Posts Tagged ‘children’s health’

Many Important Health Care Reform Changes for Young Adults

Thursday, June 17th, 2010

While many young adults faced losing coverage as they aged off their parent’s plan, had no coverage in the case of an unexpected pregnancy, or merely had the bare necessities covered by their school plans, all can breathe a sigh of relief as health care reform promises to end their fears.

As mentioned in earlier posts, the most immediate change is coverage will be extended to overage dependents, as long as they are not offered other employer sponsored coverage, up through their 26th birthday. This helps ease the burden of uninsured claims, as many of these adult children would wait over two years before attempting to obtain their own coverage.

Another helpful option for these previously uninsured individuals is the fact that more than half of them will be eligible for either Medicaid in 2014, as their income is expected to be less than 133% or qualify for government subsidies if they decide to purchase private insurance through an exchange if they are earning 400% of the poverty level.

More relief serves in the fact that maternity coverage will be a mandatory inclusion on the plans, something that is either excluded completely or greatly restricted, depending on what state you reside in. This is most important during young adulthood, as is the need for access to contraceptives, which will also be covered.

The fact that lifetime maximums will be eliminated also sheds light on the current state of most university based plans. Many tend to cover only the most basic of health needs, and offer only limited protection for conditions that are considered eligible medical expenses. With the implementation of comprehensive coverage for all adult children, in spite of of any pre-existing conditions, we can breathe easy that coverage is in place should they need it. Regardless of how you feel about health care reform, we can all agree that all youths of our nation deserve health care coverage!

Lack of Pediatric Specialists a Growing Concern

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.

Insurers to Offer Overage Dependents Coverage Earlier Than Anticipated

Tuesday, May 4th, 2010

As planned during six months following the signing of the health care reform bill, coverage will be extended for dependents up to the age of 26. This will allow parents to continue to offer health insurance coverage to their dependent children, even if those children do not live in the same household. This also holds true for young adults under 26 living out of state, and those that are married. Basically, unless they are offered employer sponsored health insurance, they can continue to remain on their parent’s coverage.  

The deadline to implement this extension of coverage is September 23rd, 2010. However, numerous insurance carriers have decided to offer the coverage much sooner than that. CIGNA, Humana, United Healthcare, and Kaiser are a few that are increasing the dependent age limit as soon as June 1st. You can check with your carrier, or with us, to determine how your eligible dependents maintain coverage on your current plan. Regardless of whether a plan decides to implement this change ahead of schedule, health care reform will ultimately bring changes to all plans.

Children with Insurance Have Brighter Prognosis in Hospitals

Thursday, December 10th, 2009

Disturbing news shows that children without insurance are 60% more likely to die from a serious illness, such as pneumonia or asthma. This is most likely due to the fact that care is not sought out until it is much farther advanced. This is tough to swallow, but keep in mind there are always options to ensure that your children are not without the coverage they need.

 The best news this year is the fact that Healthy Families (medical, dental and vision coverage for California children) has received much needed funding, and is now enrolling new members once again. In addition, many carriers have released catastrophic plans, which ensure low cost coverage for times when you need it most. There are also plans that offer coverage for immunizations and preventative care, allowing your child to keep as healthy as possible, and avoid trips to the emergency room altogether.

 We will help you find the best coverage for your child. Call us today or visit the website for a quote today!

Healthy Families Program Spared Massive Cuts

Wednesday, September 23rd, 2009

  California children will not be losing their Healthy Families coverage thanks to the implementation of Assembly Bill 1422. Over 600,000 children were going to be disenrolled starting October 1st, due to a lack of funding. Currently, there are 71,000 children on the waiting list since enrollment was frozen in Mid-July. Parents and guardians can breathe a sigh of relief, however, as this affordable medical, dental, and vision coverage will remain in place.  

This bill works in numerous ways to utilize taxes, donations, and cost sharing to avoid dropping children from the program. First, the First 5 California Commission, which oversees children’s health and educational programs via tobacco tax revenues, has offered to contribute more than $81 million. An additional $17.6 million is expected to be raised by implementing higher premiums for those above the poverty level, and raising copaymentsfor ER room visits, doctor office co pays, and prescription co pays. Health plans that administrators Medi-Cal benefits would see a 2.35% tax. This levy will replace the current 5.5% fee, which is expected to expire in October.  

With all of the above and more, let’s hope this eases the financial burden on this program, and avoids having any child go without the coverage they need.


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