Posts Tagged ‘pre-existing’

The Medical Information Bureau and You

Thursday, December 17th, 2009

Is there a database out there with all of your medical information available to prospective and current insurers? No. However, there does exist a shared central database called the Medical Information Bureau that may contain some important medical information about you. This data base is used primarily by insurance companies when applying for individual or life insurance. These companies can use information in the MIB’s database to help make a decision as to whether or not you will be offered coverage. 

 
However, based on HIPAA laws, this database does not include your entire medical history, doctor’s chart notes, etc. Instead, information in MIB reflects medical conditions (such as diabetes and high blood pressure) or lifestyle choices (i.e. skydiving or smoking) that are thought to be significant. While the decision to decline coverage is not solely based on reports in the MIB, it definitely plays a strong role.
 
It is very important that you monitor information in the MIB as you would with anything else, such as your credit report. If you note any incorrect information, you can work to have it corrected, and not hinder your chances of obtaining health or life insurance in the future.

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.

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.

Gender Based Rating and Health Care Reform

Tuesday, June 16th, 2009

These days, everyone seems to be ready for change. The idea of national health care, coverage for all people (regardless of pre-existing conditions), and the end of gender based rating, is top priority.
 
One of the biggest issues these days is the fact that men and women are charged different amount for the same plans, at the same age, regardless of health history. Insurance companies defend this disparity by the fact that women tend to utilize health services more frequently than men, especially during their child bearing years. Therefore, instead of being rewarded for taking on a proactive role with their health care, they are penalized by 25% to 50% higher rates than their male counterparts.
 
With greater government regulation, it is thought that gender differentiation will be a thing of the past. As an effort to keep health insurance out of the hands of the government, and become more user friendly, insurance carriers will need to find ways to be easier on those seeking their own plans, or the millions of currently uninsured individuals nationwide.

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:

Assembly Bill 1672 & What it means for Small Business Plans

Monday, May 18th, 2009

Small business owners in California received extra protection under the law for their rights with group health insurance when the law AB 1672 was passed in 1992. This new requirement required that group health insurance carriers provide coverage for employees covered under a group health plan, even if they have a pre-existing condition. This new law meant that insurance companies may not deny coverage, and if there is an exclusion period for a pre-existing condition, it must be kept to six months to one year. If an employee was covered by a health plan before joining the group health plan offered by their new employer, this coverage must count towards this exclusion period, as long as the employee’s coverage was enacted within 62 days of losing the previous policy.


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