Health Insurance

HOW TO FIND THE BEST MEDICAL INSURANCE POLICY

2009-12-04T15:27:00.000-08:00

Where should a chairman demeanour if they need to find a illness word routine as well as acquire illness word quotes? There have been multiform answers to these questions as there have been most sources of report for illness word plans.

The initial place which we can begin with is a internet. There have been countless internet sites which yield we a use of obtaining as well as comparing word coverage as well as quotes from assorted companies. When acid upon these sites, however, we need to recollect which a allude to we have been given is theme to change. These quotes have been given formed upon a minimal volume of information, however when a tangible word association contacts we they will need a finish minute healing story for yourself as well as any a single which we have been perplexing to cover underneath your healing word policy.

The second preference which we have accessible to we is by upon vacation an word deputy or broker. There is a vast disproportion in between each, in which an word deputy represents a single association as well as a word attorney represents multiform companies. When we work with a word deputy they will surprise we upon all a options which their association might have accessible to you. This can be a time immoderate routine if we do not find what we wish from a company, given we might have to revisit assorted companies prior to anticipating a routine which is befitting for you. An word broker, tends to be a easier charge given we will be reception quotes from assorted companies from a single person. Your word attorney will support we in anticipating befitting quotes for we as well as representing we when it comes to a sold word companies.

800 numbers have been additionally an preference accessible to we when acid for healing coverage. When contacting these companies we will verbalise with protected word brokers which will be means to support we in anticipating a right routine which their association can suggest you. There is an up as well as down side to contacting 800 numbers. The downside is which we will be articulate to a deputy of a sold word company, thus we might need to hit assorted companies prior to anticipating a routine which is befitting to you. The upside is which companies which sell word over a phone suggest a most appropriate rates upon healing coverage out of any of a alternative companies.

It is a buyer’s preference as to which routine will fit them most appropriate as well as still encounter their budgetary considerations. Research all of a report we embrace as well as have your preference formed upon what is right for we during this sold time. Remember which it is your shortcoming as a client to review all of a products offering as well as their cost quotes to be sure which we have been purchasing a product which is right for you. Insurance in all renews annually so, if we have been not happy with your strange choice, we will have a event to shift to an additional association subsequent year.

When acid for affordable illness word plans record onto www.healthquotefinder.com. At this site we can find illness insurance quotes as well as review them with alternative companies.

Where To Look For Medical Insurance

2009-12-04T15:25:00.001-08:00

By Julia Brady

There are numerous options available, where one can search for medical insurance coverage. If you are without medical insurance the following with assist you in finding ways to search and compare for a health coverage.

You could begin by checking out the Internet and the many sites they have for comparing health insurance quotes. You must remember, however, that these quotes are based on a minimal amount of information and will be adjusted accordingly when more detailed information is supplied. These companies will want to know about every illness you have ever had and will then request details for all of them. This can be an overwhelming process that may lead you to total frustration. I was questioned about an illness that I had over forty years earlier and they requested the doctors name so they could obtain the records. The doctor was over 60 when he treated me and would now be over 100. I doubt that his records are any longer available. The insurance company finally agreed to rate my policy without these records.

Another way that you can obtain your medical insurance policies and quotes is by visiting insurance agents or insurance brokers. There is a difference between each so you need to decide which way of searching for insurance will work best for you. An insurance agent represents one insurance company, normally, The insurance agent will inform you on all the products that they offer, and the options that are available to you. This will work out well if you find what you are looking for, however, if you are not satisfied with the policies and options that you are presented with your will have to meet with another agent from another company. An insurance broker, on the other hand, represents several companies. By working with a broker you will be presented with insurance policies and quotes from these insurance companies, therefore you have a greater chance of finding the suitable policy for you, without having to visit several different agents or insurance companies.

800 numbers are also an option available to you when searching for medical coverage. When contacting these companies you will speak with licensed insurance brokers that will be able to assist you in finding the right policy that their company can offer you. There is an up and down side to contacting 800 numbers. The downside is that you will be talking to a representative of a particular insurance company, therefore you may need to contact various companies before finding a policy that is suitable to you. The upside is that companies that sell insurance over the phone offer the best rates on medical coverage out of any of the other companies.

There are many options available when looking for medical coverage. Just be sure that before you purchase anything you should compare a number of policies for both coverage and monetary similarities. This is the best way to find a suitable policy at a suitable price.

Providing health insurance for your loved ones can be a strain when you find yourself unemployed and without medical coverage. When obtaining health insurance quotes it is important to compare companies to ensure you are getting what you need at the lowest cost possible. For assistance in obtaining quotes log onto www.healthquotefinder.com.

What To Look For In A Long Term Care Insurance Company?

2009-12-04T15:24:00.000-08:00

What do I look for in a good company? You know that you should buy long term care insurance, but where should you look and which company should you consider? A lot of advisers either sell one company’s policy, or they only sell a few policies a year, or truthfully, they really don’t know. So what do you look for in a good company?

We’ve all heard that any insurance policy is only as good as the company standing behind it, but what does that mean? It means that the company must meet the standards of an excellent and superior rating. In order to achieve a rating like this a company must meet certain requirements. Look for:

Financially sound companies Committed companies with a large client base Claims paying history Length of time selling LTC insurance History of rate increases

They all sort of blend into one another, but let’s look at them in detail:

Financially Sound Companies Check their ratings with the companies that rate the strength of insurance companies. Generally you can get a good flavor of the company’s financial strength by looking at their A.M. Best rating. If you want to back up your findings, you can by looking at Standard & Poor, Moody’s, Fitch, Duff & Phelps or Weiss Research, A.M. Best usually gives a very good overview of the companies strength and the companies don’t have to join the rating service in order to be rated.

Where do I get this? Updates are published monthly, quarterly and annually and can be found in any public library. In addition, you can usually find the ratings on each company’s web site. Do this first and then ask your agent.

Committed Companies With A Large Client Base “The theory of large numbers” works here. The larger the client base the better buffer you have against rate increases. As claims come in the companies need to financially spread these over their client base. If larger claims come in than forecasted then the company has to decide whether to absorb this into its projected cost of business or to pass this along to policy holders in the form of a premium rate increase. Companies who have made a commitment to this line of business normally do not raise premiums. A smaller, uncommitted company may be more inclined to do this.

Where do I get this? The company web site should have their policyholder information readily available. Also the agent representing the company should have their marketing materials, approved by the state where you live, that give policyholder information. In addition, you can get more information from the rating agencies, A.M. Best etc.

Claims Paying History Sometimes a good financial rating may not tell the whole story. Some companies with good ratings have been known to deny or delay paying claims in health insurance. If they use that same practice in other areas, then there is a good chance it will do so for long term care insurance claims. Also, it is important to ask how many claims have been paid since they started selling LTC insurance.

Where do I get this? Call your state insurance department for information on the complaints filed about specific companies. If this isn’t available then sometimes you need to use your own judgment based on size and reputation of the company. A well-known company is less likely to risk bad publicity for this type of action.

Length Of Time Selling LTC Insurance The Company that you choose should have been selling long term care insurance since the early’90’s. If they haven’t then they probably have not been in the business long enough to have experienced enough claims. Without good claims experience then a company can’t tell if they have set their premium rates correctly. You do not want a company to find out that they set them wrong to begin with and you are the recipient of a “rate adjustment”.

Where do I get this? Once again if you look at the same sources from the above items you will find this information. The state approved company marketing materials will have this information as well as an informed LTC insurance agent. History Of Rate Increases Any company that has ever had a rate increase to its existing clients should not be a company for primary consideration. There are always exceptions to this especially when it comes to health issues and the need for coverage from a company that specializes in these problems.

Where do I get this? You can always contact your state department of insurance and ask them, or ask your agent. However, a sure fire way to do it is to ask your agent for the first page of the long-term care insurance personal worksheet for that particular company. This is a part of their application and will always show their rate increase history.

Finally! Now we know what to look for in a good company. The ideal company will be very large and financially sound. It will have a lot of long term care insurance clients and will have sold these policies since the early’90’s. In addition it will not have any complaints with your state insurance department concerning the payment of claims. And finally, the ideal company will have a good reputation and will not have ever raised rates to their existing clients in any state.

Before you go out and buy a policy go to Long Term Care Insurance, ask questions and request a long term care insurance quote. We represent 20 of the top LTCi providers. This gives you tremendous options.

Where Should You Turn When Your COBRA Expires

2009-12-01T12:08:00.001-08:00

By Julia Brady

There is a bill in Congress aimed at extending the stimulus package that provides government assistance in paying for C.O.B.R.A. (Consolidated Omnibus Budget Reconciliation Act) health insurance benefits from the current nine-month period to 15 months. C.O.B.R.A. allows former employees to keep their health insurance coverage, but requires that they absorb 100% of the cost. A portion of the government’s stimulus package was directed at temporary assistance with these payments. If this bill is not enacted, all government contributions towards C.O.B.R.A. will end at the subsidy expiration date, which is December 31, 2009. This could leave millions of unemployed people without health insurance, and will cause many of them to begin shopping for some type of affordable health insurance plan to provide basic coverage.

The first step to take when trying to find health insurance would be to contact several brokers and agents who can assist you by providing a new individual health insurance policy to replace the one you will be losing. It is possible that the company who is currently insuring you through C.O.B.R.A. would be willing to offer you an individual plan. A phone call to them could be a starting point in your search.

It is important that you do not just except the coverage that you current insurance company is offering, as you may be able to get a better prices premium or better coverage by switching to another insurance company. You will want to obtain insurance policies from various companies and look through each for comparable plans. Once you have a few policy that are comparable in all areas, including co payments, deductibles and maximum out of pocket expenses, you should then contact the providers to obtain premium quotes. By obtaining the premium quotes you will then be able to compare each policy by cost and chose the one that will cost you less, over all, through out the year.

Each policy that you obtain can have a great difference in cost. You should look through each one carefully and contact an insurance broker with any question that you may have. The insurance broker will be able to assist you in understanding the areas that are not clear for you, as well as choosing the policy that will be best for your medical requirements ans budget. If you find that after all your research you are still unable to afford any of the policies that you were quoted then you should research into other ways that you can obtain your medical insurance coverage.

There are two other options that you can choose if you are unable to find an affordable premium. The first is to look into local groups or organizations that you may be interested in joining. Often times these clubs and organization will carry a group insurance plan, where the members will be able to by into medical coverage at a reduced cost. If you are unable to find any organizations in your area, your second option would be to purchase a high deductible policy. Although this policy will cost you a large amount in deductible fees, your monthly premiums will be much less. With high deductibles policies, however, you will want to be sure to save up the funds required to cover your deductible should you need medical assistance. Your insurance company will not pick up the coverage unless you have completely met the deductible of your plan.

When you are trying to research a variety of insurance quotes in order to purchase medical insurance coverage that is adequate and affordable log onto www.healthquotefinder.com.

Health Insurance More Popular Than Ever Before

2009-12-01T12:06:00.000-08:00

Daily headlines about superbugs, falling staff levels and patchy quality of care in hospitals have led to many people turning their backs on the NHS and choosing private cover.

The latest figures from the Association of British Insurers show that after a decade in decline, the number covered by private medical insurance is on the rise and now tops 6m.

And a recent survey by Bupa found that two thirds of its customers cited the risk of infection from superbugs such as MRSA as being a key reason for going private.

Fiona Harris, head of personal markets at the healthcare giant, says: ‘The whole issue of cleanliness has shot up the agenda. People don’t want to be treated in the sort of hospital where you have to keep on your slippers every time you pop to the bathroom.’

About two-thirds of those with private healthcare are insured through a company plan, but more than a million individuals choose to buy cover for themselves or their families.

Harris says: ‘The NHS doesn’t provide everything people want. We see less sitting on the fence and more people coming to try private health cover.’

Among this trend away from the NHS is Alastair Taylor. Though finances are tight, he chooses to spend £12 a month on Tesco’s Core health cover. The insurance, provided in partnership with Axa PPP, gives a basic level of cover for private treatment.

Alastair, 24, a post-graduate student of international criminal justice, lives with his partner Nicola Armstrong, 22, and their son Jacob, 22 months, in Hucknall, Nottinghamshire.

He says: ‘On our recent visits, hospitals have seemed overstretched and sometimes short of staff. I have lived in Oman and so I am used to the private system. Everything happens when you want it and the hospitals are all so clean.’

Shaun Matisonn, chief executive of PruHealth, says: ‘Patients today are sophisticated consumers of healthcare. They research the treatments they want, but cannot always get them through the NHS.

So insurers are focusing their cover on delivering in areas where the health service is perceived to be letting people down, for example, providing cover for drugs and treatments that are not universally available on the NHS.

Western Provident Association (WPA) launched mycancerdrugs last year, a simple policy that pays for cancer drugs that some NHS hospitals refuse to fund.

Insurers have also had to be more imaginative to help keep cover affordable. Treatment costs continue to rise, driven by what is known as medical inflation. ‘This tends to run at three times normal inflation,’ says Harris.

This means insurers are giving buyers a growing range of options when it comes to keeping costs under control.

MPCA Preparing to Launch Children’s Health Insurance Enrollment Initiative

2009-12-01T12:05:00.002-08:00

by: Phillip J. Bergquist, CHIPRA Program Manager, MPCA

There are many reasons 150,965 of Michigan’s children don’t have health insurance coverage – parents have lost their jobs, employer-sponsored coverage has been eliminated or it simply costs too much.

Yet thousands of families are eligible for low-cost or free health insurance for their children and haven’t taken advantage of the opportunity.

An overwhelming group of these eligible families think they can’t get health insurance coverage because they make too much money.

Wrong! The majority of children covered by MIChild, Michigan’s Childrens Health Insurance Program, come from working families. In fact, a family of four making up to $41,000.00 a year may be eligible.

Misconceptions like this one and other barriers are keeping Michigan families and children from taking advantage of the health insurance coverage they need … that’s where we come in.

MPCA is preparing to launch a bold, grassroots initiative in communities across the State of Michigan to find these eligible children and get them enrolled! Working through the Community HealthCorps program MPCA will bring Enrollment Specialists to community centers, schools, migrant camps, churches, homeless shelters and Community Health Centers from Marquette to Detroit to work with local organizations and get children covered.

We want to impact the lives of 12,000 children in the next two years and hope this movement spreads beyond our program to bring the number of uninsured children in Michigan to O.

Understanding your Employer Health Insurance

2009-12-01T12:05:00.001-08:00

If you are fortunate enough to have employer health insurance, then congratulations are in order! With your employer health insurance, however, often comes confusion and questions. While each employer will offer different plans and different policies, the following information can help you to better understand your employer-based health insurance policy:

Most employer health insurance plans include managed care plans, including health maintenance organizations (HMOs) or preferred provider organizations (PPOs). It is important to understand that a HMO plan will only cover those doctors within the plan’s network, while a PPO will pay a portion of your costs if you choose to see a doctor outside of the network.

Your health insurance may vary in cost depending on the services they offer and your out-of-pocket expenses. Deductibles, co-pays and prescription costs may also vary according to the plan you choose.

Some employers may expect you to pay a certain portion of your monthly health insurance premium, and may require a larger payment from you if you choose a more expensive healthcare plan. Likewise, a less expensive plan may result in lower out-of-pocket expenses.

Before choosing a healthcare plan, make sure it caters to your specific needs. For example, if you have many prescriptions you will want to likely search for a plan that offers low co-payment prescriptions costs.

Compare your health insurance benefits with those of your spouse to determine which plan provides better coverage at a better price. Remember to compare such factors as doctor’s visit co-pays, monthly premiums and prescription medications.

Read the plan carefully and ask your company’s human resources manager for answers with any of your questions. Many times, insurance representatives will visit companies during open enrollment to answer any questions regarding their health insurance plans.

Don’t forget to pay close attention to any cap on benefits. For example, does your plan have a yearly or lifetime cap on health insurance benefits?

Check to see if your family doctor is included in your health insurance plan. Many times, being able to keep the same doctor makes a big difference.

COBRA health insurance assistance running out for laid-off workers

2009-12-01T12:02:00.000-08:00

by Vicky Eckenrode

With the federal subsidy to help families pay for COBRA health insurance beginning to run out yesterday, many more North Carolinians likely will fall into the uninsured ranks, a consumer group reported Tuesday.

Families USA, a group that supports health care reform legislation, estimated families in North Carolina have paid an average of $389 a month for COBRA with the subsidy. Without the assistance, those families can expect to pay $723 more out of their pockets for an average monthly premium of $1,112 to keep coverage through the insurance program, which helps workers keep benefits after losing their jobs.

Read the full report here.

The federal subsidy started earlier this year as part of the federal stimulus package as a way to help people continue insurance coverage as unemployment began to rise.

The first batch of subsidies, paying 65 percent of the premium costs, expired Nov. 30. For anyone who began receiving subsidies after March, the money runs out nine months after they signed up. People who lose their jobs now also won’t be able to get the money.

“For millions of laid-off workers and their families, the federal COBRA subsidies have been a health-coverage lifeline,” said Ron Pollack, executive director of Families USA. “It is essential, therefore, that new jobs legislation extends those subsidies.”

Without help from the subsidy, a person’s COBRA bill eats up nearly 84 percent of the average monthly unemployment benefit in North Carolina, the report stated.

Legislation has been introduced in Congress to extend the benefit longer, though funding will be an issue as lawmakers continue to debate the price tag for the broader health care reform measures.

Health Insurance, Abortion and Symbolism

2009-11-17T11:22:00.000-08:00

An article in today’s WSJ goes through the numbers explaining why restricting insurance coverage for abortions as now being debated on Capitol Hill would do little in practical terms to change the affordability of abortion for the vast majority of women.

Yet the financial impact of the restrictions — the House’s overhaul bill, H.R.3962, would prohibit insurance bought with government subsidies from covering abortions –- isn’t the whole story. People on both sides of the debate say another issue is that when insurance covers abortion, it reduces the stigma associated with the procedure.

Amy Hagstrom Miller, who owns abortion clinics in Texas and Maryland, instructs her staff to ask patients if they want to pay with insurance. One reason is because the very question conveys the message that abortion is a mainstream procedure, to be treated like any other aspect of medical care.

Critics of the House bill say the coverage restrictions would send the opposite message. “It makes it even less likely that abortion will ever be normalized in this country,” Carole Joffe, a sociologist who supports abortion rights and studies the issue at the University of California at Davis.

Exactly the point, say abortion opponents.

They hope that pushing abortion out of the mainstream will discourage more women from making an appointment. There is some evidence that state laws requiring women get counseling at a clinic, then wait 24 hours before terminating a pregnancy cuts abortion rates. The House bill could have the same effect, activists say.

“You want to communicate that abortion is in a different moral category than a tonsillectomy” and eliminating insurance coverage is one way to do that, said Charmaine Yoest, president of Americans United for Life, an advocacy group opposed to abortion.

The debate on Capitol Hill about abortion coverage is mostly symbolic, said David DeWolf, a law professor at Gonzaga University who opposes legal abortion. “But it’s symbolic,” he said, “in a way that deeply matters to a lot of people.”

Disability Applicants Report Facing Foreclosure, Lost Health Insurance, Drained Retirement Savings and Worsening Illness

2009-11-17T11:21:00.000-08:00

An overwhelming majority of Social Security Disability Insurance (SSDI) applicants face grave setbacks and wish they would have known from the start that expert representation to assist them was available, according to a national survey. People with disabilities experienced financial crises, extreme stress and declining health while stuck in the federal disability backlog, according to results compiled and released by Allsup, a nationwide provider of Social Security disability representation and Medicare services.

Arthur Blair, of Gaithersburg, Md., was a program manager at a group home before a combination of osteoarthritis, severe back pain and depression made it impossible for him to keep working. During his two-year wait for SSDI benefits, Mr. Blair tapped deep into his savings and had to sell his home after he and his wife were unable to make their mortgage payments. His condition also worsened.

"I think the process takes away our humanity," said Blair. "There are no resources to help you. You are in a financially devastating position, and by the time you're approved, you have accumulated so much debt and lost everything you've worked for. It's almost impossible to recuperate what you lost."

A survey of nearly 300 successful SSDI claimants who came to Allsup after having their initial disability applications rejected by the SSA finds:

* Nearly 80 percent of respondents reported facing "barriers to handling the SSDI process on [their own," including problems with understanding (48 percent) and completing (61 percent) the necessary forms.

* Three-fourths (75 percent) said the level of stress they experienced while applying for SSDI benefits was either "extreme" (39 percent) or "significant" (36 percent).

* Only half (51 percent) of all applicants knew third-party representatives could help them apply for SSDI benefits.

In addition, almost 90 percent of applicants said they faced negative repercussions while waiting for their SSDI award. These included:

* Stress on family - 63 percent

* Worsening illness - 53 percent

* Draining of retirement/savings - 35 percent

* Lost health insurance - 24 percent

* Missed mortgage payments - 14 percent

* Foreclosure - 6 percent

* Bankruptcy - 5 percent

Almost nine in 10 (85 percent) survey respondents said they would have found it useful for the SSA to inform them in advance of their options for receiving help with their SSDI application. Another 83 percent would have found it helpful or valuable if the SSA had provided them with a list of authorized third-party representatives to choose from.

"Because applicants too often don't know help is available, too many initial claims are denied for simple mistakes that have nothing to do with the applicant's disability status," said Jim Allsup, president and CEO of Allsup. "If they only knew third-party assistance was available to professionally review their application and help properly document their disability, thousands of claimants could get through faster and avoid painful financial and personal repercussions of getting stuck in the system."

Allsup conducted the survey by mail June 29 through Sept. 4, 2009. For more information and full survey results, please contact Colleen O'Boyle, (703) 683-5004, ext. 122, coboyle(at)crcpublicrelations(dot)com.

About Allsup

Allsup is a nationwide provider of Social Security disability, Medicare and workers' compensation services for individuals, employers and insurance carriers. Celebrating its 25th anniversary in 2009, Allsup employs more than 600 professionals who deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. The company is based in Belleville, Ill., near St. Louis. For more information, visit www.Allsup.com

Women closing health-insurance coverage gap

2009-11-17T11:20:00.001-08:00

While there are still inequities between women and men in terms of health-insurance coverage, public pressure and legislation have helped females close the coverage gap.

The new national health-care bill that passed the House of Representatives by a slim 220-215 margin has advocacy groups concerned about the direction of health insurance.

One part of House Resolution 3962 -- the Stupak/Pitts amendment -- has outraged Cecile Richards, president of Planned Parenthood Federation of America and the Planned Parenthood Action Fund.

"Planned Parenthood serves three million women every year through its more than 850 affiliate health centers across the country, and has worked tirelessly on behalf of those patients for affordable, quality health care," Richards said on www.plannedparenthood.org. "On behalf of the millions of women Planned Parenthood health centers serve, the Planned Parenthood Federation of America has no choice but to oppose HR 3962."

Richards explained her group's frustration, which centers around the Stupak/Pitts amendment.

"The bill includes the Stupak/Pitts amendment that would leave women worse off after health-care reform than they are today, violating President Obama's promise to the American people that no one would be forced to lose her or his coverage under health reform," Richards said.

Richards said the amendment "violates the spirit of health-care reform, which is meant to guarantee quality, affordable health-care coverage for all."

"In fact, this amendment would create a two-tiered system that would punish women, particularly those with low and middle incomes, the very people this bill is intended to assist," Richards said. "The majority of private health-insurance plans currently offer abortion coverage, and the amendment would result in the elimination of private abortion coverage in 'the exchange,' the new insurance market created under health-care reform, as well as in the public option, if one is created."

Dr. Thomas Ayoub, head of the obstetrics and gynecology department at Norwalk Hospital, believes the state of Connecticut has done a great deal to close any disparity gaps in insurance coverage between women and men.

"The state has made a big effort to equalize (insurance coverage) a lot, and the state has mandated reproductive services be covered by all private insurers," Ayoub said. "It's hard to say any disparities are discrimination; it's really an economic issue. Certain plans cost different prices. The biggest problem we have as patients is we have no damn clue what we will be paying."

Ayoub hopes that private insurance coverage might become like a restaurant, where a $25 steak costs $25.

"Most people are straightforward in ordering things," Ayoub said. "We have to have some veracity."

Nationally, there are still impediments to women receiving insurance coverage to men. According to Web site www.healthreform.gov, women's reproductive health requires more regular contact with health-care providers, including yearly pap smears, mammograms and obstetric care.

Women are also 21 percent less likely (52 to 73 percent) to be employed full-time than men, making them less likely to be eligible for employer-based health benefits themselves. In fact, less than half the number of women have the option of obtaining employer-based coverage on their own, according to www.healthreform.gov.

That Web site notes that even women with the option to get health coverage through their employer, they are twice as likely as men to go on their spouse's plan, 15 percent versus 7 percent.

Another myth that has been debunked is that Viagra is covered by insurance, but women's reproductive services are not. According to pharmacists Mike Grimaldi and Joe Schuler at the Norwalk Community Health Center, Viagra is only covered in a lower dose to help curtail pulmonary hypertension.

"Viagra is not covered by federal money," Grimaldi said in reference to Medicare and Medicaid. "Anyone using federal money (for Viagra) is not using it for erectile dysfunction."

Schuler said he and his wife have experienced in vitro fertilization firsthand.

"My wife has gone through (in vitro) twice, and on my own we weren't covered," Schuler said. "She changed to a plan to cover in vitro. Finding the right plan may take some digging. Open enrollment is very general, and people may come to find out their plan does not cover everything they need."

Schuler added that cancer coverage can vary by insurance plan.

What Is Health Insurance?

2009-11-17T11:20:00.000-08:00

In a world full of unforeseen dangers insurance is the best way to ensure that you are financially protected when something goes wrong. Health insurance is a coverage that pays for medical expenses when a person falls ill and health insurance is considered an important investment by most people. This article will provide in-depth information about various aspects of health insurance.

Health insurance services are purchased from companies that ask for a fee for their services. These companies ask the person who wants to be insured to opt for a policy that suits his requirements and in return the company gets a fee for their services. The fee which is charged is known as a premium and this premium is usually charged on an annual basis. Most health insurance companies pay a large percentage of the total bill amount which means that after being insured the person needs to pay a small amount of the bill amount.

All insurance companies pay only for certain services and procedures like plastic surgery are not paid by health insurance companies. Majority of the health insurance companies also pay only up to a certain amount each month which means that after a certain amount you will need to pay your bills on your own. The policy booklet covers all these aspects in detail and they are usually handed to the person at the time of being insured.

Individual insurance is a term that is used to imply that a single individual is being insured. Group insurance is a term used to imply that more than one person is being insured. Many insurance companies offer group insurances to families of four or more and a discount is usually offered if groups opt for health insurance.

Company insurance is provided by an employer to its employees as part of the salary package. The insurance limit and policies depend on the agreement between the employer and the insurance company.

Health insurance is often mistaken for life insurance but it is not the same. Health insurance policies are applicable when a person is alive and needs to be hospitalized where as life insurance policies are applicable when a person dies due to an accident or natural event. Health insurance companies do not provide life insurance unless it is mentioned in the policy.

While opting for health insurance it is always advised to ask questions about policies and procedures before you sign up with any health insurance company. It is also recommended to read the fine print in the policy before you pay the premium or sign the agreement.

How to Control the Cost of Your Insurance and Cut it Fast

2009-11-17T11:14:00.000-08:00

Because health care prices are increasingly expensive, people do not have the money to pay for extra medical expenses such as health insurance plans. This is especially true for people with serious conditions which need occasional checkups and trips to the doctor.

The monthly charges for these insurances also increase in a continuous manner. Because of this, it is important to look for other ways to minimize health costs.

Nowadays, there are so many health companies that provide appealing payment schemes for insurance plans. An interested customer only needs to spend a little time searching for the best deal through the internet.

Various information and online quotes can be provided by a health insurance companies websites. Once you have gathered these online quotes, you can then start comparing the differences of these companies and find the right one which will fit your budget as well as suit your medical needs. Asking advice from your family and friends is also recommended.

Choose a health insurance company that has a higher deductible, because this will produce a lower premium. In general, healthcare providers cover basic care like prescription drugs and professional fees without consulting the plan holder to shell out for the amount deductible.

However, this option is only recommended if you are normally healthy. Otherwise, choosing a higher deductible is not advisable especially if you possess a family medical history or a chronic disease.

The best way to minimize your medical insurance expenses is to choose a healthy lifestyle. Not only does it reduce your healthcare costs, it makes you live a longer life with fewer trips to the doctor. Another benefit is that better bonuses and lower premiums are offered by health insurance providers to healthy people.

Compare Insurance Quotes – It’s an Easy Way to Save Money

2009-11-17T11:13:00.000-08:00

If your like most people suffering through today’s economy and are looking to safe a little extra at the end of the month, investing options with your insurance company may be the way to reduce the monthly payment.

Insurance companies have many different variations in which they based the policy fee on. By doing a little investigative work with your current policy, there may be other discounts you are qualified to receive. The insurance company is not going to go through the policies of each client they have, determine if they qualify for an additional discount, and call the client up and offer to lower the payment. It is up to the client to research the various options they are qualified for and present the facts to the agent.

Some of the discounts may apply to you and some may not. There are literally hundreds of discounts available that your agent is not going to tell you about. If finances have forced you to sell your brand new vehicle and trade down for an older, paid off model, this is going to reduce your payment. If there are no accidents on your driving record, the amount of time varies with insurance agencies; however, most have some degree to which a discount is offered with zero accidents. Your zip code may also make you eligible for an additional discount, if you attend school and get good grades, this is another discount. If you have a child on your policy and they receive good grades, this is another discount. There are also the obvious things such as car alarms or increasing the deduction amount.

There is competition among the insurance agencies so if you are not satisfied with the options your agency is offering after presenting them with the discounts you would like to discuss with them, go online and search with options available with another company. In five minutes you could have at least three quotes that will guarantee you a savings of as much as five hundred dollars a month. The amount of savings will vary among everyone but any extra amount of income a month will be a bonus.

It is important to compare insurance quotes before getting signed up with an insurance policy. When you compare insurance quotes you can rest assured you are saving both time and money because you are guaranteed to get the lowest insurance quote.

Given the current recession it is important to make sure to prioritize your money and compare insurance quotes online. A good place to state would be an online website that actually allows you to compare insurance quotes online for free.

Low Cost Health Insurance Quotes

2009-11-17T09:36:00.001-08:00

Health insurance has become a necessity as the cost of medication is constantly on a rise. In spite of knowing the importance of health insurance, there are a lot of people who do not have any. They cannot afford the high premiums of health insurance. In order to solve this problem, the federal government provides a number of low cost health insurance programs, for the people living under the federal poverty level. There are various low cost health insurance plans available in every state of America and the requirements of these plans differ in each state.

Medicaid is one of the preferred health insurance programs, designed by the federal government for the needy. Apart from the federal government, there are a number of other companies that offer health insurance at affordable rates. It is advisable to ask for quotes from several sources before investing in a low cost health insurance plan. The health insurance quotes give a fair idea about the policies of the insurance companies, their rates and terms and conditions.

Most of the insurance companies offer free low cost health insurance quotes to attract people towards their plans and programs. These quotes help people to compare the rates and the benefits of the different low cost health insurance plans. This helps them to take a decision, according to their specific needs. The easiest and fastest way to get quotes from the different local insurance agencies and insurance companies is through the Internet. There are a variety of low cost health insurance plans online. Most of these companies offer quotes absolutely free of cost.

Low cost health insurance quotes online are listed on a state, national or international basis. The quotes received from various the insurance companies or local agents are not considered as a binding agreement between them.

Alternative To Individual Insurance

2009-11-17T09:36:00.000-08:00

People have to bear the rising healthcare costs. One aspect of the healthcare industry is the health insurance companies. To adapt to current situations, these companies charge higher premiums.

Who pays for the expensive premiums? These are paid by average Americans who are facing budgetary constraints. That is why more and more people cannot afford to get health insurance. Employers have also been limiting the benefits of workers that they get from group health insurance plans to cut costs. As a consequence, workers have to pay for higher co-pays and deductibles.

This is a grim picture because health should be prioritized. Remember the adage that health is wealth.

Imagine also the high costs of medical services, treatments and medicines. Without insurance, you have to shell out from your pocket the whole payment. Get a health plan you can afford so you can keep up with the premiums, deductibles, co-pays, co-insurance and out-of the pocket expense. To cope up with the expensive premiums, families are choosing family health insurance policy. In a recent statistics, it revealed that family coverage increased by 5% in 2009.

Families can choose private family insurance policies especially to those who don’t have an access to employment based insurance. The insured person has the option to add immediate family members under one policy.

There are different levels to this type of policy. However, a typical health plan will cover basic surgery expenses, treatment, dental care, specialized treatment and emergency medical facilities. The levels will determine the insurance premium to be paid. These are

* Family * Subscriber and Spouse + Separate Child Only * Subscriber (Wife) and Child + Separate Single Adult (Husband) * Subscriber (Husband) and Child + Separate Single Adult (Wife)

There are two broad types of family insurance policies. These are the indemnity and managed care plan. In managed care plan, the insurance company provides a list of doctors and hospitals. The insured person can only choose from that list. One of the benefits of this plan is that the insurance company will pay medical bills directly to the doctor or hospital.

In indemnity plan, the insured person has more choices because he can choose the hospital and doctors. But he needs to pay medical bills for every visit to the doctor or hospital while the insurance company will reimburse the amount after.

Get also health insurance quotes to compare rates and policies. It is also a tool for knowing affordable health insurance and comparing insurance rates from different companies. Look for insurance companies registered in your state because insurance policies are designed to fit local conditions.

If you are having trouble choosing the right type of medical insurance, then, log on to Insurancecaredirect. Here you will find information on all aspects of health insurance including low cost health insurance options.

Online Help On Health Insurance

2009-11-17T09:35:00.001-08:00

The fast outflow and integration of technology has changed our lives for the better. One of these technological breakthroughs that were able to change the way we conduct our everyday activities is the internet. The internet was able to integrate itself in almost every part of our lives, and now it was also able to revolutionize the business of health insurance policies. The insurance business in general was revolutionized in the sense that it has broader possibilities as compared to its status a couple of years ago. One of its most affected aspects is its competitiveness; the internet was able to push insurance companies to be more and more competitive.

Competition in any market is good for one sole reason; it decreases prizes while increasing the quality of the good. As for the insurance business, competition breeds affordable health insurance without sacrificing the coverage plans that policy holders pay for. It can be said that the internet has made insurance companies more stretched in terms of premiums and coverage packages. How the internet made the whole insurance business more competitive? The answer is simple, online quotes. Insurance companies are now engaging in head to head business competition with other companies through online quotes.

Policy shoppers should fully utilize the use of free insurance quotes which are posted by major insurance companies. In the older days, policy shoppers are usually engaged by insurance agents who find their ways of luring clients through flowery talks instead of numbers. But with the dawn of the internet, the competition among insurance companies put more emphasis on the numbers that policy shoppers should know, like premium and coverage. Low cost health insurance with good coverage can only be achieved by the policy shopper through making use of all possible resources of information in his or her chosen policy.

Policy shoppers of the best health plan packages can use online quotes to directly compare the vital specifications in an insurance policy. All it takes is just a click to find the perfect insurance policy that will protect you in areas where you need it the most. Online quotations can equip policy shoppers with the needed information in getting cheap premium policy with higher deductibles. Online quotations will also force the insurance companies to find ways of catering more to the needs of the policy shoppers and holders without charging much.

It is in the best interest of policy shoppers and holders to use online quotes simply because they hold the chance they need to be covered at low expense rates.

In order to get further clarification on affordable health insurance and understand its benefits better, log in to Insurancecaredirect. This website will give you more information on all types of healthcare options that will be of use to you.

If You Need Health Insurance, Get Quotes Online

2009-11-17T09:35:00.000-08:00

The Web serves as the best source to collect various health insurance quotes. All you need is an Internet-enabled computer to gather every bit of potential data relating to your coverage inquiries, such as a free health insurance quotes. A multitude of carriers can be found on the Internet advertising their various policies, plans, etc.

The medical insurance arena can be a highly aggressive industry. Insurance businesses utilize a bunch of promotional techniques, such as offering attractive discounts for the customers on certain policies. Be careful not to fall into any trap by choosing medical insurance plans based on misleading promotions. Make sure the medical insurance plan provides solutions you can actually take advantage of. Be sure to gather a lot of diverse instant health insurance from reputable companies.

What is the fastest way to getting insurance rate estimates on the Internet? A simple response to this query lies in logging on to the Net, accessing a search engine, and then entering in words like low-cost, cheap, or reasonably priced, followed with medical insurance plans. When the search is done properly, you should get a bunch of various sites for insurance carriers that you can visit.

Whilst you are visiting these sites that are owned by these health care providers, you will need to fill out forms so that you may obtain these health insurance quotes online. Roughly all companies require you to give some elementary information about yourself. They may also request information about your family members, particularly if you are seeking complete family coverage.

The type of plan you are seeking also must be indicated. When you provide this information, the insurance provider will most likely respond right away with their quotes for the health care coverages. You will find this technique to be super effective.

This procedure for getting Internet insurance quotes may be repeated in order to obtain additional rates that are essential for comparison. After collecting rates from a bunch of Internet insurance companies, it is important to compare them and make your ultimate decision by opting for a cost effective plan that meets your coverage requirements.

Free Health Insurance Quotes: How To Save Money on Health Insurance

2009-11-17T09:34:00.000-08:00

Among the fastest growing service sectors of the insurance industry is commercial health insurance. The companies offering this sort of protection from the different kinds of health hazards are sprouting like mushrooms almost everywhere. And every year these health insurance companies are making huge revenues amounting to billions of dollars on each and every scheme they make. And every time they do not fail to introduce new package plans or make several modifications in their current scheme and launch them as new ones.

Based on fact, although the governments have some sponsored type of health insurance programs which covers comprehensive medical expense, it is not provided to everyone. But because people today enjoy better health and have better medical care than ever before, a large section of society still depends on commercial health insurance plans. This is in a way would protect and support themselves as well as their family members by means of these health insurance plans from high and unexpected medical expenses.

Apparently, private health insurance companies provide lots of schemes or package plans to choose from. This range includes lost-cost paying premiums to costly paying plans which vary from the different needs and types of people. And these companies not only provide schemes for individuals but to animals as well such as pet health insurance which is highly in demand with pet owners. Thus, these private companies are reaping undue profits out of people's hard earned money with their well maneuvered packaged insurance plans. It is the continuous persistent demand of society for their insurances that has resulted in their success.

Private insurance providers are increasing day by day, but the competition among these organizations had them benefited in terms of introducing new improved insurance schemes or package plans at better selling prices. Every insurance agency promotes their schemes by boasting about their special features. Nevertheless, they refrain from mentioning the downside of their schemes which helps them escape their claims of liability.

It is the job of every insurance agent to put on the market; may it be on the web that they could pose for suggestion of free insurance quotes, their scheme to be a possible sell out to a customer by wrapping up the entire package with impressive features and hiding the limitations by putting them in hardcore professional jargon and codes. When the customer seeks recovery of their expenses, the legal experts working for such organizations fish out terms, conditions, restrictions, or any clause that might help them dodge over their liability.

This is the usual profit making procedure followed by most of the commercial health insurance companies, and they even conquered the internet world for free insurance quotes. However, if the customer takes the extra effort to compare and study various health insurance plans, one just may get online for several online-based insurance companies offer free insurance quotes, or takes the help of an insurance adviser, he can surely get through these bureaucratic loopholes and apparently end up owning with the best health insurance package plan there is.

Cheap Long Term Disability Insurance Quote

2009-11-17T09:33:00.000-08:00

The goal of insurance companies is to provide you with the long term disability insurance quote easily.

You can shop for disability insurance quotes online which makes it easier for you. All you have to do is follow the procedures. These are.

1. Request a long term disability insurance quote from the official site. You will then receive an email with the link of the quote that the insurance company recommends for you.

2. You can view this and check whether this long term disability insurance quote is appropriate for your lifestyle and your budget. You can also look into other insurance companies and see if they offer the same plan for a lower cost on your end.

3. If you´ve finally made your decision on which long term disability insurance quote to go for, you can fill in the application form which is also available online. If you need more convincing, there are professional insurance agents that can assist you with your concern.

You can talk to them by contacting the numbers that is posted on the site.

When you sign up for a long term disability insurance quote, you naturally have expectations. You need to be updated on the processing of your benefits.

Sometimes this can last several weeks. However if you shopped for your long term disability insurance quote online, you will be constantly updated on what is going on with the processing of your benefits.

Also, the staff of the insurance company that is providing you with your long term disability insurance quote can be relied on for 24 hours a day and 7 days a week just in case you have questions on what you can gain (and lose) in this policy that you signed up for.

But you have to remember that insurance companies are competing against each other in providing long term disability insurance quote to those who need it.

The information that you provide them can determine the rate of the disability insurance that they will provide you. Normally disability insurance cost is 1 to 3 percent of what you earn in a year. This can also be determined by your choice of policy.

If you choose for long term disability insurance, this will take you a longer time to pay off what you are borrowing. If you choose to get it done fast, you can opt for the short term disability insurance.

Before you sign up for anything, make sure that you understand the policies and the terms of the plan you choose.

You can also calculate and see whether you are getting your money´s worth for this insurance.

What Factors Can Influence My Health Insurance Quote?

2009-11-17T09:31:00.000-08:00

When you talk about the different factors that are considered by the insurance provider in order to generate a quote, there is actually a lot to consider. As one can infer, it is quite impossible to try and be good at all of these factors, since many of them are beyond our control. However, if we consider the factors that are within our control, then it is possible to lower the health insurance quote. By just being better and smarter with our health, it is possible to enjoy a lower quote as well as enjoying good coverage that can be used when needed.

Amongst the factors that cannot be changed which the insurance companies consider are things like age, hereditary conditions and family history. An older person will invariably receive a higher health insurance quote when compared to a young individual. Similarly, if your family history was marked by a number of diseases, you will end up paying quite a bit and possibly have to be okay with the fact that you have to pay a higher premium than someone else in your age group. Also, hereditary diseases are something beyond your control and could possibly affect the outcome of the health insurance quote.

The factors that you can change include behavioral aspects like smoking, drinking and even how many times you typically visit a physician over a certain period of time. These are things that you can control and potentially have a say in. If possible, you could perhaps consider the option of improving yourself and abstaining from these vices. In addition to enjoying a lower health insurance quote, you might even live longer and could possibly get lowered premiums even if you do get older. Other advantages include being able to do more things and have more options when it comes to customizing your health insurance coverage.

These are the broad aspects that insurance companies would consider for your health insurance quote. There are obviously many more out there that you need to be aware of. If you do consider all of them, it can get quite perplexing. But, as much as possible, try to practice healthy habits and follow a healthy diet.

If you take care of yourself, you will automatically be rewarded lower health insurance quotes. If money is not a driving factor, then think about longevity. All of us instinctively want to live longer, and the best way to be sure of that is by leading a healthy life.

Health Insurance Tips

2009-11-17T09:11:00.000-08:00

Health insurance is one of the most important aspects of life, and far too many people live without it. But the risk of going without insurance can be too great, as many experts attribute the rise in bankruptcies directly to healthcare costs. If you are searching for health insurance quotes, be sure to consider each of these tips:

Research and compare insurance providers

There are some online resources you can use to compare insurance carriers and find out about their track records. Your individual state's laws will have some bearing on consumer ratings and overall company ratings. Look over the data you find, which can help you further understand the insurance quotes you'll receive.

Know the laws in your state

The extent to which you can buy personal health insurance, and how much it will cost you, depends on the laws of your state. Some states have regulations related to medical underwriting, which means that an insurance company could reject you because of a pre-existing condition or a past illness. Or, those issues could result in your approval for insurance, but with much higher premiums. Be prepared for these possibilities first by looking into your state's laws.

Decide what coverage options you need

Health insurance is more complicated than you might think. Depending on your needs, you might require more coverage than someone else. Your health status, comfort with risk and budget will all be factors in deciding how much coverage you need.

Some health insurance policies cover only "necessary" coverage - which can be defined in a variety of ways. Some might limit your coverage to emergency visits, or simply office visits, and could exclude "extra" services such as laboratory services, x-rays, MRIs, CT scans, and visits to specialists. Be sure you understand the limitations and extents of the insurance quotes you receive, and compare those to the coverage you wish to receive.

Know your deductibles before filing a claim

One of the fastest ways to have insurance premiums rise is to file lots of claims - sounds counter-intuitive, right:? Unfortunately, this is the case throughout the insurance industry. The more claims you file, the bigger the insurance risk you're considered. That's why it's important for you to carefully consider whether it's worth filing an insurance claim for a variety of office visits.

For example, if you go to the chiropractor, it might not be to your benefit to file a claim. Here's why: If your insurance copay is $25, but the chiropractor only charges $30 for an office visit, it might be better for you in the long run to forego the claim and just spend the money out of pocket. Of course, it's up to you to determine when it's best to file a claim and use your insurance benefits.

Understand your benefits

Too often we think of insurance costs as just related to the premium. But it's much more than that - particularly with health insurance. You should look at not only the premium, but also the deductible and the copay/office visit costs for the days you visit your doctors. You also should review prescription costs as well as whether services such as laboratory work, vaccinations and x-rays are covered in your policy.

Get a Medical Exam

It's important to get a medical exam before you purchase your health or life insurance policy so you know what your insurance company will charge you for premiums. If you are seen as more of a risk, you will be charged higher premiums. For example, people with high cholestorol, heart disease, depression, chronic headaches and all other risks will not be eligible for the best insurance rates. By getting a medical exam you may be able to change your lifestyle to improve your health and get better rates. If you are a smoker or heavy drinker, you might consider cutting back on your habit.

Compare quotes

After you've received quotes from different health insurance providers, it's time to carefully look over them and compare the coverage. Look at both the premiums and the deductibles, and decide which quote offers you the best options. You might want to look at your existing healthcare bills, and incorporate those realities into each quote you receive - that way, you can compare dollar-for-dollar how much your costs will go up (or go down) with insurance.

Understanding Your Health Insurance Policy

2009-11-17T09:10:00.000-08:00

A health insurance policy can run the gamut in terms of what it does and does not cover. On one end of the coverage spectrum, there are policies that cover only catastrophic medical events. On the other end, there are policies that cover emergencies as well as routine and preventive care. All but the most basic of policies tend to cover hospital stays and doctor visits, but they vary in the portion of the expenses they cover. Most policies also offer some coverage for prescription meds, although this coverage is one of the more expensive health insurance policy options. You can find basic policy information below, or you can review common health insurance terms to familiarize yourself with insurance options.

Extent of Coverage

A standard healthcare policy will usually pay for sick care and emergencies. Depending on the type of health insurance policy you have, your medical expenses may only be covered if you visit in-network providers and facilities. For example, with an HMO plan, you are restricted to the doctors and hospitals that participate in the plan. Medical insurance policies also vary in their coverage of preventive care. The average policy will not pay for preventive care, although many HMO plans will. Finally, a basic medical insurance policy will not cover prescription medications unless you have prescription benefits included in your plan. If included, this coverage is usually subject to deductibles and co-pays, just as with doctor visits.
How Much Coverage to Buy

Consumers have an endless array of health insurance policy options from which to choose, and selecting the appropriate amount of coverage will depend on how you intend to use the policy and your comfort level with risk. If you want a bare-bones policy that will protect you from financial disaster in the event of a medical emergency, you can purchase catastrophic-only health insurance. This kind of policy will pay for major medical disasters but will not pay for day-to-day medical expenses. On the other hand, if you need to use your health insurance policy often and/or require expensive prescription medications, a more comprehensive POS, PPO, or HMO plan may be a better choice.
Types of Health Insurance Policies

A health insurance policy typically comes in four forms: an indemnity, HMO, POS, or PPO plan. These plans differ primarily in their coverage of preventive care, their use of in-network providers, and the policyholder's degree of financial responsibility. With indemnity plans, policyholders can choose any doctor or hospital and receive the same rate of reimbursement. For HMO, PPO, and POS plans, on the other hand, rates of reimbursement will be higher if policyholders use in-network providers. PPO and indemnity plans tend to allow the most flexibility, but they are also among the most expensive types of health insurance policy options.

Health Insurance Discounts

2009-11-17T09:08:00.000-08:00

Health insurance is one of the most important expenses you can have. Whether you contribute to a policy that your employer provides, or pay for your family's entire coverage out of pocket, ensuring that you and your loved ones are protected is a top priority. With an estimated 35 million Americans living without health insurance, it seems that more and more people are unable to afford the coverage they need.

Fortunately, there are some strategies you can use to find health insurance discounts, or competitive health insurance rates for you and your family. While you initially might balk at the concept of discount health insurance, remember that quality care exists with both affordable plans and luxury health insurance plans. You can follow these tips as you begin the process of looking for health insurance rates.

Not Having Insurance Can be Costly

Sure, you might think that going without coverage will save you money. But if you get sick, the consequences could be disastrous. The overwhelming majority of bankruptcies are directly tied to health care expenses. If you are in a car accident, or slip and fall, that brief moment could have a long-lasting impact on your overall health as well as your financial health. Don't ignore your need to get discount health insurance. Instead, make it your mission to find quality coverage.
Compare Rates & Companies

It's not like health insurance is the same in every state or town in America. Quite the opposite. No two plans are identical, even from the same insurance company. That's why it's so important for you to be an educated and assertive consumer. Use services like OnlineQuotes.com to help you get insurance quotes from trusted and reliable insurers. Review your quotes and look at the extent of the coverage. Take the time to closely examine the type of plan suggested for you and compare it to the competition.
Consider More than the Premium

Remember that the plan with the lowest premium is not necessarily the cheapest one. Sometimes it can be the absolute opposite. Look at the premium as well as the deductible. Your deductible is directly tied to how much out-of-pocket costs you'll have in the event that you need to go to the doctor. Also look at costs for copays or per-office visits. These are the amounts that can add up. Review costs for prescriptions and services such as x-rays or laboratory analysis.

Health Insurance Reform May Hurt Small Businesses

2009-11-17T08:58:00.000-08:00

Several organizations representing the business community have bemoaned the potential negative impacts health insurance reform could have on them. On the one hand, this isn't surprising. Chambers of commerce generally espouse laissiez-faire economic viewpoints that protect their best interests. On the other hand, small businesses in particular have been hit especially hard by soaring healthcare costs. In that regard, Congress removing some of the burden of providing health insurance plans to their employees seems appealing. However, the healthcare reform bill passed by the House of Representatives is not to their liking.

Private industry organizations have several concerns about the Democratic healthcare reform proposals. Most importantly, they believe that their bill does not fix the underlying issue: a lack of affordable health insurance. According to spokespersons, while companies would ideally provide an employer-sponsored health insurance plan, it simply costs too much. Both the House and Senate bills allow small businesses to enter a newly established health insurance exchange market, which would allow individuals and groups to form a larger pool--resulting in cheaper health insurance. Still, some chambers of commerce fear that the government's definition of a small business is arbitrary and too strict. Mid-size firms that are over the employee or payroll limit, yet not multi-million dollar international corporations with huge workforces that allow them to buy health insurance plans in bulk, could be left out in the cold.

Chambers of commerce also claim that a public option will not lead to lower health insurance premiums. Instead of increasing competition among private insurers and driving down health insurance rates as congressional Democrats claim, it could instead result in shifting more cost to employers' health insurance plans. Opponents' logic is that in order to save money, the government will under-reimburse doctors, hospitals, and other medical providers under the public option; healthcare providers' experiences with Medicare and Medicaid reimbursements are a case in point. In order to make up the lost revenue, providers will then demand higher reimbursements from private health insurance plans. They warn that some health insurance companies will drop out of the market as a result, decreasing competition and defeating the stated purpose of the government's public option.

In addition, many chambers of commerce have a philosophical objection to government interference in free markets. Businesses are worried about the employer mandate included in both healthcare reform bills, which requires businesses to either offer a health insurance plan to their employees or financially penalize them for not doing so. This is a break from what opponents claim is the historical purpose of employer-provided health insurance: a competitive advantage that allows businesses to attract the best workforce through its inclusion in compensation packages. The Senate will not force non-compliant employers to pay a fine; rather, they will have to pay a fee or tax to the federal government in order to assist the latter in subsidizing their employees' health insurance. This contrasts with the House bill, which slaps businesses with fines of up to eight percent of their payroll if they fail to provide quality health insurance and said payroll is over $500,000 annually. The different wording is largely semantics, though; either way, businesses must offer health insurance plans or pay for not doing so.

Business organizations in the United States have legitimate qualms with the current healthcare reform bill. It has the potential to force employers into providing group health insurance plans, while making it more difficult for them to do so. It serves to lessen the motivation of many businesses to offer health insurance entirely, and neglects the issues (such as medical malpractice torts) that have assisted in making health insurance so expensive in this country - causing fewer employers to offer less health insurance, and leaving more Americans uninsured like they are now. New taxes, penalties, and other costs could cut into their revenue, putting many small businesses on the brink of failure. Chambers of commerce tend to support the idea of healthcare reform in principle; clearly, the current system isn't working well for anyone. Despite that, they feel that the devil they know is better than the one they don't.

Health Insurance Rules

2009-11-17T08:57:00.000-08:00

Many dual income couples, include their children on each group health insurance plan to maximize benfits. However, without some sort of system in place to help the health insurance companies coordinate benefits, it’s possible that either you or your doctor would be reimbursed for more than 100 percent of the actual cost of your claim.

To prevent this, health insurance companies typically designate one parent’s health insurance plan as the primary plan and the other as the secondary plan. (That’s why the patient questionnaire at your doctor’s office asks for information on primary and secondary coverage.) The primary plan is responsible for paying covered expenses up to the limits of the policy. If any unpaid costs are left over, the secondary coverage kicks in.

THE DATE OF BIRTH DETERMINES WHICH HEALTH INSURANCE PROVIDES COVERAGE

The birthday rule is often used to determine which plan is primary and which is secondary. Under this rule, the plan of the parent whose birthday occurs first in the calendar year is designated as primary. The date of birth is the determining factor not the year so it doesn’t matter which spouse is older.

Like most rules, the birthday rule has exceptions:

- If both parents share the same birthday, the parent who has been covered by his or her plan longest provides the primary coverage for the children.

- If one spouse is currently employed and has health insurance through a current employer, and the other spouse has coverage through a former employer, the plan belonging to the curently employed spouse would be primary.

- In the event of divorce or seperation, the plan of the parent with custody generally provides primary coverage. If the custodial parent remarries, the new new spouse’s coverage becomes secondary. And finally, the non custodial parent’s health insurance plan would provide a third layer of insurance protection. This order of payment can be altered by a court issued divorce decree or by agreement, but the health insurance companies must be notified.

THESE ARE JUST HEALTH INSURANCE RULES NOT THE LAW

Keep in mind that these practices are common among health insurance companies, but they are not governed by law. Practices may vary from one insurer to another. Read your policy carefully to make sure you understand how your insurance company handles dual coverage. If the policy coverage is unclear, ask for help from your employers benefit specialist or your insurer’s customer service department.

Health Care Reform Magic

2009-11-17T08:55:00.000-08:00

Health insurance reform is about give and take. If you waddle through the maze and countless pages in all the various bills before Congress you really have to wonder what is going to come out on the other end if and when this massive spending bill is finalized.

I have wondered about all the new taxes to pay for health insurance (supposedly for the uninsured) but something I read this morning crystalized the games they are playing in Washington with our money. The AP reported this on the tax credits that everyone got as part of our share of stimulus.

The tax credit, which is supposed to pay individuals up to $400 and couples up to $800, was President Barack Obama's signature tax break in the massive stimulus package enacted in February.

Most workers started receiving the credit through small increases in their paychecks in April. The tax credit was made available through new withholding tables issued by the Internal Revenue Service.

The withholding tables, however do not take into account taxpayers with multiple jobs or married couples in which both people work. They also don't take into account Social Security recipients with jobs that provided taxable income.

The Social Security Administration sent out $250 payments to more than 50 million retirees in the spring as part of the economic stimulus package. The payments were meant to provide a boost for people who didn't' qualify for the tax credit.

However, they went to many retirees who also received the credit. Those retirees will have the $250 payment deducted from their tax credit — but not until they file their tax returns next year, long after the money may have been spent.

That's a bit of a rude awakening.

President Obama called and he wants his money back.

Congress is doing the same thing with health insurance reform under the guise of taxing the rich to pay for health insurance for the poor.

That finding from a new Associated Press poll will be welcome news for House Democrats, who proposed doing just that in their sweeping remake of the U.S. medical system, which passed earlier this month and would extend coverage to millions of uninsured Americans.

The poll found participants sour on other ways of paying for the health overhaul that is being considered in Congress, including taxing insurers on high-value coverage packages derided by President Barack Obama and Democrats as "Cadillac plans."

That approach is being weighed in the Senate. It is one of the few proposals in any congressional legislation that analysts say would help reduce the nation's health expenditures, but it has come under fire from organized labor and has little support in the House.

Lawmakers also are looking at levying new taxes on insurance companies, drug companies and medical device makers.

Think about this for a moment.

They want to assess health insurance companies, drug companies and medical device makers to pay for health insurance for the poor. But what happens when the tax is imposed?

Drug companies will pass the tax on to consumers who will pay more for medication. Prescriptions covered by health insurance will be more expensive which will result in higher premiums.

Medical devices like pacemakers and wheelchairs will become more expensive which will result in higher costs to the consumer and health insurance company. This mean higher premiums.

Of course let's not forget that drugs, pacemakers and wheelchairs are also covered by Medicare and Medicaid, so those costs will increase as well.

And that tax on health insurance companies? It will be passed through as well to those who pay the premium.

As health insurance premiums rise, to cover the cost of new taxes, higher prices for medication, pacemakers and wheelchairs those plans are in danger of becoming a "Cadillac" plan . . . which will be taxed.

These changes don't even take into account the required 30%+ increase in premiums caused by health insurance reform that mandates more expansive (and expensive) coverage for wellness and mental health parity as well as the "no restrictions on pre-existing conditions" requirement.

So just like the government is giving us a break by lowering our withholding taxes and tossing a bone to Social Security beneficiaries, then taking it back next April, they are doing the same thing with health insurance reform.

Giving us more benefits (no pre-existing, low copays, wellness, mental health parity) which increase premiums so we will have to pay more tax. Actually, it is a double tax.

We pay the tax the first time when we consume goods like medication and medical devices, and then we pay again because we were forced to buy an expensive "Cadillac" plan.

This is a dog only a politician could love.

Change you can believe in. Yes you can.

Should I Consider Buying Low Cost Health Insurance?

2009-11-17T08:53:00.001-08:00

Should I Consider Buying Low Cost Health Insurance?

17 Nov

Posted by J.D Theis as Insurance

If you are in the market shopping for insurance, then you should consider all the options that you have. It is likely that you would buy something looking at the value aspect of the deal. After all, you wouldn’t want to unnecessarily spend more money on something when you could have gotten it for lesser. In this way, it makes sense to go in for low cost health insurance. But, there are two aspects to this as well, and you should consider the repercussions of going in for this kind of coverage and whether it makes sense over the other options that you might have.

The first thing about low cost health insurance is that you will not always get what you want on your claims. Hence, if you are planning to make a lot of claims, then this is not the kind of insurance that you would want to go in for. After all, the company cannot provide you low cost insurance and also provide you with all the claims. Hence, you need to be sure that you can manage by paying more out of your own pocket if it comes down to it.

However, you do save a lot of money with low cost health insurance. If you are reasonably healthy and don’t go to the physician too often, then you could potentially save a lot of money by not paying too much on your premium. Furthermore, the insurance company will also reduce your premiums if you don’t make too many claims, which should definitely be something that you would like. After all, saving money is one of the main reasons why people go in for low cost health insurance. Companies realize this and reward their customers if they don’t make too many claims while on the insurance package.

You can even customize your insurance to cover only things that you would rather want coverage for. After all, not all of us would want the kind of coverage that the insurance company thinks we ought to have.

If there are some features that you would rather do without, then it makes sense to drop them and instead opt for coverage that has the kind of features that you can use. Although this might not necessarily result in low cost health insurance, it can still help in keeping the costs somewhat down while at the same time not affecting the usefulness of your insurance policy.

In order to get further clarification on affordable health insurance and understand its benefits better, log in to Insurancecaredirect. This website will give you more information on all types of healthcare options that will be of use to you.

Why Get Travel Health Insurance?

2009-11-17T08:53:00.000-08:00

We’ve all heard the phrase, "Don’t drink the water in Mexico". Well, it’s not just Mexico. There are many places all over the world with not-so-clean public water supplies. One careless move can expose you to a world of micro-organisms your body has never seen. A nasty stomach virus can easily land an unsuspecting traveler in the hospital for a few days, just enough to ruin your trip and make you miss the flight home.

But don’t stay home just because of a few microscopic bugs. Just take some travel health insurance with you so that if you do get unlucky, the pain won’t reach your wallet. So far we have only considered the invisible dangers that could find you. What about the millions of people who travel to foreign lands for ski trips and outdoor activities? In these cases it is practically a must. In fact, many foreign tour operators require travelers to carry some form of extra insurance for medical and travel accidents. It’s not that there is danger around every corner; it’s just the extreme cost of medical care and evacuation transport if something happens. These are things we take for granted at home. It is wise to not take these things for granted when you are away from home.

More than Just Health Insurance Even if your personal health insurance plan covers you on foreign soil, you are still likely to face expensive trip cancellation and rescheduling fees. This is one more reason to purchase affordable travel insurance. Get sick or break an ankle and miss your flight? No problem. Call your travel insurance provider and they will even reschedule your trip for you as part of their plan. What about the very unlikely case of a severe medical emergency? If you are older and have a history of medical conditions, you never know when something might happen and you need to get back home, stat.

International medical evacuations can cost upwards of $50,000. If all of these doomsday scenarios have scared you off or made you rethink your travel plans, think again. The whole point of this article is to show you that, with travel health insurance, you can feel free to go anywhere and do whatever you want and do it with confidence, because travel insurance takes the fear out of traveling. Enjoy!

How Does Cash Value Life Insurance Work and Do I Need It?

2009-11-17T08:52:00.000-08:00

Cash value life insurance is permanent coverage so your premium remains level for the rest of your life and your coverage cannot be canceled, as long as you pay your premiums. It is also known for its cash value. While the term “cash value” sounds great, many people aren’t exactly sure how it works and how it can benefit them. This article will go over the basics of cash value life insurance and detail how it works and how it can grow over time.

Cash value insurance has a higher premium than term life insurance because you pay higher premiums in the earlier years. Depending on your age and situation, the premium can be as much as ten to fifteen times higher. Your premium will consist of the amount needed to insure you as well as an overpayment. This extra premium is set aside by the carrier and invested in various ways. It can be invested in vehicles such as stocks, bonds, mutual funds, or other areas, and most carriers will promise a guaranteed minimum return. Over time, this account grows and you can have a nice sum of money in your policy.

The cash value in your policy can be accessed in a couple of ways.The first way is by borrowing the cash value against your policy. You will be charged interest on the amount that you borrow. The borrowed amount plus interest would be subtracted from the death benefit if you do not pay it back. You may also get the cash value if you choose to surrender your policy. This usually has some type of tax consequences as well.

There are three major types of life insurance that grows cash value:

Whole Life Insurance: This is the basic permanent life insurance. The premium is level for life and there is a minimum guaranteed return on the cash value. You may also receive dividends, depending on which carrier you choose, and if they perform well.

Universal Life Insurance: This permanent coverage has more flexibility than other types because your premium is not fixed. You can pay more towards your policy if you want or you can skip some payments. The consequence is that your policy might lapse if enough premiums aren’t received or if your cash value account doesn’t grow.

Variable Life: This type of policy has more risk because you have the option of investing your premium payments. If your investments grow, then the cash value in your policy will also grown. On the other end, if your investment choices are poor, then your policy can lapse.

If you are considering a cash value life insurance policy, then it is a good idea to speak with an agent about your situation first to help you decide if its the right type of coverage for your family. Most people can obtain adequate coverage with a term life policy, but there are also many ways that a cash value policy can fill in some gaps.

It is best to compare multiple life insurance quotes to determine which type is most affordable for you. There is coverage available for children all the way up to age 85 life insurance.

Health insurance for individuals does need fixing

2009-11-17T08:50:00.000-08:00

By Opinion, Northeast Mississippi Daily Journal, Tupelo, Miss.

Nov. 15–As the debate about whether and how to change the U.S. health care system rages on, I seem to see more and more advertising of individual health insurance plans.

To need individual health insurance has always seemed a scary place to be.

The reasons? First, individual health insurance generally provides a very narrow range of coverages. Second, people pay significantly more for individual coverage than an employer pays to cover an individual in a group. And perhaps most important, exclusions for pre-existing conditions can defeat the purpose of buying health insurance at all.

Many young, healthy people who could afford to buy health insurance choose not to do so. Nevertheless, if they suffer hospitalization as the result of a serious traffic accident or a sudden illness requiring hospitalization, the extremely high cost of a hospital stay is unlikely to make them rethink that decision.

For those who realize the risk of not being covered, paying premiums — even high individual insurance policy rates — might still be a savings over large medical bills or ongoing treatments for lengthy illnesses.

In a segment on Mississippi Public Radio last week, Mississippi Insurance Commissioner Mike Chaney reminded listeners that insurance is a business, with a keen eye on its bottom line and a need to make profits for its shareholders.

More significantly, it is a financial business.

Insurers use underwriting — a term that applies to financial products — and actuarial data to determine what financial risk they might incur with their policyholders.

As Chaney said, that doesn’t make them bad.

It makes it necessary, however, for consumers to examine carefully what they’re buying in the health insurance product and whether they’re getting value for the money.

According to a 2008 study by the National Women’s Law Center, women are most likely to be on the losing end when buying individual health insurance.

While there are a number of state and federal laws that govern employer-based health insurance, protecting women from gender discrimination, insurance regulation at the state level that would govern individual health insurance policies is hardly regulated at all.

Women are the primary consumers of health care services, said the Kaiser Family Foundation. Not only do women use more services for reproductive issues, breast health and maternity care, women most often are in charge of managing health care for their children and sometimes their spouses and parents.

The need for more health care services works against women seeking individual policies. By law, in most states insurance companies can charge a woman a much higher premium rate than a man of the same age. And not just a little bit more. The same National Women’s Law Center study noted that “one insurer in Missouri charges 40-year-old women a whopping 140 percent more than men.”

Not everyone can buy individual health insurance, because in most states companies have the option of denying coverage for any number of reasons, such as any history of medical problems. In Mississippi, women can be denied coverage if they have been victims of domestic violence.

The kicker for women of childbearing years is that individual policies generally do not include maternity coverage. The National Women’s Law Center examined 3,500 individual health insurance policies across the country and found 12 percent that offer comprehensive coverage of maternity, 9 percent that offer limited coverage of maternity and the rest exclude maternity coverage completely.

With some of the proposed health insurance reform plans small businesses have said they will simply give a set amount of money to the individual to go out and purchase their own health insurance.

Individual health insurance as it exists now is flawed, leaving women with much greater financial exposure, even if they are able to purchase coverage.

Whatever the outcome of the national debate, in Mississippi we need to press our Legislature for more equitable access and pricing in the individual health insurance marketplace.

How Can I Get Low Cost Health Insurance?

2009-11-17T08:48:00.000-08:00

Low cost health insurance is no longer a myth. And with the health insurance regulation bill being passed, it is going to be all the easier to get affordable health insurance. So how can you ensure that you do not end up spending a lot on health insurance? Well, you first have to make up your mind as to what your needs are. Only then can you approach a health insurance company and negotiate a deal.

The first thing you need to know is whether you are going for a family health insurance package or an individual health insurance package. Family package will cost you much cheaper on a per person basis than an individual plan. Hence if you know that a single person is going to pay for the entire family, it is better to go for the family package rather than an individual plan for every member.

You also need to know what sort of services or benefits you require from your health insurance package. It will cost you a lot lesser if you are willing to drive down to a centralized medical unit which is affiliated to your health insurance company, rather than go to the neighborhood clinic. This is a matter of convenience, because during emergencies any and every insurance coverage allows you to take the case to the nearest doctor. It’s only the regular checkups that are a problem. But it’s fine if you own a car and are willing to drive down to the place.

You also need to know what sort of services or benefits you require from your health insurance package. It will cost you a lot lesser if you are willing to drive down to a centralized medical unit which is affiliated to your health insurance company, rather than go to the neighborhood clinic. This is a matter of convenience, because during emergencies any and every insurance coverage allows you to take the case to the nearest doctor. It’s only the regular checkups that are a problem. But it’s fine if you own a car and are willing to drive down to the place.

And also you have to decide what sort of hospitals you want to go to. Would you like the deluxe rooms or would the standard dormitories be fine with you? There are a few insurance agencies which provide VIP coverage which will make you eligible to stay in deluxe private recovery rooms which will beat a five star hotel suite in luxury. And this will obviously cost a bomb. And this is usually provided for mothers and infants post birth.

You also need to add ophthalmologist and dentist costs if you are going to be frequenting any of the two. You can do this only if you have an eye or teeth problem which needs regular checkups. Else it’s fine to do it with your own money every now and then when you need it. So decide what your needs are and then go out and get the most affordable insurance coverage that you can get for the money.

If you are having trouble choosing the right type of medical insurance, then, log on to Insurancecaredirect. Here you will find information on all aspects of health insurance including low cost health insurance options.

Liberals and their Church of Health Insurance

2009-11-17T08:47:00.000-08:00

The Associated Press:

WASHINGTON — First lady Michelle Obama sought to assure older women on Friday that efforts to overhaul health care won’t undercut the benefits they receive through Medicare, saying her husband considers the government-run program a “sacred part of America’s social safety net.”

House Speaker Nancy Pelosi:

“As President Obama has said: ‘Health insurance reform is entitlement reform.’ We must reverse the upward spiral of increasing cost, which again, adds an additional priority to our budget and to future generations. We have a moral responsibility to stop that and to reverse that.

“We also have a moral responsibility to pass health insurance reform and we will do so this year. It is a moral imperative, a health issue, it is an economic issue. I believe that we can do so best by increasing competition, and by increasing competition we will again, improve quality, lower costs, expand coverage, and maintain choice. I believe that a public option is the best way to do that.”

Then there is this:

After his bill died, David S. Broder and Haynes Johnson recalled in their book The System: The American Way of Politics at the Breaking Point, Senator Jay Rockefeller said, “‘There’s a special place in hell waiting for Bob Winters.’” Robert C. Winters was chairman of Prudential Insurance. At one and the same time he was head of the Roundtable’s health-care policy task force.

Wait a second, health insurance is “sacred”? We have a “moral responsibility” to pass a health insurance plan? Suddenly, Jay Rockefeller has the floor plans to hell?

These people are goofy. They have confused morality with public policy. They are bringing God into a secular debate. The liberals indulge in the very behavior that liberals mock among evangelical Christians. The sad truth is the liberals want this to cover abortion. I’m pretty sure God is not pleased with that.

Republicans Pay for Abortions

2009-11-17T08:45:00.000-08:00

Did you know the Republican National Committee offered its employees health insurance that covered abortions? Neither did the Republican National Committee. Their health policy had covered abortions since 1991... until last Friday, when Chairman Michael Steele realized the GOP needed a Stupak Amendment of its own. The RNC is thus opting out of coverage for a legal, Constitutionally protected medical procedure (or, as the RNC calls it, "a fundamental assault on innocent human life").

No word on whether the RNC plans to keep coverage for abortion in cases of health risk to the mother— the National Republican Congressional Committee insurance policy makes such exceptions—or in cases of rape or incest.

Apparently private insurance is so complicated that 18 years can pass before political experts realize that their health policy includes procedures that they find morally repugnant. I don't hold that against them: I take it as more evidence that the private health insurance is too arcane to operate according free-market rules.

And think about this: the Stupak Amendment seeks to keep abortion opponents from suffering the moral indignity of seeing their tax dollars pay for abortions... but if you pay health insurance premiums, your dollars are paying for abortions. Do you think your insurer puts your money in a separate pot so it only covers people and procedures you like? Think again.

The Republicans can grandstand dropping abortion coverage for their employees from their insurance policy, but as long as they keep buying insurance from Cigna, their money, good Republican money, will continue paying for abortions.

A Health-Insurance Criminal Pleads His Case

2009-11-17T08:44:00.000-08:00

If mandatory health insurance goes through, it will turn me into a criminal. I don’t have health insurance. I don’t want it. And I will refuse to buy it even though I can afford it. Before they lead me to the cells, perhaps the prisoner may be allowed to say a few words in his defense.

It’s understandable that politicians are eager to eliminate the medically uninsured. For years they’ve been told that we are the flies in the ointment of health care policy. It is said we are either a) wrecking the system by using services we don’t pay for, or b) we are deprived of needed medical care and therefore objects of pity and subsidy.

These points may apply to some uninsured but not to all. Some of us belong in what might be called the “successfully uninsured” category. We are not freeloaders. We believe we have an obligation to pay for the medical care we receive, and we always pay for it. I put no financial burden on doctors, hospitals, or taxpayers, and politicians are wrong to assume I am part of the country’s health care problem.

Politicians are also wrong to assume that I am an object of pity. Like many Americans, I have significant savings and can afford medical expenses out of pocket. (Census Bureau figures for 2000 show that over 18 million households had assets in excess of $250,000). Our savings make it possible for my wife and me to decline both private insurance and Medicare (we are 70). Those without savings are in a different situation: They probably need insurance, or a subsidy, or charitable help. My point is that if you can handle your own medical bills through savings and personal responsibility, this is a sound approach. Politicians should encourage this state of self-reliance, not make it a crime.

There are many advantages to being insurance-free. The first is flexibility. Several years ago, my wife had a serious bout with cancer. The successful treatment involved surgery and local radiation therapy. After much study she refused the more massive radiation treatment recommended by the doctor and pursued alternative therapies, including acupuncture, nutritional therapy, massage, and naturopathic medicine. Every decision was made in terms of what seemed best to treat this illness. We were not drawn into using inappropriate therapies because they were “free,” nor did we pass up desirable therapies because they were “not covered.”

The second advantage of being insurance-free is we avoid bureaucracy. We don’t fill out insurance forms; we don’t make phone calls trying to find out what’s covered; and we don’t play games (with the collusion of doctors) trying to get things we need paid for by someone else. If an aching back suggests the need for a different mattress, we go out and buy one and don’t waste time and money trying to prove to some clerk that it’s covered. When the government offered a new piñata of benefits in the form of prescription drug coverage, we entirely escaped the frustration of figuring out how to deal with its staggering confusion. While other seniors were closeted with lawyers and sons-in-law trying to decide what to sign up for, we went hiking.
How Much Health Care is Enough?

Refusing health insurance may have advantages, but what will happen if I face a medical problem that requires more than my savings? To understand my answer, consider a parallel question about some other commodity, say, housing. I announce that I believe in paying for housing from my own financial resources. Someone points out there might be a house I want that costs more than I can afford. That’s just too bad: I don’t get to buy it. I limit my housing consumption according to my resources.

I look at medical care the same way: If something costs too much, I do without. This position, so obvious and sensible in other areas, is considered untenable when it comes to medical care. In this realm the prevailing assumption is that everyone is entitled to all the health services he needs or wants.

It’s one thing to announce this entitlement as an ideal, but quite another to make it work. In the real world medical resources are limited, and therefore all approaches to healthcare funding employ rationing.

In tax-based systems administrators establish waiting lists so that some patients die before their opportunity for treatment comes up. They ban the use of expensive treatments and alternative therapies. And, without exactly saying so, they underfund medical facilities, so that patients wait in the halls of emergency wards, for example. In commercial insurance plans rationing is implemented by restricting coverage to specific procedures and specific doctors — and by setting upper limits to coverage.

Paying your own medical bills is simply another way of limiting consumption: If a treatment costs too much, you don’t buy it. The advantage of self-rationing is it is frank and open, and thus avoids the whining and blaming that characterize bureaucratic systems.

Paying your own medical bills also lets you see that there are more socially constructive ways to use funds than spending on health care. Suppose that to fix your limping gait requires complicated care costing hundreds of thousands of dollars. If others pay for this care, you might accept it. But suppose you are paying for it with your own savings. Now you might think twice about spending the money on yourself. You might know of a school for autistic children that could put the money to good use. Or you might have a grandchild who needs the money to start a business.

Such decisions are indeed difficult, but we need to face them if we are to make sensible choices about health care. Today we are not facing them. We are hiding behind the confusion of a tangled government/corporate system that pretends we can have all the medical care we want.

Spending my own money on health care helps me set a rational limit to medical spending, even on spending to preserve my life. Not buying health insurance and not allowing politicians to force others to fund my needs helps me keep my consumption of medical resources within fitting bounds.

This way of looking at health insurance may be old fashioned, but should it be a crime?

Health insurance scheme for govt human resources on anvil

2009-11-17T08:43:00.000-08:00

The government has formulated a scheme that will allow its employees to choose between a health insurance plan provided by an insurer run Central Government Health Scheme (CGHS).

At present, the Central government employees are covered under the CHGS scheme, being operated by the health ministry.

"The scheme is already formulated. It will open the choice for government servants," G C Chaturvedi, Additional Secretary in the Finance Ministry told news agency.

The new scheme, which will be placed before the Union Cabinet for approval soon, will directly benefit at least three lakh Central government employees, he said.

The new scheme, Chaturvedi said, will be more helpful to the employees who are posted at places where there are no CGHS dispensaries or they are far away from the place of posting.

CGHS dispensaries and hospitals are located only in 26 places in the country.

"Those who are residing external CGHS dispensaries areas will immediately opt for it. There are over three lakh employees which will directly opt for it, others will take some time," Chaturvedi said.

The government had earlier appointed an inter-ministerial committee to work out a health insurance scheme to supplement the CGHS scheme to provide better coverage to its employees.

Government to ensure fair and equitable Health Insurance Scheme

2009-11-17T08:42:00.000-08:00

Koforidua Nov. 15 GNA - Mr Baba Jamal, Deputy Eastern Regional Minister, at the weekend reiterated the commitment of government to implement a universal Health Insurance Scheme to reflect contributions to the scheme.

He said the system sought to guarantee access to free health care in all public health institutions and allow one time premium payment for registration.

Mr Jamal was addressing a strategic seminar for health insurance scheme managers in Koforidua to review the activities of the National Health Insurance Scheme (NHIS) in the region.

He said government had contracted Atubuga and Atubuga Associates, a legal consultancy firm to come out with a draft policy and legislative proposals for reforms of the NHIS.

Mr Jamal observed that the provision of Health Insurance under Act 650 had registered some success and also addressed a number of challenges, adding "but there are undoubtedly, many shortcomings in the law and its implementation, making it very necessary for a full legislative overhauling of the Act".

He said most of the problems and challenges could be traced to the institutional frame work of the district mutual health insurance schemes as provided by the act.

"A typical example is the fact that district mutual health insurance schemes depend on the National Health Insurance Authority for a chunk of their funding."

Mr Jamal said not withstanding, the district mutual health insurance schemes assert their operational autonomy in matters relating to accountability to the authority for funds received and general over sight responsibilities.

He said another challenge confronting the scheme was that huge amount of claims remained unprocessed and unpaid by several schemes for years.

"In view of this, many service providers deny clients services when claims remain unpaid for some time. Again, the scheme is inundated with fraudulent claims and increasing financial impropriety."

Mr Jamal said it was in view of these shortcomings that the ruling National Democratic Congress intended to promulgate a new National Health Insurance law, which aimed at providing new administrative, institutional and operational frameworks to provide solutions to the mirage of problems.

Mr Alex Asamoah, New Juaben Municipal Chief Executive the scheme managers to tackle the dubious claims and mounting debts facing the scheme.

Student health insurance still is not working for all

2009-11-17T08:41:00.000-08:00

When I listen to the national debate about health insurance currently raging in Congress, I'm struck by similarities to events that have happened here at CSU. I've been looking to those experiences to inform my opinion about what should be done at the federal level.

Most versions of the health care bill that are winding their way through Congress require that all Americans acquire health insurance. Similarly, in the fall of 2008, CSU instituted a requirement that all graduate students must have health insurance. The arguments about private choice versus the public good have raged among grad students as they have among politicians.

Much of the talk at the federal level surrounds the possibility of a "public option" -- a government-run plan that anyone in the U.S. can sign up for. At CSU, our closest equivalent is the student insurance plan operated by Summit America. This plan, which is required to accept any student, currently has around 3,000 people, mostly graduate and international students, on its rolls.

Congressional Democrats have argued that putting more people onto an insurance plan -- especially healthy people who normally feel like they can take the risk of not having insurance -- spreads the risk across a wider pool of people and lowers the per-person cost of insurance.

In fact, the evidence from CSU is that enlarging the pool has indeed helped with costs. But this doesn't mean costs have gone down, just that they're increasing at a slightly slower rate.

Despite potential cost savings, many consider it unconscionable to first require people to have health insurance and then to them deny coverage for things they can't control. That's why eliminating "pre-existing condition" clauses have been a priority in Congressional proposals. CSU's student insurance plan, for instance, requires that students wait until six months before it'll pay for coverage of any condition you had beforehand.

This is more than just an abstract argument -- even within as small a population as CSU's, failure to cover pre-existing conditions has very real consequences.

Last weekend, members of the CSU community held a benefit for graduate student Jason Bush, who was diagnosed with testicular cancer just days before his student health insurance kicked in. Even after his insurance had started, it wouldn't pay for his continuing cancer treatment, leaving him with tens of thousands of dollars in medical bills.

When the CSU Board of Governors considered the mandatory health insurance policy in early 2008, then-Provost Tony Frank presented the argument that requiring insurance would avoid precisely these sorts of burdensome medical bills.

Specifically, the proposal noted that "the University embraces the rationale that catastrophic financial risks while attending the University should be minimized, risks that may impact a student's ability to complete his or her graduate studies." In Jason Bush's case, this goal wasn't achieved.

The failures of graduate student health insurance might seem distant from the everyday undergraduate experience, but university officials, including CSU Health Network Executive Director Steve Blom, have expressed interest in eventually expanding the health insurance mandate to undergraduates as well.

I'm not yet convinced that the broader good has been enhanced by CSU's insurance requirement -- certainly not enough to argue for its extension to undergraduates. And until health insurance reform achieves clear success on the small scale, I'm not confident we know what will work on the national level.

Fortunately, unlike Congressional debates, which you have little chance of influencing as an individual, you do have the opportunity for direct input on your student insurance plan.

The Graduate Student Council, working with the CSU Health Insurance Office and other bodies on campus, will be hosting a health insurance forum with staff both from the university and our health insurance provider.

This forum will be held on Dec. 1, at 5:30 p.m. in the Lory Student Center Grey Rock Room. Take this chance to weigh in with the CSU leaders who make these decisions regarding student health insurance policy on campus on how the university's plan is or isn't working for you.

It's time to make your voice heard.

Health insurance

2009-11-17T08:39:00.000-08:00

Since health insurance regulations vary from state to state, health insurance agents must choose a geographic location and specialize in order to serve customers efficiently. In other words, health insurance agents have already done most of the time-consuming and frustrating work for you. What’s even better is that an agent with years of experience will also have dealt with a wide variety of customers with a wide variety of needs and situations.

So there’s a good chance an experienced agent can help you quickly because they are likely to have helped someone else with a similar situation. For example, if you are looking for a cheap family health insurance rate and you have one child entering elementary school and a newborn on the way, there’s a good chance you can find an agent who already knows which plans and options fit your situation best. The moral of the story here is that you don’t need to drive yourself crazy finding a cheap health insurance plan on your own.

There are thousands of health insurance agents across the country who focus on specific geographic areas so they can serve customers like you better. How do you find one of these agents? Well, through the internet of course. A simple search in your favorite search engine for “health insurance agents”, “health insurance quotes” or even just “health insurance” will easily turn up a number of websites that connect customers with agents. Most of these sites have their own quote search engines that ask you for a zip code or state and then return a list of agents based on your location. It’s that easy. Oh, I almost forgot, and it’s free too.

What Goes Into a Family Health Insurance Rate ? Now that you know how to find health insurance agents in your area, you need to understand a little bit about how to evaluate health insurance rates and quotes. We’re just talking about some basics here, enough to let you feel confident when talking health insurance with an agent.

The first item that catches a customer’s attention about a family health insurance rate, or any type of health insurance rate, is the monthly premium amount. After all, this is the amount of money that needs to be paid on a monthly basis in order to keep the insurance plan in effect. While this is a very important factor in determining the total cost of a plan, it is not the only one. In addition to the monthly premium, every plan has a deductible. This number reflects the amount of money you need to pay out of your own pocket before the health insurance company starts paying any of your health care costs.

For example, if you have a plan with a $2,000 deductible, and you get hospitalized with a $6,000 bill, you must pay $2,000 and the insurance company pays the rest. So do not brush aside the significance of the deductible amount thinking it won’t come into play. Be realistic about your health and lifestyle so you end up with a plan that gives you proper coverage. An experienced health insurance agent can advise you on how much protection you need given your health and income levels.

Another thing to take into consideration is any language in a cheap health insurance plan that specifies medical conditions and procedures that are not covered. This can be easy to overlook since it doesn’t have a number tied to it. But make sure you ask your agent about this issue when evaluating your options.

At the end of the day, you are buying health insurance in order to cover yourself and loved ones in case something happens. So don’t overlook the details on what is covered (and what is not) by each health insurance plan you consider.

Article Source: http://www.articlesbase.com/health-articles/finding-cheap-health-insurance-plans-1466100.html

About the Author:
This article focuses on helping consumers understand cheap health insurance plan and family health insurance rate choices and learn some of the basics of term health insurance before purchasing. The article explains what’s involved in the process of getting cheap health insurance plan and family health insurance quotes.

Shea-Porter puts the mandate in health-insurance mandates

2009-11-17T08:37:00.000-08:00

The common joke about statism is that it makes all allowable behavior mandatory — and bans everything else. Democrats certainly have adopted that approach when it comes to the overhaul of the American health-care system. Rep. Carol Shea-Porter told local constituents that the federal government should absolutely dictate to American residents that they “must” buy health insurance (via Now Hampshire):

The Alton Board of Selectmen invited Shea-Porter to an informal public forum to allow her to address concerns about the issues that have been boiling in the U.S. House of Representatives recently. While the selectmen touched upon state infrastructure, it was health care that really stirred up the crowd on Friday morning. …

Shea-Porter said those who have health insurance currently are fortunate to have it since many people are denied because of illness or various other reasons.

“I think when you can pay for insurance, you must,” said Shea-Porter. “For those who are blessed to have insurance through their companies, they should keep it.”

She suggested that those in attendance look back to where the country was last year and where it is now. She also said the new health care bill will make it better for senior citizens in need.

Er, what? Senior citizens already have access to Medicare, and the needy already have eligibility for Medicaid. In fact, the situation for those cases won’t change at all, unless one considers the $500 billion in Medicare cuts that Shea-Porter voted to impose. Those cuts will actually make it worse for senior citizens, not better, as they rob Medicare of money it doesn’t have in order to cover a broader range of people above 133% of the poverty line, the current cut-off for Medicaid. It certainly doesn’t boost Medicare benefits.

But that’s the kind of Orwellian nonsense one expects from a bill that brings 1984 to life in 2009. Big Brother doesn’t just suggest that you buy health insurance; Big Brother demands that you do your patriotic duty. If something is allowable by the statists, it’s mandatory, after all.

But from where does Shea-Porter think that she has the power to dictate that to American citizens? Don’t forget what Shea-Porter had to say about the Constitution in August:

No, the Constitution didn’t cover everything, nor did it pretend to do so. That’s why the framers included the Tenth Amendment — to circumscribe the power of Congress and ensure that the states and the people retained jurisdiction over their own choices and property. The Tenth Amendment was a feature, not a bug, to put it in modern terms.

EasyToInsureME Health Insurance Quotes Reform Weekly

2009-11-17T08:36:00.000-08:00

This week's debate focused on last Saturday's approval of health care reform legislation by the House of Representatives. Some members of the media have raised concerns over the costs associated with the Democrat version of health care reform, highlighting the challenges Democrats might face politically as health care reform legislation evolves in Congress.

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House and Senate Negotiations

House Passes Health Care Reform Legislation: Late last Saturday, the House narrowly passed its health care reform package with a 220-215 vote, which included opposition from 39 Democrats. One Republican, Rep. Joseph Cao (R-LA), voted in favor of the bill. President Barack ObamaBarack Obama visited Capitol Hill on Saturday morning to encourage House Democrats to pass the legislation.

The $1.1 trillion legislation passed by the House would extend coverage to an estimated 36 million Americans, vastly expand Medicaid, establish a government-run option, and create individual and employer mandates. It would also bar insurers from denying coverage based on pre-existing conditions or from dropping coverage for those who become sick. To pay for the expansion, the House passed measures including a $400 billion cut in Medicare spending over the next 10 years and new taxes on the wealthy. While the Congressional Budget Office (CBO) estimates that the bill will reduce the federal deficit by about $104 billion over a decade, the bill's longer term impact remains unclear, and some Democrats are still raising concerns over its costs.

In order to secure enough votes for passage, House Speaker Nancy PelosiNancy Pelosi (D-CA) agreed to hold a vote on an amendment that would specifically bar the public plan from covering abortion and prohibit those who receive insurance subsidies from using the subsidy to purchase private plan options that cover abortion. The amendment was approved 240 to 194, with 64 Democrats in favor. Abortion rights supporters, however, vowed to oppose the final legislation if it remains in the amendment, highlighting the difficult road ahead.

AARP and AMA Back House Bill: The House reform legislation received a boost last Thursday, winning the support of two highly influential lobbies - AARP and the American Medical Association (AMA). The announcements came at a critical time as the House Speaker was working to shore up the last votes needed to pass the reform legislation.

Small Businesses Voice Concern: Groups and coalitions representing small businesses showed their opposition to the health care reform late last week, sending letters to lawmakers urging them to vote against the House health care reform bill. In a statement Saturday, Susan Eckerly, Senior Vice President of the National Federation of Independent Business, said, "With unemployment at a 26-year high, the punitive employer mandates and atrocious new taxes will force small business owners to eliminate jobs and freeze expansion plans at a time when our nation's economy needs small business to thrive."

Obstacles Remain for Senate: While Senate Majority Leader Harry ReidSenate Majority Leader Harry Reid (D-NV) waits for the CBO to review the Senate's health care proposal, many hurdles remain before securing the 60 votes needed for it to pass. These obstacles include the incorporation of a public option, issues associated with federal funding for abortion, and how to pay for the health care overhaul. Recent reports indicate that Sen. Reid is favoring an increase in payroll tax on the wealthy to help pay for reform. In addition, U.S. drug makers, medical-device manufacturers and insurers are gearing up for another opportunity to reduce proposed industry fees in the Senate version of reform legislation.

With continuing pressure from White House officials to pass health care reform legislation by the end of the year, Sen. Reid has indicated that he will bring the reform package to the Senate floor for debate as early as Monday. However, Senators have indicated that, more realistically, voting will take place before Christmas, with the final passage in mid-January. In an effort to spur on Senate Democrats, Former President Bill ClintonBill Clinton - whose health care reform efforts failed 15 years ago - told the senators over lunch last Tuesday that "passing health care reform is not only a moral issue but also an economic imperative."

Public Opinion

American Support Slips for Passing a Health Care Reform Bill: A new Gallup Poll released last Monday shows that Americans have moved in a more negative direction on whether or not a new bill should be passed into law. Thirty-eight percent of Americans now say they would advise their member of Congress to vote against a new health care bill this year, while 29 percent would advise their member to vote for it. In addition, 41 percent say a new health care bill would make the U.S. health care system better in the long run, while 40 percent say it would make things worse.

Other Activities

Republicans Mobilize to Increase Opposition: In an effort to drum up opposition to the Democratic health care reform bills, Senate Republican Conference Chairman Lamar AlexanderAlexander (R-TN) indicated that Republicans are "quietly" planning approximately 50 in-person and telephone town hall gatherings over the next three weeks.

Looking Ahead

CBO estimates of the cost of the Senate health care reform package are expected late this week or early next week, which will clear the way for Senate Majority Leader Harry Reid to bring the legislation to the Senate floor for debate as early as Monday.

Health care industry

2009-11-17T08:34:00.000-08:00

The delivery of modern health care depends on an expanding group of trained professionals coming together as an interdisciplinary team.The Healthcare industry incorporates several sectors that are dedicated to providing services and products dedicated to improving the health of individuals. According to market classifications of industry such as the Global Industry Classification Standard and the Industry Classification Benchmark the healthcare industry includes health care equipment & services and pharmaceuticals, biotechnology & life sciences. The particular sectors associated with these groups are: biotechnology, diagnostic substances, drug delivery, drug manufacturers, hospitals, medical equipment and instruments, diagnostic laboratories, nursing homes, providers of health care plans and home health care.

According to government classifications of Industry, which are mostly based on the United Nations system, the International Standard Industrial Classification, health care generally consists of Hospital activities, Medical and dental practice activities, and other human health activities. The last class consists of all activities for human health not performed by hospitals or by medical doctors or dentists. This involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratiories, pathology clinics, ambulance, nursing home, or other para-medical practitioners in the field of optometry, hydrotherapy, medical massage, occupational therapy, speech therapy, chiropody, homeopathy, chiropractice, acupuncture, etc.

Life insurance and Marriage

2009-11-17T08:32:00.001-08:00

When you get married, you need to contact your insurance company and make sure that your spouse and children will be getting the money from the life insurance policy if something happens to you. This way you will know for sure that if something happens to you, your spouse and children will be protected and taken care of. This usually something very importain to remember because it is what allows you to have the peace of mind that life insurance politicies should bring . The other thing to think about is ading your spouse onto your policy if already have one whenyou are married. Most of the life insurance policies will allow you to do this .

This can be good because then whether something happens to you, or to your spouse, the money from the life insurance policy will be there for the one that is remaining and the children. Also, if something happens to both of you,you can know for sure that your children will be protected. if you don't have a life insurance policy before you get married, then you and your spouse cn take out one together . This is a good idea because it can be very important for both of you , especially when you have children. You have need to be sure that you are able to do all you can to protect one another once you are married, and when you have kids you will need to be even more sure that you are able to protect those children. if you don't have a policy when you get married ther are lots things to think about.

Life insurance

2009-11-17T08:32:00.000-08:00

Life insurance or life assurance is a contract is a between the policy owner the insurer , where the insurer agrees to pay a sum of money upon the occurrence regulars intervals or in lumps sums . There may be designs in somes countries where bills and death expenses plus catering for after funeral expenses should be included in Policy Primium . In the United Stated , the predominant form simply specifies a lump sum to be paid on the insured's demise. As with most insurance policies ,life insurance is a contract between the insurer and the policy owner whereby a benefit is paid to the designed beneficiaries if an insured event occers which is covered by the policy.

The value for the policyholder is derived, not from an actual claim event ,rather it is the value derived from the "peace of mind' experienced by the policyholder, due to the negating of adverse financial consequences caused by the the death of the Life Assured. To be a life policy the insured event must be based upon the lives of the people named in the policy.

Insurance Benefits

2009-11-17T08:31:00.000-08:00

Insurance Benefits enpompass the facilities associated with buying of insurances. Insurance is mainly a intrument used by comsumers for hedging the futere contingent risks related with life

health and non life general issues. Insurance benefits helps the policy holderor benefitciary in combating with the losses or hazards associated with him or her. The policy holder the insurance to hedge against the future perceived losses by paying a regular amount to be insurance company known as the premium.Insurance Companies insure financial reimbersement of the insured losses to the policy holders or hisher beneficiary. This is the most coveted insurance benefits .

Finding Individual Health Insurance

2009-11-17T08:29:00.000-08:00

Americans who have spent years on groups insurance are spoiled. Although co-pays and premiums have increased over the year, those on group insurance have been shileled from thge trust cost of health insurance.

The biggest challenge in leaving the group prior to age 65 via lay-off or simply a desire to start your own business is in finding and keeping suitable health insurance. $300 a month is not uncommon for a person in his or her mid -50s in good health. Much higher premius apply when pre_existingapp condition are present.

Tips to Finding Helpful Alternatives

2009-11-17T08:28:00.000-08:00

Health Insurance might be that, as a new graduate, you're getting yourself established and are no longer covered by your parent's plan. Health Insurance might be that you are currently job-hunting, or that you have just started a new job, but the group health insurance plan offered by your new employer doesn't commence until you've been there for three months. If you fall into any of these categories, there are a number of steps you can take. First, take a look at Medicaid. This program is a federally-funded, state run program, and is offered typically to those on low-incomes, so you will need to check whether or not you qualify. A caseworker will make the application on your behalf and ill inform you of what documentation you will need to provide for the application process.

You can also visit a local clinic in your area, as clinics tend to be excellent sources of information. They will either inform you of the relevant services they offer, provide you with printed information or point you in the right direction. It may also be a good idea to pay a visit to your local Social Services office, as they are often abundant sources of information for communities. Ask a representative there about cheap insurance plans.You might also wish to consider short-term health insurance. Such plans usually offer coverage for between 20-180 days. You may well be able to renew the plan upon expiration, but renewal is often limited to a period of one year. As with any such plans, you can expect certain limitations, and there will be initial costs in the form of a deductible. The benefits, however, are that you can choose your doctor and hospital, You will also receive cover for in and out-patient services, examinations (including laboratory work) and X-rays. You will also be covered in case of sudden illness and accidents.

Car Insurance Claim Payment

2009-11-17T08:27:00.000-08:00

Once you decide that filing a car insurance claim is the right think to do,you should do i timmediately so your insurer can come on Your insurer will confer with the other vehicle's insurer and iron out a plan for resolution. Expect to hear from the other insurer to corroborate the details of the accident.
Your insurer will confer with the other vehicle's insurer and iron out a plan for resolution. Expect to hear from the other insurer to corroborate the details of the accident. Once your claim is approved, you will be eligible to receive an insurance claim payment. Your vehicle may be inspected by an insurance adjustor or by a shop approved by your insurer to repair the damage. Many insurers now offer a "first time forgiveness" policy in which your rates will not be increased after you have your first claim. It is still the best advice to avoid filing a claim unless it would result in financial hardship for you.

Mandate for Health Insurance Reform

2009-11-14T10:55:00.000-08:00

As health care reform moves forward in the Senate a review of some basic insurance principles may be helpful. Although many continue to believe a single-payer system is the most desirable avenue for reform, it seems clear that such approach is not going to be part of the legislative package upon which sufficient members of Congress will agree.

We have a health care crisis in this country which is quite apparent when one considers the vast amounts of money spent per capita and as a percentage of gross domestic product (GDP) contrasted with the resulting performance of our health care system as compared to other countries. For now, the reform approach under serious consideration is restructuring our health insurance system.

Currently our system primarily relies upon insurance plans, both for-profit and non-profit, providing health insurance coverage through employer groups. Of course there are exceptions, most significantly including Medicare, Medi-Cal, Veterans Affairs coverage, Native American coverage and individual coverage purchased by those of us not eligible for insurance through a group.

Individuals seeking to purchase insurance coverage for themselves and their families are often faced with coverage limits or outright denial of coverage due to pre-existing medical conditions. While it is imperative that insurance system reform require a “take-all-comers” approach where insurers must accept everyone that applies for coverage, for such reform to work, everyone must obtain health insurance coverage. This is the individual mandate.

Health insurance is provided through pooling a large number of people to share the costs incurred by people within that pool who need medical care. At any given time, certain people in a large enough pool will be healthy, needing little medical care, while others will be unhealthy, needing lots of medical care. If people needing lots of medical care are not joined in the pool by those needing little medical care, the coverage costs will quickly become unsustainable.

Permitting people to opt-out of a health insurance system that operates on a “take-all-comers” basis will result in adverse selection. This means that unhealthy or risk-adverse people obtain coverage for themselves and their families while people who are currently healthy do not obtain coverage knowing they can “free-ride” the system until they have a condition requiring medical care. Then, they would obtain coverage that “take-all-comers” insurers would be required to issue. It would be akin to permitting someone to purchase fire insurance for their home after the fire has started and it simply will not work.

Financial Decisions to Make as You Divorce

2009-11-14T10:54:00.001-08:00

Divorce may be one of the most damaging financial events in the lives of those who go through it, but that isn’t always immediately clear to a couple about to split up.

In fact, the first response is probably emotional — whether exhaustion and sadness at having failed to save the relationship after years of struggle or shock when your spouse walks out. Then, perhaps, comes the resolve to shield the children.

It seems almost tone-deaf at that point to suggest that you write a new budget.

But as you get swept up in the rage, the disappointment and the worries, money will intrude whether you like it or not. You should expect that choices with huge financial implications will come at you with intense speed during a divorce, and they’re probably not the sort of decisions you’re used to making.

One of the first will affect how much you spend on legal fees. Should you try mediation, which can be relatively low-cost, or a newer process known as collaborative divorce? Or should you just go for the bare-knuckles approach?

And as you get sucked into the legal vortex and the cost and complications of setting up a second household, it becomes easy to lose sight of longer-term financial concerns. The list of things to think about ahead of time, from health insurance to your credit history to taxes, turns out to be much larger than you might think. People often neglect or fail to consider many of them beforehand.

So this week, I assembled that list, with help from readers and members of the Institute for Divorce Financial Analysts. The institute certifies financial planners and other professionals who specialize in helping people whose marriages have ended.

You may be willing to pay any price to remove yourself from a toxic marriage with the least amount of haggling. Many more of you, however, are probably seeking an equitable split, but have no idea what to budget for or evaluate.

So this list is a place to start. Please post additions to it in the comments with the related post on the Bucks blog.

HEALTH INSURANCE If you are on your spouse’s health insurance plan, you won’t be able to use it once you’re no longer married. The government’s Cobra rules allow you to continue coverage for up to three years, but you have to pay the premium yourself, which may not be affordable once you’re shouldering rent or a mortgage alone.

“I thought, ‘This isn’t going to be difficult,’ ” said Shira Silverman, 34, of the Bronx, who is getting divorced. “And then I looked it up and realized it was almost impossible.” Ms. Silverman works as a freelancer and doesn’t have access to insurance through work.

Some people who are older or have pre-existing conditions find that they can’t get health insurance at all. Whatever your situation, it’s best to know what insurance will cost you before the divorce is final. That way, you can negotiate a settlement that covers the premium or find cheaper housing so that you don’t have to do without health insurance.

MENTAL HEALTH Barbara Shapiro, a financial planner and divorce specialist with the HMS Financial Group in Dedham, Mass., refers to the dissolution of marriage as death without a body. The mourning and trauma that results for you (and your children, if you have any) may make therapy necessary.

David Wanderman, who got divorced earlier this decade and has seen a therapist for many of the years since, said this was not a place to skimp. “The reality is, I kind of have no choice,” he said. “These are things that are bigger than myself, and I’m not equipped to understand them.”

Mr. Wanderman, 45, a wedding and event photographer in Manhattan, went without health insurance for a while and hunted down low-cost therapists in public clinics and elsewhere. Other people with higher income, however, may need to pay $100 or more for sessions if their health insurance doesn’t cover them or has a high deductible.

CREDIT It’s easy to let the bills slip when you’re huddled with lawyers and no longer speaking to your spouse. But letting things slide can do lasting damage to your credit, and it can happen in a number of ways.

Liz Pulliam Weston, author of “Your Credit Score: Your Money & What’s at Stake,” suggests canceling jointly held credit cards and transferring any balance that a spouse is responsible for to a card in that spouse’s name.

You should also try to get your name removed from the mortgage if you are no longer responsible for the payments. If your spouse pays late, accidentally or on purpose, it will hurt your credit. That will complicate your ability to refinance, get a new mortgage or apply for an auto loan when you’re on your own.

HIRED HELP Once there are no longer two of you around, you may have to hire others for everything from yard maintenance and home repair to babysitting. This cost ought to be part of your budget — and negotiations.

KEEPING HOUSE When a couple splits, one member of the household often has a strong desire to keep the family home, perhaps to provide some continuity for the children. After a few years of being house rich and cash poor, however, reality sets in and the house goes up for sale.

The problem at that point, according to Donna Cheswick of BPU Investment Management in Greensburg, Pa., is that you’re solely responsible for all the costs of selling, including paying the real estate agent and sprucing up the house. So it’s best to be brutally realistic before the divorce is final about the costs of staying in your house.

TAXES Once someone buys that house, there may be capital gains taxes to pay if it has appreciated more than $250,000. This may seem like a high-class problem in this market. But if you had decided to sell it before the divorce was final, you and your spouse might have had a $500,000 exemption from capital gains instead of just half that.

In general, it’s crucial to consider the after-tax value of everything, from retirement accounts to deferred compensation when splitting up assets. Annette Brown, a divorce specialist in San Francisco, also noted that judges sometimes failed to consider which spouse could best benefit when awarding the right to future tax deductions and credits relating to the couple’s children.

SPOUSAL EDUCATION Haven’t worked for a while? You may need retraining or a new degree entirely. Gary L. Zaugg, a financial planner and divorce specialist in Virginia Beach, noted that some divorce settlements assumed that a few years of alimony ought to be enough to pay for this. If you expect the costs to be steep, however, they probably ought to be a separate line item in the settlement or at least part of the negotiation.

TEENAGERS If you have joint custody of your children, you may end up buying computers, clothes and other items for their second residence. What many couples don’t anticipate or budget for if their children are small, however, are the extra costs of the teenage years.

Disagreements about what is truly necessary are practically inevitable. If you don’t want your child to do without, you may end up paying the full bill for all sorts of new costs, according to Lori Dolan of Morgan Stanley Smith Barney in Pasadena, Calif.

She ticked off the following list for starters: prom expenses, cheerleading, sports gear, cars and car insurance, allowance and college visits and applications. The actual cost of college is a big one, too. And don’t forget cellphones.

FUTURE LEGAL COSTS Even after tallying up all of the above, you still have to consider that years later, your spouse may come after you for more money or try to pay less after a job loss. Then you’re liable for another four or five figures in legal bills.

While you may not want to earmark emergency funds just for that, the larger point is this: Long after you move on emotionally, divorce may haunt you financially.

This is not a reason to stay in a marriage that is making you miserable. It’s just a reminder that without a lot of planning while you’re in the middle of it, divorce may never have a happy financial ending.

Mandate for Health Insurance Reform

2009-11-14T10:54:00.000-08:00

HOW I SEE IT: Government health care won’t work

2009-11-14T10:53:00.000-08:00

I wholeheartedly oppose the health care “reform” that was recently passed by Speaker Pelosi and the other progressives in the House of Representatives. Not only is it immoral and unconstitutional, but it will harm America economically.

Remember: America has prospered in large part because of our economy’s capitalistic nature. The market system encourages efficiency of both production and resource allocation by harnessing human nature — the individual works and economizes to achieve the greatest personal profit he can, and society benefits by enjoying a greater variety of goods at higher qualities and lower prices.

By contrast, history shows that command (government-controlled) economies fail, and governments spend money inefficiently — ours included. This is because when spending is dictated, human nature is not harnessed but appeased. Government control fosters pork-barrel and special-interest spending, other types of corruption, misinterpretation of market demand and misallocation of funds. In a word, it fosters waste.

Now, it’s widely known that the health care industry comprises roughly 15 percent of our economy. If President Obama’s reform is passed in the Senate, the U.S. government will effectively take control of this enormous economic sector.

Rather than having a “government option,” the government’s insurance package will become our only option. Why? Not only will hidden features of the proposed legislation increase the government’s ownership of the health insurance industry, the state also has an another weapon: Unlike private health insurance providers, the government can artificially deflate its prices.

Are government premiums too high to be competitive in a free market? No problem! The politicians can simply draw more money from another area to “lower” premiums. They raise income taxes or start taxing soda purchases (which, coincidentally, Obama has proposed), and suddenly the government has extra money lying around to help pay for universal health care.

Then private firms will suffer as Americans increasingly choose the “cheaper” government plan, and eventually the government will be the only game in town — just as the progressives intend. Americans will still be paying more money, and the government will come to dominate a large sector of our economy. Consequently, government waste will go to work, and economic performance will deteriorate.

It is ridiculous for the Obama administration to think it can nationalize health care and reduce the net cost of insuring America. Economic theory and history prove this. Rhetoric and clever number fudging can give an appearance to the contrary, but the truth is that if the progressives succeed in socializing the health insurance industry, spending will skyrocket. The average American, who already has health insurance, will be paying much more — and for someone else’s care.

If we want to remain the world’s largest economy, we must reject this overhaul and seek market-based solutions. Fellow patriots, call your senators before they vote! Tell them to hold off on “reform.”

Rep. Blunt opposes ban on health status ratings

2009-11-14T10:52:00.000-08:00

FULTON, Mo. -- U.S. Rep. Roy Blunt said Friday that he opposes efforts to end the insurance industry practice of charging higher rates to unhealthier groups of people.

Blunt, the Republican front-runner in Missouri's 2010 Senate race, voted against a health insurance bill passed last week by the Democratic-controlled House because he says it's too costly and expands government-run health care.

Included in the nearly 2,000-page bill are sections prohibiting insurers from adjusting rates based on any factors other than age, family size or geographical areas. That would prohibit insurers from raising or lowering rates depending on the gender or health status of the group of employees being insured - currently a common practice in many states.

Blunt says he opposes the elimination of health rating variances.

"When you look at health status, there are different ways than forcing every insurance company to take every unhealthy person that applies for insurance," Blunt said in an interview.

"The better way to do that is expand the risk pool concept so that it works better for everybody," Blunt added. High-risk plans in many states provide insurance to people unable to get affordable coverage through the traditional market.

Some supporters of the House bill hope that by eliminating health status as a rating factor insurance will be more affordable to small businesses that have an employee with cancer or some other costly medical condition. But health industry analysts have noted that some small group insurance plans with healthy employees could see their rates rise because they no longer would get a discount.

Democratic Senate candidate State Robin Carnahan, who is secretary of state, has declined to specifically say whether she would have voted for the House legislation. Earlier this week, Carnahan said she was excited about the health care debate and called the House vote an important first step. But Carnahan also said she also was a little concerned about whether the House bill does enough to make insurance affordable.

Blunt said Friday that he does support some provisions in the legislation. As an example, he cited a requirement that insurers allow parents to keep dependent children on their health insurance plans until they turn age 27. Blunt had sponsored a bill that would have set that age at 25. Those cutoff ages currently vary by state.

Reid Mulls Medicare Tax Increase for High Earners

2009-11-14T10:49:00.001-08:00

WASHINGTON — The Senate majority leader, Harry Reid, is considering a proposal to increase the Medicare payroll tax on high-income workers to help offset the costs of providing health insurance to millions of Americans, Senate aides said Thursday.

The proposal is part of a legislative package that Mr. Reid has put together in secrecy and submitted to the Congressional Budget Office for analysis.

Mr. Reid, Democrat of Nevada, has said the Senate could begin debate on the legislation as soon as next week, although members of his own party do not yet know details of the bill he has assembled from pieces approved by two Senate committees.

The Medicare payroll tax is the primary source of financing for Medicare’s hospital insurance trust fund, which pays hospital bills for beneficiaries, who are 65 and older or disabled.

Employers and employees each pay a tax equal to 1.45 percent of wages. Unlike the payroll tax for Social Security, which applies to earnings up to an annual ceiling ($106,800 in 2009), the Medicare tax is levied on all of a worker’s earnings without limit.

Mr. Reid is apparently considering an increase in the Medicare payroll tax rate for workers with incomes of more than $250,000 a year, Senate aides said. One idea is to increase the tax rate by one-half of 1 percentage point, to 1.95 percent for high-income people, with an expectation that the government could raise $40 billion to $50 billion over 10 years.

As a presidential candidate, Barack Obama repeatedly said that under his administration, people making less than $250,000 a year would not see any of their taxes increased. Mr. Reid has several reasons for considering an increase in the payroll tax, a development first reported by The Associated Press on Wednesday night. He is seeking money to provide more extensive subsidies to help low- and moderate-income people buy insurance. A bill passed Saturday by the House would provide $602 billion in subsidies over 10 years, while a measure approved last month by the Senate Finance Committee would provide $461 billion.

The biggest source of new revenue proposed by the Finance Committee is a tax on high-premium group health insurance provided by employers to their employees. Mr. Reid is looking for an alternative to that tax, or a way to reduce it, because it is anathema to many labor unions, a major constituency of the Democratic Party. Labor leaders say the proposed tax on “Cadillac health plans” would hit many middle-income workers whose unions have sacrificed wage increases to secure or retain health benefits.

Steven M. Kreisberg, director of collective bargaining and health care policy at the American Federation of State, County and Municipal Employees, said an increase in the payroll tax on high-income people was “far preferable” to the excise tax on high-cost insurance plans.

“At a time of rising inequality in income and wealth,” Mr. Kreisberg said, “it is appropriate to ask those who make more to bear a greater burden.”

Democrats said an increase in the payroll tax had an additional advantage: some of the money could shore up the Medicare trust fund, which is expected to run out of money in 2017.

James P. Manley, a spokesman for Mr. Reid, said the majority leader had not decided whether to include the payroll tax increase in the bill he takes to the Senate floor.

Several Democratic senators have urged Mr. Reid to propose extending the Medicare payroll tax to income other than wages, like capital gains, dividends and rental income. Such a change could generate substantial revenue from higher-income households, who tend to derive a greater share of their income from sources other than wages.

The House also wants more money from affluent people. The House-passed bill would raise $460 billion over the next decade from a new income surtax. The surtax would equal 5.4 percent of adjusted gross income exceeding $1 million for couples and $500,000 for individuals.

Mr. Reid is not proposing to increase the payroll tax used to finance Social Security.

Economists and politicians pointed out several possible objections to Mr. Reid’s proposal. It does nothing to slow the growth of health spending, as the tax on high-cost insurance would. And, as the Congressional Budget Office pointed out recently, “higher tax rates on earnings reduce people’s incentive to work.”

Moreover, the higher payroll tax would not be sufficient in the long run. Payroll tax revenues generally grow with payroll, which is expected to increase more slowly than health costs under even the most optimistic projections.

The Business Roundtable, which represents large companies, said Thursday that more aggressive changes in the health care system could save employers as much as $3,000 per employee in 2019.

Pet expert: Can humans' health insurance learn from animals'?

2009-11-14T10:49:00.000-08:00

Got a hedgehog? Kristen Zorbini Bongard does. She loves Harriet so much that she pays $80 a year to Veterinary Pet Insurance (VPI) to protect her from the possibility of a financial "stop-treatment decision"— otherwise known as "economic euthanasia."

This information was brought to you courtesy of Public Radio International's This American Life, where one of last month's segments ("Insurance? Ruh-Roh!") treated the topic in some depth. The preternaturally geeky Ira Glass goes on tape to tell Harriet's tale:

Kristen said that when she found a tumor on her beloved hedgehog, pet insurance helped give her the green light to undertake the expensive treatments to follow. In the end, the insurer, VPI, paid about $800. Kristen and her husband paid $1,900. Despite the inequitable cash outlay, it helped. After all, Kristen is not rich. And she loves Harriet like any of us do our dogs and cats. So if it helped her save Harriet's life, it's a good thing, right?

Yes, of course!

Ultimately, that's the answer This American Life (and the pet insurance industry) is reaching for. Though it hammered the point home somewhat artificially, the idea was this: Pet health insurance helps save pets by raising the stop-treatment bar. What's more, the veterinarians and their businesses and pet owners and their pets all benefit — along with the pet health insurance companies, of course. A "win-win-win!" chants our host along with VPI's CEO. And, best of all, no one loses sight of the ultimate goal or the underlying cost issues along the way.

Human health insurance could take a lesson from animals, Glass concludes.

Amid a roiling sea of convoluted codes, big pharma marketing tactics and layers of bureaucratic billing, human patients get lost. Even more to the point is this: The upward spiraling cost of it all is an outsourced abstraction for the health care providers involved. Docs don't know what any of it costs. And patients are in no position to know any better.

Human health care is undoubtedly a mess. This we know. But to riff on Harriet's dubious success leaves me somewhat cold. How can one hedgehog's 29% pet insurance payout possibly persuade anyone to adopt pet health insurance? It's an embarrassing example that would in no way convince me that I should run to the arms of a pet health insurance carrier in the hopes of saving my pet's life. Indeed, I have no idea how this experience could be considered a win-win-win when it's clear that Harriet's owners were underinsured.

Luckily, there are far better examples of pet health insurance success out there.

But this isn't really about Harriet or her owners, much though This American Life finds it humorous to hold her out as an example of our pet-addled human ways. Rather, for me, it's more to do with how veterinary medicine's fee-for-service, lower-waste ways manage to keep costs under control.

Sure, that cruciate ligament surgery they cited might not seem like a bargain at $3,000, but it's a lot cheaper than the human ACL-tear scenario. In this respect I do agree that veterinary medicine has a lot to teach human health. That's because when veterinarians and pet owners know how much everything costs, and when everyone's a stakeholder in the cost conservation game, smarter decisions get made.

Add to this the fact that 17% of our hospitals' operating expenses don't need to go to the billing department for arcane code translation and chronic insurance carrier disputes, and you have a recipe for an automatically slimmer system.

I'll also agree that giving consumers a choice in their election of insurance carriers and plans makes a big difference to the viability of the entire shebang. Unlike our human system, for which individuals are effectively forced into one company's plan by their employers, pet health insurance offers multiple carriers with multiple plans any owner can choose based on its merits and their personal level of risk aversion. (Not that Harriet's owner had a choice, since only one carrier offers hedgehog insurance.)

Choice is critical when it's obvious that human health insurance carriers use their market share to bully hospitals and skew the game in their favor. If every individual could freely choose a plan without having to worry about belonging to a group to qualify, insurance companies would have to compete based on the quality of their product and the effectiveness of their service. What a concept!

Yes, ultimately the pet health insurance industry has a lot to teach human health … if only because it's based on a competitive, fee-for-service model in which everyone participates, competes and questions costs every step of the way.

Nonetheless, it's unlikely that pet insurance, as it's currently designed, could ever be held up as a model for human health insurance. As Glass concludes in the piece, the difference between pets and humans is responsible for this disconnect. The human-animal divide is vast and lies fundamentally in the willingness of an individual to shoulder any cost, no matter how huge, to save themselves or their children, while the reality is otherwise for pets.

Why? Because most of us consume health care for our pets with the almighty stop-treatment figure buried somewhere inside our very human brains. Like it or not, pets are not like Grandma.

What Health Reform Will Do to My Insurance

2009-11-14T10:48:00.000-08:00

I'm a registered Democrat living in New York City, and I buy my own health insurance. But now, having seen the health-care reform bill that passed the House, I'm preparing for life without health insurance. And unless I'm the only person covered under the Empire Blue Cross/Blue Shield "Tradition Plus" plan, a lot of other people will end up just like me, uninsured.

I will gain one thing, though—an annual fine for losing my insurance. The exact amount of that fine isn't clear yet, but so far it looks like I'll be paying about the same amount—$2,000 a year—for having no insurance as I do now for having it.

Let's get specific. What is the "Tradition Plus" plan that I've purchased each year since moving to New York in 2006? It's a hospitalization plan. If an accident or illness puts me in the hospital, all my hospital expenses are covered. Why is it so affordable? Because it covers only hospital expenses. Any fees from a physician who is not a hospital employee (i.e., who bills the patient privately) I would pay out of pocket.

Before I come to the big question—why will I lose this insurance plan if anything like the House bill becomes law?—I want to address a smaller one. Why do I choose the Empire "Tradition Plus" plan instead of a comprehensive HMO-type plan that covers physician fees, prescriptions, etc.? Because, unlike other states, New York already mandates two things that the current federal health-care reform will mandate. The first mandate prohibits insurers from denying coverage because of a pre-existing medical condition. The second mandate prohibits insurers from denying coverage, or determining prices, based on age. The result is that HMO plans in the state are now very expensive. The price of Empire's basic, least expensive HMO plan is more than $13,000 a year for an individual, more than $26,000 a year for a married couple, and more than $39,000 a year for a family with children. Empire is a reputable firm and those prices are typical of what's available to New York City residents. Upstate New Yorkers pay slightly less.

The only less expensive alternative is the "Tradition Plus" plan. That's why I buy it. The money I save by not buying the basic HMO plan—roughly $11,000 a year—I can draw on to pay for any doctor visits I choose to make.

The House health-care reform bill hinges on what it calls a "qualified" health-care plan. Individuals will be required by law either to buy a plan that meets the criteria of a qualified health-care plan or pay a fine. What are those criteria? They're the basic components of a comprehensive HMO-type plan, which means that Empire's "Tradition Plus" will not qualify because it covers only hospital costs. In other words, if President Obama signs into law the kind of health-care reform bill that is currently on the table, I will have only two choices: buy an expensive qualified plan or pay a fine for being uninsured.

And there is nothing in any of the pending health-care legislation that will make the cost of a qualified plan significantly lower than it is in New York now. On the contrary, once the health-insurance mandates that already exist in New York become the law of the land, insurance premiums everywhere else will rise as they did here. What I can't figure out is why Congress would want to prohibit someone like me from keeping an affordable hospitalization plan. It works for me and it works for the hospital. I guess that's the problem. It's simple, it's easy to understand, and it works.

I realize that we who buy our own health insurance are a fairly small percentage of the market, but there are millions of us. Millions more may have an employer-based plan today, but not tomorrow. So, as I prepare for the winter of my disinsurance, at least I'm not alone.

King County Public Health sends H1N1 vaccine to certain area pharmacies, but supplies short

2009-11-14T10:40:00.000-08:00

King County Public Health is making H1N1 flu vaccine available for persons at high risk for H1N1 influenza at certain area pharmacies. Some of these pharmacies are accepting vaccination appointments now.

Due to the national delay in vaccine production, H1N1 vaccine is still in short supply and coming in to the county slowly. Public Health is distributing vaccine to pharmacies to provide another option for people at high risk for H1N1 infection who cannot get vaccinated by a health care provider. The majority of vaccine in King County is distributed to hospitals and other health care providers to vaccinate high risk patients.

The amount of H1N1 vaccine at pharmacies will be limited, with each pharmacy receiving a few hundred doses each. Vaccines will be re-supplied to pharmacies as more becomes available over the coming weeks.

Many pharmacies are unable to vaccinate babies and young children because their staff is not licensed and/or trained for these age groups. Public Health is making every effort to get vaccine to healthcare providers caring for babies and young children. Health care providers who have ordered the vaccine will continue to get supplies as vaccine becomes available, Please check with your health care provider. Please see the list of participating pharmacies to find out what age groups they can vaccinate.

What you need to know before you go to a pharmacy

• Who is eligible for H1N1 vaccine currently

To protect those who are at highest risk from severe illness from H1N1 influenza, H1N1 vaccine is currently available to people in the following groups:

• pregnant women;

• people who live with or care for children younger than 6 months of age;

• young people between the ages of 6 months and 24 years old;

• people ages of 25 through 64 years of age who are at higher risk for severe H1N1 because of chronic health conditions (such as asthma, heart disease, diabetes, or brain/nervous system disorders) or weakened immune systems and

• healthcare and emergency medical services personnel with direct patient contact.

When you go the pharmacy, a screening form will determine whether you fall into one of the above categories. You can download and fill it out now to take with you to the pharmacy.

When H1N1 vaccine supply is more plentiful, people who are not in the above groups will be able to get it.

• What kind of vaccine you can get

Pregnant women, babies and children younger than 2 years, and people through 64 years of age with chronic health conditions will get the flu shot (injectable vaccine). Flu shots must be reserved for people in these groups because they are not allowed to receive the nasal-spray vaccine and they are also among those at highest risk for severe illness and hospitalization.

Healthy people between the ages of 2-49 who are not pregnant can receive the nasal-spray vaccine, due to short supplies of injectable vaccine (flu shots). Once doses of injectable vaccine are more plentiful, people in this category will also be able to get them if requested. In the meantime, we ask for your patience and understanding.

• Number of doses

People 10 years and older will need one dose of the vaccine. Children under 10 will need two pediatric doses, spaced at least 28 days apart.

• Cost and health insurance

Pharmacies may charge a fee for administering the vaccine, typically between $12-$22, not to exceed $22. If you have health insurance, this fee will likely be covered. Please bring your health insurance information with you. You may need to submit a receipt to your insurance company for reimbursement.

Ala. board suggests teachers pay more for benefits

2009-11-14T10:38:00.000-08:00

MONTGOMERY, Ala. — Teachers and other education employees could have to pay more for their retirement and health insurance benefits under a financial plan proposed Thursday by the Alabama Board of Education.

The board voted unanimously for what state Superintendent of Education Joe Morton called "a plan of survival" after two years of budget cuts and what looks like more lean funding for the 2010-2011 school year.

The board recommended to the governor that:

_the percentage of the state education budget that goes for K-12 schools be increased by slightly more than 1 percentage point.

_education employees start paying 6 percent of their salary toward retirement rather than 5 percent.

_the state education budget provide no increase for health insurance and retirement benefits for the next school year.

The plan would force the health insurance program to cut benefits or raise the amount that educators pay. Any changes would require the approval of the governor and the Legislature.

Gov. Bob Riley's press secretary, Todd Stacy, said the governor was reviewing the proposals and would comment later.

Mary Bruce Ogles, assistant executive secretary at the Alabama Education Association, said requiring educators to pay more for retirement and possibly health insurance would amount to a pay cut for teachers, who didn't receive a cost-of-living raise this year or last year.

Morton said educators have been paying $2 per month for their state's health insurance coverage since 1986, far less than what workers pay in other public and private health insurance plans.

Morton said maintaining benefits at their current level will require an extra $238 million for health insurance in the 2010-2011 school year and $57 million more for retirement.

With the recession shrinking Alabama's tax collections, that kind of money won't be available, he said. Morton said the only way to maintain benefits without charging educators more is to cut classroom programs.

"We are in dire straits," he said.

When the board next meets on Dec. 10 it will discuss whether to ask the Legislature to increase the time necessary for retirement from 25 years to 30 years for education employees hired after July 1, 2010.

Ogles said AEA opposes that change because any savings would be many years in the future.

Studies reveal fallout of no medical insurance

2009-11-14T10:36:00.001-08:00

Many points are hotly disputed during the current debate over health reform. But not this one: Going without health insurance is harmful to people's health.

It's notable that reform critics don't seriously challenge the conclusion. But it's not surprising, because numerous studies show that people who are uninsured put off preventive care, become sicker and are more likely to die.

The Institute of Medicine estimates that about 18,000 people perish each year because they don't have health insurance.

Now, two new studies add to our understanding of the consequences of being uninsured.

The first, published Oct. 30 in the Journal of Public Health, reports that uninsured children who are hospitalized are almost 60 percent more likely to die than those with insurance.

That may be because their families can't afford ongoing medical care and children are sicker when they come to the hospital, speculated Dr. Fizan Abdullah, lead author and an assistant professor at the Johns Hopkins School of Medicine. Or it may be that families are disadvantaged in other ways that affect their health.

Based on an analysis of 23 million hospital records, Abdullah and co-authors say that 16,787 children died in hospitals between 1988 and 2005 because they lacked medical coverage. Because uninsured children who lose their lives outside hospitals aren't included, the number of deaths is probably much higher, Abdullah noted.

"Can we say with absolute certainty that 17,000 children would have been saved if they had health insurance? Of course not," said co-author David Chang, also of Johns Hopkins. "The point here is that a substantial number of children may be saved by health coverage."

The second study, published online by Health Affairs on Oct. 20, reports that large numbers of uninsured adults have chronic illnesses that are undiagnosed and undertreated. Its Harvard University authors, Dr. Steffie Woolhandler and Dr. David Himmelstein, are well known advocates for universal health insurance.

According to their analysis of nearly 16,000 individuals, 46 percent of uninsured adults with diabetes were unaware they had the condition, while 52 percent of uninsured adults with high cholesterol didn't know their status, the researchers discovered. The conclusion comes from comparing answers on government surveys with results from medical exams and tests.

Meanwhile, more than 77 percent of uninsured adults had poorly controlled cholesterol, while 58.3 percent had poorly controlled blood pressure, researchers found.

The study suggests that millions of uninsured adults aren't getting "care that would prevent strokes, heart attacks, amputations and kidney failure," said lead author Dr. Andrew Wilper of the University of Washington Medical School.

For consumers, the message is clear. If you lose medical coverage and start skimping on care, you and your family might suffer preventable medical setbacks.

U.S. business group eyes cost in healthcare reform

2009-11-14T10:36:00.000-08:00

WASHINGTON (Reuters) - An influential business group said on Thursday that its continued support for President Barack Obama's healthcare overhaul hinges on whether it slows the soaring growth rate of healthcare costs.

The Business Roundtable, which represents some of the largest employers in the United States, released a report saying that "effective" healthcare reforms could save employers as much as $3,000 per worker by 2019.

"The report also shows that reform done wrong ... could make a bad situation much worse, in which case Business Roundtable could not support the bill," Eastman Kodak (EK.N) Company Chairman and Chief Executive Antonio Perez said in a statement accompanying the release of the report.

Obama said it was further evidence that the U.S. healthcare system is broken.

"If we don't pass comprehensive reform, the report finds, health care costs that are already squeezing our businesses will continue to rise, and in 10 years, employment-based spending on health care for large employers will be fully 166 percent higher per employee than it is today," the president said in a statement.

"The yearly health insurance costs for the average employee will rise to a staggering $28,530," he added, citing a finding by the report.

Companies represented by the Business Roundtable, which includes such giants as Verizon Communications Inc. (VZ.N), The Boeing Company (BA.N) and Exxon Mobil Corp. (XOM.N), provide health insurance to more than 35 million workers and their families. The group has been a major force behind the healthcare overhaul push.

The business group opposes the bill approved last week by the U.S. House of Representatives. It says the measure fails to control costs and that some provisions, including one that would create a new government insurance plan, could undermine employer-sponsored health coverage.

The report, written by Hewitt Associates for the Business Roundtable, favors some of the cost-containment reforms included in legislation passed by the Senate Finance Committee.

These include changes in the government Medicare health insurance program for the elderly that would reward quality of care and not the quantity of services and treatments performed.

The report said a strong requirement that individuals be responsible for obtaining health insurance would help ensure that premiums do not jump with a proposal that would bar insurers from rejecting people with pre-existing conditions.

The Finance Committee weakened enforcement measures of the individual mandate provision, raising concerns that healthier people will delay seeking insurance, increasing the costs for those who buy insurance.

Health Insurance Reform Could Harm Children

2009-11-14T10:34:00.001-08:00

Concerns over the negative impact of health insurance reform on children have been raised recently by child health and industry advocates. One concern is the possible burden on children’s hospitals because of cuts to hospitals, while another is associated with the repeal of the Children’s Health Insurance Program (CHIP).

Reductions to Children’s Hospitals
The first issue is the $155 billion reduction in federal payments over 10 years which hospital groups agreed to in July. A USA Today (Nov. 6) story reported that the industry’s trade group (National Association of Children’s Hospitals) claims these cuts will have a disproportionate impact on children’s hospitals, resulting in significant reductions in the health services they will be able to provide for children.

The problem is the proposed reduction in federal payments that reimburse hospitals for the care they provide to people who have no health insurance or who are on Medicaid. Children’s hospitals provide services to a greater share of patients on Medicaid than to general hospitals, and Medicaid pays hospitals less than private insurance. Children’s hospitals also have less to gain from an increase in the number of people who will get health insurance under the reform package because most of them already have coverage.

Therefore, hospitals that serve children are lobbying Congress to stop changes to health care that they claim could cost them hundreds of millions of dollars. The industry trade group estimates legislation approved by the Senate Finance Committee would reduce funding to children’s hospitals by $876 million. The bill in the House would cut it by $395 million.

Elimination of CHIP
Elimination of the Children’s Health Insurance Program (CHIP) is another concern. The health reform bill passed by the House vote would repeal CHIP in 2014 and shift some low-income children into the Medicaid program while others would have to go to private plans that could be most costly and guarantee fewer benefits, noted The Washington Independent.

The reform bill passed by the House expands Medicaid eligibility to 150 percent of poverty and then sends all other children who live above that level to private health insurance plans, the so-called exchange mentioned in the reform package. While Medicaid programs are required to offer preventive care (a plan that includes early periodic screening, diagnosis and treatment), the exchange plans do not operate under the same mandate. Thus the families of children who end up with the exchange option will be forced to pay more for less coverage.

Not everyone is behind the drive to end CHIP. Sen. Jay Rockefeller (D-WVa) has sponsored an amendment to reauthorize CHIP through 2019, and members of the Finance Committee passed the amendment last month.

The future of health insurance reform in America is uncertain. For children who have no direct voice in the matter, the fallout of cuts to health insurance coverage and medical care could have a lasting negative impact on the rest of their lives.

GOP jettisons abortion coverage from own insurance

2009-11-14T10:34:00.000-08:00

The GOP is doing its darndest to quickly move on from an embarrassing revelation -- that even as congressional Republicans insist that the health care overhaul does not cover abortions, the national party's own health plan covers elective procedures.

Late Thursday night, the Republican National Committee acknowledged that its health plan, as far back as 1991, included some coverage for elective abortion. Chairman Michael Steele instructed the RNC's director of administration to opt out of any coverage for elective abortion services in its health insurance policy, the party said.

"Money from our loyal donors should not be used for this purpose. I don't know why this policy existed in the past, but it will not exist under my administration. Consider this issue settled," Steele said in a statement.

The situation was first reported by Thursday by Politico, which cited two sales agents for Cigna who said that the RNC's policy covered elective abortion and that the RNC didn't opt out of abortion coverage when given the opportunity.

Abortion has emerged as a key issue in the health care debate after the bill approved by the House last weekend included a provision that would ban a new government-run public insurance plan from offering coverage and that would also bar private insurers that accept federal subsidies from doing so.

Supporters, including Republicans, say the provision preserves the Hyde Amendment, which prohibits the use of federal money for abortions, except in cases of rape, incest, or danger to the life of the mother. But opponents say the provision goes far beyond that and would result in many women either being denied coverage or having to pay more.

US Republicans Criticize Democrat Health Reform Plan

2009-11-14T10:32:00.000-08:00

U.S. Republicans say the country's health care costs could be lowered by cutting down on lawsuits and allowing people to buy health insurance plans across state lines.

Giving the Republican Party's weekly Saturday radio and Internet address, Illinois Congressman Mark Kirk said his party's suggested reforms are "common sense." He said he regrets their health care reform bill was rejected.

Kirk said the Democrats' plan is "a new massive spending program," when the national debt already "tops $12 trillion."

Last week, Democrats in the House of Representatives passed their plan. It includes a government-run option for health insurance and extends coverage to an additional 36 million people.

The government estimates the new bill would cost about $1.2 trillion over 10 years.

The U.S. Senate has yet to pass health care legislation.

Michelle Obama doesn't let cold stand in way of pitching health care reform

2009-11-14T10:31:00.000-08:00

WASHINGTON - First Lady Michelle Obama didn't let a common cold get in the way of keeping health care reform in the news while her husband travels to Asia for diplomatic meetings and an economic summit.

Obama apologized for her sniffles to a Friday gathering of mostly women in the East Room of the White House, where she highlighted the medical needs of older women.

"I don't think anyone here will be surprised to learn that a recent study found that one-third of all women have either used up savings, taken on debt, or given up basic necessities just to pay their medical bills," she said.

"And as many of you know firsthand, these kinds of problems - the problems of coverage and cost - only grow worse when you get older, making quality, affordable coverage harder to come by…just when you need it the most."

The popular First Lady is viewed in and out of the White House as a compelling surrogate for her husband on health care reform, yet she has only done a few events on the topic. She has focused mainly on health insurance issues that face families - a topic close to her heart.

"Our mothers and grandmothers, they have taken care of us all their lives; they've made the sacrifices that it takes to get us where we need to be. And we have an obligation to make sure that we're taking care of them. It's as simple as that," she said.

The First Lady took aim at what she described as myths surrounding Medicare, in particular.

"Not a dime of the Medicare Trust Fund will be used to pay for reform. Health insurance reform will not endanger Medicare; it will make Medicare more stable and secure," she insisted.

"My husband believes that Medicare is a sacred part of America's social safety net, and it's a safety net that he will protect…with health insurance reform."

Tools and tips for navigating Medicare open enrollment

2009-11-14T10:30:00.000-08:00

Sometimes it seems as if the raging debate about overhauling health-care insurance is filling all the airwaves. Easily lost in this din is that any reform wouldn't take affect until 2013, but Americans need to take steps today to ensure they're properly covered. For seniors enrolled in Medicare, that means reviewing prescription drug coverage, known as Part D, and so-called Advantage plans, private-insurance alternatives to the government-run plan, if they participate in such programs.

Known as open enrollment, the annual process starts Sunday, Nov. 15, and goes through Dec. 31. As in years past, health-policy experts advise older Americans to not assume that their current plan, which may have worked well this year, will be as effective (or even exist) next year. Further, an existing plan could cost more -- much more -- come January.

Choosing a plan can be daunting. That's because unlike open-enrollment for workers in employer-sponsored plans, which may involve just a handful of choices, seniors literally have dozens of plans from which to choose. "That's why people need to shop -- painful as it is," says Bill Vaughan, health policy analyst at Consumers Union, publisher of Consumer Reports. "It's something people should do each fall."

New data show that shopping during open enrollment saves as much as $2,019 on a package of five common drugs, according to comparisons conducted by CU. Potential savings vary by locale and medication history, so seniors should check new prices.

"Some plans that were good in the past have become pricey bad deals," Vaughan says. "Plans that were so-so before are now big savers." CU notes, for example, in New York state, among 43 plans with comparable data between 2009 and 2010, 28 will go down in total cost, which includes premiums, deductibles and co-pays, and 15 will go up, according to data available at Medicare.gov.

Helpful Resources

The best tool seniors have their at their disposal is the Medicare website, Vaughan says. Seniors who aren't comfortable navigating the Internet may want to enlist the aid of an Internet-savvy youngster. (Seniors can also call 800-Medicare or 800-633-4227.)

Another resource seniors can turn to turn are State Health Insurance Counseling and Assistance Programs, or SHIPS, says Lee Thompson, executive director at Health Assistance Partnership. Consumers can either call the agency in their state for free advice about choosing a plan or set up an in-person meeting, she says.

One scenario seniors should avoid are insurance company-sponsored meetings, typically held at local diners, which offer information about one company's products and offer to enroll attendees in one of those plans. "We call that a sales presentation," Thompson says. More often than not, such gatherings tend to be biased toward the sponsoring insurer's products.

Such meetings shouldn't be confused with seminars sponsored by SHIPS where all insurers are invited to attend and share information. "Those are educational presentations," Thompson says. "Nobody gets enrolled at them, but you would get a cross-section of plan information directly from the plans."

Making the Choices More Obvious

One step the Obama administration has taken to help seniors in making choices is to require insurers to reduce the number of plans that look similar, says Marc Steinberg, deputy director of healthy policy at Families USA, a health-care advocacy organization. For example, if a company offered four or five plans that were hard to tell apart, it has to merge them to create more distinguishable choices, he explains.

"Clearly, over the last several years there have been too many plans in the market," Steinberg says. Choice is a wonderful thing, but when presented with so many offerings, seniors tend to select names most recognizable to them, he adds. "And that's not necessarily in their financial interest."

When it comes to shopping for Medicare plans, CU's Vaughan concedes, it can be downright tedious. "It isn't exactly fun shopping," he says. "It's not like going out and buying new clothes or something for the grand kids." Indeed, it's not -- it can be a matter of ensuring your well being.

Seniors are advised to protect themselves against high-pressure and misleading sales tactics as annual enrollment gets underway. Here are a few guidelines to keep in mind, provided by the New York State Insurance Department:

* Unsolicited contacts are improper: Federal regulations prohibit insurance agents from contacting customers without express invitation. This includes door-to-door sales, unsolicited emails and phone calls.
* Ask a relative or friend to be with you: Selecting an insurance policy can be a complicated process for anyone. It's a good idea to have a relative or trusted friend with you whenever you meet with an insurance agent.
* Medicare has no sales agents: Medicare does not send "representatives" to solicit business. Be especially wary of any salesperson who claims to represent the program.
* There's no free lunch: Federal regulations prohibit the offer of a free meal in exchange for listening to a Medicare Advantage sales presentation.
* Read and understand the policy: Seniors considering changing their Medicare Advantage or Medicare Prescription Drug plans should be aware that not all policies are the same. They should carefully consider their needs and how a particular policy would meet those needs, making sure their providers accept the plan prior to enrolling.

Health Bill Abortion Clause May Derail Insurance

2009-11-14T10:29:00.000-08:00

Backers of controversial abortion language added to the House health overhaul bill last week say it merely continues longstanding policy that bans federal funding of the procedure. But opponents say it could have much more far-reaching consequences on access to abortion, particularly in the private insurance market.

The ultimate impact of the House abortion amendment could be to change abortion from being a procedure routinely covered by most private insurance plans to a procedure routinely excluded — even in cases of medical emergency.

The abortion amendment added to the House health bill has two parts. There's little debate about the impact of the first part: It would write into permanent law the so-called Hyde Amendment, which for three decades has been renewed annually to forbid direct federal funding for abortions except in certain specific cases — currently rape, incest and to save the life of the pregnant woman.

Codification of the Hyde language means if there is a government-run public option available in the new health program, it won't be able to provide abortion as a covered benefit.

The dispute is over the second part of the amendment, authored by Rep. Bart Stupak, a Democrat from Michigan. It would bar health insurance plans in the new health insurance marketplaces the bill would create — known as exchanges — from offering abortion as a benefit to people who are receiving federal subsidies to pay for their coverage.

Stupak says people buying coverage in the exchange who are not getting subsidies — technically known as affordability credits — will be able to buy policies with abortion coverage.

"I can go to the exchange as a private individual and purchase a plan in the exchange that has abortion coverage in it because I did not receive any affordability credits," he said in an interview.

Indeed, Stupak's amendment does say that health insurers can offer plans with abortion coverage to people who are paying the full premiums themselves, as long as they offer identical plans without abortion coverage to people who are getting subsidies. But most insurance experts say that's not likely to happen.

"I really think it would be impractical," says Robert Laszewski, a health insurance industry consultant. Several health insurance companies contacted for this story declined to comment, citing the sensitivity of the subject matter.

Laszewski says the problem is that by all estimates, the vast majority of people who will be shopping in the new exchanges will be getting subsidies, so they won't be allowed to get abortion coverage. Thus, if a health insurer did offer a separate plan with abortion coverage, it would only be available to a small universe of buyers, and it simply wouldn't make much business sense.

"It's not an ideological issue, it's not about abortion or not abortion," Laszewski says. "It's about what is administratively simpler, easier to administer. It just adds a level of complexity they will likely avoid."

Sara Rosenbaum, a health lawyer and professor at George Washington University, agrees that it's impractical to expect health insurance plans to cover abortion in the exchanges, even for people paying the full premiums without federal help.

"If you speak to insurers in the industry, they will tell you that they simply can't operate under these circumstances," Rosenbaum says. "They need to be able to offer standard products that get administered in a standard way for everybody."

There is another option for getting coverage under the House language: Women could use their own money to buy a separate policy that just covers abortion. But that's not likely to happen, either, says Laurie Rubiner, vice president of public policy and advocacy for Planned Parenthood of America.

Rubiner bases her conclusion on real-world experience. Five states — Missouri, Idaho, Kentucky, Oklahoma and North Dakota — already ban private insurance from covering abortion.

Yet, she says, "we haven't been able to find any kind of separate abortion rider, and it doesn't surprise us because there's no market for it. Why is that? Because no woman plans to have a catastrophic pregnancy, or an unintended or unplanned pregnancy. Therefore, she doesn't think about buying coverage separately for abortion. And since there's no market for it, the product doesn't exist."

So, even if lawmakers don't intend for it to happen, both insurance consultant Laszewski and health lawyer Rosenbaum say the House abortion amendment could dramatically reduce the availability of insurance coverage.

Says Rosenbaum: "The consequence of that is to exclude from the insurance system a procedure, depending on the circumstances under which it's needed, an incredibly costly procedure — and even when it's not life threatening, leave a woman and her family with thousands of dollars in unpaid bills."

Of course the debate over the health bill, and abortion's role in it, is far from over. The Senate version could come to the floor next week.

Health Insurance Reform and Veterans

2009-11-14T10:28:00.000-08:00

Health insurance reform opponents continue to spread myths about the recently-passed Affordable Health Care for America Act, including saying that reform will undermine the health care that veterans and military families have now. The latest myth spread by some Republican Members is that the bill passed by the House fails to ensure that veterans and service members will have the choice to purchase insurance through the Exchange. But the facts continue to knock these myths down.

MYTH: "The House-passed health insurance reform bill reneges on a promise to ensure veterans, service members, and their dependents have the choice of enrolling in the new Health Insurance Exchange."

FACT: The Affordable Health Care for America Act fulfills Democrats´ commitment to ensure choice for veterans, service members, and their families. The House-passed bill allows veterans receiving VA health care or service members and their families receiving TRICARE to also enroll in an insurance plan through the bill´s Health Insurance Exchange.

Section 302(d) specifically allows all individuals into the Exchange except those enrolled in Medicare, Medicaid, and certain employer-sponsored insurance. Listening to veterans´ organizations, the bill was strengthened to provide that veterans, service members, and their families are now permitted into the Exchange at their option in addition to maintaining enrollment in veterans´ health care or TRICARE. (In H.R. 3200 as introduced, veterans enrolled in VA health care and service members enrolled in TRICARE did not qualify for the Exchange.) This provides veterans and service members the opportunity to obtain additional coverage for themselves and their dependents if they desire.

This provision addresses clearly a key concern of many veterans´ organizations. For example, the Disabled American Veterans had written: "Any national health care reform legislation must make certain all veterans, including those enrolled in VA health care, remain eligible to enroll in any exchange-participating health benefits plan offered under [the bill] through the Health Insurance Exchange, or in any other public or cooperative health insurance program."

MYTH: "Enactment of the House health insurance reform bill would undermine the health care that veterans and military families are receiving now."

FACT: Veterans´ health care and TRICARE (for military families) would not be impacted by passage of the House passed Affordable Health Care for America Act. Nothing in the bill would affect, change, or undermine the health care that veterans enrolled in VA health care and military families enrolled in TRICARE are currently receiving.

Further language has been included in the Affordable Health Care for America Act that makes clear that the Department of Veterans Affairs and the Department of Defense retain full authority to operate the VA health care system and TRICARE without interference from the Health Choices Administration or other agencies established by the legislation. In addition, specific language has been included to exempt TRICARE from the requirements of the essential benefits package and other insurance requirements.

MYTH: "Veterans and military families enrolled in VA health care and TRICARE will be penalized for not having acceptable coverage – being forced to pay the penalty of 2.5 percent of adjusted income."

FACT: The Affordable Health Care for American Act as passed recognizes VA health care and TRICARE as acceptable minimum coverage—so enrollees are already meeting the shared responsibility requirement and will face no fee or penalty.

Specifically, the bill contains a section that states that 1) individuals enrolled in the veterans´ health care program; and 2) individuals and dependents enrolled in TRICARE will be considered as having acceptable minimum coverage – meaning they have met the bill´s shared responsibility requirement for individuals to purchase insurance if they can afford it. In other words, individuals enrolled in VA health care or TRICARE will never be subject to the bill´s 2.5 percent fee for those who choose not to purchase affordable health insurance.

Five Insurance Options for the "Uninsurable"

2009-10-31T07:49:00.000-07:00

Individuals with preexisting conditions (like diabetes, cancer, heart disease, heart attack, stroke, kidney disease, liver disease, AIDS, depression, and a long list of other health conditions) are considered “uninsurable” by many insurance companies, and may find it almost impossible to find affordable healthcare.

If you are one of the thousands in this situation looking for health insurance, you know how hard a task it can be. Being uninsurable due to preexisting conditions will limit your health insurance choices, but there are ways to provide you with affordable healthcare coverage. Using creative insurance planning and the knowledge and understanding of what’s available, you can greatly reduce the potential financial strain on you and your family.

Below are the 5 options for Health Insurance Coverage in Washington State, and how each option can potentially work for the “uninsurable”:

1. Group Health Insurance. Group health coverage is generally provided by your employer or your spouse’s employer, and is by far the best choice for individuals with preexisting conditions and the uninsurable. Usually premiums are a split between the employer and the employee, and the employee normally has little or no choice in deciding what features will be available to the employee and his/her family. One of the main advantages of group insurance is that coverage is usually available to newly hired employees without any medical questions or concern for a preexisting condition, though there may be a short waiting period before full coverage is available. Insurance typically ends when the employee's job ends.
2. Professional Organization. Some professional organizations offer members a health insurance program as a membership benefit. This coverage could be a way to obtain insurance if you are uninsurable. Depending on the organization, a paid membership may be all that is required to start a health insurance plan. For others, you may be required to have certain career experience or a certification. Some associations accept membership from anyone interested in joining. Even if membership is expensive, it still may be money well spent.
3. Private Individual Health Insurance. If you don’t have access to an employer sponsored or a professional organization’s health insurance plan, but you have extensive health care needs, you may find obtaining individual health insurance coverage extremely difficult. Insurers can decline coverage if preexisting conditions exist although there are some exceptions. We will help you determine if an individual medical plan is an option for you.
4. State Risk Pools. Washington provides access to health plans for the uninsurable through a high-risk health insurance pool. Consumers in this pool have access to comprehensive private coverage plans. Premiums can be very high, sometimes costing twice as much as those for regular private health insurance. You may find that this risk pool can be closed to new enrollments or has a waiting list. However, it is an important last resort for someone who has been denied medical coverage because they have preexisting conditions. We can help you determine if you are eligible for the Washington Insurance Pool, just call us!
5. Discount Health Cards. Many companies sell discount health cards to consumers seeking affordable healthcare. The cards claim to save subscribers money by offering discounts on physician visits, hospital stays, prescription drugs, dental, vision and chiropractic care. But discount health cards can be confusing, because they are not really insurance. You are still responsible for paying the medical bills yourself. These cards simply offer lower prices on services from the healthcare providers who agree to accept the discount terms. Sometimes, they make grossly inflated promises about the expected savings and benefits. Use caution when purchasing these cards as they can cost you more money than you’ll save.

Appealing Medical Insurance Claims Washington

2009-10-31T07:44:00.000-07:00

Despite many consumers paying insurance premiums faithfully for years, insurance companies regularly deny claims. How do you know if the claim was denied correctly? How do you know if you should fight? And, if so, who do you fight and how?

Luckily, when you are a client of My Health Insurance of Washington we help you every step of the way. We know the insurance company games, and we know who to call on your behalf.

Below are some helpful hints to help you understand the appeal process:

1. Call Us: At My Health Insurance of Washington our goal is to get you the maximum value out of your health insurance. Many times we will know the answer to your denied claim right away. Often we can save you the frustration sitting on hold with the insurance company, only to get passed from one person to the next.

2. Appeal the claim: The denial may have been caused by human error, which does occur as insurance companies and medical providers are overwhelmed with paperwork. Each insurance company has its own appeals process, the details of which are in your contract. Don’t worry, we already know all about your policy!
3. Get medical help: from your own doctor. Your doctor can provide the evidence required by the insurance company proving that the care you received was a medical necessity.
4. Keep records: Record all correspondence between you and your insurance company. For telephone conversations, write down the name of the person you spoke with, the date and time, and confirm the important parts of the conversation. Follow up with #5 below.
5. Put it in writing: Mail a complaint to the insurance company headquarters, to every name you have on file, to the president of the insurance company, and to the head of the customer service department. All correspondence should be sent by certified mail to confirm receipt. Include copies of all relevant supporting documentation.
6. Contact the authorities: When the former attempts fail, file a formal complaint with The Washington State Office of the Insurance Commissioner www.insurance.wa.gov
7. Negotiate the bill: You ask for discounts when shopping for new cars and appliances, and you can ask for a discount from your medical doctor or hospital. If the insurance doesn’t cover a procedure, ask whether or not payment in cash would warrant a discount, or if you can make regular payments over time.
8. When all else fails - Get a lawyer: An attorney with medical insurance and appeals experience, who focuses in health law would be your best option. Hiring a lawyer is not a cheap proposition, but it can be significantly less expensive than laying out hundreds of thousands of dollars for medical care you have been wrongly denied.

Coverage of Holistic, Homeopathic, and Alternative Medicine Treatments

2009-10-31T07:42:00.000-07:00

Many insurance plans now cover a number of alternative treatments that were once thought to be outside normal medical procedures. This is especially true in Washington State, where alternative and homeopathic treatments are widely sought out and accepted. However, there is no hard and fast rule governing coverage of alternative medicine, so be sure you check into the coverage of your specific plan before you seek alternative medicine treatments.

The most commonly covered alternative treatments include chiropractic, acupuncture, and massage therapy. Keep in mind that most insurance plans will require a referral from your primary care provider before you can see any type of specialist, including alternative medicine providers.

Additional questions to ask your insurance provider before receiving holistic, homeopathic, or alternative medicine treatments:

* Does this care need to be pre-authorized or pre-approved?
* Do I need a referral from my primary care provider?
* What services, tests, or other costs will be covered?
* How many visits are covered and over what period of time (for example, 6-10 visits per year of acupuncture)?
* Is there a co-payment?
* Will the therapy be covered for any condition or only for certain conditions?
* Will any additional costs be covered, such as lab tests, dietary supplements, equipment, or supplies?
* Will I need to see a practitioner in your network? If so, can you provide me with a list of practitioners in my area?
* If I use a practitioner who is not part of your network, do you provide any coverage? Are there any additional out-of-pocket costs?
* Are there any dollar or calendar limits to my coverage?

It can be tricky to understand which services are covered and under what circumstances. A service representative at My Health Insurance Washington would be happy to do the investigating for you and to explain your plan’s benefits and limitations in terms you understand.

offer range of benefits to bridge Medicare coverage gaps

2009-10-23T15:01:00.000-07:00

When it comes to health insurance, Medicare is definitely the 800-pound gorilla. The federally funded program covers more than 40 million Americans – those aged 65 and older, plus some younger folks who may be eligible due to certain health conditions, or because they're disabled.

There's plenty the program covers – services that include hospitalization through Medicare's Part A, and doctor visits and other outpatient expenses through Part B. But – as with most health plans – Medicare won't pick up the tab for everything.

That means that the millions who make the decision to enroll in "original" Medicare must also make decisions about Medicare Supplement Insurance – or "Medigap" – that fills the considerable gaps in Medicare's coverage. Consumers pay premiums for these plans through private insurance companies in addition to their Medicare Part B premium.

A collection of 12 different plans – identified by the letters A through L – give Medigap policy holders varying combinations of benefits. The plans cover expenses ranging from copayments, coinsurance and deductibles, to foreign travel emergency expenses, at-home recovery and preventive care.

The plans are standardized, meaning that each policy must offer the same basic benefits, regardless of which insurance company issues the policy to you. However, there are some variations in the way Medigap policies are standardized if you live in Massachusetts, Minnesota or Wisconsin.

Also, in some states, not all types of Medigap policies will be available. In other states, you may be able to purchase a Medigap policy called Medicare SELECT – a policy that requires plan holders to use specific hospitals and, in some cases, specific doctors.

You should also know that while Medigap fills many gaps, it doesn't fill them all. Policies don't cover long-term care, vision or dental care, hearing aids, eyeglasses and private duty nursing. If you want prescription drug coverage, you may want to join a Medicare Drug Plan (Medicare Part D), offered through private companies approved by Medicare.

Anyone enrolled in Medicare Part A and Part B can purchase a Medigap policy. The best time to purchase is during a six-month open enrollment period. The period beings on the first day of the month in which you are 65 years or older and enrolled in Medicare Part B. During this period, an insurance company can not refuse to sell you any Medigap policy sells, generally can't make you wait for coverage to start, and can't charge you more for a policy because of your health issues.

Appeal of employer-sponsored plans is obvious

2009-10-23T15:00:00.000-07:00

Of the U.S. citizens who have health coverage, the vast majority – nearly 60 percent – secure that coverage through an employer-sponsored plan, often called group health insurance. Even while employer-sponsored coverage has been declining – down from 64.2 percent in 2000 – millions continue to take advantage of the coverage for reasons that are easy to understand:
Costs

First, the employer typically takes responsibility for a significant portion of the health care expenses. A recent Kaiser Family Foundation survey of employers survey of employers found that in 2008, premiums for employer-sponsored health insurance climbed to $12,608 a year for family coverage. Of premium costs, employees paid less than a third – or about $3,354 – from their paychecks.

Ease of enrollment

And while cost is appealing, enrollment is perhaps even more appealing. Group health plans are guaranteed issue, meaning that the insurance company must cover all applicants whose employment qualifies them for coverage – and can't rate up increase the cost for an applicant with a pre-existing health condition.

Note: Nearly a dozen states have a provision for the self-employed to qualify as a "group-of-one," meaning that they, too can purchase a guaranteed-issue plan.

The reason: In a group plan, the risk is spread across all the participants in the group. In smaller groups, where the risk is more thinly spread, a serious illness to one employee can make the entire group more expensive to insure.
Options

Because large groups can use their size to negotiate better benefits, employer-sponsored plans typically are able to include a range of plan options. In addition to HMO or PPO plan, employees may have the option to purchase insurance for dental, life, short- and long-term disability.
To be enrolled or not to be enrolled

Do most employees enroll in available plans? As with any health plan, higher premiums result in lower enrollment. But before opting out of an employer-sponsored plan, remember that it's essential that you have health insurance for you and your family. More than 60 percent of bankruptcies in the United States are the result of medical bills. In addition, over a recent six-year period, an estimated 137,000 Americans died due to a lack of health insurance. They either received too little care or received that care too late.
What happens if you lose your job?

If you lose your job, an obvious option will be COBRA. The Congressional Omnibus Budget Reconciliation Act of 1985 allows laid-off workers to continue to purchase the health coverage from their employer-sponsored plans for a defined period – typically 18 to 36 months – after they leave their employers.

Understanding the strengths and weaknesses of this federal safety net

2009-10-23T14:59:00.000-07:00

As the nation's economic crisis continues to unfold, millions of Americans have found themselves hit by a frightening health care crunch.

Unemployment in the United States has hit record levels, fueled by layoffs as companies tighten their belts. And those laid off have found themselves faced with the challenge of finding a way to replace the insurance coverage they may have enjoyed in an employer-sponsored health plan.
For many of those newly unemployed, an obvious option will be COBRA, a federal law that allows laid-off workers to continue to purchase the health coverage from their employer-sponsored plans for a defined period – typically 18 to 36 months – after they leave their employers.

COBRA – the Congressional Omnibus Budget Reconciliation Act of 1985 – will seem an obvious option because employers are mandated to provide information about COBRA to those who have been laid off. They explain that COBRA was designed as a safety net, allowing them to extend the coverage they had with their employer while they seek new insurance coverage through such options as a new employer-sponsored plan, a spouse's employer-sponsored plan, plans from the private market, and state-sponsored plans.

But while COBRA's safety net may seem an obvious choice at first glance, it may not be the right option for everyone. In fact, a recent estimate revealed that less than 10 percent of eligible workers were opting to continue their employer-sponsored coverage through COBRA.

Many individuals find the extended coverage too expensive. And COBRA coverage is more expensive than when the employer was sponsoring the same coverage. That’s because when the employee accepts the COBRA health insurance option, he or she assumes the portion of the premium that the employer had been paying.

There is some good news: In recent months, Congress took a huge step toward cutting the cost of COBRA coverage as part of the economic stimulus package signed into law by President Obama. The package provides a nine-month subsidy that will cover 65 percent of COBRA premiums for employees who’ve been laid off.

The subsidies would apply to people who were involuntarily terminated between September 1, 2008 and December 31, 2009. They do not apply to individuals with an adjusted gross income of or $125,000 or more or to married couples filing jointly with an adjusted gross income of $250,000.

But even with the subsidies, COBRA STILL isn’t necessarily the best option by default.

Depending on provider in individual states, there may be less expensive coverage available on the private market. These insurance options may include short-term major medical insurance policies – plans designed to provide coverage for consumers who need one to six months of coverage. Short-term major medical plans may be particularly attractive because – at least with healthy individuals – the plans can be activated immediately and offer savings of up to 35 percent over other private plans.

And sadly, sometimes COBRA coverage isn’t even an option. Workers should be aware that the federal COBRA law does not apply to individuals when a company decides to save money by dropping its group health coverage OR when the coverage stops because the company is filing for bankruptcy. In these situations, individuals will again need to consider options that include plans from the private market and state-sponsored plans.

One piece of advice individuals should always remember is that it pays to do research before it’s time to consider the COBRA option. That means consumers should find out as much as possible about insurance options in your state and research the actual costs of policies by getting a quote online.

Regardless of what path you choose, it’s critical that individuals make sure that they are continuously covered – and that there is not a break in their health coverage that could invalidate an individual’s federal right to portability of coverage.

required reading for college-bound

2009-10-23T14:57:00.000-07:00

Long before the first class of the first college semester begins, prospective students and their families need to begin doing their homework to ensure that their health coverage will not only continue uninterrupted, but that coverage will receive more than a passing grade.

A recent report released by the Government Accounting Office revealed that roughly 1.7 million traditional age college students are uninsured in the United States. It’s a disturbing statistic, considering that young Americans – while tending to be more healthy – are among the group of Americans also more likely to end up in the emergency room.

And the GAO report showed that in 2005, uninsured students amassed between $120 million and $255 million in uncompensated, non-injury-related medical expenses. Equally disturbing: recent reports revealing that nearly two-thirds of young uninsured adults don’t seek treatment because it is too expensive.

They’re statistics that colleges are interested in changing and, in recent years, many colleges have begun taking steps, including instituting requirements for proof of health insurance as a condition of enrollment. So, for prospective students, a logical first step is determining whether their college of choice has such an insurance requirement.

From there, it’s a matter of considering the options for coverage.
School-sponsored plans

While schools are increasingly asking enrolling students to prove that they’re covered, many colleges are also providing a coverage option through student health plans. About 60 percent of all colleges currently offer student health plans, according to the GAO report. Of them, 82 percent of four-year public colleges and 71 percent of four-year private colleges now offer plans.

The good news is that eligibility requirements on student health plans are typically less restrictive than on individual plans. And, if you take advantage of a plan offered by your college, you should be eligible for coverage when you enroll as a full-time student. Additionally, some student health plans will allow you to extend your coverage beyond graduation.

The not-so-good news is that there are huge variations in the costs and the benefits of student health plans, which range from policies that protect you from accidents, to major medical. So it’s definitely important to check out a policy’s benefits and whether there are gaps in your coverage.

For instance, some student plans may require you to take treatment from your college’s student health center or providers within a specified distance from campus. That means you may not have coverage when you travel home. And remember that most student health plans won’t cover you if you travel outside the United States, so if you do purchase a student health plan, be certain you secure additional coverage for those trips.
Health care that’s a family affair

Despite the increase in the number of student health coverage offered by schools, the GAO's report revealed that most college students between the ages of 18 and 23 receive coverage under another person’s plans – and it's usually their parents' policy. By doing so, students avoid an interruption in coverage, a change in benefits and possible restrictions that student health plans may put on care providers.

But again, prospective students need to do their homework:

A recent report by The Commonwealth Fund showed that 60 percent of employer-sponsored health plans required students to be enrolled full-time to receive coverage as a dependent. This means that when a student drops below a specified number of credit hours, they may risk dropping their coverage.

And students should also know that their parents’ employer-sponsored coverage will, at some point, end – sometimes when the student is age 19 or 23, but in some cases as late as age 25. Students may also be dropped from their parents’ coverage if they marry.
Going it alone

If a student has been phased out of their parents’ coverage and no school-sponsored plan is available (or a good fit for the student), students may be covered by employer’s policy if they work full-time. Or, they can purchase their own standard individual health plan from a licensed health insurance provider.

One obvious difference for students considering a private plan will be a required screening in which the applicant answers a series of questions to determine whether they’re eligible for coverage. Applicants with a pre-existing condition may be denied coverage by a particular insurance provider, but should bear in mind that criteria varies from provider to provider – so keep shopping.

Depending on the state in which you reside, you may also be eligible for coverage by a state-sponsored risk pool, a program that provides coverage for individuals denied insurance by private insurers because of their health condition.

As always, no matter what type of insurance you choose, be a responsible consumer. Make sure you understand what you are purchasing and that you closely review the benefits and limitations.

short-term major medical fills tall order for “in-betweens

2009-10-23T14:56:00.000-07:00

The nation’s current economic downturn has sent reverberations through the corporate world, creating waves that have put hundreds of thousands of Americans who previously had health coverage adrift – and desperately seeking a safe harbor.

But layoffs are only the most visible of the multitude of ordinary, but life-changing, events that create millions of "in-betweens" – average consumers who need individual health insurance coverage fast, if only for a short period of time.

Consider that the number of “in-betweens” at any given time is astonishing. Estimates as to the numbers of temporarily uninsured include:

* 22 million part-time employees
* 5 million recently graduated students no longer covered by their parents’ policies
* 900,000 Americans who have lost coverage following a divorce
* 300,000 recently discharge members of the military
* 8.7 million Americans between jobs (and who may be trying to avoid more expensive COBRA health insurance coverage
* 5 million early retirees

Many of those “in-between” health care consumers are now looking for a quick fix that has appeared in the form of short-term major medical health insurance policies. These increasingly popular health plans – available through private health insurance providers – were designed to provide coverage for consumers who need one to six months of coverage to avoid the possibility of a health crisis that could cause a serious financial hardship.
A short list of pluses

Under the policies, healthy individuals can secure immediate individual and family coverage – plans that can kick in as early as the next day And, if you already know the number of days you will need to be covered, your insurer may allow you to make a single payment for a policy based on the coverage period.

The policies are typically offered with a selection of premiums and deductibles and are promoted as providing savings of up to 35 percent over a typical privately purchased plan. The policies also cover a range of physician services, surgery, outpatient and inpatient care. In addition, policy holders can often choose their own doctor and hospital without restrictions, though there may be financial incentives for using in-network providers.

So if you’re healthy and in need of temporary coverage until new coverage kicks in, a short-term major medical plan may be right for you.
What short-term major medical plans won’t cover

Short-term major medical plans may be a great fit for healthy folks who just need temporary coverage, but the plans weren’t designed to cover everything. They typically won’t cover your routine office visits and preventative care – and they won’t cover preexisting conditions. Be sure to check the list of exclusions on any policy.

Short-term major medical may not be available in all 50 states.

As always, no matter what type of insurance you choose, be a responsible consumer. Make sure you understand what you are purchasing and that you closely review the benefits and limitations.

Self-employed health insurance

2009-10-23T14:55:00.000-07:00

The self-employed face a set of unique challenges in finding and keeping health insurance. We've provided answers for a few of the most commonly asked questions.
Frequently asked questions (FAQs) about health insurance for the self-employed
I plan to become self-employed.
How do I keep my health coverage?

The brave individuals who become self-employed often preserve their health coverage by taking the initial step of extending their employer-sponsored health benefits through COBRA. The Consolidated Omnibus Budget Reconciliation Act of 1985 allows workers to extend those benefits for up to 18 months after leaving a job. The down side: employers no longer pay their portion of the plan's premium, which can be anywhere from 75 to 80 percent of a plan's cost. By keeping the coverage and paying the employer portion, you'll likely see a huge difference in what you pay for the coverage.

Beyond COBRA health insurance coverage, what are the health insurance options for the self-employed?

One option would be to buy an individually underwritten policy on the open market. If your family health history is clean, it's simply a matter of finding a policy that offers a mix of benefits and costs that work for you. Make sure to choose a plan with adequate benefits to protect both your family and your assets. Most bankruptcies in this country are caused by unexpected medical emergencies combined with inadequate protection. (This may be an even bigger issue as you grow equity in your business and have more to lose.)
My employer-sponsored benefits covered a pre-existing condition. Can I still get coverage for that condition if I become self-employed?

As long as you continue to pay for COBRA coverage, you can not be denied coverage for your pre-existing condition. However, if your 18-month COBRA period ends or you decide to leave COBRA to seek individual coverage through the private market, you do risk the possibility that you may be denied an insurance policy. (Not surprisingly, this threat is often a deterrent to those choosing between self-employment and opting to stay in an unfulfilling job which, at least, provides health benefits.)

Make sure – ahead of time – that you know your options for obtaining health insurance coverage once your COBRA eligibility ends. Some states offer the ability to move without predjudice to an individual market plan after your COBRA eligibity has expired, provided that you have not let your coverage lapse. Again, check with a licensed insurance professional versed in the laws of your state for advice.
Are there other ways to keep health insurance as a self-employed individual if there is an issue in the health history of one of my family members?

If you're married and your spouse is covered under another employer's group health insurance plan, you may be able to get family coverage that's less expensive than buying it through the private market. One significant advantage of such coverage is that when your spouse adds your family to his or her coverage, the additional coverage usually can not be denied – or premiums rated up – because of health history.
I live in a "guaranteed issue" state. How does that help?

A few states, such as New York, have what is called guaranteed-issue health insurance. In those states, companies doing business in the state must offer you the opportunity to purchase insurance coverage regardless of your health history. What that means can vary somewhat by state statute.

In some states, eligibility may be restricted to those who can show continuous coverage, meaning that you must already have a plan to be able to apply and move to the guaranteed issue plan. Check with a health insurance professional in your state before dropping any coverage you already have.
What if my state has a health insurance risk pool?

Thirty-four U.S. states have created health insurance risk pools which provide the opportunity for individuals or families with pre-existing medical conditions to buy a special state-sponsored health insurance plan, with partial costs often offset in part by assessments to health insurance carriers. Unfortunately, the usefulness of these state plans vary considerably. Some states – such as Minnesota – offer solid plans with costs slightly higher than open-market costs. Some other states have plans that are underfunded or poorly planned and do not offer a viable alternative to most self-employed people. The risk pools are considered an insurer of last resort. More on risk pools here.
What about association-endorsed health insurance plans?

Let the buyer beware. Federal and state governments have been taking a close look at association-endorsed health insurance plans, with the concern that in many cases these associations have been set up simply to market health insurance plans. These plans often use loopholes that allow them to raise prices to consumers more aggressively than they otherwise could.
Can the self-employed deduct the cost of their health insurance premiums?

Yes! Thanks to recent changes in tax law, the self-employed can deduct the cost of their health insurance premiums from their federal taxable income (not to exceed the amount of their actual income – in other words, you can't use your health insurance premiums to show a loss for your business). This puts the self-employed on equal footing with big business, which has long been able to count health insurance premiums as a business expense.

How to Evaluate Health Insurance Companies

2009-10-23T14:53:00.000-07:00

When you're debating over where to spend your money for the best possible individual or group health insurance coverage, there's plenty to consider – and it's not just the premiums and out-of-pocket costs. Before you start seeking health insurance quotes, it's prudent to take a look at the health insurance companies and their potential service to you as a consumer.

In your evaluation of an insurance company, you should ask yourself questions that include the following:

* Is your insurance company financially stable?
* Will your company make it easy for you to switch physicians if necessary?
* Does your company care about the reputation of the doctors in its network?
* Will the company respond quickly to your concerns?

How to check out your prospective health insurance provider
Financial rating

An easy place to start is your prospective insurer's financial rating. Free resources, such as A.M. Best's Financial Strength Ratings provide online ratings of insurance companies and their ability to fulfill their financial obligations to the consumer. Nowadays, health insurance portals will offer insurance company ratings before you buy.
Who provides your health care?

Take a look at a health plan's network of physicians – and take a look at the physicians. The American Medical Association offers free basic information about every licensed physician in the United States. Your local library also likely carries the Official ABMS Directory of Board Certified Medical Specialists.
Provider customer service

From the very start of your interaction with an insurance company, you can gauge their customer service by noting the way they respond to your questions (and hopefully, you'll have many). Are they sympathetic to your individual needs? Are they trying to help solve your problems?
Independent rankings

You can also get information about customer satisfaction through resources such as Consumer Reports – with membership – and through annual rankings by magazines such as U.S. News & World Report.

The National Committee for Quality Assurance also provides an online Report Card that allows you to compare plans based on criteria that includes member satisfaction.

Once you've narrowed the field, you might also resort to good old Google – and doing a search on the company's name for articles OR a search with pairing the company name with the word "complaints" or "violations." You can also do the same with the name of your state plus "insurance commissioner" and "complaints" to see the number of complaints filed against a carrier.

Naturally, you can also get a sense of an insurance company's customer service by talking to customers: your friends, family, and colleagues in your field.

Once you've done your homework on health insurance companies' customer service, financial stability and policy quality, your research comparing health insurance quotes will be that much easier.

Privacy Policy

2009-10-20T14:03:00.000-07:00

Privacy Policy for http://healthy-insurance-quotes.blogspot.com/

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The Best Health Insurance Providers in the United States

2009-10-17T10:17:00.000-07:00

In order to obtain the best medical insurance for your own as well as for your family members, it will be wise to look for the most well known health insurance companies in the market. If you don't have any idea, this article may be able to assist you.

WellPoint Incorporation

It is the leading health plan provider in United States with approximately 35 million medical members. One of every nine Americans receives coverage for their medical care through WellPoint's affiliated health plans. It offers a broad range of medical and specialty products.

United Health Group

It is the second largest health insurer in United States which is right behind WellPoint. It is famous for its health benefit plans with lower medical costs. In addition, it offers specialty care programs such as vision and dental care, as well as Health Savings Accounts and Health Reimbursement Accounts.

Aetna Incorporation

It is one of the most active and popular health insurance companies in United States. It offers a broad range of traditional and consumer based medical insurance products and related services which include medical, pharmacy, dental, behavioral health, group life, long term care and disability plans as well as medical management capabilities.

CIGNA Corporation

It is one of the top US health insurers. It is a global health service company, dedicated to helping people to improve their health, well-being and security. CIGNA covers more than 9 million people in United States with its large variety of medical plans. It also offers other health coverage in the form of dental, vision, pharmacy, and behavioral health plans.

By knowing which companies are nationally recognized, it will be more convenient for you to obtain "quality" medical coverage.

What Are the Best Health Care Systems in the World?

2009-10-17T10:16:00.000-07:00

Health care reform is on everyone's mind these days. New proposals are coming from the Senate and from the House. President Obama has made reform a priority.

Universality of access to health insurance is the most pressing issue. Universal health care simply means coverage for all eligible residents of a political area. The United States is the only industrialized country that has not implemented a universal system for citizens under age 65.

Universal health care can be implemented in several ways. In some countries the government directly manages the health care system. This is usually called socialized medicine. In most countries universal coverage is achieved by a mix of public and private funding. Taxation is the primary source of funding but is supplemented by private payor arrangements.

In 2000 the World Health Organization (WHO) produced a report which ranked all the health insurance systems used by its member countries. The is the report usually quoted when discussing both the good and bad features of a health insurance system.

It should be noted that the WHO has indicated it will no longer produce a ranking table because of the complexity of the task. The criteria for ranking the health care systems was based on a wide variety of findings, including but not limited to, life expectancy, infant mortality and cost.

Many people know that the United States ranked 37th out of 198 countries and that Canada ranked 30th. But do you know what the top 10 best health care system in the world are?

The top 10 in the order determined by the World Health Organization

1. France

2. Italy

3. San Marino

4. Andorra

5. Malta

6. Singapore

7. Spain

8. Oman

9. Austria

10. Japan

When the United Nations was formed in 1945 one of the entities that the delegates discussed was setting up an organization to monitor and assess global health trends. The World Health Organization (the WHO) came into being on April 7,1948. World Health Day is celebrated every year on that date in recognition of the WHO.

Headquartered in Geneva, Switzerland, the WHO is the directing and coordinating authority for health within the United Nations system. All countries which are Members of the United Nations may become members of the WHO by accepting its Constitution which currently has 198 participating nations.

Cheap Health Insurance - Student

2009-10-17T10:11:00.000-07:00

The cost of medical procedures and medical insurance is rising by the day. The whole country is embroiled in health care debates but nothing seems to get done. Insurance rates are high for everyone but the student is the one looking for a cheap way out.

Many companies are vying for the student end of the health care question and that is what makes looking for cheap health insurance student just a little bit easier.

The insurance that the student is looking for is not always the best but it is not the costliest either. And that is good. Since most students are young they don't have to be insured for most of the big item procedures that middle aged or older people need.

Besides students are more prone to go without insurance than other people and that is what makes it easier to find the policies that students are looking for. When talking with a representative just be sure to let him know that what you are looking for is some basic health insurance. Make certain he understands this and he will probably find something right down your ally.

Since one of the determining factors in the cost of the insurance is age you can probably get a policy pretty cheap. Even if you are on a limited budget there are low cost options out here for you to shop around for.

Most colleges and universities offer a low cost, short term student health insurance plan. These plans however cover a whole student body and are a cheap way out for the family that wants to go that route.

It shouldn't be too difficult to find a cheap health insurance student plan if you just do the research work and be diligent about it.

How to Use Your Health Insurance to Save Money

2009-10-17T10:10:00.000-07:00

I'm going to tell you about a government-approved, tax-favored program that could have you saving money on your healthcare expenses as soon as next month. This law lets you reclaim money that had been going into the health insurance company coffers. It offers you tax breaks. You could be using pre-tax dollars for some things that are not otherwise allowed to be included in your health care expenses deduction. You will have more flexibility and control over your health-related expenses than you ever thought possible, if you take advantage of what I'm about to tell you.

Wow! Just writing that down got me energized! It surprises me that what I'm writing about, though not a secret, is way under-utilized, and is misunderstood by the much of the public and health insurance agents alike.

You will see the real power of it once you put it into practice.

Now you should know, up front, that what I'm about to tell you wasn't designed for everyone. For instance, people who have ongoing medical problems - chronic conditions that keep them going back to the doctor or being admitted to the hospital on even a semi-regular basis - or people who have a hard time managing their own money are not good prospects for this program. It requires self-discipline in setting aside money into a special account. This special account has tax advantages - even if you don't itemize - but you must be able to keep the money separate from your spending accounts.

If you can do this, many opportunities open up for using this pre-tax money. You can buy things you never thought possible. Things like braces for your child - or any dental work. Things like eyeglasses and contact lenses. And many common purchases that you buy anyway can now be, in effect, tax-deductible.

Have you ever had a cold and bought some medications for the sniffles? Or - speaking of sniffles - allergy medicine? Pain relievers? Nicotine medications? Motion sickness pills? All of these qualify as eligible expenses!

Have you figured out what type of plan I'm talking about yet? I'm sure you've heard of it. President Bush mentioned it in many of his addresses to the nation. The major problem with the plan is it is not well understood, and that's my mission today.

The plan is known as an HSA. HSA stands for Health Savings Account, and it is more correctly referred to as HSA-compatible, meaning the plan fits the IRS rules which allow the owner to open an HSA account to take advantage of all the neat deductible things I've been talking about.

A little about the plans themselves: As I said in the beginning, they are not for everyone. If you go to the doctor a lot due to chronic or sever conditions, you don't want one of these plans because you would be paying more out-of-pocket than you would save with the lower premium.

And they do have lower premiums, generally. There are many different ones from many different companies, of course, so their premiums vary widely and are far too many to name them here. But the rules are the same for all of them, regardless of where you are.

The whole theory behind these accounts is this:

Higher deductibles equals lower premiums. The trick is to save the difference - put it into your pocket instead of the insurance company's. You've probably heard when it comes to life insurance the axiom to buy term and invest the difference. The principle is the same here. Only here, you are putting the difference (and more, really, up to a maximum of $5,950 annually for a family of two or more) into an HSA account. The money is deductible, on the front of the 1040 or 1040A and is what is known as an above-the-line deduction. (Ask you tax adviser as I am not in that business, but I've been assured that above-the-line is better than a Schedule A deduction.)

The trade-off: Lower premium (money saved) versus higher deductible (money out-of-pocket before the insurance starts paying its share).

So you see, if you are generally healthy and don't pay much in doctor bills or prescriptions, rather than paying a higher premium for coverage you won't take full advantage of, you pay a lower premium and save the difference (which, again, is deductible). The account savings is expected to be used to pay for doctor visits, dentist visits, et cetera . There is a whole list of eligible items that money can be spent on.

But here is the best part: Money that you don't use can accumulate and earn interest. The interest is also tax-free. And if you don't use the money in any given year (which you probably won't and don't want to anyway), it can be rolled over to the next year....and the next, and the next... Indefinitely. As long as you use it for eligible expenses, you never pay any taxes on the earnings, regardless of your income.

Be aware, though, that if you do use the money for non-qualified medical expenses, you not only get taxed on the money you use, but you also get hit with a 10% tax penalty. Once you reach 65, you no longer are required to use the money on medical-eligible expenses. You are now free to spend it on anything you want, as the 10% penalty no longer applies.

That's like an IRA. No, wait - it's better than an IRA. With a traditional IRA, if you deduct the contributions, you pay tax on the money when it is withdrawn. And you pay taxes on the earnings either way. With a Roth IRA, you don't pay taxes on withdrawals or earnings, but you weren't able to deduct the contributions. With the HSA, you get triple tax savings: (1) deduct the contributions, (2) tax free earnings, and (3) you don't pay tax on money withdrawn for qualified medical expenses.

Ah, so you smart ones who know about IRAs are thinking already, "With an IRA I can invest in mutual funds and earn a lot more than what the bank is going to pay interest on an account." And you'd be right. Except for one thing: With the HSA-compatible account, once you reach a minimum balance (usually $2,000), any additional contributions can be invested in mutual funds, just like an IRA.

Let me give you an hypothetical example of an HSA in action:

John enrolls in a PPO plan that is HSA-compatible, and simultaneously opens an HSA. The PPO has a deductible of $3,500. John can set aside up to $2,850 for 2009, but chooses to only put aside $2,500.

During the year, John has health-related expenses (doctor visits, medications, etc) of $1,000. Because his deductible is $3,500, John is responsible for all $1,000. This is how it would look:

Estimated Income Tax Reduction: $ 583

Amount Added to HSA: $2,500

Amount Paid From HSA: $1,000

Amount Remaining (Includes 3% interest): $1,545

The amount remaining in the HSA is carried over to the next year with no tax owed.

Now, suppose John continues to add $2,500 to his HSA for each of the following five years. During this time, John's expenses that he opts to pay out his HSA is $300 per year. Now his account would look like this:

Estimated Income Tax Reduction: $ 3,498

Amount Added to HSA: $15,000

Amount Paid From HSA: $ 2,500

Amount Remaining (Includes 3% interest): $13,625

It's looking pretty good for John, isn't it? Now, let's suppose in the seventh year, John has a fall on the basketball court and breaks his wrist. The total bill for this comes to $6,000. How would his account look now?

Estimated Income Tax Reduction: $ 4,081

Amount Paid Into HSA: $17,500

Amount Paid From HSA: $ 6,000

Amount Remaining (Includes 3% interest): $13,690

As you can see, that slowed John down some. But not all that much, because John only had to use $3,500 from his HSA to cover the deductible, and the health insurance policy paid the rest.

So, now that you know all about HSA-compatible health plans, what are you waiting for? If you have health insurance through your employer, call HR today and ask what your options are for changing your coverage. If they don't offer an HSA, or you don't have insurance through your employer, or you are an employer who wants to install an HSA-compatible health plan as part of your employee benefits package, contact me and I will be happy to help get you started.

Basics of COBRA

2009-10-17T09:26:00.000-07:00

It is very important if you have health insurance provided by your employer that you understand what your rights are under COBRA (Consolidated Omnibus Budget Reconciliation Act). This important legislative act guarantees that workers participating in their employer’s health insurance program, as well as their dependents, have the ability to have their health insurance coverage extended after they leave their place of employment under specific circumstances and for specified periods of time.

Before COBRA was passed, as soon as an individual was not employed access to his or her group health benefits were immediately stopped. Individuals with pre-existing conditions often could not obtain new insurance coverage. Under COBRA, individuals can elect to continue participating, at their expense, in the employer’s group health plan after qualifying events that lead up to them leaving their employment are met. It can expensive to do this, but it is better than becoming uninsured and all the consequences that follow.

If you quit your job voluntarily, you can elect to continue your employer’s group health insurance coverage for a maximum of 18 months after leaving your employment. You are also eligible if your employer terminates you unless you committed gross misconduct. For employees whose work hours are cut which results in them losing eligibility for full-time benefits, they can also choose to continue their coverage under COBRA.

There are certain conditions where COBRA coverage may be available for more than 18 months. If an individual becomes disabled and is unable to go back to work, they become eligible for 11 additional months of health insurance coverage under COBRA, making the total amount 29 months. If an individual dies who has covered dependents, the dependents are eligible for up to 36 months of coverage, as well as dependents who lose their coverage due to a divorce.

It is important to keep in mind that former employers are not responsible for covering any expenses of health insurance coverage for former employees who are continuing their coverage under COBRA. If you decide to go with COBRA coverage you will have to pay the entire cost of coverage to your former employer and may also be subject to an administrative fee.

If you elect COBRA coverage and then fail to make your premium payments, your former employer can stop your coverage. Your must make your first premium payment within 45 days of when you elect the coverage. Your subsequent premium payment due dates will vary depending on your particular plan. There is a 30-day grace period, which is required under COBRA, for making premium payments. After the grace period is over, your former employer can terminate your coverage.

Instead of having to obtain individual coverage or go without insurance, COBRA gives individuals the ability to continue their coverage for a temporary period of time after their eligibility for health benefits is over. COBRA can be quite expensive, but it is better than having no health insurance coverage at all.

Health Insurance Plan Satisfaction Study

2009-10-15T14:46:00.000-07:00

A new study by J.D. Power and Associates shows that customer satisfaction with health care providers varies widely across the United States. The J.D. Power and Associates 2009 National Health Insurance Plan StudySM reports on the results of more than 33,000 health plan subscriber interviews, conducted online between December 2008 and January 2009. In the survey, health plan members were asked to rate their health insurance company on seven key factors: coverage and benefits; provider choice; information and communication; claims processing; statements; customer service; and approval processes.

The study finds that people working for small employers (50 employees or fewer) are less likely to be satisfied with their health plan than those working for larger organizations. Satisfaction among people working for small employer groups averages 692 points on a 1,000-point scale, while members of health plans sponsored by large employers (501-5,000 employees) and jumbo employers (more than 5,000 employees) have satisfaction levels averaging 717 and 725 points, respectively. Health plan members working for larger organizations are also more likely to re-enroll and recommend their plan to others, compared with members working for small employers.

“As unemployment rates rise across the nation, more members are moving to individual health plans from employer-sponsored plans,” said Jim Dougherty, executive director of the healthcare group at J.D. Power and Associates. “By more effectively managing the member experience for this growing segment of subscribers, health plans could reap considerable financial benefits through increased retention and recommendations, and prepare themselves for the anticipated healthcare reform measures facing the industry, which are likely to drive additional enrollment among previously uncovered individuals and small employers.”

Results Vary By Region, Age, Gender
Health plan members in New England (regional index score of 732) report the highest levels of satisfaction among the 17 geographic regions covered in the study, while those in Colorado (694) are the least satisfied. Closely trailing New England are Michigan (731) and Pennsylvania-Delaware (728). Among demographic groups, satisfaction is significantly higher among members age 65 or older compared with other age groups, while females (715) are, on average, slightly more satisfied with their health plans than males (706). Also, African-Americans (750) are, on average, more satisfied than Caucasians (712) and Hispanics (705). In fact, satisfaction among Hispanic members declined compared to the previous year’s study (721).

Other highlights of the study:

* Overall satisfaction remains fairly consistent between plan types (HMO, PPO, and POS), with HMO members having the highest level of satisfaction (719).
* National plans are highest in customer satisfaction in just two of 17 regions, and have problems delivering a consistent experience across the country.
* The Coverage and Benefits factor has the most impact on satisfaction, accounting for 30% of the health plan experience rating, while Provider Choice remains the most satisfying health plan factor in 2009, accounting for nearly one-fourth of the health plan experience rating.
* Information and Communication is the third most important factor for members but, on average, health plans get very low scores in this area. Consequently, improving satisfaction for this factor provides an opportunity for health insurance providers to improve overall member satisfaction.

Health Insurance Reform in 2009

2009-10-15T14:42:00.001-07:00

President Obama made this bold promise to hopeful Americans in his recent address to Congress. Few listeners debate the importance of health care, but providing quality affordable health care for every American will clearly challenge Democrats and Republicans to work together to meet this goal.

As unemployment rises, even fewer Americans will have health insurance through an employer. And, rising medical costs are forcing small and large businesses to reduce coverage, increase co-pays and deductibles and raise the amount that employees must pay each month. Some small business owners have even converted traditional health insurance plans to high deductible plans.

Insurance.com offers these tips for evaluating your health care options and saving money on your medical bills.

My employer offers an HMO and a PPO. How do I decide?
Both provide excellent care, but you may want to choose an HMO if its network of doctors and hospitals matches your needs. Health insurance with a Health Maintenance Organization (HMO) is generally less expensive. You're required to select an HMO physician to be your primary health care provider. This doctor will coordinate all of your medical care, including referrals to specialists within your HMO network. If you seek treatment from a non-network physician, you will generally pay most of the cost yourself.

A Preferred Provider Organization (PPO) is more flexible than an HMO plan, but it still operates with a list of physicians and hospitals that are "within the PPO network." You may visit an out-of-network provider, but you will pay the difference between the PPO network and out-of-network prices. Both plans usually offer a prescription drug benefit, as well. Some companies are offering options that allow you to combine features of both HMO and PPO plans.

I can't afford full health insurance, but I want coverage for major emergencies.
A high deductible health insurance plan or catastrophic health insurance offer coverage for major illnesses or accidents. For example, a plan with a $5,000 deductible requires you to pay all of your medical expenses up to $5,000 before your insurer begins to pay. If you choose a high deductible plan, try to save a small amount of money each month in a Health Savings Account (HSA) so that you're not overwhelmed by routine medical expenses.

I have health insurance, but it seems like I'm always paying for something.
Sad but true. You may owe a co-payment for doctor's visits or a trip to the ER. Usually, this is a flat fee, but it can get expensive if you don't stay within your plan network.

Secondly, payment for expenses is subject to your annual deductible, which is the amount you pay toward your medical expenses before the insurance company begins to pay claims. Some HMO plans do not have deductibles but do have co-payments.

Lastly, there's co-insurance, which is the percentage of your medical costs that you pay after you reach your annual deductible. 80/20 co-insurance is a common option, and that means that your insurer pays 80% of your bills and you pay 20%—after your deductible. So, anything you can do to reduce your medical bills will help you reduce your out-of-pocket expenses, too.

I don't have health insurance. What can I do?
Almost every hospital has a financial aid office that will evaluate your personal situation and determine your ability to pay for required care. Generally, a hospital will provide sliding scale fees if your income is 400% or less of federal poverty limits and may eliminate bills entirely if your income is 200% or less of federal poverty limits. But hospitals have to make money, too, so they may not publicize these programs or provide much assistance in applying. Be prepared with recent copies of your tax returns and W-2's to prove your need.

Short-Term Health Insurance

2009-10-15T14:42:00.000-07:00

You've just graduated from college or moved out on your own, and you're no longer covered under your parents' health insurance plan. Or perhaps you've flown the coop on your cubicle job and you're looking for the next big thing. Maybe you've found a new job, but your new employer's group health insurance plan won't kick in until you've been with the company for three months. These are good reasons to look into short-term health insurance if it's available in your state.

What's in a name...
As the name implies, short-term health insurance typically offers coverage for 30 to 180 days, although some plans will cover you initially for up to 12 months. If your short-term need runs longer than the coverage, you may be able to renew the plan, but don't count on anything beyond a year.

Most short-term plans will cover you in the event of an accident or a sudden illness. As you might expect with almost any health insurance plan, short-term plans may have benefit limits, and you'll be required to cover an initial deductible and to make co-payments. You'll be allowed to pick your own doctors, hospitals, or other health-care providers. You'll get coverage for inpatient and outpatient services, hospital room (including intensive care unit) and board charges, lab examinations, and X-rays. These plans rarely require a physical exam, and coverage often begins as soon as the insurer receives your application and first premium payment. Applications may be mailed in or submitted over the Internet, and payments may be made by check or credit card. Check with the provider for complete information on coverage and the application process.

...And what's not
To keep the premiums down, short-term health insurance plans don't offer all of the benefits of permanent plans. Most won't cover treatment of a pre-existing condition (i.e. an illness or injury that has produced signs or symptoms, or for which you've received treatment, in the past five years). In addition, these plans don't cover routine medical exams, preventive care, dental or optical care, or pregnancy and childbirth expenses.

Short-term health insurance policies are exempt from the portability requirements in Title I of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Insurance carriers issuing these policies don't have to guarantee their renewability, and most don't. They also don't have to waive any pre-existing condition limitations for individuals otherwise eligible for those waivers.

But despite their limitations, short-term health insurance plans can help you fill the gaps in your health insurance coverage. And that's just what the doctor ordered!

Health Insurance for Unmarried Partners

2009-10-15T14:41:00.000-07:00

Generally, and unfortunately, if an employer offers health insurance coverage to the spouses of employees, they usually don’t extend the coverage to unmarried partners too. Under the Employee Retirement Income Security Act (ERISA), employers are not required to offer health insurance to any employees, spouses, or "domestic partners" (this term is often used to include same-sex couples and unmarried opposite-sex couples, as well as common law marriages). ERISA also does not compel employers that provide health insurance for employees and legal dependents to extend coverage to domestic partners.

Nevertheless, thousands of employers across the country have begun offering domestic partner benefits in the last several years, and the number continues to grow. Employment experts predict that this trend will continue, as small companies start to follow the lead of large employers that have introduced domestic partner benefit plans in recent months.

In addition, some state and local laws have recently been passed in favor of domestic partner rights. San Francisco, Los Angeles, and Seattle have ordinances requiring all businesses with municipal contracts to offer same-sex benefits if they offer benefits for married couples. Vermont recently enacted the country's first "civil union" law, which grants same-sex couples nearly all of the benefits to which the state's married couples are entitled. Provisions regarding health insurance are still being written, and it is not yet known what they will entail.

When benefits are offered to domestic partners, the level of coverage varies depending on the employer. Domestic partner benefits may include long-term care, group life insurance, family and bereavement leave, and most commonly, health, dental, and vision insurance. The definition of domestic partner may also vary from employer to employer. Some companies include same-sex couples, unmarried opposite-sex couples, and common law marriages. Others cover only same-sex partners on the grounds that opposite-sex couples can receive spousal benefits by getting married, while same-sex couples do not have this option. Regardless of how the term is defined, employers typically require domestic partners to sign an affidavit stating that they are in a lasting, committed relationship. They may also require that a couple live together for a specified period of time before they become eligible for domestic partner benefits.

All You Need to Know About Health Insurance

2009-10-15T14:40:00.000-07:00

With medical expenses soaring higher every year, health insurance is an expensive necessity. Knowing more about health insurance can help you get the coverage you need while keeping your expenses down.

What types of health insurance are available?
Health insurance plans generally fall into one of two categories: indemnity plans (also known as reimbursement plans) and managed care plans such as health maintenance organizations (HMOs), preferred provider organizations (PPOs), and point of service (POS) plans. (Learn more about HMO, PPO, and POS plans.)

* An indemnity plan allows you to choose your own doctors and pays for your medical expenses—totally, in part, or up to a specified amount per day for a specified number of days.
* Managed care plans generally provide broader coverage, but they all involve an arrangement between the insurer and a selected network of health-care providers (doctors, hospitals, etc.). This arrangement provides a strong incentive for you to stay in-network, usually by covering less for services received outside the network.

No matter which type of health insurance you buy, you'll need to make sure it offers the right kinds of coverage.

What should be covered?
A good health insurance policy contains several types of coverage.

* Hospital expense coverage pays your room, board, and incidental services costs if you're hospitalized
* Surgical expense coverage covers surgeons' fees and related costs associated with surgery
* Physicians' expense coverage pays for visits to a doctor's office or for a doctor's hospital visits
* Lab coverage pays for laboratory services like X-Rays and other diagnostic lab tests

What might be covered?
When comparing health insurance plans, check to see if they provide additional benefits that you may need, including:

* Prescription drugs
* Preventive care
* Mental health benefits
* Maternity care
* Vision care
* Dental care
* Chiropractic coverage

What will it cost?
In addition to the monthly premium expense, you may have other out-of-pocket costs. These costs can really add up, especially if you have children or other family members who visit the doctor frequently. Check to see if the health insurance plan you're considering requires you to pay any or all of the following:

* Co-payment: The flat fee you'll have to pay each time you visit a health insurance provider (can vary by provider type).
* Deductible: The amount you'll have to pay toward your medical expenses (usually annually) before the insurance company begins to pay claims (generally required by indemnity plans).
* Coinsurance: The percentage of your medical costs you'll have to pay after you reach any deductibles that apply.

Where can I get health insurance?
You may get health insurance through a group plan at work or through another group affiliation (a school, a club, etc.) or by purchasing an individual plan on your own. By purchasing an individual plan, you may be able to customize the health plan.

A good way to compare rates, plans, and options for your individual needs is to shop online. Comparing online health insurance quotes helps to ensure you get your best rate.

How do I decide which plan is best?
The best health insurance plan for you is the one that gives you the greatest flexibility and the most benefits for the lowest cost. Unfortunately, there's no such thing as a standard health insurance plan. As you would when making any major purchase, you'll need to shop around and get several quotes before choosing a plan. Here are a few points to consider:

* What co-pays, deductibles, and coinsurance requirements apply?
* How much freedom do you have to choose your own health-care providers?
* Does the plan cover the health services that you need?
* Does the plan cover the health-care providers you're currently using?
* Does the plan offer family, as well as individual, coverage?
* Does the plan cover pre-existing conditions? If so, is there a waiting period?
* Does the insurance company have a good reputation in the industry and a positive rating from a major ratings organization and your state's department of insurance?

Saving on Group Health Insurance

2009-10-15T14:39:00.000-07:00

Here are the frightening facts: the past three years have seen double-digit increases in group health insurance premiums and these increases were largest for the smallest companies. All indications are that this trend will continue for the foreseeable future.

As a business owner, if you think this is good cause to panic, you’re not alone. The rising cost of providing health insurance for employees is regularly cited as the number one concern of smaller companies today. Employers know how highly their workers value medical coverage, but many feel that they’ve been pushed to the wall and are now facing a fatal dilemma: pass the crippling rate hikes on to their employees, or cut benefits entirely.

The truth is that you don’t have to settle for one of two equally bad choices. If you currently have a health plan that’s straining your budget or have no health plan but would like to offer one for your employees, here are three tips to help you find a quality group health insurance plan at a reasonable rate:

Compare quotes and benefits from multiple insurance companies.
You wouldn’t buy a car without first familiarizing yourself with the different makes and models available. Similarly, when shopping for group health coverage, don’t limit yourself to the offerings of a single insurance company. The most convenient way to get an overview of the insurance options in your area is by working with an online agent. A licensed group health insurance agent can provide you with the benefits and rates from a large number of insurance companies and plans. With more to choose from, an agent will help you match your business to the best plan and save you money by making sure you’re not paying for “extras” that you and your employees don’t need. Make sure that any agent you work with, on or offline, is licensed in your state.

Consider a high-deductible plan.
Another way to save is by opting for a high-deductible plan. If your employees are healthy and don’t make frequent visits to the doctor, this may be a good option for you. You can save money and still retain valuable coverage for your employees through a high-deductible plan. Though they will face deductibles before coverage kicks in, your employees will be protected from the catastrophic consequences of having no coverage in the event of serious illness or injury. Your licensed agent can provide you with information on high-deductible plans in your area and help you determine if such a plan makes sense for your business.

Take advantage of available tax incentives.
Educate yourself on the tax benefits available to you as a business owner when you provide group health insurance for your employees. You may be able to fully deduct the premiums paid on your group health plan, and offering coverage as part of a total compensation package may reduce your payroll tax. Health Savings Accounts (HSAs) provide another important tax break for you and your employees. These tax-favored accounts can be used in conjunction with certain high-deductible plans and your contributions to them are exempt from payroll tax. Talk to your agent about HSAs and HSA-eligible plans. All these incentives contribute to the affordability of your group health insurance plan.

Early Intervention Can Help Cut Disability Costs

2009-10-15T14:38:00.001-07:00

Sun Financial Life, an international wealth management and insurance company, and the Integrated Benefits Institute (IBI), a non-profit benefits research organization located in San Francisco, states that employers who intervene soon after employees are first disabled can help them return to work faster and happier, while cutting disability-related costs.

An IBI study of Steelcase, a Michigan manufacturer of office furniture, showed that worker satisfaction shot up 48 percent from 1997 to 2001 after the company introduced a disability management program that integrated aspects of workers compensation, short and long term disability, and the federal Family Medical Leave Act.

Employers who move quickly to communicate with and accommodate their disabled workers can help them return to work 20 percent faster, according to Sun Life's study, “Early Intervention Programs Can Speed Disabled Employees Back to Work.”

The reason Steelcase decided to try a program like this was because many employees were confused by traditional, disjointed employee benefits. Often, employees didn’t know who to call or who to turn to, resulting in employees feeling like they weren’t getting good service. In addition to the program, Steelcase also implemented an early return-to-work component for employees.

The Sun Life Return-to-Work Study
The Sun Life return-to-work study tracked the outcome of nearly 1,000, non-maternity, short-term disability claims. The claims were then divided into 2 groups – those who received early intervention disability, and those who did not. Available services included:

* Claimant and physician coaching about return-to-work expectations
* Employer education on disability issues
* Identification of viable job alternatives, including light duty positions
* Job site modifications to accommodate disabled workers
* Medical intervention to ensure the employee was receiving appropriate medical care
* Three-way coordination and communication between the employer, employee, and physician
* Vocational counseling

Those who received early intervention worked with their employers and physicians to develop return-to-work plans and set expected return-to-work dates that were the earliest recovery date (to be determined by the physician or medical disability advisor). The final outcomes were compared, including the date the employee returned to work, whether it was full- or part-time, and if the claim transitioned into the long-term disability stage.

The study showed that the early intervention services yielded a high success rate in returning disable employees to work. Among the findings:

* On average, employees receiving early intervention services returned to work 2.7 weeks sooner, saving the employer approximately $810 per claim
* 47 percent more employees returned to work during the short term disability states with early intervention
* 33 percent fewer claims extended into the long-term disability stage with early intervention

Services Make All the Difference
“Nine times out of 10, disabled workers stay out on disability longer than they have to — or don't return at all — due to employment problems rather than their medical problems,” says an official from John Hewitt & Associates Inc., a disability risk management and consulting firm with headquarters in Portland, Maine. “Usually it isn't the disability that prevents them from returning to work, but all kinds of extraneous job issues,” notes the official. “Maybe the company has just been sold, or the worker just got a new boss, or the worker's duties are changing and the employer hasn't put any kind of support mechanism in place. If the employer doesn't recognize that the disabled worker has value and they aren’t communicating this idea directly to the worker, then the employer risks losing that employee.”

Sun Life concluded that early intervention in short term disability cases can overcome two main barriers:

* Psychological: The disabled employee hasn't mentally adjusted to not working; nor have they adjusted to their new lifestyle without work.
* Work: A close relationship still exists between the employer and employee, and everyone remains focused on recovery and return to work. Before long, an employee can quickly become “out of sight, out of mind.”

Real Savings
“Employers who ignore the importance of early intervention risk higher absenteeism, higher staffing costs, and lower productivity,” says Sun Life. “Conversely, employers that implement early intervention programs can reap real savings.” In the long run, employers that don’t pay attention to potential rewards of return-to-work programs will pay a higher price than those that actually do use the programs.

According to a Sun Life’s study, with an average company of 10,000 employees, 600 employees can expect to receive short-term disability benefits in any given year. If just 10% of these employees receive early intervention services, that may mean an annual savings of $48,000 per year. This is based on a $300 weekly, short-term disability benefit payment that is multiplied by the shorter average disability duration of 2.7 weeks.

These findings complement those discovered by Watson-Wyatt Worldwide and the Washington Business Group on Health in their fourth annual survey report for 1999/2000 called “Staying@Work.” The study examined 178 major companies with an average of 13,500 workers and found that those which implement short term disability claim management activities — such as independent medical exams, behavioral health interventions, case management, and transitional return-to-work programs — reported savings between 18 percent and 19 percent.

Eating Your Way into the Hospital and the Poorhouse

2009-10-15T14:38:00.000-07:00

Ballooning costs and ballooning waistlines. When it comes to health and health insurance, these are the two biggest issues on the plate today. But are these really two separate problems? You already know that too many super-sized meal deals will cost you in the long-term, but you may not have realized how much of a price you`re paying now --in health insurance dollars-- for the national weight problem.

Dollars & Pounds
Health insurance rates have long been on the upswing, with double-digit increases in each of the past three years. Most analysts blame an increased use of medical services for driving up costs. But are we really just a nation of doctor`s office junkies? Surely we don`t go for fun. Why are we seeing the doctor so much anyway? The answer may be: obesity. Curiously, insurance started getting more expensive at about the same time Americans really started getting heavier. It`s impossible to know exactly how much obesity contributes to the increase in insurance costs, but take a look at some numbers: Over 60% of Americans presently qualify as overweight or obese. Even among children, obesity rates have tripled over the past decade. And obesity is known to result in a higher risk of heart disease, diabetes, stroke and certain types of cancer, as well as respiratory problems. And get this: The Surgeon General`s office estimates that, all told, obesity cost the economy $117 billion in the year 2000 alone.

Obesity and Health Insurance

Insurance companies understand that obesity isn`t profitable. If you`re an obese person trying to get health coverage on your own, chances are that you`ll be turned down due to the risks associated with your weight. And if you`re not turned down, you`ll probably pay more for coverage, up to twice as much as a slim person. Even though you can`t be turned down for employer-sponsored health insurance based upon your weight, the increased cost of insuring you is still there, borne not only by yourself but by your coworkers as well.

Now this doesn`t mean that slim folks should blame heavier folks for the annual insurance rate hikes that everyone dreads. There are other factors involved, like the increased use of prescription drugs and the renegotiation of rates that insurance companies pay to doctors. But, these examples serve to demonstrate the fact that this problem touches most all of us in one way or another. And if so many Americans across the country are obese and it`s twice as expensive to profitably insure an obese person, you can begin to see how big a role expanding girth may play in expanding health insurance costs.

Our Prospects for a National Diet

So, what can be done, and who`s responsible? In the United States, it`s expected that obesity will soon overtake smoking as the number-one cause of preventable death. Through a combination of government action and an aggressive public persuasion campaign, smoking is on the decline. These tactics can be employed in the battle on obesity as well.

Perhaps a greater awareness of the connection between obesity and health insurance costs will encourage government and public health organizations to step into the fray. Perhaps it will prod health insurance companies to expand coverage for weight-loss programs and procedures. And if we as individuals can`t bring ourselves to take our health more seriously, perhaps we can bring ourselves to take our pocketbooks more seriously.

Pros and Cons of Catastrophic Health Insurance

2009-10-15T14:37:00.000-07:00

Catastrophic health insurance plans—more formally known as High Deductible Health Plans (HDHPs)—were created as a way to lower overall medical costs by providing a lower monthly premium in exchange for a higher annual health insurance deductible. With catastrophic health insurance plans, you pay for almost all medical care until you reach the annual deductible amount. After that, traditional health insurance coverage begins.

About High Deductible Health Plans
Under a high deductible plan, you pay out-of-pocket for most medical bills until the total of your payments reaches the amount of your annual deductible. After that, the catastrophic health plan will cover most medical expenses, although you usually have to pay co-insurance until you reach your total out-of-pocket maximum amount. If your catastrophic health plan is eligible for a Health Savings Account (HSA), you can use the HSA funds to pay the deductible and out-of-pocket expenses. Even if you don't use an HSA, it's smart to set aside some money each month to pay for future medical expenses that you may incur. If you never need the money, it's a bonus.

For 2008, the IRS requires that people with tax-exempt HSAs have catastrophic health insurance plans with deductibles starting at $1,100 for an individual and $2,200 for a family. The total out-of-pocket maximum (which includes the deductible and co-payments) for these HSA-linked catastrophic health plans is $5,600 for singles, and $11,200 for families. The U.S. Department of the Treasury has more information on HSAs and high deductible health plan requirements for 2008 and 2009.

Many HDHPs have high lifetime maximum benefit payment limits (also known as "caps"), usually between $1 million and $5 million. Once you reach the cap, your health insurance company will not pay for any of your medical costs and your policy will be cancelled.

Where to Get Catastrophic Health Insurance
High deductible health insurance can usually be purchased either as an individual plan or as a group plan. Certain pre-existing conditions, such as diabetes and mental health disorders, might mean you can't qualify for an individual catastrophic health plan without prior qualifying group coverage, or at least that you can't get coverage for those pre-existing conditions. Group catastrophic health plans are subject to HIPAA regulations, meaning you can't be denied enrollment or coverage, but may have to wait for coverage of pre-existing conditions, depending on your prior health insurance coverage.

What Do High Deductible Health Plans Cover?
The type of coverage varies based on which high deductible health insurance plan you choose. Always read and understand the full policy and what it covers when comparing health insurance plans. Ask your agent or company to explain anything that seems unclear, and make sure you will get or can add coverage for medical conditions you might develop. In the past, catastrophic health plans did not cover things like routine care and prescriptions. Today, however, many high deductible health plans offer coverage for routine and non-catastrophic care. However, as a general rule, the more a plan covers, the higher the premium will be. Agreeing to pay more out of your own pocket shifts some of the risk away from the health insurance company on to you, resulting in a lower monthly premium. Be aware that the IRS currently specifies that if your high deductible health plan provides prescription benefits before you meet your annual deductible, your HDHP does not qualify for use with an HSA.

Catastrophic Health Insurance Considerations
The reason you pay generally lower premiums with a high deductible health plan is that the health insurance company knows you'll pay for a larger portion of your costs if you need medical care. You will have to pay out-of-pocket for the majority of medical costs you incur before reaching your annual deductible. If the sole reason you choose a catastrophic health plan is to save money, you'll need to carefully weigh the benefits against the risks. If you're truly worried about money, will you be able to pay medical expenses until you meet your deductible? For example, if your annual deductible is $4,000 and you have emergency surgery that costs $5,000, you are required to pay $4,000 of that out-of-pocket, assuming you have not yet paid any of your deductible. The remaining $1,000 would be paid by your health insurance. Ask yourself if a lower monthly payment is worth the risk of paying your deductible or a large portion of it all at once.

Should You Get a High Deductible Health Plan?
If you're sure you can cover the deductible and want to save money on the monthly premiums, a high deductible health plan may make sense. If you qualify for an HSA or other tax-exempt medical savings account and can contribute the deductible amount, you may have an easy way to pay your out-of-pocket medical costs while saving on premiums. Most people who consider catastrophic health insurance either are getting their own health insurance for the first time or are nearing retirement. The younger group tends to be less likely to incur medical expenses because they are young and healthy, while the older group tends to have enough money to pay for most medical care unless they experience a serious illness or emergency. Typically, high deductible health plans provide the most benefit to those who don't require frequent prescriptions or office visits.

Top 10 Ways to Cut Your Health Insurance Bills

2009-10-15T14:36:00.000-07:00

With health care costs constantly rising, you may be looking for ways to lower your medical expenses. These 10 ideas can get you started.

1. Practice prevention
This may seem basic, but one of the most effective ways to lower your medical expenses over time is to maintain a healthy lifestyle. For example, you can:

* Take advantage of wellness programs
* Maintain a healthy weight
* Exercise regularly
* Kick unhealthy habits (e.g. smoking)
* Have regular checkups

2. Shop around for health insurance
If you don't have employer-sponsored health insurance, you may be ready to look for individual health insurance. Because premiums vary widely, you'll probably save money if you get quotes from several companies. Evaluate each plan's coverage and features, taking into account exclusions, limitations, and the freedom to choose health care providers, among other things. Also find out how much you'll end up paying out of pocket in the form of co-payments, coinsurance, and deductibles, because even relatively small amounts of money can really add up if you make frequent visits to your doctor. If you're healthy and just want protection for a major illness or accident, consider Catastrophic Health Insurance Coverage.

3. Cut the cost of prescription drugs
Try ordering your prescriptions through the mail, using a traditional or online pharmacy. If you belong to a prescription drug plan (e.g. through your health insurance), you may be able to get a three-month supply of your prescription drug through the mail for the same price you would pay for a one-month supply at your local pharmacy. You can also ask your pharmacist or doctor to recommend a less-expensive generic drug whenever possible. In addition, many groups and pharmacies offer prescription drug discount programs, although they usually offer small savings at best and large drawbacks at worst. Senior citizens and others on a limited budget may also apply directly to pharmaceutical companies for prescription assistance.

4. Check your medical bills
Check every itemized statement your receive from a hospital or physician to make sure that the bill accurately reflects the treatment you received and applies all available insurance coverage. Some errors, such as incorrect computer codes, are common, and you may be billed for health care you never received. Contact the billing office if you think you've found a mistake. If you've received an explanation of benefits from your insurance company that you believe is wrong, ask the company to review your claim.

5. Join your spouse's health plan
Many married couples maintain separate health insurance coverage even though it may not be cost effective to do so. Examine both your coverage and your spouse's coverage to see if it makes sense for either of you to join the other's plan. Keep in mind that most plans allow you to add a spouse to your plan within a certain period after you get married (e.g. 30 days). Otherwise, you may have to wait for the plan's annual open enrollment period.

6. Keep track of your medical expenses
Come tax time, you may be able to deduct certain medical expenses. The current IRS rules specify that you must itemize your deductions, and your total medical expenses must exceed 7.5% of your adjusted gross income. Allowable medical expenses include everything from health care services to medical aids (e.g. eyeglasses, hearing aids). And, don't wait until the end of the year to track these expenses, if there's a chance you'll be able to deduct them on your income tax return.

7. Negotiate a discount with your health care provider
Many people don't realize that you can sometimes negotiate to lower your medical bills. While it may not always work, it doesn't hurt to ask your doctor, hospital, or pharmacy if they're willing to come down in price. Before you begin to negotiate, do a little research to find out what other health care providers in your area are charging. You can also ask your health care provider if they'll lower their price if you pay in cash up front.

7. Investigate health care incentives
Health care providers sometimes offer wellness incentives to their customers. These can include regularly attending a gym, pledging not to smoke, and preventive care programs. Many health insurance companies will give an annual or monthly discount if you simply get a physical once a year and have a doctor certify that you're receiving proper preventive care.

8. Contribute to a tax-favored medical account
Your employer may offer a tax-favored health plan such as a flexible spending arrangement or health savings account (HSA) that allows you to put pretax dollars in an account. You can then use these funds to pay for or reimburse your out-of-pocket medical expenses, such as prescription drugs, dental care, and co-payments. Because these contributions are taken out of your pay before federal and state taxes are calculated, you get to use pretax dollars to pay your medical bills. In some cases, these accounts can provide an investment savings option as well.

9. Take advantage of free health screenings and immunizations
If your health insurance doesn't provide adequate coverage in some areas, or if you don't have any health insurance coverage at all, you may want to look into free health screenings. Local clinics and hospitals often provide a variety of screenings, such as blood pressure, cholesterol, and mammograms. You may also find free flu shots and well-child check-ups at government offices or your local WIC program.

10. Get to know your health insurance
Your health insurance may cover more than you think. Insurance companies often provide benefits designed to help you stay safe and healthy. For example, you may receive discounts on vitamins, alternative medicines, health club memberships, exercise equipment, and bike helmets.

You may also be surprised at the range of coverage your health plan offers. For instance, it may cover dental care for young children, chiropractic care, and acupuncture. Read your plan membership materials to find out what products and services are available through your health plan before you pay for them on your own.

How Healthy is Your Health Club?

2009-10-15T14:33:00.000-07:00

With more and more insurance companies offering discounts on health and fitness club memberships, now may be a good time to join a health club, get into shape, and improve your overall health. But if your health club cuts corners when it comes to safety, sanitation, and staff training, you may actually be jeopardizing your health by working out there. Here are some signs that your club puts the health and safety of its members first.

Club members are instructed on the proper use of equipment and facilities
When you join a health club, a member of the club's staff should ask you to fill out a health history questionnaire. If you have a serious health problem (e.g. a heart condition or a bad back), the club should require that you obtain medical clearance before beginning an exercise program. Then, you should be invited to a new member orientation session (usually a one-on-one session) in which you learn club rules and find out how to properly use the exercise equipment. Staff members should work with you to design an exercise program that meets your needs, taking into consideration any health problems or physical limitations you might have.

Staff members should test your fitness when you start an exercise program, then check on you periodically thereafter. Even long after you've joined, they should be readily available to answer questions and teach you proper exercise techniques. This may be possible only if there is an adequate instructor/member ratio. If only a few staff members are on duty, they may not be able to give you the personal attention you need to exercise safely.

Staff members are qualified and well trained
All staff members should be knowledgeable about health and fitness issues, and most should be trained in CPR and first aid. In addition, exercise instructors should be certified by a nationally or internationally recognized organization such as the Aerobics and Fitness Association of America or the American College of Sports Medicine.

Equipment and facilities are clean and safe to use
Check out the condition of the equipment and the cleanliness of the facility. Although health clubs must be licensed by state and/or local governments to do business, they may not be closely regulated. However, they may be certified by a national organization (such as the International Health, Racquet and Sports Club Association) that requires members to maintain clean, safe facilities and adhere to a code of ethics.
Regulated or not, your health club should be well maintained. Dirty locker rooms and broken equipment can sometimes signal that the club is in financial trouble, especially if the condition of the club has recently taken a turn for the worse. Look for the following signs that your health club is adequately maintained:

* The club should have routine sanitation procedures--find out what they are
* Members should be instructed to clean off machines after use (look for adequate paper towels and spray bottles of disinfectant)
* The facility should be spacious enough to accommodate members even during peak periods--find out if the club limits membership to prevent crowding
* Exercise equipment should be relatively new, not outdated
* All equipment should be clean and in good repair--worn or torn equipment may be a safety hazard
* Instructions for use should be attached to each machine
* Mats and flooring should be clean and resilient enough to protect against injury
* Showers and locker rooms should look and smell clean (no mold or mildew)
* The pool and hot tub should be adequately sanitized--signs of inadequate sanitation include pool water that burns your eyes or foam in the hot tub
* Rules of use should be posted in the pool/hot tub area (e.g. shower before entering the pool, limit use of the hot tub to 15 minutes)
* First aid kits should be well stocked and readily accessible

Security in and around the club is adequate
Health clubs often post signs warning members not to leave valuables in their lockers. Because lockers are notoriously easy to jimmy open, petty thieves often target them. This doesn't necessarily mean that the health club has lax security, but it does mean that you should find out if the health club is going the extra mile to protect you and your possessions. Determine whether the club you belong to has:

* Security measures in place to ensure that only members or their guests can enter or leave the building (e.g. membership cards, surveillance cameras, gates)
* Well-lit parking areas
* Security guards if the area is especially dangerous
* A well-attended child-care facility if the health club offers it

What if you find problems?
If you feel that your health club is not as clean or safe as it should be, talk to the club's director. If your concerns aren't resolved or if serious health violations exist, contact the local or state authority responsible for monitoring business and/or sanitary practices in your area (e.g. the Attorney General's office, Health Department).

Lack of Dental Benefits for Low-Income Children is a Serious Problem

2009-10-15T14:32:00.000-07:00

A striking disparity in dental disease based on income can be seen within low-income children versus children who come from more affluent families. In this country, children, minorities and the elderly are said to have the worst oral health, due in part to a lack of dental insurance. In fact, about 108 million Americans do not have dental insurance, according to “The Surgeon General’s Report on Oral Health.”

Recent research findings have linked oral health infections to diabetes, heart and lung disease, stroke and low-birth-weight babies. In the long run, serious dental problems in children can lead to lack of self-esteem, long term stress and depression, and may also interfere with normal, everyday functions, such as eating, breathing, swallowing and speaking.

Tooth Decay
Tooth decay is the single most common chronic childhood illness. Children in families living below the poverty levels ($18,850 being the annual income for a family of four), have more severe and untreated tooth decay.

Publicly Funded Programs Are Falling Behind
Reports state that children from low-income families without dental insurance are three times more likely to have dental needs than children with either public or private insurance. Uninsured children are 2.5 times less likely than insured children to receive dental care, and for each child without medical insurance, there are at least 2.6 children without dental insurance. Simply put, having medical insurance with dental benefits greatly influences whether consumers seek dental care.

A new program called The State’s Children’s Health Insurance Program is out in an attempt to get kids covered, and though it increases the number of insured children, many still are left without effective dental insurance. Medicaid has tried to fill the gap in providing dental care to low-income children, but not much progress has been made. Less than one in five Medicaid-covered children received a single dental visit, notes a recent, year-long study.

In addition to low-income children and minorities, the elderly are also at risk, due to the fact that when they retire, Medicare does not cover their dental services.

The Health Insurance Association of America, an industry trade group, says it “recognizes the inexorable link that exists between coverage and increased access to dental services, and good oral health.”

Delta Dental Plans Association is a national network of independently operated not-for-profit dental service corporations that provide dental benefits and community-outreach programs. They say oral diseases are a “silent epidemic”. Dr. Roger C. Smith, chairman of Delta Dental's dental policy committee says, “We have the ability to drastically reduce some of our nation's most common dental diseases, like dental cavities and periodontal disease. Legislators, educators, communities, and providers need to work together to focus on this important issue and continue improving our nation's oral health.”

Living Abroad and Your Health Insurance Needs

2009-10-15T14:31:00.000-07:00

Taking an extended trip abroad requires an enormous amount of planning. Although it may not be foremost in your mind, your health insurance coverage is an important part of this planning.

Standard health insurance plans are generally not designed to cover extended periods of international travel. Most managed care plans do cover emergency treatment regardless of where it is administered, but other types of care are typically limited to a local network of providers. Health maintenance organizations (HMOs) may pay nothing if you seek routine care from a non-network provider, while preferred provider organizations (PPOs) generally cover only a portion of these costs. And most Americans do not qualify for the national health-care programs offered to citizens of many European nations. Before you go abroad, find out what coverage you will have. Tell your insurance company how long you will be overseas and what countries you will visit.

For some travelers, travel insurance may be an adequate solution. However, travel insurance may provide only limited coverage, typically for no more than six months.

If your stay abroad will last more than six months and you want to get the most comprehensive health insurance available, you may want to look into expatriate health insurance. Many larger insurers such as Lloyd's of London offer this type of insurance specifically for Americans living in other countries.

Expatriate health insurance plans can be customized in many ways. In addition to standard medical and emergency coverage, you can get a plan that includes maternity coverage, specialty treatments such as acupuncture and chiropractic, and even emergency evacuation. Choosing the right features depends on your family's needs, your financial situation, and your travel plans.

If you decide to purchase an expatriate plan, you can expect to complete an extensive application. You'll need to disclose any health problems your family members have had in the past 10 years, from broken bones to hereditary conditions to substance abuse. The cost of an expatriate plan varies depending on the features you choose; the number of family members to be covered; the age, sex, and state of health of each family member; your travel itinerary; and various other factors.

The Truth About Lies-When Doctors Change Information To Get HMO Approval

2009-10-15T14:30:00.000-07:00

The relationship between doctors and health insurance companies can be a rocky one at that, and much of the tension stems from the hassles doctors encounter when it comes to HMO denials. The potential for HMO's to deny a request, coupled with the hassles surrounding the denial, have risen to the point of doctors actually misrepresenting their patients, just to get approval. If a patient's HMO denies their request, a doctor can appeal the decision, but the process to get a health insurance company to change their decision is a troublesome one.

Studies have shown doctors are more willing to lie about their patient's medical condition to get them approved when their case is considered severe, or when there is a high likelihood that an appeal will be denied. If the appeal has a higher probability rate for acceptance, doctors and physicians are less prone to stretch the truth when it comes to medical records and conditions. The more likely the HMO will deny coverage, the more likely a doctor will consider lying about the patient's condition.

The potential problem that may arise if a doctor lies to a health insurance company about a patient's medical condition is that the lie will also be reflected in the patient's medical records. A little white lie to the HMO company may seem innocent at the time; but the lie could wreak havoc if the patient switches doctors or develops a more serious illness. And while doctors think they are helping their patients through the HMO approval process, in reality, they could be setting them up to fall.

Many solutions have been suggested, but it really comes down to doctors and health insurance companies working together to control cost and provide access to the best health care for patients.

If you are interested in getting a health insurance quote, log on to Insurance.com. Here you will be able to evaluate multiple rates from best-in-class health insurance providers - helping you find the best health insurance coverage at the most affordable rates.