Posts Tagged ‘Fallon Health Insurance’

Use Health Exchanges to Get Fallon Health Insurance

Sunday, December 12th, 2010

Starting in 2014, Americans will be using health exchanges to shop for their health insurance.  The exchanges were put into place by the Affordable Care Act of 2010 and are supposed to be one-stop shops for Americans to get affordable insurance coverage from companies like Fallon Health Insurance.  The goal is for the exchanges to allow individuals and small businesses looking for health insurance to join forces and be able to purchase health insurance coverage together.  With larger purchasing power, they should be able to get affordable care at the kind of discounted prices that large businesses can.  Tax subsidies and cost-sharing discounts will also be given to individuals below a minimum income level to help with financial assistance.

According to Insurance Journal’s “Midwest States Getting $1M Each for Health Exchanges,” $49 million will be given out by the U.S. Department of Health and Human Services to help establish the health exchanges in individual states.  Illinois, Nebraska, North Dakota, and South Dakota will each receive $1 million to get their health insurance exchanges up and running.  All states were given the option to run their own insurance exchanges with companies like UPMC.  States that choose not to run their own exchanges will have one created and run by the federal government.  Those states receiving a portion of the $49 million will use that money to start their exchanges and determine how they will actually operate.

9/23/10: Compare Health Insurance Reform for Students

Thursday, September 23rd, 2010

collegeAs of today, college students and their parents have a lot to look forward to regarding the health insurance changes going into effect.  Health Insurance Sort published a news article regarding the changes entitled “What health care reform means for students.” Students will compare health insurance costs since they can now stay on their parents’ insurance plans until the age of 26.  Many students have gone without health insurance after being kicked off of their parents’ plans at age 23.  This new health care reform is part of President Obama’s Health Care Reform Bill of 2010.

Health Insurance Sort’s article clears up misconceptions with the law and explains to college students and their parents how they will be affected now that this provision has taken effect.  Some insurance companies opted to follow the new law as soon as it was passed rather than waiting until today’s deadline.  As of today, everyone from Fallon Health Insurance to Mercy Health Plans will be covering college students longer.  You will learn about how students’ privacy will be protected, what happens when a student goes to college out of the service area, if employer-sponsored plans will see an increase in premium cost, who may not be eligible, and when purchasing a basic plan from the college may be more beneficial from this article.

UPMC Covers High Risk Pools

Tuesday, August 10th, 2010

obama2In the past month approximately 2,400 Americans have signed up for President Obama’s high risk health insurance pools.  This information comes from Gene Rickman’s “2,400 Apply for High Risk Health Insurance Pool,” in Top News. The exact state by state data is not yet available, but this number includes members in both states that are running their own high risk pools and states like South Carolina that are letting the government run the high risk pools for them.  Beginning in 2014, health insurance companies like UPMC will not be able to deny insurance coverage because of any preexisting conditions.  To bridge the gap between now and then, the U.S. federal government has required these high risk health insurance pools.

The Affordable Care Act passed earlier this year calls for the mandatory stop to preexisting condition denials by health insurers in less than four years.  Preexisting conditions can include cancer, asthma, diabetes, HIV or AIDS, and even pregnancy.  It is currently almost impossible to get health insurance coverage from companies like Fallon Health Insurance if you have one of these or another preexisting condition.  Within the last month, Americans have been able to sign up for individual state high risk health insurance pools where they will be able to obtain some type of health insurance coverage.  The federal government offers the states subsidies for this program, but states do have to utilize their own government funds as well.

AIDS Treatment From Fallon Health Insurance Helps Stop Spread

Sunday, July 18th, 2010

From the Associated Press’ Marilynn Marchione, “Treating HIV also prevents its spread, study finds.”  A recent Canadian study, partly funded by the United States, found that the rate of AIDS infections decreased in the areas of Canada where more people started taking drugs for the disease.  Infections dropped by 3% in British Columbia, where the study was performed.  Since 1996, the number of new infections has been reduced by half, which correlates with a rise in treatment since Canada has offered free AIDS care and the introduction of modern AIDS drug treatments.  The director of the U.S. National Institute of Allergy and Infectious Diseases states that where there is more drug therapy there is less transmission.  He says that there is really no other explanation for the drop in news AIDS cases in Canada.

While the U.S. does not offer free treatment to everyone, Fallon Health Insurance and other health insurers often cover the cost of drug therapy for AIDS patients.  With 1.1 million HIV infected Americans, AIDS experts hope that the results of this study will help improve U.S. funding for AIDS patients to get drugs.  While there are 55,000 new cases of AIDS each year in the U.S., that is a number that hasn’t increased or decreased in a decade or so.  Since AIDS is incurable, it is crucial to find a way to stop the spread of the disease.  Previous studies in Africa showed similar results, as did studies indicating that pregnant women taking AIDS drugs are less likely to pass the disease on to the unborn fetus.  An increased effort in Washington, San Francisco, and New York to test and give early treatment to more people will hopefully be taken throughout the U.S. soon.

Fallon Health Insurance: Sleeve Gastrectomy Coverage

Tuesday, June 29th, 2010

The laparoscopic sleeve gastrectomy is a new weight loss procedure available to treat obesity and diabetes.  According to “Insurers Divided Over Experimental Stomach Surgery to Treat Obesity,” Matthew Sturdevant of The Hartford Courant says that some insurers are not covering the procedure while others are.  The procedure has the same goal as gastric bypass and gastric banding.  It shrinks the stomach to 15% of the original size so that you eat less.  Fallon health insurance and other insurers have had to make a tough decision whether or not to cover the newer procedure.  Some companies believe that more research should be done, while others are already covering the costs to help avoid the other long term costs related to obesity and diabetes.

UnitedHealthCare and Aetna decided to cover the sleeve gastrectomy at a cost of $16,000-$25,000 for the procedure.  CIGNA Corp. and Anthem Blue Cross Blue Shield of Connecticut are not covering the procedure currently because they believe it is experimental and needs more research to be proven effective and safe.  The sleeve gastrectomy procedure turns the shape of the stomach into a sleeve rather than the natural kidney bean shape.  It is deemed better than gastric bypass by some people because it doesn’t skip over the small intestine where important nutrients are absorbed.  The benefit over gastric banding is that you don’t have to have repeat surgeries like you do to adjust the gastric band.  Some advocates believe that the sleeve gastrectomy pays for itself in about two years because of the obesity related health costs that are avoided.

Fallon Health Insurance Individual Plans

Friday, May 28th, 2010

pie chartThe Patient Protection and Affordable Care Act contains a provision that may force smaller insurance companies like Fallon Health Insurance out of the individual insurance market completely.  According to “Actuary: Act Fast, Or Individual Health Insurers Will Flee,” Allison Bell of Life and Health National Underwriter summarizes the dilemma.  The minimum medical loss ratio requires health providers to spend 80% or more of their premium revenue on paying the medical claims of their insureds.  Experts recommend regulators come up with a way for companies to make this transition.  They worry that smaller companies will opt out of providing individual health insurance because of this new provision.  If that is the case, they would most likely have to let insureds know by June to give them a 6 month warning that they won’t offer individual coverage next year.

Those hoping for some transitions to be spelled out would like to see them immediately so companies know before making the decision to leave the individual market.  The idea behind the 80% medical loss ratio is that insurance companies like UPMC would just reduce administrative costs and other costs they have not related to claims.  It might be hard for insurers to reduce those costs so quickly, not to mention the fact that it will likely hurt smaller insurers much more.  In order to stay competitive, smaller insurance companies offer lower rates for the same coverage as larger companies and have higher marketing and administrative costs.  One suggested solution is to make the minimum medical loss ratio smaller for insurance companies with less market share or for those who sell low-cost plans like high deductible insurance.  Without any changes it is very possible that more smaller insurers will stop selling individual health plans.

Insurance Freeze From Fallon Health Insurance & Other MA Insurers

Wednesday, April 28th, 2010
Governor Deval Patrick

Governor Deval Patrick

The Wall Street Journal article “The Massachusetts Insurance Blackout” explains the fallout from Governor Deval Patrick’s price controls on insurance premiums.  Insurers are not selling small business and individual premiums because they say that the Governor’s rate cap will force them into huge losses.  This small-group market consists of 800,000 Massachusetts residents, many of whom will have to go without health care.  Fallon health insurance, Blue Cross Blue Shield, and Tufts Health Plan are three of the largest four insurers in the state.  All of them had operating losses in 2009 and say that this premium freeze will force another $100 million in losses this year.  All of the major health insurers in Massachusetts operate as non-profits and some are having their solvency threatened by this rate cap.

Governor Patrick says that this is his response to the greed that health insurance companies have shown.  The Boston superior court has heard an emergency case and is expected to make a decision soon.  State officials, however, are demanding the insurance companies go back to selling their policies at last years premiums.  The state’s Attorney General believes that the cost of health care in general is to blame for Massachusetts having the highest premiums in the nation.  He says that if you compare health insurance costs to the cost of the actual health care, the industry is not abusing its customers.  This debate in Massachusetts between political power for candidates and health care will likely happen all across the United States because of President Obama’s so-called ObamaCare.

Fallon Health Insurance: Health-Care Bill Timeline

Friday, March 26th, 2010

calendarThe passing of the health-care bill on Sunday will bring about changes in the industry for individuals and companies like Fallon Health Insurance.  In The Washington Post’s article “When does the health-care bill go into effect,” the newspaper summarizes the timetable.  The first change should happen within the year, offering a rebate of $250 for Medicare recipients whose initial prescription drug coverage has run out.  Within 90 days, people who were denied insurance based on preexisting conditions will have access to high-risk pools.  Changes that will come about for insurance companies within 6 months include a requirement for children to remain on their parents’ policies until age 26 if they desire and the banning of insurance companies imposing lifetime coverage caps, denying coverage when people get sick, and denying children with preexisting conditions coverage.

By 2011, individual and small group insurance plans like UPMC Health Insurance are required to use 80% of premium money towards medical services while large group plans must use 85%.  The Medicare payroll tax will be increased and expanded by 2013.  Families who earn 400% or less of poverty level income will receive subsidies to buy health insurance by 2014.  Also that year, most employers will have to provide insurance coverage or will receive penalties and most Americans will have the same stipulation for obtaining health coverage.  High-end insurance policies will have an excise tax of 40% imposed in 2018.  And by 2019, health insurance will cover 32 million more people than it does today.

Fallon Health Insurance for the Vancouver Olympics?

Wednesday, February 24th, 2010

vancouverWhile the 2010 Vancouver Winter Olympics are in full swing, thousands of spectators from all over the world have flocked to Vancouver, Canada.  With snow, ice, and cold temperatures, hopefully fans planned ahead and purchased travel health insurance for their trip.  Daniel Workman of Health Insurance Suite 101 wrote about available coverage in “Winter Olympics Travel Medical Insurance.”  Manulife Financial is Canada’s largest health insurance company.  They offered individual rates to travelers from the United States, Sweden, Germany, Australia, Russia, China, Italy, and Japan; all countries who have athletes participating in the games.

For consumers with Fallon health insurance, Aultcare health insurance, or other insurance plans, they should always check with their personal insurance company first to see if they cover medical care while traveling.  If not, additional coverage is wise.  No one wants an accidental injury or emergency on vacation to ruin not only their trip, but their finances as well.  The rates are much cheaper the younger your age, but are the same for males and females and residents of any included country.  The exclusions to the insurance are few, but should always be checked out before purchase.  Whether traveling to the Olympics or somewhere else, if your health plan doesn’t include travel insurance look into separate trip coverage.

Fallon Health Plans: How the Massachusetts Election Could Effect Health Care Reform

Sunday, January 24th, 2010

Scott Brown is the new Massachusetts Senator.  Seeing that he is a Republican, this could change everything about President Obama’s health care plan.  In “Massachusetts Senate race results: Obama’s signal that all is changed” by Peter Grier of The Christian Science Monitor, the repercussions are discussed.  Unfortunately for President Obama, things have not gone as he planned during his first year in office.  The economy is still struggling, a record number of Americans are unemployed, and his much anticipated health care reform plan has been a battle between Democrats and Republicans.  With a new Republican Senator in a “blue state”, what happens now with health care is up in the air.

Insurance companies have a lot at stake with the proposed health care reform bills.  Fallon health insurance, part of Fallon Community Health Plan of Massachusetts, is dedicated to making communities healthier.  They have a strong interest in health care reform and are waiting to see what will happen in the government with health insurance coverage for more Americans.  Nancy Pelosi, the House Speaker, is insistent that health care reform will pass even with the Democratic loss in Massachusetts.  Only time will tell how President Obama’s agenda may change after his first difficult year in the presidency.