Posted October 14th, 2013, in News by Frank Mossucco
KHN Staff Writer
OCT 13, 2013
This KHN story was produced in collaboration with
Alexandra Dixon threads her way among the people waiting to see a doctor at the Community Clinic, Inc. in Silver Spring, Maryland. She introduces herself with a bright smile and an outstretched hand: “I’m one of the new health care navigators. Have you heard of the Affordable Care Act?”
While some folks mumble, “um, no I don’t think so,” Dixon is nonetheless booked up with appointments. She’s one of 350 people in Maryland who have been hired and certified to help consumers enroll in the new health insurance options that are offered as part of the health law.
Navigator Alexandra Dixon discusses insurance options with Alex Compagnet at Community Clinic, Inc., in Silver Spring, Md. (Photo by Jenny Gold)
She says that a few frown at what they call “Obamacare,” but “for the most part, people have been really excited and really happy and know what this is, you know.”
Dixon sits down with Maria Hernandez, a construction worker who’s a legal immigrant and has been uninsured for the past five years. Hernandez says sometimes she gets sick, but without insurance, it’s better just to take some medicine and stay home. With Dixon’s help, she’s gotten an application started for insurance. READ MORE
Posted April 18th, 2013, in Health Insurance, News by Frank Mossucco
Earlier this week, tax day presented the first taste of Obamacare for some lower- and middle-income taxpayers.
Though most of the aspects of Obamacare, or the Affordable Care Act, won’t go into effect until 2014, many in lower- and middle-income tax brackets who do not have health insurance will start to see the benefits of the program when it comes to calculating subsidies.
Upon filing their 2012 return, uninsured taxpayers will find out whether they qualify for a subsidy and, if so, the amount of that subsidy. Those who receive a subsidy will then need to make a choice to either purchase insurance later this year to comply with the law by 2014, or pay a fine to the IRS in 2015.
State-run health exchange programs will begin enrollment in October of this year and, at that time, those who qualify for the tax subsidies can buy into the program. In 2014 when Obamacare takes full effect, the federal government is projected to spend $25 billion to help those who qualify to purchase plans in the online marketplaces where they can choose from many private insurance plans.
Over the course of 10 years, the Affordable Care Act is expected to collect more than $1 trillion in tax revenues to help pay for the extended health care coverage. The IRS, Health and Human Services and other agencies will work together to coordinate the program and encourage qualified Americans to join.
There’s quite a bit of unknown as to how Obamacare will eventually work. While some effects, such as subsidies and additional taxes, will begin this year, no one will really know how all the pieces will fall together until the program is in full effect in 2014.
Households with incomes from 100 to 400 percent of the Federal poverty level will be able to receive the subsidies depending on their individual income and family size.
It is projected by the Congressional Budget Office that around 26 million U.S. citizens could receive health insurance through the program by 2022. Yet most people have no idea how taxes will be used to subsidize the program.
While enrollment for Obamacare begins in October 2013, coverage will not kick in until 2014. Qualified taxpayers’ subsidies will be used to purchase private insurance through the plan and be paid directly to the insurance company with the difference in price being the responsibility of the individual taxpayer who qualifies.
Once the taxpayer elects to use the subsidy, they must report it to the IRS the next year. The IRS will make adjustments to the subsidy through the taxpayer’s refund.
In 2015 things get really interesting. A year after the mandate to be covered goes into effect; proof of insurance will need to be made to the IRS. If proof is not established, a fine of $95 will go into effect. If the taxpayer does not comply the next year, the fine jumps to $325 in 2015 and finally goes up to $695 if the taxpayer still doesn’t comply.
There will be some exemptions to the law in extreme cases of poverty, Native American tribes, etc. Estimates for non-compliance will be at about $6 million by 2016 according to the CBO.
The popular belief is that non-compliance will be small as most would rather take the money than owe it to the Federal government through their tax return.
This year wealthier Americans are paying higher taxes because of Obamacare. A surtax of 0.9 percent of income over $200,000 for those who file as single or $250,000 for joint filers is being assessed.
Another tax is also being assessed in the form of a 3.8 percent surtax on investment income for taxpayers with a modified adjusted gross income above $200,000 or couples with an income above $250,000 . Combined, the two new taxes are projected to add $317.7 billion over 10 years.
These two new taxes are expected to bring in $317.7 billion over 10 years, making them two of the biggest revenue raisers in the Affordable Care Act.
Posted April 8th, 2013, in Health Insurance, News, Preexisting Conditions by Frank Mossucco
When you are diagnosed with HIV or AIDS the news alone can be crippling. You are thinking about how it happened and what you are going to do about it. You feel tremendous stress and heartache. The last thing on your mind is your insurance plan. But it is an unfortunate fact that as a person with HIV/AIDs it can be a challenge to receive coverage.
It is tough for many people to deal with the news and then move forward. But moving forward is the most important part. You can’t be brought down by the news. Instead you must take action to find coverage and receive the proper treatment you deserve.
The major challenge faced when looking for HIV/AIDS insurance is whether or not you will actually be covered. HIV/AIDS is considered to be a pre-existing condition and, as we always discuss, many insurance companies will not provide coverage to anyone with a pre-existing condition. And, the few companies which do offer HIV/AIDS insurance only cover the bare essentials of treatment leaving a patient with an excess of out-of-pocket costs.
The good news is, there are still some insurance companies which offer full health insurance coverage no matter the pre-existing condition and First Preferred Health Insurance is one of them. With First Preferred Health Insurance you don’t have to worry about your financial security. Instead, you can focus on your health and your family – and that’s what really matters in life, after all.
Posted April 5th, 2013, in News, Preexisting Conditions by Frank Mossucco
There are countless mental illnesses out there and all vary in severity. But no matter who you are or what problems you are suffering from it is important to seek treatment and achieve a clear mind.
Not all insurance companies treat mental health insurance equally. Some companies will charge you top dollar to receive proper treatment for your mental illness whereas some companies won’t treat you at all. The major problem is that a fair number of insurance companies perceive a mental illness as too risky. Although it is true that as a person with a mental illness you will most likely need ongoing treatment, it doesn’t mean that you shouldn’t be able to receive treatment.
When looking for mental health insurance, it is important to look at specific factors. Whether you suffer from depression, bipolar tendencies, or are just in need of therapy you need to be aware of your coverage. Each mental illness brings with it different treatment. If you are depressed you may need anti-depressants. If you have just hit a rough patch then you may just need some therapy to talk through it. Whatever your circumstances are, understand they bring about different stipulations for insurance companies.
Another factor to think about is whether or not your mental illness is a long-term problem. Some mental illnesses are curable and only require a short-term treatment. But there are a number of mental illnesses that require lifelong treatment. If this is the case for you then seek health insurance that will be able to take care of you for the rest of your life.
Regardless of the mental illness you may be suffering from, whether it be depression, bipolar disorder, or schizophrenia, you can worry about one less thing when you have ample insurance coverage.
Posted April 4th, 2013, in News, Preexisting Conditions by Frank Mossucco
A recent study found that 25 million Americans have some form of substance addiction, whether illegal drugs, pharmaceutical drugs or alcohol. It was also cited that only 4 million of these people actually receive treatment. A number of factors play into the lack of treatment and one of them is insurance coverage, or lack thereof.
Finding insurance for substance addiction abuse can be a serious challenge. Plenty of people are looking to be fully rehabilitated and restart their lives. But rehab centers can be extremely expensive and not all insurance plans will cover the cost.
Before committing to a specific insurance plan, there a few expenses associated with rehab you should consider. First, you need to identify which facility you will be entering. Not all rehab facilities are created equal. Some treat only specific types of substance abuse. Others won’t let you stay in their facility for an extended period of time. Still others mandate the length of a patient’s stay. Research these factors and understand that each one will influence your substance addiction insurance coverage.
For those who have been successful in making a fresh start, heath issues wrought by years of substance addiction are most likely another factor to consider. Some of these conditions may be permanent and require medication for the rest of the patient’s life. Because of this, many insurance companies are wary of insuring those who have had a substance abuse problem in spite of the fact that they are recovered.
Substance addiction can be considered a pre-existing condition to insurers and that definitely creates an additional challenge when seeking insurance. First Preferred Health Insurance is widely regarded as one of the select few that cover a wide variety of pre-existing conditions. Whether you are seeking treatment and want to kickstart you’re your new life, or you are already on the straight-and-narrow and just want health insurance, First Preferred may be the answer you are looking for.
Posted April 1st, 2013, in News, Preexisting Conditions by Frank Mossucco
With more than 100 different forms of arthritis effecting more than 46 million Americans, if you don’t have arthritis yourself, chances are you know someone who is suffering from it.
Arthritis causes pain in a person’s joints due to inflammation and it comes in varying degrees of severity – the two most common forms are osteoarthritis and rheumatoid arthritis. For some, arthritis is just a minor inconvenience. But for others it can be completely debilitating. No matter how severe a case may be, anyone who is suffering must seek treatment in order to live life to the fullest, free of pain to whatever extent possible.
However, because arthritis is considered to be a pre-existing condition, obtaining health insurance that covers treatment can be a challenge. When researching your arthritis health insurance options, factor in the following: pain medications, doctor visits and the unfortunate possibility that your arthritis may worsen over time.
Some insurance companies will cover basic issues caused by arthritis but will force you to pay costly out-of-pocket expenses for anything not considered standard treatment. An alarming number of insurance companies won’t insure you at all or will have elaborate stipulations in order to be insured through their company. One of these stipulations is called an “elimination rider” which completely bans you from receiving coverage for your condition. Another stipulation you may encounter is called an “exclusion period.” This is when an insurance company makes you wait a certain length of time before you receive full coverage. Some wait times can take up to 18 months.
The good news is, First Preferred Health Insurance offers a variety of health insurance plans that cover arthritis. So, whether you are suffering from osteoarthritis, rheumatoid arthritis or any of other 100+ forms, you will be covered. Make the change to the First Preferred Health Insurance Pre-Existing Condition plan and be pain-free once again.
Posted March 26th, 2013, in Health Insurance, News, Preexisting Conditions by Frank Mossucco
Last month it was announced that the government will officially close the Preexisting Condition Insurance Program (PCIP) due to the overwhelming cost and high premiums which made it difficult for people with preexisting 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 preexisting 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 preexisting conditions are affected.
Posted March 22nd, 2013, in Health Insurance, News by Frank Mossucco
Complementary and alternative medicine, such as acupuncture, massage therapy, chiropractic care and naturopathy, has been gaining more attention in recent years. Also known as integrative medicine, alternative medicine has been around for a long time, but, up until recently, had not been wholeheartedly embraced by mainstream due in part to a lack of clinical research available on long-term results. However, when the Patient Protection and Affordable Care Act (PPACA) goes into effect later this year, this could very well change.
For example the PPACA includes language discussing placing an integrative medicine representative on the Patient Center Medical Home advisory board, which is a group of doctors who help primary care physicians with their treatment of patients. There is also a suggestion for an integrative medicine representative on the board of governors for the National Institute of Health.
Additionally, the act includes details on more clinical research. This will benefit everyone as doctors may now be able to uncover the true benefits of integrative medicine and apply these benefits to patients experiencing chronic health issues and pain that traditional medicine has yet to find a cure for.
The healthcare industry is rapidly changing, and with support from the PPACA, alternative medicine might just turn out to be the path to a whole new world of medicine.
Posted March 20th, 2013, in Cancer Insurance, News, Preexisting Conditions, Uncategorized by Frank Mossucco
When an individual is diagnosed with cancer, the typical reaction does not initially center on personal finances. However, a cancer diagnosis can be devastating to your family’s long-term financial plan.
To begin, many people can no longer work when they have cancer which results in a loss of income. Hospital bills are another big factor. And, last but not least, the cost of tests necessary to determine which treatment is best for your particular cancer may also make a dent in your family’s budget.
Although a standard health insurance policy may cover some of these bills, oftentimes it does not. However, cancer insurance is specifically designed to help such expenses that are involved with treatment of the disease. In fact, The American Cancer Society has said that the average cancer survivor incurs $38,000 worth of debt. Most people are using their entire life savings just to pay for the medical bills.
The landscape of the healthcare industry is changing and although the future is uncertain, health insurance continues to rise in price each year. But, while premiums increase this does not necessarily translate into broader coverage, especially when it comes to long-term illness such as cancer.
Unfortunately there is no cure for cancer and more and more people are diagnosed each year. Therefore, preparing yourself for the worst-case scenario by choosing cancer insurance may be the only line of defense you have against cancer for you and your family.
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Posted March 18th, 2013, in Eating Healthy, News by Frank Mossucco
There are plenty of diets out there that guarantee good health based on a regiment of limiting intake to very specific foods. But, the reality is these diets are setting people up for failure as they tend to be more of a quick-fix than a long-term lifestyle change.
To form an effective long-term habit takes a much longer time than what most of these diets purport, but when implemented properly, the effects of new eating habits will last a lifetime. To begin, the best approach is to cease focus on short-term diets and instead begin building a new lifestyle one step at a time. Start with eating one piece of fruit each day. Then, perhaps, add a vegetable to your routine in the same manner. This whole process should be done over a one month period.
Once this routine becomes automatic, it is time to move on to the next step – preparing meals at home at least once a week. Do this for a few weeks along with the daily intake of fruits and vegetables. Then move it up to two healthy meals a week. As time moves on, you will find that you are now eating healthy for almost every meal. You have been eating fruits and vegetables for months now and you will notice an uptick in your health.
In short, if you keep things simple and change your routine in small increments, you never have to worry about sticking to a “diet.” Instead, you’ll be rewiring your taste buds for healthy cravings. You’ll no longer yearn for fried and fatty foods. Your taste buds are now craving water, fruits, vegetable, beans, nuts and lean chicken.
There will always be a new fad diet out there or a commercial advertising extreme weight loss in a matter of weeks. However, if you take the time to invest in your health by developing good eating habits over time, you’ll gain a lifetime of benefits.