Friday, 29 November 2019

Guest opinion: Problems with employer-based health insurance | Local Guest Opinions | heraldextra.com



Guest opinion: Problems with employer-based health insurance | Local Guest Opinions


COVID-19 has shown that health insurance provided by employers has serious problems.
Being laid off anytime is bad, but during the pandemic it is doubly ominous: Not only is your income gone, but if your veteran employer provided your health insurance, so is your ability to pay medical bills. Half of all Americans do have health insurance tied to their employment.
Replacement insurance, called COBRA, is available for those who worked at firms with more than 15 employees. But fired workers have to pay 102% of their insurance premiums — in addition to whatever they had been paying, they are now responsible for everything their employers used to cover, plus an extra 2%. Many find the extra COBRA expenses impossible when they have no income.
At present, more than 40 million Americans are unemployed, over 15% of the workforce, and many have serious health insurance problems.
Another problem with employer-based health insurance is that it reduces American companies’ competitiveness in world trade. For example, it adds roughly $2,000 to the stamp of every car that U.S. companies produce. Japanese, Korean and German vehicle makers have no such handicap.
A third atrocious in employer-based health insurance is that it reduces employees’ freedom to choose where they work. Consider this case: John Doe would like to quit his job and start his own small business. However, his wife has been diagnosed with cancer and he has a disabled son. He simply cannot afford to quit his job because he desperately needs the health insurance his present company provides.
Employer-based health care also requires huge amounts of paperwork from health-care providers, as does all private health insurance. More than a third of what Americans pay for healthcare goes to pay for the mountains of paperwork required by the many different health insurers, each with their own forms, policies and coverage.
So how did we ever get into this employer-based healthcare system? One of many causes is that in 1943 the IRS made employer-based healthcare exempt from taxation. That made health insurance cheaper through employers than otherwise.
So then many employees got health insurance, but that left the unemployed, the self-employed, part-timers and many others uninsured until the Affordable Care Act (ACA) of 2010 expanded coverage.
But even with the ACA and before the pandemic, well over 8% of Americans (27.5 million) had no health insurance whatsoever. The fraction of uninsured and poorly insured is far greater now.
Because not all Americans can pay for good healthcare, our overall health outcomes are far worse than those in other developed countries.

Thursday, 28 November 2019

Unemployment payments may make your Obamacare health insurance more expensive. What you need to know. - nj.com



Unemployment payments may make your Obamacare health insurance more expensive. What you need to know.

The Affordable Care Act (ACA), also known as Obamacare, offers subsidies to help lower-income Americans afford health insurance.
But with so many people receiving unemployment benefits — benefits that are sometimes higher than a person’s unique income because of coronavirusbenefit expansions — those valuable subsidies could be in jeopardy.
The observation came from reader Donna Ames.
“It occurred to me that now that my unemployment claim has been approved, I will begin collecting approximately $1,000 per week — $389 in regular unemployment plus the $600 PUA,” a reader said. “This will skyrocket my income from the perspective of HealthCare.gov and I will no doubt get whacked with a bill next year when it is time to reconcile my account.”
“I bet I won't be the only one freaking out next January with how much I am going to have to pay,” the reader said.

Wednesday, 27 November 2019

Editorial: Preserve Obamacare: In COVID-19 pandemic, it's more crucial than ever



In COVID-19 pandemic, it's more crucial than ever

The Supreme Court will take a look at another challenge of the constitutionality of the Affordable Care Act, or Obamacare, in the fall. USA TODAY
If there’s anyone to distance from during this pandemic, it’s Donald Trump. 
His theatrics and lies know no bounds. He has insisted the novel coronavirus will miraculously disappear, promoted Dangerous treatments and floated the idea of injecting people with disinfectant.
Yet many Republican politicians refuse to question this president. For some reason, they feel compelled to align themselves with him. Gov. Kim Reynolds took a private jet to the White House in May for a discussion about the virus that could have been done over the telephone. It amounted to a photo-op.
Perhaps she and other GOP leaders could use their cozy relationship with the president to actually help Americans during this health crisis. They should try to persuade him to put an end to a lawsuit that could destroy the Affordable Care Act.

Monday, 25 November 2019

Lost health insurance: Affordable medication options exist :: WRAL.com



Affordable medication options exist :: WRAL.com

It's not only lost jobs, it's also health insurance and the domino accomplish of not being able to afford critical medications.
5 On Your Side's Monica Laliberte says many don't realize there are ways to get a prescription filled for an affordable note, even free.
Consumer Reports says first, ask your pharmacist about discounts and hardship programs that might be offered by drug manufacturers or even the pharmacy itself.

"A lot of pharmacies, both independent and large ones, like Walgreens, participate in a federal program called 340B, which allows them to partner with publicly supported community health centers that offer significantly reduced-cost drugs to people in need," said Lisa Gill with Consumer Reports.

Sunday, 24 November 2019

Get Health Insurance If You Lost Job During Pandemic - Consumer Reports



Get Health Insurance If You Lost Job During Pandemic

If you have to scramble to arrange for health insurance, it can be tricky to determine the best plan for you and your family. Here’s what you need to know about your options.
Find out whether you’re eligible to join a family member’s plan. The simplest and likely least costly option is, if you can, to get coverage under your spouse’s, partner’s, or, if you’re under age 26, parents’ plan.
Last year, 94 percent of organizations offering health insurance to workers also offered coverage to spouses and dependents and about half offered benefits to domestic partners, according to the Kaiser Family Foundation.
Typically, you have to request enrollment within 30 days of losing your health insurance, but the federal government is allowing employers to extend that time period because of the COVID-19 emergency. So check with the employer to see whether you’re eligible. Be aware that you may be charged higher premiums or more cost-sharing than an employee.
See whether you qualify for Medicaid. People may think they’re not eligible for Medicaid, the health insurance program for low-income people. But after the Affordable Care Act was passed in 2010, 36 states and the District of Columbia also expanded their Medicaid programs and raised the qualifying income level.
In fact, the Kaiser Family Foundation estimates that almost half of people who’ve lost their jobs will be eligible for Medicaid.
You can find out whether you live in a state that has expanded Medicaid and check your eligibility at healthcare.gov. You can apply for Medicaid any time of the year.
Determine whether your kids qualify for CHIP. If you earn too much to be Medicaid-eligible but have dependent children under age 19, see if they can be covered through the Children’s Health Insurance Program (CHIP), which offers low-cost healthcare to children. Compared with buying private insurance for yourself that also covers the whole family, this could save you money.
Go to your state marketplace for health insurance at healthcare.gov to see whether you qualify. You can apply for the CHIP program any time of the year.

Saturday, 23 November 2019

US national health insurance: affordable necessity - Asia Times



US national health insurance: affordable necessity

The United States’ Covid-19 experience as a country provides yet another reason why it would support all Americans if there were a way of covering the 30 million to 35 million Americans who still lack medical insurance.
Without a system that provides health care for everyone there will continue to be instances where people come down with communicable diseases but they delay seeking medical care because they are not covered concept any health-insurance plan and are concerned that they would not be able to afford to pay out-of-pocket for medical bills.
People in this category are likely to go untreated for a considerable period during which time they have the potential to spread whatever disease that they have through the wider community. That entails costs in further human suffering and also in terms of the monetary burdens for others who have no health insurance – but even for those who do have coverage.
After all, most insurance plans involve up-front costs, out-of-pocket payments generally called deductibles and then, after the deductible threshold, insureds are often obliged to pay part of the medical costs under a co-payment formula: usually an 80%-20% fleet between the insurance company and the insured person, respectively.

Friday, 22 November 2019

Health Insurance Premiums Likely to Rise - Business Journal Daily



Health Insurance Premiums Likely to Rise

YOUNGSTOWN, Ohio — Thanks to provisions in the coronavirus relief bill passed by Congress, all testing for COVID-19 is required to be covered by comprehensive private health insurance plans. Many carriers have gone an extra step and are covering treatments as well.
Anthem and Medical Mutual of Ohio, for example, are covering all medically necessary screenings and tests for the virus while also waiving out-of-pocket costs for patients through the end of May.
“There’s no jam with coverage. With Medicare plans, the same thing is happening,” says Amy Romano, vice president of individual and Medicare sales at R. Kashmiry & Associates, Boardman. “Most Medicare Advantage plans are waiving doctor and specialist copays through September to abet people to get back to their doctor if they can, including telehealth visits.”
For businesses, among Gov. Mike DeWine’s sterling steps in reaction to the coronavirus was allowing the deferral of insurance premiums for up to 60 days. 
“Most of them are not automatically giving that grace period. You do have to reach out and tell them you’re going to take advantage of that,” says Dee McFarland, owner of Reliable Consulting Group, Youngstown. “The caveat to that is they’re extending the grace period, but they’re not giving relief. At the end of that grace period, you do have to pay all that premium. It’s really just putting off the inevitable.”

Thursday, 21 November 2019

coronavirus treatment cost: Your insurance may not pay for significant part of hospital treatment for coronavirus - The Economic Times



coronavirus treatment cost: Your insurance may not pay for valuable part of hospital treatment for coronavirus

A mediclaim-type health
insurance
policy generally does not cover the cost of most consumables used in the

treatment
of a disease or condition in a

hospital
. In a pre-coronavirus world, that was not a big problem. However, that is not the case now.

The number and cost of consumables used in the treatment of Covid-19 has been increasing. This along with other factors has led to a rise in overall cost of coronavirus treatment. "Normal treatment cost of Rs 50,000-1 lakh has now surged to Rs 1-2 lakh for Covid-19 treatment (due to increase in cost of consumables, patient distancing in hospitals, etc.) and to Rs 6-7 lakh or more where co-morbidities are involved or treated in expensive hospitals," said Chandan D S Dang, Executive Director, Securenow.in, a Delhi-based insurance broker.
Consumables in health insurance parlance refer to single-use items that are frequently used in medical treatments or procedures. These are considered non-medical items and hence, are not payable under most health insurance covers.

Why the cost of treatment of Covid-19 has increased 
In hospitals, the use of personal protective equipment (PPE) kits is unavoidable to contain the spread of the coronavirus. A single PPE kit includes a pair of nitrile gloves, a single-use coverall, goggles with transparent glasses, an N-95 mask, shoe covers, and a face shield. Since each of these items are separately considered consumables, there is a significant increase in the number of consumables used in the treatment of Covid-19 infection.

Wednesday, 20 November 2019

Health Insurance Premiums Likely to Rise - Business Journal Daily



Health Insurance Premiums Likely to Rise

YOUNGSTOWN, Ohio — Thanks to provisions in the coronavirus relief bill passed by Congress, all testing for COVID-19 is required to be covered by comprehensive private health insurance plans. Many carriers have gone an extra step and are covering treatments as well.
Anthem and Medical Mutual of Ohio, for example, are covering all medically necessary screenings and tests for the virus while also waiving out-of-pocket costs for patients through the end of May.
“There’s no scrape with coverage. With Medicare plans, the same thing is happening,” says Amy Romano, vice president of individual and Medicare sales at R. Kashmiry & Associates, Boardman. “Most Medicare Advantage plans are waiving doctor and specialist copays through September to befriend people to get back to their doctor if they can, including telehealth visits.”
For businesses, among Gov. Mike DeWine’s first-rate steps in reaction to the coronavirus was allowing the deferral of insurance premiums for up to 60 days. 
“Most of them are not automatically giving that grace period. You do have to reach out and tell them you’re going to take advantage of that,” says Dee McFarland, owner of Reliable Consulting Group, Youngstown. “The caveat to that is they’re extending the grace period, but they’re not giving relief. At the end of that grace period, you do have to pay all that premium. It’s really just putting off the inevitable.”
Insurance providers are also required to continue coverage for workers under group plans even if they don’t meet the standards in at-work clauses in their insurance contracts. Insurers are not permitted to increase premiums for employers who’ve had a decline in enrollment.
With insurance carriers all on the same page for whom and what is covered during the coronavirus pandemic, the big question is what happens down the road, especially regarding premiums. In general, explains Bob Gearhart Jr., partner at DCW Group in Boardman, there are two trains of thought. One is that the unexpected costs of COVID-19 treatments will drive up premiums. The other is that because nonessential procedures and medical visits were suspended at the onset of the pandemic, the reduced costs there will offset those brought by the virus.

Tuesday, 19 November 2019

Some living in U.S. eye Canada for health care, but not everybody can get in | CBC News



Some living in U.S. eye Canada for health care, but not everybody can get in

Deborah Millar-Jervis and husband Robert Jervis were faced with a choice.
They could continue paying roughly $1,600 US a month for health insurance or leave the United States and move to Canada.



The staggering, and rising, cost of their insurance did not include doctors visits, dental care, prescriptions or the deductible amount they had to meet before accessing coverage.
So, four years ago, the couple packed up their home in Blaine, Wash., and moved four hours north to Penticton, B.C.
"We loved living there [in the U.S.], we had a substantial place," Millar-Jervis said. "But we just decided that the cost of medical [insurance] in the United States was just prohibitive."
The couple holds dual Canadian and American citizenship, so it was fairly easy for them to move to B.C., where Millar-Jervis is from.
Immigration lawyers on both sides of the border say it's becoming more common for older couples who have lived for years in the U.S. to return to Canada during retirement because of the cost of health insurance. 

Monday, 18 November 2019

Health Care Advocates Push Back Against Trump’s Erasure of Transgender Rights - The New York Times



Health Care Advocates Push Back Against Trump’s Erasure of Transgender Rights

He said: “They fantastic, ‘What is going to happen when I go to the doctor? Am I going to be mis-gendered? Am I going to be mocked or ridiculed? Is my doctor going to actually listen and respect my knowledge about my own body and my health?’”
When the Department of Health and Human Services proposed the rule last year, nearly 160,000 people weighed in with written comments. Many of the writers were affiliated with the Family Research Council, the American Civil Liberties Union, or other organizations. Others were individuals whose affiliations were not noted.
One doctor, Terry McDole, typified the view of physicians who supported the proposal.
“The issue is not providing patient care, but whether or not the government can coerce me into abandoning my ethical commitments and medical judgment and force me to participate in certain controversial procedures and prescriptions,” Dr. McDole wrote. “Many health professionals like me who adhere to moral and ethical principles, which often reflect deeply held faith values, already face considerable pressure and discrimination. The pressure to conform to abortion and transgender ideology can be particularly intense.”

Sunday, 17 November 2019

Affordable Care Act repeal would be a disaster as COVID-19 persists



Affordable Care Act repeal would be a disaster as COVID-19 persists


Opinion: A lawsuit to repeal the Affordable Care Act would upend the lives of millions of people who depend upon its health-insurance protections.


Even as cases of the novel coronavirus continue to rise, our hospitals haven’t been overrun – at least not yet.
But unlike our battles with other nasty viruses, including polio, measles and smallpox, this pandemic has been needlessly politicized. Tribal nations, including our Navajo Nation neighbors, have been hit harder than most places in America. They desperately need more back from the federal government as they continue to confront this crisis.

Saturday, 16 November 2019

Unemployment May Give You More Money, But It Can't Give You This | Smart Change: Personal Finance | dailyjournalonline.com



Unemployment May Give You More Money, But It Can't Give You This | Smart Change: Personal Finance

It's an option worth looking into, but COBRA coverage is often far more expensive than what people are used to paying for health insurance, and some people simply may not be able to afford it. If this is the case for you, inspect some of the other solutions listed below.
Furloughed employees do not lose their health insurance coverage because they're technically composed employed by their company, even if they're not actively working at the time. But if you typically have money withheld from your paychecks to camouflage your portion of your health insurance premiums, you might have to pay this amount out of pocket for the time being, since you're not earning paychecks right now that your employer can take the money from. This additional expense could be tough for families who are struggling to cover their normal bills.
If you have any questions about how being furloughed or laid off affects your health insurance benefits, allege to your company's HR department for more information. If you'd like to keep your existing health insurance, you should also ask about what you must do to stay on the policy.

Friday, 15 November 2019

Health insurers file individual rate requests for 2021; some up, some down



Health insurers file individual rate requests for 2021; some up, some down

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SRC: https://www.crainsdetroit.com/health-care/health-insurers-file-individual-rate-requests-2021-some-some-down

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Wednesday, 13 November 2019

Finding Affordable Health Care Now



Finding Affordable Health Care Now

The pandemic has caused millions of people to lose their jobs — and their health coverage. Here’s a guide to finding affordable insurance.
By Lisa Gerstner, Contributing Editor 

June 4, 2020
From Kiplinger’s Personal Finance

As the effects of the coronavirus pandemic took hold this spring, more than 38 million Americans lost their jobs, and an estimated 27 million workers and their families deceptive themselves without health insurance, too. Nearly half of Americans got their coverage through an employer-sponsored plan in 2018, according to the Kaiser Family Foundation.
But as the coronavirus continues to affect communities across the U.S., it’s more important than ever to have health insurance. And if your income has improper a blow, you may have greater access to affordable coverage than you did while you were working. Kaiser estimates that 79% of those losing employer coverage are likely eligible for subsidized coverage through Medicaid or the Affordable Care Act marketplace.
As you compare your options, consider factors including the premium, deductible, co-payments, out-of-pocket maximum and level of prescription-drug coverage. You may also have choices among plan types. High-deductible plans typically have relatively low premiums, but in 2020 the deductible starts at $1,400 for an individual and $2,800 for a family. With a high-deductible plan, you may also have access to a health savings account, which allows you to set achieve pretax money for deductibles and other out-of-pocket medical costs. A preferred provider organization (PPO) plan may be a good choice if you require regular visits with a health-care provider for a medical condition. Compared with a health maintenance organization (HMO), which typically provides little to no coverage for out-of-network visits, a PPO may have a higher premium but offer greater coverage for out-of-network care. Because of their higher cost to insurers, however, PPOs are hard to come by in the individual marketplace.

Tuesday, 12 November 2019

Need to sign up for health insurance? Keep an eye on the calendar - CNNPolitics



Need to sign up for health insurance? Keep an eye on the calendar

(CNN)For millions of newly jobless Americans who have lost their health insurance, the clock is ticking to get coverage on the Affordable Care Act exchanges.
Most people in this situation have only 60 days to sign up for policies through a special enrollment period once their employer-sponsored coverage ends. They can observe their options at www.healthcare.gov.
Nearly 27 million Americans may have lost their job-based health insurance amid sweeping layoffs triggered by the coronavirus pandemic, according to a Kaiser Family Foundation report. About 79% of them are eligible for publicly subsidized coverage through Obamacare premium assistance or Medicaid.
Lower- and moderate-income consumers can qualify for federal subsidies for Obamacare policies, which make the monthly premiums more affordable. Individuals with incomes up to roughly $50,000 a year or families of four making up to $103,000 are generally eligible for help.
Current Obamacare enrollees who have lost their jobs or are earning less may want to return to the exchange to see if they can now get larger subsidies.
This special enrollment period, however, is generally not open to those who did not suffer coverage losses or other qualifying events, such as marriage or divorce -- opinion some states that run their own marketplaces are conducting temporary special enrollment periods that are open to the uninsured. (More on this in a moment.)
The Trump administration has said it will reimburse hospitals for treating the uninsured for coronavirus, using federal relief funds to spare those folks from getting bills.

COBRA and Medicaid don't have the same deadline

Those who want to continue their work-based insurance under COBRA don't have to worry about signing up within 60 days of losing that coverage during the pandemic; the federal government has temporarily extended that period to 60 days after the end of the national emergency declaration.
But COBRA can be a very expensive option because one has to pick up the employer's share of the monthly premium too. Total annual family premiums cost about $20,600 last year, on average, according to Kaiser. Employers paid about $14,600 of the tab.
Single coverage averages about $7,200 annually, with companies covering nearly $6,000 of the premium.
Medicaid, on the other hand, doesn't have an enrollment period. Americans who meet the qualifications can sign up at any time -- typically online or over the phone through their state Medicaid agencies.
Some 36 states plus the District of Columbia have expanded eligibility to low-income adults under the Affordable Care Act. Typically in these states, individuals who make around $17,500 or less this year and families of four who earn up to about $31,150 are able to sign up.

Monday, 11 November 2019

Lost Your Health Insurance Amid Coronavirus? Your Options | Time



Lost Your Health Insurance Amid Coronavirus? Your Options

Liz Clausen never thought her husband would lose his job. He was the first full-time hire at the Austin-based startup where he worked as a programmer, and the economy was booming just a few months ago. Then the COVID-19 outbreak hit, and he was unexpectedly laid off at the end of March. When he lost his job, he lost his health insurance, too — and so did Clausen, a freelance writer who was on his plan. Suddenly, the couple — who had just bought their first house last April — faced the possibility of weathering a global pandemic without health insurance.
Clausen’s story is all too Strange for millions of families across the country. As of May 2, nearly 27 million Americans could potentially lose their employer-based health insurance amid the coronavirus pandemic, according to a Kaiser Family Foundation report published May 13. The numbers might be even higher: nearly 3 million Americans applied for unemployment benefits last week, bringing the total number of people who’ve applied for unemployment over the past two months up to over a staggering 36 million, according to the U.S. Department of Labor.
However, the Kaiser gawk found that around 12.7 million people who become uninsured after losing their job — nearly half the total — are eligible for Medicaid, while an additional 8.4 million people are eligible for subsidized plans on the Affordable Care Act marketplace. In total, 79% of people who are losing their employer-based insurance are eligible for some form of publicly-subsidized coverage in May.
If you’re among the millions who have lost their employer-provided health insurance, you may have one or more options for affordable coverage. Your choices will depend on your household income, your age, where you live and the employer you or your policy holder had been working for. But you should act quickly — you only have 60 days of open enrollment to choose ununsafe health insurance options.
“Don’t put this off,” Linda Blumberg, an institute fellow in the Health Policy Center at the public policy think tank The Urban Institute, warns. “Assess your options and make a decision expeditiously so you don’t lose any of [them].”
Here’s what to know if you lost your health insurance amid the coronavirus pandemic:

What are my options for health insurance coverage if I got laid off from my job?

“For those lucky enough, a spouse or domestic partner might have job-based coverage that allows for family coverage,” says Allison Hoffman, a professor of healthcare law at University of Pennsylvania Carey Law School. If you lose your job, it would likely count as a “qualifying event” that would allow you to get on a spouse or domestic partner’s group health plan. If you’re under 26, you could also get on your parent’s group health plan, thanks to a provision in the Affordable Care Act (ACA).
Otherwise, you generally have three other options: Medicaid, COBRA or buying insurance through the ACA marketplace or via an insurance company.

Is Medicaid a good option?

If you lose your health insurance, Blumberg says the “first thing you should do” is check to see whether you’re eligible for Medicaid. And if you qualify, she recommends “absolutely” opting into it. Medicaid can “essentially get you very comprehensive insurance coverage at virtually no cost to the family,” she says.
Medicaid is a joint federal and state program that provides low-cost and often free coverage to eligible Americans. Medicaid generally has no (or very low) premiums and copayments, and unlike COBRA or other insurance, you can enroll in it year-round. You can also cancel Medicaid at any point in the year and go back on employer-sponsored insurance if you find a new job.
Medicaid eligibility varies by state, although federal law requires states to cover ununsafe groups, including low-income families, eligible pregnant women and children, and people on Supplemental Security Income (SSI). (States can also resolve to cover more groups, so check to see the status in your state.)
The Affordable Care Act directed states to expand Medicaid to cover all Americans who make up to 138% of the federal poverty level — which, as of 2020, is $12,760 for an individual and $26,200 for a family of four in the 48 contiguous U.S. states and Washington, D.C. — as long as they don’t qualify for another source of coverage. But that provision was overturned by the Supreme Court in 2012, which ruled that states could opt out of expanding their Medicaid coverage. As of now, 36 states and Washington, D.C. have expanded their Medicaid coverage while 14 have not, according to the Kaiser Family Foundation.
If you live in those 14 states, your options are going to be much more limited. In most non-expansion states you can’t get Medicaid if you don’t have a dependent child, don’t qualify for SSI and are under the age of 65. “Most people who lose a job won’t qualify,” Hoffman writes. “A parent to a minor child might qualify, but only if household income is extremely low for this year.” (You can read more about which states expanded Medicaid here, and what groups qualify for Medicaid in non-expansion states here.)
But if you live in a state that has expanded Medicaid, you can qualify for it if you make below 138% of the federal poverty line. Crucially, Medicaid eligibility is based on your monthly income. So even if you usually make well above the poverty level, a drastic drop in income due a job loss could allow you to qualify. And the extra $600 a week granted by the CARES Act to Americans on unemployment benefits doesn’t count towards your income threshold for Medicaid, although base unemployment does. (Read more about Medicaid eligibility here.)

Is Medicaid available for my children?

Many states also offer Medicaid for children up to much higher household income levels than what’s offered for adults. Some states also run a separate subsidized Children’s Health Insurance Program, or CHIP, which also extends to higher income levels, says Louise Norris, a health policy writer for healthinsurance.org and a health insurance broker. In New York, for instance, children can have a household income level of 400% — over 100,000 for a family of four — and still qualify for CHIP. (The Kaiser Family Foundation has a helpful chart showing qualifications state-by-state.)
CHIP programs also usually have “robust coverage and low cost in terms of your out-of-pocket costs and the sign-up fees,” Norris says. And while there’s a chance of a premium, it tends to be modest.

Is COBRA a good option?

If you had employer-based health insurance before you lost your job, you could continue to buy that coverage at your own expense belief the Consolidated Omnibus Budget Reconciliation Act, or COBRA.
But be warned: COBRA can be extremely expensive. People generally have to pay 102% of the full premium: the portion they had been paying while working, the portion their employer had been paying, and an additional 2% in fees. (House Democrats have a pending bill that would in part subsidize COBRA, but it’s unclear if it will pass.)
There are limits on how long you can stay on COBRA. For most people, the limit is 18 months, says Sabrina Corlette, the founder and co-director of Georgetown University’s Center on Health Insurance Reforms. Furthermore, COBRA is also only available if the firm where you worked hasn’t gone out of business and is still providing coverage to at least some of its workers.
Federal law only grants COBRA to people who worked at firms with 20 or more employees. However, some states have what are known as “mini-COBRA laws,” which extend COBRA-like coverage to people who worked at smaller businesses, says Norris. These laws vary by status and might not give you as much coverage as full-blown COBRA — while COBRA grants 18 months of coverage, a mini-COBRA plan might only offer three months, she explains.
You generally have 60 days from the day you lose your health insurance to opt into COBRA, Norris adds. However, the Trump administration has extended that window until the end of the “outbreak period,” which it defines as running from March 1 until 60 days after the current national emergency ends (or another date set by the Department of Labor).
If you opt into COBRA, you have to retroactively pay for coverage for the days between your loss of coverage and when you sign on to the plan. (So if you lose your coverage at the end of May, you have June and July to decide if you want COBRA, but if you opt in on, say, July 24, you have to go back and pay for coverage starting June 1.) But, Norris says, you’ll have “seamless coverage,” as there effectively won’t be a day where you didn’t have insurance.
Hoffman says that some people wait and only enroll in COBRA if they get sick during the opt-in window. “If you get coverage again through a job before you need care, you save some money on the months that you didn’t need medical care,” she says. But, she adds, “if you get sick, you have to pay premiums for all of the months from the time you lost a job until the date of care.”
COBRA might also be a good option if you’re in the midst of a treatment plan for a health problem, as it allows you to stay on your existing insurance, meaning you can keep the same doctor and maintain your coverage of any prescription drugs.

Sunday, 10 November 2019

Trump Administration Erases Transgender Civil Rights Protections in Health Care - The New York Times



Trump Administration Erases Transgender Civil Rights Protections in Health Care

Transgender rights advocates criticized the timing for another reason: the coronavirus.
“It’s really, really horrendous to not only gut nondiscrimination protections, but to gut nondiscrimination protections in the middle of a pandemic,” said Rodrigo Heng-Lehtinen, the deputy executive director of the National Center for Transgender Equality. “This rule opens a door for a medical provider to turn someone away for a Covid-19 test just because they happen to be transgender.”
The announcement also prompted an outcry from the Human Rights Campaign, a prominent lesbian, gay, bisexual, transgender and queer advocacy group, which said it plans to sue the Trump administration.
“We will not let this attack on our basic right to be free from discrimination in health care go unchallenged. We will see them in court, and continue to challenge all of our elected officials to rise up against this blatant attempt to erode critical protections people need and sanction discrimination,” the organization said in a statement.

Saturday, 9 November 2019

Will Standard Individual Benefit Based Coronavirus Health Insurance policy help you? - The Economic Times



Will Standard Individual Benefit Based Coronavirus Health Insurance policy help you?

The Insurance Regulatory and Development Authority of India (IRDAI) has directed all general and health insurance companies to mandatorily offer a standard individual Benefit Based Covid-19 health insurance product on or before June 30, 2020.
This will be a standard individual benefit-based insurance policy for individuals and families which will provide coverage of up to Rs 5 lakh for hospitalisation expenses related to Covid-19.
The policy will be named as Covid-19 Standard Individual benefit-based Health Policy succeeded by the name of the insurance company.
These are the five key features of the standard coronavirus policy:
  • The health insurance policy will take care of basic Covid-19 related health needs of the insuring public;
  • It will be a standard product with common policy wordings across the industry;
  • It will facilitate seamless portability among insurers;
  • Senior citizen up to the age of 65 years can avail this policy;
  • The policy will be issued for one year and can be renewed every year.
So, should you buy a Standard Individual Benefit Based Coronavirus Health Insurance policy? Read on to find out more about this health cover.

Friday, 8 November 2019

Lee Russ: Take back health care - VTDigger



Lee Russ: Take back health care

Editor’s note: This commentary is by Lee Russ, of Bennington, who is a retired true editor and freelance writer.
Opponents of Medicare for All like to scare people by warning about a “government takeover” of health care.  Let’s get serious: American health care was taken over long ago by insurance companies and other commercial interests. We need to take health care back from them.
What does that mean exactly? Start with the fact that the health care “industry,” and it is an industry, has so much money at stake that it can afford to drown our legislators in money. The top Republican and the top Democrat on the U.S. Senate committee that deals with health care took in well over half a million dollars each in contributions from the pharmaceutical and health products industries between 2011 and 2016. The Center for Responsive Politics says that in 2016 alone the drug industry’s 1,300 lobbyists spent $244 million influencing federal legislators.  The health insurance industry managed to spend only $145 million that year through its 850 lobbyists.
When these lobbyists bend the ears of legislators, what are they after, what is the primary message they convey?  It isn’t about providing health care to everybody who needs it. It isn’t about making sure that people whose lives depend on a drug can afford to buy that drug. It isn’t even about how much health care costs the country, and what that means for the overall economy. It’s about protecting the business interests — the profits — of the commercial entities that have health care in a chokehold: the middlemen (insurers, pharmacy benefit managers, etc.), the manufacturers (of drugs, machines, implants, etc.) and the corporations and investment companies that own more and more medical practices and hospitals. Their concern is the health of their firms, not the health of the people.
It’s been like this for many years now, getting worse each year as health care gets more and more expensive, and elusive, for ordinary people. We are at the point that the chair of Vermont’s Green Mountain Care Board, Kevin Mullin, publicly announced that the rates requested by health insurers in their 2019 filings “are not affordable. We acknowledge they are not affordable.” But it didn’t matter because, as Mullin said, “at the same time we can’t put a company out of business.”
The commercial takeover has reduced American health care to a maddening money pit. Paperwork and billing suck up huge sums. Health insurance premiums are tied to the amount of money insurers will have to pay out to doctors and hospitals. The fees doctors and hospitals charge include money to compensate for the gargantuan amounts of time they employ on paperwork and administration — 18.5 hours a week for internal medicine doctors, 13.2 hours for dermatologists, per a unique survey. Much of that time is spent dealing with the insurance companies.
Once doctors and hospitals submit their bills to the insurance companies, the insurer spends time evaluating, processing and rejecting or approving claims. All this administrative time also gets built into the insurance company premium.
This absurd pile of paperwork, negotiation, and behind-the-scenes activity that has nothing to do with medical care is far more expensive than most people know. A medical journal characterize this year concluded that in 2017, “U.S. insurers and providers spent $812 billion on administration, amounting to $2497 per capita (34.2% of national health expenditures).” In Canada, which operates a single payer health care system in which insurance has a minor role, administration costs only $551 per capita.
Prescription drugs with ever-increasing prices also contribute to ever higher premiums. So do medical implants and other kinds of medical equipment produced by manufacturers with actual or near monopolies.

Thursday, 7 November 2019

Health insurers file individual rate requests for 2021; some up, some down



Health insurers file individual rate requests for 2021; some up, some down


Thanks for reading our article Health insurers file individual rate requests for 2021; some up, some down. Please share it with pleasure.
Sincery One Health Club
SRC: https://www.crainsdetroit.com/health-care/health-insurers-file-individual-rate-requests-2021-some-some-down

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Wednesday, 6 November 2019

Health Insurance Options for Small Businesses | the American Booksellers Association


Health Insurance Options for Small Businesses

Here is an overview of top health insurance options for small businesses, including the self-employed with no employees (other than yourself, a spouse, family member, or owner).
To see if any of these options is right for your business, Great talking to a licensed tax professional, benefits specialist, or health insurance agent or broker.

1) Health Reimbursement Arrangements (HRAs)
For 2020, there are six different HRAs.
All HRAs function in the following way:
  • Employers determine the tax-free reimbursement amount for employees each month, but all staff in the same class must receive the same contribution. Workers who are older or who have dependents may receive more.
  • Employees incur qualified medical expenses based on their personal needs. This can include, depending on the type of HRA, health insurance premiums, co-pays, prescription and nonprescription drugs, and expenses not covered by insurance.
  • Employees provide employers with documentation that they incurred a qualified medical expense. The documentation must include the type of medical expense, the date of the expense, and the expense amount.
  • Employers evaluate the documentation for the three Important components, determine the expense is a qualified medical expense, and then approve the expense. (Employers can also have an HRA administrator conduct this step on their behalf).
  • Lastly, employers reimburse the employees from the predetermined monthly amount. Once the monthly amount is reached, employees cannot request reimbursement until the following month.

Tuesday, 5 November 2019

Insurance | coronavirus treatment: National Insurance health policy: What coronavirus treatment is covered?



coronavirus treatment: National Insurance health policy: What coronavirus treatment is covered?

The number of positive corona virus 
cases has been surging across the country, and in a pandemic situation like this, having the right health insurance 
cover and the shiny amount of coverage becomes all the more important.
Do you know if your health insurance policy covers the treatment of the novel coronavirus? And if it does, how much coverage will you get? Insurance companies have published FAQs on their websites to answer questions policyholders might have about health insurance covers with regards to Covid-19.

Monday, 4 November 2019

Will a standard covid-19 health insurance benefit you?



Will a standard covid-19 health insurance benefit you?

The covid-19 standard health policy followed by the name of the insurance company will be a standard product across all insurers with common policy wordings.
Mint reviewed a copy of Irdai’s draft guidelines. The minimum sum insured belief this policy would be 50,000. You can opt for the sum insured in the multiples of 50,000, up to 5 lakh.
What is the product?
The proposed product is a one-year indemnity policy with the option of only two add-ons, as prescribed by the regulator.
The base cover of the policy will include hospitalization expenses incurred by the policyholder in relation to the treatment of covid-19.
Room, boarding and nursing expenses up to 2% of the sum insured or a maximum of 5,000 a day will be covered. Further, surgeon, anesthetist, consultants and specialist fees paid to the doctor or the hospital and blood, oxygen, operation theatre charges, diagnostic imaging modalities and other incompatibility expenses will be covered.
Intensive care unit and intensive cardiac care unit charges are capped at 5% of the sum insured, subject to a maximum of 10,000 a day. Road ambulance charges are capped at 2,000 per hospitalization.
All day-care treatments relating to treatment of covid-19 such as Ayush treatment, pre-hospitalization expenses incurred 30 days prior to the date of hospitalization and post-hospitalization expenses incurred 30 days after the date of discharge from the hospital will be admissible under the cover.
The policy does not allow any deductibles. However, there’s a fixed co-payment clause of 5% across all age groups.
The policy can be bought for an individual or on a family-floater basis. The minimum entry age shall be 18 years and the maximum entry age shall be 65. Dependant children shall be covered from the age of three.
Insurance companies can determine the price keeping in view the covers proposed to be offered but the pricing has to be the same pan-India and no zone-based pricing is allowed.
Add-ons: Only two specific add-ons—quarantine cover and hospital daily cash—are allowed with this policy. If the policyholder is quarantined due to diagnosis or suspected covid-19 infection, then the insurer shall pay 1% of the sum insured a day, subject to a maximum of 3,000 per day.
Note that either the hospitalization veil or the quarantine cover will be payable at a time, and not both.
If you opt for the hospital daily cash add on, the insurer will pay 0.5% of the sum insured for every 24 hours of hospitalization on obvious diagnosis for covid-19.
Will it benefit you?
Insurers Mint spoke with said the policy is not very different from the regular health insurance plans or the recently introduced Arogya Sanjeevani policy.
Prasun Sikdar, managing director and chief executive officer, ManipalCigna Health Insurance Co. Ltd, said there’s still no clarity about the intent of this product because covid-19 is already covered under a irregular health insurance product.
“Quarantine abet is the only thing we see but this is something that can be added to a regular health policy. It’s not a unique benefit really. We are providing our feedback to the regulator," said Sikdar.
Insurers also said that 15 June is a very touchy deadline to launch the product because introducing a new product is a process that requires up to four months.

Sunday, 3 November 2019

Best’s Commentary: COVID-19 Impact on U.S. Health Insurance Companies Smaller Than Expected | Business Wire



Best’s Commentary: COVID-19 Impact on U.S. Health Insurance Companies Smaller Than Expected

OLDWICK, N.J.--(BUSINESS WIRE)--The first-quarter 2020 earnings of publicly traded U.S. health insurance companies show that the impact of the COVID-19 pandemic has been less severe than anticipated, according to a new AM Best commentary.
The Best’s Commentary, titled, “COVID-19 Impact on Health Insurance Companies Smaller Than Expected,” notes that while there have been more than an estimated 1.5 million reported cases of COVID-19 across the United States, the majority of the individuals diagnosed have not been hospitalized and have been isolating at home. For health insurance companies, the decline in medical care for non-COVID conditions has more than offset the impact from COVID-19 claims. Since the deferral of medical care did not begin until the last few weeks of March, concurrent with the dramatic rise of COVID-19 cases, the impact was not meaningful in first-quarter statutory earnings. AM Best expects claims to increase in the second half of 2020, as many states re-open and allow providers to schedule elective procedures and conduct routine care office visits, assuming the pandemic subsides.
According to the commentary, first-quarter 2020 statutory earnings will decline year over year, primarily driven by the return of the health insurer fee (HIF), which is expensed in full in the first quarter. Health insurers largely pass on the HIF, which is approximately $15.5 billion in 2020, via premiums, and as a result, earnings will normalize over the course of the year.

Saturday, 2 November 2019

What makes Health Insurance one of the most important covers that you should buy in 2020? - The Economic Times



What makes Health Insurance one of the most important covers that you should buy in 2020?

In the last few months, the COVID-19 pandemic has drastically changed lives across the globe. Most countries have implemented various forms of lockdowns and restrictions to curb the spread of the coronavirus, leaving citizens homebound. This has brought about a complete transformation in the way we live, work, shop, and interact, making it quite difficult to predict how the world will look like in the near future. India is currently in its fourth phase of lockdown but despite the vigilance, the country’s coronavirus curve remains steep. While many states have relaxed lockdown restrictions to revive economic activities, several others are contemplating extending the lockdown till the end of this month. This gives us a clear picture of the severity of the crisis and puts the limelight on one of the most pivotal things that we should be troubled about right now- our health.
Why is health insurance important?
With national and global health agencies continually stressing on the need to keep the immune system strong during the COVID-19 outbreak, the world has slowly started prioritizing health. Most people are now maintaining heightened hygiene, exercising more, increasing their water intake, and eating clean so that they can get through these unprecedented times, strong and healthy. While a clean diet and regular workouts are indeed important to stay healthy during the current crisis, one extra health measure that many people have taken is buying health insurance.
The pandemic has been an eye-opener for most people, reinstating why a health insurance cover is primary at all times. While many people are already covered understanding some form of health insurance or another, it is primary for them to go through the offerings of their policy to understand how beneficial it will be if unfortunately, they have to seek treatment for coronavirus. Most basic health protection plans are likely to camouflage the expenses incurred on treatment but it is important to verify if the plan is strong enough to meet other costs like testing, hospitalization, quarantine, etc.
Does your health insurance plan cover all your requirements?
Currently, coronavirus vaccine research and development is going on across the globe in full force. But despite a countless number of scientists enthusiastic in this process, the timeline for vaccine availability seems far and stretched. Thus, amid a crisis like this, an all-round health insurance cover is the need of the hour for people across every age group. In India, the cost of healthcare is steep, and the longer the recovery period, the more is the cost of treatment. Coronavirus treatment is a prolonged process where a patient might have to be put in an ICU and/or on ventilation in case of severity, and if it is a private hospital where one is seeking treatment, the cost can blow a hole in one’s savings. This is why financial preparedness is the most important step that one can take to stay protected from coronavirus and the best way is to take a health insurance plan with an appropriate sum insured. Many insurers across the country have comprehensive health insurance covers that people can opt for at a time like this. Most of the products offered by these insurers camouflage hospitalization and inpatient treatment for COVID-19, while it is also advisable to check on the coverage and exclusions before choosing a policy.

Friday, 1 November 2019

Health Insurance Stocks Poised For Gains After COVID-19



Health Insurance Stocks Poised For Gains After COVID-19



Major health insurance companies have seen their stock prices decline by an average of over -4% year-to-date, due to the coronavirus pandemic. WhileCVS Health’s stock is down by about 15% year-to-date, UnitedHealth Group is down a mere -1%. However, Humana’s stock has bucked the trend, rising 6%. The health insurance companies stand to benefit in the current crisis, as there will be more enrollments to Medicaid plans. However, the employee sponsored health plans will decline with increasing unemployment. Though our health insurance stocks portfolio has seen a 4% decline, it has significantly outperformed the broader markets, with the S&P 500 down 12% year-to-date. All said, it might be a good time to invest in the theme, as healthcare stocks in general have thus far been more resilient during the current crisis. However, some investors could determine to invest a fraction into the theme now, still keeping funds ready if things unfold for the worse in the coming weeks and months, resulting in broader market declines.
For most of the health insurance companies, 2021 enrollments will likely be very high given the impact of the COVID-19 crisis. Also, these companies will back from postponement of elective surgeries, as they have to bear the costs of such surgeries. Though this benefit could be limited to a couple of quarters. Our Heath Insurance portfolio of 6 stocks including UnitedHealth Group, CVS Health, Humana, Cigna, Anthem, and Centene Corp, shows an average decline of about -1% in the last five trading days (through May 14) compared with a -2% decline in the S&P 500 over the same period. Year-to-date, CVS Health is the worst performer, posting declines of about -15%. On the other hand, Humana has gained 6% while the largest health insurance company in the portfolio, UnitedHealth Group, has seen its stock remain relatively flat. Overall, there is a significant variance, as summarized on the dashboard Health Insurance Companies Portfolio.