Millions of Americans fall into the ‘coverage gap’ where they do not get Medicaid, but are too poor to qualify for federal subsidies on the new insurance exchanges.
With the Affordable Care Act in full swing; consumers are now realizing that most of the Qualified Health Plans (QHP) found on the public exchanges are costly and have high deductibles. A recent article in the Wall Street Journal noted that Deductibles have increased 42% since 2013. Consumers are faced with the decision to increase their deductibles to keep the monthly health insurance premiums manageable. SASid has developed two supplement insurance productswhich brokers can use to assist consumers which can pair with their major medical insurance plans to help manage high deductibles and out of pocket costs.
Deductible Supplement Insurance: Consumers can save money by increasing their deductibles and supplementing their major medical insurance
QHP Supplement Insurance: Helps fill the gaps in the Qualified Health Plans found on public and private exchanges
Consumers can save money and/or increase benefits by getting creative with their healthcare…
Health care systems differ, and there can be many myths about their pros and cons. — Photo by RK Studio/Kevin Lanthier/Getty Images
En Español| How does the U.S. health care system stack up against Canada’s? You’ve probably heard allegedly true horror stories about the Canadian system — like 340-day waits for knee replacement surgery, for example.
To separate fact from fiction, Aaron E. Carroll, M.D., the director of the Center for Health Policy and Professionalism Research in Indianapolis, identified the top myths about the two health care systems.
How many times have you heard that Canadians, frustrated by long wait times and rationing where they live, come to the United States for medical care?
I don’t deny that some well-off people might come to the United States for medical care. If I needed a heart or lung transplant, there’s no place I’d rather have it done. But for the vast, vast majority of people, that’s not happening.
The most comprehensive study I’ve seen on this topic — it employed three different methodologies, all with solid rationales behind them — was published in the peer-reviewed journal Health Affairs.
Source: “Phantoms in the Snow: Canadians’ Use of Health Care Services in the United States,” Health Affairs, May 2002.
Then, the researchers looked at how many Canadians were discharged over a five-year period from acute-care hospitals in the same three states. They found that more than 80 percent of these hospital visits were for emergency or urgent care (that is, tourists who had to go to the emergency room). Only about 20 percent of the visits were for elective procedures or care.
Next, the authors of the study surveyed America’s 20 “best” hospitals — as identified by U.S. News & World Report — on the assumption that if Canadians were going to travel for health care, they would be more likely to go to the best-known and highest-quality facilities. Only one of the 11 hospitals that responded saw more than 60 Canadians in a year. And, again, that included both emergencies and elective care.
Finally, the study’s authors examined data from the 18,000 Canadians who participated in the National Population Health Survey. In the previous year, 90 of those 18,000 Canadians had received care in the United States; only 20 of them, however, reported going to the United States expressively for the purpose of obtaining care.
The Obama administration has known for at least three years that millions of Americans would not be able to keep their current health care plans, despite repeated promises to the contrary made by President Barack Obama, NBC News reports, citing sources “deeply involved” in Obamacare. Americans across the country have begun receiving cancellation letters from their health insurance providers informing them that their current plans do not meet requirements of Obamacare. NBC News’ “expert” sources say 50 to 75 percent of consumers who have individual health care plans can expect to receive such a letter — and they can also expect some “sticker shock” due to more expensive policies.
None of this should come as a shock to the Obama administration. The law states that policies in effect as of March 23, 2010 will be “grandfathered,” meaning consumers can keep those policies even though they don’t meet requirements of the new health care law. But the Department of Health and Human Services then wrote regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date — the deductible, co-pay, or benefits, for example — the policy would not be grandfathered.
Buried in Obamacare regulations from July 2010 is an estimate that because of normal turnover in the individual insurance market, “40 to 67 percent” of customers will not be able to keep their policy. And because many policies will have been changed since the key date, “the percentage of individual market policies losing grandfather status in a given year exceeds the 40 to 67 percent range.”
That means the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.
Yet President Obama, who had promised in 2009, “if you like your health plan, you will be able to keep your health plan,” was still saying in 2012, “If [you] already have health insurance, you will keep your health insurance.”
Robert Laszewski, a consultant with Health Policy and Strategy Associates, told NBC News that the administration repeatedly made a promise that officials knew couldn’t be honored.
“This says that when they made the promise, they knew half the people in this market outright couldn’t keep what they had and then they wrote the rules so that others couldn’t make it either,” he explained.
On Monday, White House Press Secretary Jay Carney admitted that some people would not be able to keep their health insurance plans, but argued the replacement plans will offer better coverage. He also argued that there are subsidies available to help with any increased costs.
This story was originally published by The Blaze.
This post originally appeared at The Blaze. Copyright 2013.
Posted October 28th, 2013, in Cancer Insurance, Dental Insurance, Diabetes, Eating Healthy, Health Insurance, Medicare, News, Obesity Insurance, Preexisting Conditions, Uncategorized by Frank Mossucco
October 26, 2013
U.S. President Barack Obama says the glitches of the Healthcare.gov website are “frustrating,” but people are working around the clock to to fix the problems.
The president said in his weekly address Saturday the fight for health care reform is not about a website, but was instead about establishing the “principle that in this country, the security of health care is not a privilege for a fortunate few, but a right for everyone.”
Obama said the site has been visited more than 20 million times and nearly 700,000 people have applied for coverage.
The president accused Republicans in Congress of spending the last few years obsessed with denying people access to health insurance.
In the Republican address, Chairman of the House Energy and Commerce Committee Fred Upton said his committee will hear directly from Health and Human Services Secretary Kathleen Sebelius to find out why the so-called Obamacare website does not work, despite the investment of hundreds of millions of taxpayers dollars.
The expert the White House has hired to fix the massive problems with the website says he expects it to be running smoothly by the end of November.
Thousands of people trying to buy government mandated health insurance using the website have run into numerous problems. Some users complain of extremely long wait times while others have had their passwords rejected. Other users said they were given conflicting prices for the same health plan.
Executives of the companies who built the website told Congress Wednesday the system was not fully tested and that last-minute changes to the website contributed to the problems.
Republicans opposed to the Afrodable Care Act – commonly known as Obamacare – said the computer problems illustrated their argument the health care law is not ready.
Under the Affordable Care Act, people without private health insurance can sign up for government subsidized plans through the website. Those who fail to carry any health insurance would pay a penalty.
Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, frustrating some consumers who want to keep what they have and forcing others to buy more costly policies.
The main reason insurers offer is that the policies fall short of what the Affordable Care Act requires starting Jan. 1. Most are ending policies sold after the law passed in March 2010. At least a few are canceling plans sold to people with pre-existing medical conditions.
By all accounts, the new policies will offer consumers better coverage, in some cases, for comparable cost — especially after the inclusion of federal subsidies for those who qualify. The law requires policies sold in the individual market to cover 10 “essential” benefits, such as prescription drugs, mental health treatment and maternity care. In addition, insurers cannot reject people with medical problems or charge them higher prices. The policies must also cap consumers’ annual expenses at levels lower than many plans sold before the new rules.
But the cancellation notices, which began arriving in August, have shocked many consumers in light of President Barack Obama’s promise that people could keep their plans if they liked them.
“I don’t feel like I need to change, but I have to,” said Jeff Learned, a television editor in Los Angeles, who must find a new plan for his teenage daughter, who has a health condition that has required multiple surgeries.
An estimated 14 million people purchase their own coverage because they don’t get it through their jobs. Calls to insurers in several states showed that many have sent notices.
Florida Blue, for example, is terminating about 300,000 policies, about 80 percent of its individual policies in the state. Kaiser Permanente in California has sent notices to 160,000 people – about half of its individual business in the state. Insurer Highmark in Pittsburgh is dropping about 20 percent of its individual market customers, while Independence Blue Cross, the major insurer in Philadelphia, is dropping about 45 percent. Read More..
The landscape of the healthcare industry is changing. Medicare and Medicaid may be reformed and the future is uncertain. But one fact that does not change is the number of elderly who have problems which require immediate attention. In such cases, skilled nurses can save lives and improve quality of life.
When most people hear skilled nursing and Medicare they assume the worst. It’s not uncommon for someone to assume that these terms add up to a homebound patient in desperate need of long-term care. However, this is not necessarily the case. Skilled nursing actually translates into custodial care and it is not entirely covered by Medicare.
The best example is when an elderly person needs physical therapy. This type of care is covered by Medicare but there are specific guidelines put in place that limit coverage. In most cases, the first 20 days of skilled nursing will be covered by Medicare, but past that point, patients are charged $148 a day out of pocket – a cost that can add up pretty quickly.
Along with these guidelines are special circumstances that require qualification. In order to receive skilled nursing you must have been admitted to the hospital for a minimum of three days due to that illness or injury. That requirement may sound like an easy one to meet, however there are still loopholes. For instance, not every individual who goes to the hospital is admitted – many people are put under observation instead. On top of that, Medicare does not count the last day of your hospital stay. Be sure to know the guidelines and criteria to ensure you get the help you need.
The future of the healthcare industry is uncertain but it has been said that reform is coming. It is clear that many people are suffering and are in need of skilled nursing. Unfortunately this can still be an expensive endeavor which is why it is beneficial to get a supplemental insurance plan.
First Preferred Health Insurance offers affordable plans that can provide you with the care you are looking for. There are both individual and family plans that can provide you with the comfort of knowing that your quality of life doesn’t have to suffer. Get in touch today and make the positive change in your life.
On February 15 it was announced that the government will officially close the Pre-Existing Condition Insurance Program (PCIP) due to the overwhelming cost and high premiums which made it difficult for people with pre-existing health conditions to afford coverage.
While the program was initially allotted $5 billion, the program has already totaled $2 billion in claims and $180 million in administrative costs. While this decision comes at a time when there is heated debate regarding health insurance and the future costs to all Americans, the government ultimately came to the conclusion that the program could not continue at this pace.
The good news is, the government is already making strides toward even better, more efficient programs that could very well change the landscape of healthcare coverage for folks with pre-existing conditions. One of these programs is the Patient Protection and Affordable Care Act of 2010 (PPACPA) which goes into effect Jan. 1, 2014. Among the advantages of this program will be lower premiums, which will allow more patients to participate, and a more efficient administrative process sure to make better use of allocated funds.
It is too early to tell where this will all lead. The health insurance industry is rapidly changing as the government shuts down programs and gets ready for new reform. As time goes on we will witness the change and see first-hand how those with pre-existing conditions are affected.
DaVita Dialysis has come under the spotlight over the last two years, but not because they focus on dialysis or because they provide a great service to their patients. On the contrary, the nation has grown more and more aware of their shady Medicare fraud, a case that has drawn major attention from the media.
CNN reports that two men, a medical director and a local nurse, had been in a discussion about clinic procedures a few years ago when they noticed that loads upon loads of expensive medicines were being thrown away in mass quantities. Workers were being told to dispose of the medicines without much knowledge as to why. These two men figured out the problem almost immediately. They’ve claimed that DaVita Inc has been attempting “to defraud the government, overbill Medicare and Medicaid, and make a fortune.” As one of the men described the situation, “We’re talking in the hundreds of millions, easily. The profit this company raked from those two schemes, only from those two drugs, was hundreds of millions of dollars.”
For those who don’t receive Medicare or don’t see the significance of the problem, Medicare and Medicaid medicines are paid for through hard earned American tax dollars. If those medicines are wasted in order to earn profit for doctors, clinics, and pharmaceutical companies, then those hard earned dollars are actually the main object being thrown in the garbage.
The case of DaVita is still under scrutiny, but investigators are learning that whether it be them or any other organization, Medicare fraud is a big problem and it’s time to rein in those lost dollars for the benefit of the American taxpayer as well as the patients to whom the medicine and the care were intended.
Our individual and family plans are a step ahead of the competition, so contact us today and speak with a representative to learn more. We offer plans for Pre-Existing Conditions, Diabetes, Obesity, and more.
Here at First Preferred Health Insurance, we recognize that your life is filled with many unique challenges. Likewise, we recognize that your vote on Election Day is determined by many, many issues that concern your family and your community. Health care is just one of the many issues you consider when casting your vote, so we’d like to remind you of the views that both presidential candidates have shared on this matter.
“Health care is at once among our nation’s greatest strengths and most serious challenges. People come from around the world to receive treatment in America’s top medical centers, yet too many of our own citizens have difficulty gaining access to basic services. No issue is of deeper or more personal concern than guaranteeing the health of our loved ones. No American should ever have to fear being left uncared for in the middle of the world’s most advanced health care system.
President Obama’s 2700-page federal takeover does not solve our problems. His $1 trillion in tax increases hits the middle class hard and drives medical innovation overseas. His $700 billion in Medicare cuts “will not be viable,” according to the program’s trustees, jeopardizing access to care for senior citizens and throwing millions of beneficiaries off the coverage they rely on. Millions of other Americans who were told they could keep their coverage will lose it, and more than one third of new coverage will come through the dramatic expansion of a broken Medicaid system. After all this, his plan still fails to control costs (according to Medicare’s chief actuary) or to provide a long-term solution to the nation’s entitlement crisis (according to the Treasury Secretary), so he leaves those tasks to a board of 15 unelected bureaucrats empowered to sidestep Congress and impose drastic cuts.
If elected President, I will repeal Obamacare and replace it — not with another massive federal bill that purports to solve all our problems from Washington, but with common-sense, patient-centered reforms suited to the challenges we face.”
“Supporters and detractors alike refer to the law as Obamacare. I don’t mind, because I do care. And because of Obamacare we’re moving forward toward a health care system that broadly provides health security.
For the majority of Americans who get health insurance through their employer, the law won’t change that, but it will make their coverage more secure and affordable. Today, 105 million people have seen a lifetime cap on their coverage lifted, so your patients no longer face the tragedy of approaching a lifetime limit in the middle of a round of chemotherapy or an episode in the ICU. Most of your patients can now get preventive care without paying deductibles and copays, care that you know saves lives, from early colon- and breast-cancer screenings to cardiovascular tests and flu shots. Because of new limits on insurance overhead costs, 13 million Americans got more than $1 billion in rebates — and by 2019, economists believe, family premiums will be about $2,000 less.
The law also roots out waste and fraud in Medicare and Medicaid, gets rid of insurance overpayments, reinvests those savings back into the system, and adds 8 years to the solvency of Medicare. Obamacare is closing the Medicare doughnut hole — saving people an average of $600 last year — and bolstering your efforts to get your patients to adhere to their medications. More than 3 million young adults who would otherwise be uninsured have coverage on their parents’ plan until they are 26 years old, and up to 17 million children with preexisting conditions are no longer at risk of being denied coverage. Small-business owners are getting tax credits to provide coverage for their workers and will soon be able to pool together to leverage better rates, just like big corporations.”
Today is a great opportunity to enjoy your American privilege and vote. After the dust settles on November 7, we’ll be able to more fully analyze the future of American health care and your role in the acquisition of health insurance.
So while the voters get into their respective ballot boxes, consider us as one of the most affordable health insurance companies in the country. Our individual and family plans are a step ahead of the competition, so contact us today and speak with a representative to learn more. We offer plans for Pre-Existing Conditions, Diabetes, Obesity, and more.