Tricks for Comparing Health Insurance

November 30th, 2011

When it comes to health insurance, finding the best policy is not always an easy task. A number of things should be researched before making a decision on any coverage. The following are features to consider when comparing health insurance and trying to find the right plan.

Who Will Be Your Physician?

Who Will Be Your Physician?Creative Commons License photo credit: heipei

Some plans offer a specific network of physicians and will cover little to none of the expenses of a physician out of the network. If all other features of a plan are favorable, maybe considering a new physician wouldn’t be difficult for some people. Those who see a specialist may not be able to choose the same plan if the specialist they see isn’t in the plan’s network of physicians.

What About Emergency Room and Hospital Visits?

What About Emergency Room and Hospital Visits?Creative Commons License photo credit: irrezolut

When comparing health insurance plans, some plans only cover visits to certain hospitals. It is a good idea to be informed of the plan’s definition of an emergency. Any visits determined not to fit into this definition may not be covered under the plan.

How Much Are Monthly Premiums and Deductibles?

The most expensive plans may not necessarily be the best for everyone. Most experts advise against purchasing the cheapest plan but rather purchasing one that is midway between the most expensive and the least expensive. People should also be aware of how much deductible they will have to pay before insurance coverages begins.

Prescription Costs and Copayments

Prescription Costs and CopaymentsCreative Commons License photo credit: Purple Penning

Some plans require prescription deductibles to be paid separately from the insurance deductible. Some cover the total cost of prescriptions while others require different copayments depending on the drug prescribed. The extra cost of prescriptions should be figured into the total cost of the health plan before making a decision.

How Much Are Copayments for Physician Visits?

Some plans may require a smaller copayment or even no copayment for certain types of medical visits, and a larger copayment for others. The copayment amount may also depend on whether the visit is with a regular physician or a specialist.

Are Pre-Existing Conditions Covered?

It is important for those with certain health conditions to find out if a prospective health plan covers pre-existing conditions before choosing the plan. It is possible for some conditions to be covered after a certain amount of time even if they aren’t covered in the beginning.

Additional Services That May Be Covered

Each individual should research the additional services provided by each plan to find the coverage they need. Some plans may include maternity, dental or vision coverage at no extra cost while others require a higher monthly premium to include any additional services.

Comparing health insurance requires careful research. Each person must find the plan that best fits his or her health needs, prescription needs and financial situation. Taking the time to check out every aspect of a plan while keeping in mind the health needs it should meet will help narrow down the best plans available.

 

Melissa Johnson

References:
1. 10 Key Considerations When Comparing Health Care Plans. Sage, Bobbie. http://personalinsure.about.com/cs/healthinsurance1/a/aa070703a.htm.
2. How to Compare Health Insurance Plans. www.wahm.com/articles/how-to-compare-health-insurance-plans.html.

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California Health Insurance

November 9th, 2011

Though health insurance is important for any and all Americans to have, it is especially important in the state of California. California is one of the leading states with businesses that do not provide health insurance benefits for their employees. Many jobs in California are based on the W9 form rather than the W-2 form, which makes the employee personally and fully responsible for all health insurance benefits.

High Competition

However, California health insurance is one of the most competitive markets in the health-insurance industry, precisely because the insurance companies are competing for the plans of individuals rather than large corporations. And although California had one of the largest health insurance rate increases in the recent premium debacle, the fees were one of the lowest in the nation to begin with, especially for cities and metropolitan areas with comparable populations.

California Health Insurance
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Many Options

California health insurance also has many different types of plans for different situations. California is one of the best states when it comes to the sheer volume of plans that are available or people of different demographics. This is done because the insurance companies can provide better services as well as create profit the more segregated each of the demographics are that it serves.

However, the fact that the health insurance companies in California are making more profit from segmentation is nothing for the individual health insurance buyer to worry about. As a matter of fact, this is part of the reason why insurance rates in California are able to stay so low, and individuals who receive services from their health insurance plans are much more covered than those people in other states.

California also has many laws which require insurance companies to pay out for injuries and preventive services that many other states do not. Overall, the health-insurance industry in California is one of the best in the nation, and one in which you can get a health insurance policy that is specific to your needs, whether you are an individual or you have a family to take care of. There are also many more companies in California that offer health insurance than in any other part of the nation, giving customers a much wider variety of plans to choose from, as well as competition to drive the prices of healthcare insurance premiums down to the lowest in the nation.

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Few Small Businesses Taking Advantage of Health Care-Related Tax Break

November 8th, 2011

The United States Treasury Department has released a report that shows very few small businesses interested in taking advantage of an incentive for offering health care benefits to their employees.

Under the provisions of the Affordable Care Act, which was signed by President Obama in 2010 and enacted the same year, certain small businesses would qualify for a substantial tax benefit if they meet a number of requirements. In order to qualify, the number of staff members employed must be less than 25, the average salary must of a full-time worker must be under $50,000 per year, and the small business owner must pay -at the least- fifty percent or more of the staff’s health care insurance benefits.

The Treasury Inspector General found that only about 228,000 tax filings from small businesses claimed the tax break. The Internal Revenue Service (IRS) made a considerable effort to reach out to potentially qualified business taxpayers; more than 4 million postcards were mailed to businesses in general to inform them of the new tax break. A more precise number of small businesses which would be eligible for the tax credit has not yet been determined by the IRS.

While the Congressional Budget Office had calculated that $2 billion would be utilized to absorb the cost of the tax credit in 2010, less than $250 million have been claimed. The report from the Treasury Inspector General recommends that the IRS should take a more proactive stance on their education and outreach efforts for small business owners. For their part, the IRS has agreed to create focus groups with attorneys, accountants and tax preparation professionals to come up with ways to increase awareness of the tax credit.

In a response to the Inspector General’s report, the Treasury has commented that since the enactment of the Affordable Care provisions took place in mid-2010, it is possible that many small business owners decided not to pursue the tax credit right away. The small business “tax season” typically takes place in September and October, and many business owners wait until the beginning of a new year to make decisions related to health insurance benefits for their employees.

The number of insurance-related tax credit claims made by small businesses is expected to climb in the future, and the Congressional Budget Office has stated that more than $35 billion has been set aside for this purpose. It isn’t clear how other general health care reform provisions will affect the tax credit once they go into effect.

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Record number of Americans without health insurance

November 3rd, 2011

According to a report from the United States Congress Joint Economic Committee, a record number of Americans lacked health insurance in 2010. United States Senator Bob Casey, D-Pa., chairs the committee, which issued the report on September 13. The percentage of Americans who have health insurance is at its lowest point since 1987, when researchers began to collect the data.

Percent uninsured

The report states that in 2010, 49.9 million Americans, or 16.3 percent of the population, lacked health insurance. The percentage of Americans without coverage has increased by 1.6 percent since 2007.

Private coverage

According to the report, the number of Americans with private insurance coverage has steadily decreased since 2000. Job losses during the recession have resulted in 8.3 million fewer Americans with employment-related health insurance. Between 2008 and 2010, the percentage of Americans with job-based health insurance dropped from 58.9 to 55.3 percent. In 2010, 20.2 million full-time employees and 7.8 million part-time employees lacked health insurance. Between 2009 and 2010, the number of direct purchases of private health insurance increased from 9.6 to 9.8 percent of the American population.

Public coverage

The percentage of Americans with public health insurance increased by 1.7 percent, or 7.4 million people, between 2008 and 2010. In 2010, 31 percent of the American population had public health insurance coverage, such as Medicare, Medicaid and the Children’s Health Insurance Program (CHIP).

Young adults

Thanks to the Affordable Care Act, 1.6 percent more young adults had health insurance coverage in 2010 than in 2009. Since September 2010, a provision has allowed 19- to 25-year-olds to retain dependent status for health insurance purposes. Between 2009 and 2010, the number of insured adults in this age group increased by 29.7 percent.

Children

One in 10 American children lacks health insurance coverage; however, 571,000 more children had health insurance coverage in 2010 than in 2007. Between 2007 and 2010, the number of children enrolled in Medicaid increased by 5.1 million, and the number of children enrolled in CHIP increased by 608,000. In 2010, 3.4 million fewer American children had private coverage than in 2007.

Minorities

The percentage of Hispanic Americans without health insurance decreased from 33.1 percent in 2006 to 30.7 percent in 2010, but the percentage of African Americans without coverage increased from 18.6 percent to 20.8 percent between 2007 and 2010. Minorities are less likely to have health insurance than white people.

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7 Companies Offering Health Care Benefits to Part-Time Workers

October 27th, 2011

For the most part, if you are not a full-time employee, you have no option for health insurance coverage. However, some of the more renowned companies do offer insurance coverage to their part-time employees.

Below are seven companies offering health care coverage to their part-time employees:

 

Part-Time Workers
Creative Commons License photo credit: carianoff

Starbucks

Starbuck’s program (benefits package) offers complete health care for the full-time and part-time partners (employees) that are eligible, to be eligible, a partner has to work approximately 20 hours weekly, a competitive starting wage, a savings plan in the form of a 401(k) where the employer matches the partner’s contribution, stock in the company, short-term disability, tuition reimbursement, paid time off (vacation) and discounts on the company’s products.

Target

After six months, the ‘team members’ at Target working at least two and half days per week, are eligible to receive health care coverage. Erin Madsen, who is the spokeswoman for Target, stated that Target is ’very proud’ of their current programs and medical plans. These medical plans offer 100% coverage on recommended preventative care with no lifetime maximums, as well as, no pre-existing conditions.

Whole Foods

The team members at Whole Foods are scheduled to work in excess of 20 hours weekly, but no more than 30 hours a week become eligible for medical insurance benefits after meeting particular thresholds related to their service hours.

A team member must work 30 hours weekly to be considered a full-time employee. Part-time team members are eligible for other benefits that include a store discount of 20% and paid time off. Those team members who decide to participate in the ‘healthy discount incentive program’ for team members can receive another 10% off of their store discount.

Land’s End

It is anticipated that Land’s End will employ roughly 2,700 employees for the holiday season. These new employees will work in the call center and the distribution centers of the company. Many of these part-time employees will receive vision, dental and even life insurance benefits.

Lands’ End offers seasonal and ongoing part-time employees vision, dental and life insurance coverage options. The seasonal and part-time hourly requirements depend on each of the different department’s policies.

UPS

Hourly employees are offered full benefits with UPS. These benefits include tuition assistance as well as medical and dental coverage.

Most of the positions that are part-time are covered under a collective bargaining agreement. The benefits for health and wellness may not actually begin for part-time employees until 12 months after their date of hire. These benefits are not available to the temporary seasonal workers that only work for the four to eight weeks of the peak holiday season.

Home Depot

The spokesman for Home Depot, Stephen Holmes has stated that they company offers its part-time associates who have been employed with the company for no less than 90 days vision, dental and some medical benefits. This also includes an option for a critical illness.

Costco

Employees that work part-time at Costco may be eligible for medical and dental health care. The part-time employees need to work an average of 20 hours per week after being employed for 180 days.

Employees may also have the ability to use the company’s in-house optical centers for their vision care. Costco also offers a discounted co-payment pharmacy program when using the in-house pharmacy. Some of the generic medication co-pays are only $5, the brand name co-pays are typically capped at 15%.

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Obama health care law headed to Supreme Court‎

October 24th, 2011

The Obama initiative for required healthcare for all US citizens is heading to the Supreme Court, and the opening action seems to be only weeks away. Under the healthcare law, every US citizen would be required to purchase health insurance by 2014 or face penalties for not doing so.

The Obama administration as well as challengers on the new law are taking it upon themselves to accelerate filings to the Supreme Court and are racing each other to submit their preliminary arguments way ahead of the formal deadlines. The arguments were not set to be received by the Supreme Court until mid-November, which is about a month away.

Obama Healthcare

The Obama healthcare initiatives have been challenged by no less than 26 states ever since its passage in Congress on March 23, 2010. The National Federation of Independent Business is another lobbying interests that has sued to keep the legislation from becoming active law.

The Justice Department in September waived a request for a lower court to rehear arguments. In the first hearing, the 11th circuit court which is based in Atlanta strut down the key provision of the Obama health care plan which required all US citizens to buy health care by 2014. The Justice Department then petitioned the Supreme Court to hear the case.

Obama health care law headed to Supreme Court‎
Creative Commons License photo credit: US Embassy New Zealand

It is most likely that the frame court will take up the dispute over the Obama healthcare initiative in the current term, which does not end until late June of 2012.

It is possible that the acceleration of preliminary arguments by the opponents of the Obama healthcare initiative were politically motivated, as they could play a large role in how the public views Obama and the accomplishments of his administration during the upcoming election next November.

Filing ahead of time is quite rare when it comes to putting legislation before the Supreme Court. This also might have been done so that the screen court justices could add it to their private conference agenda. Doing so would allow the justices to confirm that the matter had been accepted in time for the elections and the long process of reviewing the legislation put into effect.

Opponents of the Obama healthcare initiative have argued that an overriding claim of Congress regulating private enterprise fall short of an individual mandate.

When will the Supreme Court hear the case?

The Supreme Court could hear the case as early as next March. If they do so, they will most likely have a ruling before the June recess. The private conferences of the Supreme Court are set to take place next on October 28, November 4 and November 10.

Although arguments have been submitted, Supreme Court justices maintain the right to veer off schedule, and will probably handle this important issue with the utmost of care.

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Health Insurance Premiums Rising Since Reform Law

October 19th, 2011

One of the main arguments made for passing the Patient Protection and Affordable Care Act was the need to control constantly rising health care insurance premiums. However, the early results are not very promising concerning cost controls, according to a survey by the Kaiser Family Foundation. In their 2011 survey of Employer Health Benefits, Kaiser claims that annual healthcare premiums paid by employers rose 9% since 2010, with the nationwide average premium costs now over $15,000.

There is considerable disagreement over what has gone wrong. Defenders of the new law argue that it is too early to judge the cost restraining effects of the law. Most aspects of the bill do not take effect until two or three years from now, and supporters of the legislation urge critics to withhold judgement until 2014 when the entire law is in effect.

Critics of the legislation claim that the cost increases are actually a reflection of the law’s weaknesses. They point to such provisions as the new requirement under the law that anyone under age 26 who is covered by their parent’s insurance can stay on it if they have no other way to get coverage. . This has added over two million young adults to the family health insurance policies of their parents, an extra expense which leaves insurers with little choice but to raise prices.

Health Insurance Premiums Rising
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Both sides agree that this latest round of price increases couldn’t be more badly timed. With the economy experiencing slow growth, there is little extra money coming in to absorb the increases. This year’s price hikes come on top of relentless increases throughout the past decade. Cost of family health care plans have risen by 113% since 2001, a rate which most economists consider to be unsustainable.

Republicans and Democrats are sharply divided on what should be done. The Republicans are claiming that government involvement is distorting the healthcare market and that the law is not reformable. Therefore they say the law should be repealed. Democrats complain that the legislation hasn’t had a fair chance to work, not just because it is not yet fully implemented, but also because it lacked a government subsidized “public option” to provide the competition with commercial insurers that would keep costs down.

Others suggest there should be a willingness to fine tune the legislation as problems arise. This may involve scaling back the law in some areas that prove unworkable or too expensive, and expanding and encouraging those aspects that prove successful. In any case one thing is for certain: The Patient Protection and Affordable Care Act will be a subject of heated debate for a long time to come.

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Health Care Reform: The Epic Debate Rages On

October 3rd, 2011

Supreme court justices will very soon be expected to decide whether or not President Obama’s Patient Protection and Affordable Care Act, signed into law early last year, can deemed as constitutional. The health care reform law, which would force millions of Americans to purchase health insurance by 2014 or face fines, is the center of heated debate all across the country. The issue is so epic that it even seems to be overshadowing other hot-button issues set before the Supreme Court such as gay marriage, immigration, abortion and indecency.

Some people believe that the law is a godsend. Many others believe that it is unfair, a violation of their constitutional rights, to force them to purchase something they may not even be able to afford. Some even believe the law to be a sinister effort to line the pockets of wealthy heads of large insurance corporations. So far, 28 states and numerous individuals and organizations have filed suits against the Obama administration. The state of Michigan has filed an appeal against the new health care law, and Florida and Virgina are expected to follow suit. The states’ supporting argument is that the Commerce Clause U.S Constitution does not provide the government with the authority to require American citizens to purchase any commercial product, like health insurance, against their will. Even the lower courts cannot seem to agree on the constitutionality of the Patient Protection and Affordable Care Act, and there are more than 20 cases against it pending in federal court.

US Supreme Court
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The Justice Department believes that the law is quite necessary, however, stating that all Americans will require medical care at some time or another in their lives. According to 2008 statistics, an estimated $43 billion dollars in uncompensated costs came from people with no health insurance coverage. These costs inevitably get passed on from the insurance companies to the consumer, causing the price of health insurance to skyrocket. Requiring people to purchase health insurance would supposedly help to spread out the costs more evenly and eventually make it affordable to everyone.

The Supreme Court is expected to deliver a ruling by June 2012, before the end of the presidential elections. The fact that this review is happening in the midst of the 2012 presidential races all but guarantees that it will become a hot topic during debates and campaigns.

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Apparent Opportunities in Workers with Low Wages

September 30th, 2011

Private health care plans that are responsible for overseeing the care of patients on Medicaid have taken hold of the federal health law provision. This could further complicate the industry boom that is expected in 2014, when sixteen million more patients will be steered toward the program for people with low incomes.

States are being lobbied to create “basic health plans“, which would provide coverage to people who are earning as much as 200% of the federal poverty line. This is close to $22,000 each year for individuals according to the Medicaid-like rules. Already, Medicaid benefits are already expanded through the law to individuals earning $15,000.

Deborah Bachrach is a former director for New York Medicaid who currently offers health policy advice to states for the Manatt, Phelps & Phillips consulting firm. She said, “Medicaid-only plans are looking at the BHP as an opportunity to expand their market position.” Without having to compete with the big name commercial insurers, it is possible for Medicaid plans to bring in higher-earning members.

Cover Low-Wage Workers

Stephen O’Dell, the senior vice president of Molina Healthcare, which is a publicly traded Medicaid insurer, argues that it makes sense to cover low-wage workers who currently do not have insurance through Medicaid-like plans, as opposed to commercial insurance policies.

Piggy-Bank
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A $4 billion company, Molina Healthcare joins small nonprofit plans lobbying California among other states to adopt such a program. The Medicaid program in California has plans to add over two million members starting in 2014. In addition, the BHP could send over seven hundred thousand more people to the potential market for insurers such as these.

O’Dell says, “People would look at it and say, I have to pay more, why would I even want to join. These are not people who have historically been without insurance anyway.”

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Use of Healthcare Remains Slow

September 27th, 2011

The economic state of the U.S. remains fragile, as does the health of the nation, with more and more people being kept out of doctors’ offices and away from hospitals. This is affecting earnings reported by major organizations such as Johnson & Johnson and UnitedHealth Group, Inc. in different ways.

Use of Healthcare Remains Slow

Feeling Their Effects

For organizations such as UnitedHealth that work to pay bills, the fact that patients are going to the doctor’s office less often is a big boost to earnings. However, for companies in the business of making products, such as Johnson & Johnson, the slowdown dampers sales. This is something that has been going on for a number of months, and just like high unemployment, it is not likely to change anytime soon.

During a recent conference call with analysts, the vice chairman of Johnson & Johnson’s executive committee, Alex Gorsky said, “I think it’s fair to say that these head winds are proving to be stronger and more persistent than we would have hoped, and we’re feeling their effects.”

This is having a great effect on the medical devices and diagnostic unit at Johnson & Johnson, which is the biggest of the company’s three franchises. The second-quarter results were still better that what was expected by Wall Street due to help from advantageous currency exchange rates, which helped to boost sales overseas and returning to growth in the recall-battered consumer products unit.

Use of Healthcare Remains Slow

Health care has become more economically sensitive

According to portfolio manager for the Miller Tabak Health Care Transformation Fund, Les Funtleyder, “Health care has become more economically sensitive.” He also said that besides the obvious impact of entirely losing insurance, increasing deductibles and copayments are forcing more potential patients to avoid visits to the doctor.

Gorsky said, “There might be some recovery just based on our lapping of last year’s results, but we think that economic pressures are going to continue to play a role in any type of elective procedure and through the remainder of the year.”

Creative Commons License photo credit: Images_of_Money - Tim Pearce, Los Gatos

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