Archive for the ‘Resources’ Category
Tuesday, January 31st, 2012
Retail clinics, which are walk-in medical clinics found in supermarkets, drug stores, and pharmacies is on the rise among young healthy people. Not only are these facilities available more often than typical doctor’s offices, they are usually staffed with nurse practitioners and physician’s assistants, much like their typical doctor’s office for non-severe illnesses. Most cases were seen for minor conditions, such as coughs, colds, and sinus infections, and expressed that should the clinics not be available to them, they were not likely to seek out the care with their primary care physician. This is not only due to convenience; it also was shown that these costs were 30% to 40% cheaper than their doctor’s office, and up to 80% less expensive at the emergency room. With a drop in general practitioners nationwide, this also may be a reflection on the need for more providers in these fields. However, as long as access to inexpensive and quality care is available, people will seek out means that are easily fit into their hectic schedules.
In this day and age where every minute counts, and we are constantly on the move, being able to seek out quick care at the drop of a hat is priceless.
Permanent link to this post (205 words, estimated 49 secs reading time)
Tags: added benefits, health insurance, individual health, preventative care, wellness
Posted in Family, General, Resources, Tools | No Comments »
Tuesday, January 24th, 2012
Anthem Blue Cross policyholders who remained on grandfathered plans (those administered by the Department of Managed Health Care rather than the Department of Insurance) faced an unexpected surprise. Along with increased premiums, their plan benefits changed as well. Co pays, deductibles, and out of pocket maximum amounts all increased as a result of these changes. Anthem said this was a necessary move to keep up with increasing health costs, but policyholders had enough, and Consumer Watchdog stepped in. The lawsuit that has been filed states that Anthem used “bait and switch” tactics, leaving “consumers are left with no certainty about what they will have to pay and what coverage they’ll receive.” Many customers who had met their deductible earlier in the year were surprised to receive bills from their providers stating that they had not yet reached their portion of medical expenses, though the patient was under the impression they had.
The lawsuit serves to protect the 100,000 policyholders who have experienced what they feel is a misrepresentation of plan coverage. Company spokespeople from Anthem state that there is no violation of state laws and regulators were made fully aware of the proposed plan changes. Consumer Watchdog stated that even though these state regulators were aware of the plan changes, they in no way received a stamp of approval to move ahead with them. Per Jerry Flanagan, staff attorney at Consumer Watchdog, “Basically, higher deductibles mean you’re paying more for less health care. It’s a change to the essential definition of a plan.”
While it is understandable that changes need to be made to policies from time to time, it is important that these changes be presented in a clear and concise manner. This will help to avoid confusion and allow members to make necessary adjustments ahead of time.
Permanent link to this post (300 words, estimated 1:12 mins reading time)
Tags: deductibles, health insurance, individual health, premiums
Posted in Federal, General, Laws, Resources, State, Tools | No Comments »
Thursday, December 8th, 2011
In an effort to give consumers more knowledge when it comes to premium rate increases, the Department of Health and Human Services can now require that all insurance carriers file their rate increases online via a government website -http://companyprofiles.healthcare.gov. As of September 1, 2011 insurers who plan on raising their rates 10% or more must not only provide the rate detail, but the reasons justifying the need for such an increase. This information will now be made available to consumers, allowing them to not only be made aware of premium changes, but also allow them an option to add their questions, concerns, and comments – giving them a voice where previously they felt powerless to fight against the insurance companies. It also allows them to make more educated decisions when choosing to purchase a policy with a company, or move to another more competitive carrier. During a time when most Americans are struggling while big corporations continue to reap in big profits, holding them to some accountability is a big relief.
Tags: health care costs, health insurance, premiums
Posted in Federal, General, Government Run Health Plan, Laws, Resources, State, Tools | No Comments »
Thursday, November 24th, 2011
Recently, the autism insurance reform bill was passed, and SB 946 will be signed into law by Governor Jerry Brown. This means that as of July 1, 2012, services will be subject to the mental health parity law and require that health plans subject to this bill provide coverage for treatment to “develop or restore, to the maximum extent practicable, the functioning of an individual with pervasive developmental disorder or autism.” Such programs that will fall under behavior health treatment are applied behavior analysis, occupational therapy, and speech therapy. Benefits for such therapies cannot be subject to age limits or dollar limitations.
Much of this is thanks to the organization called Autism Speaks, as they have been a strong force in pushing legislators to bring the law to fruition. While many families were faced with paying for medical care and much needed therapies out of their own pockets, this bill will help them get the care they need. Visit Autism Speaks to learn more, and urge Governor Brown to sign this bill as quickly as possible.
Permanent link to this post (177 words, estimated 42 secs reading time)
Tags: added benefits, health care costs, health insurance, pre-existing
Posted in Federal, General, Laws, Resources, State | No Comments »
Thursday, November 17th, 2011
Alarming trends show that almost half the United States population will be obese by 2030. In California, rates have doubled in the last 20 years – resulting in over 20% of the State’s residents falling under the category of obese. With increasing size comes increasing health problems, such as diabetes and heart conditions. In 2009, obesity related medical costs were 15.2 billion in California, which is the highest in the country. The rest of the country in not far behind, however, and only further demonstrates a need for change.
According to a CDC report:
- Obesity rates were higher among people ages 50 and older (most likely due to an aging population)
Tags: Chronic Condition, health care costs, pre-existing, preventative care
Posted in General, Individual, Resources, Tools | No Comments »
Tuesday, September 13th, 2011
Health care administration under the Affordable Care Act is tricky enough, but none more so than in California. Currently there are two options for the golden state – either consolidating into one regulatory agency or combining between two agencies, the California Department of Insurance (CDI) and Department of Managed Health Care (DMHC), to properly maintain a system that will ensure consumer protection. Those supporting consolidation believe that the fewer hands in the pot will avoid confusion and conflicting interpretations of federal laws. Oversight between two entities can also result in added government and administrative burdens, and difficulty in monitoring what is being purchased and sold in the marketplace.
This is a preview of
Health Insurance Regulation in California Under Health Care Reform
.
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Tags: group health, health care costs, health care reform, premiums, Universal Health Care
Posted in Federal, General, Government Run Health Plan, Group, Laws, Resources | No Comments »
Tuesday, September 6th, 2011
Shocking reports show that over one tenth of elective angioplasty procedures are not necessary, causing undue danger to the patient and extensive damage to their wallets. While a much needed help to those with urgent medical needs, for those with less severe conditions (many with mild or no symptoms at all) over 12% were found to be “inappropriate” as a means of treatment. Instead, treatment with medication may have been a better route to go.
Tags: Chronic Condition, health insurance, pre-existing
Posted in General, Resources, Tools | No Comments »
Friday, August 12th, 2011
All of us are finding that our dollars are not going as far as they used to, but none are feeling the hit as much as senior citizens. It is shown that senior citizen’s expenses are rising twice as fast as their Social Security checks, and as many use this as their sole means of income, this is a frightening statistic. As a means to combat this gap in living expenses versus check totals, the Social Security Department created the Cost of Living Adjustment (COLA) in 1975. COLA was intended to be an automatic yearly increase based on the Consumer Price Index (CPI), and proved to be consistent until 2010. However, over the last two years, our senior citizens have received no COLA on their monthly checks.
With cost of living expenses far outpacing the calculated percentage of the CPI, many are lobbying for a review on this process. Currently, the Consumer Price Index is calculated via urban wage earners for all age groups. However, this does not take into account the higher costs for health care and other expenses older Americans need. As a means to more accurately gauge COLA, it is proposed the government use the spending patterns of seniors by means of the CPI for Elderly Consumers, and use this information to balance their checks accordingly.
Permanent link to this post (220 words, estimated 53 secs reading time)
Tags: health care costs, medicare, medigap, wellness
Posted in Federal, General, Laws, Resources, Seniors, Tools | No Comments »
Friday, August 5th, 2011
Whether you are for it or against it, health care reform marches on. As states scramble to either fight the constitutionality of the bill, or create models for health care administration, January 1, 2014 edges ever closer and brings with it the start of health insurance exchanges. These exchanges are proposed to be implemented by January 1, 2014. In theory, these exchanges purport to provide individuals and businesses the same buying power as larger companies by pooling risks and premiums. However, how these exchanges operate remains to be seen.
Tags: health care reform, health insurance, individual health, Universal Health Care
Posted in Federal, General, Government Run Health Plan, Laws, Resources, State | No Comments »
Monday, July 18th, 2011
As part of their medical underwriting review requirements, Anthem Blue Cross has starting using a paramedical exam as part of the application process. These in house exams will be required for any applicant age 55 and older who have not been seen by a physician in the last twenty four months, as well as anyone age 30 to 54 who have not seen a physician in the last five months. These exams will be performed at no cost to the applicant, and are intended to provide the most up to date and current health status of the individual.
This is a preview of
Anthem Blue Cross Implements Paramedical Exam Requirement
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Read the full post (299 words, estimated 1:12 mins reading time)
Tags: health insurance, health plan, individual health
Posted in Family, Individual, Resources, Tools | No Comments »
