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Archive for the ‘General’ Category

H1N1 Flu Vaccine and Your Insurance Plan

Monday, October 12th, 2009

Many carriers have released information that they will be covering the H1N1 virus (swine flu) vaccine and all administrative costs associated with obtaining the vaccine. Although focus will start with clients at most risk, all members will be ultimately covered. The two anti-viral medications, Tamiflu and Relenza, both offered in a generic formula as well, will be covered under the Tier 1 benefit, which ensures the lowest copayment for members to get their medications.

Companies that have agreed to this thus far are Blue Shield of California, Aetna, and BCBS IL, with more carriers joining in every day. Please contact us or check your insurance companies website to see how they will help you to protect yourself and your family members.

Note:

It is important to understand that these benefits are subject to the vaccine’s availability. The CDC is working with local health departments to ensure the following targeted priority populations receive the vaccine first:

1. Pregnant women
2. People who live with or care for children younger than 6 months of age
3. Healthcare and emergency medical services personnel
4. Persons between the ages of 6 months through 24 years
5. People ages 25 through 64 years who have chronic health disorders or compromised immune systems.

Tags: Coinsurance, deductibles, preventative care, wellness
Posted in General, Resources, Tools | No Comments »

Healthy Families Coverage Losing Financial Support in California

Tuesday, September 8th, 2009

The State of California has been in financial crisis as of late and now is going to hit home for many families whose children are enrolled on the Healthy Families program. This is a low cost state run plan that offers affordable medical, dental, and vision coverage for California children. Unfortunately, due to a lack of financial support from the state, they are planning on disenrolling children from the program starting October 1, 2009.

Budget cuts that totaled over $128 million dollars caused a major financial strain, and further enrollments were halted this July. This resulted in a waiting list of over 55,000 children, and a prediction of the removal of nearly 670,000 children having to be removed from coverage.

It is important to keep updated on these proposals, to ensure that California’s children maintain comprehensive medical, dental, and vision care. With too many children already forgoing vital preventative care, we have to find a way to keep our future healthy. Please visit the California Major Risk Medical Board for updated information and ways to become involved.

Tags: health insurance, preventative care
Posted in Family, General, Individual, Resources, State | No Comments »

Ways to Save on your Medicare Supplement Plan

Wednesday, August 12th, 2009

We all know how hard it is to keep up with ever increasing insurance premiums. Fortunately, there are always alternate plans or carriers to consider, in an effort to keep your insurance coverage comprehensive without breaking the bank.

For example, Aetna has released competitive rates for their Medicare Supplement plans. Our most popular plan, Plan F, has seen some sky-high increases over the year. If you have found yourself in this position, it may be time to shop for a new plan. Did you know that you can move them anytime of the year? However, if you do have pre-existing conditions, then you will want to wait for the guarantee issue period. This would be 30 days before and 30 days after your birthday, allowing you to change from like plan to like plan or downgrading plans (example would be Plan F to Plan F or Plan J to Plan F) without medical underwriting.

Another plan to consider would be the SmartChoice options with Anthem Blue Cross. This plan is almost identical to their regular Plan F, but has a deductible to meet prior to receiving covered benefits, like your Part A deductible, and lab work. By taking on more of the cost-sharing, in turn you receive greatly reduced premiums.

To see all of the options available to you, please visit our website today. www.insuresaver.com

Tags: medicare
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Helping Seniors in the “Doughnut Hole”

Friday, July 3rd, 2009

Medicare Part D is the drug portion of Medicare coverage. It is designed to assist with the overwhelming cost of medications, but there is one major flaw in their design – the gap in coverage called the “doughnut hole”. This is when the enrollee is responsible for covering the entire cost for their medications between $2,700 and $4,350. Studies show that one in four Part D enrollees reached the doughnut hole in 2007, and numbers have only increased since then.

What does this mean? Considering seniors are often living on very fixed incomes, these out of pocket expenses are too high, and results in medications being halved to make them last longer, or dosages being skipped altogether. This, of course, can create a very dangerous situation to these individuals, which clearly shows that something needs to be done.

One of the most important changes that can help to relive some of this burden would be a break in the costs of the medications themselves. Turning to the drug manufacturers has proven helpful, as they have agreed to reduce Medicare drug costs in a number of ways. From forgoing $80 billion dollars in revenues to offering substantial discounts in the medications themselves, it seems like the drug companies and Medicare drug coverage is headed in the right direction. We can only hope things continue to improve, and coverage for seniors remains comprehensive.

Tags: doughnut hole, medicare, part d
Posted in General, Resources | 1 Comment »

SB 810 (LENO) The California Universal Healthcare Act

Wednesday, July 1st, 2009

Senate Bill 810, the Universal Health Care Act, proposes methods to provide affordable and attainable healthcare to all Californians. In a time where there are more uninsured individuals than ever before, and more stringent medical underwriting requirements (leaving those with pre-existing conditions ineligible for coverage), this bill could bring some much needed relief to our strained economy.

Under SB 810, eligibility would be based on residency. All residents would be covered, regardless of health status, employment status, or income level. Would this mean an increase in taxes? Well, theory states that over $200 billion dollars were spent in California on healthcare last year. By utilizing this enormous cash flow already being spent on healthcare by Federal, State, and County funds, such a plan is possible. By changing the way the funds are directed, such as purchasing prescription medication and durable medical equipment in bulk, California can save billions in the first year alone.

Ensuring fair reimbursements to providers, allowing consumers to choose their own doctors, and relying on a shared source of financial support, may be the answer to one of the biggest issues facing our State and Nation as whole.

Tags: health insurance, pre-existing, Universal Health Care
Posted in General, Laws, Resources, State | No Comments »

Educating the Patient With a Chronic Disease

Saturday, June 20th, 2009

Once you or your loved one has been diagnosed with a chronic health condition, the most important thing is to become self-aware and gain the ability to manage the impact that this illness will have on your life. The first step is to understand your illness. In doing so you will gain the upper hand in preventing further complications.

Most insurance carriers offer nurse lines specific to your illness and access to support groups. Such groups can be vital for both physical and emotional support, resulting in overall improved health. Subjects covered include:

• Communicating well with your family, friends, and health care providers
• Exploring the possibility of new techniques and treatment options.
• Learning ways to deal with problems such as frustration, low energy, pain management, etc.
• Utilizing exercise to maintain and improving strength and flexibility, and increase endurance
• The proper use of medications
• The role nutrition plays in your healing process

Studies have proven that individual with chronic conditions who take an active role in their treatment plans and take proactive steps to improve their lifestyle have achieved significant advances in their healing process, and fewer hospital, emergency room, and outpatient visits.

Call us with any questions, or access your insurance carrier website to get more information on the management of chronic illnesses.

Tags: Chronic Condition, wellness
Posted in Employees, Employers, Family, General, Individual, Resources | No Comments »

The Importance of Flu Prevention

Thursday, June 18th, 2009

With the recent swine flu scare thankfully come to an end, it does bring to light the fact that we should always be concerned during flu season. It is vital to do everything possible to remain healthy, avoid contamination, and keep the illness from spreading to others. One of the simplest answers is to stay home from work when one is sick, but this unfortunately is not a reality when it comes to American workers.

The Center for Disease Control (CDC) clearly states instructions to stay home when ill with the flu. This will not only prevent the spreading of the flu, but will also lessen the recovery time for the individual. However, more than half of the workers in America state that they do not get paid for sick days. This means that they either have to follow medical advice by losing their pay, or by heading to work and infecting others. Taking time off is not an option for many.

What is the cure? Other than a nice bowl of chicken soup, and staying home, lawmakers are considering guaranteed paid sick days for all workers. In California, AB1000 aims to protect those workers with pay for days while ill. This would not only allow workers to stay home and recover, it will also keep the possibility of further infection from spreading to others. Studies show that over a third of flu cases are transmitted in schools and workplaces. By allowing a more lenient policy for sick days, we ensure better health for workers and their families, a decreased risk for further outbreaks of the illness, and the reduction of health care costs. It is a win-win for all.

Tags: preventative care, wellness
Posted in General | No Comments »

The Argument Against Government Run Health Plans

Sunday, June 14th, 2009

While many people think the answer lies in a Government run health insurance plan, but there is also a negative side to the theory. While the idea of health coverage for all is a dream worth pursuing, we need to make sure the quality of coverage is not sacrificed in doing so.

Currently, there are state and government run plans in place, such as Medicaid and children’s health insurance. While these programs benefit many people who would normally not have any coverage at all, concerns lie in the fact that there are lower reimbursement rates to providers, thus resulting in less access to doctors.

Obama’s plan is to allow those who have a plan they already like to keep their current coverage. However, should Employers have the choice between current higher premiums, or a lower cost option of the Government run plan, the lesser of the two would be elected. Therefore, employees would now be subject to a plan with more limited access to providers, and could possibly lose their current doctors altogether.

In terms of the doctor’s themselves, they may refuse the low reimbursement rates altogether and decide not to accept any insurance. Lower compensation would also means cuts in care and staff at your doctor’s office. Would-be physicians may decide to pursue more lucrative careers, instead of dealing with the red-tape of a government dictated medicine.

Tags: health insurance, Universal Health Care
Posted in Federal, General, Laws, State | No Comments »

Understanding Insurance Terms

Friday, June 5th, 2009

We all know how confusing insurance terminology can be. Here is a short list of the most commonly used terms to help you better understand the fine print on your policy:

HMO: refers to Health Maintenance Organization. HMO’s provides comprehensive health care by network physicians to those in a particular geographic area. With an HMO, you need to access care through a designated Primary Care Physician.

PPO: Preferred Provider Organization. PPO plan members receive full coverage by using doctors and hospitals within the PPO network, or they can pay more to go outside of the network for care.

Deductible: The initial amount you pay in a calendar year before particular covered services are covered by your coinsurance.

Coinsurance: The percentage of the allowable amount or billed charges that you pay for covered services after meeting any applicable plan deductible.

Copayment: The fixed amount and/or percentage amount you pay for covered services.

Copayment/coinsurance maximum: The limit on the amount you pay for certain covered services during a calendar year. Once the maximum is reached, your insurance carrier will pay 100% of the allowable amount for all applicable covered services (up to specified maximums) for the rest of the calendar year. Certain PPO plan covered services, such as office visits, generally do not count towards these maximums, and continue to be your responsibility.

If you have any questions on plans, rates, or terminology, please give us a call or send an email and we will be happy to help you!

Tags: Coinsurance, deductibles, HMO plan, ppo, ppo plan
Posted in General, Resources | 1 Comment »

Economic Concerns and Your Health Care

Monday, June 1st, 2009

We are all tightening our belts as we ride out the economic crisis, but some people have gone as far as to neglect their own health care as a result. Walgreen’s has released a report stating that the number of prescriptions filled has decreased considerably. It has also been noted that the number of physician visits and overall health care services have too been on a steady decrease.

It is important to note that even if your plan limits your doctor visits, has a brand name drug deductible, or high co pays services, it is important to keep your health your number one priority. Something that may seem minor now could result in a more chronic condition later on. What could have been taken care of in a doctor’s office may end up in the emergency room or hospital if left untreated, thus resulting in even higher out of pocket costs.

We can help you determine if there is a less expensive option for you and your family at this time, or help you to utilize your current plan to pay out as much as possible for your health care services. It is vital to keep you and your family healthy during these times.

Please call or send us an email if you need help in finding an affordable health plan. We are here to help!

Tags: deductibles, health plan, wellness
Posted in General, Resources | No Comments »