depending on the length of your trip—anywhere from a few days to six
months. Check online or with a
trusted insurance or travel agent to review options, benefits and costs.
Aside from
making sure your insurance coverage is in order, there are several other safety
measures you can take that will make your trip more enjoyable. If you have a medical condition that
requires prescription medication you might want to carry a note from your
physician describing your situation and any drugs you are currently prescribed,
including the generic names for those medications. Be sure to leave prescriptions in the original pharmacy
packaging with the label clearly visible.
Check with the foreign embassy of the country where you’ll be staying to
make sure your prescription is not an illegal narcotic there. Pack your medications in your carry-on
luggage and consider leaving a back-up supply in your checked baggage just in
case. If you wear eyeglasses or
contacts, take an extra pair with you; pack these in your carry-on as
well. If you suffer from allergies
or any other unique medical condition you should wear a medical alert bracelet
or carry a letter from your physician indicating proper care procedures should
you fall ill suddenly and not be able to communicate.
In taking
these few simple steps to plan your trip more completely, you can relax knowing
that you will be taken care of in the event of an emergency.
Click here to view this article
08/05/2009
Diabetes is a
disease in which blood sugar levels are high because the body does not produce
adequate insulin. Insulin is a hormone used by the body to convert sugar into
energy. Enough amount of sugar in the blood is necessary but too much blood
sugar is not good for one’s health.
There are
several types of diabetes: type 1, type 2 and gestational diabetes. Type 1
diabetes is common among young adults and children. This condition usually
lasts most of their lives and in most cases, requires insulin shots. The most
common type of diabetes is type 2 diabetes which can occur at any age. This
type of diabetes can usually be treated with good diet and medications. The
other type of diabetes, gestational diabetes, only occurs in pregnant women. It
disappears once the woman gives birth.
Although the
cause of diabetes remains a mystery, genetics appear to play a great role.
Environmental factors such as lack of exercise, obesity, or too much sugar
intake can cause the development of the disease.
Having diabetes
is quite scary. It is a struggle that complicates nearly 21 million American
children and adults. Most of them are uninsured, thus, significantly limiting
their options for treatments and leaving them at high risk for other illnesses.
If you are diagnosed with diabetes and you do not have a health plan that
covers it, you should be aware of the risks that may arise later for being
uninsured. Diabetes usually leads to a broad range of diseases. Health
complications can arise as a result of diabetes. These include strokes, heart
diseases, blindness, kidney failure, and lower limb amputation.
Thus, a good
health insurance plan is indeed necessary for diabetics. Health plans offer a
way for people diagnosed with diabetes to control their condition through
insulin, doctor visits, and medical treatments necessary in treating the
disease and its accompanying medical issues. Moreover, since this condition is
usually a lifelong illness, health care should be constant and long term
insurance is the best option to pay for your medical needs.
If diagnosed
with diabetes, there are some things to consider when purchasing a health plan
to cover your medical needs. You should get a policy that covers all possible
medical needs in treating diabetes. Also consider the necessary needs for
insulin shots. Get an insurance plan that covers a good amount. It should also
cover the costs of other prescriptions.
When requesting
a health insurance quote, consider those insurance providers who are committed
to helping you get the best available health insurance.
It may be
difficult to obtain an insurance policy if you are already diagnosed with
diabetes. With pre-existing conditions such as diabetes, the new insured
usually undergoes a waiting period before the insurance policy starts to cover
his health expenses. Usually, the waiting period is 12 to 18 months. The good
news is that there are laws that help protect those with pre-existing
conditions. The Health Insurance Portability and Accountability Act requires
every company to pay for the medical coverage of their workers who have
pre-existing conditions. Also, under this law, people who have previously been
covered by a group health insurance and are purchasing a new type of health
insurance may also be able to have their pre-existing conditions covered
provided that they meet certain criteria.
Click here to view this article
08/05/2009
Many
individuals with serious medical conditions like AIDS, cancer, diabetes, heart
and kidney disease, depression, or a history of heart attacks, are ineligible
for or cannot afford health insurance to help them pay for the essential
medical care they need. If you
have a pre-existing condition, there are options for affordable insurance that
will cover your medical needs. You
just have to be creative and educate yourself.
Most of the
plans that do provide coverage for pre-existing conditions have extremely high
premiums and very limited coverage.
Although this is certainly not an ideal scenario for someone with a
serious medical condition, it is usually a much better alternative to going without
coverage altogether. If you manage
to find a company that will insure you despite your health issues, take the
coverage until you can find something better.
The first
place to search is within an employer-sponsored group plan, professional
organization or trade union coverage, or private individual health insurance. Some states have laws meant to protect
people with pre-existing conditions who are forced to change insurance plans
because of a new job. If none of
these is an option for you, though, there are still other avenues to explore.
State risk
pools are allowed in some states and protect people with serious medical
conditions. These programs give
access to either private insurance or special health plans for the uninsurable,
and provide access to comprehensive private plans. The premiums for these policies can be very high — sometimes
twice as much as the cost of private insurance for a healthy person — and enrollment
is often limited to certain times of the year, or requires placement on a long
waiting list. These risk pools are
generally a last resort for people who need care for a medical condition, are
currently paying astronomical fees for insurance, or cannot find an insurer at
all. Certain conditions and
requirements are usually mandated for enrollment into these pools. Your state’s
Insurance Department website will have more information.
Guaranteed-issue
insurance for the uninsurable and for those with pre-existing conditions that
exclude them from eligibility in a quality health plan -- also called
“mini-meds” -- are not discount health card plans. Guaranteed-issue plans are usually quite affordable, and
coverage is often surprisingly good.
Most plans cover pre-existing conditions after one year. These types of plans are not intended
to be used as comprehensive insurance; they will only pay in limited scope for
things like doctor visits, hospital stays, surgery, and emergency care. Most guaranteed-issue plans require a
medical questionnaire or physical to qualify.
Medical discount
cards are not insurance, but offer reduced rates on many services and
procedures. Yearly membership is
generally required and some plans have deductibles as well. Research discount card programs carefully
before making a decision as many of these organizations have been known to
front scams or never deliver as much as they have promised.
If you have
been turned down for individual health insurance because of a medical
condition, continue to explore other avenues for care before you give up on
getting the protection you need.
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According to
the United States Census Bureau, almost 25% of Charlottesville’s population does
not have health insurance.
There are a few
renowned hospitals in Charlottesville, including Martha Jefferson and the
University of Virginia Medical Center. Still, one in four people living in
Charlottesville does not have individual health insurance. According to
exports, college towns usually have more people who are uninsured.
When Brittany
Burgess, a resident of Charlottesville, turned 19, she decided to stop getting
individual health insurance. She chose not to have insurance because she says
she is healthy.
“I've never
tried looking into getting everything. I'll just deal without it until I really
need it,” she said.
Charlottesville’s
free clinic tends to hundreds of patients every day who do not have insurance.
According to Charlottesville Free Clinic Executive Director Erika Viccellio,
more than 30% of the youth are uninsured.
“A lot of
that has to do with trying to find jobs, or they might have beginning jobs that
don't offer health insurance,” she said. “They're typically healthy, and they
decide not to pay for expensive health insurance.”
Another
reason for the high number of uninsured, according to Viccellio, is that many
students do not leave Charlottesville immediately after they finish school.
However, that is not the sole reason.
“Charlottesville
has more small employers than large employers, and it's hard for small
employers to offer health insurance. It's expensive,” she said.
Students of
the University of Virginia are usually well-insured. In order to enroll,
students are required to have health insurance for their first school year; however,
they can drop their coverage after that. According to Dr. James Turner of the
university’s Student Health, the university’s students are the largest group of
insured people in Charlottesville.
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08/05/2009
Karen Ignagni,
president and CEO of the insurance industry’s trade group – America's Health
Insurance Plans – tactfully responded to House Speaker Nancy Pelosi’s recent
comments about insurers.
House Speaker
Pelosi just recently commented that health insurance providers were the
“villains” and they have been “immoral” in the Congress debate regarding the
health care system’s overhaul.
Karen Ignagni
told reporters in a conference call, “For a country that's trying to accomplish
what it has failed to do for a century, pass health care reform, the same old
Washington politics ... is a major step backward.”
“This is the
playbook of consultants, not of consensus.”
In 1994, the
insurance industry helped kill off health care legislation by financing and
backing the “Harry and Louise” television advertisements. However, this time
around, the health insurance group has taken a nuanced approach toward
legislation and reform. Now, it is agreeable to certain ideas with bipartisan
support, like doing away with the practice of denying insurance to persons with
pre-existing conditions. The trade group has also stayed at the lobbying table
as President Obama’s government and Congress work on the matter.
Ignagni has carefully
stood by that message during the conference call, and has avoided any
intimidating statements that the influential group could again turn into
negative TV ads if provoked any further.
"For our
part, we will set the record straight," Ignagni asserted. “The American
people wouldn't know it based on the rhetoric that has been used over the past
week or so.”
Ignagni also
denied that the health insurance industry has anything to do with the protest
groups turning up at the town hall meetings.
“That's not us,”
she remarked.
Around 25% of
population in Charlottesville does not have health insurance, says census.
According to the
United States Census Bureau, almost 25% of Charlottesville’s population does
not have health insurance.
There are a few
renowned hospitals in Charlottesville, including Martha Jefferson and the
University of Virginia Medical Center. Still, one in four people living in
Charlottesville does not have individual health insurance. According to
exports, college towns usually have more people who are uninsured.
When Brittany
Burgess, a resident of Charlottesville, turned 19, she decided to stop getting
individual health insurance. She chose not to have insurance because she says
she is healthy.
“I've never
tried looking into getting everything. I'll just deal without it until I really
need it,” she said.
Charlottesville’s
free clinic tends to hundreds of patients every day who do not have insurance.
According to Charlottesville Free Clinic Executive Director Erika Viccellio,
more than 30% of the youth are uninsured.
“A lot of that
has to do with trying to find jobs, or they might have beginning jobs that
don't offer health insurance,” she said. “They're typically healthy, and they
decide not to pay for expensive health insurance.”
Another reason
for the high number of uninsured, according to Viccellio, is that many students
do not leave Charlottesville immediately after they finish school. However,
that is not the sole reason.
“Charlottesville
has more small employers than large employers, and it's hard for small
employers to offer health insurance. It's expensive,” she said.
Students of the
University of Virginia are usually well-insured. In order to enroll, students
are required to have health insurance for their first school year; however,
they can drop their coverage after that. According to Dr. James Turner of the
university’s Student Health, the university’s students are the largest group of
insured people in Charlottesville.
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08/05/2009
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08/05/2009
The health care
debate last Wednesday reached its boiling point with the appearance of
badgering protesters, the same protesters who had plagued several other
Democratic town-hall forums prior to the debate. Democrat party leaders
labelled the critics as ‘angry mobs’ trying to ‘destroy President Obama’ while the
Republicans accused the Democrats of rejecting public opposition to their
proposals.
A few Democrats
encountered jeers, taunts and even an effigy, as the House members went home
for the August recess. Video footages of protests, intended to drown out the
health plan debate that were to be the focus in an otherwise relatively quiet
news week were seen on television and online.
As the political
power struggle is getting stronger due to the current situation, each side is
questioning whether the pickets being held at gatherings in different locations
have been arranged by conservative groups or were ignited by the common people
who just wanted to voice their own discontentment and displeasure.
Democrats have
opted to marginalize the complaints as a fringe movement, prompting House
Minority Leader John A. Boehner (R-Ohio) to respond Wednesday, "Democrats
are in denial. Instead of acknowledging the widespread anger millions of
Americans are feeling this summer toward Democrat-controlled Washington,
Washington Democrats are trying to dismiss it as a fabrication."
Some political figures attempted to find a
middle ground in the midst of the vicious partisanship.
"We have to
be careful we don't just jump to the conclusion and label every bit of
opposition above a certain decibel level as organized and contrived," Senator
Robert P. Casey, Jr. (D-Pa.) said Wednesday.
This week, Robert
Gibbs, the White House spokesman stated that the opposition contains voices
that are genuine.
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08/05/2009
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08/05/2009
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08/05/2009
Attorney General
Mike Cox and Blue Cross Blue Shield of Michigan reached a tentative agreement
last Thursday to lower the health insurance rate of increase from up to 56% to just
22%, effective October 1.
The deal would
include the company’s non-group and group conversion policies that were bought
by individuals 65 years old and below who have no employer-based or government
plans. The proposed agreement still needs the backing of state regulators.
The deal replaces
the earlier proposal of Blue Cross that included a 56% increase for every
policy. The company said that they needed the increase because of the economic
recession. Cox contested the proposal, which led to rate hearings. The company covers
about 200,000 people with its medical insurance.
Moreover, the
rate increase hearings set for the company’s Medicare supplemental or ‘Medigap’
policies will continue, since these are not part of the tentative agreement.
Cox called the
tentative deal "a victory for families who are struggling to afford access
to health care". He also said that Blue Cross’ rates would be higher if he
had not intervened. Cox is a Republican and he will be running for a
gubernatorial position in 2010.
Blue Cross Blue
Shield of Michigan would be allowed to increase their monthly premiums by $47
for non-group policies according to Cox. The original request of the company was
as high as $122 monthly.
Blue Cross says that
the state has a “broken regulatory system” that should be changed to guide the
insurance market. According to Andrew Hetzel, the spokesperson of Blue Cross, "Because of financial losses and the prospect of a lengthy rate-setting
process, we determined new rates were needed sooner rather than later".
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08/05/2009
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08/05/2009
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08/05/2009
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08/05/2009
The
bill that will merge with H.R. 3200, or the America's Affordable Health Choices
Act, has been approved by the House Energy and Commerce Committee with a 31-28
vote.
H.R.
3200 is a version that was passed by the House Ways and Means and Education and
Labor committees and was approved on August 3. On September 8, it will be voted
on by Congress after its summer recess.
The
passing of H.R. 3200 was not favored by many employers, insurers and the
public. Protests have been staged by conservative voters and America's Health
Plans at town hall meetings held by members of Congress.
The
reform on said act has, however, been postponed by the senate until September. The
version from the Senate Finance Committee is expected to be more conservative
than the version put forth by Congress.
“We're
still waiting for the Finance Committee to take action. That really is what
folks are waiting for now,” said the senior counsel on health policy, Kathryn
Wilber, at the American Benefits Council in Washington.
H.R.
3200 creates a health insurance program that competes with private insurers. The
Senate’s version is expected to widen the options with the inclusion of nonprofit
and state-sponsored cooperatives.
Advocates
of the public plan, the Obama administration and most Democrats, have been
taking into consideration the benefits to the citizens who will subscribe to
health insurance plans. The pros firmly believe that the public program will
give rise to greater competition among insurers.
According
to Watson Wyatt Worldwide’s senior consultant, Steve Raetzman, the Senate
Finance Committee is considering proposals that do not appeal at all to
employers, but the hope is that an improved version will eventually receive
bipartisan support.
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08/05/2009
A report from “The
Orlando Sentinel” stated that experts are worried about the fact that more
young workers in Florida are working without health insurance coverage because
of tight budgets.
The young employees,
who consist of about 25% of the uninsured in the state, could possibly have many
problems in the future.
According to the
report, "Of the 2.4 million Floridians in that age group, an estimated
915,000 are uninsured, according to U.S. census data. And a national study
released Thursday by the private research group Commonwealth Fund pegged the
number of uninsured young adults in 2007 at 13.2 million - up from 11 million
in 2000. That the youngest segment of the adult population is forgoing regular
doctor visits and delaying urgent medical care for lack of insurance worries
health experts, who say if the trend persists it could mean a sicker country in
the future."
The young
workers, who usually pay for their own treatments in emergency rooms or in
clinics, are actually paying for the medical expenses of older or chronic users
of the medical insurance system, according to the “Sentinel” article. However,
the health insurance reform bill that is being discussed in the Congress could
improve the current situation of the young laborers.
The report added, "Under the reform bills in Congress, Medicaid would be expanded to include
childless adults who have incomes less than 133 percent of the federal poverty
level - or about $14,400 a year; children could remain dependents until age 26;
premiums would be capped; and insurers wouldn't be able to exclude people or
charge more if they have pre-existing conditions such as asthma or
diabetes".
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08/05/2009
To win the White House,
President Barack Obama and his associates created a wide, grass-roots network
of volunteers and supporters, considered to be among the most important assets
in American politics. The network’s goal after the election was to restructure
itself into a ground-level force to push Obama’s health care reform.
But currently, as a
crucial congressional break is approaching, Obama’s health care plan is facing
stiff opposition. A few member of Obama’s network said the group is still
thinking about how to operate. Some also said they are being slowed by several
factors, including tension and disenchantment among some essential supporters.
In Chester, Va., Obama
supporter Beth Kimbriel volunteers 40 hours a week to convince people to give
their support to Obama’s health care reform. But with critics of the health
plan disseminating what she calls false information, Kimbriel finds it hard to
be convincing every time she presents Obama’s position.
Also, in Cary, N.C.,
Murray Silverstone, who said he is eager to pitch in on Obama’s health care
battle, wonders why Obama staff people arrived late in his area. It took five
weeks for Obama’s supporters to reach his area to restructure the campaign
system.
"It wasn't clear to
us why there was such a delay," said Silverstone, an astronomer who
volunteers to work supporting Obama’s campaign amid his research and college
teaching.
Even with an increasing
number of people being sceptical about Obama’s plan, Democrats are still hoping
the August break will give them a chance to explain the health care system
overhaul to the public. But Republicans are also as determined to use the break
to disrupt town hall meetings of the Democrats.
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08/05/2009
When Glenda Krull and Mark
Moody couldn’t afford their mortgage and health insurance payments any longer,
they knew what they had to do. The couple sold their home.
Four year ago, Moody, 60
years old, underwent a liver transplant; it is possible that he will need
another one. Every month, Moody pays $1,345 for the best policy he can afford
from Premera Blue Cross.
Moody is desperate to keep
the policy despite the consequences. The expensive premiums of his individual
health insurance forced his wife Glenda to have her coverage downgraded, the
couple’s retirement savings were slashed, and they were forced to move to a
house half the size of their original home.
A good insurance policy
doesn’t guarantee Americans who have serious illnesses that they will receive
the care they require and that they will not go broke.
According to a study by
researchers from Ohio University and Harvard University, in 2007, about
two-thirds of all of the personal bankruptcies that were filed throughout the
US were related to medical bills, illnesses or income loss. Of those who filed
for bankruptcy, 78% had individual health insurance during the time they got
sick.
Economist Sara Collins
said, “It’s not just the uninsured. It’s people who have insurance that doesn’t
protect them [who are increasing the need for reform].” Collins is also a
vice-president of the Commonwealth Fund, a New York-based foundation for
private health care.
For Moody, when health
insurance coverage goes beyond the reach of people like him and his wife, it
shows that the health care system of the country has gone gravely awry.
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08/05/2009
As
a way to lower costs, more and more families are opting not to avail themselves
of family medical insurance. According to reports, an estimated 50 million
Americans have no coverage, and therefore are not protected against possible
financial woes in the future, which could lead to bankruptcy. That’s why
financial experts are advising families to seek family health insurance policies.
When
it comes to cost-cutting, families can always find alternative measures instead
of dropping medical insurance plans. Many affordable medical plans in the
market are suitable for different budgets. Families can seek help from
insurance experts when it comes to figuring out confusing insurance language,
to help them decide on the plans that will perfectly suit their needs and
budget.
A
good look at available family medical insurance policies can help families make
informed decisions. Families can choose from a variety of available policies,
from the basic to catastrophic to comprehensive insurance plans.
For
starters, families should look back at their own medical histories, and the
medical services they’ve sought during the previous five years; this will give
them an idea of the kind of coverage they may need in the future and what they
should be looking to buy.
Client
Services Director Tom Carolan of BestHealthcareRates.com explains, “Finding the
right family medical insurance coverage
can be both confusing and overwhelming, but it is a vital part of protecting
your family’s future.”
“We
enjoy walking families through the process of selecting a plan that can give
them solid coverage at the price they need, which is why we offer one-on-one
consultations for each and every new customer,” he added.
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08/05/2009
The supporters of the
recently launched faith-based, pro-health reform campaign clarified that those
involved in the campaign are not pushing for a particular health reform plan.
But supporters also said they are taking a “moral position” on the health plan
issue.
“This isn’t a
political issue, it is a deeply theological issue, a biblical issue, and a
moral issue,” said Jim Wallis, president of Sojourners. “So we are not going to
at any time during the debate weigh in on the particulars of policy questions… [We’ll]
leave the plumbing to the politicians.”
The “40 Days for
Health Reform” campaign was launched by Wallis and other religious leaders. The
campaign involves religious leaders from across America who will push Congress
to submit legislation that will help offer more options for affordable health
plans in America.
The group also
sponsored television ads featuring Catholic leaders, local evangelicals,
pastors, and other religious people. The group has been leading prayer rallies
and events to reach 100 members of Congress.
National Healthcare
Sermon Weekend, scheduled at the end of this month, will be observed by Christian,
Jewish, and Muslim clergy who will speak about health care reform in congregations
nationwide.
Some of the events
scheduled for September include candlelight vigils and visits to Congress
members.
Evangelical pastor
John Hay, Jr., of the West Morris Street Free Methodist Church in Indianapolis,
explained in a teleconference what inspired him to participate in the campaign.
“As pastor of an
urban core church within walking distance of major hospitals, it seemed like
some people in our congregation might as well have lived a 1,000 miles away
from those shining institutions,” Hay said.
“They often put off
a serious health problem until it reaches chronic stages and then make an
emergency run,” he said. “This is no way for the most blessed country in the
world to treat its most vulnerable citizens.”
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08/05/2009
The Republican Senator Charles Grassley, a key player in the
controversy surrounding the health care system overhaul,
faced crowds that showed little doubt that they’re unhappy with what's on the
table.
"It seems
to me that people are expressing, not just on health care, but people are just
very scared about the direction the country is taking," said Grassley and accentuated
that he has not signed off on anything.
Grassley, who
is a ranking Republican on the Senate Finance Committee, has been bargaining
for a compromise health plan to get some Republican votes.
"I don't
want the government or a bureaucrat working for the government to come between
you and your doctor," said Grassley. "I think the stakes are very,
very high."
The forums
arranged by several federal lawmakers have presented challenges for the administration
of President Barack Obama as it struggles to win over those who are skeptical about
a costly plan for health care system reform.
Missouri Senator Claire McCaskill
and Pennsylvania Senator Arlen Specter were among those who held raucous town
hall meetings on Tuesday. On Wednesday in Harrisburg, Pennsylvania, Specter stated
that the health care protesters are "not necessarily representative of America"
but should be listened to.
"There's
more anger out there now than I have ever seen before," the Democrat said.
"And I think the anger is caused by so many people having lost their jobs
and (being) worried about losing their health insurance."
In North
Dakota, an angry crowd packed a hall in Casselton to speak to Democratic Senator
Byron Dorgan, with just a few signs of support for the health care overhaul
plan. A woman was booed by the crowd after saying the reform is important.
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08/05/2009
The U.S.
Chamber of Commerce started running its TV ad on Wednesday warning Americans
that the health care overhaul would increase the deficit and raise taxes. The
TV ad came after President Barack Obama emphasized that his health care plan would
not add to the nation’s deficit.
"Washington's
latest health reform idea: a trillion-dollar health plan and a government-run
public option with big tax increases, even on health benefits," says a
narrator in the Chamber's ad. "And the federal deficit? The non-partisan
Congressional Budget Office says the federal deficit will grow $239 billion."
"Inflated
taxes, swelling deficits, and expanded government control of your health ---
tell Congress let's slow down, and reform health care the right way," the
narrator concludes.
Changing
the nation’s health care system to provide more health-plan options to
uninsured Americans is among the top domestic priorities of Obama in his first
year in office.
The
first to accomplish markup of a bill was the Senate Health Committee. Recently,
the Senate Health Committee approved a $600 billion measure created by Senator
Ted Kennedy, which has a public health plan option. According to the Congressional
Budget Office, Kennedy’s bill would cost $1 billion over 10 years.
The
Republicans believe the President’s "bureaucratic takeover of health care"
will affect businesses, increase deficit, and raise taxes.
"The
creation of a new government-run insurance plan is a step in the wrong
direction," the Chamber wrote. "We do not believe that the government
plan will be a fair competitor. Because of the increased costs and lack of
competition caused by a government plan, employers will not be able to continue
offering their current plans, which cover more than 170 million
Americans."
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08/05/2009
The
Sanford Health Plan intends to join the competitive North Dakota insurance
market if approved.
Blue
Cross Blue Shield of North Dakota is currently the leading health plan
provider, controlling over 90 percent of the health plan market and covering
over 475,000 people.
“I
think it’ll be a minor tremor, but I think it’ll shake things up a bit,” said
David Middaugh, president of Middaugh & Associates, referring to the
possibility of Sanford entering the fray. “They’ll have a presence right away.”
Sanford,
based in Sioux Falls, South Dakota, has been a health coverage provider since
1998, and has become one of the top private health insurance firms in South
Dakota, second to Wellmark, the Blue Cross Blue Shield plan.
The
Sanford plan is now covering 51,000 people in Minnesota, Iowa and South Dakota,
and it hopes to increase enrollees to 100,000 in five years.
The
Sanford plan is affiliated with Sanford Health, a major health care provider
network; it is poised to merge with Fargo-based MeritCare before the year ends.
Executives of both health systems look forward to offering their insurance
program, with coverage starting January 1, but Sanford is still waiting for regulatory
approval.
“In
North Dakota we have already started getting requests for information about
Sanford’s insurance plan,” MeritCare spokesman Darren Huber said. “It’s clear
people want additional high-quality options for insurance.”
North
Dakota insurance commissioner Adam Hamm said his staff is still evaluating
Sanford’s application to join the health insurance market in the state.
“They’re a significant player in South
Dakota,” Hamm said of Sanford. “They’ve indicated a strong intent to expand in
our state. I’m obviously interested in seeing more choice and competition in
North Dakota.”
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08/05/2009
Officials of
the Oklahoma Employee Benefits Council were happy to reveal that the state was
successful in recent negotiations for HMO contracts that would cover 37,000
employees. The negotiated price was $30 million less than the original
contract.
The state
predicts an average cost increase of 5.86% in vision, dental, and health
benefit plans in 2010, as compared to the finance office’s estimate of 12.88%,
and Hewitt Associates’ projected an 11.8% average nationwide increase. But
according to Brian King, a council spokesman, members of those HMOs will be
subject to higher co-pay and out-of-pocket expenses.
In a planned
statement, Chairman Bryce Fair said, “The council has a difficult balance to
achieve, especially with the current economic situation. We’re determined to
protect the needs of state employees and their families, while at the same time
weighing the financial challenges of state agencies.”
Executive
Director Philip K. Kraft commented, “Our contract negotiations with the HMOs
are an exhaustive effort that requires many hours from the council members and
staff. Without this effort, the costs would be significantly higher. We work
hard to minimize the impact of rising health care costs on the employees, state
agencies and taxpayers.”
According to
council officials, the increases were lowered by means of “tireless, meticulous
negotiations,” as well as the assistance of Gallagher Benefits Consulting
Services.
Both standard
and alternative plans offered by the participating HMOs are in turn offered by
the Employee Benefits Council to state employees. Higher premium costs and
lower co-pays are featured in standard plans, while lower premium costs and
higher co-pays are typical of alternative plans. There will be an overall
increase of 3.91% in standard plans and 8.69% on alternative plans.
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08/05/2009
One reason that health insurance is the top priority of many politicians
is because 47 million people are not enrolled in health plans, while the
government spent $2.3 trillion on health care last year.
In 2006, according to the Census Bureau, 59.7% of the population had
employer-provided health insurance, 27% availed themselves of government health
plans like Medicaid and Medicare, and 15.8% did not have any health insurance
at all.
These statistics are broken down by economic status and race. People who
have higher incomes are more likely to access health care through private
health plans while most of those in the low-income bracket had the cheaper
health plans funded by the government.
In 2008, the cost of health insurance increased by 6.1%. This increase
has also caused 0.3% of employers to drop their workers’ health insurance. The
number of Americans with government-subsidized health insurance also went down
slightly.
For a family of four, the average cost of insurance is between $12,000
and $15,000 per year. While that is already expensive for those with low
incomes, not enrolling in any health insurance is usually even more expensive.
Depending on the state, the average cost of an emergency-room visit alone
is between $560 and $1,250, while cancer treatment averages $33,248 and a
colonoscopy averages $2,000. The hospital costs of labor and delivery also
vary, ranging from $7,000 to $14,000.
Moreover, health insurance without maternity coverage can quickly put
any woman into debt, as the average OB visit costs $90. In addition, ultrasound
and laboratory work cost an average of $300 and $200, respectively. Naturally,
complicated pregnancy costs even more, which is why health insurance with
maternity coverage is so important.
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08/05/2009
Students who are bound for college and are moving out of their parents’
house, but are still under the umbrella of their parents’ health insurance
coverage, need to weigh their options regarding student health insurance cover.
There are several options that should be considered to ensure that students
remain insured even after moving out of the family home.
The first option is to stay on their parents’ health plan by remaining
in school and letting it take care of any medical expenses they will incur.
Parents can inquire with their agent about the scope of benefits that can be
provided to their children. Most health insurance plans provide coverage for
children aged 19-25 years old, allowing them to continue using their parents’
policies.
The next option would be to use the Consolidated Omnibus Budget
Reconciliation Act (COBRA). This helps students retain the student health
insurance coverage their parents bought for them. For those over 25 years old
still attending school, or those who have decided to stop studying after
reaching 18 years old, losing their parents’ health insurance coverage is a
likely possibility. However, they might be able to temporarily continue the health
coverage their parents carry for them through the utilization of COBRA.
Another option for those who will be working soon is to try short-term
health insurance coverage. For those who won’t be a student for a short time
and therefore won’t be able to use COBRA, considering a short-term health
insurance policy may be a wise decision. This will be advantageous for those
who are expecting to get insurance through a job and are just looking for
coverage that is inexpensive and short term.
The last option is to get an individual health insurance plan that will
keep you permanently protected.
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08/05/2009
Health insurance options used to be limited as the health insurance
industry was dominated by only a small number of companies. Back then, the
insurance companies had the power in their hands. Today, there are more
insurance companies from which consumers can choose. Legal protection has also
been given to the consumer. Recent laws ensure fairness when it comes to costs
and the quality of service.
Looking at the health plans available today, one can also see that there
is more flexibility given to the consumer. Before, the coverage plans that were
offered were the same no matter what company was offering it. However, today
there are more options available to the consumer. They can now choose a plan
that is able to meet their specific needs.
The flexibility enjoyed by consumers significantly affects the cost of
their health insurance coverage. For example, they can opt to have a high
deductible so that they can have low monthly payments. They can also choose a
plan that focuses on emergency care and care for illnesses instead of a plan
that focuses on general care.
For people who used to find it difficult to pay for health insurance,
the legal protection measures that have been enacted in the past ten years have
given them a wider and more varied set of health insurance options. Many states
have programs available that provide health insurance options at a very low
cost.
The health insurance system has seen many improvements. These are the
result of the increase in the number of health insurance providers, as well as
the enactment of legal protection. To choose a health insurance plan that is
perfect for your needs, you only need to spend some time on research.
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08/05/2009
Years ago, the kinds of health insurance plans available were very
limited. Today, there are a lot to choose from. It is not always easy to choose
the perfect health insurance plan, so it is very important to know your needs.
You can choose from either a managed care plan or an indemnity plan. As both
have unique benefits, you must decide what is best for you and your family.
Indemnity plans offer a lot of benefits. One of these is being able to
choose any doctor you want. Normally, an indemnity plan will pay a percentage
of your expenses. It usually does not cover services such as preventive exams.
A Preferred Provider Organization (PPO) is another kind of health insurance
that is similar to indemnity health plans. Going to a doctor that is within the
PPO’s system will get you discounts.
Health Maintenance Organization (HMO) health insurance plans are also
available. Through these health plans, you pay a monthly fee to receive health
care benefits. Also, you must go to a doctor that is within the plan’s system
or else your care will not be paid for. A number of HMO’s may also require
co-payments for visiting a doctor.
You may find it difficult to choose a health plan because of the wide
variety that is currently available. What you must keep in mind is that your
health needs must be met by your health insurance plan at a reasonable price.
It is very important for you to find a health plan that will answer your
family’s specific needs. And, of course, it must also be within your budget.
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08/05/2009
Getting a health insurance policy will protect you from the expensive
costs of health care. However, having a health insurance policy is not just
protection from these costs; it can also be protection from serious illnesses.
Health insurance costs have been rising partly because of the
advancements in health care. Modern medical technology has given us more
options for treatment. Many illnesses that were difficult to cure before can be
effectively treated by doctors today. However, getting these treatments is
expensive. This is where your individual health insurance policy comes in.
You don’t have to worry about treatment expenses, including anything
from a diagnostic test to specific forms of treatment, when you have a health
insurance policy. You are also not limited by the amount of money you have
available. This is why it is so important to have a comprehensive health
insurance policy.
With a health insurance policy, it is also easier to maintain your
health. Many policies focus on preventative care, not only coverage for
catastrophic and emergency health situations. Preventive care can help you
avoid more serious medical conditions.
Purchasing a health insurance policy is just like making any other
significant purchase. You need to take the time to assess the details of each
policy. Also, you need to consider the expenses that you will incur when you
decide to get a specific health plan. Taking these steps will ensure that you
get a health plan that is right for you.
It is a very wise decision to invest in a health insurance policy. Not
only will you enjoy the medical benefits, but you will have the security of
knowing that a policy is there to cover you in case something unexpected
happens.
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08/05/2009
The health insurance industry can appear very intimidating and
unfriendly. You might be wondering what qualities a health insurance provider
should have. You might also be unsure about how to understand the language of
your policy. Choosing a health insurance provider is not easy. However, you
only need to educate yourself to know what to do.
There are a number of things to look at when choosing a health insurance
provider. First, a health insurance provider should have stable monthly
premiums. A provider whose premiums change every month should be avoided.
Unstable premiums make it difficult to manage your expenses; in addition, it is
very possible that the provider is shady.
Efficient claims processing is another thing to look for. You would not
want to receive collection notices asking you to pay your medical bills because
your provider has delayed payments. Also, you don’t want to have to follow up
your claim several times before they process it. It is time to look for a new provider
if your current provider has claims processing and customer service that is
very poor.
When requesting quotes, ensure that your provider gives you several
options. A provider should not bully you into purchasing a specific policy or
health plan. Consider talking to an independent agent rather than a company agent.
An independent agent will normally show you quotes from different providers.
During your health insurance comparisons, evaluate each provider’s
network of facilities and doctors. Avoid providers with a limited network. Most
doctors know details about the health insurance providers located in your area.
There must be a reason why they did not choose to work with certain companies.
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08/05/2009
Because there are many health insurance companies that you can choose
from, it can be challenging to find the health insurance that best suits you.
First find out what type of coverage will meet your needs. After figuring this
out, start looking at companies that offer that type of coverage and start
comparing their rates. An online quote for health insurance can be obtained
from numerous sites on the internet. When you do go to the internet for an
online health insurance quote, make sure to fill the forms out correctly.
Another way to get a health insurance quote is to talk to an insurance
agent. An agent will help you with your decision and with finding the right
plan for you. They can present several plans from different companies. After
that, you can easily compare the features of each plan. This will save you the
difficult task of talking to people from many different companies about health
insurance quotes.
If talking with an insurance agent is not what you have in mind, you can
visit websites that will allow you to review insurance plans. These websites
can also give you quotes. Some websites may ask for your personal information.
They use this to provide you with health insurance quotes from a variety of
health insurance providers. This only takes a short while and you can
comfortably compare the plans and rates on your computer.
It is very important to get several health insurance quotes and compare
them. Doing so will help you choose the insurance plan that is perfect for your
needs and budget.
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08/05/2009
Although a number of health issues affect people despite their age,
gender, or geographic location, there are some health issues that usually only
affect a specific group of people. An example of this is men’s health issues.
Prostate cancer occurs when there is abnormal growth in this male sex
gland. Normal sexual functions, as well as bladder control, are impeded when a
man’s prostate has a tumor. One of the disease’s symptoms is manifested by
urination problems.
Heart disease is usually caused by atherosclerosis, which happens when
fatty substances amass on the inner walls of an artery. Together with stringy
tissue and calcium, the fatty substance will harden and block the artery.
Another health issue for men is high blood pressure, or hypertension.
There are various factors that lead to hypertension. These include one’s
hormonal levels, the state of one’s nervous system, kidneys, and blood vessels,
and the salt and water in one’s body.
One of the major diseases affecting American men is lung disease. Its
symptoms include cyanosis, wheezing, swelling, chest pain, and breathing
difficulties.
There are many things men should do to stay healthy. It is important to
be physically active and to eat a balanced diet. It is also wise for men to get
screening exams for diabetes, depression, cholesterol, blood pressure, cancer,
and obesity.
The health issues that plague men are not just significant to them, but
to the people who care for them as well. To be able to receive preventive care
and to maintain good health, it is important for a man to get an individual
health insurance plan that is right for his needs.
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08/05/2009
The health care insurance industry in the U.S. is quite complicated.
There are so many health plans available that many Americans find it difficult
to select the best one.
Every year, ‘U.S. News & World Report’ collects and publishes the
rankings of the country’s top health insurance plans. In spite of this, there
is no insurance plan that can be considered the absolute best. Rankings of
health insurance plans can be a helpful starting point, but rankings should not
be the single source of information when you are looking for the best plan.
Rankings have a number of problems and disadvantages. For one, the
rankings can become useless when a listed plan has already become unavailable.
If it still is available, it is possible that the benefits included in the plan
have changed as well.
Also, rankings are usually not based on data; instead, they are most
often based on surveys. Rankings are therefore more subjective. The results are
influenced more by the opinions of consumers than by the coverage provided by
the plan itself.
The main reason why rankings shouldn’t be taken at face value is that
each person has different insurance needs. The highest ranked plan may be ideal
for one person but completely inappropriate for another.
Instead of consulting rankings, consider carefully the benefits that you
need when choosing your plan. For example, if you do not have a pre-existing
health condition, you can choose a plan that has low premiums. On the other
hand, you may want a plan that covers prescription drugs, has benefits related
to mental health, and has low deductibles.
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08/05/2009
Preferred Provider Organization (PPO) plans, sometimes referred to as
participating provider organization plans, are health care programs managed by
an insurance company. Medical doctors, clinics and hospitals, and other health
care providers are contracted by the insurance company to assist its insured
members with their medical needs.
Under a PPO plan, the insured pays a fee at the time of every medical
service. However, with this type of plan, a member is provided with a
substantial discount by the professional partners of the insurance company.
Before the insurance company starts paying for the insured’s medical fees,
the insurance company collects a yearly deductible. The company typically pays
80% of the insured’s medical cost for the in-network physician. The patient is
responsible for the remaining cost not covered by the insurance company. The
patient also has the option to request an out-of-network physician or medical
service provider. The deductible for these services may be more expensive than
PPO physicians and the insurance will cover less of the cost. In order for
people with PPO plans to get cheaper rates, it is best if they use the doctors,
hospitals, and other medical providers in their plan’s network.
PPO plans also provide prescription services at a discounted rate. PPO
plans cover most health care services, and PPO premiums are lower than those
for individual health insurance. Moreover, insured members have more health
care options with PPOs, since they are part of a wide network of medical
providers.
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08/05/2009
Free or discounted fees for doctors' visits and prescriptions are not
the only things your health plan can offer. Today, many insurance companies
also offer improved coverage for mental health conditions, disease management
programs, infertility, and much more. Sometimes these benefits may not be well
explained by your insurer.
Disease management programs are health programs designed to help health
insurance plan members with chronic health conditions, such as asthma and diabetes.
For diabetic members, your health plan may offer benefits, such as counseling
sessions on proper diet, nurse consultations, and drug monitoring. However,
because most insurance companies sell plans to employers, many workers are not
aware that these benefits exist.
Your health insurance may also include coverage for those trying to
conceive. Since the cost of reproductive technology, such as in vitro
fertilization (IVF), is very high, many insurers do not include such benefits
in the package. However 14 states, including New Jersey and New York, have
passed a bill requiring insurance companies to provide some level of coverage
for infertility treatment. In most states, legislation includes IVF in the
coverage.
For people who are diabetic and who need to lose weight, some insurance
companies also reimburse a portion of a health club membership and other
programs that promote weight loss to manage diabetes. For people with heart
disease who are smoking, some health plans also offer support programs that may
help them kick the bad habit.
You may also enjoy coverage for alternative medicines and therapies,
such as massage, acupuncture, and herbal medicine. Today, a growing number of
insurance companies now include such treatments in their health plans.
It is unlikely that your health plan is trumpeting information about state-mandated
coverage. It is up to you to get the details.
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08/05/2009
Although the majority of Americans avail themselves of subsidized health
care coverage through their employers (group/business health insurance), some
people who do not have access to this kind of insurance just purchase their own
independently (individual health insurance). However, the challenge is when the
person has what is called a “high risk” medical condition, like cancer, central
nervous system issues, cardiovascular conditions and other diseases that
require frequent and costly treatments. Aside from treatment costs, these
conditions also often last longer and can result in complications that become
another responsibility of the insurance company. Since the law allows insurers
to reject the applications of individuals with serious pre-existing health
issues, most insurance companies do.
The most common health care option for “high risk” individuals is
high-risk health insurance. High-risk health insurance provides almost the same
coverage options as those offered by individual health insurance. Both
typically are comprehensive and have diverse options. In many states, a
Preferred Provider Organization (PPO) plan is one of the most popular types of
high-risk insurance plans. Health Maintenance Organization plans are also
available in many areas.
Today, individual states provide this type of health plan through
high-risk insurance pools. The coverage is funded by the state but the insured
has to pay a premium, which is often quite expensive, to the state insurance
agency.
High-risk insurance provides broad health coverage and even pays for
prescription drugs. Mental health and maternity are also often covered by
high-risk insurance. The main disadvantage of purchasing high-risk insurance,
however, is costly premiums which are determined by the insured’s pre-existing
health conditions, location, and age.
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08/05/2009
In most states, the majority of insurance companies deny people with
pre-existing health conditions health insurance coverage. Some people get
medical insurance either through their employer or as a dependent on someone
else’s health insurance plan.
Currently, 31 states run high risk pools, which are designed to help
those who cannot get health coverage due to pre-existing health conditions. In
many states, the health coverage offered by high risk pools is similar to what
individual health insurance offers. Most pools provide comprehensive medical
plans covering extensive disease-specific benefits. Many high risk pools also
include disease management programs for people with chronic diseases.
Typically, enrollees are provided with an option of choosing a PPO, HMO or
indemnity plan.
Like other insurance options, high risk pool coverage has limitations in
terms of benefits. This type of insurance also requires higher deductibles,
co-payments, and out-of-pocket costs. In most states, high risk pool coverage
usually imposes a so-called ‘pre-existing condition exclusion’ period of up to
12 months. Only after this period has ended will the insurance company start
paying insurance claims.
High risk pool insurance is usually more costly than regular individual
health insurance. Enrollees in high risk pools usually pay 150% to 200% more in
premiums than the standard rate charged by insurance providers for individual
insurance policies. This is mainly because the people enrolled in this type of
coverage have illnesses that require frequent and expensive treatments.
Although costly, this can be the best option for those who are unable to
purchase an individual policy because of existing health problems. Generally,
the health care cost of being uninsured will be a lot greater than the cost of
high risk pool premiums.
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08/05/2009
When one looks for a health insurance plan, one may have difficulty
choosing between a Health Maintenance Organization (HMO) and a Preferred
Provider Organization (PPO). The common ground on which HMOs and PPOs stand is
the concept of a primary care physician (PCP), who represents the first contact
for the medical care of a member. But what actual differences are there between
HMOs and PPOs?
An HMO requires a patient to select a PCP from the HMO network. This PCP
will be the one responsible for the maintenance of the patient’s health. This
physician will also be the one to refer the patient to other physicians within
the same HMO network for specialist care, should the need arise. A patient may
not see a specialist without being referred by his or her PCP.
In a PPO, on the other hand, a patient may get medical care from any
medical provider, even if the provider is not a member of the PPO network.
The advantages of an HMO are the premiums, which are usually lower, and
the absence of deductibles to meet. Another advantage is that there is only one
PCP responsible for the patient’s overall health maintenance. The benefit of
this lies in the fact that the PCP will be very familiar with the medical
background of the patient.
On the other hand, the advantage of a PPO is that a patient is not bound
to a single doctor. Also, a patient does not need to be referred by his or her
PCP should he or she wish to see a specialist.
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08/05/2009
In response to consumers’ demands, the insurance industry has created
linked, or ‘hybrid’, health insurance policies. These policies offer health
benefits provided by annuity or life insurance and traditional long-term health
plans. Hybrid policies also guarantee that the insured’s long-term health
coverage that has not been used can be used by beneficiaries.
Hybrid health insurance functions in many ways. One type of hybrid
health insurance that links a life insurance policy to long-term care insurance
requires the insured to deposit a premium into a policy to create a pool of
money for health care benefits.
Another type of hybrid insurance policy works like a fixed annuity that
does not have a premium rider. Instead, a part of the internal return is used
to pay for the health coverage. Insurance companies typically provide a payout
of up to 300% of the aggregate value of a policy for up to three years after
the value of the account is depleted. For example, a policy owner, who has a
$100,000 annuity and has chosen a two-year benefit factor and aggregate
coverage limit of 300%, would immediately create a pool of money worth $200,000
to cover long-term care expenses and another $200,000 of life insurance
benefits. This only takes effect after the initial policy value, which is
$100,000, is depleted. But, if the policy holder is healthy and does not need
health care, the unused benefits will be paid out as a lump sum to the policy
holder or to any named beneficiary.
The cost of these new policies differs from one person to another
depending on the person’s health condition, age, gender, benefits requested,
and premiums.
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08/05/2009
There are many health care plans available to consumers depending on
their needs and budget. Even though many health plans seem to offer the same
thing, the coverage and benefits they offer are very unique.
Preferred Provider Organizations (PPOs) are one of the popular health
insurance options today. Although PPOs basically work like HMOs, or Health
Maintenance Organizations, the two provide different benefits.
Even though their networking methods work in much the same way, PPOs
have a wider network. They also impose a smaller fine for services acquired
outside the network. For a higher cost, PPOs allow their members to choose
their preferred providers. HMOs, however, do not cover out-of-network services.
Point of Service (POS) plans integrate the formulas utilized by PPOs and
HMOs. In this type of plan, members shoulder a co-payment when utilizing the
services of providers that belong to the network. However, there are no
deductibles. POS plans function like a PPO regarding out-of-network services.
POS plans allow their members to seek services from providers outside their
network. However, customers must initially pay deductibles and coinsurance.
PPOs don’t have one single plan. The differences in coverage and benefits
are due to the differences in the needs of customers. Some of the factors
people might want to consider include the cost of monthly premiums, the
coinsurance they need to pay even if they don’t seek out-of-network services,
and the size of the annual deductible.
There are still other factors to consider before choosing the
appropriate plan. Perhaps the best thing to keep in mind is that the benefits
you receive will depend on the amount you pay.
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08/05/2009
Heath insurance for freelance writers and independent contractors can be
very expensive. As a result, no matter how tempting the freelancer lifestyle
may be, many people still stick to a nine-to-five job because of the employer
subsidized health plans.
Finding a health plan for an independent worker requires some research.
As when making any other major decision, a careful assessment of the options
available is necessary.
There are several routes freelancers can take when getting a health
plan. Joining a group, like a guild, may offer some affordable medical
insurance options. Some states consider one individual who works independently
as a “group”. This means that, in those states, independent workers may just be
charged a group or discounted rate without the additional fees of joining a
guild or group.
The Editorial Freelancer Association, for example, provides health plans
to its members. Discount health plans and dental HMOs are also available to
members. Some health insurance providers offer plans that are targeted to
freelance writers for as low as $333 per month for each member. Other options
include the National Association for the Self Employed, AvantGuild, and the
Author’s Guild, all of which provide discounted insurance for published writers
in selected states.
Another option for freelance writers is COBRA, a program run by the
federal government. COBRA offers a subsidy to individuals who have just lost
their jobs and who wish to continue the health plans subsidized by their
previous employer. Should an editor or writer leave their full-time job and
become a full-time freelancer, the COBRA subsidy may be a good option. COBRA
offers 18-36 months of coverage, depending on various factors.
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08/05/2009
Many people feel that group health insurance is better than individual
health insurance because the former usually costs less and provides more
benefits than the latter.
However, many people cannot get group health plans because they work for
a small company that does not provide them with group health insurance, they
are self-employed, or they have run out of COBRA benefits. Thus, their only
option is to purchase individual health insurance.
Individual health plans are offered by many insurance companies;
however, people who are over 50 years old, especially those with medical
problems, are often declined by insurance companies.
Before enrolling in an individual health plan, it is important to
consider how much of your physician and hospital bills the insurance will
cover, how much you will have to pay in premiums, and how much you have to pay
before the plan starts to pay for your medical expenses.
Enrolling in an individual health plan provides you with several
options, such as fee-for-service policies and managed care plans.
Also called indemnity insurance, a fee-for-service insurance plan is a
traditional type of health insurance that pays a portion of every medical
service you access, such as hospital stays and physician visits. With this type
of plan, although you pay for the rest of the expenses, you can go to the
hospital and doctor of your choice.
A managed health plan, on the other hand, is insurance provided by a
group such as a Preferred Provider Organization (PPO) or Health Maintenance
Organization (HMO). Insurers that offer managed health plans contract with
hospitals and physicians, which make up the "network" of the plan.
With this type of individual insurance, the insured are advised to patronize
the physicians and hospitals that are part of their plan's network.
Other types of individual health insurance are Open Enrollment in
Managed Care Plans and Association-Based Health Insurance.
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08/05/2009
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08/05/2009
Several states in the U.S., particularly Massachusetts, are working on
enacting or have enacted laws that require the residents of the state to get
individual health insurance. Usually called insurance mandates, these laws are
passed in an attempt to reform the U.S. health care system.
Expanding a state’s risk pool is the concept behind these insurance
mandates. The result of this would be reduced costs for all the state’s
residents.
Risk pools work based on the idea that a state has low-risk and healthy
residents who will counterbalance the high expenses brought about by the pool’s
high-risk and less healthy members. When low-risk and healthy individuals are
insured, the members of the pool will then assume a larger part of the expenses
of the pool’s high-risk members.
There are instances when the members of the pool start to find it very
hard to pay for their premiums. This is usually called a “death spiral” by the
insurance industry. To lessen the probability of a “death spiral” occurring,
insurance mandates are issued so that everyone will be forced to purchase
insurance, thus diversifying the members of the risk pool and lowering
individual costs.
There are some problems with insurance mandates. For one, there will be
low-risk and healthy individuals who would prefer not to buy insurance as they
are hardly ever sick. The state would then need to create penalties for those
who fail to comply with the mandate. Another problem is that there are some
people who cannot afford health insurance. The state must then work on
subsidizing or lowering insurance premiums.
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08/05/2009
Just like individual health insurance, the purpose of life insurance is
the same: to provide financial aid. Life insurance policy holders also pay
premiums: monthly, quarterly, or annually. Policies can run for one year up to
a full lifetime. In health insurance, the policy holder receives the benefits
in the form of discounts, reimbursements, etc. In life insurance, the policy
holder’s beneficiaries will be paid a specified amount upon the death of the
policy holder.
Life insurance started in ancient Rome. Burial clubs collected money
from the poor to pay for the funerals of their members. Starting in the Middle
Ages, labor guilds, religious and fraternal organizations, and mutual life
insurance companies took over the life insurance business. Mutual life
insurance companies are owned by its members, just like credit unions. Edmond
Halley, an astronomer in the 17th century, developed the very first actuarial
tables that were used to calculate insurance risks according to mortality
statistics. As a rule of thumb, higher risks result in higher premiums.
Risk calculation determines how much a premium will cost, or whether an
applicant will be given a policy at all. Everything from the applicant’s full
medical history, hobbies and lifestyle, driving record, travel history, and
credit history will be taken into consideration by insurance actuaries when
determining the actual cost of the applicant’s premium.
Some of the major factors that affect the cost of life insurance
premiums include age, gender, and pre-existing medical conditions. Men and
older people are likely to pay higher premiums. People with “dangerous”
hobbies, such as scuba diving and skydiving, also pay more for life insurance
policies.
It is possible for life insurance claims to be denied. For example, most
life insurance policies do not provide coverage for suicide. Fraudulent claims
will be fully investigated.
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08/05/2009
Many people consider buying long-term care (LTC) health insurance. However,
there are a number of factors that need to be considered.
LTC coverage may not be affordable or necessary. Before purchasing LTC
insurance, it is best to consider your family status. Incurring out-of-pocket
costs for long-term care may be a financial risk worth considering, because
this type of health plan may not be affordable. Ideal candidates for this type
of coverage are those who can afford to pay high premiums, and can also handle
increasing fees.
The affordability of LTC plans is also determined by your general
financial picture. Your net worth is one reliable measure, but this should
exclude your home and even your savings and the investments and pension you
expect after you retire. People who have less than $500,000 in investments
might also not be able to afford this type of coverage.
It is also necessary to calculate the insurance costs as a percentage of
your calculated retirement income. You might not be able to afford the
insurance plan if the premiums consume more than 10 percent of your income.
Individuals with investments worth $1 million, and couples with $1.5
million worth of investments, may be able to afford this coverage.
You may also consider your family health history. Although not a perfect
predictor, many inherit their parents’ or grandparents' health patterns.
It is also wise to understand the features and disadvantages of
long-term care policies. Although insurance of this type is aggressively sold,
many people who purchase it do not understand what they are getting. Make the
most of your hard-earned money. Know every aspect of the health plan you are
interested in before purchasing.
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08/05/2009
For most people, going to college
is a big adjustment in their lives. There are new things to learn, new people
to meet, and more experiences to enjoy. Most young people look forward to
graduating, while having fun in the process. However, there are also important
things to consider, such as tuition fees and other expenses.
With all the hassles that
college life brings, it is easy to neglect one’s health. Although young people
are considered healthier than the rest of the population, there are studies
showing that college students are also prone to accidents and health problems
just like anyone else. In the US, about 1.7 million students are uninsured,
meaning their medical expenses are paid with money from their pockets. This
fact is aggravated by another finding which shows that some uninsured students
do not seek medical help, due to the high costs of consultations and
treatments. This kind of scenario could result in numbers of students dropping
out of school due to illness or to get work to pay their medical bills.
In response to this
problem, some colleges have begun to force students to acquire some form of
medical coverage, while others offer affordable medical packages. Student
health insurance plans are more flexible and have fewer requirements than
traditional individual plans. In addition, some plans offered by colleges can
be extended even after one’s graduation.
Medical insurance plans
are also important to students covered by other people’s policies. Insured
students are commonly covered under their parents’ policies which are offered
by their parents’ employers. It is important to check the eligibility of
students under their parent’s medical coverage; the coverage might be
terminated due to certain factors, such as when a student reaches a certain age
or has married.
For college students,
health insurance is important in safeguarding their health, reducing future
expenses, and improving their chances of graduating.
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08/05/2009
Different types of
alternative medicine, also known as CAM (Complementary and Alternative
Medicine), are becoming more popular with people living in the U.S. All
health-related practices and therapies that are not considered as traditional
medicine are classified as CAM. Examples of CAM include treatments such as
energy healing, acupuncture, biologic therapies, body and mind mediations,
massage and chiropractic therapies, and spiritual healing and prayer.
According to the Center
for Disease Control, in 2004, around 36% of the people living in the United
States had undergone alternative therapy. Nowadays, a lot of people think that
combining CAM therapies with traditional medicine provides better possibilities
for healing. The term “alternative” is used to refer to therapies that are used
in place of traditional medicine therapies. On the other hand, the term
“complementary” is used to refer to therapies that are used together with
traditional medicine therapies.
Insurance for alternative
therapy is now being offered by a number of insurance companies in the United
States. CAM therapies such as massage therapy, chiropractic care, and
acupuncture are covered by this type of insurance. Many job-based group health
insurance plans cover this option as an answer to the requests of employees.
CAM therapies are used by
an increasing number of people in the U.S. As a result, CAM is now one of the
health care industry’s fastest-developing segments. However, many insurance
companies still think twice about providing coverage for CAM, in spite of
increasing public demand.
It is important to take
into account that for some states, this kind of insurance coverage is not
considered as an insurance product.
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08/05/2009
Bipolar disorder is
manifested through a person’s alternating moods, from extreme elation to deep
depression. In truth, this disorder is more complicated than was previously
perceived. It is an illness that influences the behavior, feelings, thoughts,
perceptions, and physical condition of the individual who has the illness.
It is important for a
person experiencing the symptoms of this depressive disorder to seek help right
away. The person suffering from this illness should be examined and treated
immediately to ensure his/her safety and wellbeing. A medical practitioner
would be able to outline the proper treatment and medication for your
condition.
Bipolar Disorder is a
lifelong illness. If untreated, this disorder will make it difficult to live a
fruitful and productive life, due to the recurring manic and depressive
incidents it will produce. Having the proper treatment for this disorder would
help you continue living your life on your own terms, preventing the disruptions
caused by extreme mood swings. Medication is not enough to cure it. A
combination of educating yourself about the illness, seeking help from doctors
and therapists, a reliable support group, making healthy decisions, and
sticking to the right treatment plan will help you keep the mood swings under
control.
Finding the right
treatment is vital. Your primary doctor is a good place to start seeking advice
for therapists appropriate for your condition. You can also try to make a list
of therapists that your medical insurance or health plan will allow you to see,
if your policy has some restrictions. When you have found the right therapist
for you, an accurate diagnosis would be your next goal. Knowing what you are up
against will help you prepare mentally and physically for the treatment you
need.
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08/05/2009
Sleep is vital for
everyone because it is the body’s opportunity to energize and repair itself
after a tough or tiring day. Sleep is essential for making us feel refreshed in
the morning and for staying mentally and physically alert during our daily
activities.
Almost everyone has
encountered sleep problems at some time. This may lead to daytime sleepiness,
which will greatly affect one’s performance in work, school and community life.
Sleepiness not only reduces an individual’s productivity but can also cause
other problems such as accidents, irritability and slow mental processing. You
may be physically present at your meeting but your mind seems to wander because
of an irresistible urge to sleep.
Difficulty sleeping may be
caused by stress brought about by tough deadlines, failing relationships, or
increasing debt. It may also be caused by poor bedtime habits or a change in
time zone. You may get back to your regular sleeping pattern after the
stressful ordeal has passed or after your body has adjusted its natural clock.
However, if you are still having trouble getting the right amount of sleep on a
regular basis, then you may be suffering from a sleep disorder. You can tell
the difference if you are just having an occasional sleepless night or a sleep
disorder by addressing the symptoms.
Some of the common sleep
disorders include insomnia, narcolepsy, sleep apnea, restless legs syndrome,
and sleep paralysis. Some of the sleep disorders, such as insomnia, can be
treated through a change in lifestyle, but some of them require medication and
can be potentially dangerous. You can seek medical help through your health
plan or your preferred Health Maintenance Organization.
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08/05/2009
Having problems getting
back on track and communicating with people around you after a traumatic
ordeal? You might be suffering from Post-Traumatic Stress Disorder (PTSD). PTSD
is an illness where a person feels that there is no hope and she/he will not be
able to live a normal life again after surviving a harrowing and life changing
experience. These people should bear in mind that help is available and that
recovery from this illness is possible. All you have to do is be open to the
idea of seeking treatment, joining a strong support group, and sticking to the
recovery plan.
Having PTSD is not easy
and overcoming it is definitely not a walk in the park. But, to get your life
back in order, you will need courage to face the truth. Seek help immediately.
The earlier the disorder is diagnosed and treated, the earlier you will be able
to live normally again. It is not a sign of weakness to admit that you have
PTSD, and the only option to defeat it is to get professional help and
guidance.
An expert and
well-informed approach to crisis intervention and management can help
individuals and their families with PTSD, in a way that promotes healing and
growth. There are several managed health plans that support PTSD treatment
facilities to provide an environment that gives plenty of privacy and comfort.
Some medical insurance companies also cover mental health services that may
also include consultation with a therapist. Coordinate with your health
insurance agent to get information on your policy coverage.
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08/05/2009
Depression is an illness that
affects millions of people around the globe. In the United States alone, the
number of adults who suffer from depression is estimated at 33 to 35 million.
The good news is that it can be successfully managed, if not always completely cured.
One only needs to reach out to medical professionals, family, or even just
friends. Some health plans have also adapted higher deductibles and co-payments
for prescription drugs.
Everyone, regardless of
age, gender, economic status, or race, may be affected by depression. However,
studies show that women are more prone to the illness and experience episodes
of depression twice as often as do men.
As to what causes
depression, no specific cause has yet been singled out. However, there is a
consensus that it is caused by a mixture of environmental, genetic,
psychosocial, and biochemical factors.
Major depressive disorder
(MDD), commonly known as depression, is diagnosed when a patient manifests a
depressed mood or loss of interest and if this manifestation is accompanied by
at least four symptoms. Symptoms include difficulty in concentrating, fatigue,
feeling of worthlessness or guilt for no reason, irritability, difficulty in
sleeping, and hopelessness.
As no one can deny the importance
of the mind and body connection, a person who suffers from depression may find
it helpful to adopt a lifestyle that is good not only for the mind, but also
for the body. This lifestyle entails maintaining proper hygiene, having a
well-balanced diet, managing anxiety under the supervision of a health
professional, setting realistic goals in order to avoid disappointment, and, of
course, having a social network or close and intimate relationships.
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08/05/2009
Diabetes is the medical
condition wherein a person has a very high level of blood sugar. It is
necessary and normal to have sufficient sugar in one’s blood; however, too much
sugar in one’s blood can be dangerous and can lead to diabetes. Gestational
diabetes, Type 2, and Type 1 are two of the types of diabetes.
Almost 21 million
Americans, adults and children alike, struggle with diabetes. Many of these 21
million Americans do not have health insurance. Thus, they have significantly
limited options for treatment and they are at great risk in case of illness.
People who have diabetes but do not have medical insurance should know the
risks of remaining uninsured.
Not only is diabetes
itself harmful, but it can also lead to other illnesses. These include kidney
failure, heart disease, blindness, stroke, and amputation of the lower limbs.
For diabetics, visits to
the doctor, medication, and other medical treatments are the benefits of having
health insurance. These are necessary in order to control a person’s diabetes
as well as other medical issues that will arise from it. Diabetes is usually an
illness that lasts a lifetime. Health care for diabetics is ongoing and the
best solution for financing one’s medical expenses is getting health insurance.
When selecting a health
insurance plan that will answer your needs, it is important to look at a number
of things. For one, find a policy that will cover all the necessary treatments
for diabetes. Also, make sure that the policy will cover treatments for the
medical conditions that are linked to diabetes. Finally, make sure that your
health insurance plan will cover a substantial amount of the costs of your
pharmaceutical needs.
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08/05/2009
Health insurance can be
split into two general groups: managed care and traditional. There are four
main types of plans within these groups, namely, traditional enmity plans
(fee-for-service plans), Preferred Provider Organizations (PPO),
Point-Of-Service Plans (POS), and Health Maintenance Organizations (HMOs).
For many years, up to the
1960s and ‘70s, traditional enmity (fee-for-service) plans were the common
coverage. These plans are like car insurance – the policyholder pays a
particular amount of his or her medical expenses (deductible), and after that,
the insurance company covers the majority (around 80%) of the bill. Over all,
fee-for-service plans offer flexibility to policyholders, wherein they can
freely consult and choose their doctors and hospitals without getting
permission from the insurance company. However, these plans also involve higher
out-of-pocket costs, higher premiums, and more paperwork.
Managed care has boomed
recently, together with the advancement of medical technology. Of all the types
of managed care coverage, Health Maintenance Organizations (HMOs) are the least
flexible, but they are also the least expensive. In exchange for minimal
paperwork and low premiums, HMOs require policyholders to see only their
prescribed network of doctors. Meanwhile, Preferred Provider Organizations
(PPO) offer a bit more flexibility. PPOs also have their own network of health
providers. Policyholders are given financial incentives to stay within the
network, but they are not completely restricted to it. The third type of
managed care is the Point-Of-Service plans (POS). These plans are like a
combination of a PPO and an HMO plan, because of the Primary Care Physician
(PCP) feature. Policyholders choose their PCP from the POS’ doctor network.
In summary, no health
insurance type can be considered the absolute best - it all depends on a
person’s preferences and needs.
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08/05/2009
Depending on the coverage
needed, there are different kinds of travel insurance: trip protection, car
rental or luggage protection, and medical coverage.
The health and medical
insurance policy type of travel insurance provides coverage for medical and
dental expenses caused by injury or illness during travel. Under this type is
medical evacuation coverage, which is helpful when hospital transfer is
necessary. Typically, this is bundled with medical coverage. However, it could
also be purchased separately.
Another kind of medical
coverage is the dismemberment and accidental death policy. This covers the
duration of the vacation. Just like the usual life insurance policies,
beneficiaries get a certain amount in case the policyholder dies.
With regard to medical
policies, consumers need to check for issues about pre-existing medical
conditions, as well as age limitations. Many policies have increased rates for
senior citizens.
The second type of travel
insurance is trip protection. Under this are cancellation coverage, delay
coverage, and trip interruption protection. With cancellation coverage, your prepaid expenses would be
reimbursed if ever your trip were cancelled due to illness or death of a family
member. Delay coverage, on the
other hand, takes care of transport delays. If flights are cancelled due to bad
weather, delay coverage will shoulder your prepaid hotel expenses. Last but not least under trip
protection, an interruption protection provides coverage for travel company
bankruptcy, airline strike, jury duty, or whatever reason that cuts your trip
short.
As for the third type of
travel insurance, luggage and car rental protection provides coverage for
rental car accidents and missing/stolen baggage.
If you want to purchase any of these policies, be sure to choose the ones that
provide travel assistance aside from the monetary coverage.
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08/05/2009
It is very difficult to go
through a divorce. There are many things to worry about, and health insurance
is one of these. Health insurance coverage issues, such as continuing the
policy you had before the divorce, can be very challenging. People who are
about to be divorced may be worried about how their health insurance coverage
will be affected by the divorce. You must study the options that are available
to you. If you are satisfied with your current coverage, find out how you can
maintain it. If not, you can look for another health insurance plan whose rate
you find reasonable.
There are fewer things to
worry about when you are insured under a group health insurance plan provided
by your employer or when you have individual health insurance. In these cases,
your health insurance coverage will not be affected when you get divorced. The
bigger problem happens when you are insured under the group health insurance
policy of your spouse. When the divorce is finalized, your coverage is
terminated as well.
In this case, getting
COBRA coverage is a good option. With COBRA, you can continue your coverage
simply by paying premiums.
If COBRA coverage is not a
possible option for your use, or if you are not satisfied with your current insurance
company, you always have the option to get a health insurance policy from a
different insurance company. In some ways, doing this would be beneficial, as
you will have a fresh start with a possibly better insurance company. However,
getting a completely new policy may be difficult, as there will also be a
number of restrictions associated with a new policy.
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08/05/2009
Below the Employee Rate
Breakdown in a group or business health insurance proposal, there may be column
headings that indicate EE Rate, Total Rate, Dep Rate, ER Cont and EE Cont.
Though business health insurance quotes come in various formats, most insurance
providers use the same abbreviations. The EE Rate is the employee rate. This is
usually placed in the column to the far left, on that same line. This is the
rate of the employee’s insurance, regardless of whether they have dependents or
not. The Dep Rate column displays the rate for the employee’s requested
dependents, such as children. This rate is the total premium for all of the
dependents. The premium will not adjust if it is rated as “family”, or even if
the member or employee chooses to add more dependents to his or her health
plan. An employee’s total premium is displayed in the Total Rate column, which
includes the premium for the employee only, and the premium for their
dependents. In case that an employee does not enroll any dependents, the result
of the EE Rate will be the same as the Total Rate, and the space intended for
the Dep Rate will indicate $0.
The column labeled EE
contribution displays the percentage of the Total Rate which the employee will
shoulder. This is derived from the employee and dependent contribution portions
or percentages that are applied to compute the health plan quotes. In addition,
the column labeled ER contribution shows the percentage of the Total Rate which
the employer will shoulder. This amount should be equal to the difference
between the Total Rate and the EE Contribution. Each of the columns should show
a total amount at the bottom – this shows the combined rates for every
employee.
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08/05/2009
Typical insurance premiums
cost around 8% to 10% of the total payroll amount. The majority of this
percentage will go to health insurance coverage. Companies can offer three
kinds of health care coverage for their employees: either fee-for-service or
the traditional type of coverage, Health Maintenance Organization or HMO, and
Preferred Provider Organization or PPO.
The traditional health
plan or fee-for-service provides employees with the most flexible coverage. As
far as this type of coverage is concerned, there are no restrictions when it
comes to choice of doctors and hospitals. Because of their flexibility,
traditional health plans are usually more expensive.
Health Maintenance
Organization is the second type of health plan. Basically, HMOs are considered
prepaid health plans. Employees covered by an HMO can only seek services from
doctors and health providers inside the HMO network.
Employees under HMOs also
make co-payments worth $5 to $25 every time they go to the doctor’s office or
emergency room. Typically, employees also need to select their primary care
physicians (PCP) for health monitoring. PCPs also make the necessary referrals
if ever their patients need the services of specialists. HMOs are geared towards
preventive care.
As for the last main type
of health insurance coverage, Preferred Provider Organization works as a
combination of the traditional and HMO coverage. PPOs also have their own
network of doctors and hospitals, just like HMOs. Employees are also required
to have primary care physicians and pay small co-payments. However, employees
under PPOs are given the option to seek out-of-network services. This option
will require employees to pay more than the usual premium amount and to fill
out forms.
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08/05/2009
Key Senate Democrats presented a modified health care bill, calling for private insurance companies to compete with insurance options offered by the government. In a letter, Senators Edward Kennedy and Christopher Dodd said their improved bill dramatically decreases the costs of the earlier incomplete proposal. The two senators stressed that the Congressional Budget Office’s estimate of the proposal’s cost is now down to $611.4 billion over 10 years from $1 trillion. In a press conference, Senator Dodd said the revised plan is closer to the “historic health care reform.” This bill, he added, offers the public options on a health plan that is run by “what functions best for Americans, not by what makes enormous profits.”The revised bill also calls for a $750 annual fee for each full-time worker and $375 for each part-time worker at large companies not subsidizing health coverage for their employees. Small companies with only 20 employees would be exempt from penalties. It is estimated that the fee would raise $52 billion in 10 years. This would be used to subsidize those who cannot afford to pay for medical insurance. The government’s budget would be coming from higher taxes and trimmed Medicaid and Medicare spending. The two senators also emphasized that the legislation aims to reduce the number of employers who want to drop their workers’ health coverage next year due to high health care costs. The bill also urges private insurance companies to provide medical coverage to any applicant at a lower cost, especially to those with pre-existing medical conditions. The revised proposal is also projected to advance President Barack Obama’s proposal that aims to cover an estimated 47 million people who lack health coverage.
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08/05/2009
A recent survey commissioned by health insurance company CIGNA has found that when it comes to health care costs women are far more likely to search for bargains, such as by using healthcare comparison sites, than men are.Kurt Weimer, who leads the companies division for individuals along with small businesses, says: “From our perspective, women have always been sort of the key decision maker in health care selection. It’s moved to the next level… Not only are they making that health care decision, now they’re looking at the economics.”The survey found that out of the 1,000 people questioned only 15% of men compare the costs of medical treatments and doctors in comparison to 20% of women. The survey also found that 79% of Women were more likely to buy the generic own brand range of medications, whereas only 69% of men would look to a generic range as opposed to the well known, and more expensive brands.Weimer goes on to say that the recession has forced mothers to take on the role of “Chief financial officer” as well as “Chief medical officer”, pointing out “If you’re like all of us, you’re looking at how to make ends meet.”Executive director of the National Association of Mothers Centers (motherscenter.org) believes that women might be feeling the pressure of the recession and downturn in the economy more so than men because they make “the bulk of the buying decisions for the family”.
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08/05/2009
U.S. Health and Human Services Secretary Kathleen Sebelius disclosed Monday that local and government organizations could now avail themselves of outreach grants to enroll more children in health care insurance plans.The outreach program aims to cover 4 million children who do not have health care plans and keep 7 million children insured under the Children’s Insurance Programs and Medicaid. Sebelius said that the project prioritizes residents of “historically under-served” or rural areas.“These grants arrived just in time, when we need them the most,” Sebelius added, referring to recent news on the country’s unemployment rate, which has reached 9.5%. Sebelius also stressed that when the unemployment rate is high, the rate of uninsured individuals also rises. This is because the majority of Americans are enrolled in group health insurance plans, which are employer-provided health plans. “When parents lose their jobs, they and their children also lose health coverage,” Sebelius added.The grants, made through the Children's Health Insurance Program Reauthorization Act signed by President Barack Obama and which was released in February, will be initially funded by the federal government. The outreach program will last until 2013 and will be providing a total of $100 million worth of grants.To get the most qualified applicants, Cindy Mann, director of the Center for Medicaid and State Operations, advised using innovative methods, such as technology-driven or even localized and community-based initiatives. “We should think of ways that can really help us reach all qualified children in order for them to enroll with less red tape,” Mann said.Local governments, community-based or non-profit organizations, schools, and religious groups are welcome to apply. Eligible candidates may submit their applications at grants.gov until early August.
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08/05/2009
Rep. Chris Murphy of the 5th Congressional District of Connecticut says that America’s current health care system is sick. "I like to say we've got a disease in our health care system that's very difficult to diagnose. So the solution to that disease is going to be equally complex."Murphy stressed the need for reforms to cover the uninsured and fix the problems in the current health care system. According to the Congressman, the reforms will be centered on freedom of choice.Addressing those with individual and business health insurance, Murphy discussed the availability of choices: "If you like what you have, you get to keep it. If you're an individual or a small business that doesn't like what's available, we're going to give you options."Murphy currently works in the Health subcommittee of the House of Representatives, as well as in two other House committees, writing the health reform legislation. Also writing the reform packages are two committees from the Senate.According to Murphy, bills are often bogged down because of the number of House committees that work on the actual legislation. "We're trying in the House to have all three committees write a similar bill''Despite the complex legislation, Murphy is sure that Congress will be prepared to vote on the health care reform before July ends.The reform will require some changes in the American way of life. Everybody will be required to avail themselves of health insurance. Companies will also be compelled to either offer coverage to their employees or pay costs instead.As for the insurance industry, the reform will pave the way for a basic insurance package that will be available to all American citizens.
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08/05/2009
Connecticut state attorney
general Richard Blumenthal is pushing for the rejection of Connecticut insurance
companies’ request for a health care rate increase of 30% by October this year.
In response to Anthem
Blue Cross Blue Shield’s request for a rate increase of 22%–30%, Blumenthal
commented, “This request is legally or factually unjustified by anything this
company has submitted.”
In Anthem’s submitted
increase request, the premium for the $250-deductible Century Preferred PPO,
one of Anthem’s popular health plans, will increase by $62 monthly, from $264
to $326.
Sarah Yeager, the
company’s director of corporate communications, said that increased claim costs
have exceeded the insurance premium enough for the company to demand for higher
rates.
A spokesperson of
Anthem Blue Cross Blue Shield also said that the finances and rates of the
company are regularly evaluated to ensure that the premium fees can cover claim
expenses and costs.
The company, which
filed its request on June 9, agreed to waive the 30-day deadline for the state
Insurance Department to continue its evaluation. Based on state law, the
changes in the company’s rates would have been automatically instated on Thursday
without the department’s implied disapproval. The changes in rates could affect
56,000 insured Connecticut residents. According to the Insurance Department’s
records, the population covered by the company comprises 4% of the 1.4 million
residents of Connecticut.
An increase of this
magnitude, Blumenthal said, is clearly against the statutory standard. “The current
economic condition and the October 1 implementation also make it necessary for
the state to reject this request.”
Insurance rate
increases and the insurance companies’ compliance with regulations and laws
involving insurance business are regulated by the state Insurance Department.
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08/05/2009
Last Monday, Connecticut Senator
Christopher J. Dodd asked Anthem Blue Cross to review its proposed rate
increase. The proposal constitutes an increase of 23% on the average, while in
Connecticut the proposed rate increase is 32% for individual health insurance
plans.
Last Wednesday, Anthem
Blue Cross and Blue Shield asked the Connecticut Insurance Department to
approve the increases. Once approved, the majority of the 56,000 residents
below 65 years of age who bought health and medical insurance from Anthem will
be affected.
The proposed increases
will not affect Anthem’s group and business health insurance policies. However,
some employers complained about recent premium increases.
In a letter addressed to
David R. Fusco, Anthem’s president in Connecticut, Senator Dodd stated that
Anthem’s proposed individual policy rate increase “runs counter to the goal of
providing all Americans with quality, affordable health care,” especially now
that the insurance industry is taking part in federal efforts to reform
America’s health care system.
Considering that 322,000
residents are uninsured, the senator said, "Should these new rates kick
in, there is no question that additional Connecticut families will join the
ranks of the uninsured."
Back in January, Dodd
started a “listening tour” to hear what constituents think about health care
reform. And according to the senator, Fusco was “kind enough” to attend the
kickoff.
In Monday’s letter, Dodd
requested that Fusco "reconsider the proposed rate increases in
Connecticut and instead join me once again in my efforts and those of the
Senate and the House to enact comprehensive health reform legislation this
year."
In response, Anthem expressed its appreciation for
the senator’s concerns, but stated, “Our proposed rate increase is a reflection
of increasing health care costs." The company explained that some of its
policies will not be affected by the increase. However, those policies would
require buyers to shoulder more of the health expenses.
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08/05/2009
A survey
released last Wednesday revealed that only a little less than half of the
American population believes that their health plans would cover their cancer
treatment costs in full, while around two-thirds have the false notion that
Medicare will not cover anything.
Out of the 1,000
adults who participated in the survey, 70% stated that they were “very
concerned” about shouldering cancer treatment costs if they ever had cancer,
while 59% fear putting their families in financial trouble.
Released by the
Community Oncology Alliance, the survey implies
that Americans are worried and at the same time misinformed about the country’s
health care system, as well as the modifications that might take place after
Congress and the White House finish working on the overhaul.
According to Dr.
Patrick Cobb, president of the Community Oncology
Alliance and a managing associate of Hematology-Oncology Centers of the
Northern Rockies in Billings, Montana, it is right for people
to fear the costs of cancer treatment since cancer is the second leading cause
of death in America.
When it comes to
health insurance comparisons, only a small number of private insurance plans
provide full coverage for cancer treatment. These plans could have premiums of
$5,000 or more.
Cobb further
explained, "Monthly out-of-pocket costs for cancer care and treatment, not
covered by private insurance plans or Medicare, can easily run to $1,000 or
more. For many cancer patients, the costs of
diagnostic imaging, surgery and expensive cancer medications, especially in the
first few months of treatment, can add up to well beyond $2,500 per
month."
As part of the
proposed health care reform, President Obama has begun to push for a
government-managed insurance option that will be offered along with the
traditional private and employer-sponsored insurance.
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08/05/2009
Insurance companies are seeing an increase
in short-term health insurance applications this year.
Texas insurance company Blue Cross and Blue
Shield expects an increase of 33% in individual short-term health insurance applications
in the first half of the year.
Margaret Jarvis,
spokesperson for Blue Cross and Blue Shield, Texas, said sales of individual
health plans, whether short-term or long-term, in the first half of last year, were
at a record high for the company. Sales of both types of individual insurance,
Jarvis said, increased by over 30%.
The increasing
interest in getting individual health care plans, in general, and in short-term
insurance plans, in particular, is evident in the recent launching of more
short-term individual policies by big health insurance companies. Shifting from
group health insurance to temporary individual health coverage indicates the
growing number of unemployed people in the U.S.
Recently, the
Golden Rule subsidiary of United Healthcare in Texas launched two new
short-term health plans that are specifically designed to cater to the health
care needs of the unemployed not qualified for the subsidized health plans
under the Consolidated Omnibus Budget Reconciliation Act (COBRA) or those who
cannot afford it.
COBRA is a federal program
that offers up to nine months of subsidy to those who wish to continue their
health insurance after losing their job. COBRA, however, can also be very
expensive for those who do not meet the primary requirements.
Another
insurance company, Humana, opened a new short-term insurance plan in April for
Arizona, Colorado, Alabama, Ohio, Nebraska, Wisconsin and Michigan.
Richard
Collins, CEO of United Healthcare Golden Rule, said temporary health plans are
necessary especially now, when the economy is not yet stable.
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08/05/2009
Due to the soaring cost of
health care, small businesses in Utah are now ready to embrace a health care
reform, including the government-run insurance option, just to offer health
care subsidy to their workers and earn a profit.
A recent survey reveals
only 40% of the 300 randomly chosen businesses provide health care insurance to
their employees, and 79% of those are struggling to subsidize their workers’
health plans. In addition, 88% of the companies that dropped their employees’
health coverage say they cannot afford to shoulder the costs anymore.
“What comes through loud
and clear is the health crisis is huge, it’s crushing, and something needs to
be done right away,” said John Arensmeyer, CEO and founder of Small Business
Majority.
Small business owners in
Utah believe a comprehensive reform on health care is an economic necessity,
and that controlling the costs should be the top priority of the reform.
“The problem is that the
cost of the health insurance is rising,” said Betsy Burton, a small bookshop
owner, whose health plan cost increased by more than 20% last year. “At that
rate, it is really difficult to make a profit in a business like this, with a
low profit margin,” she said.
While almost 50% of
business leaders in Utah consider themselves as Republicans and identify
themselves as having conservative political views, small businesses in the
state are now ready to embrace a bold health care system reform.
The struggle of small businesses
with the rising cost of health care and their eagerness to do something to
solve the problem is not really surprising, said Judi Hilman, executive
director of the Utah Health Policy Project. "It is because small
businesses are the first that experience the current problems in our
system," she explained.
Click here to view this article
08/05/2009
As the U.S. government
continues to work on reforming the country’s health care system, business
groups fear that many small companies throughout Southeast Valley would be
forced to shut down.
The senate proposal for
the bill on health care reform would compel employers to provide business
health insurance for their workers. Otherwise, they need to contribute a fee
worth 8% of their payrolls for a government-managed insurance plan.
Via Homes president, Trudy
Licano, said that "A lot of times legislation is meant to help people, but
this could shut doors. There's going to be a pretty huge impact on us. Some
businesses just can't afford it."
Under the said bill,
employers who will provide insurance for their workers would be required to
cover 72.5% of the premium cost for full-time employees and 65% for family
policies. Companies are also required to insure their part-time workers.
However, some businesses would be exempted depending on their size, which has
yet to be determined.
Mary Ann Miller, president
and CEO of Tempe Chamber of Commerce, explained the possible effect of the
proposed health bill to the business sector: "I think that most businesses
would love to be able to provide health insurance to its employees, and do so
wherever they can. But mandating such coverage will only drive up costs for
businesses of all sizes during tough economic times."
Last month’s proposed bill
was described by the U.S. Chamber of Commerce as "a dangerous proposal."
According to Jack Alspaugh
of the Arizona Small Business Association, companies with less than 50
employees will find it difficult to balance efforts between providing coverage
to their employees and maintaining their payrolls.
The Senate and House
members are still working out the details of the bill, which President Obama
wants to sign by fall.
Click here to view this article
08/05/2009
Brian Urban, an insurance
broker, refused to believe a caller who told him a story about an owner of a
small business in Nebraska who couldn’t afford health plan premiums because it
would require him to pay around $24,000 to $40,000 annually.
Urban said, “Just the size
of the numbers was far out of what the market would dictate even for someone
with some severe medical conditions. And according to the story, these were
healthy individuals.”
The Nebraska health insurance
market is a familiar territory for Urban since he is the CEO of Corporate
Resource Group, as well as the legislative chairman in Nebraska for the
National Association of Health Underwriters.
33-year-old Larry Harbour
was the man who complained about the high cost of premiums. As the owner of LB
Custom Chrome and Detail in Nebraska, he tried his best to find affordable
insurance coverage. In a phone call, Urban offered to get Harbour affordable
premiums.
Harbour, who was happy to
hear Urban’s offer, described the search for health insurance as “very
confusing.” “It's very tough to understand unless you have someone, so to
speak, holding your hand and walking you through the process.”
Urban’s phone call was the
first of many geared toward helping Harbour find affordable business health
insurance coverage. “According to the story, he was uninsured, and I don't find
that acceptable. It's my job to make sure that as many people are insured as
possible,” Urban said.
Urban also made a comment
about how confusing premiums affect the health insurance debate. “We're not
opposed to reform. It's just that we want to make sure we're dealing with
real-life facts and numbers and that reform is focused on the areas it's truly
needed.”
Click here to view this article
08/05/2009
Despite the continuing
support for President Obama’s health care reform, some of the major players in
the debate are beginning to worry about the overhaul’s success. They fear it
won’t be sufficient to solve the problem of runaway medical costs.
Some even believe that the
deals the White House made with drug makers and hospitals to keep the
negotiations alive could make the problem worse.
On Monday, there will be a
closed-door meeting between labor leaders and Obama. They will discuss
aggressive measures to keep health care costs from escalating. Terry
O’Sullivan, head of the Laborers' International Union of North America,
expressed his support of the plan to have everyone covered by medical
insurance, and at the same time his concerns about the reform.
"We are certainly for
expansion of coverage. We think every American ought to have health insurance.
But if that doesn't come with making sure there is real prevention, if we're
not talking about really controlling healthcare costs, this is going to be a
train wreck."
On the other hand,
business groups are urging the current administration and its allies in
Congress to tackle the cost issues by making changes to the way doctors,
hospitals and providers are paid.
According to Steve Wojcik,
the National Business Group on Health’s vice-president for public policy,
“Going into health reform, there was a lot of talk from the president on how
controlling costs had to be on a par with expanding coverage. The priority on controlling
costs seems to have fallen by the wayside."
Consistent survey results
point to the public’s biggest health care concern: rising cost of medical bills
and health plan premiums. At the core of his campaign for health care reform,
Obama insists that his health care reform will provide relief.
Click here to view this article
08/05/2009
Health insurance costs in Alabama
have increased by 95% since 2000, according to the Health Care Status report.
The report reveals that the
number of small businesses or companies providing health coverage benefits to
workers dropped by two percent since 2000. Currently, only 48% of small
employers in Alabama offer health benefits to workers.
The soaring costs of health
insurance have affected individuals as well. According to the report, 28% of middle-class
families spend at least 10% of their total income on health care.
A related study found that the
limited options offered by health insurance companies is an issue related to
these rising costs. According to the study, BlueCross-BlueShield controls an 83%
share of Alabama’s health insurance market. Roughly, 13.6% of Alabamians are
uninsured.
Options for health insurance are
even more limited for individuals with pre-existing conditions. In Alabama, the
costs of health insurance vary based on health status and demographic factors.
Coverage can also exclude some pre-existing conditions or even be completely
denied.
The report also
says that 16% of people in Alabama do not visit a doctor due to the high costs.
Moreover, families and businesses in Alabama pay a hidden health tax of about
$600 each year on premiums to subsidize the costs of the uninsured.
Currently,
approximately 2.9 million people in Alabama avail themselves of health plans
through their jobs. Subsidized by their employers, these people have an average
family premium of $12,230.
Based on the Health
Care Status Quo report, the need for health care reform in Alabama and across
the U.S. is clear.
Click here to view this article
08/05/2009
Health Net Inc. suffered a major disappointment when
the U.S. Department of Defense awarded its $2.8 billion annual military Tricare
contract to Aetna Inc, another Health Maintenance Organization (HMO).
Estimated to be worth around $17 billion, the contract
includes five one-year options along with a 10-month base period. The contract
will provide service to millions of personnel in the military, National Guard
and Reserves, dependents, and retirees in 20 Midwest and East Coast states.
The Tricare military health care program involves 900
of Health Net’s 2,500 employees. The devastating news had a negative effect on
the company’s stock, which fell by around 15%. However, it managed to close at
$145.13, down only 3%.
In a press statement, Health Net Federal Services president
Steve Tough expressed the company’s disappointment about the decision of the
Department of Defense.
“We anticipate that a debriefing will be conducted
within the next couple of weeks. We will consider the information provided at
the debriefing, and within two weeks following, we will determine whether we
will accept or challenge the award decision.”
Another health care provider that lost a government
contract is Humana Inc. After an extensive bidding attempt, the company lost
its $3.73 billion annual contract that covers 10 southern states. The contract
was awarded to California PacifiCare’s parent company, United Health Group Inc.
TriWest Healthcare Alliance Corp. was the only company
to retain its $2.9 billion annual contract. It provides services to military
personnel located in 21 Western states.
In 1988, Health Net won a pilot contract to provide
service to military personnel, retirees, and dependents in Hawaii and
California. Aetna got the contract in 1993 and, after three years, Health Net
won it back.
Click here to view this article
08/05/2009
House democrats unveiled an extensive plan
for a bold reform of the nation’s health care system. Contained in the 1,018-page
bill are provisions on regulating the health insurance market, formation of a
new health insurance option run by the government, and other steps for implementing
universal health coverage.
The bill sets out initiatives for reducing
health care costs, which are expected to rise to $2.5 trillion this year. In
addition, the cost of the legislation, which is estimated at $1 trillion, will
be offset with a new tax to be imposed on wealthy Americans.
The proposal, which is considered one of the
most liberal in revamping the system, was criticized by Republicans and 30
leading business groups, although many of these also showed support for some
aspects.
If implemented, employers will either
provide medical insurance to their workers or pay the government a fee based on
their payroll. Small businesses with an income below $250,000 will be exempt from
paying the fees. Also included in the plan are regulations prohibiting
insurance companies from denying Americans with pre-existing medical
conditions. This is to ensure more affordable options for everyone.
All low income Americans will also become
eligible for Medicaid, and private insurance companies will be offering a
standard universal benefit package designed by the government.
The Congressional Budget Office (CBO)
estimates that 97% of Americans, including legal immigrants, will have health
coverage by 2019. Furthermore, the CBO estimates that nearly 162 million people
will have continued employer-provided insurance and 30 million people will
avail themselves of health coverage through the new health insurance exchange.
Nine million of those who would avail themselves of the new exchange are
expected to choose the new health program run by the government.
Click here to view this article
08/05/2009
After Wal-Mart pledged support for the proposal that
requires employers to contribute to their workers’ health insurance costs, the
National Retail Federation is asking its members to oppose Wal-Mart’s stance on
the issue.
In a letter issued by NRF chief executive Tracy
Mullin, group members are urged to “Come out swinging.” He added that, “To
truly lead on the health care debate, it is imperative that businesses,
associations and politicians take a stand where it counts and not shy away from
deal-breakers like employer mandates.”
The letter shows the different views of companies
toward the health care reform, which aims to cover the uninsured.
Different companies have allowed trade groups like the
National Retail Federation, the largest trade group in the industry, and the
Chamber of Commerce, the biggest business lobbying organization in the country,
to spearhead the opposition to the health care plans in congress. Wal-Mart
isn’t part of the NRF.
In a June letter to the senators in the drafting
committees, the NRF said that it would prompt its members to oppose politicians
who support an employer mandate. Meanwhile, the Service Employees International
Union, Wal-Mart, and the Center for American Progress sent their own letter to
the White House, voicing their support for a company mandate that will urge
employers to provide health benefits like group health insurance to their
employees.
The letter was signed by Michael Duke, president and
CEO of Wal-Mart, Andrew Stern, president of SEIU, and John Podesta, president
of the Center for American Progress.
The NRF is not alone in expressing opposition to
Wal-Mart’s stance. In its letter to the White House, the United Food and
Commercial Workers Union raised questions about Wal-Mart’s position.
Click here to view this article
08/05/2009
This news bit goes out to
parents and professionals alike. It’s time we stop using that “toothache
excuse” for school and office absences, the American Association for Dental
Research (AADR) says. In the Oral Health Care Within Health Care Reform policy
statement issued by the association on July 14, 2009, it was stressed that the
need to attend to one’s oral and dental aches is urgent, as poor oral care can
result in other serious problems—health-related and not.
According to the AADR,
U.S. employees take 164 million hours off from work in a year, only to attend
to a toothache or a gum irritation. Similarly, children are absent from school
for 51 million hours a year, to be free from dental pain. The association has
concluded that these periodontal diseases create the same full-body
inflammatory response as other internal ailments would, yet they receive much
less attention. The AADR claims that many Americans—more than 80 million, to be
exact—have applied for medical insurance, but not for dental insurance.
In line with this, the
association recalled what the U.S. Surgeon General mentioned in 2000. Back
then, the Surgeon General called upon everyone to recognize the importance of
oral health measures. He even proposed that lawmakers "build an effective
health infrastructure that meets the oral health needs of all Americans and
integrates oral health effectively into overall health.”
Today, the AADR recommends
that continued information dissemination regarding accessible and affordable
oral health insurance must be conducted among Americans, if that would mean
better oral health and, in turn, general health, as well.
Click here to view this article
08/05/2009
The White House and the
Democrats in Congress who are working hard on the health care bills to beat
President Obama’s deadline, are trying to keep legislation costs to $1 trillion
for 10 years. But would that be enough?
There is no doubt that $1
trillion would cover a lot of uninsured people. However, it will not be enough
to meet the goals that the advocates initially wanted. Congress is currently
working on proposals that include a $1.042 trillion bill that will be presented
by Democratic leaders in the House on Tuesday. The proposals intend to provide
subsidies to a smaller number of moderate-income families. They will also
prevent most workers from abandoning the health plans provided by their
employers.
According to the Congressional
Budget Office, the estimated number of uninsured people will go down to 15-20
million after 10 years. As of now, around 50 million people are uninsured.
Last Monday, Senate GOP
leader Mitch McConnell stated that "One of the major concerns that
Americans have about health care reform is the price tag. Every proposal we've
seen would cost a fortune by any standard."
In defense of the health
care reform, President Obama says that the overhaul is a crucial investment
toward fixing the nation’s dysfunctional health care system. Straightening the
rough edges of the current health care system would prevent financial problems
in the future.
Lawmakers are still trying
to figure out how to finance the overhaul. According to Obama, fixing the
health care system will not increase the country’s financial deficit, and to
offset such a deficit there will be a need to either raise taxes or cut
national spending.
Click here to view this article
08/05/2009
Aetna
expressed its support and concern for the welfare of college students in terms
of health care. Head of Aetna Student Health Kate Begley said, “At Aetna, we
work closely with campus health and counseling centers, as well as community
and travel service providers, to offer students access to convenient care at an
affordable price, no matter where they are located.”
Most
parents find summer the ideal time to ensure the academic and financial
preparedness of college students for life on campus. This is also the time when
vital decisions are made. What is often overlooked, however, is student health
insurance. Aetna encourages parents to view a student’s health insurance
options as one of the important considerations when they prepare their children
for college education.
Kate
Begley further said that they “support the efforts of colleges and universities
to ensure students have access to affordable, quality health care.” Aetna also
gave tips to parents who are in the process of selecting a student health
insurance plan. These tips include weighing the option of carrying a dependent
on one’s plan against the benefits of a school plan; identifying a health-care
contact on campus by reviewing the school’s website and visiting the campus
health center; and understanding the health insurance requirements of the
school.
"Choosing
a student health insurance plan that is right for your child is a personal
decision and one that should be examined carefully, particularly in today's
uncertain economy," added Begley. "Evaluating the true cost, meaning
the premium plus out-of-pocket expenses, of a family plan versus a student
health plan is critical to understanding which plan is most cost-effective and
will best serve the needs of your college student."
Click here to view this article
08/05/2009
A considerable amount of the
American family’s budget is spent on medical insurance. The USA government
alone allocates over $2.2 trillion yearly or $8,000 per person on health plans
to ensure healthy workers and a productive economy. It is projected that the
amount the government spends on the health care system will increase to more
than $4 trillion by 2017 if no program for the reform of the system is enacted.
President Obama has
initiated ways to modernize the system of health care in America. The Recovery
Act of 2009 includes a provision for the citizens who have recently lost their
jobs, which will provide a tax credit that will continue their health insurance
contribution through COBRA. He also signed a law that supports health plan
coverage for children through the Children’s Health Insurance Program (CHIP). The
president has also pushed for the computerization of health records in the
United States in five years in order to make the system more efficient and more
accurate. The government will save much money if the paper-based records, which
are time-consuming and expensive, are replaced with a computer system that will
deliver speedy results with minimal or no errors.
The government also seeks
to uplift the research and development of the current health system. The
Recovery Act has also allocated $1.1 billion for comparative research that
details data on the effectiveness of a medical treatment or procedure. This
will aid the doctors in proper diagnosis and treatment of their patients. Programs
on wellness will also be promoted in the country because almost one-third of illnesses
are attributed to poor lifestyle choices. This will reduce the risks of acquiring
diseases, such as hypertension, cardiovascular ailments, and cancer.
Click here to view this article
08/05/2009
Aside from
mortarboards, graduating college students have other things to think about.
A report from
the National Association of Colleges and Employers estimated that this year, at
least a million alumni pulled out from their parents’ health insurance coverage
after graduating. Because of financial shortages, former college students are
having a hard time getting replacement insurance policies.
According to
Jon Gabel, graduates should go for health insurance plans offered by employers.
The senior fellow from the University of Chicago’s Opinion Research
Center—Health Policy and Evaluation Department also added that it is the most
affordable health plan for fresh graduates.
But the thing
is, landing a job in today’s struggling job market is difficult. NACE says that
around 2.5 million fresh graduates are unemployed. Samantha Whiteside, a
24-year-old graduate of health and fitness from Virginia Polytechnic
University, is one of them.
After
graduating last year, she had a promising career outlook after getting a job in
an outpatient rehabilitation center around March. She worked as a technician as
well as a wellness instructor for seniors with mental illness. Her employer
promised that she would get health insurance benefits after three months.
However, she was fired three days before her fourth month began.
“I've never
been in this situation before," she said. "I know everybody's been
saying that the economy's bad … but I never thought it would happen to
me."
She is currently
working as a part-time swimming instructor. Marla Whiteside, her mother, got
her an individual health insurance plan for $96 per month. Even though the plan
would only cover 70% of hospital bills, it’s better than having no coverage at
all.
According to
Cheryl Fish-Parcham from Families USA, graduates should not be part of the
uninsured population.
Click here to view this article
08/05/2009
President Barack Obama continues to push for
the overhaul of the U.S. health care system. He says that this matter cannot be
delayed because it would affect “the stability of our entire economy.”
In Obama’s weekly Internet and radio address,
he urged the Representatives from the two parties to work on laws that will
decrease costs and regulate the “unwarranted giveaways to [health] insurance
companies in Medicare and Medicaid,” while keeping the Americans’ health care
options intact.
Obama added, “This is what the debate in
Congress is all about: Whether we’ll keep talking and tinkering and letting
this problem fester as more families and businesses go under, and more
Americans lose their coverage, or whether we’ll seize this opportunity.”
Obama is ramping up this health insurance reform
campaign, as he is set to hold two legislation events for the press this week. He
will gather the Representatives to the White House for deliberations, and will
hold a primetime press conference on July 22. The House and Senate are hard set
to meet Obama’s August deadline, as he urges them to act on legislation before
the coming congressional recess.
According to Obama’s recent statements, he will
deny support on legislation that would add to the deficit.
“I don’t believe that government can or should
run health care,” Obama remarked. “But I also don’t think insurance companies
should have free rein to do as they please.”
Obama wants a final bill in about two months
time, by October. Certain members of both parties criticize Obama’s action
timetable for this health care overhaul campaign as “too ambitious.”
Jon Kyl, Arizona Senator, commented in the
Republican weekly address on radio: “Something this important needs to be done
right, rather than done quickly.”
Click here to view this article
08/05/2009
Michigan
state employees have already dropped their health benefits, Gov. Jennifer
Granholm said today while giving a cold shoulder to House Speaker Andy Dillon’s
plan to pool some 400,000 public employees covered by individual health plans
to help the state save money.
Last
week, Dillon, D-Redford Township, claimed this bold health care reform will
help the state save as much as $900 million per year. Dillon further said this plan would provide insurance for retirees
and local employees who would be covered by a single health plan that would
provide extensive health plan options for individuals, depending on the
premiums they can afford.
“Show me
the money. I do not know where the savings come from,” Granholm told the
reporters. She further said she had not seen the details of Dillon’s
proposal. “I haven’t seen the
legislation and I have a million questions about it,” she added.
The
proposal evidently does not work for Granholm. She said it will never resolve
the state’s financial problems. She doubted that bigger pools of workers will
help the state save money, noting that the state currently has 55,000 employees
that belong to big insurance pools.
She
further added that she believe that Dillon was wrong to say that state
employees pay less for health insurance and receive better benefits than those
in private sectors. Granholm then cited last year’s House Fiscal Agency report
that reveals that state employees have lower wages and receive fewer benefits
than private sector employees.
In a
prepared statement, Dillon replied to Granholm, saying, “Change is never
easy—there will always be countless reasons not to change. But one thing is
clear: business as usual isn’t working.”
He
suggested lowering government expenses to prevent layoffs, and decreasing
college scholarships. “We need leaders like Governor Grandholm, Senate Majority
Leader Mike Bishop and others to work together in the days ahead so we can turn
Michigan around,” Dillon said.
Click here to view this article
08/05/2009
UnitedHealth Group plans to
acquire Health Net’s subsidiaries in the Northeast for $510 million.
Announced by the two companies
on Monday, the acquisition will strengthen UnitedHealth’s networks in New York,
New Jersey, and Connecticut. Based in Minnetonka, the health plan and medical
insurance provider generates the most revenue among health insurers in the
nation.
Jay Gellert, chief executive
of Health Net in Los Angeles, expressed his confidence about the deal.
"For our members, this offers a very, very good alternative. We have
confidence [UnitedHealth] will do first-rate by our members."
Health Net will continue its
operations in Arizona and in western United States. The deal, which needs
regulatory approval, is expected to be completed within a year.
New York, New Jersey, and
Connecticut have around 578,000 Health Net members combined. 437,000 of them
are risked-based commercial members and 35,000 are self-insured commercial
members. Another 55,000 are Medicare Advantage members, while the remaining
51,000 are Medicaid members. Operations in those areas are expected to generate
$2.7 billion in revenue.
Jeff Alterm, UnitedHealth
chief executive in the Northeast, talks about the company’s reputation in the
region. "We have a long, successful history of serving people in the
Northeast and are committed to responding to local market needs while also
providing people with access to the innovative health care products, programs
and technology applications of a company with a national scale."
Health Net’s Medicaid and
Medicare businesses, along with the commercial membership renewal, will cost
UnitedHealth around $60 million. Once the deal is closed, UnitedHealth will pay
Health Net another $290 million. The remaining $160 million will be paid within
a span of two years.
Click here to view this article
08/05/2009
These
days, young adults are learning about individual health insurance the hard way.
Sarah
Posekany, a 27-year-old nursing student, was forced to file for bankruptcy. She
underwent colon surgery and she was uninsured. Posekany is still in debt and
she owes a medical bill of thousands of dollars.
"It's
not fair," Posekany said. "We should learn how to be a strong nation
and take care of everybody."
Katie
Miletti is a 24-year-old college student. Although she survived cancer as a
child, she still has to deal with her treatment’s side effects. She was removed
from her mother’s policy, as she was already too old. For one month, she was
left uninsured. She later qualified for Medicaid, a federal-state program for
health insurance.
"Everyone
should have health insurance," she said. "I don't think it should
matter what your health problems are, how rich you are, or what your income
is."
Called
“the young invincibles” by the insurance industry, these young adults think
that they will never get hurt or sick.
Nick
Bernstein felt that way once, too. Bernstein became a waiter to pay off his
college loans. He also planned to get a wine-production graduate degree. He
filled his leisure time with snowboarding and backpacking.
While
snowboarding last April 1, Bernstein had an accident, which left his collarbone
broken.
At
first, he wasn’t sure if he had insurance at all. Fortunately, his stepfather’s
health plan was still able to cover a part of his $27,000 medical bill. However,
this coverage might stop before he gets well. He was diagnosed with a staph
infection. As he is incapable of working now, he still has to find a way to get
insurance before his 25th birthday, as he will be dropped from the policy of
his stepfather.
Click here to view this article
08/05/2009
Expensive premium costs are
the main reason being cited by millions of US citizens as to why they cannot
avail themselves of individual health insurance policies, according to a recent
study published in “Health Day News” last Tuesday.
Approximately three out
four people want to buy a policy but are not able to get one because the cost
of the premium is prohibitive, based on a report by the Commonwealth Fund,
which is a foundation that financially supports an independent research on
health insurance reform. Around 57 percent admitted that finding coverage they
could afford is bordering on very hard to downright impossible.
A survey conducted for the
report also cited that 47 percent of the respondents said that finding the plan
with the coverage they needed was difficult or impossible. Another 36 percent
stated that they were charged additional rates or their application was denied
due to a pre-existing condition. Some companies had their condition excluded
from their coverage altogether.
The report, called
‘Failure to Protect: Why the Individual Insurance Market is Not a Viable Option
for Most US Families, compared the experiences of adults in the working-age
bracket who have employer- and individual-based private health insurance.
In the report, it was also
found that people who acquired health insurance individually pay more money on deductibles
and premiums than those with group or business health care coverage.
Among US adults who have
individual insurance, the survey showed that 64 percent spend more or less
$3,000 on premiums annually, while only 20 percent of people who have
employer-based insurance are spending that much.
Click here to view this article
08/05/2009
Lawmakers
in Connecticut are moving forward with their plans to establish universal
health care, as there has been no federal legislation on the issue. This move
follows Massachusetts’ pioneering law.
Currently,
President Barack Obama’s administration and the Democrats in Congress are
struggling to rally support for a plan to provide health care for a large
number of Americans. Connecticut is part of a small minority of states that are
planning to create universal health care independently. The state is aiming to
improve the system that has caused more than 40 million Americans to be left
uninsured.
On
Monday, Republican Connecticut governor Jodi Rell’s veto was overridden by the state
legislature, which is controlled by Democrats. A board composed of nine members
will be created to develop a system for universal health care in the state. On
January 1, 2011, this board will be giving lawmakers recommendations for the
health care plan. Called SustiNet, the plan will cover almost all of the 3.5
million residents of Connecticut, including the 350,000 residents of the state
who do not have coverage.
In
2006, Massachusetts enacted a law that made health coverage compulsory. It was
the first state to do so in the U.S., and it brought health coverage within the
reach of people who cannot afford it by providing subsidies and by reforming
the industry. Maine and Vermont are also in the process of advancing their health
care reforms.
Connecticut
will be building a system around a health insurance pool that includes
employees of the state and Medicaid participants. The pool would eventually be expanded
to include private employers and residents who require individual health
insurance.
Click here to view this article
08/05/2009
According to health officials and doctors,
adult vaccinations and the issues surrounding them are some of the numerous
problems that haunt legislators as Congress continues to work on the health
care reform.
In a survey released by health officials, only
a small number of adults are aware that they can avail themselves of vaccines
against meningitis, tetanus, whooping cough, pneumonia, and shingles.
Experts however believe that demand and
awareness are just tiny bits of the whole problem. According to Dr. William
Schaffner from Vanderbilt University in Tennessee and the National Foundation
for Infectious Diseases, the health care system is a hindrance to vaccination.
Not all medical insurance and health plans provided by companies cover
vaccinations, doctors are paid only minimally for administering them, and nobody
can ensure the availability of vaccines.
In a news conference, Schaffner said, "They
system is cumbersome almost to the point of not being able to get the
vaccine."
Schaffner, along with vaccine experts, is
hoping for Congress to tackle vaccination issues in the health care reform
legislation. He said, "More than $10 billion a year is spent in direct
medical costs and indirect costs" to treat pneumonia, meningitis and
influenza. “These diseases can be prevented through vaccination.”
A survey of 22,000 U.S. adults released by Dr.
Anne Schuchat of the U.S. Centers for Disease Control and Prevention indicates
that most adults in the U.S. don’t get the necessary vaccines.
Dr. Anne Schuchat further stated in the news
conference that, "About half of adults had received a tetanus shot within
the past 10 years." People should get tetanus vaccines every 10 years.
Click here to view this article
08/05/2009
Robert
Reich, the labor secretary during the Clinton administration, spoke to
healthcare executives on Thursday in San Francisco. Reich said that Obama must
“start knocking heads” on the health reform issue if he wants a bill from
Congress by this fall.
He
also said that the president has learned from Bill Clinton’s mistakes. Unlike
Clinton’s reform proposals in the 1990s, Obama did not send Congress a bill
that he knew would not be passed at all.
Reich
also said that Obama should have begun working on the issue two weeks in
advance. Obama is now at risk of Congress adjourning and leaving the bill
unsettled. With this, the opponents of the package will have time to plan their
attacks. Reich was the speaker at the Leadership Summit that was sponsored by
the American Hospital Association and Health Forum.
Even
so, Reich said that “you will see an Obama bill.” He added that “Obama will
play his cards” when a Senate and House joint committee works on the
legislation. Reich is now a professor at the University of California, Berkeley. He
is a regular commentator on political policy and economic issues.
Reich
also said that the president will be adamant in adding standards to the
insurance of medical malpractice. He also said that Obama as well as Obama’s
allies are now more interested with HMO-style pre-paid health care and the
accountable care provided by integrated systems such as the Cleveland Clinic or
the Mayo Clinic. Obama and his allies are becoming aware that offering coverage
to those who are uninsured is only a piece of the health reform puzzle.
Click here to view this article
08/05/2009
President Barack Obama currently travels the
country to promote health care reform. Obama brought his campaign for the
health care revamp to a public forum on Thursday near the Midwestern city of
Cleveland, Ohio.
With the increasing number of Americans
getting skeptical about his overhaul plan on the American health care system,
and with the growing costs of health plans, the president has become more
determined to gain support for his health care reform campaign.
“We can rescue our economy,” Obama said. “We
can rebuild it stronger than before. We can achieve quality, affordable health
care for every single American. That is what we are called upon to do. That is
what we will do, with your help, Ohio.”
The president seeks major and bold changes
in the nation’s medical care system that costs $2.4 trillion. The United States is
the major industrialized nation that does not have a comprehensive health care
system.
The president emphasized that changing the
nation’s health care system can no longer wait. “We spend one of every six of
our dollars on health care in America, and that is on track to double in the
next three decades,” said the president.
But the Congress’ top Democratic lawmakers
have left their plans to meet Obama’s deadline for voting on his reform. Senate
Majority Leader Harry Reid said senators will not vote on Obama’s plan before
their recess in August, as the president had wanted. Reid said more work is
still necessary to come up with the right plan.
Obama stressed that there is a sense of urgency
about the issue, saying “I have no problem, if I think people are really working
through all these issues in making sure that we get it right. But I do not want
a delay just because of politics.”
Click here to view this article
08/05/2009
This
week, President Barack Obama will be in North Carolina and Virginia to promote
health care reform. During the recess next month, the president will be keeping
Congress under pressure. The fact that 47 million people are uninsured in
America is only one of the arguments that support health care reform. Another
argument, which many people are unaware of, is the fact that 25 million people
in the U.S. are underinsured.
John
Stewardson wakes up very early in the morning and goes to work at the 602 union
located in Washington, D.C. He’s home before noon as he needs to prepare lunch
for Linda, his wife who is a cancer survivor.
"I'm
just going to have to take medicine for the rest of my life," Linda said.
Last
summer, she was diagnosed with a tumor in her brain; she is currently in
remission. Now, the financial health of her family is at stake, as their group
health insurance only paid $150,000 for the treatment. Their savings were
demolished by the cost of the treatments, both for the cancer itself and for
the side effects.
"It's
like she fell out a cancer tree and hit every branch on the way down," said
John Stewardson.
The
family is around $100,000 in debt.
At
the Senate, Sen. Chris Dodd is working to make health choices affordable. He is
supporting the government’s insurance plan that would eliminate caps on health
plans.
"The
underinsured are a critical group," said Dodd. "In some cases, fifty-three
percent don't know they're underinsured. So they either have huge co-pay if a
problem happens or the deductibles are so high they might as well not have
insurance."
John’s
union only offered him one plan. After this reached its cap, they were left
uninsured. Every day, John calls Medicare and his union to ask for additional
coverage. So far, John has had no luck.
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08/05/2009
July
is nearly over and everybody is still having disagreements about the real
progress of the health care reform legislation. According to Speaker Nancy
Pelosi and White House officials on Sunday, legislation is progressing, however, their fiscally conservative allies are still less optimistic and
the Republicans continue to oppose it.
On
CNN’s “State of the Union,” Pelosi said, “When I take this bill to the floor,
it will win. We will move forward, it will happen.”
North
Dakota senator and budget committee chairman Kent Conrad expressed his opinion that
a bill that only carries votes from Democrats is impossible and undesirable.
“Look, there are not the votes for Democrats to do this just on our side of the
aisle,” he said on ABC’s “This Week.”
Senate
minority leader Mitch McConnell also stated on CNN’s “State of the Union” that,
“The only thing bipartisan about the measures so far is the opposition to
them.”
The
White House originally wanted the legislation to be completed before Congress
takes a break in August. Robert Gibbs, spokesman for the White House tried to
be positive about the missed deadline: “We are enthusiastic about the progress
that’s been made. We think we’re on the road to getting
comprehensive health care reform by this fall.”
He
also stated that even though committees from the House and Senate are
considering different versions, 80% of the contents of a final version have
already been agreed upon.
In
a statement on CBS’s “Face the Nation,” Obama’s senior advisor, David Axelrod,
similarly described the progress of the bill. “Now, we are at that final twenty
percent. We are trying to work through those details.”
Health
care reform has been at the top of Obama’s plans since he assumed the presidency.
He wants every American citizen to have medical insurance as well as other
health plans.
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08/05/2009
President
Barack Obama and other Democrats in Congress are pursuing a new health
insurance plan. According to nonpartisan budget experts, this health plan would
work with private insurance companies without forcing them to shut their doors.
Good news for
Democratic ears, the Congressional Budget Office’s estimate comes as officials
pushed for progress on the health care reform before the recess in August.
Democrats had a
meeting on Monday afternoon with their allies in the House, and, according to
House Speaker Nancy Pelosi, a floor vote may still be pushed through in the
coming days. Meanwhile, negotiations between a small number of Republican and
Democratic lawmakers resumed in order to find a compromise.
Democratic dissension
has slowed the progress of legislative work from the President’s strict
timetable.
Two weeks ago,
Budget Office Director Douglas Elmendorf infuriated congressional Democrats and
the White House with his statement in Congress about the House bill’s inability
to control health care costs due to lack of mechanisms.
In order to
disprove allegations that their proposal would make way for a federal takeover
of the commercial and private health insurance industry, Democrats are now
backing a suggestion from the budget office for a government insurance option that
will not harm private insurance companies.
Given the
unclear projections about how an actual reformed health care system would work,
the controversy has yet to have an end in sight.
Poll results show that
Americans favor a public coverage option as a component of the health care
system reform. However, both employer groups and the insurance industry fear
that a government-run insurance option will destroy private insurers.
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08/05/2009
President
Obama might face another hurdle in his push for universal health care. This
time, it’s not from lawmakers but from a recent paper on economics, which
argues that health insurance makes people fat.
Authors
Jay Bhattacharya and Kate Bundorf from Stanford University, Neeraj Sood from
the RAND Corporation, and Noemi Pace from University College London all stated
that Americans with either public or private health and medical insurance
coverage have a higher tendency to become obese. According to weight-gain
estimates in the paper, “private insurance increases body mass index by 1.3
points and public insurance increases body mass index by 2.1 points.”
Even
before the paper came out, economists already mentioned that fat people are a
burden on taxpayers.
According
to a study that came out today, overall obesity-related health-care treatment
costs have doubled in the last 10 years to $147 billion. The costs have even
outgrown the obesity rates, which “only” climbed by 37% for the same period.
The
new evidence supports the authors’ argument that health insurance is not just a
simple transition of financial wealth from thin taxpayers to fat ones, but
instead a “true economic subsidy for obesity.” The study suggests that obesity
is literally encouraged by health care coverage. Knowing that insurance
coverage provides protection against expenses caused by some weight-related
issues, people tend to take weight gain for granted.
Even
if the study only gathered weak evidence about more-generous coverage
encouraging more people to gain weight, there is “strong” statistical evidence pointing
to health or medical insurance coverage boosting obesity and body mass index.
The
question now is how the universal health care system, which is still a work in
progress, would affect the obesity rates of Americans in the near future.
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08/05/2009
Evaluating health plans
can be tough, especially when it comes to provider networks and managed-care
plans like HMOs and PPOs. A major factor to consider when choosing an insurance
plan is the out-of-network service coverage.
Any kind of medical care
sought outside the network arranged by your managed-care plan is categorized as
non-network services. Even though most networks try to include all sorts of
providers - from family doctors to pediatricians - not all types of specialists
can be included. Things could become tricky especially when the type of service
you are looking for is not covered by the network.
HMO members pay for
out-of-network services by themselves since HMOs don’t cover out-of-network
services. Since PPO plans cost more than HMO plans, members can get partial
coverage for out-of-network services as long as the services required were
eligible and pre-approved by the insurer.
For example, a PPO
member’s visit to a doctor who is part of the network will be shouldered by the
insurance company. The member only needs to make a co-payment. However, seeking
the services of a doctor who is not part of the network could be covered only
up to 80%. The plan holder would have to pay for the remaining 20% out of his
own pocket.
Obviously, it would be
wise for managed-health-care plan holders to avoid out-of-network treatments.
Luckily, many managed-health-care providers are responsive to the plight of
their customers when it comes to out-of-pocket expenses. Some providers have
managed to deflect the expenses by creating a payment plan, since they are
willing to do anything to keep their customers in the network.
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08/05/2009
The health insurance
system is full of complexities. The more choice that you have in terms of
doctors, hospitals, and treatments, the more costly it will be it. And if you
choose a cheaper premium over an expensive one, your freedom to choose is
compromised. Before deciding to purchase a plan that should be perfect for your
needs, you should be aware of the different kinds of medical insurance plans
that are available and the benefits that they offer.
Nowadays, Preferred
Provider Organizations (PPOs) are the most popular type of health plan. Within
this year alone, around 158 million Americans were enrolled in PPOs. Here are
some of the reasons why PPOs have become popular as a health insurance option.
In the PPO system,
doctors, hospitals, and other health providers agree on a deal with insurance
companies to provide substantial discounts to plan members. Health insurance
firms benefit from discounts given by health care providers. In return, the
providers get to bill more patients.
In this way, the plan
holder benefits from discounted rates from the doctor’s office, while the
doctor, on the other hand, benefits from a guaranteed pool of patients, and
finally, the insurance provider benefits from the premiums purchased by a
larger group of customers. This system is similar to the “you scratch my back
and I'll scratch yours" concept.
PPOs have some advantages
over other health insurance options. Unlike other health care organizations,
PPOs don’t require the members to retain primary care physicians (PCP). It
means that members can consult specialists even without referrals. PPO plan
holders also have the freedom to choose any provider–even those that are
outside the provider network.
PPOs have a lot more to
offer their customers. But what makes them very popular to a lot of people is
the balance between cost and freedom.
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08/05/2009
Purchasing the right travel
insurance is not an easy choice to make. Despite the many different risks they
may face when travelling, some people refuse to take out travel health plans
because they think that not all trips are worth insuring. But no matter what
type of trip you’re taking, it is always best to purchase travel insurance
before going on a vacation.
Individual health
insurance carriers, travel insurance specialists, credit card companies, and
travel agents are just some of the establishments that offer travel insurance.
Before purchasing travel insurance, it is a must for consumers to check what
vacation-related incidents are already covered by their health and auto
insurance. This is very important because purchasing extra insurance without
first noting the risks already covered by primary insurance could just be a
waste of money.
Flight insurance policies
could cost as little as $10; they provide coverage in case of death as a result
of a plane crash. Typical comprehensive policies cost around 3% to 8% of the
overall cost of the trip. One of the best features of travel insurance is its flexibility.
Consumers can choose just the kind of coverage they feel they need.
So, what are the things to
note before purchasing travel insurance? It’s just a matter of finding the
balance between coverage and price, need versus budget. Try to shop around,
like when you’re looking for typical insurance coverage. Expensive premiums
don’t always offer the best coverage. Sometimes, there are cheaper premiums
that offer the exact coverage needed. Take note of the policies offered by
travel agencies. Most of the time, they cost more than regular travel
insurance.
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08/05/2009
Health Maintenance
Organization (HMO) is an umbrella term referring to any organized health plan
aside from those offered by traditional health insurance firms. It is a prepaid
health plan that requires a member to pay a monthly premium in exchange for
comprehensive health care. Some of the basic services offered by HMOs are
doctor’s visits, emergency care, hospital stays, laboratory tests, x-rays,
surgery, and therapy.
HMO members are given
access to primary care providers. These primary care providers will examine you
and assess your condition before referring you to a specialist. HMOs also
ensure lower medical expenses.
Because of the fixed
monthly premium, an HMO ensures that its members are provided with basic health
care before their conditions deteriorate. Examples of the preventive care HMOs
provide are office visits, well-baby checkups, immunizations, physicals, and
mammograms.
Many people prefer HMOs to
other health plans because of their efficient service. Claim forms are not
required for hospital stays or hospital visits; members use cards instead.
If you plan to choose an
HMO, you have to consider many factors. First, you have to think about the
kinds of services that you will need in the future. If you have special needs,
it is important to take note of them. If you already have a health care
provider, consider the benefits to know if you need to switch to another
provider.
When it comes to the
actual provider, reputation and reliability are very important. The quality of
service that HMOs provide should tell you what provider to choose. You can also
talk to acquaintances enrolled in the particular HMO you are considering and
ask them what they think of the services that are provided.
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08/05/2009
There are still many
students who do not have student health insurance, primarily because of
poverty. Not all students are fully covered by scholarships and loans; they
struggle just to finish their college education. These students are in need of
affordable health insurance to protect them when the need for health care
arises.
Some lucky students have
parents who pay for their health insurance, but others do not. Regardless of
whether a student is supported financially by parents or not, having health
insurance is really a necessity. These days, living without insurance,
especially insurance that covers the medical basics, is like courting financial
disaster. This calls for affordable student health insurance.
In the light of the
current financial uncertainties in our modern society, insurance companies have
come up with some affordable solutions to really fulfill the need for
individual health insurance in the education community. Thus, students can now
focus on their studies and not worry about what will happen if or when sickness
strikes them.
There are many things to
consider when buying medical insurance. For instance, a student should want to
know exactly what his or her plan covers. He or she should find out if the plan
allows selecting a physician of his or her own choice. Other considerations
include: the cost of the annual payments for the plan, reimbursements and the
length of time these take, and even the company’s customer service (i.e., if
the company offers 24-hour customer service). These considerations tip the
balance in favor of going online to find affordable student health insurance.
The websites of insurance companies provide complete, up-to-date information on
the services they offer.
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08/05/2009
PPO stands for Preferred
Provider Organization. It is a care system that provides members with health
benefits and medical coverage within a structured, medical professional network
and facility. This care system is typically sponsored by employers or insurance
companies to help subsidize the medical costs that members would otherwise have
to carry themselves.
The organization selects
the doctors, health care providers and hospitals in the network that provide
members with medical assistance and health care coverage. While a PPO
encourages its members to avail themselves of the services of the doctors and
hospitals within the network, it also allows members to visit medical services
that are outside of the network. A PPO covers more of the medical costs of a
patient if an in-network, health service provider is visited.
In a PPO, the member costs
involved are determined by a member’s specific needs. Thus, a PPO member pays
only for the medical expense incurred from the actual medical services that
were rendered. This contrasts the health maintenance organization (HMO) for
which a member pays a monthly coverage. Like an HMO, however, a co-payment is
often required in a PPO. This refers to the amount paid at the time of
treatment to cut the medical costs. This amount is not fixed and depends on the
particular medical treatment received.
The major advantage of a
PPO is that is offers more choices than other health care insurance systems. If
a patient has a medical need that, for some reason, cannot be addressed by
health care providers within the network, he or she may avail him or herself of
the services of those outside the network while still having a certain degree
of their cost covered.
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08/05/2009
People like many things,
such as pets, jewelry, and seafood, but these things are not always safe. For
those who have allergies, coming into contact with these things can result in
discomfort and pain.
An allergy is a reaction
of a person’s immune system to an object that is usually not harmful to human
beings. People who have allergies are usually allergic to many things. These
can include pollen, pets, insect bites, food, dust mites, mold, and
medications. Allergies are believed to be acquired through one’s environment
and through one’s genes. When an allergic reaction happens, the person’s immune
system generates a "false alarm." Sneezing, a runny nose, itching,
rashes, swelling, and asthma are some of the common symptoms of an allergic
reaction.
An allergy exam will
identify a person’s allergies. This involves a thorough documentation of a
person’s medical history. The person will also be screened for allergy-related
disorders. His/her body will also be assessed as to how it responds to various
allergens. An allergy exam also includes blood and skin tests.
Allergies can be treated
in different ways. Decongestants are used to lessen swelling. They are also
used to bring back blood to the blood vessels in a person’s nose. Metered-dose
inhalers are used to expand bronchial tubes. Sneezing and itching are treated
with antihistamines. Getting allergy shots will lower a person’s body’s
capacity to produce an allergic reaction. There are also alternative treatments
that are done to treat allergies.
A person’s individual
health insurance plan can be affected if he or she has allergies. Coverage for
medication is usually limited in most plans. Only a small number of plans,
mainly HMOs, provide coverage for preventive care.
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08/05/2009
Health care is an
ever-growing need, and with the cost of insurance premiums it is very important
to consider every option available to you related to your health. Health
insurance really is vital and careful comparisons can and should be made when
choosing the best health plans offered in the market.
The use of alternative
medicines is sometimes relied upon these days as a back up to health plans by
some people. Since the start of
civilization, man has been using herbs to solve health issues. From simple
colds and digestive issues to depression, many medicinal herbs have been proven
effective against a wide range of diseases. The good thing about these
alternative medicines, aside from being cheap, is that they can be grown in
your own backyard.
Oregano is one of the most
popular medicinal herbs in the world. Aside from enhancing immunity to disease,
this herb can provide relief from cold and flu. When placed in hot water, the
vapors produced by this plant contain antibacterial and antiviral properties.
It also serves as a good decongestant.
Rosemary on the other hand
is a popular brain tonic used in Chinese traditional medicine. Its volatile
oils help increase brain activity and alertness. This plant also helps
digestion and boosts the immune system.
Another popular
alternative medicine is St. John’s wort. Researchers from the Center for
Complementary Medicine in Munich concluded that the herb’s extract provides a
more effective treatment against depression symptoms than any antidepressant.
According to the studies, St. John’s wort actually worked better than the placebos
given. It provides the basic medical effects of tricyclics and SSRIs with fewer
side effects.
The best option is to be
covered by a comprehensive health insurance policy, but having medicinal plants
in your own backyard can also be helpful when treating minor illnesses.
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08/05/2009
The growing demands of the
public are continuing to push the insurance industry into providing wider
coverage. More and more people are willing to spend on health and medical
insurance policies. In addition, as far as expanding coverage is concerned,
insurance companies are starting to consider alternative treatments and
medicines.
As a consumer, you want to
get the most out of your insurance plan. If you’re planning to apply for
coverage, you must first understand the issues related to health plans and
alternative treatments.
Back in 2006, 18 major
Health Maintenance Organizations (HMOs) and insurance providers, including
Medicare, Prudential, Aetna, and Kaiser Permanente, participated in a survey,
which listed 14 companies that covered 11 out of 34 alternative treatments.
Massage therapy, chiropractic treatments, and acupuncture are some of the most
common alternative treatments covered by insurance. However, coverage is
limited to discounts and fewer sessions.
The health care systems of
the West emphasize the use of drugs for treating mental illness. But with
concerns about the use of drugs like tricyclics or SSRIs (selective serotonin
reuptake inhibitors), alternative medicines like St. John’s wort could be an
option. Scientists from the Center for Complementary Medicine in Munich
discovered and concluded that the herbal extract of St. John’s wort may be far
more effective than any antidepressant.
If you want to avail
yourself of these alternative treatments and medications, you must first find
out a few basic facts about your insurance policy. The first thing you might
want to know is whether the insurance plan provides coverage for alternative
treatments and medications, and, if it does, to what extent.
Before getting treatment,
you might also want to ask a particular practitioner whether he or she accepts
health insurance and if there are additional costs involved. This basic
information will help you choose the best insurance for your money.
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08/05/2009
Although acupuncture seems
to relieve pain, many insurance companies still consider similar therapies,
including herbal supplements and massage, to be outside the medical mainstream.
They are still considered as complementary and alternative medicine (CAM).
However, some insurance companies do offer coverage for selected alternative
medicines and therapies on a case-by-case basis.
The easiest way to get
insurance companies to cover your alternative therapies is by making a good
case that a certain alternative treatment is necessary for you. The best way to
do this is to ask for a prescription from your doctor. This should include the
length and frequency of your treatment. Among the frequently covered
alternative therapies are massage therapy, chiropractic care, herbal remedies,
acupuncture, mind-body stress management, and homeopathy.
For some insurers,
covering alternative medicine is a good way to save money. For instance, common
treatments for chronic back pain are more expensive than alternative therapies,
such as acupuncture and biofeedback. Also, some people sometimes find these
conventional treatments less effective. Acupuncture therapy only costs $200,
while medication costs around $600 and surgery costs $10,000, but getting
frequent alternative therapies may also cost more than the conventional
treatments.
If your medical insurance
does not cover your alternative therapies, you may be able to find affordable
alternative treatments by alternative medicine college interns, who often offer
therapies at discounted rates. The Pacific College of Oriental Medicine, for
instance, has treatment centers located in New York, Chicago, and San Diego
that offer herbal medicine consultations and acupuncture therapies for only $10
to $60. You may also save money on your alternative therapies through your
Health Savings Account’s pretax money or Flexible Spending Arrangement.
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08/05/2009
Some people nearing
retirement age dream of spending the remaining years of their lives in a
community full of camaraderie and friendship, which is also a place that provides
various social, cultural, and fitness activities. Others grab the chance to
stay in a smaller house that is easier to maintain and provides the luxury of
seclusion, while at the same time feeling the comfort of being surrounded by
fellow senior residents. Both scenarios provide the elderly with a sense of
independence.
Senior citizens are
provided with six housing options for their retirement, namely, Independent
Living, Assisted Living, Board and Care, Nursing Homes (Skilled Nursing
Facilities), Congregate Housing, and Continuing-Care Retirement Communities
(CCRCs). Among these housing options, Independent Living is the best choice for
those who want freedom and versatility. It provides a residence in a compact,
easy-to-maintain, private apartment or house within a community composed of
fellow senior citizens.
True to its name,
Independent Living allows the elderly to maintain their own residence and enjoy
their daily routine without custodial or medical assistance. However, the
senior citizens are allowed to bring in their preferred custodial or medical
assistance from outside the community once it becomes necessary.
Independent Living for
senior citizens includes community services, such as laundry and cleaning.
There are also some community activities offered, namely, outings, golf, and
other social events. The residents are free to decide what will be in their
daily schedules, and since the residents are generally in good physical and
emotional health, it will be up to them to arrange for their own medical
insurance, such as Medicare, which provides health insurance coverage to people
who are 65 years old and above. Medicare operates a single-payer health care
system.
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08/05/2009
Medicare is a social
program provided and administered by the U.S. government. It grants health
insurance benefits to senior citizens, and other people who meet certain
criteria. If a citizen is granted Medicare health insurance, he or she is also
granted other rights pertaining to it. Some of these are the right to partake
in the decisions that affect health care; the right to understand, identify and
freely choose all treatment options; the right to appeal the decision to deny a
member certain services; the right to get medical services in cases of
emergency; the right to file grievances and complaints; the right to a timely
and fast appeal resolution; the right to privacy regarding personal medical
information; the right to be treated fairly and without discrimination.
In general, the rights
most often executed by patients are the right for a speedy appeal of a decision
and the right to appeal a health care resolution that is not acceptable to a
policyholder’s satisfaction. No matter what type of Medicare plan a person has,
he or she has the right to make an appeal regarding the decisions of his or her
insurance company or of Medicare.
Whenever a policyholder
feels that services and benefits available to him or her are ending before they
should, he or she can make a Fast-Track appeal. This is available if the
policyholder is released from a skilled nursing care facility, a hospital, a
rehabilitation facility, an agency for home health care, or a hospice.
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08/05/2009
Large group health
insurance is also called corporate group health insurance. A company will be
categorized under and qualified for this type of insurance if its number of
employees grows beyond the limit of companies classified as “mid-size.” Each of
the insurance companies has eligibility requirements on how many employees a
company must have in order for it to qualify for large group health insurance.
This is the highest category for group health insurance, so usually there is no
limit to the number of members or employees accepted.
In addition to better
flexibility, corporate group health insurance has many similarities to mid-size
group health insurance policies. In most health insurance providers’ portfolios,
one would usually see a greater selection of plan options under the large group
category. Large group health insurance policies are not the guaranteed issue
type, as is the case with mid-size group health insurance. However, large
companies or groups usually do not have many “high risk” employees or members.
Thus, it is less likely that the group concerned would be denied insurance
coverage for this reason.
Additional benefits are
offered to large groups that are not available to smaller group sizes. This is
because the insurance providers or companies assume the cost of these benefits,
with the risks covered and absorbed by the total premium usually charged to
large groups.
When searching for a large
group health insurance policy, the concerned party must study the available
options offered by the insurance companies in their state. There may be
significant differences regarding the premiums charged and the benefits
provided. Additionally, it is also important to know employees’ needs and wants
pertaining to health insurance. If the group’s size is large enough, the
insurance company might provide them with additional benefits.
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08/05/2009
Some insurance providers
call Mid-size Group Health Insurance “mid-market” health insurance. Compared to
small group health insurance, Mid-Size Group Health Insurance presents more
plan choices. Depending on the insurance company, the number of required
members or employees needed to qualify for this category may vary. Usually, if
a certain company goes over the 50-member maximum count for small group health
insurance, it will be offered with the next level benefits, and this will fall
into the mid-sized category. More plans are offered under this category, and
some of these plans have better benefits than the ones presented to smaller
groups.
Not being a guaranteed
issue is one distinguishing feature of Mid-Size Group Health Insurance.
Therefore, a mid-sized company that has many employees with health problems may
be refused insurance. Consequently, an insurance provider may request a claims
history report from the concerned company’s previous health insurance provider.
They may also issue a health survey that will query how many employees have
particular medical conditions, such as diabetes, pregnancy, cancer, or other
health conditions with great claim payouts. The group or company will be
evaluated as one entity, and not per employee.
In searching for insurance
providers that offer Mid-Size Group Health Insurance, the interested party has
to consider several of the available options. Additionally, the concerned party
should ask for both composite and age-rate quotes. A composite-rated Mid-Size
Group Health Insurance provides a flat rate, which will be paid by each of the
employees. This way, if the company lets its employees pay for a share of the
insurance costs, bookkeeping would be simplified. An insurance that is
age-rated has premiums rated in relation to the age of the employee. This is
rated per employee.
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08/05/2009
Every state has its own
regulations that determine how small a business should be in order to fall
under the classification of a “small business.” Businesses that fall under the
small-business category are qualified for small group health insurance. In
order to be classified as a small business, a company usually has to have from
2 to 50 members or employees. In some situations, insurance companies may
promote small group health insurance policies to a solo and self-employed
individual. These one-person groups are not eligible for particular guarantees
or policies that pertain to groups with more members.
Health insurance is
state-regulated; thus, the laws that regulate small group health insurance may
vary considerable. However, there are still some common procedures being
followed in most U.S. states. Further information about state-specific laws can
be gathered from a state’s State Department of Insurance or a duly accredited
small business health insurance broker.
One of the main advantages
of being categorized as a “small group” is that the company’s coverage of
health insurance is assured by the health insurance provider. Therefore, if a
company qualifies and meets the requirements of being classified as a “small
group,” the insurance provider must grant and approve the application,
regardless of past and present health conditions of all the company’s
employees. This is called guaranteed issue coverage. The insurance provider may
still ask the employees some health questions, but this is only performed to
rate the premium for the group health plan.
There are particular
eligibility requirements in order to qualify for a small group health insurance
plan. The company needs to prove that it is a legitimate and legal entity. The
tax payer identification number, business tax returns, payroll records,
business license, and other documents are needed for this.
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08/05/2009
Most of the universities
and colleges in the U.S. require their full-time students to have a student
health insurance plan. After taking time to carefully research all of his or
her student health insurance choices, the concerned student should now be
comfortable with a decision regarding which health care policy would best suit their
needs. The next step, of course, is to file an application for enrollment in
the desired health insurance plan.
If the student has chosen
the student health insurance being offered by the university or college where
he or she is studying, they may not need to apply. Most universities and
colleges automatically enlist their full-time students in their student health
insurance plan, if the student does not show proof of private health-plan
coverage first.
Meanwhile, if the student
has chosen a private student health insurance policy or individual health plan
instead, he or she must submit an application, together with the premium payment.
Most insurance companies require the premium payment upon application. The
premium is fully refundable, of course, if the application is declined.
In the process of applying
for a private health insurance plan, the applicant is asked a series of health-related
questions. This will determine his or her eligibility and qualification for
coverage, and also the risk factor. If the applicant is presently undergoing
treatment for a serious injury or illness, the application may be declined. It
is also of utmost importance to disclose all requested information honestly.
The applicant will also be
asked to choose the effective date of coverage. Most insurance policies can be
made effective immediately after application, but sometimes the processing can
take weeks, so it is best to file the application early.
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08/05/2009
Medicare has greatly
improved its services and health plans; however, there are still many eligible
persons who find it difficult to pay for their share of expenses, especially
for prescription drugs, and even for their Medicare premium. Individuals, who
only rely on their Social Security benefits, or those with a relatively low
income, may not be capable of paying all the costs. For this reason, they can
avail themselves of the following assistance programs: Supplemental Security
Income Benefits (SSI), Medicaid, Medicare Savings Programs, and others.
Supplemental Security
Income Benefits (SSI) is a benefit provided by the Social Security
Administration office to individuals with limited income, or to those who are
blind, disabled, or are aged 65 years and above. SSI benefits are given every
month to cover a member’s basic needs.
Medicaid is a program
jointly administered by the State and Federal governments. Persons who qualify
for this usually have all their health care costs covered in full. Income level
qualifications for this program vary depending on the state.
Medicare Savings Programs
are state-level Medicare programs designed to assist citizens in paying for
their Medicare premiums, coinsurance percentages, and deductibles. A person
must have Medicare Part A to qualify for this.
Additionally, individuals
with limited income may avail themselves of Medical Prescription drug
assistance. If eligible, he or she will get financial assistance for the
premium every month, the annual deductible, and some selected medication plans.
For queries regarding qualifications for this program, concerned persons may
contact their Social Security Administration office.
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08/05/2009
Medical insurance
companies are usually wary of providing coverage to athletes who want to get
health insurance. This is true despite the fact that the very active lifestyle
of athletes results in their good health. Compared to other people, athletes
eat well, exercise regularly, and get a lot of rest. Although this kind of
lifestyle could be beneficial for an athlete’s long-term health, athletes are
not immune to getting injuries.
For an athlete to improve
his performance, he usually goes through strenuous training. However, when an
athlete exerts himself too much in training, he is bound to experience its
negative effects. While pushing one’s limits can mean triumph for an athlete,
overdoing one’s training can lead to serious injuries and a visit to the
hospital.
Every year, two million
adults experience injuries that are sports-related. Sciatica, concussions, bone
fractures, anterior knee pain, medial epicondylitis, rotator cuff injury, and
lateral epicondylitis are just some of the injuries commonly sustained by
athletes.
Many people are finding
that getting preventative health care is becoming more difficult with the
rising cost of health care in the U.S. This is even worse for athletes who need
to regularly see health care professionals, as they strain their bodies with
exercise on a regular basis. To supplement an athlete’s fitness and nutritional
needs, regular visits to the doctor are essential in maintaining good health.
Athletes who have a health
plan can optimize their training by regularly meeting with a physical therapist
or a doctor who has experience in working with athletes. If an athlete has an
accident, he has a number of options to choose from to get physical therapy. If
an athlete has appropriate access to health care, he will find it easier to
maintain his health and to prevent expensive and possibly irreversible
injuries.
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08/05/2009
The Health Insurance
Portability and Accountability Act (HIPAA) was enacted by Congress in 1996 to
provide privacy and health coverage for patients. The recording and electronic
exchange of health information prompted the need to secure the privacy of
patients. Prior to the enactment of HIPAA, there was a scarcity of laws to
protect the privacy of patients when their health and medical files were stored
in computers instead of the traditional paper charts.
HIPAA has two main titles:
Title I and Title II. Title I deals with individual health insurance and group
or business health insurance. It works to ensure the availability of insurance
for every citizen. Title II, on the other hand, provides a list of rules and
penalties regarding the national health care system. It is well-known for the
"Administrative Simplification" guidelines.
The rules were drafted by
the Department of Health and Human Services. They are meant to ensure the
security and efficiency of electronic health data during exchanges throughout
the country’s health care system.
HIPAA helps provide
insurance coverage to as many people as possible. However, there are limits to
what it can do. HIPAA cannot coerce employers to pay or offer insurance
coverage for their employees. And because of that, it cannot guarantee coverage
for everyone in the workforce. It also cannot force employers to provide their
employees with the same health insurance coverage and benefits that were
provided by their previous employers.
Even though HIPAA assists
in the availability of insurance to everybody, it cannot regulate how insurance
companies charge group or business health insurance coverage. It also cannot
force business health plans to provide specific benefits.
HIPAA has been helping
Americans for almost 12 years now. People should understand the basic
provisions and limitations of the Act to be able to maximize the benefits they
receive.
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08/05/2009
Unlike Preferred Provider
Organization (PPO) and Health Maintenance Organization (HMO) health plans, many
indemnity policies provide the insured with an option to choose their preferred
doctors and hospitals when needing health care services. Sometimes, this type
of insurance is more expensive than PPO and HMO provided plans, but the payoff
means more options for the insured.
Some important points to
consider when choosing an indemnity policy for a health plan is the deductible,
which refers to the amount of money one has to pay before the health coverage
is provided. Moreover, some insurance plans require a co-payment, a portion of
the remaining fees one has to pay after paying the deductible. For example, if the
eligible fees are $1,000 and the deductible is $200, then what’s left is $800.
The co-payment is a percentage of what is left from the eligible charges. If
the insurance company requires a co-payment of 20%, then the co-payment of
$1,000 eligible charges with a $200 deductible would be $160.
In addition, many
indemnity health plans do not cover preventative health care services. These
services, including annual check-up exams and other doctor visits, are health
services that may prevent diseases or illnesses.
Unlike other types of
health insurance, the good thing about indemnity health insurance policies is
that most of these policies provide the insured with the freedom to use the
services of his or her chosen doctor. Some policies also allow the insured to
go to his or her preferred hospital.
Indemnity health insurance
policies also vary in terms of benefits, depending on the rate, the insurance
provider, etc. Some insurers offer indemnity plans covering more benefits, but
charge high premiums, while some offer the same coverage but with high
deductibles. The challenge is to get affordable insurance that covers what type
of health care one really needs.
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08/05/2009
The adolescent years can
be very difficult for young people who are going through this stage. Feeling
melancholic or short-tempered is quite normal, and having an emotional high
once in a while is natural for teenagers who are constantly bombarded with
different kinds of educational demands and activities. However, if these strong
emotions don’t go away or become so intense that you’re unable to handle them,
you might be experiencing teenage depression. But you don’t need to keep on
suffering this way. Help is just around the corner, and all you need to do is
seek it out. Always remember that you are stronger than your depression.
An important thing to know
is that you’re never alone in this battle. Depression is more common in teenagers
than you might think, and the solution for this problem is within your reach.
No matter what you may feel and believe, a lot of people are concerned about
you. You just have to have the courage to speak up about it, because that’s the
first step in overcoming depression.
Although depression is not
your fault, there are steps that you can take to steer your emotions towards
feeling better. Keep your body healthy. If you are stressed, don’t hesitate to
ask for help from your parents or a trusted adult. Although it may seem as if
you and your parents don’t always see eye to eye, their love and concern for
you will drive them to seek therapists and specialists that will give optimal
treatment for your condition. If you don’t have student health insurance, your
parents’ medical insurance will come in handy for the necessary arrangements.
Also, it is best to form your own strong support group that will help and encourage
you every step of the way to regaining good health.
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08/05/2009
In the health insurance
industry a benefit waiting period refers to the time before health insurance
coverage commences. There are different kinds of waiting periods with
corresponding rules for how they work within the framework of certain kinds of
health insurance plans. In general, some of the typical waiting periods are
employer waiting periods and affiliation periods.
The employer waiting
period is the most common type of waiting period. This is applicable to
business group plans. Newly hired employees must wait for a certain period
before becoming eligible for health insurance coverage. The waiting period,
which is usually three months, is enforced by employers to prevent new
employees from filing large claims and then leaving the company quickly.
Employer waiting periods have fewer restrictions. However, it is better to have
a “back-up” health care plan since the new benefits are not yet in effect.
The employer waiting
period runs concurrently with a pre-existing condition exclusion period. They
both begin on the same date. It means that employees are spared from a longer
waiting time.
Meanwhile, an affiliation
period is set by a Health Maintenance Organization. With specific guidelines,
this waiting period usually lasts less than two months. But for late enrollees,
the affiliation period could stretch up to three months.
Affiliation periods are
regulated by HIPAA or Health Insurance Portability and Accountability Act.
While waiting for coverage to commence, you don’t need to pay premiums since
HMOs are not providing the benefits yet. One of the benefits of enrolling in an
HMO plan that imposes an affiliation period is the absence of pre-existing
condition exclusions. HMOs can’t deny coverage for pre-existing conditions.
Benefit waiting periods act
as gaps in your insurance coverage. By understanding how they work, you will be
able to decide whether you need an additional health plans as a backup.
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08/05/2009
Most of the primary
universities and four-year colleges in the U.S. require their full-time
students to have a student health insurance plan. A student has several
available options in choosing the best health plan for him or her. Obviously,
in order to determine which is best, he or she must make certain enquiries and
be knowledgeable regarding the various student health plans being offered.
In researching the
different options for student medical insurance, it would certainly be helpful
to be familiar with the health care coverage that one should expect. Although
the coverage of services and benefits vary depending on the insurance company,
there are particular benefits that ought to be a part of all health insurance
policies. Given that health insurance policies are regulated by the state, the
state in which a student is attending college may impose particular
requirements on all insurance companies. If the state has specific mandates, a
student should clearly see these on the leaflet or brochure of the medical
insurance policy he or she is considering.
Here is a list of some
benefits that are commonly covered by most student medical insurance policies.
The amount of the deductible and limits of coinsurance vary significantly, so
those items are not addressed here.
Preventive health care
(usually with maximums)
Visits and consultations
with a physician
Hospital room and board
Outpatient prescription
drugs (usually with maximums)
Inpatient prescription
medication
Outpatient surgical
procedures
Registered nurse fees
Anesthesiology
Ambulance
Durable medical equipment
Hospital intensive care
Lab and radiology
Psychotherapy (some states
mandate this, usually with maximums)
Radiation and chemotherapy
Physiotherapy (usually
with maximums)
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08/05/2009
Around 51% of the
immigrants in the United States are not enrolled in any health insurance plan.
Getting health care coverage may be particularly difficult for an immigrant,
considering that many immigrants are not working at companies that offer
group/business health insurance.
There are only a few
options for insurance coverage for immigrants. Usually, immigrants are not
eligible for federal insurance like Medicaid. Although Medicaid provides
subsidies to people with low income, poor immigrants are still not qualified to
receive public benefits like Medicaid because of the Personal Responsibility
and Work Opportunity Reconciliation Act (PROWRA). Immigrants may only avail
themselves of a subsidy after five years of residence in the U.S. Undocumented
non-citizens are not eligible for Medicaid.
Similarly, although there
are many subsidized health programs for children in the U.S., like State
Children’s Health Insurance Program (SCHIP), the children of immigrants who
have not been in the U.S. for at least five years are restricted from receiving
health care assistance due to PROWRA. They may still be ineligible for an
extended period due to economic requirements. Moreover, unrecorded non-citizens
do not qualify for SCHIP.
The easiest way for
immigrants to get access to health coverage is through private individual
health plans. The cost of this type of insurance is, however, higher than many
other health plans.
Nonetheless, in a nation
where health care costs are soaring at a very alarming rate, it is a necessity
for every U.S. resident, whether an immigrant or one who was born in the U.S.,
to purchase an insurance plan that greatly lessens the burden of medical costs.
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08/05/2009
Cancer health insurance is
designed to help reduce expenses for cancer care. However, it is not intended
to replace group/business or individual health insurance policies. Rather,
cancer insurance is meant to complement health plans that are already in place
by dealing with extra expenses not covered by your existing policy.
To be eligible for cancer
insurance, an individual should not have an existing cancerous condition.
People who have been diagnosed and treated for cancer are in most cases
ineligible for such a policy.
There are a wide variety
of cancer insurance policies, so it is necessary to read the documentation
carefully and understand it thoroughly before buying one. The coverage differs
based on its provider, although most plans cover both medical and non-medical
expenses. You should read it and compare it with your existing policy to check
if there are certain benefits that overlap. You also need to be aware of the
limitations of the policy beforehand.
To know if you really need
a specific health insurance plan, like cancer insurance, you should determine
the extent of your cancer risk. If you have a strong family history of cancer,
it would be wise for you to consider including this kind of insurance in your
coverage. However, if you only have an average risk of having cancer, a better
option might be to upgrade the coverage of your existing insurance policy. This
will help you save money and increase your range of benefits. Lastly, before
signing anything, make sure that you have completed a comparison check of all
the plans available to decide which policy is best for you.
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08/05/2009
Health insurance has
always been a necessity, especially for seniors. Many older people even
consider purchasing supplemental health plans to cover medical expenses that
their insurance plan may not cover.
Medicare, a federal health
insurance developed for seniors through the Social Security Act of 1965, is the
most popular option among the elderly. To qualify for Medicare health
insurance, the applicant must have worked for 10 years. If the person does not
meet this requirement, he or she is required to pay a monthly premium.
Medicare covers diverse
health care services, although some services are subject to extra costs.
Services that are often not covered by this type of insurance include
in-patient hospital deductibles and other fees.
Usually, to ensure that
most of their medical expenses will be covered, many seniors enroll in
secondary health insurance plans to supplement their Medicare health plan. A
Medigap policy, an individually purchased health insurance policy, is a widely
used option as a supplemental health plan for seniors. Since only a few
prescription drugs are covered by Medicare, many seniors also choose to enroll
in Elderly Pharmaceutical Insurance Coverage or the EPIC Program, which
subsidizes prescription drugs costs. This insurance covers almost all
prescription drugs. The insurance’s deductible plan is also applicable to
seniors who earn over $20,000 per year.
Medicare coverage used to
be limited to hospital care, physician and outpatient care. But in 2003,
through the Medicare Prescription Drug Improvement and Modernization Act,
Medicare started providing coverage for the cost of prescription drugs.
Seniors may also enroll in
other Medicare Advantage Plans, such as Medicare Medical Savings Account Plans,
Preferred Provider Organizations, Private Fee-For-Service Plans, Health
Maintenance Organizations, and Medicare Special Needs Plans.
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08/05/2009
Medicare offers various
options aside from the Medicare Supplemental Insurance. The original, or
default, Medicare plan is a fee-for-service plan. This means that it offers a
certain amount of flexibility to its policyholders, with different types of
prescription medication coverage and health care services. Policyholders can
also avail themselves of the services of doctors or hospitals of their
choosing, as long as these health care providers accept payment from Medicare
for the services they render.
There are other choices
that can either replace or augment the original Medicare plan, including
Medicare Special Need Plans, Medicare PFFS (Private Fee-for-Service) plans,
Medicare PPO (Preferred Provider Organization) Plans, Medicare HMO (Health
Maintenance Organization) Plans, PACE (Programs of All-inclusive Care for the
Elderly), and others.
Policyholders are advised
not to make any alterations to their current coverage if they are covered by a
trade union, employer, TRICARE, the Department of Veteran Affairs, a special
program or plan, or Medicare supplemental policy until they consult with a
benefits administrator or a licensed insurance provider.
Before a person decides on
which Medicare coverage to choose, he or she must consider the plan’s benefits,
cost, choice of hospitals and doctors, the location of medical facilities, and
other important matters. If needed, assistance can be received in order to get
advice regarding prescription medication coverage and health care policy is
best for a particular person’s needs. Persons with queries can call Medicare’s
hotline at 1800-633-4227 to talk with a service representative, or they can
visit www.medicare.gov. Medicare personnel will respond via email with the
requested information in approximately three weeks.
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08/05/2009
The current financial
crisis has created many “in-betweens”— average people who need immediate health
insurance coverage for short and limited periods of time. To answer the needs
of the “in-betweens,” private insurance companies have designed short-term
medical insurance policies. This quick fix is perfect for consumers who seek
insurance coverage for one to six months just to avoid getting into a difficult
financial situation.
Through short-term health
policies, healthy individuals are able to benefit immediately from family or
individual health insurance. Coverage can start after 24 hours of processing.
Once a consumer determines the total coverage period required the insurance
provider can opt to allow a plan holder to make a one-time payment depending on
the period of coverage.
Most of the time, these
types of policies include a range of deductibles and premiums. They are
promoted as 35% cheaper than regular private health plans. Some of the most
common services covered by short-term policies are outpatient and in-patient
treatment, as well as surgery. Plan holders can also select their preferred
doctor or medical facility without limitations. However, using the services of
in-network providers can lead to financial incentives.
As for the drawbacks,
short-term medical insurance won’t cover everything. It could be perfect for
healthy consumers who need to be temporarily insured; however, short-term plans
don’t cover preventive care and routine office visits. Pre-existing medical
conditions are also not included in the coverage. In addition, short-term
medical insurance is not available nationwide.
So if you need temporary
insurance coverage while waiting for new insurance to kick in, you can choose
between different short-term major medical plans. However, before choosing any
type of insurance, practice responsible consumerism. It is always best to know
your needs and analyze the benefits of your possible insurance choice before
enrolling in a plan.
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08/05/2009
One of the most important
decisions for families is selecting the appropriate family health plan. Before
modern health plans were offered, there was only one kind of service, which is
now known as the fee-for-service option. Today, there are many plans to choose
from. Before choosing a health insurance plan, it is best to make health
insurance comparisons to know fully what are the available options. Basically,
there are two major issues that people must address when choosing a health
insurance plan: the needs and the budget.
Firstly, people must
realize that health plans do not cover everything. It is crucial to know the
needs that must be addressed to avoid spending on plans that offer irrelevant
services. After considering the type of plan to purchase, the next logical step
is to fully understand the benefits offered, as well as the plan’s guidelines.
So where do budget and
needs meet? As we all know, a teenager and a baby boomer have different needs.
It’s a good thing that every health insurance plan employs different ways to
cover different kinds of situations. After understanding the type of coverage
needed, the next thing that needs to be considered is affordability. As a rule
of thumb, the more comprehensive the insurance plan, the more expensive it will
be. Often, consumers base the type of coverage they purchase on their financial
status.
Of course, monetary issues
are important because health insurance is just one of the basic needs that
families must address. Families also have to pay for the children’s education
and everyday needs. That is why it is very important to consider all the
factors before purchasing a health plan: in order to find a plan where price
and coverage meet.
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08/05/2009
Recently, there has been a
steady increase in health insurance premiums. Many insurance options have been
affected by this. However, you can choose options without the increased costs
by planning and researching carefully.
As health insurance
premiums are becoming more expensive, you will want to get the most out of what
you pay. To do this, you must ensure that your health plans only meet your
heath care needs. Everyone has different health care needs so it is possible
that you might have chosen the wrong plan if you pay high premiums for a plan
that covers options that you do not need. When this happens, it would be best
to reassess your needs.
For a person who is
generally healthy and who doesn’t visit the office of his health care provider
that often, an individual health insurance plan that features a high deductible
or a high co-payment could be the right choice. This is an example of spending
your money wisely when it comes to insurance. It is important to make sure that
you are only paying for the services that you need.
A health insurance plan
that focuses on affordable medications would be advisable for those who have
health conditions that need constant medication, such as asthma or allergies.
It is vital that you figure out the health insurance options that matter to
you. This will help you maximize your health insurance premiums.
Even though there has been
a rise in health insurance premiums, it is still possible to not spend too
much. You can do this by making wise choices, and by ensuring that the options
you are paying for are what you really need. A little bit of research will help
keep your expenses down.
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08/05/2009
Often, people with small
businesses do not have health insurance plans. It is important for them to find
health coverage through a self-employed health insurance plan. What they need
is an affordable, quick and easy health plan.
Being hurt or struck by a
sickness is tragic not only to one’s family but also to one’s finances.
Although sicknesses and accidents may come anytime— sometimes, when they are
least expected—one can be prepared for them by having a health plan. As an
owner of a small business, a person can get health coverage through a variety
of plans. He or she may consider looking into plans that are like discount
cards, a family plan that can cover him or her as a business owner, or group
health insurance plans for the self-employed. Also, individual health care
plans may be an option.
It is not difficult to
look into different health insurance policies available; one can secure online
quotes in no time. Eye care, dental and ER services may be obtained along with
quotes for health coverage. Knowing the type of insurance to look for is
important. Some plans offer discount cards that can be used in transactions
with anyone who accepts them. These types of plans are ‘down-to-earth’.
However, there are other, more typical insurance plans, which may require one
to wait in order to be covered for any pre-existing condition.
There are many different
types of health insurance policies for the self-employed. Quotes for these can
be easily organized online.
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08/05/2009
The health maintenance
organization (HMO) dental insurance plan is the type of insurance that requires
some type of prepayment from a patient. The patient, in turn, is provided with
dental care from providers within the network. Of course, if the patient wishes
to use the service of a dentist outside the network, he or she will have to pay
the entire bill, which is known as a capitation dental insurance plan.
A dentist within the
network receives his or her payment once a month by the insurance provider, and
this payment is usually fixed. This is one of the differences between an HMO
and preferred provider organization (PPO) dental insurance plan. A dentist who
is within the network may agree to lower the cost for the patient provided that
the insurance company refers other patients to the dentist so that he or she
may have more clients, and therefore a greater income.
An HMO dental insurance
plan covers the following services: basic dental services. This includes
cleaning, dental exams and X-rays, and other procedures such as dental crowns,
dentures and bridgework. These procedures, however, are slightly less common.
Furthermore, part of the cost of these procedures is shouldered by the patient.
Nevertheless, the costs of the basic dental services are not shouldered by the
patient.
The advantages of an HMO
dental plan lie in the absolute entitlement of an eligible patient to dental
care. This means that despite the lack of full compensation, the patient will
still be treated. There are a number of companies that provide a variety of
dental plans. These may help patients weigh the coverage he or she needs
against the amount of money he or she is willing to pay for dental care.
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08/05/2009
Understanding how loved
ones fall into drug addiction may be hard for you to grasp. Watching them fall
into the vicious cycle over and over again even after swearing that they will
never do it again is a very difficult and painful experience. However, we have
to recognize the fact that drug abuse is not an issue of moral limitations and
flawed resolve, but a cruel cycle that affects the brain and causes the person
to fall deeper and deeper into the quicksand of addiction.
The damage drug abuse and
addiction can cause might snowball from one disaster to another and can lead to
death. It would take a great amount of courage and resilience to recover from
drug abuse and addiction. The first step towards a full recovery is admitting
that you have a drug problem. Being ashamed and trying to do the healing
process alone will not help you. A strong support group goes a long way in
providing you with the strength to battle the internal conflict.
Drug addiction is a very
tricky disorder. Relapses often happen, even if you thought you were fully
recovered, which might be very exasperating and discouraging. But don’t lose
hope. There are various drug treatments that can help lead you towards
recovery. Being sober is only one of the initial steps you need to make. You’ll
need trained health professionals to outline a recovery program for you and
there are rehabilitation centers that offer a wide range of programs with the
most appropriate treatment for you. The treatment cost should not be a problem
if you are familiar with what services your medical insurance covers. Other
financial concerns can be discussed with the management and will provide
choices that match your arrangement.
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08/05/2009
Until today, people had
very few long-term, health care insurance options. Most commonly, people would
have traditional policies, which offered a certain amount of health benefits.
But, the traditional, long-term health care policies weren’t really enough and,
with the soaring health care costs, self-ensuring is also a risky move.
Depending on family may also be an alternative, but it is still not a viable
option.
While the traditional
long-term-care health plans were a great help for some, many still wanted
guaranteed benefits in the event that the health plan was never used. Thus, the
insurance industry came up with traditional health plans that had a “return of
premium” rider. With this type of policy, the health insurance company, over a
period of time, would return part of the premiums to the owner of the policy if
the health benefits were never used.
The insurance industry has
designed health insurance described as “linked or hybrid” policies. These
health plans provide the benefits offered by an annuity or life insurance
agreement and the traditional, long-term care insurance plans. With this type
of policy, the insured is guaranteed that if he or she remains healthy and does
not use the health care, the benefits can be used by his or her beneficiaries.
Some hybrid insurance policies do not have a “premium rider”. Instead, a part
of the internal return is used in paying for the long-term care benefits. The
cost of the long-term care benefits is based on the amount of coverage chosen
upon the purchase of the term. Usually, the insurers of some hybrid health
plans provide a payout of 200% or 300% of the aggregate insurance value up to
three years after the value of the annuity account is depleted.
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08/05/2009
With so
many different health insurance plans to choose from and so many people without
any health insurance at all, prescription drugs can be expensive and difficult
for many Americans to obtain. Many
people who require daily medication face financial hardship while struggling to
afford their prescriptions; some even find themselves having to choose between
the drugs they need and paying their bills. No one should have to make decisions like this. There are many options available for
those who need help with the cost of their prescription medications.
Several
programs help patients obtain prescriptions for free or at a discount,
regardless of their health insurance coverage. The Janssen Ortho Patient Assistance Foundation offers free
prescriptions donated by a group of companies to patients who meet
qualification guidelines. The
Partnership for Prescription Assistance is a clearing house that helps patients
locate the best discount or free prescription programs available and assists
with applications and enrollment.
Together Rx Access works directly with several pharmaceutical companies
to provide discounts on many different medications. For people aged 65 and over who qualify for Medicare, the
optional Part D plan provides coverage for prescriptions. Many states also have programs to help
qualifying patients receive help with the cost of prescriptions.
Most health
plans offer some form of prescription drug coverage. If you decide to use your insurance to help with the cost of
medications be sure that you understand the particular rules set out by your
policy terms. Many insurers cover
only a select group of drugs, while others require co-pays for
prescriptions. These out-of-pocket
expenses can vary depending on the kind of medication. Some plans restrict or exclude
medications that are not prescribed by a network provider or those not deemed
medically necessary. Consult your
policy before making a decision.
Independent
prescription plans are an increasingly attractive option for many people. These programs give consumers discount
cards to use when buying prescriptions.
If your health insurance does not cover a medication you have been
prescribed or does not offer prescription coverage at all, purchasing one of
these plans could be a good alternative to paying for medications out of
pocket. There is usually an annual
fee for participation in a plan, and plans can be offered through a variety of
sources including pharmaceutical companies, drug stores or pharmacies,
insurance companies, and non-profit organizations. There is a lot of variation between plans, but they are
generally structured in tiers and charge fees based on a sliding scale of
factors. Discounts also vary, but generic
drugs are usually much cheaper than name-brand medications. It is very important to carefully
research several different prescription plans before making a decision. Consider what medications you need,
whether you can substitute generics for name brands, and how often you purchase
your prescriptions. You may even
need to participate in more than one plan if you take many different
prescriptions.
Prescription
medication can be expensive, especially if you require daily treatments to keep
you healthy. Consider one of these
options to help you get the prescriptions you need without breaking the bank.
Click here to view this article
08/05/2009
Many
Americans suffer from some form of mental health issue such as depression,
anxiety or stress. The stigma that
was once so firmly attached to these disorders has significantly lifted and
many health insurers now provide comprehensive coverage for substance-abuse
treatment, therapy, in-patient care and other mental-health services.
Insurance
coverage for mental-health services varies from provider to provider and across
states. Some states have laws
outlining a minimum standard of care for mental issues or substance-abuse
treatment, though many plans offer much more coverage than state minimums. Coverage for mental health or substance
abuse is typically not as comprehensive as other medical services and may
require higher deductibles or co-pays.
The Mental Health Parity Act of 1996 mandates that insurance plans that
offer mental health services set dollar amount limits for this coverage equal
to those of other kinds of medical care.
The law does not, however, require all health insurance carriers to
offer coverage for mental-health treatment. Many states have parity laws, as well, so check with your
state’s insurance department to find out about regulations in your area.
There are
potentially very many professionals involved in mental-health treatment: primary-care physicians, physician
assistants, clinical psychologists, psychiatrists, social workers,
substance-abuse counselors, therapists, nurses, etc. It is important to explore all of your options before
seeking treatment and to coordinate care with specialists through both your
primary-care doctor and your insurance company. Before you seek treatment for a mental health issue, contact
your insurance carrier and request a written outline of the services covered by
your plan. Find out if you will
need a referral from your primary-care physician, and if there are any
restrictions on the kind of care you are eligible for or the providers you have
access to. Be sure to ask about
any out-of-pocket fees you may incur while seeking treatment, whether you are
required to use in-network providers, and other options available to you
through your insurance plan.
Some
companies offer employee assistance programs (EAP). These services can be a part of a larger health insurance
package or can be entirely separate programs. Visits to therapists or counselors are usually free, though
the number of times you can see a provider may be limited. EAPs cover preventative and diagnostic
services; many provide assistance with substance abuse, stress, depression,
family and marriage counseling. If
your employer offers an EAP, you can rest assured that any information you
share with a mental-health professional is completely confidential and your
employer never receives any information about your treatment.
Both
Medicare and Medicaid cover mental-health and substance-abuse services. If you are eligible for either of these
programs, check with your plan representative or caseworker for more
information and help locating an approved provider or treatment facility.
Certain
states offer public mental-health services such as state-funded clinics where
payment is calculated on a sliding scale based on your income level or what you
can afford to pay. Many of these
facilities also offer financial assistance to patients who qualify.
Click here to view this article
08/05/2009
As
unemployment rates continue to climb, more Americans who were previously
insured through an employer or union suddenly find themselves without health
coverage. For these people, short
term health insurance is an affordable option that can provide a much-needed
temporary safety net. A product of
the Congressional Omnibus Budget Reconciliation Act of 1985—COBRA—is one of
these options.
The idea
behind COBRA health coverage is fairly simple. The plan allows workers who have been laid-off to continue
to purchase health insurance from their former employer for a set period of
time following their dismissal.
The term of a COBRA policy is generally 18 to 36 months, and the plan is
meant to protect workers while they search for another job or consider
alternative options for health care coverage. Employers are required by federal law to provide information
about COBRA plans to laid-off workers, but COBRA is not always a good fit. In fact, the majority of laid-off
workers choose to forego COBRA coverage altogether in favor of more viable
options.
While COBRA
coverage is intended to provide care for healthy people who have recently lost
their jobs and to act as added security in an unsteady job market, it can be
cost-prohibitive for newly laid-off workers who have lost their source of
income, and may be impossible to obtain for those with serious medical
conditions or health risk factors.
COBRA policy premiums are more expensive, as workers who purchase the
policy are required to take on the added cost of the portion of the premium
that their employer once paid. So
workers are paying more for the same coverage. For people with serious medical concerns the cost of care
and treatment, even with a COBRA plan, could put coverage completely out of
reach. Furthermore, COBRA is not
always offered by employers. For
example, when a company chooses to drop group medical coverage for existing
employees or has filed for bankruptcy, it is not required to extend COBRA to
laid-off workers.
Recent
federal legislation tied to President Obama’s economic stimulus package has
provided some relief for workers considering COBRA. Under Obama’s plan, laid-off workers who purchase COBRA
coverage can receive government subsidies for up to nine months that cover
about 65 percent of COBRA premiums.
The subsidies are offered to workers who involuntarily lost their jobs
between September 1, 2008 and December 31, 2009. This has made COBRA health plans a much more realistic option
for many unemployed people. There
are restrictions, however:
Individuals with annual income over $125,000 and married couples with
annual income over $250,000 are not eligible for the program.
Even with
this help from the federal government, COBRA may not be the most affordable
health insurance coverage available for laid-off workers. It certainly pays to do some research
into alternatives such as short-term major medical plans, state-sponsored programs,
or a spouse or partner’s employer-sponsored coverage. Researching these other options before necessity sets in is
wise, as it allows workers the luxury of time and the opportunity to consider
all factors before making an informed choice.
Click here to view this article
08/05/2009
Health
insurance plans are about as unique as the people who purchase them. With so many options to choose from it
is hard to know which is the right fit.
Being informed about your choices is the first step to deciding wisely.
Health
Management Organizations (HMO):
These plans are characterized by a range of services provided through a
network of doctors, hospitals, labs and clinics who agree to treat members at
predetermined rates. Members need
to arrange all care with specialists through their primary care physician—who
acts as sort of an overseer of treatment.
Patient choice is often restricted under HMOs, as those who wish to use
out of network providers or services may face additional costs; in some cases,
patients are required to pay total expenses out of pocket. HMO premiums are usually very low and
plans cover most routine preventative procedures like mammograms, vision exams,
immunizations, and physicals.
Preferred
Provider Organization, PPO, is another kind of managed care plan that allows members
to visit any in-network doctors without a referral from a primary care
physician. Though members do not
need to see a primary care doctor and are free to see a specialist of their
choice, there is generally better coverage for in-network providers. PPOs sometimes require co-pays for
office visits, and most plans require members to pay the annual deductible in
full before coverage begins. These
policies also oblige members to obtain approval before receiving any major
medical treatment or services.
Point of
Service, or POS, are managed care plans with varying benefit levels based on
where care is obtained—in the plan network or out of it. Most POS plans combine benefits from
HMOs and PPOs. Patients are
required to name a primary care physician, but are free to seek out of network
care for greater personal expense if they choose. Some POS plans may ask patients to cover office visit
co-pays, an annual deductible or coinsurance out of pocket. Coinsurance is the percentage of the
total cost of care that a patient has to assume once the insurance company has
paid their share. For example, if
an employer health plan covers 80% of the total allowable cost of treatment
then an employee with that plan would have to come up with the additional 20%
of the cost from their personal financial accounts.
A health
savings account, or HSA, is a personal savings plan with tax benefits. Used in conjunction with policies that
have high deductibles, these low premium plans provide an account that can be
accessed at any time with the withdrawn funds going to pay for qualifying
medical care. Additional funds can
be deposited tax-free, and funds remain in the accounts from year to year. Funds can also be invested according to
the account owner’s discretion.
Interest and dividends build up without tax penalties. In fact, the only time penalties are
assessed is when the withdrawn funds are used to pay for things other than
medical care.
With so
many options it is always a good idea to take your time and carefully consider risks
and benefits before committing to a policy.
Click here to view this article
08/05/2009
eHealth
Insurance is a top Web site for people searching for the best health insurance.
It is a certified, health-insurance company that caters to persons, families
and small companies that want to purchase health insurance. They have about
800,000 policy-holders throughout the US, and they offer a wide-ranging
selection of health insurance plans from the major health insurance companies
in the country. To top that off, they also deliver exceptional customer
service. With their well-informed and professional representatives,
easy-to-follow online tools, and pioneering Web site, people will discover that
getting health insurance doesn’t have to be expensive and difficult.
The
easy access to eHealth Insurance helps people get the health insurance they
want, and at the same time understand what they need. Just by supplying the zip
code and basic information about the applicant, he/she can receive free
quotations, figure out the plan appropriate for him/her, and gather enough data
to make the correct decision on which health insurance to buy. There are
certified insurance agents that will accommodate those who are in need of
clarification and further explanations regarding their policy.
After
the online application has been submitted for the plan or coverage, eHealth
will work with the insurance company that the applicant has chosen, to speed up
the approval process. eHealth Insurance will still continue forwarding the
applicant’s concerns and questions to the health insurance company to ensure
that any small glitch or query will not be left unnoticed. This ongoing service
also helps the applicant with any future needs from the health insurance
department.
eHealth
Insurance offers a wide range of options in health insurance products that
applicants can choose from.
They have individual
and family health insurance, which can benefit singles or families that
weren’t able to acquire health insurance coverage through their employer.
This kind of health plan is the most appropriate for individuals and
families. They also offer Small
Business Health Insurance, which is good for companies and/or
organizations that have two to fifty employees. eHealth also offers short-term
health insurance, which is good for temporary coverage. This is applicable
to those who are between jobs or are fresh graduates, since the term of
the policy is not that long, and therefore not that pricey. They also have offer student
health insurance, which is good for full-time college students living far
from home who are no longer covered by their parents’ policy. eHealth offers
affordable dental insurance. They also have dental
discount cards, which are another option for standard dental coverage.
This is not considered an insurance plan, but it can give the applicant
discounts to any dentist in the local area on several dental procedures. Lastly, eHealth
Insurance offers health savings accounts.
Click here to view this article
08/05/2009
In the
current health insurance system, Americans who are in employment pay for their
portion of employer-sponsored coverage with pre-tax dollars that are
automatically withheld from the workers’ paychecks. For those who do not have access to employer-sponsored
health insurance and must pay for policies on their own, they almost always use
after-tax dollars to pay premiums.
This creates an unfair tax benefit for workers who take advantage of medical
insurance through an employer and makes private health plans unaffordable for
many working Americans. One
proposed solution to this problem is state-sponsored health insurance
exchanges.
Statewide
health insurance exchanges are a way to make healthcare more affordable for a
wider audience of working people as federal lawmakers debate tax code reforms
that would improve access to health insurance for more Americans. Like the stock market, these exchanges
would include all different kinds of insurers and provide a single market for
all different kinds of insurance plans—traditional indemnity policies, HMOs,
health savings accounts, PPOs and other options. Exchanges could also include federal insurance programs like
Medicare and Medicaid, thus protecting low income families and those with
special medical needs. Instead of
offering health insurance from a single source, employers would designate the
exchange as their preferred “plan” and pay their contributions directly to the
exchange. Workers would then be
free to choose any of the participating plans in the exchange, thereby offering
the opportunity to find coverage that best fits their circumstances.
Supporters
of health insurance exchanges insist the system would save small businesses
significant administrative costs as processes like enrollment, claims services
and premium payments would be centralized and simplified. This would allow businesses who have
never been able to provide health insurance for employees the chance to extend
this coverage to workers.
Furthermore, because employers would make fixed payments to the exchange
rather than to individual companies, the possibility of coverage non-renewal,
group coverage cancellations, and ballooning premiums are eliminated.
Employees
would benefit financially because all contributions to the exchange would come
before taxes. This would level the
field for workers who currently have to provide their own insurance with
after-tax dollars. Because
coverage would never be tied to a particular employer, people would have the
freedom to carry a health plan from job to job without penalty or lapse in
coverage. Continuity of care and
policy portability have been hailed as some of the most attractive options with
statewide health insurance exchanges.
Statewide
health insurance exchanges would ease the financial burden for many working
individuals and families without requiring extensive intervention from the
federal government. The system
would be a relatively easy transition from the existing model, a quick solution
to the healthcare crisis, and would create significant improvement in access to
healthcare for millions of working Americans whose employers do not currently
offer group health insurance or for those who simply cannot afford personal
insurance on their own. If the
federal government fails to enact widespread tax reform to remedy the
predicament of healthcare coverage for working Americans, health insurance
exchanges could be the answer.
Click here to view this article
08/05/2009
Family
planning, the process of delaying or accommodating pregnancy, is a growing
concern for both health insurance companies and reproductive health advocates. The main focus on both sides of the
issue is what defines comprehensive care.
Traditionally, insurance companies have distinguished family planning
care as providing customers access to contraception. However, through activism and legislation, that definition
is gradually expanding to encompass a wider range of preventative services.
In the
current health insurance market, many states require private insurers who offer
prescription drug coverage as part of their comprehensive health plans to
include the full range of FDA-approved contraceptives. This covers pills and injections as
well as devices like birth control patches, rings and IUDs. It is important to note, however, that
19 of the 27 states with these laws in place allow certain employers—like
religious organizations or churches—to withdraw coverage for contraceptives for
employees. Furthermore, many
health insurance plans do not offer equal coverage for these drugs; women may
have to pay more out of pocket for birth control prescriptions than for other
medications.
Perhaps the
biggest complaint against private insurance companies is that the scope of
coverage for family planning services is generally narrow and doesn’t include
counseling, education, or many clinical procedures like contraceptive device
implantation. This often leads
women to choose a method of contraception based solely on cost rather than
suitability.
While most
private health insurance plans cover contraceptives on some level, all
state-sponsored public plans are required by law to provide comprehensive family
planning coverage. These plans pay
the full cost of prescriptions and many clinical services, allowing a large
number of women, and especially the poor, greater access to care. Yet these public health plans are not
without their own problems.
In many
states the regular income levels for Medicaid eligibility are very low. This excludes a large number of poor
women simply because they are not “poor enough.” Care is generally offered to women who already have young
children, which does not help women who wish to avoid a first pregnancy. Some states do offer Medicaid waivers
that expand income limits and include women who do not already have
children. These waivers have
proven moderately effective in reaching a greater portion of the population, but
the area that remains lacking for Medicaid programs is provider
reimbursement. Delayed or
incomplete payments negatively impact doctors and clinics, threatening the
financial stability of these providers and their ability to care for
patients. Timely reimbursement
would also encourage private physicians to work with Medicaid, thereby giving
even more women access to quality family planning resources.
Family
planning is a very personal issue that involves obtaining detailed information
about a woman’s sexual history and reproduction objectives. Services such as counseling, community
outreach, education, language assistance and interpretation, and care that is
sensitive to cultural differences are all integral to the process. These services make up a more complete
picture of family planning and reproductive care, and should be increasingly
present as part of overall comprehensive health insurance packages, whether
from private or public insurers.
Click here to view this article
08/05/2009
Business or
group health coverage is defined as any type of employer-sponsored medical
insurance for business owners, employees and their dependents. The majority of Americans with health
insurance have this type of medical coverage.
General
requirements in most states identify at least two workers as a business and
therefore eligible for group medical coverage. However, some states set a lower threshold and a few even
allow “business groups of one” which make it possible for sole proprietors to
buy health insurance at group rates.
If you own your own business, check with your state’s insurance
department to determine the particular regulations in your area.
With group
health coverage, employers and employees split monthly premiums based on
percentages. Though there is
variation across plans, in most groups employers cover the bigger portion of
the premium, typically at least 50 percent. There are different laws, benefits, coverage options and
costs associated with small and large businesses. Small businesses are generally defined as companies with
less than 50 employees; large businesses have more than 50 employees.
Whether a
business is classified as small or large, group coverage has the same basic
structure. The employer chooses
the plan that best fits the company’s needs and workers can either accept
enrollment or seek other alternatives for health insurance. Most group health plans are
underwritten by a health insurance company, though some very large businesses
can choose to self-insure health care coverage for employees. This means that instead of paying
premiums to an insurance company, the business sets aside funds to cover the
cost of employee health care and therefore assumes all risks associated with benefits
and claims. A self-insured plan
could drastically influence the quality of care you receive if you develop a
serious medical condition or are significantly injured so it is wise to find
out how your employer’s group policy is funded. Regardless of the type of underwriting your employer
chooses, however, all group health insurance is subject to state regulation.
With small
group coverage, no employee can be turned down for insurance regardless of
their medical history. Plans must
be renewed by the underwriting company each year provided the business complies
with all the terms of the policy agreement; premiums are paid on time, there
has been no fraudulent claims activity and no breach of contract. This kind of coverage protects
employees of small firms who might not otherwise have access to health
insurance plans.
For large
businesses, the rules are slightly more restrictive. Large group plans can deny coverage based on employees’
medical histories and can exclude certain pre-existing conditions from the
coverage offered. In fact, whole
companies can be rejected based on past-claims history, though once a policy is
issued to the business every employee of that business must be included in the
coverage. Policies have to be
renewed by the underwriter every year as long as the business complies with all
the terms of the contract.
Companies
that provide group health insurance for their workers are able to attract new
employees, retain quality personnel and reap tax benefits. No matter what the size of your company
is, offering a group plan makes sense.
Click here to view this article
08/05/2009
AIDS, or Acquired Immunodeficiency Syndrome, is a human immune system
disease caused by the human immunodeficiency virus (HIV). This disease
progressively makes the immune system ineffective, leaving a person susceptible
to tumors and infections. HIV is transmitted through direct contact of a mucous
membrane with a bodily fluid, such as semen or vaginal fluid, containing HIV.
The transmission can be transmitted through blood transfusion, sex and
contaminated needles.
Since 2007, AIDS has affected 33.2 million people worldwide and it has
killed more than two million people, including an estimated 330,000 children.
And while this virus progressively makes your immune system weak, being
infected with HIV weakens your body’s capability of fighting against other
disease-causing bacteria and viruses.
AIDS and HIV have no cure but treatments can slow down the course of the
disease. People with HIV or AIDS should undergo the Antiretroviral treatment
that reduces both the morbidity of HIV infection. However, aside from being
expensive, these drugs are not available in many countries.
If diagnosed with AIDS, getting a health plan or being enrolled in a
health program is indeed necessary.
There are some programs that provide assistance to people with AIDS. The
AIDS Health Insurance Program (AHIP) is designed for those with AIDS or any
HIV-related disease but not eligible for Medicaid and cannot afford an
insurance. The AHIP pays for your health insurance premiums but excludes deductibles
and co-payments.
To qualify, you must be ineligible for Medicaid and should have an
insurance plan during the time of application. Monthly income should also not
be higher than $2,096 for a household of two or $1,559 if single.
If your income disqualifies you from the AHIP program, you may also apply
for the ADAP Plus Insurance Continuation Program (APIC). APIC, which started in
2000, is administered by the AIDS Drug Assistance Program of the New York State
Department of Health. The program assists in paying health plan premiums of
people with HIV. Individuals with an annual gross income of $44,000; a family
of two with up to $59, 200; and a family of three or more with $74,400 may
qualify. For individuals and families, the resource limit is about $25,000. If
you are not qualified for AHIP but think you can qualify for APIC program, call Client
Advocacy Helpline at 212/367-1125 from 2:00 to 5:30 p.m. weekdays.
Unlike Medicaid,
AHIP does not count assets in determining eligibility. However, AHIP examines
the income generated by the assets of the applicant. When determining
eligibility, the income of the applicant’s assets is added to his or her
monthly income.
Applicants should
show proofs for eligibility. These include: birth certificate, naturalization
certificate, green card or passport for proof of citizenship; SSI/SSD award
letter, unemployment benefits statement or pay stub for proof of income; letter
of diagnosis from doctor or M11Q form for medical documentation; and insurance
premium or COBRA statement for verification of health insurance; and insurance
card.
If diagnosed with
AIDS or HIV, you should apply immediately or before your current health plan
coverage ends. If you lose your health policy, AHIP will require you to
purchase a new insurance.
To qualify, you must
be able to complete the Medicaid application process. A relative or a friend
can also apply for you and give you all your required AHIP documentation.
Click here to view this article
08/05/2009
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08/05/2009
Many health
insurers decline coverage for experimental medical treatments simply because
there is not enough evidence of success to warrant deeming them medically
necessary. Because these
treatments and medications cannot be established as effective for a large group
of patients, the cost of covering them is not justifiable. Yet for many patients, these
investigative treatments and cutting-edge medications represent real hope for
improved health. If you have been
denied coverage by your health insurer, request a written statement of exactly
why your desired treatment has been rejected. This will give you a starting point for working with your
company and your doctors to get coverage for the treatment you seek.
When
seeking experimental or investigative treatment, you are your own best
advocate. The first step is to
establish that the treatment is indeed medically necessary in your particular
case. To do this, gather evidence
to support positive outcomes resulting from the procedure or medication. It is important to collect scientific
or anecdotal support explaining that the treatment has been effective for
others with your condition. However, it is more important to establish that you
have personally exhausted all other options. If you can show that traditional treatments or medications
have not worked for you or have ceased working, this can go a long way to
convincing your health insurance carrier to consider alternatives. Furthermore, if you have been able to
pay for your desired experimental treatment out of pocket or have participated
in a clinical trial and have had positive results, showing documented proof of
this can lend further credence to your case.
Educate
yourself in the terms and language of your health insurance policy. Read your policy carefully to determine
how your insurer defines experimental treatment. If the terms of your policy are vague, this ambiguity can
work in your favor. Your
particular therapy may not be categorized as experimental, even if your claim
has been denied. If your health
plan includes coverage for prescription medications, find out if your state has
laws regulating off-label uses of approved drugs. In many states, health insurance providers who offer prescription
drug coverage are required to pay for any and all uses of the medications
included in their plans, even if the treatments are non-traditional and as long
as those uses can be proven to be effective or are supported by the scientific
literature.
As a last
resort, plead your case in terms of economic common sense. Would it be more cost efficient for
your insurer to pay for experimental treatment or a traditional course of
therapy? Could the investigational
treatment be cheaper than not treating your condition at all? Will the experimental treatment prevent
a more serious, and potentially more expensive, condition from developing? Work with your primary-care physician
or specialist to determine the answers to these questions and take them to your
insurer for consideration.
When you
want experimental or investigational treatment for a medical condition, it is
important to educate yourself, advocate for your health and work with trusted
healthcare providers to help you get the coverage you need.
Click here to view this article
08/05/2009
Mental health refers to how we feel, think, and act while coping with
life. It also determines the way we handle stress, make choices, and how we
relate to others. Everyone gets anxious, sad or worried sometimes. But, people
with a mental disorder find it hard to control these feelings, and often these
feelings interfere with their daily lives. Fortunately, these disorders—schizophrenia, phobias,
depression, bipolar disorder and many others—can often be treated. Therapy and
medicines can improve the lives of those with mental disorders.
In the U.S., having a mental illness is very common; one in five
families has a member with a mental illness. And, with the rising number of
people with these disorders, getting mental health insurance has quickly become
a hard-fought issue. As of 2003,
many states have passed laws that require insurers to offer mental health
coverage, although a few may offer minimal coverage. Some states also have laws
that regulate insurance parity to ensure that mental health coverage is as
strong as physical health coverage. Lawmakers are still working on the national
bill to improve health parity, hoping to regulate the mental health coverage
offerings of insurance companies.
So, what are the necessary benefits one must be aware of in getting
mental health insurance? Until
now, many mental health plans offer policy holders a limited amount of doctor
visits and the deductible amount. But, before shopping for mental health
insurance, it is best to first check the state laws to know what your rights
are. In most cases, the coverage for mental illnesses requires a higher
deductible and co-payments compared with the physical health insurance. If this
is the case, try looking for cheaper options. If you have other insurance
provided by your employer, an MSA, or a medical savings account may be the best
choice for you.
People working for small businesses, with 50 or less workers, can access
an MSA. An MSA is also available
to self-employed individuals, provided they have a high-deductible health plan.
Medical savings accounts can be used in mental health treatments along
with your high-deductible health insurance plan, provided that it is your only
health insurance. You may pay as much as $1,600 or more annually for every
individual, and as much as $3,200 per family. MSA can be used in paying your health care costs, provided
that you are not in between jobs and do not have an income. The amounts you
deposit into your MSA are tax-exempt, and you can also claim the amount you
didn’t spend.
A Flexible Spending Account (FSA) is also another option for mental
health coverage. An FSA works the same as an MSA except that these can be used
even without a high-deductible insurance plan. Workers whose employers offer a high-deductible plan are
qualified to get an FSA. The disadvantage of this option, however, is that
unused money cannot be withdrawn for non-medical expenses.
As the number of people diagnosed with mental illness increases, the
need for mental health plans also increases. It is necessary to stay informed
of new laws and health insurance company policies.
Click here to view this article
08/05/2009
Although not required, health
plans for workers in small businesses are often provided by their employer. In
good business practices, providing a health plan is usually used as an
incentive to hire the best people.
A business with two to 50
employees is considered a small business. Many small business employers offer
health plans through group health insurance plans that use organized medical
networks such as Health Maintenance Organizations (HMO), Preferred Provider Organizations
(PPO), Point of Service (POS) and the new Health Savings Accounts. Each of these options has different
characteristics that may affect your new health insurance choice.
Many employers get HMO plans
because they have low premiums. PPO and POS plans usually cost slightly more
but are more flexible, allowing workers to use their own doctor and medical
care choices. The HAS plans, the newest option in the market, provides
employers and workers with a way to save money through tax-free expenses.
A certain group of small
industries can also join together to form a bigger group which acts as a
“purchasing group” for health insurance. There are many Alliances or pools of
small businesses types, some are even statewide. To form a pool of small businesses,
check with your state insurance commissioner or your Chamber of Commerce.
Although this is a great idea in many states, in some cases this may also not
work best for you, depending on where you live.
How to lower the cost of my
health insurance plan?
Lowering the cost of these health
plans is always a concern for employers. Changing the deductible affects the
premium employers have to pay every month. Additional coverage also affects the
cost of the plan. Some small businesses include additional options, such as
vision, dental and alternative medicines, which add more costs. Increasing the
options and health benefits, increases the premiums. Moreover, health insurance
plans provide two maximum limits that affect the premium price: the maximum
limit over a person’s lifetime and the maximum limit for each claim. The higher
limits also mean higher premiums.
When looking for more efficient
but affordable health insurance for small businesses, there are certain points
a business owner should consider. It always helps if you understand the types
of medical networks used in group or business health plans, and the amount of
the deductible you choose when setting up the health policy, as this also
greatly affects how much you will pay for the premium. It also helps a lot to
compare your final two options’ annual premiums and the approximate amount your
workers will have to pay out-of-pocket, yearly. Check whether both you and your
workers can afford the cost of the health plan. Considering the total costs of
the policies, including the estimated out-of-pocket expenses of your employees,
and the services offered by the policies will probably help you make a good
decision on which type of group health insurance you will choose. If you think you will be spending too much,
having your small business become a member of small business alliance in your
state may also help to access affordable health insurance policies.
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08/05/2009
About 50
million Americans are without health insurance.
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08/05/2009
Although California ranks second in terms of
the highest number of uninsured children in the U.S., California is still one
of the top states in the Agency for Healthcare Research and Quality list. It
offers exceptional home health care and pain management quality.
Individual Health Insurance policies in
California have different rules. One can be denied from getting health
insurance because of pre-existing conditions, unless he or she is eligible for
HIPAA. HIPAA eligible individuals cannot be denied individual health insurance
and cannot be provided with pre-existing condition exclusion periods. They also
do not have limitations on their health care insurance costs.
According to the California Department of
Insurance, people with individual or group insurance that have no breaks in
coverage for more than two months, must receive credible coverage from the new
insurance company for their previous health insurance. Moreover, in California,
individual health insurance cannot be cancelled if the policy holder gets
sick.
California also offers the Major Risk
Medical Insurance Program that covers individuals for 36 months, who cannot
afford individual health insurance policies because of a pre-existing health
condition. But, after the given period, individuals who accessed the Major Risk
Medical Insurance Program will be guaranteed an individual health insurance
policy. This health insurance must cover all the policy holder’s medical needs
for their pre-existing health condition, but with limits on their treatment
costs.
The state also offers the Medi-Cal program
to assist those with limited income.
Moreover, families with children who are 18-years-old or younger and who
do not have health insurance may also purchase health insurance policies
through the state’s Healthy Families insurance program. Eligible middle-income
mothers and infants can also access affordable health plans through Access for
Infants and Mothers.
Moreover, individuals, even those with a
pre-existing health problem who apply for a group health insurance plan, cannot
be denied. This means that if you change jobs, you cannot be denied group
health insurance at your new job. You will also not be charged any extra fees,
as long as you meet certain requirements.
In addition, small businesses with a small
group of employees cannot be turned down by insurance companies. But, if one in the group has a disease
or has pre-existing condition, the insurer may charge a higher premium for the
health coverage of the group. Small businesses with two to 50 employees or any
business of any size may also purchase cheaper health plans through a statewide
alliance or trade association. The
California Department of Insurance has the list of associations one may join
for the purpose of purchasing cheaper health plans.
Pregnant women, who had group insurance for
three months and suddenly lose it for certain reasons, may also get health
coverage through some state programs.
Self-employed individuals in California
cannot enjoy the health benefits provided by group health insurance, although
they are allowed to join certain associations that may assist them in paying
for health coverage.
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08/05/2009
Aside from skin
cancer, prostate cancer is the major disease that affects many men in the
United States. Erectile dysfunction and difficulty in urination are the
symptoms of prostate cancer.
One of the most
important risk factors that concern the development of the disease is age.
Research show 70 percent of those diagnosed with prostate cancer are 65 years
old and above. Research from the American Cancer Society also reveals that most
of those diagnosed with this disease are African-American men. Genetic factors
are also considered a risk factor. The number of relatives diagnosed with
prostate cancer may correlate with one’s chance of developing the disease.
Health
Insurance’s role in detection of Prostate Cancer
Since prostate
cancer has affected hundreds of thousands of Americans, many researches have
been done on prostate cancer. These researches reveal that men covered by
health insurance are less likely to die from this disease. But this does not
mean that men with health policies do not develop prostate cancer. The
difference is just that these insured men diagnosed with prostate cancer have
access to medical care, had examinations that detect the disease early, and had
early treatments.
When purchasing
a health insurance plan, make sure that the policy you are getting offers
prostate cancer preventive care, and options for prostate cancer treatment.
Studies show
that men over 50 years old, those whose family has a history of prostate cancer,
and those who are considered “high risk” are advised to have an annual exam to
detect prostate cancer. Detection of prostate cancer at an early stage enables
one to have early treatments to prevent the spread of cancer. Preventive
detection examinations for prostate cancer are: digital rectal exam and blood
test called prostate specific antigen testing. Many insurance companies offer
policies covering these preventive exams. Moreover, many states also require
insurers to provide coverage on prostate cancer treatments.
Talking to a
health care professional may help you see whether your health care policy
offers coverage for preventative exams on prostate cancer. If it does not, it
helps to purchase a health plan that does.
Treating
Prostate Cancer
There are two
popular ways in treating prostate cancer: radiation therapy and surgery. Many
health insurance plans cover both; if not, however, at least to some degree.
Coverage differs depending on the plan, thus, if purchasing a new health plan,
make sure to talk to a health insurance representative to understand the
coverage of your plan and the payments.
If undetected,
prostate cancer is a threat to your health. Since early detection and
preventive care is a life saver when it comes to any disease, a comprehensive
health insurance plan is indeed necessary.
Insurance
companies offer many options. Even if you already have the traditional health
care plan through PPO or HMO, it may be of help for you to explore the benefits
you can get from new health care options, including the High Deductible Health
Plan. This plan, along with Health Savings Account or a Health Reimbursement
Arrangement, offers a traditional medical coverage that is tax free. This helps
saving funds for future medical expenses. Like any health plan, getting this
type of plan also has advantages and disadvantages. Thus, talking to a health
care professional before purchasing one is necessary.
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08/05/2009
For the
purposes of this article, four types of health insurance have been
identified. A high deductible
heath plan is private insurance with lower monthly or annual premiums than
other types of insurance, but consumers pay greater out of pocket expenses for
care. A consumer-directed health
plan, also known as a health savings account, combines a high deductible plan
with a special, tax-free account that can be used to pay for medical
expenses. Private insurance is a
plan provided by an employer, a trade union, or purchased directly by the
customer and includes managed care plans like HMOs, but does not include
military insurance. Public health
insurance includes state or federally funded programs like Medicare, Medicaid,
and State Children’s Health Insurance Plans (SCHIP).
A 2007 US
Census Bureau survey reported that both the percentage and actual number of
uninsured people decreased slightly between 2006 and 2007. Despite this promising trend, the number
of people who receive health insurance through public programs increased during
that same period, from 80 million in 2006 to 83 million in 2007. This could be due to any number of
factors including turnover in the workforce as baby boomers retire or the
current economic recession and subsequent job loss.
Of people
under the age of 65, 43 million are uninsured. This represents slightly less than16 percent of the
population. In this same age
group, more than 67 percent of people who have health coverage own policies
issued by private insurance companies.
Of this 67 percent with private health insurance, 17 percent are
enrolled in a high deductible health plan. Five percent of people with private medical insurance are
enrolled in consumer-directed health plans. Those enrolled in individual health insurance plans are more
likely to have a plan with a high deductible than those who have group health
insurance through an employer or trade union. Citizenship has a significant impact on access to medical insurance,
as foreign-born residents of the US are about two and a half times more likely
to be uninsured than those born here.
Thanks to
increased awareness of and access to state health plans for children, only
about nine percent of children under the age of 18 are uninsured. More than 60 percent of children are
covered by private health insurance, while nearly 33 percent are covered under
a public health plan backed by state or federal government. Economic status clearly plays a role in
a child’s access to health insurance, as children living at or below the
poverty level are more likely than other children to go without medical
insurance, either through a private or public plan.
Economic
factors also affect the population at large. Income level has been shown to directly correlate to rates
of medical coverage. About 25
percent of citizens with annual income of less than $25,000 do not have any
health insurance, while the more affluent are likely to have at least some kind
of health coverage. The plan
quality and percentage of the population increases in relation to income
levels.
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08/05/2009
In the U.S., breast cancer is a major cause of cancer-related death in
women, second only to lung cancer. The percentage of breast cancer occurrences
is high, with one in every eight women suffering from the disease. However,
only one in 28 breast cancer patients die from it. Because breast cancer, like
any other type of cancer, is one of the most costly diseases that require
frequent treatments, having a solid health insurance plan helps you access the
medical care necessary for overcoming this disease. Solid health insurance
provides a better chance of fighting breast cancer, with access to treatments
and early detection exams.
Breast cancer results from an uncontrolled growth of cells in the
breast. These abnormal cells may also spread to nearby tissues and organs. The
growths the cells form are called tumors.
Tumors can be benign or malignant. While benign tumors do not spread and
are harmless, malignant ones invade nearby organs.
Both men and women can have breast cancer. Breast cancer may be cured if
detected at an early stage. The best way to detect this disease early is
through mammograms and breast exams. Women below 40 years old are advised to
have a mammogram every three years, while women who are 40 years old and above
should have this type of exam every year. Although breast cancer can be
prevented, some uncontrollable risk factors may cause the development of the
disease. The most important risk factor is having a family history of breast
cancer or any type of cancer. Some lifestyle-related factors including not
breastfeeding and having children at the risk age (30 years old) or beyond may
also trigger the development of the disease.
Since breast cancer is a disease that affects many women, it is necessary
for women to make sure that their health plan covers mammograms and other
medical treatments and exams that may be necessary if diagnosed with breast
cancer. Make sure that you purchase the right policy—one which covers
chemotherapy, breast cancer reconstructive procedures, mastectomy, and doctor
appointments. By law, if a woman’s
policy includes coverage of a mastectomy, it must also provide coverage for
reconstructive surgery as well.
Insurance for Breast Cancer
Patients
Individuals with cancer, whether it be breast or lungs, are considered
“high risk” to health insurance providers. With different and more
comprehensive medical needs, one insurance option for breast cancer patients is
the high risk insurance, which is almost the same as individual health
insurance, but generally covers comprehensive medical plans with a wide range
of deductible options. A Preferred Provider Organization plan is the most
common coverage option for “high risk” individuals. The Health Maintenance Organization plans are also available
in many states.
Women’s Health and Cancer Rights
Act
Signed into law in 1998, the Women’s Health and Cancer Rights Act was
designed to assist breast cancer patients who, after a mastectomy, choose to
have reconstructive surgery.
Under this law, HMOs and other insurance providers that provide coverage
for mastectomy procedures must also cover breast reconstructive surgery after
the mastectomy. Breast
reconstruction includes the reconstruction or augmentation of the affected
breast to provide a similar appearance with the other breast, breast
prosthesis, and treatment or therapy for complications that may arise after
surgery.
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08/05/2009
Health insurance is a guarantee
that whenever a person contracts a disease or suffers an accident he/she won’t
have to pay the full payment for his/her medical expenses. Health insurance
aids people in protecting themselves against costly or unexpected medical
expenses. The mechanics of health insurance is that a person pays for an
insurance policy that states what kinds of accidents or diseases the insurance
company is willing to cover. If the person agrees to the coverage of the policy
then the insurance company and the person have a binding contract. These can be
purchased through private insurance companies or government-funded insurance
programs. It can be acquired individually or by a group. Both ways aim to
provide the individual with a less costly means of getting medical treatment.
Health insurance companies determine the kind of
coverage a person or group might need. They determine this by looking at the
age of the person, the kind of lifestyle he/she has, the kind of work they do,
and the current state or physical health they are in. After going through these
processes the health insurance company will determine how much the person would
have to pay for his/her first premium.
The health insurance policy has several factors:
Premium: This is how much the insured (or if the individual is insured
under his/her company, the employer will pay for this) would have to pay
to acquire medical coverage. Deductible: This is how much the insured must pay from his/her account before
the health insurer 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 insurer. It may take several doctor's visits or
prescription refills before the insured person reaches the deductible and
the insurance company starts to pay for care. Co-payment: This is the amount that the insured person must pay for from his
own pocket before the insurance company pays for the patient’s visit to
his doctor. Co-insurance: This requires the insured to pay a certain percentage of the total
payment, which is agreed beforehand in the health insurance policy. Exclusions: This explains that not all treatments or services are covered by
the policy. The insured person must also pay the full cost of non-covered
services. Coverage limits: In some health insurance policies the health insurance company
will only pay up to a certain amount. In case of extra charges, the
insured person would be required to pay for that from his own pocket. In
addition, some insurance company plans have lifetime or annual coverage
maximums. If the insured reaches this limit he/she would have to pay for
the rest of the expenses from his/her own pocket.
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08/05/2009
In the United
States, a big portion of the immigrant population is uninsured. Approximately
50% of the non-citizens do not have health insurance. Purchasing a health
policy can be difficult for immigrants, considering the fact that most of
immigrants do not have high-paying jobs or work that provide them with health
insurance packages. There are a few choices for immigrants to have access to
cheaper health care. But it is necessary to take note that immigrants may not
be eligible for health care programs administered by the government.
Though Medicaid
helps assist people with low income, many uninsured non-citizens with low
income are still not qualified for Medicaid in some cases due to some
restrictions. The Personal and Work Opportunity Reconciliation Act (PRWORA)
restricts legal immigrants from getting health benefits like Medicaid. Under
this law, non-citizens who are living in the United States for not more than
five years are not qualified for federal health care programs. Even after five
years of stay, they can still be ineligible for these programs if they do not
meet the income requirement. Immigrants who are undocumented are also not
eligible for Medicaid.
Moreover,
children immigrants cannot avail themselves of the health care benefits the
State Children’s Health Insurance Program (SCHIP) offers. In the same case with
Medicaid, PROWRA restricts immigrants from getting SCHIP benefits in the first
five years of their stay in the US. They may still not qualify for the SCHIP
for an extended period because of economic factors.
Because of
these restrictions, it is easier for immigrants to purchase private health
insurance only if they have sufficient income. Immigrants with higher income
may find private health plan the best option if their employer does not provide
them with health insurance benefits.
So, what are
the options for immigrants?
Legal
immigrants in the US can choose to buy group plans to save money. Group plans
use some medical networks such as Health Maintenance Organization (HMO),
Preferred Provider Organization (PPO), and the new Health Savings Accounts
(HSA).
When choosing
an HMO, you need to live in close proximity to where you are required to visit
your primary care physician. An HMO plan is usually less expensive. Similarly,
the PPOs and POSs use a medical network but offer a wider geographic area.
Although PPO and POS encourage you to use health care within the network, with
these plans, you may also be allowed to use out-of-network physicians. PPO and
POS plans, however, are slightly expensive than HMO plans.
The Health
Savings Accounts work similarly but it only requires a high deductible health
plan and charges lower premiums. The money you saved with lower monthly
payments is deposited into your Health Savings Account which you can use for
your medical fees. For more information about the possible health plans you can
get, talk to health care experts.
It is very
important for all residents in the US, whether born there or immigrated, to
have the means to pay for health care. In this country where health care costs
are soaring at an alarming rate, getting a solid or comprehensive health plan
helps a lot in reducing the burden of these costs.
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08/05/2009
Medical care
costs can be quite daunting. That is why there is health insurance, to help you
alleviate any pain or sickness you might have without breaking the bank. Health
insurance policies are available in most companies. Generally, employees
acquire this as soon as they become part of the company. Most employers avail
their employees with health insurance policies, which are often structured as a
managed care plan. These plans benefit employees with health care treatment and
medical facilities at low costs.
Health
insurance policies can also be acquired through the government, like Medicare
and Medicaid. If you are able to meet the requirements of the government, these
policies can be made available to you.
For further
understanding about health insurance policies here are a few details:
What health insurance covers
A health insurance policy
is a written agreement between the insurance company and you, in which you can access
certain benefits, such as drugs, tests and treatment services. The insurance
company agrees to handle the cost of certain benefits that are in your policy.
These are called "covered services."
The insurance company also
lists in your policy the forms of services that are not available to you. In an
event that you suffer from a sickness or accident that is not covered by your
policy you have to pay for the medical care that you acquire.
What a medical necessity is
A medical necessity is
different from a medical benefit. A medical necessity is what a doctor will
deem as necessary. A medical benefit is something covered in your insurance
policy. There might be incidents that your doctor might decide that you require
medical care that is not available in your insurance policy.
The insurance company will
decide what drugs, services or tests they will avail to you. They base this on
what kind of medical care each patient needs. This might mean that the drug,
test or service that you require is not available in your policy.
What you should do
You should ask your doctor
to study your insurance coverage carefully so that he/she can give you the treatment
that is most appropriate for your coverage. Since there are so many insurance
plans it is wise to study the details of each plan. When you have studied your
insurance policy, you can help your doctor by suggesting medical care that is
appropriated to your plan. Here are a few tips to better understand your
policy:
Read and learn your insurance policy. It's wiser
to know what your insurance company will pay for before you get tested, receive
a service or fill a prescription. Your insurance company will have to
approve the kind of care that you need before your doctor can give it to
you. Forward your queries to your insurance company
and ask a representative to clarify it with you. Always be mindful that your insurance company,
not your doctor, decides what will be paid and what will not.
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08/05/2009
Today’s economic downturn has affected many aspects of
people’s lives. Even purchasing a healthcare insurance plan became troublesome
when it comes to finding the best plan at an affordable price. But despite this
dilemma there are still ways for you to purchase a health insurance policy that
will cover your basic needs at no burdensome cost. Here are a few ways to
acquire the health plan:
Exhaust all options in your employer plan
If you acquired your insurance policy through your
employer, study your coverage yearly when your company offers open enrollment.
Explore your
options with your policy. Find out what it doesn’t cover and what it does.
Determine what kind of service or treatment it offers and see if you can
add more to it without breaking the bank. Study your deductibles,
co-payments, lifetime maximum benefits, limits on out-of-pocket expenses
and lifetime maximum benefits and prescription coverage.
Determine if
your medical needs have altered. A plan with a lower co-payment but a higher
premium is more advisable for people with health problems.
You can pay for health-care
expenses with your own money by using a flexible spending account with pretax dollars, which means that the US government will pay
for a third of the tab.
You can adjust
the price of your premium through employee incentives, like quitting
smoking, losing weight and exercising regularly. People with a healthy
lifestyle have lower premiums.
Less costly ways to purchase a health
insurance plan
The health savings account is another way to pay for
medical expenses from your own pocket. You can get an HSA through an employer
if you purchase a high-deductible health insurance.
$2,900 is the
maximum contribution of the HAS to individuals, while $5,800 is for
adults. Your contribution is either deductible or pretax, even if it’s not
itemized, and withdrawals and earnings for medical expenses are tax-free.
In this plan
your money is invested, and what you don't spend will move over to the following
year. If you change jobs you can take the account with you.
Use HealthDecisions.org,
eHealthInsurance.com or HSA Insider to look for insurance that qualifies
as highly deductible under IRS regulations.
The maximum age
to make contributions is 65; afterwards taxable withdrawals for any
purpose are permitted.
For those who have a hard time coursing
through the economic slump
Do not let insurance coverage lapse if you’re between
jobs. If you’ve neglected to attend to your insurance policy and you’ve been
without coverage for 63 days some provisions of the federal law will not apply
to your policy.
The Consolidated Omnibus Budget Reconciliation Act, COBRA, of 1985,
permits you to retain group coverage after the end of your job, for 18 months,
but you will pay the entire premium. You should know about your rights under the
state and federal law.
You can keep on
contributing to your flex account under COBRA, giving you more chance to
use the money.
You can use your
HSA to pay COBRA or other health insurance premiums if you're receiving
unemployment compensation.
Under certain
circumstances, you can make penalty-free withdrawals from an IRA to pay
premiums if you're unemployed.
Click here to view this article
08/05/2009
As
health-care costs continue to rise and more Americans than ever are going
without individual health insurance, health-care reformers and politicians
alike are seeking new ways to address consumer trepidation. A controversial new proposal aims to
link rates for medical insurance to lifestyle choices such as diet, exercise
and smoking.
According
to a recent study conducted by the University of California, the average yearly
cost of treating people for health issues related to smoking is about $72
billion. A survey from the Centers
for Disease Control found that another $75 billion is spent caring for people
with medical conditions arising from obesity. The cost of treating and managing these conditions
contributes significantly to an overall increase in health insurance premiums
for all insured people. Some
experts even suggest that poor lifestyle choices raise prices so much that they
are a causative factor in making medical insurance unattainable for more than
50 million Americans.
Supporters
of this plan suggest that people who make good decisions about their health,
exercising regularly, maintaining a healthy weight, avoiding alcohol and drugs,
and refraining from smoking, should benefit financially in the form of lower
health insurance premiums. They
feel that people who are responsible and proactive about their health should
not have to bear the burden of other peoples’ poor decisions. Proponents often point to existing
insurance discounts for preventative or safety measures, auto insurers give
premium breaks to owners of vehicles with alarm systems, airbags, or theft
recovery devices; homeowners can get insurance discounts if their residences
are equipped with burglar alarms, smoke detectors, or sprinkler systems. It has also been suggested that
rewarding good lifestyle choices would not only encourage more people to take
better care of their health, but would also increase competition in the
insurance industry. This would have the added benefit of forcing health
insurance companies to be more innovative in the benefits they offer consumers
without compromising the quality of their coverage.
Surprisingly,
many health care insurers advocate these initiatives and cite numerous studies that
seem to suggest that poor lifestyle choices decrease a person’s overall health,
require more medical intervention and therefore increase the cost of health
care for all Americans. In fact,
several health insurers have traditionally backed higher taxes on everything
from cigarettes to junk food.
On the
other side of the argument, controversy arises from the opposition who feel
that the government does not have the right to interfere in individual
choice. They believe people should
be able to live their lives as they see fit and should not be punished for
their lifestyle preferences.
Furthermore, detractors worry that these types of incentives would
create prejudice against certain groups, such as smokers or the obese. Furthermore, opponents fear that those
who struggle with addiction would not only be unfairly categorized, but would
also find it more difficult to obtain treatment if they needed it.
Though a
highly controversial proposal, rewarding healthy behavior is one example of how
consumers are willing to at least explore different possibilities in an effort
to make the cost of health insurance more affordable to the millions of
Americans currently living without medical coverage.
Click here to view this article
08/05/2009
Like accidents and
calamities, a failing health condition is something that one does not wish to
encounter. However, life does not always deal a fair hand and if one does
encounter health problems and you need to be prepared. For those employed by
companies, this may not be much of a concern, as companies have Health
Maintenance Organizations (HMOs) for their employees. For the self-employed,
whether voluntarily or not, individual health insurance is the option.
Individual health
insurance is a health insurance type available to individuals, not to groups
and organizations. Given the fast increase in the unemployment rate because of
the current economic slump, many citizens seek cost-effective health insurance
plans. The good news is that the variety and the affordability of the options
available are rather pleasantly surprising, especially to those laid-off
workers who seek an alternative to the costly Congressional Omnibus Budget
Reconciliation Act of 1985 (COBRA) coverage. COBRA is a federal law which
allows an 18-month extension of benefits to laid-off workers should they intend
to continue buying the health coverage from their employer-sponsored plans
within a defined period.
Applying for an individual
health insurance is not without its drawbacks, however. In applying for an
individual health insurance, one will typically be accepted if he or she is
healthy and without any pre-existing medical condition. This, nevertheless, is
to the advantage of an individual without any pre-existing medical condition,
since individual policies are usually inexpensive.
Among the few
organizations with data based on a national source is eHealthInsurance. The
data of the organization best reflects purchasing patterns and prices in the
individual health insurance market.
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08/05/2009
The food that we eat
greatly affects our energy level, mood, the way we think, and how we relate to
other people. Carefully choosing the right kinds of food may prove to be a
challenge because of the wide variety of great tasting meals that surround us.
More often, we eat more than what our bodies can actually burn. We consume
excessive amounts of sugar, calories and fat, daily, which may lead to obesity
and other health illnesses such as diabetes, hypertension and cardiovascular
ailments.
Healthy eating does not
mean being unrealistically strict about what we should eat. There is no need to
deprive ourselves of the food that we love. We have to remember that food
nourishes our bodies and energizes us. Maintaining a balanced diet means
consuming the right proportions of carbohydrates, fats, proteins, fibers,
vitamins and minerals. The food serving size will depend on your age, gender
and level of physical activities. Increasing water intake is also a vital part
of a healthy diet because it helps clean our systems of harmful toxins and
waste products.
Choosing a healthy eating
lifestyle also means widening our food choices by trying food that we don’t
normally eat, including vegetables, fruits and whole grains. You can still
enjoy the food that you love as long as you consume them in moderation. A
nutritious diet and an active lifestyle will help reduce the risk of serious
diseases such as cancer. It is also best to have a regular annual exam through
your preferred Health Maintenance Organization to ensure that you are on the
right track.
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08/05/2009
Finding a good broker is
important when choosing the right health insurance coverage for your employees.
A broker can present a number of health plans from different insurance
providers. A vast number of options will enable you to make a comprehensive
comparison of health insurance offers.
Rates of deductibles and
co-insurance are valuable factors to consider when choosing a health insurance
plan. A policy that requires a co-payment of more than 25% of the total cost of
procedures is not a good insurance plan. A good health insurance plan should
offer a range of services, as well as coverage for pre-existing medical
conditions and long-term illnesses. Coverage should be at least $1 million.
And, to further evaluate maximum reimbursement for health care procedures,
check with local doctors to learn their rates.
The next thing to check is
the insurers themselves. Standard and Poor’s website contains a lot of helpful
information about the financial health of different insurance companies. An
insurer’s claim payment history is also important to know. Nobody wants an
insurer with a bad record when it comes to paying claims. Normally, a broker
can help you out in this area.
If your business is a
small one, your state’s department of insurance can help you to find health
providers that provide coverage specifically for small businesses in your area.
Another option would be consulting association plans or health purchasing
alliances. Health purchasing alliances enable small business owners to avail
themselves of group health insurance coverage at a lower price.
Whether you own a small or
large business, the only way to get the best insurance deal is to do your
homework.
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08/05/2009
The mental and emotional
health of an individual plays an important role in a person’s success, whether
in his personal life or professional career. People who are healthy, both
mentally and physically, lead a fruitful and productive existence with other
people in their community. They are able to face whatever challenges are hurled
their way, build relationships, and contribute constructively to the group they
are affiliated with. These mentally healthy people consider the problems they
face as part of their day-to-day living and as a means to improve one’s
character.
However, not all of us
give much importance to our mental and emotional health. In fact, most of us
take our emotional well-being for granted, only recognizing its importance when
problems begin to arise and reach the point of deep depression. To prevent
this, it is wise for individuals to make sure that they have health plans in
place that cover not only physical health insurance, but also to support their
mental and emotional needs.
In order to care for our
psychological well-being, we should take the time to build and exercise on the
areas where we need improvement. As with maintaining our physical health, we
should also invest our energy in developing our mental health to make it
stronger and increase its immunity from an emotional breakdown.
Being mentally and
emotionally healthy, however, does not mean that a person will never encounter
rough times and emotionally draining experiences. The true test in having a
good and stable psychological well-being is the ability to face all the
disappointments, loss, anger, and many other kinds of emotions, but still have
the resiliency of being able to bounce back and learn from the experience.
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08/05/2009
The loss of group health insurance may not be a question of whether or
not it will happen, but of when it will happen. When it does, as in any other
undesirable situation, one must know what to do. Otherwise lack of information
might add insult to injury. While there may be instances when this scenario is
inevitable, the good news is that there are a number of health insurance
options to be explored in case of the loss of group health insurance.
Each year, many adults under the age of 65 lose their health insurance
coverage for varying reasons. These reasons include the death of a spouse,
divorce, retirement from a job before reaching the age of 65, a decrease in
working hours, and, of course, separation from the job. If any of these causes
a person to lose their group health insurance, there are steps to counter the
problem.
A person who has just lost their insurance may opt to find out if they
can get COBRA benefits. COBRA stands for Consolidated Omnibus Budget
Reconciliation Act, a federal law enacted in 1985 that can help them keep their
insurance longer. Furthermore, because of the new provisions added to the law,
a person’s cost for this continuing coverage under COBRA may not be prohibitive.
A person who is changing jobs may want to know about the Health
Insurance Portability and Accountability Act of 1996, or HIPAA. This provides
protection of one’s right to have insurance when moving from one group plan to
another, as well as from a group to an individual plan.
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08/05/2009
As the
green movement continues to sweep the nation—consumers are snapping up
everything from hybrid cars to all-natural cleaning products—there is an
increasing market for non-traditional medical treatments. More and more Americans are seeking
alternatives to conventional medicine to help prevent and treat various
conditions. This customer demand,
along with the emergence of scientific evidence that supports the effectiveness
of alternative medicine, has fuelled a shift in how many health insurance
companies provide coverage for these services. Progress has been slow, but is certainly leaps and bounds
from where it was just a few years ago.
Alternative
medicine is an approach to health that encompasses factors like herbal
remedies, ancient cultural healing methods, and non-invasive or natural
treatments. The most common
alternative therapies covered by health plans are chiropractic care, massage,
and acupuncture. Naturopathic
medicine—treatments that include things like nutrition and diet, use of herbs,
and holistic healing—is also covered by some plans. Some health plans even cover things like guided meditation,
homeopathic treatments, herbal supplements, and mind-body stress management.
Although
traditional health insurers are broadening their coverage for natural or
alternative therapies, there is still quite a wide gap between coverage for
these types of treatments and more conventional medical intervention. In health plans that offer coverage for
alternative medicine, insureds usually incur some out of pocket expense for
treatment—though usually at a much lower cost than if they had to pay without
medical coverage at all—or are limited in the number of sessions insurance will
cover. If you are interested in
exploring alternative or natural therapies, check with your health insurance
carrier to see if they provide coverage and what the terms of such coverage
are.
When you
contact your insurance company, you should ask the following questions to
ensure you have as much information as possible before making a decision:
-Is
pre-approval, authorization, or a referral from my primary care physician
required for alternative care?
-What kinds of treatments are covered?
-Will I incur any out of pocket expenses like co-pays, coinsurance, or charges
for additional services or products like supplements, tests and supplies?
-Do I have to choose a natural healthcare provider from a network?
-What are the limits of coverage?
Are there caps on per-visit dollar amounts or number of visits? Are certain medical conditions excluded
from coverage?
If your
health plan offers limited or non-existent coverage for alternative medical
treatments, you may be able to increase or add this coverage by exploring
options in your existing policy.
For example, some plans allow customers to use alternative therapies if
they agree to pay a higher deductible.
There are also policy amendments, called riders, that some health
insurance plans offer to customers that provide extra coverage for things like
homeopathic remedies. You may also
be able to work with a provider in your insurance company’s network to arrange
for non-traditional treatments.
It may take
some investigative work, but if you desire alternative, natural or
non-traditional medical therapies, there are options for this kind of coverage
from many health insurance plans.
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07/28/2009
President Obama might face another hurdle in his push for universal health care. This time, it’s not from lawmakers but from a recent paper on economics, which argues that health insurance makes people fat.
Authors Jay Bhattacharya and Kate Bundorf from Stanford University, Neeraj Sood from the RAND Corporation, and Noemi Pace from University College London all stated that Americans with either public or private health and medical insurance coverage have a higher tendency to become obese. According to weight-gain estimates in the paper, “private insurance increases body mass index by 1.3 points and public insurance increases body mass index by 2.1 points.”
Even before the paper came out, economists already mentioned that fat people are a burden on taxpayers.
According to a study that came out today, overall obesity-related health-care treatment costs have doubled in the last 10 years to $147 billion. The costs have even outgrown the obesity rates, which “only” climbed by 37% for the same period.
The new evidence supports the authors’ argument that health insurance is not just a simple transition of financial wealth from thin taxpayers to fat ones, but instead a “true economic subsidy for obesity.” The study suggests that obesity is literally encouraged by health care coverage. Knowing that insurance coverage provides protection against expenses caused by some weight-related issues, people tend to take weight gain for granted.
Even if the study only gathered weak evidence about more-generous coverage encouraging more people to gain weight, there is “strong” statistical evidence pointing to health or medical insurance coverage boosting obesity and body mass index.
The question now is how the universal health care system, which is still a work in progress, would affect the obesity rates of Americans in the near future.
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07/28/2009
President Barack Obama and other Democrats in Congress are pursuing a new health insurance plan. According to nonpartisan budget experts, this health plan would work with private insurance companies without forcing them to shut their doors.
Good news for Democratic ears, the Congressional Budget Office’s estimate comes as officials pushed for progress on the health care reform before the recess in August.
Democrats had a meeting on Monday afternoon with their allies in the House, and, according to House Speaker Nancy Pelosi, a floor vote may still be pushed through in the coming days. Meanwhile, negotiations between a small number of Republican and Democratic lawmakers resumed in order to find a compromise.
Democratic dissension has slowed the progress of legislative work from the President’s strict timetable.
Two weeks ago, Budget Office Director Douglas Elmendorf infuriated congressional Democrats and the White House with his statement in Congress about the House bill’s inability to control health care costs due to lack of mechanisms.
In order to disprove allegations that their proposal would make way for a federal takeover of the commercial and private health insurance industry, Democrats are now backing a suggestion from the budget office for a government insurance option that will not harm private insurance companies.
Given the unclear projections about how an actual reformed health care system would work, the controversy has yet to have an end in sight.
Poll results show that Americans favor a public coverage option as a component of the health care system reform. However, both employer groups and the insurance industry fear that a government-run insurance option will destroy private insurers.
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07/28/2009
July is nearly over and everybody is still having disagreements about the real progress of the health care reform legislation. According to Speaker Nancy Pelosi and White House officials on Sunday, legislation is progressing, however, their fiscally conservative allies are still less optimistic and the Republicans continue to oppose it.
On CNN’s “State of the Union,” Pelosi said, “When I take this bill to the floor, it will win. We will move forward, it will happen.”
North Dakota senator and budget committee chairman Kent Conrad expressed his opinion that a bill that only carries votes from Democrats is impossible and undesirable. “Look, there are not the votes for Democrats to do this just on our side of the aisle,” he said on ABC’s “This Week.”
Senate minority leader Mitch McConnell also stated on CNN’s “State of the Union” that, “The only thing bipartisan about the measures so far is the opposition to them.”
The White House originally wanted the legislation to be completed before Congress takes a break in August. Robert Gibbs, spokesman for the White House tried to be positive about the missed deadline: “We are enthusiastic about the progress that’s been made. We think we’re on the road to getting comprehensive health care reform by this fall.”
He also stated that even though committees from the House and Senate are considering different versions, 80% of the contents of a final version have already been agreed upon.
In a statement on CBS’s “Face the Nation,” Obama’s senior advisor, David Axelrod, similarly described the progress of the bill. “Now, we are at that final twenty percent. We are trying to work through those details.”
Health care reform has been at the top of Obama’s plans since he assumed the presidency. He wants every American citizen to have medical insurance as well as other health plans.
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07/28/2009
This week, President Barack Obama will be in North Carolina and Virginia to promote health care reform. During the recess next month, the president will be keeping Congress under pressure. The fact that 47 million people are uninsured in America is only one of the arguments that support health care reform. Another argument, which many people are unaware of, is the fact that 25 million people in the U.S. are underinsured.
John Stewardson wakes up very early in the morning and goes to work at the 602 union located in Washington, D.C. He’s home before noon as he needs to prepare lunch for Linda, his wife who is a cancer survivor.
"I'm just going to have to take medicine for the rest of my life," Linda said.
Last summer, she was diagnosed with a tumor in her brain; she is currently in remission. Now, the financial health of her family is at stake, as their group health insurance only paid $150,000 for the treatment. Their savings were demolished by the cost of the treatments, both for the cancer itself and for the side effects.
"It's like she fell out a cancer tree and hit every branch on the way down," said John Stewardson.
The family is around $100,000 in debt.
At the Senate, Sen. Chris Dodd is working to make health choices affordable. He is supporting the government’s insurance plan that would eliminate caps on health plans.
"The underinsured are a critical group," said Dodd. "In some cases, fifty-three percent don't know they're underinsured. So they either have huge co-pay if a problem happens or the deductibles are so high they might as well not have insurance."
John’s union only offered him one plan. After this reached its cap, they were left uninsured. Every day, John calls Medicare and his union to ask for additional coverage. So far, John has had no luck.
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07/28/2009
President Barack Obama currently travels the country to promote health care reform. Obama brought his campaign for the health care revamp to a public forum on Thursday near the Midwestern city of Cleveland, Ohio.
With the increasing number of Americans getting skeptical about his overhaul plan on the American health care system, and with the growing costs of health plans, the president has become more determined to gain support for his health care reform campaign.
“We can rescue our economy,” Obama said. “We can rebuild it stronger than before. We can achieve quality, affordable health care for every single American. That is what we are called upon to do. That is what we will do, with your help, Ohio.”
The president seeks major and bold changes in the nation’s medical care system that costs $2.4 trillion. The United States is the major industrialized nation that does not have a comprehensive health care system.
The president emphasized that changing the nation’s health care system can no longer wait. “We spend one of every six of our dollars on health care in America, and that is on track to double in the next three decades,” said the president.
But the Congress’ top Democratic lawmakers have left their plans to meet Obama’s deadline for voting on his reform. Senate Majority Leader Harry Reid said senators will not vote on Obama’s plan before their recess in August, as the president had wanted. Reid said more work is still necessary to come up with the right plan.
Obama stressed that there is a sense of urgency about the issue, saying “I have no problem, if I think people are really working through all these issues in making sure that we get it right. But I do not want a delay just because of politics.”
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07/28/2009
Robert Reich, the labor secretary during the Clinton administration, spoke to healthcare executives on Thursday in San Francisco. Reich said that Obama must “start knocking heads” on the health reform issue if he wants a bill from Congress by this fall.
He also said that the president has learned from Bill Clinton’s mistakes. Unlike Clinton’s reform proposals in the 1990s, Obama did not send Congress a bill that he knew would not be passed at all.
Reich also said that Obama should have begun working on the issue two weeks in advance. Obama is now at risk of Congress adjourning and leaving the bill unsettled. With this, the opponents of the package will have time to plan their attacks. Reich was the speaker at the Leadership Summit that was sponsored by the American Hospital Association and Health Forum.
Even so, Reich said that “you will see an Obama bill.” He added that “Obama will play his cards” when a Senate and House joint committee works on the legislation. Reich is now a professor at the University of California, Berkeley. He is a regular commentator on political policy and economic issues.
Reich also said that the president will be adamant in adding standards to the insurance of medical malpractice. He also said that Obama as well as Obama’s allies are now more interested with HMO-style pre-paid health care and the accountable care provided by integrated systems such as the Cleveland Clinic or the Mayo Clinic. Obama and his allies are becoming aware that offering coverage to those who are uninsured is only a piece of the health reform puzzle.
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07/28/2009
According to health officials and doctors, adult vaccinations and the issues surrounding them are some of the numerous problems that haunt legislators as Congress continues to work on the health care reform.
In a survey released by health officials, only a small number of adults are aware that they can avail themselves of vaccines against meningitis, tetanus, whooping cough, pneumonia, and shingles.
Experts however believe that demand and awareness are just tiny bits of the whole problem. According to Dr. William Schaffner from Vanderbilt University in Tennessee and the National Foundation for Infectious Diseases, the health care system is a hindrance to vaccination. Not all medical insurance and health plans provided by companies cover vaccinations, doctors are paid only minimally for administering them, and nobody can ensure the availability of vaccines.
In a news conference, Schaffner said, "They system is cumbersome almost to the point of not being able to get the vaccine."
Schaffner, along with vaccine experts, is hoping for Congress to tackle vaccination issues in the health care reform legislation. He said, "More than $10 billion a year is spent in direct medical costs and indirect costs" to treat pneumonia, meningitis and influenza. “These diseases can be prevented through vaccination.”
A survey of 22,000 U.S. adults released by Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention indicates that most adults in the U.S. don’t get the necessary vaccines.
Dr. Anne Schuchat further stated in the news conference that, "About half of adults had received a tetanus shot within the past 10 years." People should get tetanus vaccines every 10 years.
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07/28/2009
Lawmakers in Connecticut are moving forward with their plans to establish universal health care, as there has been no federal legislation on the issue. This move follows Massachusetts’ pioneering law.
Currently, President Barack Obama’s administration and the Democrats in Congress are struggling to rally support for a plan to provide health care for a large number of Americans. Connecticut is part of a small minority of states that are planning to create universal health care independently. The state is aiming to improve the system that has caused more than 40 million Americans to be left uninsured.
On Monday, Republican Connecticut governor Jodi Rell’s veto was overridden by the state legislature, which is controlled by Democrats. A board composed of nine members will be created to develop a system for universal health care in the state. On January 1, 2011, this board will be giving lawmakers recommendations for the health care plan. Called SustiNet, the plan will cover almost all of the 3.5 million residents of Connecticut, including the 350,000 residents of the state who do not have coverage.
In 2006, Massachusetts enacted a law that made health coverage compulsory. It was the first state to do so in the U.S., and it brought health coverage within the reach of people who cannot afford it by providing subsidies and by reforming the industry. Maine and Vermont are also in the process of advancing their health care reforms.
Connecticut will be building a system around a health insurance pool that includes employees of the state and Medicaid participants. The pool would eventually be expanded to include private employers and residents who require individual health insurance.
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07/28/2009
Expensive premium costs are the main reason being cited by millions of US citizens as to why they cannot avail themselves of individual health insurance policies, according to a recent study published in “Health Day News” last Tuesday.
Approximately three out four people want to buy a policy but are not able to get one because the cost of the premium is prohibitive, based on a report by the Commonwealth Fund, which is a foundation that financially supports an independent research on health insurance reform. Around 57 percent admitted that finding coverage they could afford is bordering on very hard to downright impossible.
A survey conducted for the report also cited that 47 percent of the respondents said that finding the plan with the coverage they needed was difficult or impossible. Another 36 percent stated that they were charged additional rates or their application was denied due to a pre-existing condition. Some companies had their condition excluded from their coverage altogether.
The report, called ‘Failure to Protect: Why the Individual Insurance Market is Not a Viable Option for Most US Families, compared the experiences of adults in the working-age bracket who have employer- and individual-based private health insurance.
In the report, it was also found that people who acquired health insurance individually pay more money on deductibles and premiums than those with group or business health care coverage.
Among US adults who have individual insurance, the survey showed that 64 percent spend more or less $3,000 on premiums annually, while only 20 percent of people who have employer-based insurance are spending that much.
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07/28/2009
These days, young adults are learning about individual health insurance the hard way.
Sarah Posekany, a 27-year-old nursing student, was forced to file for bankruptcy. She underwent colon surgery and she was uninsured. Posekany is still in debt and she owes a medical bill of thousands of dollars.
"It's not fair," Posekany said. "We should learn how to be a strong nation and take care of everybody."
Katie Miletti is a 24-year-old college student. Although she survived cancer as a child, she still has to deal with her treatment’s side effects. She was removed from her mother’s policy, as she was already too old. For one month, she was left uninsured. She later qualified for Medicaid, a federal-state program for health insurance.
"Everyone should have health insurance," she said. "I don't think it should matter what your health problems are, how rich you are, or what your income is."
Called “the young invincibles” by the insurance industry, these young adults think that they will never get hurt or sick.
Nick Bernstein felt that way once, too. Bernstein became a waiter to pay off his college loans. He also planned to get a wine-production graduate degree. He filled his leisure time with snowboarding and backpacking.
While snowboarding last April 1, Bernstein had an accident, which left his collarbone broken.
At first, he wasn’t sure if he had insurance at all. Fortunately, his stepfather’s health plan was still able to cover a part of his $27,000 medical bill. However, this coverage might stop before he gets well. He was diagnosed with a staph infection. As he is incapable of working now, he still has to find a way to get insurance before his 25th birthday, as he will be dropped from the policy of his stepfather.
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07/28/2009
UnitedHealth Group plans to acquire Health Net’s subsidiaries in the Northeast for $510 million.
Announced by the two companies on Monday, the acquisition will strengthen UnitedHealth’s networks in New York, New Jersey, and Connecticut. Based in Minnetonka, the health plan and medical insurance provider generates the most revenue among health insurers in the nation.
Jay Gellert, chief executive of Health Net in Los Angeles, expressed his confidence about the deal. "For our members, this offers a very, very good alternative. We have confidence [UnitedHealth] will do first-rate by our members."
Health Net will continue its operations in Arizona and in western United States. The deal, which needs regulatory approval, is expected to be completed within a year.
New York, New Jersey, and Connecticut have around 578,000 Health Net members combined. 437,000 of them are risked-based commercial members and 35,000 are self-insured commercial members. Another 55,000 are Medicare Advantage members, while the remaining 51,000 are Medicaid members. Operations in those areas are expected to generate $2.7 billion in revenue.
Jeff Alterm, UnitedHealth chief executive in the Northeast, talks about the company’s reputation in the region. "We have a long, successful history of serving people in the Northeast and are committed to responding to local market needs while also providing people with access to the innovative health care products, programs and technology applications of a company with a national scale."
Health Net’s Medicaid and Medicare businesses, along with the commercial membership renewal, will cost UnitedHealth around $60 million. Once the deal is closed, UnitedHealth will pay Health Net another $290 million. The remaining $160 million will be paid within a span of two years.
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07/28/2009
Michigan state employees have already dropped their health benefits, Gov. Jennifer Granholm said today while giving a cold shoulder to House Speaker Andy Dillon’s plan to pool some 400,000 public employees covered by individual health plans to help the state save money.
Last week, Dillon, D-Redford Township, claimed this bold health care reform will help the state save as much as $900 million per year. Dillon further said this plan would provide insurance for retirees and local employees who would be covered by a single health plan that would provide extensive health plan options for individuals, depending on the premiums they can afford.
“Show me the money. I do not know where the savings come from,” Granholm told the reporters. She further said she had not seen the details of Dillon’s proposal. “I haven’t seen the legislation and I have a million questions about it,” she added.
The proposal evidently does not work for Granholm. She said it will never resolve the state’s financial problems. She doubted that bigger pools of workers will help the state save money, noting that the state currently has 55,000 employees that belong to big insurance pools.
She further added that she believe that Dillon was wrong to say that state employees pay less for health insurance and receive better benefits than those in private sectors. Granholm then cited last year’s House Fiscal Agency report that reveals that state employees have lower wages and receive fewer benefits than private sector employees.
In a prepared statement, Dillon replied to Granholm, saying, “Change is never easy—there will always be countless reasons not to change. But one thing is clear: business as usual isn’t working.”
He suggested lowering government expenses to prevent layoffs, and decreasing college scholarships. “We need leaders like Governor Grandholm, Senate Majority Leader Mike Bishop and others to work together in the days ahead so we can turn Michigan around,” Dillon said.
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07/28/2009
President Barack Obama continues to push for the overhaul of the U.S. health care system. He says that this matter cannot be delayed because it would affect “the stability of our entire economy.”
In Obama’s weekly Internet and radio address, he urged the Representatives from the two parties to work on laws that will decrease costs and regulate the “unwarranted giveaways to [health] insurance companies in Medicare and Medicaid,” while keeping the Americans’ health care options intact.
Obama added, “This is what the debate in Congress is all about: Whether we’ll keep talking and tinkering and letting this problem fester as more families and businesses go under, and more Americans lose their coverage, or whether we’ll seize this opportunity.”
Obama is ramping up this health insurance reform campaign, as he is set to hold two legislation events for the press this week. He will gather the Representatives to the White House for deliberations, and will hold a primetime press conference on July 22. The House and Senate are hard set to meet Obama’s August deadline, as he urges them to act on legislation before the coming congressional recess.
According to Obama’s recent statements, he will deny support on legislation that would add to the deficit.
“I don’t believe that government can or should run health care,” Obama remarked. “But I also don’t think insurance companies should have free rein to do as they please.”
Obama wants a final bill in about two months time, by October. Certain members of both parties criticize Obama’s action timetable for this health care overhaul campaign as “too ambitious.”
Jon Kyl, Arizona Senator, commented in the Republican weekly address on radio: “Something this important needs to be done right, rather than done quickly.”
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07/28/2009
Aside from mortarboards, graduating college students have other things to think about.
A report from the National Association of Colleges and Employers estimated that this year, at least a million alumni pulled out from their parents’ health insurance coverage after graduating. Because of financial shortages, former college students are having a hard time getting replacement insurance policies.
According to Jon Gabel, graduates should go for health insurance plans offered by employers. The senior fellow from the University of Chicago’s Opinion Research Center—Health Policy and Evaluation Department also added that it is the most affordable health plan for fresh graduates.
But the thing is, landing a job in today’s struggling job market is difficult. NACE says that around 2.5 million fresh graduates are unemployed. Samantha Whiteside, a 24-year-old graduate of health and fitness from Virginia Polytechnic University, is one of them.
After graduating last year, she had a promising career outlook after getting a job in an outpatient rehabilitation center around March. She worked as a technician as well as a wellness instructor for seniors with mental illness. Her employer promised that she would get health insurance benefits after three months. However, she was fired three days before her fourth month began.
“I've never been in this situation before," she said. "I know everybody's been saying that the economy's bad … but I never thought it would happen to me."
She is currently working as a part-time swimming instructor. Marla Whiteside, her mother, got her an individual health insurance plan for $96 per month. Even though the plan would only cover 70% of hospital bills, it’s better than having no coverage at all.
According to Cheryl Fish-Parcham from Families USA, graduates should not be part of the uninsured population.
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07/28/2009
A considerable amount of the American family’s budget is spent on medical insurance. The USA government alone allocates over $2.2 trillion yearly or $8,000 per person on health plans to ensure healthy workers and a productive economy. It is projected that the amount the government spends on the health care system will increase to more than $4 trillion by 2017 if no program for the reform of the system is enacted.
President Obama has initiated ways to modernize the system of health care in America. The Recovery Act of 2009 includes a provision for the citizens who have recently lost their jobs, which will provide a tax credit that will continue their health insurance contribution through COBRA. He also signed a law that supports health plan coverage for children through the Children’s Health Insurance Program (CHIP). The president has also pushed for the computerization of health records in the United States in five years in order to make the system more efficient and more accurate. The government will save much money if the paper-based records, which are time-consuming and expensive, are replaced with a computer system that will deliver speedy results with minimal or no errors.
The government also seeks to uplift the research and development of the current health system. The Recovery Act has also allocated $1.1 billion for comparative research that details data on the effectiveness of a medical treatment or procedure. This will aid the doctors in proper diagnosis and treatment of their patients. Programs on wellness will also be promoted in the country because almost one-third of illnesses are attributed to poor lifestyle choices. This will reduce the risks of acquiring diseases, such as hypertension, cardiovascular ailments, and cancer.
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07/28/2009
Aetna expressed its support and concern for the welfare of college students in terms of health care. Head of Aetna Student Health Kate Begley said, “At Aetna, we work closely with campus health and counseling centers, as well as community and travel service providers, to offer students access to convenient care at an affordable price, no matter where they are located.”
Most parents find summer the ideal time to ensure the academic and financial preparedness of college students for life on campus. This is also the time when vital decisions are made. What is often overlooked, however, is student health insurance. Aetna encourages parents to view a student’s health insurance options as one of the important considerations when they prepare their children for college education.
Kate Begley further said that they “support the efforts of colleges and universities to ensure students have access to affordable, quality health care.” Aetna also gave tips to parents who are in the process of selecting a student health insurance plan. These tips include weighing the option of carrying a dependent on one’s plan against the benefits of a school plan; identifying a health-care contact on campus by reviewing the school’s website and visiting the campus health center; and understanding the health insurance requirements of the school.
"Choosing a student health insurance plan that is right for your child is a personal decision and one that should be examined carefully, particularly in today's uncertain economy," added Begley. "Evaluating the true cost, meaning the premium plus out-of-pocket expenses, of a family plan versus a student health plan is critical to understanding which plan is most cost-effective and will best serve the needs of your college student."
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07/28/2009
The White House and the Democrats in Congress who are working hard on the health care bills to beat President Obama’s deadline, are trying to keep legislation costs to $1 trillion for 10 years. But would that be enough?
There is no doubt that $1 trillion would cover a lot of uninsured people. However, it will not be enough to meet the goals that the advocates initially wanted. Congress is currently working on proposals that include a $1.042 trillion bill that will be presented by Democratic leaders in the House on Tuesday. The proposals intend to provide subsidies to a smaller number of moderate-income families. They will also prevent most workers from abandoning the health plans provided by their employers.
According to the Congressional Budget Office, the estimated number of uninsured people will go down to 15-20 million after 10 years. As of now, around 50 million people are uninsured.
Last Monday, Senate GOP leader Mitch McConnell stated that "One of the major concerns that Americans have about health care reform is the price tag. Every proposal we've seen would cost a fortune by any standard."
In defense of the health care reform, President Obama says that the overhaul is a crucial investment toward fixing the nation’s dysfunctional health care system. Straightening the rough edges of the current health care system would prevent financial problems in the future.
Lawmakers are still trying to figure out how to finance the overhaul. According to Obama, fixing the health care system will not increase the country’s financial deficit, and to offset such a deficit there will be a need to either raise taxes or cut national spending.
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07/28/2009
This news bit goes out to parents and professionals alike. It’s time we stop using that “toothache excuse” for school and office absences, the American Association for Dental Research (AADR) says. In the Oral Health Care Within Health Care Reform policy statement issued by the association on July 14, 2009, it was stressed that the need to attend to one’s oral and dental aches is urgent, as poor oral care can result in other serious problems—health-related and not.
According to the AADR, U.S. employees take 164 million hours off from work in a year, only to attend to a toothache or a gum irritation. Similarly, children are absent from school for 51 million hours a year, to be free from dental pain. The association has concluded that these periodontal diseases create the same full-body inflammatory response as other internal ailments would, yet they receive much less attention. The AADR claims that many Americans—more than 80 million, to be exact—have applied for medical insurance, but not for dental insurance.
In line with this, the association recalled what the U.S. Surgeon General mentioned in 2000. Back then, the Surgeon General called upon everyone to recognize the importance of oral health measures. He even proposed that lawmakers \"build an effective health infrastructure that meets the oral health needs of all Americans and integrates oral health effectively into overall health.”
Today, the AADR recommends that continued information dissemination regarding accessible and affordable oral health insurance must be conducted among Americans, if that would mean better oral health and, in turn, general health, as well.
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07/28/2009
After Wal-Mart pledged support for the proposal that requires employers to contribute to their workers’ health insurance costs, the National Retail Federation is asking its members to oppose Wal-Mart’s stance on the issue.
In a letter issued by NRF chief executive Tracy Mullin, group members are urged to “Come out swinging.” He added that, “To truly lead on the health care debate, it is imperative that businesses, associations and politicians take a stand where it counts and not shy away from deal-breakers like employer mandates.”
The letter shows the different views of companies toward the health care reform, which aims to cover the uninsured.
Different companies have allowed trade groups like the National Retail Federation, the largest trade group in the industry, and the Chamber of Commerce, the biggest business lobbying organization in the country, to spearhead the opposition to the health care plans in congress. Wal-Mart isn’t part of the NRF.
In a June letter to the senators in the drafting committees, the NRF said that it would prompt its members to oppose politicians who support an employer mandate. Meanwhile, the Service Employees International Union, Wal-Mart, and the Center for American Progress sent their own letter to the White House, voicing their support for a company mandate that will urge employers to provide health benefits like group health insurance to their employees.
The letter was signed by Michael Duke, president and CEO of Wal-Mart, Andrew Stern, president of SEIU, and John Podesta, president of the Center for American Progress.
The NRF is not alone in expressing opposition to Wal-Mart’s stance. In its letter to the White House, the United Food and Commercial Workers Union raised questions about Wal-Mart’s position.
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07/28/2009
House democrats unveiled an extensive plan for a bold reform of the nation’s health care system. Contained in the 1,018-page bill are provisions on regulating the health insurance market, formation of a new health insurance option run by the government, and other steps for implementing universal health coverage.
The bill sets out initiatives for reducing health care costs, which are expected to rise to $2.5 trillion this year. In addition, the cost of the legislation, which is estimated at $1 trillion, will be offset with a new tax to be imposed on wealthy Americans.
The proposal, which is considered one of the most liberal in revamping the system, was criticized by Republicans and 30 leading business groups, although many of these also showed support for some aspects.
If implemented, employers will either provide medical insurance to their workers or pay the government a fee based on their payroll. Small businesses with an income below $250,000 will be exempt from paying the fees. Also included in the plan are regulations prohibiting insurance companies from denying Americans with pre-existing medical conditions. This is to ensure more affordable options for everyone.
All low income Americans will also become eligible for Medicaid, and private insurance companies will be offering a standard universal benefit package designed by the government.
The Congressional Budget Office (CBO) estimates that 97% of Americans, including legal immigrants, will have health coverage by 2019. Furthermore, the CBO estimates that nearly 162 million people will have continued employer-provided insurance and 30 million people will avail themselves of health coverage through the new health insurance exchange. Nine million of those who would avail themselves of the new exchange are expected to choose the new health program run by the government.
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07/28/2009
Health Net Inc. suffered a major disappointment when the U.S. Department of Defense awarded its $2.8 billion annual military Tricare contract to Aetna Inc, another Health Maintenance Organization (HMO).
Estimated to be worth around $17 billion, the contract includes five one-year options along with a 10-month base period. The contract will provide service to millions of personnel in the military, National Guard and Reserves, dependents, and retirees in 20 Midwest and East Coast states.
The Tricare military health care program involves 900 of Health Net’s 2,500 employees. The devastating news had a negative effect on the company’s stock, which fell by around 15%. However, it managed to close at $145.13, down only 3%.
In a press statement, Health Net Federal Services president Steve Tough expressed the company’s disappointment about the decision of the Department of Defense.
“We anticipate that a debriefing will be conducted within the next couple of weeks. We will consider the information provided at the debriefing, and within two weeks following, we will determine whether we will accept or challenge the award decision.”
Another health care provider that lost a government contract is Humana Inc. After an extensive bidding attempt, the company lost its $3.73 billion annual contract that covers 10 southern states. The contract was awarded to California PacifiCare’s parent company, United Health Group Inc.
TriWest Healthcare Alliance Corp. was the only company to retain its $2.9 billion annual contract. It provides services to military personnel located in 21 Western states.
In 1988, Health Net won a pilot contract to provide service to military personnel, retirees, and dependents in Hawaii and California. Aetna got the contract in 1993 and, after three years, Health Net won it back.
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07/28/2009
Health insurance costs in Alabama have increased by 95% since 2000, according to the Health Care Status report.
The report reveals that the number of small businesses or companies providing health coverage benefits to workers dropped by two percent since 2000. Currently, only 48% of small employers in Alabama offer health benefits to workers.
The soaring costs of health insurance have affected individuals as well. According to the report, 28% of middle-class families spend at least 10% of their total income on health care.
A related study found that the limited options offered by health insurance companies is an issue related to these rising costs. According to the study, BlueCross-BlueShield controls an 83% share of Alabama’s health insurance market. Roughly, 13.6% of Alabamians are uninsured.
Options for health insurance are even more limited for individuals with pre-existing conditions. In Alabama, the costs of health insurance vary based on health status and demographic factors. Coverage can also exclude some pre-existing conditions or even be completely denied.
The report also says that 16% of people in Alabama do not visit a doctor due to the high costs. Moreover, families and businesses in Alabama pay a hidden health tax of about $600 each year on premiums to subsidize the costs of the uninsured.
Currently, approximately 2.9 million people in Alabama avail themselves of health plans through their jobs. Subsidized by their employers, these people have an average family premium of $12,230.
Based on the Health Care Status Quo report, the need for health care reform in Alabama and across the U.S. is clear.
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07/13/2009
Despite the continuing support for President Obama’s health care reform, some of the major players in the debate are beginning to worry about the overhaul’s success. They fear it won’t be sufficient to solve the problem of runaway medical costs.
Some even believe that the deals the White House made with drug makers and hospitals to keep the negotiations alive could make the problem worse.
On Monday, there will be a closed-door meeting between labor leaders and Obama. They will discuss aggressive measures to keep health care costs from escalating. Terry O’Sullivan, head of the Laborers' International Union of North America, expressed his support of the plan to have everyone covered by medical insurance, and at the same time his concerns about the reform.
"We are certainly for expansion of coverage. We think every American ought to have health insurance. But if that doesn't come with making sure there is real prevention, if we're not talking about really controlling healthcare costs, this is going to be a train wreck."
On the other hand, business groups are urging the current administration and its allies in Congress to tackle the cost issues by making changes to the way doctors, hospitals and providers are paid.
According to Steve Wojcik, the National Business Group on Health’s vice-president for public policy, “Going into health reform, there was a lot of talk from the president on how controlling costs had to be on a par with expanding coverage. The priority on controlling costs seems to have fallen by the wayside."
Consistent survey results point to the public’s biggest health care concern: rising cost of medical bills and health plan premiums. At the core of his campaign for health care reform, Obama insists that his health care reform will provide relief.
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07/13/2009
Brian Urban, an insurance broker, refused to believe a caller who told him a story about an owner of a small business in Nebraska who couldn’t afford health plan premiums because it would require him to pay around $24,000 to $40,000 annually.
Urban said, “Just the size of the numbers was far out of what the market would dictate even for someone with some severe medical conditions. And according to the story, these were healthy individuals.”
The Nebraska health insurance market is a familiar territory for Urban since he is the CEO of Corporate Resource Group, as well as the legislative chairman in Nebraska for the National Association of Health Underwriters.
33-year-old Larry Harbour was the man who complained about the high cost of premiums. As the owner of LB Custom Chrome and Detail in Nebraska, he tried his best to find affordable insurance coverage. In a phone call, Urban offered to get Harbour affordable premiums.
Harbour, who was happy to hear Urban’s offer, described the search for health insurance as “very confusing.” “It's very tough to understand unless you have someone, so to speak, holding your hand and walking you through the process.”
Urban’s phone call was the first of many geared toward helping Harbour find affordable business health insurance coverage. “According to the story, he was uninsured, and I don't find that acceptable. It's my job to make sure that as many people are insured as possible,” Urban said.
Urban also made a comment about how confusing premiums affect the health insurance debate. “We're not opposed to reform. It's just that we want to make sure we're dealing with real-life facts and numbers and that reform is focused on the areas it's truly needed.”
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07/13/2009
As the U.S. government continues to work on reforming the country’s health care system, business groups fear that many small companies throughout Southeast Valley would be forced to shut down.
The senate proposal for the bill on health care reform would compel employers to provide business health insurance for their workers. Otherwise, they need to contribute a fee worth 8% of their payrolls for a government-managed insurance plan.
Via Homes president, Trudy Licano, said that "A lot of times legislation is meant to help people, but this could shut doors. There's going to be a pretty huge impact on us. Some businesses just can't afford it."
Under the said bill, employers who will provide insurance for their workers would be required to cover 72.5% of the premium cost for full-time employees and 65% for family policies. Companies are also required to insure their part-time workers. However, some businesses would be exempted depending on their size, which has yet to be determined.
Mary Ann Miller, president and CEO of Tempe Chamber of Commerce, explained the possible effect of the proposed health bill to the business sector: "I think that most businesses would love to be able to provide health insurance to its employees, and do so wherever they can. But mandating such coverage will only drive up costs for businesses of all sizes during tough economic times."
Last month’s proposed bill was described by the U.S. Chamber of Commerce as "a dangerous proposal."
According to Jack Alspaugh of the Arizona Small Business Association, companies with less than 50 employees will find it difficult to balance efforts between providing coverage to their employees and maintaining their payrolls.
The Senate and House members are still working out the details of the bill, which President Obama wants to sign by fall.
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07/13/2009
Due to the soaring cost of health care, small businesses in Utah are now ready to embrace a health care reform, including the government-run insurance option, just to offer health care subsidy to their workers and earn a profit.
A recent survey reveals only 40% of the 300 randomly chosen businesses provide health care insurance to their employees, and 79% of those are struggling to subsidize their workers’ health plans. In addition, 88% of the companies that dropped their employees’ health coverage say they cannot afford to shoulder the costs anymore.
“What comes through loud and clear is the health crisis is huge, it’s crushing, and something needs to be done right away,” said John Arensmeyer, CEO and founder of Small Business Majority.
Small business owners in Utah believe a comprehensive reform on health care is an economic necessity, and that controlling the costs should be the top priority of the reform.
“The problem is that the cost of the health insurance is rising,” said Betsy Burton, a small bookshop owner, whose health plan cost increased by more than 20% last year. “At that rate, it is really difficult to make a profit in a business like this, with a low profit margin,” she said.
While almost 50% of business leaders in Utah consider themselves as Republicans and identify themselves as having conservative political views, small businesses in the state are now ready to embrace a bold health care system reform.
The struggle of small businesses with the rising cost of health care and their eagerness to do something to solve the problem is not really surprising, said Judi Hilman, executive director of the Utah Health Policy Project. "It is because small businesses are the first that experience the current problems in our system," she explained.
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07/13/2009
Insurance companies are seeing an increase in short-term health insurance applications this year.
Texas insurance company Blue Cross and Blue Shield expects an increase of 33% in individual short-term health insurance applications in the first half of the year.
Margaret Jarvis, spokesperson for Blue Cross and Blue Shield, Texas, said sales of individual health plans, whether short-term or long-term, in the first half of last year, were at a record high for the company. Sales of both types of individual insurance, Jarvis said, increased by over 30%.
The increasing interest in getting individual health care plans, in general, and in short-term insurance plans, in particular, is evident in the recent launching of more short-term individual policies by big health insurance companies. Shifting from group health insurance to temporary individual health coverage indicates the growing number of unemployed people in the U.S.
Recently, the Golden Rule subsidiary of United Healthcare in Texas launched two new short-term health plans that are specifically designed to cater to the health care needs of the unemployed not qualified for the subsidized health plans under the Consolidated Omnibus Budget Reconciliation Act (COBRA) or those who cannot afford it.
COBRA is a federal program that offers up to nine months of subsidy to those who wish to continue their health insurance after losing their job. COBRA, however, can also be very expensive for those who do not meet the primary requirements.
Another insurance company, Humana, opened a new short-term insurance plan in April for Arizona, Colorado, Alabama, Ohio, Nebraska, Wisconsin and Michigan.
Richard Collins, CEO of United Healthcare Golden Rule, said temporary health plans are necessary especially now, when the economy is not yet stable.
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07/13/2009
A survey released last Wednesday revealed that only a little less than half of the American population believes that their health plans would cover their cancer treatment costs in full, while around two-thirds have the false notion that Medicare will not cover anything.
Out of the 1,000 adults who participated in the survey, 70% stated that they were “very concerned” about shouldering cancer treatment costs if they ever had cancer, while 59% fear putting their families in financial trouble.
Released by the Community Oncology Alliance, the survey implies that Americans are worried and at the same time misinformed about the country’s health care system, as well as the modifications that might take place after Congress and the White House finish working on the overhaul.
According to Dr. Patrick Cobb, president of the Community Oncology Alliance and a managing associate of Hematology-Oncology Centers of the Northern Rockies in Billings, Montana, it is right for people to fear the costs of cancer treatment since cancer is the second leading cause of death in America.
When it comes to health insurance comparisons, only a small number of private insurance plans provide full coverage for cancer treatment. These plans could have premiums of $5,000 or more.
Cobb further explained, "Monthly out-of-pocket costs for cancer care and treatment, not covered by private insurance plans or Medicare, can easily run to $1,000 or more. For many cancer patients, the costs of diagnostic imaging, surgery and expensive cancer medications, especially in the first few months of treatment, can add up to well beyond $2,500 per month."
As part of the proposed health care reform, President Obama has begun to push for a government-managed insurance option that will be offered along with the traditional private and employer-sponsored insurance.
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07/13/2009
Last Monday, Connecticut Senator Christopher J. Dodd asked Anthem Blue Cross to review its proposed rate increase. The proposal constitutes an increase of 23% on the average, while in Connecticut the proposed rate increase is 32% for individual health insurance plans.
Last Wednesday, Anthem Blue Cross and Blue Shield asked the Connecticut Insurance Department to approve the increases. Once approved, the majority of the 56,000 residents below 65 years of age who bought health and medical insurance from Anthem will be affected.
The proposed increases will not affect Anthem’s group and business health insurance policies. However, some employers complained about recent premium increases.
In a letter addressed to David R. Fusco, Anthem’s president in Connecticut, Senator Dodd stated that Anthem’s proposed individual policy rate increase “runs counter to the goal of providing all Americans with quality, affordable health care,” especially now that the insurance industry is taking part in federal efforts to reform America’s health care system.
Considering that 322,000 residents are uninsured, the senator said, "Should these new rates kick in, there is no question that additional Connecticut families will join the ranks of the uninsured."
Back in January, Dodd started a “listening tour” to hear what constituents think about health care reform. And according to the senator, Fusco was “kind enough” to attend the kickoff.
In Monday’s letter, Dodd requested that Fusco "reconsider the proposed rate increases in Connecticut and instead join me once again in my efforts and those of the Senate and the House to enact comprehensive health reform legislation this year."
In response, Anthem expressed its appreciation for the senator’s concerns, but stated, “Our proposed rate increase is a reflection of increasing health care costs." The company explained that some of its policies will not be affected by the increase. However, those policies would require buyers to shoulder more of the health expenses.
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07/13/2009
Connecticut state attorney general Richard Blumenthal is pushing for the rejection of Connecticut insurance companies’ request for a health care rate increase of 30% by October this year.
In response to Anthem Blue Cross Blue Shield’s request for a rate increase of 22%–30%, Blumenthal commented, “This request is legally or factually unjustified by anything this company has submitted.”
In Anthem’s submitted increase request, the premium for the $250-deductible Century Preferred PPO, one of Anthem’s popular health plans, will increase by $62 monthly, from $264 to $326.
Sarah Yeager, the company’s director of corporate communications, said that increased claim costs have exceeded the insurance premium enough for the company to demand for higher rates.
A spokesperson of Anthem Blue Cross Blue Shield also said that the finances and rates of the company are regularly evaluated to ensure that the premium fees can cover claim expenses and costs.
The company, which filed its request on June 9, agreed to waive the 30-day deadline for the state Insurance Department to continue its evaluation. Based on state law, the changes in the company’s rates would have been automatically instated on Thursday without the department’s implied disapproval. The changes in rates could affect 56,000 insured Connecticut residents. According to the Insurance Department’s records, the population covered by the company comprises 4% of the 1.4 million residents of Connecticut.
An increase of this magnitude, Blumenthal said, is clearly against the statutory standard. “The current economic condition and the October 1 implementation also make it necessary for the state to reject this request.”
Insurance rate increases and the insurance companies’ compliance with regulations and laws involving insurance business are regulated by the state Insurance Department.
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07/13/2009
Rep. Chris Murphy of the 5th Congressional District of Connecticut says that America’s current health care system is sick. "I like to say we've got a disease in our health care system that's very difficult to diagnose. So the solution to that disease is going to be equally complex."
Murphy stressed the need for reforms to cover the uninsured and fix the problems in the current health care system. According to the Congressman, the reforms will be centered on freedom of choice.
Addressing those with individual and business health insurance, Murphy discussed the availability of choices: "If you like what you have, you get to keep it. If you're an individual or a small business that doesn't like what's available, we're going to give you options."
Murphy currently works in the Health subcommittee of the House of Representatives, as well as in two other House committees, writing the health reform legislation. Also writing the reform packages are two committees from the Senate.
According to Murphy, bills are often bogged down because of the number of House committees that work on the actual legislation. "We're trying in the House to have all three committees write a similar bill''
Despite the complex legislation, Murphy is sure that Congress will be prepared to vote on the health care reform before July ends.
The reform will require some changes in the American way of life. Everybody will be required to avail themselves of health insurance. Companies will also be compelled to either offer coverage to their employees or pay costs instead.
As for the insurance industry, the reform will pave the way for a basic insurance package that will be available to all American citizens.
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07/13/2009
U.S. Health and Human Services Secretary Kathleen Sebelius disclosed Monday that local and government organizations could now avail themselves of outreach grants to enroll more children in health care insurance plans.
The outreach program aims to cover 4 million children who do not have health care plans and keep 7 million children insured under the Children’s Insurance Programs and Medicaid. Sebelius said that the project prioritizes residents of “historically under-served” or rural areas.
“These grants arrived just in time, when we need them the most,” Sebelius added, referring to recent news on the country’s unemployment rate, which has reached 9.5%. Sebelius also stressed that when the unemployment rate is high, the rate of uninsured individuals also rises. This is because the majority of Americans are enrolled in group health insurance plans, which are employer-provided health plans. “When parents lose their jobs, they and their children also lose health coverage,” Sebelius added.
The grants, made through the Children\'s Health Insurance Program Reauthorization Act signed by President Barack Obama and which was released in February, will be initially funded by the federal government. The outreach program will last until 2013 and will be providing a total of $100 million worth of grants.
To get the most qualified applicants, Cindy Mann, director of the Center for Medicaid and State Operations, advised using innovative methods, such as technology-driven or even localized and community-based initiatives. “We should think of ways that can really help us reach all qualified children in order for them to enroll with less red tape,” Mann said.
Local governments, community-based or non-profit organizations, schools, and religious groups are welcome to apply. Eligible candidates may submit their applications at grants.gov until early August.
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07/13/2009
A recent survey commissioned by health insurance company CIGNA has found that when it comes to health care costs women are far more likely to search for bargains, such as by using healthcare comparison sites, than men are.
Kurt Weimer, who leads the companies division for individuals along with small businesses, says: “From our perspective, women have always been sort of the key decision maker in health care selection. It’s moved to the next level… Not only are they making that health care decision, now they’re looking at the economics.”
The survey found that out of the 1,000 people questioned only 15% of men compare the costs of medical treatments and doctors in comparison to 20% of women. The survey also found that 79% of women were more likely to buy the generic own brand range of medications, whereas only 69% of men would look to a generic range as opposed to the well known, and more expensive brands.
Weimer goes on to say that the recession has forced mothers to take on the role of “Chief financial officer” as well as “Chief medical officer”, pointing out “If you’re like all of us, you’re looking at how to make ends meet.”
Executive director of the National Association of Mothers Centers (motherscenter.org) believes that women might be feeling the pressure of the recession and downturn in the economy more so than men because they make “the bulk of the buying decisions for the family”.
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07/13/2009
Key Senate Democrats presented a modified health care bill, calling for private insurance companies to compete with insurance options offered by the government.
In a letter, Senators Edward Kennedy and Christopher Dodd said their improved bill dramatically decreases the costs of the earlier incomplete proposal. The two senators stressed that the Congressional Budget Office’s estimate of the proposal’s cost is now down to $611.4 billion over 10 years from $1 trillion.
In a press conference, Senator Dodd said the revised plan is closer to the “historic health care reform.” This bill, he added, offers the public options on a health plan that is run by “what functions best for Americans, not by what makes enormous profits.”
The revised bill also calls for a $750 annual fee for each full-time worker and $375 for each part-time worker at large companies not subsidizing health coverage for their employees. Small companies with only 20 employees would be exempt from penalties. It is estimated that the fee would raise $52 billion in 10 years. This would be used to subsidize those who cannot afford to pay for medical insurance. The government’s budget would be coming from higher taxes and trimmed Medicaid and Medicare spending.
The two senators also emphasized that the legislation aims to reduce the number of employers who want to drop their workers’ health coverage next year due to high health care costs.
The bill also urges private insurance companies to provide medical coverage to any applicant at a lower cost, especially to those with pre-existing medical conditions. The revised proposal is also projected to advance President Barack Obama’s proposal that aims to cover an estimated 47 million people who lack health coverage.
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07/13/2009
Key Senate Democrats unveiled last Thursday a health care revamp bill that imposes a fine of more than $1,000 for Americans who refuse to avail themselves of affordable health coverage. The bill aims to fulfill the top domestic priority of President Barack Obama.
In a statement, Obama supported the legislation saying that it “reflects many of the principles I’ve laid out, such as reforms that will prohibit insurance companies from refusing coverage for people with pre-existing conditions and the concept of insurance exchanges where individuals can find affordable coverage if they lose their jobs, move or get sick."
In the proposed health care system, it would be an obligation for citizens to be covered by health insurance as it is necessary for motorists to get auto insurance coverage now. The government would also subsidize health insurance for the poor and even for middle-class families. However, those who decline to apply for health care coverage would face penalties.
As estimated by the Congressional Budget Office, the said penalties can raise $36 billion in 10 years. The penalty system is patterned after the method used in Massachusetts, which imposes an annual penalty of about $1,000 per individual who declines to get medical coverage. Federal legislation also dictates for the fines to be higher on families.
Data from a survey by the Kaiser Family Foundation show that in 2008, employer-paid health care family plans averaged at $12,680 while individual plans were at $4,704. It is estimated that the cost of the revised federal health plan will be less than this.
The penalties will be set at half the price of basic medical coverage. Called “shared responsibility payments,” the penalty aims to urge people to avail themselves of a health plan while they are still healthy and not wait until they get sick. Penalties shall be collected through the income tax system.
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07/13/2009
Key Democratic senators are pushing for a government-managed insurance policy to provide alternatives that will compete with private health plans. This proposal, which aims to help President Obama’s health care reform, will also require large companies that do not provide insurance to their employees to pay an annual fee of $750 per worker.
Democratic Senators Edward M. Kennedy of Massachusetts and Christopher Dodd of Connecticut said that the modified proposal would be cheaper compared to its previous version. The revised proposal aims to cover up to 97 percent of the American population.
Two weeks ago, the Congressional Budget Office estimated the cost of the previous proposal at $1 trillion over 10 years. The revised proposal on the other hand will cost around $611.4 billion. This modification on the actual cost of the proposal also “virtually eliminates” the earlier prediction that many companies would be forced to drop health insurance coverage for their employees.
On Wednesday, the two senators wrote to the members of the Senate Health, Education, Labor and Pensions Committee in anticipation of the return from vacation of lawmakers to the Capitol.
As early as next week, the Health Committee could finish its version of the bill. A party-line vote is virtually guaranteed because of the proposed government-run health insurance alternative.
On the other end, the Senate Finance Committee is working separately towards a companion measure that aims to achieve a bipartisan concession.
At the end of the month, the three House committees working on the legislation are expected to arrive at a vote that is sure to include the proposed insurance option from the government.
Obama is pressing for Congress to pass legislation within the year.
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07/13/2009
WASHINGTON – From the very start, President Obama’s administration has been working hard to sell health care reform to the middle class as part of the solution to increasing medical costs, and not just as something costly for the benefit of the poor.
But with the way legislation is being shaped by Congress, the most important issue yet to be addressed is whether the extent of the benefits for the middle class will be sufficient to gather their support.
Back in the 1990s, President Bill Clinton’s health insurance regulations failed because of the “Harry and Louise” ads. The insurance industry used these ads to suggest that Clinton’s health plan was “a bad deal” for the middle class. Even though recent polls suggest some public discontent with the way Obama is handling the issue, the President is yet to go down the same road as Clinton.
According to Len Nichols, New America Foundation’s health policy program director, the middle class’ decision will decide the fate of this year’s health care debates. "It will come down to Obama's portrayal of the benefits of the new world," and his solutions to the rising cost of insurance premiums." All this is complicated. All this is hard to show.”
Obama is selling a different payoff to Americans who are going to shoulder most of the bill that will cover the uninsured. Even though the portrayed payoff is generally appealing, quantifying it would be more difficult to do as compared to the subsidies needed to help cover the poor. The President wants the public to underwrite the cost of legislation and look forward to smaller premium increases in the future and guaranteed coverage.
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07/13/2009
The purpose of health insurance is to provide medical and financial protection. But according to estimates, three-quarters of those who filed for personal bankruptcy due to medical problems were actually insured.
As Washington pushes to cover almost every American in the proposed health insurance reform, many health-policy experts agree that having everyone insured will not fix the rough edges of the system. With many people already covered, a medical crisis would definitely mean financial calamity.
Lawrence Yurdin, a computer security specialist, filed for bankruptcy even though he had medical insurance. The 64-year-old’s Aetna policy indicated up to $150,000 worth of coverage per year. However, almost his treatments at a hospital in Austin, Texas, were not covered by his policy. Last December, Yurdin and his wife filed for bankruptcy with $200,000 worth of medical bills to pay.
Lawmakers are struggling with legislation details that would create minimum insurance coverage standards. With the expensive price tag, lawmakers could lean toward less comprehensive coverage for some policy holders.
However, patient advocates stress the necessity of laying down basic levels of insurance coverage to protect individuals like Yurdin from bankruptcy. They also want new federal rules that would prevent some insurance firms from selling worthless and incomprehensive policies.
According to Elizabeth Warren, a law professor from Harvard who studies medical bankruptcies, “Underinsurance is the great hidden risk of the American health care system. People do not realize they are one diagnosis away from financial collapse.”
Republican senator Charles E. Grassley from the Senate Finance Committee points out the same thing as he emphasizes the need to make “meaningful” insurance policies more accessible and affordable. “Until that happens,” Grassley continued, “any presentation of limited-benefit plans ought to be completely straightforward, and not misleading in any way.”
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07/13/2009
Standard Insurance Company (“The Standard”) recently signed a partnership agreement with Health Advocate, one of the leading health advocacy and assistance companies, in a bid to simplify healthcare plans and services. The Standard, a subsidiary of StanCorp Financial Group, Inc., announced today its new offering—the Health Advocacy Solution—in collaboration with Personal Health Advocates.
Luce Giroux, Second Vice President of Product Management at The Standard, said that the Health Advocacy Solution would help increase worker productivity by reducing the employees’ stress in navigating the healthcare system. “The Health Advocacy Solution offers direct access to our Personal Health Advocates who will provide more efficient ways of solving healthcare-related issues.”
Giroux said the Health Advocates are mostly nurses or well-trained assistants who will help workers navigate the usually complex healthcare system. They will help locate doctors, explain and clarify billing statements and negotiate fees, explain benefits plans and healthcare-related terminology, and even give assistance on issues related to prescription drugs. Moreover, the Health Advocates, backed by medical doctors and other health experts, also extend their help to their client’s spouse, parents, parents-in-law, and dependent children.
Regardless of industry, groups with at least 10 employees can avail themselves of the Health Advocacy Solution at a discounted rate, in addition to The Standard’s other health insurance plans and services.
David Rocchino, Chief Sales Officer of Health Advocate, Inc., also expressed his gratitude for The Standard’s partnership with his company. “We are indeed very pleased to be part of The Standard’s offering. Our advocacy complements their services and programs… This new service can help clients save time and money,” he added.
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07/13/2009
President Obama will visit northern Virginia on Wednesday to hold another town-hall meeting as he continues to push for the overhaul of the country’s healthcare system.
Those who want to participate in the event are encouraged by the White House to send questions and video responses online. People can visit the White House’s official Web site or connect through social networking sites like Facebook (http://facebook.com/Whitehouse) and Twitter (#WHHCQ).
According to Sheryl Gay Stolberg of “The New York Times,” Obama’s administration has created a multi-pronged strategy to help the president promote his health plan to the public. The strategy aims to persuade government officials outside of Congress, like state governors, to help by acting as Obama’s emissaries. However, the strategy contains many potential risks, like funding problems, which will be tackled by lawmakers when they return to Capitol Hill next week from recess.
“If Mr. Obama waits too long to exert his presidential muscle to forge consensus on Capitol Hill,” Ms. Stolberg warns, “his moment of opportunity could pass. He could also lose control of the final outcome if lawmakers cut backroom deals he dislikes, for example, by deciding to pay for the expansion by taxing employee health benefits, a move that worries Mr. Obama’s political advisers because it could cause the president to break a campaign promise.”
According to senior adviser to the president, David Axelrod, the administration wants “as many people as possible” to take part in the nationwide discussion about the healthcare reform.
Dan Balz and Shailagh Murray of the “Washington Post” analyze the administration’s plans. Just like healthcare, the energy and immigration bills will also face tough opposition in the Senate.
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07/13/2009
For small-business owners, maintaining their workers’ health insurance is becoming increasingly difficult with the soaring costs and a weak economy.
Pedro Alfonso, owner of the small telecommunications firm Dynamic Concepts Inc. said subsidizing the health plans of his 85 employees now entails out-of-pocket costs. Alfonso says that before, his company could afford 70% of its workers’ insurance premiums. Now, however, it can only pay 35%.
Alfonso, 61, said that rising health costs is hard for workers. “But it’s also hard on us,” he added.
Small companies, such as Alfonso’s, are among those which the non-partisan Congressional Budget Office (CBO) is concerned about. With higher health costs, 15 million people employed in small companies may lose their health plan benefits or may voluntarily drop their health insurance. Moreover, about 10% of small-business employers are now contemplating dropping their workers’ health coverage next year due to the sky-high health care costs.
Based on an incomplete bill in the Senate Health, Education, Labor and Pensions Committee, employees working in small companies are more vulnerable, especially if their company is paying for high premiums.
Policy analyst at the Heritage Foundation, Greg D’Angelo, agrees that the current insurance system does not work for owners of small companies. “The number of people who will lose their health-plan benefits depends on what the lawmakers are still negotiating,” he added.
Based on CBO estimates, over 10 million people who receive low wages would choose to terminate their current, high-cost insurance plans. With the government’s proposed health care overhaul, workers at small firms will most likely buy cheaper insurance in the open market.
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07/13/2009
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), the federal economic recovery plan offers a subsidy for employees who wish to continue their health insurance after job loss. As long as they are qualified for a new health insurance plan, the subsidy will pay 65% of their insurance premium for nine months.
COBRA offers continuing group/business health insurance for workers who lost their jobs. Signed into law in February 2009, this new subsidy covers involuntary job loss between September 1, 2008 and December 31, 2009, and applies to those who were terminated for any cause as long as it was not because of gross misconduct, as set in the IRS guidelines. Workers cut in large layoffs may also avail themselves of the subsidy.
In a notice, the IRS explains, “If the company would have terminated the employee’s services and the employee had knowledge that he/she would be terminated, the retirement is involuntary.”
Moreover, although COBRA mostly covers offices with at least 20 workers, smaller companies or groups that are under state mini-Cobra plans may also avail themselves of the subsidy. If the employee worked in a company that pays for COBRA premiums, he/she is only required to pay 35% of the total health plan for up to nine months.
nce qualified, a laid-off employee can use the Health Coverage Tax Credit, which shoulders 80% of health premiums for retirees that receive financial support from Pension Benefit Corporation. This also covers workers who lost their jobs due to technical modernization or deferral trade policies.
Workers who do not qualify for the subsidy are those who have a gross income of more than $125,000 a year or $250,000 for joint filers.
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07/13/2009
Despite the strain of soaring costs, the government is continuing to head towards a huge health care overhaul, which, it is feared, will lead to sky-high costs for everyone. Americans are supportive of President Barrack Obama’s proposed health insurance reform plan yet many are worried about its impact.
In a forum held last week at the White House, which was broadcasted live on the ABC television network, President Obama presented his health insurance reform plan to the public. Obama confidently answered questions on his proposed insurance reform, including questions relating to how people can keep their existing individual insurance plans.
A fact check on the President’s speech and his answers to questions show that he is eager to pursue his reform but that he sometimes glosses over details in his explanation of how he plans to make the reform successful.
The president campaigned for his health care plan and informed the audience that the costs of health care have increased three times faster than wages in the United States. Some studies, however, like the one prepared by Family USA, a group that is advocating for reforms in health care, reveal that heath care insurance costs have actually increased five times faster than wages in the US, as reported in October 2008.
The president said, “If you are happy with your current [health care] insurance plan and happy with your doctor, we don’t want you to have to change.” However, some speculate that the president’s plan cannot change the fact that private companies have the freedom to choose the health care plans of their employees.
Moreover, it has been found that Americans find it important for President Obama to offer a reform on health care without adding to the national deficit. But the price tag for this health care proposal is pegged to be between $1.3 and $1.6 trillion, which means it will clearly need more revenue for it not to add to the deficit.
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07/13/2009
Most health insurance providers in Guam will start covering ambulance services as the Guam Fire Department starts to charge fees for the use of ambulances on July 1.
According to Bri Hosei Habin, Health Care Management Division chief at Moylan\'s NetCare Life & Health Insurance program, various health insurance plans provide different levels of coverage for ambulance services. This means that a subscriber must pay ambulance fees or make a co-payment if he does not meet his health insurance deductible.
Based on Public Law 29-02, the Guam Fire Department will charge $95 for non-emergency ambulance services and $195 per transport for emergency ambulance services.
The bills for the services rendered will be mailed to health insurance providers while those uninsured will be charged directly, Edward Cruz, Fire Chief Aide, said during a press conference.
Cruz said that beginning July 1, the Guam Fire Department will issue ambulance invoices and bill health insurance providers.
Invoices for non-emergency purposes will cover the transport only while the fees for emergency services will include equipment and supplies used to provide medical care, such as a defibrillator, masks and oxygen, Cruz added.
Cruz also said that the funds from the ambulance services will be utilized to train personnel and maintain medical equipment.
Calvo's Select Care program health plan administrator, Frank Campillo, said that most ambulance services in the country’s mainland are offered by private companies. He further added that ambulance services are given by most health insurance companies in the island but that the Guam Fire Department did not charge for this before and will only start charging for them now.
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01/30/2009
Courtesy of Assurant Health
Short Term Medical Insurance - For individuals and families in brief periods of transition.
Short Term Medical Insurance, also known as temporary health insurance, protects you and your family from large medical bills that can result from an unexpected illness or injury. It’s protection and coverage you can rely on – no matter if you’re in between permanent coverage or in a life transition. And, if you’re uncertain about how long you’ll need coverage, Short Term Medical Insurance is ideal since you can pay on a month-to-month basis.
Short Term Medical Insurance is appropriate for:
People in Transition or others who may be in-between permanent health insurance plans like those offered by most employers.
Examples of people who might purchase Short Term Medical insurance: people between job, people seeking a less expensive alternative to COBRA, employed people who need coverage while waiting for their new employer’s group coverage to begin, temporary or seasonal employees, and recent college graduates.
Individual Medical Insurance - Permanent Health Insurance for Individuals and Families.
For individuals and families in need of coverage for 6 months or more. Individual Medical insurance is designed to provide people with the permanent protection they need from the financial hardship that can come from just one unforeseen illness or injury. Individual Medical Insurance also allows you the flexibility to choose the right plan for you – from the most cost-effective to the most comprehensive.
Permanent Health Insurance is appropriate for:
Individuals and Families whose need for health insurance is expected to last greater than six months.
Examples of people who might purchase Individual Medical insurance: self-employed individuals and their families, individuals working at companies that do not provide health insurance, individuals who are not satisfied with their employer’s health insurance, and retirees not yet eligible for Medicare.
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10/03/2008
Maybe you've changed jobs, or started a new job, and the health coverage doesn't take effect right away. Or, you've finished college, and are no longer covered under your parents' plan. Perhaps you may be between jobs, and don't know when you will get another job with health benefits.
Even a minor gap in insurance coverage can be cause for worry, because medical bills paid out-of-pocket can be financially devastating.
If this is the case, then short-term medical insurance may be appropriate. When you leave a job, you can choose to continue your coverage under the COBRA act of 1985, or get temporary coverage as your state laws dictate. Or, you can elect to purchase a short-term medical plan.
Weigh the pros and cons, and decide which choice is best for your situation.
Short-term medical insurance is best for those who are in good health, and have no pre-existing conditions. One of the biggest appeals of a short-term plan is its low premium. Depending on the policy, benefits can be up to $2 million per person. However, most policies have a limit on how long they last. The majority last for 12 months, although some insurers have plans with coverage up to 36 months. Short-term insurance can be bought in one-month increments, making it easy to drop the benefits at the end of any given month.
Surgery, hospitalization, emergency room visits, diagnostic tests, prescription drugs, follow-up visits, and limited mental health care are included under most short-term health policies, but under limits and conditions.
Because of its low cost, short-term health insurance does not usually cover routine preventative care such as physical exams, immunizations, and PAP tests. A good rule to remember with short-term health coverage is that it doesn't pay unless you've actually suffered an illness or injury for the first time during the policy period.
Most companies offer a 30-day guarantee period, and will refund 100% of your premium within this time if you decide that you don't want the policy . To get your money back during this window, however, you must not have filed any claims.
With some short-term medical plans, your deductible will apply on a per-injury or per-illness basis. After you've paid the deductible, most insurers will pay up to 50 or 80% of the next $5,000 of medical bills before 100% coverage takes effect, up to the plan maximum.
A short-term health insurance policy works like an "indemnity" plan that gives you the choice to go to any doctor or specialist you like. However, most plans do require pre-authorization, requiring that you obtain approval from your insurer before you are hospitalized (except for emergency treatment). If you don't get pre-authorization, your insurance company won't reimburse you.
If you aren't one of the 170 million Americans covered under an employer plan, short-term health insurance may be an appealing, less expensive alternative. We offer short-term medical from Assurant Health and you can begin the application process at our homepage.
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09/16/2008
Since being enacted in July of 1965, Medicare has become an important part of American life. According to the Center for Medicare Advocacy, approximately 44.8 million people are expected to be enrolled in Medicare in 2008, up from 43.1 million in 2006. Medicare not only provides healthcare coverage for people aged 65 and older, but also people under the age of 65 with certain disabilities, and people with End-Stage Renal Disease.
While Medicare with its many benefits and parts may seem confusing at first glance, there is a vast amount of information readily available to help you make an informed decision about which plan best meets your healthcare needs. The four major parts that make up Medicare are Part A, B, C, and D.
Medicare Part A covers inpatient hospital services and skilled nursing facility stays. Its benefits also cover some short-term home health care and hospice care, providing certain conditions are met. Part A and Part B Medicare are often referred to as the "Original Medicare". There is no fee for Part A Medicare.
Medicare Part B covers outpatient services such as doctor's visits, lab tests, hospital treatments that are not inpatient, and other basic medical care including preventative services. Part B usually will pay 80% of a service covered by the program and you will be responsible to pay the other 20% along with a yearly deductible amount and a monthly fee.
Medicare Part C or Medicare Advantage plans include both hospital and outpatient services, similar to Part A and Part B, but are provided by private insurance companies that have been approved by Medicare. Most plans will provide you with a list of doctors that are approved by the plan. Usually Medicare Advantage plans require you to see a doctor on their list, or your medical service may not be covered. Additional costs such as copayments, coinsurance, or deductibles are often part of the Medicare Advantage plans. Costs can vary greatly depending on the plan. Prescription drug coverage and dental or vision care may be included in Medicare Advantage Plans at an additional cost.
Medicare Part D is also known as the Medicare Prescription Drug Plan. These plans are optional and are also provided by private insurance companies. Each prescription drug plan will have different costs and will cover different prescription drugs. It is very important to be careful when choosing a Prescription Drug Plan to be sure the prescriptions you are currently using are on the plan you choose and a pharmacy you want to use is also included in the plan. Medicare Part D may not only lower your current prescription drug costs, but it may help protect you against higher costs in the future.
Medicare Supplemental coverage or Medigap plans are provided by private insurance companies. They pay for health expenses that Medicare doesn't cover, such as co-payments. There is an additional cost for these supplemental plans and costs vary depending on the plan you choose.
The first step in choosing any healthcare plan is determining what healthcare benefits you want and need. The coverage you choose will not only affect your current, but also your future health care. Medicare has been a life saver for many older Americans over the years, providing access to affordable healthcare to more older Americans than ever before.
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10/03/2008
As children, we never dreamed of the day that our country would be faced by such a health insurance crisis. According to Income, Poverty, and Health Insurance Coverage in the United States, the number of uninsured Americans would increase to a record high of 47 million people in 2006. That is over 13 percent of the population. As a nation, we cannot say that we didn't see it coming. Healthcare costs were on the rise; unemployment was on the rise too. The cost and development of new technology would continue to increase as would gas and transportation costs. All of these had a major impact on the healthcare industry.
Some American simply claim they cannot handle the increasing cost of healthcare. Meanwhile, some employers do not even afford coverage to employees. And for those that do, many Americans continue to lose their coverage as companies downsize and turnover employees. So all the while, those who may in fact need the healthcare coverage most are stuck standing out in the rain.
No one has to be stuck in that position. Since 2006, healthcare has taken a turn in the opposite direction. America has seen over a 1% increase in health insurance coverage. This is not to say that we will see the same healthcare costs that we became accustomed to only 2 decades ago, but healthcare is becoming somewhat affordable again. And as cost of insurance improves, most of us will continue to hope that we will see a correlation in the extent of coverage as well.
Healthcare is a hot topic of discussion, especially during this election year. Some believe that it is up to the government to take action to get America out of yet another crisis. But regardless of what the government plans on or objects to doing, it is important that individuals take note of their own healthcare situation. After all, it is the individuals who will actually be impacted by these circumstances.
Purchasing insurance coverage is now simpler than ever. Today, we see more individual healthcare companies on the rise, opening new doors and opportunities for those without coverage. Companies like these are making it nearly impossible to not have healthcare coverage or insurance. Health insurance is readily available through a simple search online or by directly contacting health insurance providers regarding personal health insurance.
Imagine your child lying there ill and you not being able to do anything about it. It is up to you to protect your family. And if you don't, who will?
Ultimately, that choice is left up to the individual level. Yet in the long run, those without insurance coverage may find themselves further in debt than if they taken advantage of these opportunities in the first place. And these will be the Americans left standing in the rain.
Source: C. DeNavas-Walt, B.D. Proctor, and J. Smith. Income, Poverty, and Health Insurance Coverage in the United States: 2007. U.S. Census Bureau. August 2008.
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09/16/2008
Although traditional methods of purchasing and maintaining insurance aren't likely to disappear anytime soon, the option to purchase policies online is the fastest growing method of distribution for insurance product, and appears unlikely to lose popularity any time soon. Too many customers are calling for innovative products that take less time and add less inconvenience to their already hectic lives, and insurance companies are answering that call by selling their products online.
Benefits to Consumers
As consumers became comfortable purchasing products on the Internet in the 1990's, insurance companies began to offer policies online. As technology and information sharing grew more and more reliable, online aggregators began to collect information on policy prices. These aggregators allow consumers to compare the costs and coverage between companies. Although many consumers purchase insurance online, an even greater number research online before purchasing more traditionally through an agent. Comparison shopping benefits consumers by providing them with more variety of choice in coverage and price. This availability of information to consumers in almost instant, and thus increases competition between insurance companies to provide a quality product at a competitive price.
For most online insurance purchasers, ease of comparison shopping, personal convenience, and savings are the top reasons for using online services. Before online comparisons for insurance premiums were available, shoppers got on the phone or in the car and spoke to an agent. This made comparison shopping take longer and added agent pressure tactics and inconvenience to the cost of purchasing insurance. Purchasing online takes away the salesperson pressure, and allows customers to take time and review the differences in coverage as well as in price. Further, the only appointment online shoppers have to make is with their laptops!
For those who crave a little human contact, or have questions, over 80% of sites offering online purchasing have links to contact an agent available, and the ability to contact an agent or representative to insure there are no unforeseen gaps in coverage or to get answers to questions consumers might have is another service online insurers offer their customers. Agents are trained to help consumers find the policy that covers them comprehensively, and to answer questions about the product.
Purchasing online insurance is certainly easier and more convenient, but is it really cheaper? Purchasing insurance online saves consumers an average of $600.00 per year, but insurers insist that the policies are not cheaper online. Insurance companies point out that the online format allows for more comparison shopping, which is what generally saves the consumer money.
Benefits to Insurance Companies
Insurance companies save money on commissions when consumers purchase policies directly from the company, because they don't have to pay the agents. Further, as policies purchased online generally require less paperwork and man hours to process, companies save time and money in this way as well.
Insurance consumers like online product. This benefits companies because policy holders use insurers that offer product that benefits them and cater to their lifestyle. Some companies are beginning to allow policies and proof of insurance to be printed offline, which makes the company seem greener to environmentally conscious consumers. Other companies donate to environmental causes out of online sales in an effort to support the growing interest in green lifestyles of many of their purchasers.
Future of Online Insurance Sales is Bright
Recent research shows that 21 percent of all new customer insurance sales occur online, according to the Insurance Information Institute's online discussion (http://www.iii.org/media/hottopics/insurance/distribution/?table_sort_782813=5). This is a significant amount of purchasing power.
This trend seems to be growing quickly. The Insurance Information Institute also reports a 37 percent increase in online sales from 2006-2007. The increases are expected to continue. The largest anticipated increase is in the auto insurance industry, where Celent estimates online sales will increase from 70 percent of sales in 2007 to 90 percent by 2011. J.D. Power and Associates reports that 39 percent of purchasers switched insurance companies, up from 33% in the 2007 study.
Free quotes, less pressure, more choices, and added convenience have made shopping for insurance online a commonly used method of purchasing car insurance today, and the trend is becoming more popular daily. Policies are available for everything from auto insurance and life insurance to individual health insurance, and consumers are appreciative of the added conveniences this type of service offers. According to J.D. Power's most recent survey, consumers will likely continue to make the switch into 2009.
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