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Everything You Need to Know about the Affordable Care... On September 30, the Affordable Care Act—commonly known as “Obamacare”—officially went into effect as the law of the land, after having been initially signed by the...

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Chicago's Innovative Model for Urban Medical Care Working Chicago’s innovative plan to help deliver better medical care to its urban poor and decrease overall costs is proving more successful than critics originally anticipated....

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Missouri Referendum Rejects Individual Mandate Last Tuesday August 3, 2010 Missouri voters overwhelmingly approved Proposition C, a ballot measure that would prohibit the state government from requiring residents to have...

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Will Obama Fund Abortions in High Risk Insurance Pools? The debate over whether the new federally-funded high risk pool programs will allow funding for member’s elective abortions continues. The mandatory state high risk pools...

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Young Applicants Targeted by Obamacare Proponents

Posted on : February 7, 2014 | By : HealthPlanOne | In : Health Insurance, Politics

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The White House and other supporters of the Affordable Care Act, with a deadline on the way, are working hard to sign up young people to new health insurance plans offered as part of Obamacare. It’s a major initiative that emphasizes just how important younger individuals are to the success of the new law.

Those ranging in age from 18 to 34 are being targeted by volunteers on college campuses and other locations. This effort is apparently inspired partly by the innovative grassroots methods used by the Obama campaigns to track voters during both of the President’s election runs.

It seems that more than just about any other demographic group, participation from these younger individuals (often referred to as “young invincibles”) will be essential to the overall success of the newly adopted Affordable Care Act. For one thing, younger people tend to be healthier people, and it’s been roughly estimated that they will need to make up nearly 40 percent of Obamacare enrollment in order to balance out the relatively higher costs that will be incurred by insuring older, and often sicker people.

It is now less than two months until the deadline for application on March 31. The Obama administration has not reached its goal as of yet. Currently, young adults compose just about one quarter of the 2.2 million applicants who have enrolled in the exchanges through December (which is the last time the administration released official demographic data.) In mid-January, it was announced that 3 million people had signed up for insurance plans so far, but officials have not yet updated demographic details.

Those who oppose Obamacare have declared that young people would be the ones most likely to be discouraged by the technical problems that plagued the online application process at first. Critics also believe that young people will likely often choose to pay the penalty for not enrolling ($95, or 1 percent of income) as an alternative to paying even more for coverage.

If you’re a young person looking to enroll, visit Health Plan One now for more information on how we can help!

Not All Health Plan Options Are the Same

Posted on : January 24, 2014 | By : HealthPlanOne | In : Health Insurance

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With Obamacare now the law of the land, some (including Forbes magazine, which recently ran a story on the subject) are recommending that those looking to buy coverage can save cash on premiums by going with the bronze health plan. The belief is that the gold and platinum options are not nearly as cost-efficient.

After analyzing dozens of potential plans offered under the Affordable Care Act, something interesting has been discovered: Both the provider networks and the drug formularies are very often identical regardless of whether you’re purchasing a particular bronze plan, as opposed to the same option in gold or platinum.

Fast Facts About Health Insurance Coverage

Posted on : January 3, 2014 | By : HealthPlanOne | In : Health Insurance

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Did You Know…

 

Prior to the ACA’s individual mandate to obtain health insurance, more than 40 million non-elderly remained uninsured. Without a mandate, private health insurance would drop by 11 million, while non-group premiums would increase anywhere from 10 to 25 percent.

In 2011, almost 4 million Medicare recipients received a total of $2.1 billion in discounts for out-of-pocket prescription drugs. Under the Affordable Care Act (ACA), that comes to an average savings of more than $604 per person. The new health care reform law, commonly known as “Obamacare”, requires pharmaceutical companies to provide discounted brand name drugs to seniors and the disabled. It also subsidizes generic drugs.

Also in 2011, 48.6 million Americans went without health insurance coverage. That translates to 15.7 percent of all Americans!

Due to the ACA, Americans can no longer be denied coverage because of preexisting conditions. This means they will have access to insurance when they need it most, minus the traditional lifetime and annual benefit limits.

Even with the mandate put forth by Obamacare, designed to provide quality, affordable coverage options to individuals and families, approximately 29 million are still expected to be uninsured in 2019.

Prior to the ACA going into effect, 7 million children nationwide, or 9.4 percent, did not have health insurance.

The majority of states cover children in families earning up to 200 percent of the Federal Poverty Level (FPL). That comes to about $44,000 per year for a family of four, for example. Eligibility levels in each state vary based on family size and other factors, including costs of living.

Uninsured kids are 70 percent less likely than insured kids to get medical care for everyday conditions like sore throat, which tends to cause these little problems to eventually develop into bigger and more serious ones.

Children covered by CHIP or Medicaid tend to have a higher quality of care than kids who are uninsured. They also go to the doctor more often, but the emergency room less. Children who have health coverage also miss less school than uninsured children.

A grave injury or illness can clean out a family’s bank account if they are uninsured, or even just underinsured. In fact, upwards of 60 percent of U.S. bankruptcies are attributed to medical costs.

Having a job doesn’t guarantee coverage: Nearly 80 percent of the uninsured come from working families.

When it comes to being uninsured, the numbers go up in communities of color. Take 2011, for example: 30.1 percent of Hispanics were uninsured; 19.5 percent of African Americans; and 16.8 percent of Asians. This, compared to only 11.1 percent of non-Hispanic whites.

Approximately 22,000 Americans die every year due in part to a lack of proper health insurance coverage. Very simply put, access to proper care can make all the difference between life and death.

For more information on health insurance carriers, visit Health Plan One now! Or for Medicare information in particular, visit Medicare Solutions!

The DSM-V and How It Relates to Mental Health Care

Posted on : December 12, 2013 | By : HealthPlanOne | In : Health Insurance

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Last May, the much-anticipated fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was published. As with prior editions, there are many dramatic changes, and some of them have tended to spark debate and controversy in the psychiatric community.  Certainly, there are many ways in which the new edition will impact mental health care in general, and already have been in the past few m0nths.

Published by the American Psychiatric Association, the DSM is the standard by which doctors classify, diagnose and treat mental disorders.  Naturally, it’s also heavily referenced in the health care industry, as well.

The first revision of the DSM in nearly 20 years, it certainly has introduced some changes that have caused division. These include the elimination of Asperger’s disorder and the addition of conditions like cannabis withdrawal, gambling addiction and disruptive mood dysregulation disorder (DMD).

All of the subcategories of autism have now been grouped into a single category, autism spectrum disorder (ASD). This has led some to wonder if this development might have the unintended effect of excluding some of those already diagnosed with disorders like Asperger’s or PDD-NOS.

Further, in light of the trend in recent years to overmedicate very young children, the DSM V eliminated pediatric bipolar disorder, creating in its place what’s known as disruptive mood dysregulation disorder (DMDD). Specifically, DMDD is described as intense outbursts and irritability beyond plain old temper tantrums. Though it does address a growing problem, some have expressed concern that the new category may wind up being applied too broadly.

Substance abuse is treated differently in what is called the Substance Use Disorders chapter.  In particular, diagnostic criteria have been expanded, and the arguably stronger word “addiction” replaces “dependence”. Gambling disorders and cannabis withdrawal have been added, and most substance use disorders are categorized on a sliding scale that depends on a particular patient’s condition.

Obsessive compulsive disorder (OCD), now has its own category, rather than being categorized under anxiety disorders.  The new category also includes Body Dysmorphic Disorder (BDD) and Hoarding Disorder.

Just as in 1994, the new edition of the DSM brings some interesting and far-reaching changes that will certainly impact the field of mental health care in the years to come.

 

HealthPlanOne Named a Deloitte 2013 Technology Fast 500 Winner

Posted on : December 10, 2013 | By : HealthPlanOne | In : Health Insurance

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Shelton, Connecticut HealthPlanOne announced it ranked No. 166 on Deloitte’s Technology Fast 500™, a ranking of the 500 fastest growing technology, media, telecommunications, life sciences and clean technology companies in North America. HealthPlanOne’s fiscal year revenue grew an impressive 679%.

Chief Executive Officer, William Stapleton, credits the company’s continued growth to its ability to assist health plans improve the efficiency and quality of their direct to consumer sales channel.  “Medicare and individual products are growing significantly, and HealthPlanOne’s technology platform and capabilities in digital marketing, agent training and compliance are helping health plans reduce their cost of acquiring new members, while improving the customer buying experience.” Over the past twelve months, HealthPlanOne has entered into partnerships with a large Blue Cross plan, and several other prominent carriers to provide support to their members through its direct to consumer platform.

“The 2013 Deloitte Technology Fast 500 companies are exemplary cases of those spurring growth in a tough market through innovation,” said Eric Openshaw, vice chairman, Deloitte LLP and U.S. technology, media and telecommunications leader.  “This year’s list is a who’s who of companies behind the most exciting and innovative products and services in the technology space. We congratulate the Fast 500 companies and look forward to what they do next.”

“The fastest growing companies in the US are drivers of constant innovation and operate with the agility to stay ahead of a quickly evolving marketplace, and software, biotech/pharma and internet companies continue to be at the forefront,” added James Atwell, national managing partner of the Emerging Growth Company practice, Deloitte Services LP. “The companies excelling in these sectors have a startup mentality that allows them to be nimble and adapt quickly, which is why they consistently lead the list of fast-growing companies each year.”

About Deloitte’s 2013 Technology Fast 500™

Technology Fast 500, conducted by Deloitte LLP, provides a ranking of the fastest growing technology, media, telecommunications, life sciences and clean technology companies – both public and private – in North America. Technology Fast 500 award winners are selected based on percentage fiscal year revenue growth from 2008 to 2012.

HealthPlanOne Media Contact:
Liza Cooke, Online Marketing and Communications Director
Email: lcooke@healthplanone.com

Everything You Need to Know about the Affordable Care Act

Posted on : November 12, 2013 | By : HealthPlanOne | In : Health Insurance, Reform

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On September 30, the Affordable Care Act—commonly known as “Obamacare”—officially went into effect as the law of the land, after having been initially signed by the President in March of 2010. Now that it’s here, there has been some confusion as to what it will accomplish, and what it means for the average American. There are understandably many questions, and we’ll try to sort some of them out here by providing some basic info on what the ACA is, in a nutshell. Think of it as “Obamacare for Dummies”…

  • Those who benefit the most from the ACA are those who do not currently have health insurance, as well as those who have difficulty paying their premiums. For uninsured families, the ACA expands options for affordable health care.
  • The ACA helps families that may have health insurance, but have difficulty paying the premiums. Financial assistance is administered as follows: families are given the opportunity to shop for plans using exchanges that operate as state insurance marketplaces. A refundable tax credit allows for discounts on their premiums.
  • There are also benefits for those who are insured but have unmanageable copayments, deductibles, or sudden gaps in coverage. Certain limits on what an insurance plan will pay for will be eliminated, providing crucial help with out-of-pocket costs.
  • Those covered by their employers also can benefit from the ACA. As of 2014, a $5 billion program will be put into effect to assist employer-based plans in providing coverage to retirees between the ages of 55 and 65 (including spouses and dependents).
  • Pre-existing conditions can be a major issue for some, and the ACA has provisions for them, as well. By 2014, all discrimination against pre-existing conditions will be prohibited. Those uninsured for more than six months due to a pre-existing condition now qualify for greater access to insurance, under the Pre-Existing Condition Insurance Plan (PCIP), run on a state-by-state basis. If a state chooses not to elect, a plan will be established by the Dept. of Health and Human Services.
  • Families that couldn’t afford coverage in the past will now benefit from premium tax credits and an expansion of Medicaid.
  • States will receive an additional two years of funding from the federal government to provide for coverage for children who are ineligible to receive Medicaid.
  • Under the ACA, young adults are permitted to remain under a parent’s coverage until their 26th birthday.

US Census statistics from 2010 indicate more than 16% of Americans do not currently have insurance. Those without insurance tend to receive less timely care and have worse eventual outcomes. Health insurance is an issue of grave importance in America, and the ACA is intended to alleviate the difficulties faced by some who need it most. A little information can go a long way toward clearing up any confusion arising from this new, important legislation.

5 Ways Mobile Apps are Streamlining Patient-Doctor Communication

Posted on : September 5, 2013 | By : Ann Cooke | In : Health Insurance

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Much has been said about today’s mobile apps, whether it’s their ability to empower the patient or create a more portable practice for physicians. Yet, according to Michael Nusbaum, MD, founder of mobile application MedXCom, one of the most beneficial aspects of mobile applications could very well be better communication between doctor and patient.

Secure messaging. According to Nusbaum, HIPAA-compliant, secure messaging from doctor to patient is possible through certain mobile apps. “[Apps can] improve patients communicating with doctors and doctors communicating with patients, but, at the same time, provide doctors with the valuable information they need about the patient, when they need it most,” he said.

Appointment requests. Nusbaum said according to recent research, about 85 percent of patients would like to be able to request or schedule an appointment directly from their app. “And the whole system [should be] HIPAA compliant, so nothing is stored in your phone,” he said. Ideally, he continued, within a certain app, the database should be encrypted and the only way to access appointment requests and more is for the patient to give permission to the doctor.

Sharing lab results. An efficient app should enable a doctor to get and then share lab results with a patient. “So if you go to a lab, and information is pushed to me, I can review it on my smartphone, and I don’t have to be in my office,” said Nusbaum. “This makes it easy because I can do it wherever I am and whenever I have free time.” If a doctor receives blood work, for example, he/she can review it on the app and then push the information to a patient portal or a smartphone. “And then they can say everything looks good, and let’s check it again in six months,” he added. “It makes it easier for the patient and the doctor.”

Documenting personal health information. “The idea here is to reduce mistakes,” said Nusbaum. Certain apps, he said, allow patients to scan information from their drivers license or insurance card, without either “ever leaving his or her hands,” he said. “This way, each time you go into the office, you don’t have to keep filling out the same forms. [The app] should also have a place for insurance info as part of a patient health profile.”

Voice communication. Recording conversations between a doctor and patient can come in handy during what Nusbaum calls “bad news deafness,” he said. “Whenever a patient hears something they’re not happy with…[he/she] tends to blank out and they don’t listen to anything the doctor says,” he said. Available apps now allow doctors to record conversations with patients, and then send the recording to them. “Systems can also transcribe conversations,” said Nusbaum. “This is important because a lot of the time, doctors will give instructions to patients, and it’s too much.” For example, if a patient receives instructions for wound care, the doctor can forward all steps involved to their app or patient portal. “It goes over [what the doctor] told you, so that it reinforces the instructions,” he said. “That’s unique.”

7 Costly Health Insurance Mistakes

Posted on : May 20, 2013 | By : HealthPlanOne | In : Health Insurance

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http://money.msn.com/health-and-life-insurance/7-costly-health-insurance-mistakes-insure.aspx?page=0

7 costly health insurance mistakes

1. Your doctor isn’t in the network

You’ll pay more to use health care providers who aren’t in your health plan’s network, so check to see if the doctors and other professionals you want are included.

A plan that tightly restricts you to a local network might be sufficient if you need care only in your area, but it won’t benefit a kid away at college or meet all your needs if you spend a lot of time on the road, says Pete Villemain, the president of Employee Benefit Services, which manages employer benefits plans.

Make sure any specialists you need are also covered by the plan, Rosen says. Don’t assume a specialist is in the network just because your primary care doctor gave you the name.

2. You pay huge insurance premiums to save a few bucks on the co-pay

“The mistake I see individuals make so many times is they focus so much on getting a low co-pay and they fail to look at how much extra premium they pay for it,” says Villemain.

He suggests evaluating how you’ll use your plan and comparing the costs accordingly. If you go to the doctor only a couple of times a year, is it worth hundreds of dollars extra on the premium just to get a lower co-pay?

3. The drugs you take aren’t covered

Some states require individual plans to offer prescription drug coverage, but in other states, many individual health insurance plans don’t cover drugs, says benefits consultant Michael Goodheim of Farsighted Strategies in Seattle.

If the plan provides prescription-drug coverage, check to see if your medications are included on its formulary, which lists the preferred drugs for coverage, Goodheim says. Expect to pay more if you take a drug that is not listed.

4. You’re overinsured

In addition to comprehensive health plans, many employers offer supplemental insurance policies, such as cancer or critical illness insurance, that pay a lump sum of cash after diagnosis. Such policies can provide valuable protection, but they might be unnecessary if you already have broad coverage under your medical insurance and short-term and long-term disability insurance, Goodheim says.

5. You can’t afford your share of the medical bills

Low premiums are an attractive feature of high-deductible health plans, but make sure you’re prepared to pay all the out-of-pocket medical expenses, Goodheim says.

Besides the deductible, check the maximum out-of-pocket expenses you pay. After you pay the deductible, many plans pay only a portion, such as 70%, of covered medical expenses. Your 30% share is called co-insurance, which you must fork over until you reach the cap on out-of-pocket expenses.

“Those dollars can really add up,” Goodheim says.

6. You’re expecting, but your policy doesn’t cover maternity care

Most employer-sponsored plans cover maternity and prenatal care, thanks to the federal Pregnancy Discrimination Act of 1978 and the Health Insurance Portability and Accountability Act of 1996, as well as many state health insurance mandates for group coverage. Some states also require individual health insurance plans to include maternity coverage, but in states where there is no such mandate, many individual health plans pay only a small portion of the costs or don’t cover maternity at all. Even if the plan includes maternity coverage, read the fine print to know exactly what is covered and whether there’s a monetary cap.

Starting in 2014, individual and small-group plans sold through state health insurance exchanges must include pregnancy and newborn care, along with other essential benefits.

7. You don’t check your health plan for changes

Scrutinize group health plan offerings from employers each year during open enrollment, Rosen says. Don’t assume the plan is still the same. Coverage levels, costs and networks could change from one year to the next, even if the plan is offered by the same insurer.

“If you’re not sure about something and it raises a flag in your mind, then check it out,” Rosen says.

X-Rays and Your Health

Posted on : March 2, 2011 | By : Sophie Callahan | In : Health and Fitness

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Doctors have been using X-Rays since the late 1800s (History).  The fact that X-Rays are still used around the world today shows their functionality in the medical world.  “X-Ray” is a shortened form of the term “electromagnetic radiation”, which sends wavelengths through solid objects.  When X-Rays were first introduced, doctors were amazed by the new technology and used it frequently in examining their patients.  They were unaware of the consequences of the radiation until the doctors themselves and their patients started to become ill.  This is called “radiation sickness”.  Today, doctors must consider the amount of electromagnetic radiation that is harmful to humans because too much radiation can cause many debilitating health risks.

Excessive amounts of radiation from X-rays can cause cancer and many other health issues, like DNA mutations and leukemia.  X-rays can be dangerous because the charge of the wavelengths can break a cell’s DNA chains.  This cell now has the potential to die or mutate, which can cause the cell to become cancerous.  Additionally, it is dangerous for both men and women to get and X-Ray if you are pregnant or looking to become pregnant.  Exposure to X-Rays (especially in the reproductive area) can cause mutations of the sperm or egg, causing your child to develop leukemia or birth defects.  However, if you get occasional X-rays at doctor’s office visits, you will not be at high risk for cancer.  It’s the excessive amounts of exposure that pose a threat.  In fact, X-Rays may be more beneficial than problematic.

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Are X-rays Really Dangerous?

X-Rays are used to examine broken bones, detect cancer and tumors, and reveal many other medical conditions.  Using an X-Ray Machine is much safer than methods used previous to X-Rays.  For example, doctors in the past had to perform surgery on their patients to examine broken bones.  This more easily posed health threats to the patients, such as putting them at risk of infections.  Now, a simple X-ray can help the doctors with these examinations and without the risks of surgery.  It is also important to note that since the discovery of X-Rays, researchers have discovered that lead is a key component of X-Rays.  Due to its thick density, lead can be used to shield patients from some (but not all) of the electromagnetic wavelengths from an X-Ray.  This shield gives us more protection and a lower risk of the rays harming our body.  Lead shields can be made for any type of X-Rays, both dental and medical.

If you go for regularly scheduled exams, doctors are aware of the radiation risks.  Don’t refuse a single X-Ray because you’re afraid of its health effects.  Now you know that the amount of radiation that reaches your body is very minimal, especially with shielding.  And the harm on your body will me slim to nothing.  This X-Ray can detect a posing health risk that is more threatening to you health than the radiation from an X-Ray.  If you go to multiple doctors and are concerned about the X-Rays, let your doctor know about your other experiences with radiation.  Your doctor will know the precautions to take regarding radiation and your health.

9 Preventative Practices for a Healthy Lifestyle

Posted on : February 23, 2011 | By : Sophie Callahan | In : Health and Fitness

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Preventative healthcare saves lives and money.  It is estimated that thousands of lives and millions of dollars can be saved annually if more Americans take preventative measures with their healthcare.  Preventative tests promote early detection of many medical conditions as well as thwart conditions from arising in the first place.  They allow doctors to check for any signs of a threatening condition.  By finding a condition before it is able to develop, you are able to medicate (and hopefully cure) the condition before while it is still tolerable.  These tests will require less advanced technology and therefore will be less expensive.  Depending on your age and gender, it is recommended that you get certain tests and vaccines more often than others.

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Vaccinations are just one of the preventative services we all need

9 preventative measures to maintaining your health:

  1. Routine Vaccinations: it is important to get routine vaccinations, like the flu, tetanus, and Hepatitis shots.  Protecting yourself from illnesses will keep your immune system healthy and ready to fight off other diseases.
  2. Blood Pressure Screenings: these screenings will monitor your blood pressure and advise you on how to maintain a healthy blood pressure level.  Regular screenings will monitor your level to avoid the risk of a cardiac event.
  3. Cholesterol tests: your awareness of this level will also help you know if your level risks a cardiac event.  If your cholesterol level is too high, your doctor can give you tips for lowering it.
  4. Blood tests: these tests can determine if you have certain conditions that you are unaware of.  Such conditions include diabetes, anemia, and thyroid disorders.
  5. Annual check-ups: these will check to make sure you’re maintaining a healthy weight (unhealthy weigh puts you at risk for many medical conditions) and they will check that you are up to date on all your medications.  Check-ups are also another opportunity to get your blood pressure and other tests updated.
  6. Bone mass tests: these tests examine you bone density to determine if you are at risk for osteoporosis.
  7. Mammograms (for women): women should get an annual mammogram to detect breast cancer.
  8. Cervical Cancer Shots (for women): these shots will help protect women against developing cervical cancer.
  9. Prostate Cancer check-ups (for men): There is a 1 in 6 chance that men will develop prostate cancer.   Men should get regular examinations to catch any signs of the development of prostate cancer.

Now, new Healthcare regulations require that many preventative tests are covered by your insurance carrier!  These new regulations will be applied to insurance plans no later than September 23, 2010.  So there is no reason why you should avoid doctor’s office, even when you are healthy.  Also, it is important to stay up-to-date on all of your medical tests.  This task of managing all of your medical needs may seem daunting at first, but making it more of a routine will help you stay on track.  Importantly, routine visits to the doctor’s office will develop your relationship with your doctor.  Your relationship is so central to your health because it allows your doctor to become familiar with you and your conditions.  This way, he or she will be able to notice changes in your behavior and medical tests that may be indicative of an arising medical condition.