Archive for May, 2014

A New Partnership for Florida Health Insurance

Thursday, May 29th, 2014

There is a new partnership in central Florida that hopes to make it easier for Floridians to get health insurance and hospital care.  They also want to improve Floridians’ overall healthcare experience.  This includes the overall health of the community, the care they receive, and the per person cost of healthcare.  According to Yahoo! Finance article, “US News & World Report’s #1 Hospital & NCQA’s #2 Insurance Company, Partner Together to Better Serve the Community,” this partnership has the potential to help a lot of people.  It started as a way to bring the new Medicare Advantage plans to central Florida residents.  Health First Health Plans was ranked 2nd in Florida by the National Committee for Quality Assurance for their Medicare Advantage Plans.  They have consistently received 4.5 out of 5 stars by the Centers for Medicare & Medicaid Services.

Back in January of this year, Health First started working with Florida Hospital to reach a wider range of Floridians seeking Medicare Advantage plans.  These particular plans are known as Florida Hospital Care Advantage.  Florida Hospital was recently ranked #1 by US News & World Report for Florida hospitals.  The partnership between these two organizations should help keep healthcare affordable and local for Florida residents.  They are also looking to create sustainable community health systems.  It’s important to keep up with healthcare reform changes, especially on a local level.  The partnership between Florida Hospital and Health First will expand through different phases, the first of which was the Medicare Advantage plan phase.  Although they started in central Florida, they will likely move to other regions of the state as well.  If you are looking for more information about Florida health insurance, click here.

Large Employers May Stop Offering Health Insurance Plans

Wednesday, May 21st, 2014

A lot of people who get their health insurance from their large group employers might just be searching for insurance coverage elsewhere soon.  While it certainly wasn’t the intention of the Affordable Care Act to make it more difficult for employers to offer insurance to their employees, that has been an effect of the health insurance mandate often referred to as Obamacare.  In the Forbes article, “Obamacare Increases Large Employers’ Health Costs“, Sally Pipes tells us about recent study findings.  S&P Captial IQ’s study determined that 90% of workers in America who currently have health insurance through a large employer will be searching for a policy in the government exchanges by 2020.  That figure seems extreme, but the harsh reality is that the taxes, fees, and added insurance mandates placed on large employers are hurting them.  Many of these employers simply don’t think that they can afford to offer health insurance if something doesn’t change.  They are currently mandated to offer you health insurance plans, so that is something that will have to be considered as well.

Group health plan sponsors pay a new fee to help fund the government sponsored Patient Centered Outcomes Research Institute (PCORI).  This organization tests the effectiveness of certain medical treatments and Medicare uses the results to determine what they will cover for their patients.  Some skeptics worry that results could be twisted to support lower cost treatments over more effective, but higher cost ones.  Another fee that large employers have to pay is a Temporary Reinsurance Fee.  This fee is supposed to stabilize premiums in the individual health insurance marketplace.  The American Health Policy Institute estimates that $15.3 million will be collected by this fee in just two years.  In 2018, large employers will start paying a 40% excise tax on health insurance plans that are deemed “expensive”.  Individual premiums above $10,200 and family premiums above $27,500 are considered “expensive”.  One company estimates that this excise tax will cost them $378 million over the course of five years.

In addition to the direct taxes, there are indirect tax increases for employers as well.  There is the mandate for companies to offer health insurance to full time workers within the next year or two.  If they don’t, they will pay a fine.  Companies also have to allow children to remain on their parents’ health insurance until the age of 26 now.  That last mandate alone has increased employer insurance costs between 1 and 3%.  Mandating full coverage of preventative care services, such as immunization and birth control is drastically increasing employer health care costs as well.  The AHPI survey estimates large employer health care costs to rise by 4.3% in 2016, by 5.1% in 2018, and increase by 8.4% in 2023.  This equates to hundreds of billions of dollars extra that large employers will have to shell out over the next decade or so.

Unfortunately, what this means to Americans with health insurance from their large employer is that their costs will likely increase as well.  More than 80% of large employers have already increased their employees’ deductibles, or plan to do so soon.  Some employers might stop offering health insurance altogether and pay the fine for not offering plans.  They might actually save money by doing that, although employee morale could decrease from such a move.  Companies may also offer incentives for sick employees to search for health insurance in the exchanges instead of using the company plan, saving both the employer and employee money.  But if all of the sickest employees head into the health insurance exchanges, costs within those will increase for everyone.  The potential destruction of employer health insurance plans was certainly not a goal of the Affordable Care Act, but it might just be a consequence.  If you are worried about losing your employer health insurance, you can compare health plans and rates here.

Pregnant Women Have More Maternity Health Insurance Choices

Tuesday, May 13th, 2014

There was a time, not very long ago, that you were hard pressed to find health insurance as a pregnant woman.  This pre-existing condition was the only reason needed for a health insurance company to deny a pregnant woman’s application for coverage.  The Affordable Care Act has changed this former reality, according to “Health law gives pregnant women more options“.  In the Associated Press article, it says that Medicaid will help to supplement private insurance plans bought in health insurance exchanges.  Pregnant women who recently purchased private health insurance plans through the government exchanges will also be able to access Medicaid coverage from their state as well.  This applies to lower-income women, but the income limits vary significantly from state to state.  Some state limits are close to the poverty level, while others are more like a middle class income.

Did you know that Medicaid already pays for almost half of the births in the United States?  This new expansion of Medicaid services to pregnant women will be effective in every state, even if they have not opted to expand their overall Medicaid system under the Affordable Care Act.  Unfortunately the logistics of this Medicaid expansion are fairly complicated.  States and the federal government are trying to iron out the details, so it is still complex for consumers to navigate.  Overall though, it’s a good thing for women because they will end up paying less out of pocket.  They have the option of using only their private health insurance, only Medicaid, or a combination of both plans if that is what will be best for their pregnancy scenario.

While the cost of insuring more women is going to be higher, there are anticipated lower costs overall.  Taking care of a woman and her unborn child with good prenatal services helps to avoid the larger expense related to premature births and birth defects.  Pregnant women without health insurance often don’t seek prenatal care and can’t be treated for problems that they don’t know exist.  The Affordable Care Act made it so that health insurance companies must offer maternity coverage, even if the woman is seeking health insurance while she is already pregnant.  For those lower-income women who bought private plans in the health insurance exchanges using federal subsidies, the original law stated that they were no longer eligible for Medicare.  Then there was a ruling that said Medicare coverage did not meet the “minimum essential coverage” that the law requires because it is temporary and states can deny certain services.  Now they can use their private plan along with Medicaid coverage.  A woman might benefit from using both plans because her coverage will continue after she has the baby, but the Medicaid coverage could help with cost-sharing.

If you are looking for health insurance with maternity coverage, you can find affordable health insurance in any state.

RI Insurers Are Sharing Health Insurance Claims Data

Saturday, May 3rd, 2014

There is an interesting development when it comes to your health insurance and your privacy.  According to Rhode Island news station WPRI, health insurance companies in Rhode Island are preparing to send your personal health care information to the state.  This is happening in twelve other states as well in an effort to better understand health care trends and costs.  The goal of this information sharing is to make the entire health care system in Rhode Island, and the other states participating in this program, run more smoothly.  All sharing of information is said to be anonymous, so you shouldn’t have to worry about personal consequences related to your health insurance company sharing your health care information with state or federal agencies.

This program in Rhode Island is called the All-Payer Claims Database Project and is a collaboration between multiple agencies.  Rhode Island’s Department of Health, Office of the Health Insurance Commissioner, their health benefits exchange and their health and human services department will be sharing health care information and compiling data related to both medical and pharmacy claims.  The project assures residents that names, addresses and any other personal information will be removed before the health insurance data is shared.  Claims information will be used to help the Rhode Island health care system improve overall.  They also seek to improve the quality of health care.  Companies started gathering data at the beginning of this year.  Starting May 1, companies are now submitting their data to the project.

A representative from the ACLU fears that the information sharing will not be as anonymous as the program promises.  He thinks that people would be able to put a name to the indirect information given if they truly wanted to.  Sharing your personal health information could hurt you in a job hunt or in other areas as well.  But you truly should be safe because the agencies involved assure Rhode Island residents that their information is safe.  Keep in mind that you can opt out of having your health insurance claim information shared for this project.  You can opt out online through a special website, but there have been complaints that is wasn’t working.  Some people worry that those who opt out might actually be targeted though, so that’s something to think about.  If the anonymous sharing of your health, dental and pharmacy claims helps improve the overall health care system in your state, would you support it?