Featured Posts

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....

Readmore

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...

Readmore

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...

Readmore

What Does SPF Really Mean? Summertime and warm weather means a lot of time spent outdoors in the sun.  More exposure to the sun and its UV rays means you are going to need greater protection for your...

Readmore

The Medical World Goes Green …Or at least it’s on its way to it.  In the 1990s it was reported that doctor’s offices and hospitals in the US produced 2 million tons of medical waste per year! ...

Readmore

TwitterFriendFeedLinkedIn
DiggStumbleUponSubscribe via RSS

Study shows that recent grads don’t know their health insurance options

Posted on : May 19, 2009 | By : Sophie Callahan | In : Health Insurance, Miscellaneous

Tags: , , , , , ,

0

According to a UnitedHealth Group poll, more than half of young adults surveyed lack information about their options for health insurance. The poll surveyed 1,000 young adults between the ages of 18 and 21. The survey found that 67% of the students polled haven’t made any plans for health insurance when they graduate. 69% of those covered by their parent’s health insurance plans are unclear about the details of their coverage as well as 26% having no idea when their coverage will end.

Approximately 87% state that educators should do more to communicate information about obtaining health insurance and the basics of health insurance. Some of the options recent graduates and young adults have include:

  • Employer-sponsored health insurance: If you’re lucky to get a job out of college, you will most likely have the option of an employer sponsored group plan. Benefits are usually very comprehensive and your employer pays for a portion of it if not all.
  • Short term health insurance: If you are looking for a job and working part time or not at all for the meantime, getting a short term health insurance plan may be beneficial. Plans tend to last up to one year and you can cancel at any time. They are fairly low cost but they will most likely not cover any preexisting conditions.
  • COBRA: COBRA, or the Consolidated Omnibus Budget Reconciliation Act of 1986, lets students keep their coverage under their parents for up to 36 months. However, COBRA plans are expensive.
  • Individual Health Insurance plan: If the above options don’t seem appealing, an individual health insurance plan is another option. Either going directly to a carrier like Aetna, or a health insurance broker, you can choose a plan that caters to your needs. You can also cancel at any time if you get a job or find another plan that suits you better.

Just remember, health insurance is vital and everyone should have it. If something were to happen, it will cost a lot more to treat you than that couple hundred you pay a month for your coverage.

What happens when your COBRA coverage runs out?

Posted on : February 27, 2009 | By : Sophie Callahan | In : Health Insurance

Tags: , , ,

0

Under the new economic stimulus plan, the federal government will subsidize 65% of the cost of health insurance under COBRA for workers who have lost or may lose their jobs between September 1, 2008 and December 31, 2009. The stimulus package was signed into law on February 17.

COBRA, or the Consolidated Omnibus Budget Reconciliation Act of 1985, allows individuals who have been laid off to stay on employer-based health plans for up to 18 months after termination. Individuals who elect COBRA coverage must pay the share of the premium that they paid while working, as well as their employer’s share plus a 2% administrative charge. COBRA, for most, is too expensive and individuals usually elect to go without health insurance or buy an individual health insurance plan through a private health insurance carrier.

COBRA’s revision under the economic stimulus plan only allows individuals to stay on COBRA up to 9 months. So, what happens in 9 months when you no longer can benefit from COBRA coverage and your new job, if any, doesn’t provide employer based coverage? Individual health insurance plans from private health insurance brokers or carriers, such as Health Plan One, can help in providing affordable health insurance.

High deductible plans offer low premiums and work best for healthy people who don’t go to the doctor that often. Now why would you need insurance if you’re healthy? One reason, life is unpredictable. Sudden illnesses can occur as well as tragic accidents and there is no better way to prepare for what may or may not happen with a health insurance plan.

Inauguration Day

Posted on : January 20, 2009 | By : Sophie Callahan | In : Miscellaneous, Politics

Tags: , , , ,

0

“On this day, we gather because we have chosen hope over fear, unity of purpose over conflict and discord,” Barack Obama said today after taking the oath of office as the nation’s 44th president.

Over 2 million people came to DC to see the swearing in of this country’s first African American president. It is a day that will go down in history. His speech captured many peoples’ hearts and helped us to believe that change for our country is coming. He acknowledged all of the real challenges we face today including the state of our economy that calls for action to create new jobs, and to lay a new foundation for growth.  He then goes on to speak about the restoration of science that needs to take place as well as raising health care’s quality and lower its cost.

Health care is a huge priority for Obama and his cabinet. He has a three part plan for reforming our nation’s health care system.

The first part is to give all Americans access to affordable health coverage. This new health plan would be a public health insurance plan similar to that of federal employees. Regardless of any citizen’s health status, it would be available to everyone at an affordable premium.  In addition to a public health plan, there would be a service (National Health Insurance Exchange) that would help Americans find private health insurance plans. Also, there would be an individual mandate for children.

The second part to Obama’s health care system is the implementation of reforms to help lower health costs and improve health care quality. Obama wants to provide federal funding assistance to business with high-risk employees. He also believes that health care spending can be reduced by improving health care quality in cases such as preventing medical errors, implementing disease management programs, reforming medical malpractice, and promoting health information technology.

The third part is to promote health and wellness. Obama supports increasing federal spending for efforts to address childhood obesity, education for healthcare professionals, and individual and community incentives to help Americans make healthful choices.

With a new president sworn into office today, we should expect a positive change for our country.

Everything you need to know about health insurance…

Posted on : December 22, 2008 | By : Sophie Callahan | In : Health Insurance

Tags: , , , , , , ,

0

But were too afraid to ask!

According to Lesson 16 from CNN’s Money 101, there are a few things to know about health insurance:

A lot of people who think they are healthy may believe that having no insurance saves them a lot more money than having insurance. But what if there’s a catastrophe? You may get into a car accident and get hurt or get hurt on your yearly skiing trip. You may be a healthy person but no one can avoid accidents or unexpected illnesses. A major illness can even push you to bankruptcy.

Make sure you compare plans. Benefits vary from plan to plan and comparing plans can help you find the plan that fits your specific needs.  Also know that a low premium doesn’t always mean cheaper health coverage. A low premium usually means a higher deductible. This means that you must reach this deductible before the insurance starts paying.

In the event you lose your job, COBRA can protect you from losing your health coverage. COBRA usually has higher premium costs but expensive health insurance is better than none at all. COBRA fills the gap while you are looking for an individual plan, getting on your spouse’s insurance, or finding another job.

Indemnity plans v. Managed Care planshealth-insurance.jpg

Indemnity plans allow you to go to any primary care doctor, specialist or hospital. You or your employer pays the premium and there is a deductible that needs to be met before insurance kicks in. After your deductible is met, your health plan pays for a percentage of your health care expenses, usually 80%.  Indemnity plans offer the best choice of a provider but usually have more expensive premiums, deductibles, and coinsurance.

Managed Care plans consist of Health Maintenance Organizations (HMO), Preferred Provider Organization (PPO), and Point of Service plans (POS). HMOs have the least expensive monthly premiums but offer the least choice of a provider.  HMOs manage both the financing and delivery of a broad range of healthcare services. HMOs focus on prevention and primary care. You usually pay a small copayment for each doctor’s visit instead of a deductible and coinsurance.

PPOs allow you to go to out of network providers but you receive better benefits if you stay in network. You usually have direct access to specialists but some PPO plans require you to obtain a referral from your primary care physician (PCP) before seeing a specialist.

POS plans are a combination between HMOs and PPOs. You can choose how to access the plan each time you need treatment. You can stay in network or go out of network but will have to pay deductible and coinsurance charges if you choose to go outside the HMO network.

To make an informed decision, compare many plans before diving into a health plan that looks good. Check out providers; compare deductibles and premiums, and the benefits associated with the health plan.  A good health insurance policy covers hospital expenses, surgical expenses, and physician’s expenses. Some additional benefits are prescription drugs, preventive care, vision care, and maternity care. The best health insurance plan gives you flexibility at a low cost. Make sure you know the health services that you need because you want your plan to cover the health services you need.

Top Health Insurance Plans of 2008

Posted on : December 18, 2008 | By : Sophie Callahan | In : Doctors and Providers, Health Insurance

Tags: , , , ,

1

U.S. News & World Report has released the rankings of the best health plans of 2008. The highest possible score is 100 points. Scores are based on performance relative to other plans in consumer satisfaction, prevention, and treatment, as well as accreditation by the National Committee of Quality Assurance (NCQA). Listed below are the top 5 health plans for each region of the United States: North, South, Midwest, and West. Also listed is the America’s Best Health Plans Honor Roll which recognizes the very best of the hundreds of commercial plans reviewed. The plans below list the state they have members, the type of plans they have (Health Maintenance Org., Point of Service), their star ranking (1-5) in Consumer Assessment, Prevention, and Treatment, and their overall score.


Best Commercial Health Plans: North

1.       Harvard Pilgrim Health Care:  Offers HMO and POS plans to members in Maine and Massachusetts. Earned 5 stars for Consumer assessment, prevention, and treatment and an overall score of 91.2

2.       Tufts Associated HMO: Offers HMO and POS plans to members in Massachusetts, New Hampshire, and Rhode Island. Earned 5 stars in Consumer Assessment, Prevention, and Treatment and overall score of 91.2

3. Harvard Pilgrim Health Care of New England: Offers HMO and POS plans to members in New Hampshire. Earned 5 stars in Consumer Assessment, Prevention, and Treatment and an overall score of 90.6

4. Geisinger Health Plan: Offers HMO and POS plans to members in Pennsylvania. Earned 5 stars in Consumer Assessment, Prevention, and Treatment and an overall score of 88.2

5. Health New England: Offers HMO and POS plans to members in Connecticut and Massachusetts. Earned 5 stars in Consumer Assessment, Prevention, and Treatment and an overall score of 88.1

Best Commercial Plans: South

1. Capital Health Plan: Offers HMO plans to members in Florida. Earned 4 stars in Consumer Assessment, 5 in Prevention, and 4 in Treatment and an overall score of 86.8

2. Kaiser Foundation Health Plan of Georgia: Offers HMO plans to members in Georgia. Earned 2 stars in Consumer Assessment, 5 in Prevention and Treatment and an overall score of 86.7

3. CIGNA HealthCare Mid-Atlantic: Offers HMO and POS plans to members in DC, Maryland, and Virginia. Earned 3 stars in Consumer Assessment, 4 stars in Prevention and Treatment and an overall score of 84.9

4. Optima Health Plan: Offers HMO and POS plans to members in Virginia. Earned 4 stars in Consumer Assessment, Prevention, and Treatment and an overall score of 84.9

5. Health First Health Plans: Offers HMO plans to members in Florida. Earned 4 stars in Consumer Assessment, Prevention, and Treatment and an overall score of 84.5


Best Commercial Plans: Midwest

1. Grand Valley Health Plan: Offers HMO plans to members in Michigan. Earned 4 stars in Consumer Assessment and Prevention, 5 in Treatment and an overall score of 89.1

2. Group Health Cooperative of South Central Wisconsin: Offers HMO plans to members in Wisconsin. Earned 3 stars in Consumer Assessment, 5 in Prevention and Treatment and an overall score of 87.8

3. Priority Health: Offers HMO plans to members in Michigan. Earned 5 stars in Consumer Assessment, 4 in Prevention and Treatment and an overall score of 87.2

4. Security Health Plan of Wisconsin: Offers HMO plans to members in Wisconsin. Earned 4 stars in Consumer Assessment and Prevention, 5 in Treatment and an overall score of 86.9

5. Unity Health Plans Insurance: Offers HMO and POS plans to members in Wisconsin. Earned 4 stars in Consumer Assessment and Prevention, 5 in Treatment and an overall score of 86.8

Best Health Plans: West

1. Kaiser Foundation Health Plan of Colorado: Offers HMO plans to members in Colorado. Earned 2 stars in Consumer Assessment, 4 in Prevention, 5 in Treatment and an overall score of 85.7

2. Kaiser Foundation Health Plan of Northern California: Offers HMO plans to members in California. Earned 2 stars in Consumer Assessment, 4 in Prevention, 5 in Treatment and an overall score of 85.3

3. Kaiser Foundation Health Plan of the Northwest: Offers HMO plans to members in Oregon and Washington. Earned 2 stars in Consumer Assessment, 3 in Prevention, 5 in Treatment and an overall score of 85.3

4. CIGNA HealthCare of Colorado: Offers HMO and POS plans to members in Colorado. Earned 3 stars in Consumer Assessment, 4 in Prevention and Treatment and an overall score of 83.9

5. Group Health Cooperative: Offers HMO plans to members in Idaho and Washington. Earned 3 stars in Consumer Assessment and Prevention, 4 in Treatment and an overall score of 83.1

America’s Best Commercial Health Plans Honor Roll

1.       Harvard Pilgrim Health Care: 91.2

2.       Tufts Associated HMO: 91.2

3.       Harvard Pilgrim Health Care of NE: 90.6

4.       Grand Valley Health Plan: 89.1

5.       Geisinger Health Plan: 88.2

6.       Health New England: 88.1

7.       Anthem BC/BS of CT: 87.8

8.       Group Health Cooperative of South Central WI: 87.8

9.       BC/BS of MA: 87.8

10.   CIGNA HealthCare of NH: 87.6

For the complete list, refer to the U.S. News & World Report website. The site also ranks best Medicare health plans as well as best Medicaid plans.

Blue cross Blue Shield launches new individual health insurance plans

Posted on : December 18, 2008 | By : Sophie Callahan | In : Doctors and Providers, Health Insurance

Tags: , , , ,

0

Blue Cross Blue Shield member health insurance plans have been launching new individual health insurance products that are designed to be more affordable. Due to the weak economy and our country’s recession, many people are losing employer-based health coverage and are resorting to individual health coverage. Below are three BCBS plans that are launching or have already launched affordable individual health plans.

In September, Blue Cross Blue Shield of Arizona launched 5 new individual plans to provide more options to meet the needs and budgets of Arizona residents. Richard L. Boals, BCBSAZ president and CEO says “By matching our individual product line to fit the evolving health coverage needs of today’s customer, we are providing competitively priced products delivered with the quality and service customers have come to expect from Blue Cross Blue Shield of Arizona.”

Their new plans are:

  • BlueOptimum is a preferred provider organization (PPO) with co-pays covering in-network services such as office visits and urgent care. Deductibles range from $250 to $10,000 for individuals in-network, and $500 to $20,000 for families in-network. Coinsurance is 80/20 meaning BCBSAZ pays for 80% of most covered services after you meet the deductible and you only pay 20%. BlueOptimum is ideal for people who want set co-pays and first dollar coverage for in-network preventive care visits.
  • BlueValue is a PPO plan with a mix of co-pay and coinsurance cost sharing, and the flexibility of fixed generic prescription co-pays. Deductibles range from $250 to $10,000 for individuals and $750 to $30,000 for families in-network. Coinsurance is 70/30 after the deductible is met. BlueValue is ideal for people who want to pay for services with a blend of co-pays and coinsurance that result in a lower monthly premium and who also want no deductible for preventive care visits.
  • BlueEssential is a low cost PPO plan with basic coverage, a $1,000 cap on preventive care to help make the policy more affordable, and co-pays for three primary care physician (PCP) office visits per year. Deductibles range from $250 to $10,000 for individuals and $750 to $30,000 for families in-network. BlueEssential is ideal for people who want a plan with low monthly payments designed for low utilization of services and $15 co-pays for generic prescriptions.
  • BluePortfolio is a qualified high deductible PPO plan for use with a health savings account (HSA). HSAs are tax-exempt trust or custodial account to be used for paying qualified medical expenses. Deductibles range from $1,750 to $5,500 for individuals and $3,500 to $11,000 for families in-network. BluePortfolio plans are ideal for people who want co-pays for in-network services such as physician office visits, urgent care, and prescription medications.
  • BlueSecure and BlueSecure Plus are two options for a Health Maintenance Organization (HMO). PCP referrals are not required to visit specialists and co-pays apply to many covered services. The deductible for BlueSecure is $1,000 for individuals and $2,000 for families in-network. There is no deductible for BlueSecure Plus. BlueSecure or BlueSecure Plus is ideal for people who want an HMO plan that covered routine maternity after a 12-month waiting period or who want co-pays that cover most services.

WellPoint’s SmartSense product line makes up more than 50% of individual health insurance sales in California and is also available to Georgia residents. Since November, their SmartSense line of individual health insurance plans has been in the process of being launched in Colorado. SmartSense is tailored to fit your needs and is priced very low with premiums ranging from $33 to $178 a month for a health 25 year old male. The plan offers a wide range of annual deductibles and monthly rate combinations. It also has lower rates on services from in-network providers. They offer simple co-pays for your first three in-network doctor visits without having to meet your plan’s deductible first. SmartSense also offers out-of-state coverage which protects you from the high cost of unexpected emergencies when you travel.

Horizon BCBS of New Jersey has been making adjustments to their individual health plan prices. A new law in New Jersey allows them to use an applicant’s age in their rate calculations which should make plans more affordable for younger individuals.

Blue Cross Blue Shield isn’t the only health insurance company trying to launch new plans for individuals. Health Insurance is vital and many health insurance carriers are trying to make health plans for individuals more affordable.