Archive for the ‘Tools’ Category
Thursday, July 1st, 2010
However you may feel about health care reform and the changes it will bring, one major outcome will be the mandatory implementation of preventative care on all policies. It is proposed that preventive care will be covered without any co pays or deductibles. Considering it is thought that half the conditions we treat in our health care system could be avoidable, the expansion of preventive screenings and vaccinations should help to bring down the number of chronic conditions that we see today.
It is estimated that 75% of our health care spending in on such chronic health conditions. If these illnesses could be treated and diagnosed in the earliest stages, the better the outcome for the patient. Plus, it would result in less financial strain on our health care system. While opponents to the bill state that “unnecessary screenings” will ultimately cost us more, you can’t argue that prevention yields a longer, healthier, and more productive life.
Tags: Chronic Condition, health care costs, health insurance, preventative care, wellness
Posted in General, Resources, Tools | No Comments »
Monday, May 17th, 2010
We are now well into the first year following the passing of the health care reform bill. However, we still are not completely sure of what the changes are going to be, and how it will affect all of us. While some portions of the bill are clear cut, such as extending coverage to overage dependents, many of the larger concepts remain to be fully explained. How are small and large businesses going to be able to afford coverage for their employees? How will the tax breaks help or hurt? How can coverage for all Americans remain affordable?
We have yet to see where this will take us, but we are going to do our best to keep up with each passing moment in the world of health care reform, and pass on the information to you. It will be a lengthy learning process, but we are jumping in headfirst to the plethora of information out there. It is our ultimate goal to get the answers you need!
Tags: group health, health care reform, health insurance, preventative care, Universal Health Care
Posted in General, Government Run Health Plan, Resources, Tools | No Comments »
Wednesday, May 12th, 2010
Health Care Reform promises to ensure that all Americans have access to medical coverage. The most pressing concern is the fact that many children are without coverage and the care they need now, so the bill states that by September 23rd, 2010, no child can be denied coverage due to pre-existing conditions. While this is well needed, it does bring to light the fact that there is an increasing shortage of Pediatric Specialists. With an influx of new patients entering the system, and the demand for both medically necessary and non-medically necessary treatments rising, will there be enough physicians to handle the load?
The problem lies in the way these specialists are compensated. Since the majority of their reimbursement comes from Medicaid, and is only covering about 67% of the cost, many new physicians decide to pursue alternate fields of specialty. With limited doctors, the average wait time to see a specialist can be as long as 114 days. This may cause parent’s to turn to the emergency room instead of waiting for a pediatric visit, putting the child at risk with inferior medical care. Hope lies in requiring Medicaid to pay Medicare rates, assisting new doctors with outstanding medical school loans, and funding for continued training. If we lose our pediatric specialists, we put our future at risk.
Tags: children's health, health insurance, pre-existing, Universal Health Care, wellness
Posted in Family, General, Individual, Resources, Tools | No Comments »
Monday, March 22nd, 2010
No one really knows! It seems that revisions are made by the hour, and nothing is quite set in stone as of yet. Also (as of this hour) 11 states have filed lawsuits stating that the bill is unconstitutional, in that it forces people to pay for coverage or face financial penalties. Does it promise to cover all Americans? Supposedly, by 2014, after spending the next few years inching towards this goal by means of guaranteed issue policies, no lifetime maximum amounts, the cessation of policy rescission’s, etc. Once this is in place, individual policies would be purchased via an exchange:
Health Benefit Exchanges. Effective in 2014, state-based American Health Benefit Exchanges and Small Business Health Options Program (SHOP) Exchanges are established, administered by a governmental agency or non-profit organization, through which individuals and small businesses with up to 100 employees can purchase qualified coverage. States are permitted to allow businesses with more than 100 employees to purchase coverage in the SHOP Exchange beginning in 2017. States may form regional Exchanges or allow more than one Exchange to operate in a state as long as each Exchange serves a distinct geographic area. (Funding available to states to establish Exchanges within one year of enactment and until January 1, 2015)
We will see some changes right away, such as offering coverage to all children regardless of pre-existing conditions, and the creation of high risk health pools. Others will take more time, such as the adult pre-existing conditions being a non-issue when it comes to obtaining medical coverage.
Proponents of the bill claim this will save us trillions over the years, while opponents can’t see how that is possible. Guaranteeing and requiring that all obtain health insurance coverage cannot be without a hefty price tag, can it?
Stay tuned………
Tags: health insurance, individual health, pre-existing, underwriting, Universal Health Care
Posted in Federal, Government Run Health Plan, Laws, Resources, Tools | No Comments »
Tuesday, March 16th, 2010
Though no one knows where the health care reform bills are headed, it is of utmost importance that disease prevention and health promotion are at the top of the list. If we aim to “fix” a broken system, we need to ensure that the system is designed to “fix” us as well. This will be achieved by balancing the cost of providing medical care with providing services to help avoid the need for such services in the first place. Some concepts for prevention strategies are (notes from San Francisco Chronicle):
- a yearly personalized prevention plan for Medicare patients
- national assistance to wellness programs at the worksite
- a vast public-private partnership to teach everybody about prevention and health promotion, including Web site tools for self-assessment and personalized prevention
- educating patients how to reduce their risks for chronic disease
- support for community-based prevention and health promotion (i.e. no-smoking rules, seat belt mandates, calorie counts on restaurant menus)
The concern lies in the fact that if these strategies are not implemented, positive and healthy life choices will not occur. By encouraging such lifestyle changes, and providing resources to help people start and maintain healthier living, the return is invaluable – healthy people, fewer chronic conditions, and an enormous reduction in the need for medical intervention.
Tags: Chronic Condition, health insurance, preventative care, wellness
Posted in Employees, Family, Government Run Health Plan, Individual, Resources, Tools | 1 Comment »
Tuesday, March 9th, 2010
You would be surprised to hear how many Medicare eligible clients do not understand how Medicare actually works. With an aging population, and enrollees at the highest levels to date (expected to increase dramatically with the baby boomers entering the system starting in 2011), it is most important to know the ins and outs of the system to ensure coverage in place when you need it.
People age 65 or older are entitled to Medicare Part A (hospital coverage) if they or their spouse are eligible for Social Security payments and have made payroll tax contributions for 10 or more years. Medicare coverage was also expanded to offer coverage for clients under the age of 65 if they have permanent disabilities.
Medicare Part B (physician services) is primarily funded by monthly premiums, adjusted accordingly by your modified adjusted gross income. If you get benefits from Social Security or the Railroad Retirement Board (RRB), in most cases, you will automatically get Part B starting the first day of the month you turn age 65. If you don’t want Part B, make sure to return the card to Medicare, per instructions. If you keep the card, you keep Part B and will pay Part B premiums. Note – if you don’t sign up for Part B when you are first eligible, you may have to pay a late enrollment fee.
Part D will offer you prescription drug coverage. If you choose Original Medicare (as opposed to a Medicare Advantage plan – Part C) and you want drug coverage, you must join a Medicare Prescription Drug Plan. Keep in mind that under Part B, you pay 100% for most prescription drugs, unless you have Part D or other drug coverage.
Please feel free to contact us with any questions, or to discuss your Medicare Supplement needs.
Tags: heath insurance, medicare, medicare supplement, medigap
Posted in Resources, Seniors, Tools | No Comments »
Tuesday, March 2nd, 2010
A recent poll shows that 57% of Americans do not like any of the proposed health care bills, and agree that Congress should start fresh, rather than attempting to piecemeal a model from scrapped ideas. Trying to reach a bipartisan agreement as to what needs to be done is not an easy task, but it is vital to ensure that resolution is achieved. These polls shows interesting trend among voters as to how they feel now, as compared to a year ago in regards to health care reform:
• 53% said they strongly or somewhat oppose the legislation in both House and Senate plans
• 33% stated they were more supportive of reforming the health care system now
• 24% said they were just as supportive as they were a year ago
• 38% of voters now think it is at least somewhat likely that the plan proposed by the president and congressional Democrats will become law this year
• 51% believe passage of the plan this year is unlikely
• 24% of voters now say health care reform is the budget priority the president is most likely to achieve
Regardless of where this leads us, we will be there to guide you through and answer any questions you have.
Thanks for your continued support!
Tags: health care reform, health insurance, health plan
Posted in Employees, Employers, Family, General, Group, Individual, Resources, Tools | 1 Comment »
Thursday, December 24th, 2009
Important news for our Blue Shield of California clients who are currently on individual and family plans. If you miss a payment, and exceed your grace period, they will no longer reinstate you after January 1, 2010. In these cases you will have to reapply for coverage and be subject to medical review once again. You are not guaranteed approval, even though you were a recent member.
We will make every effort to give you updates if you show late on payments. Not only will we send you email reminders, Blue Shield will also send you late payment notices via mail. Make sure to send in your premium, or contact us to set up monthly automatic payments via credit card or checking account to avoid cancellation.
Tags: health insurance, premiums, underwriting
Posted in Family, Individual, Resources, Tools | 1 Comment »
Thursday, December 3rd, 2009
Recent studies show that the United States spends almost 44% more for health care than Switzerland, though Switzerland has the second higher per capita health care costs. Even with these escalated costs, Americans have fewer visits and spend less time with their doctors, as well as experience shorter hospital stays than any other industrialized nation.
The reason for this is also one of the strongest arguments for health care reform: Americans pay more for the same level of care than anywhere else in the world. Part of the problem lies in the fact the governments set the rates that will be paid for different treatments and drugs in other countries, while this is not the case here in the United States. This results in private insurers paying higher rates for the same services – at times astronomically higher — as they are carrying the load of negotiating fees. This results in a trickledown effect as consumers face skyrocketing insurance premiums, and ever higher deductibles and coinsurance.
As Americans, we need to take control of our health care costs and re-evaluate what we consider “medically necessary”. The latest and greatest technology, though nice to have on hand when necessary, should really only be used if they achieve a desired clinical benefit. By controlling unnecessary spending, we can curb excessive spending, and put the money back in our pockets for when we really need it.
Tags: health care costs, negotiated rates, wellness
Posted in General, Resources, Tools | No Comments »
Saturday, November 7th, 2009
We all know that changes need to be made in the health insurance industry, though no one as much as someone who experienced a major illness without health coverage. For those who are nearer to retirement age, a major illness (i.e. cancer or heart disease) can mean a loss of close to half of their household assets in order to get the medical care they need. This loss is more severe for the uninsured ages 51 – 64 as they have accumulated greater assets for retirement, along with fewer options to re-establish these assets if they are lost due to an illness. The situation in these cases can mean a financial disaster.
It is vital to ensure that your assets are protected, and even more imperative that care is sought out in the case of an illness. Treating conditions earlier mean a better chance of recovery, and better quality of life. Even basic insurance can help you avoid catastrophic losses, and the added support from a Long Term Care policy will help you protect your future, and your family’s as well. Contact us today to see how we can help you protect your health and your peace of mind.
Tags: Chronic Condition, health insurance, long term care
Posted in Family, Individual, Resources, Tools | 1 Comment »
