Archive for the ‘Federal’ Category

No Premium Increases for Medicare Part B in 2010

Monday, September 28th, 2009
For the 42 million seniors and people with disabilities who are currently enrolled in Medicare Part B, a recent vote has ensured that there will be no premium increase for Part B. The standard premium is currently $96.40; slightly higher for those with incomes over $85,000 for individuals or $170,000 for couples. This premium is calculated annually to cover around 25% of the Medicare program. For 2010, this would mean the premiums would be at about $103 (and up!) per month. However, there is a “hold harmless” policy which eliminates this rate hike, by utilizing $2.8 billion from a 2008 fund to improve Medicare.
 
Due to the economic recession, Social Security’s cost-of-living adjustment is expected to be zero, and therefore the checks will not increase. Therefore, if the Part B premium increase is projected to be more than the increase in Social Security, most current Medicare enrollees are ensured no premium hikes. As with any law, however, there are loopholes and if Congress did not step in, there would have been some enrollees who would have not fallen under the hold harmless policy (i.e. new Medicare enrollments, and those whose premiums are not deducted from the Social Security checks). With the implementation of this act, all Medicare enrollees will be spared any rate increases for their Part B premiums.

The Mental Health Parity and Addiction Equity Act of 2008

Wednesday, September 2nd, 2009

In October of 2008, the President signed the Mental Health Parity and Addiction Equity Act (MHPAEA), which provided some vital changes in the way group mental health and addiction benefits are to be covered. This ensures that those needing such coverage will not be denied or restricted in their ability to seek treatment.
 
The MHPAEA applies to Large Group plans; both self-funded and fully insured, and works to prevent the placement of dollar limits on mental health care. Instead, it ensures that mental health benefits and substance use disorders are covered just as any other medical or surgical benefits.
 
However, there are some snags. If the group plan does not currently have mental health benefits on their plan, they will not be required to add them to their current benefit package. Also, the number of covered visits may be limited, even if there is no visit limit imposed on regular medical visits. Cost sharing may be higher for mental health or substance abuse visits as well.
 
Though this law may only apply to large group plans, those individuals who are on small group or an individual/family plan will find the same protection under “Mental Health Parity”. You can click on www.ncsl.org to see state specific laws regarding mental health benefits.

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.

Help for Uninsured Californians!

Wednesday, May 20th, 2009

Many Californians don’t have medical coverage, and are unable to qualify for health coverage due to pre-existing conditions. However, it is important to know that there are options you may qualify for:

California, the Stimulus Package, and You

Wednesday, May 13th, 2009

We have all heard by now that the American Recovery and Reinvestment Act of 2009, also known as the Stimulus Package should bring some much needed relief to the State of California. As the unemployment rate jumps to historic highs, and millions of Californians find themselves also without health insurance, it is vital that federal agencies step up to the plate. The goal is to obtain health coverage assistance, increase the quality of health care, and invest in health-related technologies.

So what does this mean for us? According to American Recovery and Reinvestment Act analysis, some of the major health care provisions are:

Changes to Federal COBRA for 2009

Wednesday, May 6th, 2009

In February of 2009, President Obama signed into law the American Recovery and Reinvestment Act. Designed as part of the economic stimulus bill, this also provides some major assistance to COBRA coverage for certain individuals. Some of the major points to this bill are:

  • Will provide for a federal subsidyon the COBRA continuation coverage premiums for qualified beneficiaries due to involuntary termination of employment between Sept. 1, 2008 and Dec. 31, 2009 (Assistance Eligible Individuals)
  • Qualified beneficiaries will include the covered employee, the covered employee’s spouse, and covered employee’s dependent children. This means that the spouse or dependents of the involuntarily terminated employee will be eligible for benefits even if the employee does not elect COBRA.

© 2009 Abrams California Health Insurance Agency. All rights reserved.
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