Archive for the ‘health insurance’ Category

It’s March Madness for Health Insurance Sign-Ups As Well

Saturday, March 29th, 2014

Not only is it a big weekend for March Madness basketball, it’s a big weekend for the health insurance industry as well.  March 31 is the deadline to sign up for health insurance or else risk receiving a penalty by the government when you file your taxes next year.  As long as you have started filling out a health insurance application, there is a grace period until April 7 to finish filing your paperwork.  The Associated Press offered important information in their article, “Monday is the deadline to sign up for health law”.  Government reports say that more than 6 million people have already signed up for health insurance through the newly created marketplaces since they opened October 1.  That number doesn’t even take into account the number of people who have signed up for new health insurance plans outside of the marketplaces since the new law took effect.  Four out of five of the people signing up in the marketplace have gotten a government tax credit to help pay for their premium cost.

The federal government’s website has a deadline of midnight on March 31, but states that are running their own marketplaces might have different deadlines in place.  You can sign up online, by phone, or even in person because many local areas have sign-up centers.  Since we are down to the wire with sign-up time, there will probably be long wait times no matter which way to choose to sign up through Monday.  If you don’t qualify for a government tax subsidy, but want to get health insurance to follow the law, there are many more options for finding health insurance.  You can compare health rates for individual or family insurance plans here.

In Tennessee, there is a “Local push underway to get health insurance before (the) deadline“.  Local ABC News affiliate WATE reporter Kayla Strayer posted a list of locations where people in East Tennessee can receive free help from insurance agents.  One out of six people in Tennessee has been living without health insurance.  Most of these people say that they simply can’t afford it.  Insurance experts are helping many of these Tennesseans determine whether they qualify for government subsidies as well as helping them with the application process.  One volunteer says that you can see the relief on people’s faces when they find a health insurance plan that they can afford.  Many have been going without health insurance, and in turn doctor visits and tests, even though they know they need treatment.  Americans have to sign up for health insurance by March 31, or risk being charged a fee.  Fees are equal to 1% of your income, or $95 per adult and $50 per child.  Some Americans will be exempt from this insurance mandate.

Latinos React Differently to Health Insurance Marketing

Saturday, March 8th, 2014

While we are the United States of America, we are made up of a wealth of different cultures and backgrounds.  Some health insurance marketing fails to take that fact into account.  In “Selling Health Care To California’s Latinos Got Lost In Translation,” NPR Station WCAI discusses the nuances with the Latino culture and health care.  The article specifically looks at California because 30% of the state speaks Spanish.  Unfortunately for many advertisers and health insurance companies, simply translating an English slogan or commercial to Spanish does not work.  Covered California, the state insurance exchange, started advertising benefits of the new health insurance laws that don’t actually appeal to many Hispanics.  Advertising the importance of not being denied coverage for pre-existing conditions is great for most Americans.  Many people have been denied individual health insurance or know someone who has.  But this article says that the majority of Hispanics in California not only have never even been insured, they also haven’t even shopped around for health insurance because they didn’t consider it.  Having health insurance isn’t typically a norm in their culture.

Another problem with the Covered California Spanish advertising is that the commercials end by listing a website to visit, but no phone number or address.  Latinos are all over the internet, but research has shown that they don’t prefer to do transactions online.  They would rather speak to someone on the phone or in person.  This especially holds true for purchasing health insurance because it can be complex, confusing, and many of them have never had health insurance before.  Officials say that they have been working on offering more locations for Latinos, as well as other residents, to be able to physically go somewhere and speak with someone about their health insurance options.

The Covered California name itself doesn’t really translate to something exciting and the ads have been perceived as “dry”, exactly the opposite of the Latino culture.  It’s seems simple as an outsider to see that you need to market your insurance plans differently to different cultures.  And in California, when 30% of the population is Spanish speaking, you have to account for that and the differences in the Latino culture.  It matters to the general population if Latinos sign up for health insurance coverage.  Why?  Latinos are younger and healthier, on average, so when they are in health insurance pools overall premium costs are lower for everyone else.  Only 6% of those who have signed up for the new California health insurance speak Spanish as their first language.  While the March 31 deadline for coverage sign-ups is fast approaching, an overall improvement in marketing strategy will help Latinos and the health care industry as a whole.

Individuals Paying More for Health Insurance Without Government Subsidies

Friday, February 28th, 2014

On the heels of the Office of the Actuary of the Centers for Medicare and Medicaid Services report detailing premium increases for many small businesses, there is another report saying that individuals are paying more for health insurance as well.  According to The Business Journal’s Kent Hoover in his article “Take out subsidies and Obamacare is Really Expensive,” those Americans who are not receiving government subsidies are paying significantly more in health insurance costs.  Some Americans qualify for government tax subsidies when they buy an individual or family health insurance plan in the health insurance exchanges.  Low and middle income Americans can buy insurance plans through the government website or individual state health insurance exchanges and receive a tax break based on their income level.

But eHealth Inc. just performed a study to see how much health insurance plans cost for those who don’t qualify for the government subsidies.  They compared data from before the Affordable Care Act went into effect with plan costs as of February 24 of this year, after the ACA prices took effect.  Average individual health insurance plans now are $274 per month.  That is a 39% increase from average plan costs before the ACA requirements changed health care.  Family plan monthly average costs increased to $663 per month.  This is up 56% from the same time last year.  The company performing the study sells an array of health insurance plans and wants to highlight what they perceive as the negative changes brought about by the Affordable Care Act.  Those who already had affordable health insurance may be negatively affected, while those people who didn’t have health insurance or with very high plan costs receive the benefits of the health care law.

Compare health rates from multiple insurance companies to find the most affordable premiums for you or your family.  If you don’t qualify for a government subsidy or have health insurance through your employer, there are countless health insurance plan options available from an array of health insurance companies.

Health Insurance Is Going the Way of Retirement Plans

Sunday, February 16th, 2014

Just a couple decades ago, American retirement plans made a big shift from pensions to 401k’s.  Instead of receiving a defined benefit pension, workers started contributing to plans and making their own decisions about how they would receive their money.  A lot of people are forecasting a similar change in the health insurance industry over the next 5-10 years.  Right now many employers offer health insurance in a defined benefit way.  They choose the exact health insurance options and you can choose to pay for the plan or opt to buy your own individual health insurance.  Insurance News Net posted an article from The Pittsburgh Post-Gazette’s Bill Toland which says that “In 2020, Workers Will Decide (their own) Health Benefits.”

Many experts believe that the face of health insurance will change dramatically.  They forecast that people will shop online and choose the specific health insurance options that they want for themselves from private exchanges.  Companies will pay a certain stipend to their employees via a health account and that will go towards their health insurance plan costs.  If people choose a health insurance plan that is more than their employer stipend, they will have to pay the rest of the bill themselves.  They will shop in online private health insurance exchanges run by health insurers, like Highmark, or benefits consultants or brokers..  If an insurance company is running the exchange, all of the plans will be from them.  But if the exchange is run by benefits consultants or brokers, there will be plans from multiple insurance companies.  Plans will differ in prices and coverage.  Each exchange will likely offer around 6-10 different plans.

It was easier for large companies to make the pensions switch because they almost immediately saw huge cost savings.  It is a little different with the health insurance plans because although they will not see huge cost savings, they will see a large reduction in the amount of administration.  They are also offering better benefits to their employees, making them more competitive as employers.  But small and mid-sized employers will see even more benefits initially than the larger companies.  Experts predict that many smaller companies will make this switch to private exchanges in the next year and a half.  Larger companies will switch as well, but it will take a large employer like McDonalds or WalMart making the big move before many other make the jump as well.

Get Paid to Take Your Medications

Sunday, February 9th, 2014

It seems strange, but you really might start getting paid by your insurer to take your medications, quit smoking, and go to the gym regularly.  According to Forbes magazine’s Robert Szczerba, we should watch for a big shift in the healthcare industry.  We currently have a “fee for service” model, where doctors and hospitals get paid for each service they provide.  But in “Why Your Insurance Company Will Pay You to Take Your Medicine,” Szczerba says that the shift will take us to a “fee for outcome” model instead.  This means that doctors and hospitals will get paid when their patients have a successful health outcome, no matter how many services they have provided.  This approach is meant to help lower overall healthcare costs and will reward patients and doctors with smaller “micro” payments rather than the large “mega” payments that providers currently receive.

Right now the healthcare system is way too focused on big money.  Medical students want to go into big money specialties and marketers target big money medical devices.  Large payments from insurance companies to doctors and hospitals encourages them to continue ordering more tests and doing more procedures.  When we have the mindset that more care is better and that we need intervention instead of waiting minor problems out, and doctors and hospitals get paid more for each intervention, it’s the “perfect storm” for America’s overuse of health care.  We use more services than anyone else but are certainly not the healthiest nation by far.  In order to make this overall change to the health care system, we as Americans have to change our mindset when it comes to healthcare, health insurance, and overall health.

Believe it or not, clinical health care is only a 20% factor in our overall health care.  Healthy behaviors actually account for 30% of a country’s overall health and 40% is made up of socioeconomic factors.  It’s more effective to focus on preventative care like smoking cessation, exercising, eating right, and properly taking prescription medications.  Close to 1/3 of prescriptions never get filled.  In most cases, it is cost effective to pay patients $1 per day for keeping up with heart or diabetes medication than it is to pay for their future problems related to not taking prescribed medications.  When doctors take a conservative and supportive approach to medical care by not ordering unnecessary testing and taking a wait and see approach when applicable, thousands of dollars can be saved.  Micro payments to doctors who are conservative encourages better behaviors all around and can lead to lower overall healthcare costs.  Those people who are truly sick will still receive the necessary testing and treatments in this new system.  But people who are a little bit sick or not really sick at all will be given a more conservative treatment approach to save money all around.  Health insurance companies will even be able to lower premiums when the system isn’t so misused and overpriced.

Insurers Will Now Offer Better Mental Health & Addiction Coverage

Saturday, January 11th, 2014

There is some great news for Americans struggling with mental health or addiction who were having problems with their insurance coverage.  Insurance plans offered in the federal and state run health insurance exchanges are required to offer coverage for mental health care and addiction treatment under the 10 essential benefit requirements.  This information comes from The New York Times article “Understanding New Rules That Widen Mental Health Coverage,” by Ann Carrns. This coverage expansion is welcome news to millions of Americans who have been suffering with seemingly no hope for help.  Whether they couldn’t find an insurance plan that offered mental health coverage or the benefits were not the same as medical coverage, they will now have help.

Inclusion in the 10 essential health benefits is not the only change affecting mental health and addiction treatment.  Back in 2008, the Mental Health Parity and Addiction Equity Act worked to make mental health coverage the same as coverage for physical health ailments.  While they have had a long road, parity rules will finally take effect in July of this year.  Most health insurance companies will have to follow these rules in their individual and family insurance plans starting next January.  When insurance companies offer mental health coverage, they will not be able to charge higher deductibles or co-pays for these visits than they do for medical visits.  They also cannot limit the number of mental health visits allowed in a more restrictive way than they do for medical visits.

Some insurance companies already follow the parity rules, but how they comply with them will now be detailed by the government.  They can’t limit the geographical region for mental health coverage if they don’t limit it for medical coverage.  Insurance companies cannot make it more difficult to get pre-approval for inpatient mental health treatments than they do for inpatient medical care.  They also have to make it clear to consumers what criteria they are using to determine their ruling.  This is good news for consumers who have been struggling to get mental health care because the insurance coverage was less adequate than their medical coverage.

It’s important to note, however, than it won’t necessarily be easier to get mental health treatment because of one big factor.  Around half of psychiatrists do not accept private health insurance as payment, mostly because their reimbursement has been terrible in the past.  Since these new rules are going in effect, it is possible that more office based psychiatrists will accept private insurance in the next few years.  Be an advocate for yourself and make sure that you know the laws and rules that apply to mental health and addiction coverage.  If you are having a hard time with your insurance company or can’t find a therapist who will accept your plan, there are free services to help you locate one.

Physical & Lifestyle Factors That Affect Health Insurance Costs

Thursday, November 28th, 2013

There are a lot of factors that go into determining health insurance premium costs.  They aren’t always easy for the average consumer to figure out, but Money Crashers has put together a list of the “10 Factors That Affect Your Health Insurance Premium Costs.”  Kira Botkin says that insurance companies first place a value on your risk profile, which is made up of information from your insurance application and your medical history.  Some things in your risk profile are under your control, while others are not.  Once the company does extensive research to determine your risk profile, they compare it with company benchmarks and decide whether they will offer you health insurance coverage.  Your premium is then determined based on your individual risk factors.

The first group of risk factors is that of the medical and physical variety, some of which you have full control over.  Number one is your BMI, or Body Mass Index.  People with a high BMI are almost always charged more for individual health insurance policies.  They have a higher risk for diseases like diabetes and heart disease and women with high BMI’s can have complicated pregnancies.  Whether or not you smoke or chew tobacco will affect the price of your health insurance.  Some companies deny you altogether, but many offer plans with higher premiums and cover the cost of programs to help you stop smoking if they are prescribed by a doctor.  Gender and age are the next two factors affecting your insurance premiums.  Women often pay more for health insurance because they go to the doctor more often, fill more prescriptions, and get more diseases on average.  Maternity costs are also very high for women of child bearing age.  Speaking of age, younger people often get lower health insurance premiums because they visit the doctor less and typically have fewer health conditions.

Pre-existing medical conditions have been in the news headlines a lot lately.  Many insurance companies wouldn’t even cover people with these pre-existing conditions until the Affordable Care Act started requiring insurers to do so.  Any pre-existing medical conditions like asthma or a cancer history will increase the cost of your insurance premiums.  Although you have no control over your family health history, family history does often play a role in the cost of your health insurance premiums.

The second group of risk factors pertain to your lifestyle and personal health.  Your job plays a part in determining your insurance premiums.  Those in very risky or dangerous jobs might be charged more because they could get injured.  Also, people who work in very sedentary jobs are often charged an increased premium because of their increased likelihood to develop cardiovascular disease.  Where you live can also affect how much you pay for health insurance.  If your area has more unhealthy people and a more sedentary lifestyle, you could pay more for insurance, even if you are healthy.  Married people pay less for health insurance than single people, on average.  Married couples are often healthier and live longer than unmarried people.  Finally, whether or not you have been uninsured in the past can affect your new health insurance premium.  If you were uninsured or are just now shopping for your own insurance policy, you will likely have a higher premium.

Be healthy and control the things that you can control in your lifestyle to give yourself the best chance at a lower health insurance premium.  Compare insurance companies and policies and do your homework before choosing an individual health insurance plan.  Some risk factors are out of your control, but take charge of those that are not.

Individual Health Insurance Plans in Illinois Extended for a Year

Saturday, November 23rd, 2013

There is good news for people with individual and small group health insurance plans Illinois.  Many of the more than 185,000 people who received cancellation notices from their insurance company will have a year long reprieve from finding new coverage.  After an outcry from Americans, President Obama has urged state insurance regulators to make exceptions to the Affordable Care Act requirements.  Many existing health insurance plans do not meet all of the requirements, causing hundreds of thousands of people to get a cancellation notice.  If your insurance plan was effective prior to October 1 of this year, you will now have until October 1 of 2014 to select a new insurance plan.  This is great news to Americans who were scrambling to make health care plan decisions by January 1.  WGN’s Peter Frost discussed the details for Illinois residents in the story “Illinois to let companies sell existing health insurance plans.”

Blue Cross and Blue Shield of Illinois, the largest insurance company in the state, said that they will be contacting people who received cancellation notices to tell them their new options.  More than 475,000 people in Illinois had individual health insurance policies as of data collected in 2012.  Some of the people whose plans do not meet Affordable Care Act requirements will receive federal tax credits to help pay for new insurance plans.  But many others are upset because their new plan options cost double what their prior health insurance plans cost.  So far, 15 states have told their insurers that it’s okay to extend current insurance plans for another year.  Some states are not allowing this plan extension though, despite the President’s request for them to do so.  Some insurance companies worry that extending old plans will keep too many people out of the health insurance exchanges, which could raise those plan costs.  Those people who are buying plans in the health insurance exchanges have until December 23 of this year to purchase a plan that will go into effect January 1.

Uninsured Veterans May Be Helped by Affordable Care Act

Monday, November 11th, 2013

On this Veteran’s Day, The Washington Post reports that one out of every ten veterans does not have health insurance.  In Sarah Kliff’s article “One in 10 veterans lacks health insurance. Obamacare could change that.,” she says that the expansion of Medicare could be the biggest game changer for veterans without health insurance.  Despite the fact that the Veterans Health Administration is the biggest health care system in the United States, not all veterans are receiving care at their 1,700 hospitals.  Some veterans don’t qualify because they have to serve for 24 consecutive months in order to qualify for coverage from the Veterans Health Administration.  Others don’t meet other specific requirements, including disability and income.

There are 1.3 million veterans who do not currently have health insurance.  In addition to that, there are more than 900,000 veteran family members who are uninsured.  But veterans actually have a lower uninsured rate than the national average of 18%.  While 10% of veterans are uninsured, it doesn’t mean that all of those people don’t qualify for Veterans Health Administration benefits.  Some people don’t know they qualify, others think the process of applying is too complicated, and some veterans may live too far from the facilities to use them.  Those veterans who are uninsured are typically younger than insured veterans and have lower levels of education and higher rates of unemployment.  That isn’t really surprising, but explains in greater detail why some Veterans are uninsured.

So how might the Affordable Care Act help to insure some of these uninsured veterans?  A recent report estimated that 40% of those uninsured veterans will now qualify for Medicaid under the new poverty guidelines.  Unfortunately for some veterans, 24 states are not currently planning to expand Medicaid.  Even so, hundreds of thousands of veterans may be able to receive health insurance under the expanded Medicaid system.  Many of their family members will also qualify for insurance coverage.  Researchers also wouldn’t be surprised if the VA started changing their policies regarding health insurance coverage.  This remains to be seen of course because this is all uncharted territory, but expansion of health insurance overall might mean some expansion at the Veterans Health Administration.

Divorce Brings Up Health Insurance Concerns for Many

Saturday, September 28th, 2013

A large group of people seeking individual health insurance coverage may be able to celebrate lower premiums because of the Affordable Care Act.  If you know anyone who has gotten divorced, you may be well aware of the sting that ex-spouses face when they lose their health insurance coverage because it was tied to their ex.  Each year, 115,000 women lose health insurance coverage because of a divorce.  This information comes from Marketwatch’s Elizabeth O’Brien in the article “Obamacare could ease divorce’s financial sting.”  While the overall divorce rate has slowly declined, people over 50 have seen an increasing divorce rate.  This is like a double whammy for those getting divorced and losing their health insurance because insurance is often more costly overall as you age.  Although ex-spouses are usually able to continue their healthcare through COBRA, the program is very expensive and ends in less than two years.  This leaves a lot of recent divorcees without insurance coverage, often for a long time.

Not only is it more expensive to find individual health insurance for over-50s, pre-existing conditions have excluded many of them from even being able to find an insurance plan.  The fact that they do not yet qualify for Medicare means that divorce is setting many women’s retirement goals even farther back because of health insurance costs.  When the Affordable Care Act takes full effect January 1, 2014, many of these divorcees will have good news when it comes to health insurance.  Those who were disqualified from plans will have choices for health insurance and costs should be more affordable for those who already found plans.  Attorneys have said that many older couples remain married until they are 65 just so the non-working or non-insured spouse with pre-existing medical conditions can remain on the spouse’s plan until they qualify for Medicare.

Health insurance is often a factor in divorce negotiations and was tricky in the past.  Now that health insurance exchanges will help people find affordable coverage and plan tiers will be more standardized to show out-of-pocket costs, estimating health insurance costs will be easier in negotiations.  Federal subsidies will be available to many divorcees looking for individual health insurance plans, especially if they have little to no income.  And these subsidies will be a big factor in alimony calculations since health care costs can contribute to higher alimony payments.  There are other health considerations when it comes to divorce and arranging for the division of policies.  Long term care insurance policies must be divided and those who didn’t have such a policy should consider one since they won’t have a spouse to help care for them if needed.  Many people also get a court order at the start of divorce proceeding to make sure that spouses are maintaining payments on health insurance and other insurance policies while details of a divorce are being worked out.  If you are looking for a health insurance policy because of a divorce, we have many affordable plans from which to choose.