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What’s in the Health Care Bill for Small Business
Assurant Video explains how health care reform impacts those with existing insurance
Anthem Small Business insurance to offer new benefits
Anthem California to increase Blue Cross rates October 1, 2010
Anthem to removed lifetime maximum limits on all plans
Hartford Hospital to terminate Anthem Contract
Pre-Existing Condition Insurance Plan to launch July 1 2010
Anthem Blue Cross resubmits rate increase to state
Tenet and Blue Cross Blue Shield of Georgia finally come to an agreement
Anthem Blue Cross of California Pilots with College Health IPA for Behavioral Health Services
Sebelius: “Health Care Can Learn From Business”
Nevada Joins Health Care Reform Lawsuit without Attorney General
Tenet Health Systems terminates contact with BCBSGA
Aetna Illinois offers new rates and applications for Medicare Supplemental Plans
Wellpoint to Obama “the Attacks on the Health Insurance Industry…Must End”
2010 Medigap Modernization: 6 Facts You Must Know
HSA Benefits Changed under “ObamaCare”
Adult Children on Parent’s Health Plan: When will it happen?
Anthem Blue Cross Delays Rate Increase Beyond May 2010
Obama extends COBRA Subsidy to May 31, 2010
Small Business Tax Credits for Health Insurance
Coverage of Preventive Health Care Required under Reform bill
Man to read the entire Patient Protection and Affordable Care Act
How the Health Care Bill Could Affect Your Health Insurance immediately
Major House Health Insurance Reform vote today: What Does it Mean?
Dependent Health Care Coverage for Adult Children age 26 offered in new health care bill
SCHIP to Offer Two New Enrollment Opportunities
Anthem CA Launches “Premier” health plans
Young and Without Health Insurance
Obama Invites Republicans and Democrats to Health Care Summit
Will Georgia’s “Any Willing Provider” law apply to Blue Cross Blue Shield of Georgia’s HMOs?
What Should Clients Do About the Delayed Anthem Blue Cross Rate Actions?
Anthem Agrees to Price Review; Alerts Members of Rate Action Delay
Anthem Postpones Health Insurance Rate Hike until May 2010
Will Anthem Delay Rate Increase?
Poizner Speaks out on Anthem Blue Cross Rate Increase
Ban on manditory insurance?
Brown’s Victory May Slow Down Health Care Reform
You’ve Got Tonik Blue Cross Health Insurance in CA…Now What?
Anthem CA launches CoreGuard and ClearProtection Plans
The Most Asked Tonik Questions
Anthem Blue Cross Tonik Plans Finally In More States
Popular Tonik Health Insurance Comes to Colorado
HealthyGrads.com: Hope for Recent Grads Looking for Health Insurance
What’s in the Health Care Bill for Small Business
September 04, 2010
This health insurance reform video that is being sent out over the internet does a good job identifying the current problems facing small business owners.
While it is a good overview, it lacks the necessary details to explain how the current reform will help small business owners. Missing are specifics on health reform tax credits and mandatory coverage.
Assurant Video explains how health care reform impacts those with existing insurance
September 04, 2010
By Phil Raymond
Assurant has done a pretty good job of explaining how health care reform those who have existing insurance. While they say that its specific to those with Assurant health, it applies in general to most all individuals who currently have health insurance. Take a look, there are some real advantages to having existing “or grandfathered” coverage. If you still have questions after watching the video, whether you have assurant or not, give Medicoverage.com a call.
Anthem Small Business insurance to offer new benefits
September 01, 2010
Mike Solis
We just got this in today from Anthem regarding their small business coverage:
The following benefit changes have gone into effect based on the new federal health care reform provisions effective on or after September 23, 2010. This is regardless of whether the plan is or is not “grandfathered”:
Dependents are eligible to retain or enroll in coverage under their parent’s plan until they turn 26.
We removed some yearly dollar limits on certain plans:
*Durable medical equipment
*Smoking cessation program
*Removed annual maximum on physical exam benefit
*Removed limitations on office visits, diagnostic X-rays and labs for Elements Hospital Plus and Elements Hospital Preferred plans only
*We removed limitations on office visits, diagnostic X-rays and labs for Elements Hospital Plus and Elements Hospital Preferred plans only
*We removed the $5 million lifetime maximum from PPO plans.
*We removed pre-existing exclusions for members younger than 19 from plans in which such exclusions existed.
*In-network preventive care is now covered at 100% on all plans.
We will continue to update this blog as more information comes in -Mike
Anthem California to increase Blue Cross rates October 1, 2010
Today Anthem announced that they have sent out 800,000 letters to its members alerting them to this new rate adjustment. We, Medicoverage.com, are supposed to receive a list of our members affected by this new rate increase in early september. We will email all our members with an update of what increase (if any) they can expect to see.
If you have an Anthem Blue Cross plan in California and are subject to the October Rate action (or you don’t know but want to find out) please call us and we can review your plan and suggest alternatives. You can reach Medicoverage here to speak to a licensed health agent.
Anthem to removed lifetime maximum limits on all plans
August 21, 2010
By James Wilson Jones
Anthem Blue Cross announced today that it has begun the process to remove lifetime maximum payouts to its health insurance plans. The recent health care reform legislation states that insurance plans can no longer have lifetime and annual dollar limits on “essential health benefits” as soon as September 23, 2010.
Since the U.S. Department of Health and Human Services (HHS) has yet to clarify its definition of “essential health benefits,” Anthem Blue Cross has come up with the following list of the services they believe will be affected:
Alcoholism-related services
Ambulance services
Asthma education
Bariatric surgery
Chiropractic manipulation and osteopathic manipulation services
Diabetic supplies
Diagnostic services
Durable medical equipment
Enteral formula and food products
Hearing aids
Home health care
Hospice
Infusion therapy
Kidney disease treatment
Mental health/substance abuse
Ostomy supplies
Outpatient occupational therapy
Outpatient physical therapy
Outpatient speech therapy
Pharmacy
Physician office visit (diagnostic services)
Preventive services
Prosthetic devices/limbs
Skilled nursing services
Prosthetic devices/limbs
Skilled nursing services
Transplant services
Treatment of temporomandibular joint disorder (TMJD or TMJ)
Anthem states that the listed services still may be subject to copays and other cost shares and will be phazed in over time. Annual dollar limits of at least $750,000 will be allowed for plan years from September 23, 2010, to September 23, 2011. Annual dollar limits of at least $1.25 million will be allowed for plan years from September 23, 2011, to September 23, 2012.Annual dollar limits of at least $2 million will be allowed for plan years from September 23, 2012, to January 1, 2014. After January 2014 there will be no lifetime limits and annual dollar limits.
Hartford Hospital to terminate Anthem Contract
August 06, 2010
By Kelly Moders
Hartford Healthcare Corp has alerted Anthem that if they are unable to reach contract agreement they will terminate its participating hospital contracts for Hartford Hospital and Windham Community Memorial Hospital. Without a new contract, starting November 1, 2010, these hospitals will no longer be considered in-network for Anthem. This issue will not affect MidState Medical Center.
Anthem claims that if they were to accept the current proposal that members monthly premium would increase. We will keep you posted on the status of negotiations.
Pre-Existing Condition Insurance Plan to launch July 1 2010
July 01, 2010
By Mike Rose
If you have been uninsured for at least six months because of a pre-existing condition, a new law may provide you with new coverage options. As part of the recent Affordable Care Act, the Pre-Existing Condition Insurance Plan was designed to provide alternatives to uninsured Americans with pre-existing condition. Each state can choose to run this program or, if not, to be part of the plan established by the Department of Health and Human Services. The plans cost are expected to be higher than comparable traditional health insurance and benefits may be limited. If you are not sure if you can be approved for traditional health insurance due to a pre-existing condition, please contact a Medicoverage associate to assist you.
Anthem Blue Cross resubmits rate increase to state
June 30, 2010
By Mike Rose
Anthem Blue Cross of California announced today that they have resubmitted new rate requests with the California Department of Insurance and Department of Managed Health Care. According to the company the average increase is 14% and, if approved, would be effective on September 1, 2010. The rate action is expected to affect 602,500 Anthem Blue Cross members.
The move comes after a very publicized withdrawal of a previous rate hike after a review from a state appointed independent auditor.
“We realize we made mistakes in our prior rate filing,” said Anthem in a memo to its agents. ” To avoid future mistakes, we’ve updated processes, such as including an external third party review and a rigorous internal peer review process by actuaries who are independent of the Individual business.” The company claims that the new rate increase comply with the Medical Loss Ratio (MLR) standard of the new health care reform law.
Will Anthem Profit from Proposed Hikes
A followup memo also stated that Anthem would not make any profit from these rate hikes: “With these filings we expect to continue to lose money on the Individual business in California again throughout 2010. Current estimates indicate that we can expect to lose more than $100 million in the California Individual market in 2010.”
California state requires that insurers notify members of rate adjustments at least 30 days prior to implementing any
change so members should get an official notification in Aug. As soon as Medicoverage knows the exact amount of individuals rate action or any other affordable family insurance options, we will send them on to our members. Just to clarify, rates for Anthem California members will stay the same until further notice.
Tenet and Blue Cross Blue Shield of Georgia finally come to an agreement
June 25, 2010
By Mike Solis
After months of negotiations, Blue Cross and Blue Shield of Georgia (BCBSGA) and Tenet Healthcare have finally agreed to work together again. The new agreement covers Tenet’s five acute care hospitals in Georgia (Atlanta Medical Center, North Fulton Hospital, South Fulton Medical Center, Spalding Regional Medical Center, and Sylvan Grove Hospital) as well as freestanding outpatient centers and physicians who are employed by Tenet subsidiaries.
According to BCBSGA’s Amy Cheslock, “We are pleased to continue our relationship with Tenet. As the state’s largest health benefits provider, we strive to create the best health care value for our customers through a broad network of quality health care providers.”
The financial terms of this agreement have not yet been disclosed.
For questions, please contact Medicoverage using the contact tab above.
Anthem Blue Cross of California Pilots with College Health IPA for Behavioral Health Services
June 09, 2010
By Mike Rose
Anthem Blue Cross health insurance company recently contracted with the Los Angeles based behavioral health provider, College Health IPA (CHIPA). The company will offer professional behavioral health services for Anthem Blue Cross members. While currently being piloted in the greater Los Angeles area, the company hopes to expand statewide to the entire CHIPA network of 300 plus behavioral health practitioners.
According to Anthem “This agreement is representative of the work we are doing towards payment restructuring programs on behalf of our customers. It also offers customers a reduction in behavioral health care costs.” How CHIPA will save money is unclear. It looks as though CHIPA utilizes its own contracted physicians to provide inpatient professional services to somehow save money.
The following is a list of Anthem Blue Cross Network Hospitals Participating in CHIPA Pilot Program. Note: not all Hospitals are participating.
Aurora Charter Oak
Aurora Vista Del Mar
BHC Alhambra
Canyon Ridge
Cedars Sinai
Chapman Medical Center
College Costa Mesa
College Hospital Cerritos
Community Medical Center , Fresno
Cornerstone of Southern CA
Del Amo Hospital
Glendale Adventist Medical Center
Good Samaritan of Bakersfield
Hemet Valley Medical Center
Henry Mayo Newhall Memorial Hospital
Hoag Memorial Hospital
Huntington Memorial Hospital
Little Company of Mary
Loma Linda
Northridge Hospital
Redlands Community Hospital
Riverside Center for Behavioral Medicine
Mission Hospital, Laguna Hills (Formerly South Coast Medical Center)
St Joseph’s Hospital of Orange County
Tarzana Treatment Center
Sebelius: “Health Care Can Learn From Business”
June 04, 2010
By Mike Rose
Michigan- U.S. Secretary of Health and Human Services Kathleen Sebelius states that our current method of providing health care is unsustainable and can learn from some of the advances of the private sector. According to Sebelius, without intervention, Health care costs in the next ten years are expected to increase to an average of $30,000 per employee. It is up to business to assist in providing solutions for affordable health insurance for small business.
One area that can benefit from the business sector’s experience, says Sebelius, is in the implementation of electronic medical records systems. A>?,?_"We’re still at a place in America where only 10 percent of hospitals and 20 percent of physicians’ practices use electronic records,A>?,?A_ she said.
She then asked an audience of business leaders from Detroit. A>?,?_"Think of any other business model… it’s not only inefficient, but also prone to errors.” According to the Secretary, “there’s a huge overhead in transferring paper from person to person, and it’s almost impossible to measure quality outcomes.A>?,?A_
She claims there there is evidence that switching to electronic records does make a difference.
A>?,?_"What we know from systems using electronic records is that it works. It works to lower costs, it works to reduce errors… and every physician I’ve talked to who uses electronic records says they would never go back to a paper file.A>?,?A_
By learning from the successes of the business sector will, in turn, help the business sector. Small businesses cannot afford health care for their employees and those that can end up paying 20% more than large companies.
A>?,?_"Warren Buffett has been quoted as saying that heath care costs are eating America’s competitiveness like a tapeworm,A>?,?A_ she said. A>?,?_"Health inflation well exceeds consumer price inflation, and was continuing at a pace that is simply unsustainable…A>?,?A_
Nevada Joins Health Care Reform Lawsuit without Attorney General
June 01, 2010
By Mike Rose
Without the Nevada Attorney General’s consent, Governor Jim Gibbons announced that the State of Nevada will join the federal lawsuit that states the recent health care reform act is unconstitutional.
Gibbons, who spearheaded the Silver State’s involvement in the lawsuit, said in a recent press release that the Health Care reform act is, A>?,?_"a national disgrace,A>?,?A_ that A>?,?_"clearly exceeds constitutional authority.A>?,?A_
(Governor Jim Gibbons before he was defeated in the Nevada State Primary. Source: gov.state.nv.us)
The lawsuit follows a political tug of war with Attorney General Catherine Cortez Masto. When Cortez Masto refused to file the lawsuit, Gibbons sought outside lawyers who agreed to take the case for free and raised additional money for the litigation through donations.
With the lawsuit, Nevada joins 19 states in the litigation stating that the new legislation would force all Nevada citizens to buy health insurance or face tax penalties.
The governor went on to say that the act is A>?,?_”...patently unconstitutional for the federal government to break the backs of Nevadans by trampling the Constitution and then threaten to use IRS agents to enforce this ridiculous plan.A>?,?A_
Gibbons claimed that the act has already cost the state of Nevada $250,000 in tax money just “to pay for pre-planning for the Nationalized Health Care Plan.A>?,?A_
Tenet Health Systems terminates contact with BCBSGA
May 13, 2010
By Medicoverage Staff
Tenet Health System has terminated its contract with Blue Cross Blue Shield of Georgia effective 7/1/2010. Tenet Health System is comprised of several health care providers including five hospitals: Atlanta Medical Center, North Fulton Hospital, South Fulton Medical Center, Spalding Regional Medical Center and Sylvan Grove Hospital. According to BCBSGA, the company knows that their customers “value the care Tenet Health System provided to our members and we made considerable effort to keep them in our network.” However no agreement was ever finalized.
BCBSGA has ensured its members that services rendered by Tenet providers are available from other in-network area providers in the area. According to the company they have implemented several tools to assist their clients with this network change. The company stated that the termination does not impact any of the more than 185 hospitals that are part of extensive BCBSGA networks throughout Georgia. If you are considering BCBSGA insurance and have specific questions about the Tenet Health Systems terminated contract, please contact Medicoverage Inc.
Aetna Illinois offers new rates and applications for Medicare Supplemental Plans
May 13, 2010
Medicoverage Staff
Aetna has just received approval from the state of Illinois for their premium rate structures for Aetna Individual Medicare Supplement Plans. In March 2010, Aetna was in the process of obtaining state approval to market their MIPPA-compliant Individual Medicare Supplement plans for policy effective dates of June 1, 2010 and later. These requests were just approved by the state and do not affect dental insurance for seniors
Aetna Medicare Supplemental Plan Offerings
There is no change in the plans Aetna offers in Illinois.They will continue to offer Plans A, B and F. There is, however, a new application which now contains a comprehensive Producer Certification section (Section 9). This must be used for all policies effective June 1, 2010 or later. Additionally the Outline of Coverage was updated to comply with MIPPA and include rate information. When it come to guaranteed issuance there were really no new changes except when necessary to reflect state requirements although in the Notice to Applicant does clarify that pre-existing condition limitations may apply. As mentioned before Aetna medigap rate sheets are now included as part of the Outline of Coverage.
To learn more about senior supplemental, visit our medigap page. If you would like to apply for Aetna senior coverage in Illinois please contact Medicoverage.
Wellpoint to Obama “the Attacks on the Health Insurance Industry…Must End”
May 12, 2010
Marcus Wilip (Editor at Large)
Wellpoint CEO Angela F. Braly responded to Obama’s weekly address with a formal letter saying among other things “I was disappointed to hear you repeat false information regarding WellPoint’s coverage of breast cancer.” She also says that, “If we are going to make this law work on behalf of all Americans the attacks on the health insurance industry—an industry that provides valued coverage for more than 200 million Americans—must end.” We were able to track down the most recent one on may 8th. And we have included it below.
You will see it does mention Wellpoint / Anthem by name regarding price increases but we don’t see any reference to breast cancer recissions as featured in her letter. Here is the letter Braly sent to Obama regarding Wellpoint and Anthem health insurance. Check it out and let us know what you think:
Dear Mr. President:
I was disappointed to hear you repeat false information regarding WellPoint’s coverage of breast cancer in your weekly Presidential radio address as a demonstration of your Administration’s commitment to strong patient protection. Mr. President, I will tell you the same thing I told HHS Secretary Sebelius in a recent letter, your statement grossly misrepresents WellPoint’s efforts to help prevent, detect and treat breast cancer among our 34 million members.
To be absolutely clear: despite your claims, WellPoint does not single out women with breast cancer for rescission. Period.
The actual facts could not be clearer. In 2009, WellPoint covered the treatment of approximately 200,000 women with breast cancer at a cost of nearly $2 billion. During that same period, there were four cases nationwide where the issue of breast cancer or the possibility of breast cancer was identified in a rescission, but they were not singled out because of their breast cancer. Clearly, covering the treatment of close to 200,000 while rescinding four policies should make our intent in this regard quite clear. Our policy on rescissions has always been that it is based on fraud or misrepresentation - a policy consistent with that contained in the new legislation. In fact, we adopted the precise policy of the new legislation before any other insurer.
We should also note that we cover screening for women 40 and older, 10 years earlier than the guidelines published by your own US Preventive Services Task Force. We made this decision because we know that early detection is the key to survival, with a 5 year survival rate of nearly 100% when diagnosed at stages 0-1. This also reduces costs for the entire system by avoiding the nearly ten-fold increase in costs associated with treatment beginning after stage 3.
Mr. President, this country has a long history of coming together after tough debates. The implementation of the new health care reform law should be no different. If we are going to make this law work on behalf of all Americans the attacks on the health insurance industry—an industry that provides valued coverage for more than 200 million Americans—must end. We believe that our recent action to adopt many of the insurance reforms earlier than required by law is an indication of our willingness to work with your Administration to achieve this objective.
We agree that healthcare costs are rising at an unsustainable rate. While we continue to strive to make healthcare coverage more affordable for our members, we know that there are many causes for rising costs. Some of the most concerning cost drivers include inflation in the cost for medical services provided, increases in utilization, or the frequency with which these services are provided, and the increased cost borne by the insured population when healthy individuals choose not to carry health care coverage. These issues are of critical importance to all Americans and will require solutions that include all stakeholders in healthcare, business and government. In fact, we have repeatedly asked to meet with Secretary Sebelius, but have not yet received a response. This is simply not productive and not in the best interests of Americans.
We share your vision for a better America and look forward to working with you and your Administration.
Sincerely,
Angela F. Braly
2010 Medigap Modernization: 6 Facts You Must Know
May 04, 2010
by Natalie Boudreau
Medigap Modernization has been a hot topic in the media lately, and for good reason. Medigap, which is another name for Medicare supplemental insurance, is changing on June 1st, 2010 and the coming changes have potential for significant impact on seniors who are currently in the market for Medigap insurance.
There are 6 key facts that you must know now in order to make the best decision regarding your current or future Medigap policy.
Fact 1: “Medigap Modernization” is the nickname for the changes that Medigap will undergo starting on June 1st, 2010.
Though the changes that will affect consumers go into affect this year, the modernization process started much earlier.
As a requirement of the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA), the National Association of Insurance Commissioners (NAIC) assembled a task force to improve Medigap plans and benefits. This task force included state regulators, consumer advocates, industry representatives, CMS representatives and other interested parties. They developed a modernization proposal that was approved by the NAIC in 2007.
Then on July 15, 2008, Congress enacted a law called the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). MIPPA included direction to the Secretary of Health and Human Services to implement modernization proposal developed by the NAIC-led task force. That modernization proposal, referred to in the MIPPA law as the NAIC Medigap Model Regulations, includes all the changes to Medigap that will take place on June 1, 2010.
Fact 2: There will be fewer total plans available for sale.
There are currently 12 senior medical insurance plans for sale and these are named for the letters of the alphabet A>?,?_"AA>?,?A_ through A>?,?_"L.A>?,?A_ After June 1st there will be 10 plans. By clicking on the link below, you can see a PDF table of the plans available for sale through May 31st, 2010.
Starting on June 1st, plans E, H, I and J will no longer be offered for sale. The PDF table below summarizes the new plans and their benefits available starting in June.
Though four plans will be eliminated (see Fact 2 above), two new ones will be available for sale. Plans A>?,?_"MA>?,?A_ and A>?,?_"NA>?,?A_ will be added to the mix of Medigap plans. The PDF table above shows a summary of all the plans and their benefits, including these two new offerings.
Fact 4: Some Medigap benefits will change.
Some changes will affect all policies, while others will affect only one or a few Medigap policies. The best way to understand how the plans will change is to print out the PDF tables (above) and compare them side by side. That way you can see how each plan has changed or stayed the same. For example, you’ll see that the May 2010 Medigap Plan D covers A>?,?_"At Home RecoveryA>?,?A_ expenses while the June 2010 Medigap Plan B does not. If you are interested in reading about some of the nitty-gritty details of the changes, see our article titled ?,?A_”>A>?,?_"Medigap Changes Coming June 1st.A>?,?A_
Fact 5: Existing Medigap policyholders may keep their old policies.
This means that if you currently have one of the plans that is slated to be discontinued and you like it, you can keep it. This also means that if you see a plan that is currently offered for sale that will be discontinued after June 1st, you should buy it now.
Fact 6: There is no single Medigap plan that is the best for everyone.
According to the Medicare Rights Center, the most popular Medigap plans are currently C and F, because they cover major benefits and tend to be less expensive than some of the other plans. A quick comparison of the pre and post-June 1st Medigap charts (above) will confirm that these two plans will stay fundamentally the same.
However, it is extremely important to examine all of the plans while keeping in mind which benefits are most important to you and which you can do without. As with most decisions, the decision about which Medigap plan is right for you is all about trade-offs. What can you give up in order to have more of what you value most?
Next steps to choosing the right Medigap plan.
To obtain quotes on any Medigap plan, visit our quote engine and enter your zip code in the box at the top of the page. (All other information is optional.) Then click on the A>?,?_"next stepA>?,?A_ button on the bottom of the page. Once you do, you will be given a list of quotes on Medigap policies available in your area. From there you can shop based on price, provider reputation, and customer reviews.
In short, Medigap Modernization simply refers to the changes that the Federally standardized Medigap policies will undergo starting on June 1st, 2010. Again, if you are a researcher at heart and are interested in reading more about these changes, see our page called “Medigap Changes Coming June 1st.”
If you would prefer to have personalized help in sorting through these changes and selecting the Medigap plan that is right for you, contact a licensed Medicoverage agent. WeA>?,??,>re here to help.
HSA Benefits Changed under “ObamaCare”
May 04, 2010
Marcus Willip: Editor at Large
Health Savings Accounts (HSAs) are featured in the health insurance reform bill but I haven’t heard anyone mention yet. The new change will affect over 8 million plus people with HSAs so why isn’t it news? Effective January 1, 2011, taxpayers with HSAs no longer will be allow to use them to purchase over-the-counter medicines. This is according to Sec. 9003 of the Health Reform Act. Previously if you had an HSA and needed aspirin you could pay for it with your HSA account…meaning you got the aspirin tax free! But not anymore after the new year. This new restriction will also apply to individuals with Flexible Spending Account or Health Reimbursement Accounts.
Unfortunately you cannot include all the details of the health care reform in 4 minutes. We have watched this white house video over and over and there is no mention of changing HSA tax benefits.
Additionally 2011 will mark the first time HSA 20% penalties will be assessed for non-qualified withdrawals from your Health Savings Account. You can learn more about these penalties by checking out Sec. 9004 of the health care reform act.
Adult Children on Parent’s Health Plan: When will it happen?
April 29, 2010
Marcus Wilip
The new health care reform bill has promised that children as old as 26 can stay on their parents health plans. Due to the bill’s fine print, however, many parents may have to wait until 2011 before this benefit becomes available.
Adult children health care coverage explained
Prior to health care reform, may children who were over 18 and not full-time students could not remain under their parent’s health insurance. Under the new health care act, children less than 26 year can stay under their parent’s coverage, as long as the adult child is not offered insurance through an employer. Although the act will be in place by September 23rd, it will not become effective until the next plan year. This is the fine print that some people didn’t read. This will mean that most people trying to take advantage of this provision will have to wait until January 1, 2011.
What should Adult children do for health insurance
Whether your adult child qualifies for this benefit or not, you should probably compare your options with an individual affordable child health insurance plan. When kids are young and healthy, insurance companies always charge less than their older counterparts for individual health insurance. We are not aware of any provision that makes sure that children covered under their parent’s plan will be guaranteed a competitive rate. On the contrary, we believe that the health insurance companies will, in the short-term, consider Adult children on their parents plan as “risky” since they chose not to move to less expensive plans that require medical underwriting. The assumption is they pre-existing conditions that will proclude them from being approved on an individual plan. This, of course, will change in 2014 when all new health care plans will be mandated to approve everyone.
What are some low cost alternatives
Before placing your child on your family plan you will want to check out if there is an individual plan that is less expensive. HSAs or Health Savings Account qualifying plans are great alternatives for coverage. You can learn more about hsa contribution limits and how much you can put away tax free on our site dedicated to health insurance HSAs.
Anthem Blue Cross Delays Rate Increase Beyond May 2010
April 26, 2010
Medicoverage Staff
For the second time in two months, Anthem Blue Cross of California has postponed the rate hike previously scheduled for March of 2010. Members who were originally told they would see higher prices in March will see that their premium are to remain unchanged in May 2010. There is no official word from the insurance company if or when the price will be going up again.
According to spokeswoman Kristin Binns on Friday April 23, 2010, “Members will receive adequate notification of any rate change. Until they receive information indicating otherwise, rates remain unchanged.”
Since State law requires insurers to give members at least 30 days notice before increasing premiums, Medicoverage should be able to give members fair warning of future changes.
President Obama has approved another short-term extension of COBRA premium subsidy. With this new extention, employees terminated from April 1, 2010 through May 31, 2010, will receive the 65% subsidy on their COBRA premiums. This means if you were recently laid off (or fired) you could purchase your COBRA plan at a significant discount. You will want to compare that discounted price before purchasing individual health insurance.
Prior to this most recent extension, the old cut off date to qualify for subsidies was March 31, 2010. President Obama has been asking lawmakers to extend the COBRA premium subsidy through the end of 2010. It looks like the Senate is currently working on this new extension. We will update you as soon as we have any new news.
Small Business Tax Credits for Health Insurance
April 21, 2010
By Medicoverage Staff
The Patient Protection and Affordable Care Act approved by Congress last month offers up to 35% tax credits to small companies that offer health care for their employees. The credit, effective in 2010, can be used by both small businesses who have previously never offered health insurance as well as those who are currently offering health coverage to their employees.
Qualifications for the health care tax credit:
The tax credit is designed for small business employers who pay at least 1/2 their employees health care cost. The largest tax credits (35% of the annual premiums) go to small companies with less than 10 employes who make less that $25K per year on average. The credit is not available for employers that have 25 full time equivilent employees or more or that pay average wages of $50,000 per year or more.
These tax credits are mentioned in brief in the MSNBC health care overview below:
Next Steps:
Visit the IRS site on the new health insurance tax credit then consult your tax professional to see if you qualify.
Coverage of Preventive Health Care Required under Reform bill
SEC. 2713. COVERAGE OF PREVENTIVE HEALTH SERVICES.
Basically this section says the insurance companies cannot “impose any cost sharing requirements” for certain preventive treatment. Meaning that insurance companies will have to foot-the-entire-bill for preventive treatment in the future if this bill stands. This is a huge provision and it is rarely, if ever, mentioned by the mainstream media.
Currently many health insurance plans require patients to pay for physicals, OBGYN visits and their related diagnostic tests until the member first satisfies their calender year deductible. That means that today most people pay for most preventive work with money out-of-pocket. Some insurance plans on the market today will request a doctor visit co-pay of say $40 but will not cover the related preventive lab work. It is rare to find a plan that has no doctor visit co-pay and covers all related diagnostic testing. The only examples I can think of are very expensive comprehensive HMOs and some of the high deductible HSA plans.
When will Coverage of Preventive Health Services take place?
It is unclear when health insurance companies will have to offer full reimbursement of these preventive services.. The document says the minimum shall not be less than 1 year. Ok, so we know it won’t happen for at least a year. But what is the maximum time before this will be implemented on all health insurance plans. I haven’t figured that one out yet. If I do come across it I’ll post it up here.
Fun fact of the day: There is no such word as preventative. It’s preventive. Now you to can feel smug and correct others who mispronounce the word.
My next post: How this confusing to read bill will force health insurance companies to explain their benefits is a simple and standard way. Sounds like fun!
Man to read the entire Patient Protection and Affordable Care Act
March 23, 2010
By Marcus Wilip (Editor-at-Large)
So if you have been following this blog, you know the good folks at Medicoveage allow me to speak my mind on anything regarding health insurance and reform. I think they know that I don’t have a heavy political agenda and they have a good bit of tolerance for my unorthodox grammar and spelling. My latest goal is to read through the new health care reform bill page-by-page and squeeze out all the juicy stuff and they are ok with that.
Just in case you were misled by the title, I will not do it in one sitting but I am going to read it every day until I finish it. I’m going to try to have daily short entries about what is in there and how it may affect you. I’m going to share things with you that may not see on CNN or FoxNews twenty-second-news-bite.
First of all, I must tell you that it’s a rather thick document. Put it this way, the BMI (body-mass-index) on this book would not meet most health insurance underwriting requirements for approval. Even the title is long. Get this: they call it the “Patient Protection and Affordable Care Act - Title I: Quality, Affordable Health Care for All Americans - Subtitle A: Immediate Improvements in Health Care Coverage for All Americans.” Regardless of the name, at slightly under 2000 pages there is a lot of information to digest. It will no doubt provide me with a plethora of Health Insurance related material. I might even find something humorous in there. Who knows because I’m guessing no one has actually ever read it.
How the Health Care Bill Could Affect Your Health Insurance immediately
March 22, 2010
By Medicoverage Staff
The U.S. House of Representatives passed the Senate-approved health insurance bill with some provisions to take place immediately and others to take place in 2014. If the reconciliation conditions included in the House bill are approved and it becomes law, the following would provisions would take place.
WITHIN A FEW MONTHS, THE NEW HEALTH CARE BILL PROPOSES:
Lifetime maximums would be removed from health insurance plans.
Typically, health care plans have a listed maximum amount that insurance companies will pay for medical expenses throughout the lifetime of the policy. It varies by plan and state but in California the industry average is $5 million dollars. This currently means if a client has a plan with a $5 million lifetime maximum and has over $5 million in medical cost, he or she is require to pay for any additional fees. Moving forward there would be no lifetime maximum and in the last example the insurance company would be obligated to continue paying beyond the lifetime maximum. To our knowledge, none of our current clients has ever reached their lifetime maximum in reimbursed medical fees.
Adult Children Covered under Parents policy
The new bill will force health insurance companies to allow children up to the age of 26 to stay on their parents plans. Previously,the age dependents would have to leave their parents plans varied by state and student status. It is unclear if this rule applies to existing plans or only new plans purchased by parents. Also there doesn’t seem to be a provision stopping insurance companies from charging a huge fee to keep older children on the policy.
New “risk pools” set up for those with pre-existing conditions.
Currently many individuals who apply for insurance plan can be turned down for coverage because of pre-existing medical conditions. The bill sets aside $5 billion dollars to help set up a risk pool for people who want coverage but have been turn down due to a medical condition. We are still looking into the details how this pool would work, but we know it will only last until 2014 when the Health Insurance Exchanges (described below) are set up.
Senior Drug Coverage
Although not addressed in most media coverage, the new bill offers some additional drug coverage for those who qualify for Medicare part D. The amount starts off at $250 dollars but goes down in price as drug companies agree to reduce their costs.
IN 2014, THE NEW BILL PROPOSES:
All insurance plans must approve everyone
Guaranteed issuance health insurance is probably the largest change to our existing health care system. It will mean that if you apply for health insurance in 2014 you cannot be turned down due to previous health conditions. It is unclear at this time if the health insurance companies will be able to charge more for people with pre-existing conditions than those who have no previous medical issues.
Health Insurance Exchanges
The proposed health insurance exchange would only be offered in 2014. The exchange would not offer a public option but would be a place where people could research and purchase private health insurance. If you want to see what a health insurance exchange looks like now, just visit www.medicoverage.com. Our site currently acts as a health insurance exchange offering quotes from multiple private insurance companies at the guaranteed lowest price. As you can see, we are unsure what benefit the proposed new health insurance exchanges will offer now that a public option is off the table.
Tax Breaks for Health Insurance Premiums
The recent bill approved by the House will also offer some tax breaks in 2014 if ratified.
Fines for People Without Health Insurance
If you don’t have health insurance in 2014 you will be required to pay a penalty of 1% of your income or $95 (whichever is higher). By 2016 this fee would raise to about $700 or 2.5 percent of your income. This is the health insurance mandate that people talk about. There will be subsidies for certain people who cannot afford health insurance.
Medicare Expansion
The proposed bill will expand medicare to cover more individuals in 2014. Certain people who are living below the poverty line will now quality for Medicare even if they are not 65 years of age.
Major House Health Insurance Reform vote today: What Does it Mean?
March 21, 2010
by: Marcus Wilip Editor at Large
The U.S. House of Representatives will vote today on health insurance reform intended to bring health care to roughly 30 million uninsured Americans. Members of the Democrat party only need a simple majority to pass the legislation and they claim they have it.
What will it mean if this health care bill passes?
Well that depends on who you speak to. Many Republican’s say the bill would mean higher taxes, higher insurance premiums and a bigger government to meddle in your health decisions. They claim the bill does little to address the run-away cost of health care.
Democrats, on the other hand, say that this bill is the best way to provide health care insurance to millions of Americans currently without coverage. Regardless of whose side you are on, the proposed legislation will force health insurance companies to accept all individuals with pre-existing medical conditions should it pass. It would also require that people purchase health insurance or face fines. We will explain all the ramification of the bill in this blog should it become law.
What health care legislation are the voting on today?
There will be two votes today in the House of Representatives. The first vote is on the health care bill previously passed Senate. Congress will then vote on a second bill (the so-called reconciliation bill) that is intended to resolve the major differences between previous versions of the bill. If the first one passes then that is law. If the first bill fails and the second one passes, the Senate would still have to vote on the reconciliation measure.
This should be interesting. Remember, that any health care reform that should pass today will take a long time before it is implemented. If you are currently uninsured, you should consider getting individual health insurance for the foreseeable future. We will keep you posted as soon on our health insurance blog as we see the results.
SCHIP to Offer Two New Enrollment Opportunities
March 03, 2010
by Medicoverage Staff
The State Children’s Health Insurance Program (SCHIP) was recently extended for four and a half more years. As part of the Children’s Health Insurance Program Reauthorization Act of 2009 there are two new special enrollment opportunities that affect small group coverage.
A 60-day enrollment period will be allowed if:
A) A member or dependent becomes eligible for premium assistance under a state Medicaid or SCHIP plan; or
A) A member or dependent’s coverage under Medicaid or the SCHIP is terminated due to loss of eligibility.
The new enrollment rules begin for group plans that began after April 1, 2009. Check with your HR manager or group insurance agent if these rules apply to you.
Anthem CA Launches “Premier” health plans
March 02, 2010
By Medicoverage Staff
Anthem’s Blue Cross of California announced today that it has launched a new set of health insurance plans called Premier. According to the company the offer unlimited office visits and richer benefits for preventive care and prescription drugs.
The plans which are now available for quotes now but start April 1, 2010 include the following:
$7 million lifetime payout for medical cost per member
Annual eye exams
Unlimited doctor office visits with the deductible waived
A range of preventive benefits
Generic and brand name (patented) drug coverage
You can get a quote for these plans now and we will keep you posted as we learn more about these plans.
Young and Without Health Insurance
February 26, 2010
Author: Marcus Wilip Editor-at-Large
No surprise but when you are 22 years-old you have the greatest odds of being uninsured. A recent February 2010 Gallup Health Survey shows that only 66% of Americans at age 22 have health insurance. That’s the lowest health insurance coverage of any age demographic. Why is it that this group doesn’t have a comparable percentage of health coverage as others?
Here what I think:
1) When you are 22 years-old you are often no longer eligible for your parent’s plan. By contrast roughly 84% of 18-year-olds have health coverage.
2) Many 22 year-old individuals have recently graduated from college and no longer qualify for school sponsored health insurance.
3) A large amount 22 year-old Americans find it hard to land a job that offers health insurance as a benefit.
4) Many 22 year-olds are expected to purchase health insurance for the first time. The process can be overwhelming and expensive. Many young people give up trying to purchase health insurance and just assume it’s too expensive.
Now many experts say this demographic is under insured because they don’t value health insurance. They media says this group thinks they are invincible. I’m not buying this. Young people do care about health insurance. Every young person knows someone whose last ER trip cost 1000s of dollars and they don’t want to be next. I’m sure there are many recent grads today that are stressing because they “need to get covered.” I think reasons 1-4 above explain why this group is the least likely to be insured not because they think they are supermen (or superwomen). So if you 22 all you really need is to find a individual health plan that is easy to understand, affordable and doesn’t require that you be a full time student. There are actually a few plans that fit this requirement, the most publicized is Tonik.
Here is the good news according to Gallup: From age 22 on, the percentage of individuals health insurance number begins to climb. By the time their 65, roughly 95 percent of American’s are covered. So we all have something to look forward to.
What should young people do for health insurance
My opinion is that all young people should have an HSA. That’s a health saving account. They are less expensive and allow you to put away 1000’s of dollars each year tax free. If a young person were to set up an HSA at age 22 he would save so much money on the high cost of traditional premiums that his HSA bank account would be loaded with more money than he knows what to do with. Learn more about HSA’s here.
Obama Invites Republicans and Democrats to Health Care Summit
February 21, 2010
Author: Marcus Wilip Editor at Large
With no alternative other than to reach out to the Republican party, President Obama has scheduled the first bi-partisan televised health care summit of the current administration this Thursday, Feb. 25, 2010.
As you can see from the video below, Obama is asking that both sides find common ground in the health care debate. It will be interesting to see what happens. One typically Republican point of reform allows for health insurance companies to provide coverage across states. Despite previous claims that this initiative would allow insurance companies to “poach the healthiest in each state”, Obama now says it is a good idea. Are there any other examples of common ground? We will keep you posted on the results of the summit.
Will Georgia’s “Any Willing Provider” law apply to Blue Cross Blue Shield of Georgia’s HMOs?
February 18, 2010
Author: Medicoverage Staff
The Georgia Commissioner of Insurance is meeting today to determine whether Georgia’s “Any Willing Provider” law applies to HMOs.
Background into the Any Willing Provider law
In 2007, Northeast Georgia Cancer Care, LLC (NEGCC) decided to end its HMO provider contract with Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (BCBSHP) after a reimbursement dispute. NEGCC subsequently requested a significant increase in its reimbursement rates. As a result of NEGCC’s abrupt contract termination, BCBSHP negotiated an agreement with the largest oncology provider in the State to ensure that continuous cancer care could be provided to Athens’ area patients at a reasonable cost. In the intervening time, NEGCC contracted to participate in Blue Cross and Blue Shield of Georgia’s (BCBSGA) Indemnity and PPO networks. After ending its HMO contract, NEGCC later tried to re-enter the HMO network after they realized that these services would be provided by another provider.
Today’s Insurance Meeting
NEGACC now wants the Court to apply the Any Willing Provider law and force Blue Cross Blue Shield of Georgia to offer HMO contracts to their medical oncologists. Today’s decision will show us if the ‘any willing provider’ statute is applicable to HMOs. Stay tuned….
What Should Clients Do About the Delayed Anthem Blue Cross Rate Actions?
February 18, 2010
Author: Medicoverage Staff
If you currently have a policy with Anthem Blue Cross of California, you may have received a letter stating that your price will be changing as of March 1, 2010. As you may have heard in the news, this health insurance rate action will be postponed until May 1, 2010 pending further review. If you are a Medicoverage client, we have already sent you an email with an update. Please let us know if you have not received it. If you are not sure if the rate action will affect you, please contact us, as not all members with Anthem Blue Cross plans are subject to the rate action. If you are one of the individual/families who are facing the proposed monthly increase, here is what is coming next according to Anthem:
What will happen to my billing now that the insurance rate increase has been postponed by Anthem?
1) You will receive a pre-recorded message from Anthem, which provides further explanation and information detailing specifics of the March 1, 2010 Rate Action postponement and next steps.
2) A letter will go out to you that will also address how the rate increase will affect you.
3) As of March 1, 2010 your will be billed at their prior rate of premium (the same monthlyprice you were paying in January or February)
4) If you have already paid your monthly premiums at the new increased rate, you can expect a refund by the end of March.
5) Clients who pay with recurring checking or credit card deductions will be debited their previous rate for their March 1, 2010 bill.
6) Clients not on automatic-withdrawal payments will have 30 days from receipt of their new bill to pay their premium.
The steps noted above will be automatically processed and there is nothing that you will need to do right now.
What if I have already changed or canceled my Anthem Blue Cross of California coverage?
Anthem encourages you to wait until May 1, 2010 before making any plan changes. You will receive a letter which will provides you with information on what you need to do if you have already changed or canceled their health insurance coverage and would like to be reinstated to their prior coverage. You can call us for assistance if you would like to discuss your plan options or alternatives.
Anthem Agrees to Price Review; Alerts Members of Rate Action Delay
February 17, 2010
By Medicoverage Staff
Anthem Blue Cross Life and Health Insurance Company of California has contacted Medicoverage to confirm that they agreed to a request by the California Department of Insurance to postpone our March 1, 2010 rates to May 1, 2010, pending an additional third-party review. The review will be conducted by Axene Health Partners, LLC, retained by the California Department of Insurance. According to Anthem, they “have already conducted an independent third-party review, we welcome the additional scrutiny by the commissioner and are confident that our rates will continue to reflect anticipated medical costs and are established consistent with actuarial principles and state law.”
In addition to the email that we sent directly to our clients, Anthem will also be contacting policy holders to inform they of the delay. They will be sending pre-recorded messages to clients beginning Tuesday, February 16th, with details about how the rate action postponement of our March 1, 2010 rates will affect them and their insurance premiums. They will also be mailing letters to members this week, with details about how the postponement of our March 1, 2010 rates will affect them.
Anthem Postpones Health Insurance Rate Hike until May 2010
February 13, 2010
By Steve Wilip
Anthem Blue Cross of California announced today that it would postpone any health insurance plan increases until May 1, 2010. Anthem parent company Wellpoint maintained that the controversial price increases were A>?,?_"actuarially sound and in full compliance with all requirements in the law.A>?,?A_
The average health insurance premium increase according to Anthem is about 25% . The company claims that less than one fourth of members should see increases of 35% to 39%, the company said. They also pointed out that some policyholders will see their rates go down.
California State Insurance Commissioner Steve Poizner has been working with Anthem to delay the rate hike so he could have a third party review the rates and see if they are fair. “Should they find that these rate increases were unwarranted,A>?,?A_ he stated. A>?,?_"I will immediately take action to get Anthem Blue Cross to follow the law and lower their rates.”
WellPoint executive Brian Sassi, responded, “Anthem filed these rates with the appropriate regulators in November of 2009,” he said. “They are actuarially sound and in full compliance with all requirements in the law.A>?,?A_
SassiA>?,??,>s point highlights the question in our recent health insurance blog entry:
Will Anthem Delay Rate Increase?
February 10, 2010
by Marcus Wilip
Just one day after we jumped on Steve Poizner for being reactionary in his handling of the Anthem rate hike, the California State Insurance Commissioner has asked Anthem to delay the proposed 3/1/2010 rate increases until 5/1/2010 to give his office time to investigate.
As of this blog posting, Anthem has yet to respond. While it is too early to know if the new rate hikes are justified or not. The new rate hike has angered many and has reinvigorated health care reform. Check out this quick sampling of sound bites:
“I can think of no better example of why we need health insurance reform,” said senator Diane Feinstein.
“They (Anthem) have clearly made themselves the poster child for why we need health insurance reform,” Assemblyman Dave Jones.
“If we don’t act, this is just a preview of coming attractions. Premiums will continue to rise for folks with insurance; millions more will lose their coverage altogether; our deficits will continue to grow larger. And we have an obligation—both parties—to tackle this issue in a serious way.” President Barack Obama
So it looks like this rate action is now a political issues. We will have to see how that affects customers who have to pay for the insurance plans. We will keep you posted.
The opinions expressed in this blog do not necessary reflect the opinions of Medicoverage Inc. Anyone is free to participate in the Health Reform debate on this site.
Poizner Speaks out on Anthem Blue Cross Rate Increase
February 09, 2010
By Marcus Wilip
Today California Insurance Commissioner Steve Poizner’s office shot a press-release-type email to all licensed California health insurance agents commenting on the recent Anthem Blue Cross rate increases scheduled for 3/1/2010. He wrote:
“IA>?,??,>m alarmed by the Anthem Blue Cross health insurance rate hikes, especially in a time when the recession has forced so many people into the individual health insurance market. State law requires that insurers spend at least 70 cents of every dollar of premium on medical care. I have instructed my department to hire an outside actuary to examine their rates line by line to ensure they are complying with this state law. If we find that their rates are excessive, I will use the full power of my office to bring these rates down.”
While I commend Mr. Poizner’s commitment to keeping prices low, I need one thing clarified. Since health insurance companies have to get all rate actions reviewed by the state before they can increase rates, wasn’t he aware of these new rates before today? When was he exactly “alarmed?” Was it when he learned of the new rate or when it became a news issue? We knew about these proposed rate hikes weeks ago.
Our California Insurance Commissioner should make sure that all increases to health insurance are justified and we are anxious to learn who or what is behind the rapidly increasing rates at Anthem. I hope, however, that in the future that cost issues are his active goal, not just a reactionary response that looks good in the papers.
Ban on manditory insurance?
February 01, 2010
by Martin Joseph
Lawmakers in 34 states are attempting to make amendments to their constitutions to stop government health insurance mandates. Is it a good idea?
The proposed ban would make it illegal to penalize those who choose not to carry health insurance. This generally is a response to the current democratic initiatives in the Congress and Senate. I guess you could focus on whether this technique would even work. If there was a sweeping federal health bill that included mandatory purchasing of health insurance, it would most likely over-ride these state initiatives. The bigger issue concern we have is that this is just another illustration of how dysfunctional the health care reform process is. Rather then looking for real solutions, one group is trying to cram down reform while the other group is trying to block it.
Let’s get back to the core issue. COST. As everyone knows, health care costs in the United States are out of hand. According the the Kaiser Foundation, the average cost of a family policy offered by employers increased 5% in 2009 to a whopping $13,375. For the same amount of money, a small business owner could purchase a 2010 Nissan Versa 4-door car for each employee each year! Talk about benefits!
One way to address costs is to get more people into the insurance pool. There would be more healthy people paying premiums and this could offset the claims of those that get sick and could bring down the price of insurance. This is why some people support the mandate that everyone should purchase insurance. And while this may make sense in the abstract is would be very difficult to enforce. Yes, many make the comparison to the mandate to purchase car insurance. But there is a big difference. You can choose not to drive car but to choose not to live isn’t really an option. So a health insurance mandate doesn’t give individuals the chance to opt out like those who do not want to pay for car insurance. Also car insurance mandate is easy and cheep to enforce. No car insurance = no drivers license. We don’t think there is the equivalent in health care.
By the way, there is currently a mandate (of some sort) in small business health insurance. Most companies must require that 70% or more of their employees participate in the plan. This is to avoid what we call “adverse selection” where only the people with health issues join the plan. So this mandate aims at getting more healthy people into the plan yet prices are still very high. So a mandate cannot be seen as a fix all solution. One area they seem to be leaving alone are maximum HSA contribution limits for small businesss.
So what is the solution? Well, while we do think it is challenging to implement, we are not yet comfortable ruling out some sort of incentive to get more people into the insurance pool whether you call it a mandate or not. We do believe, however, that there are a few more politically viable alternatives that lawmakers should focus on right now.
1) Electronic Record Keeping
2) Transparency of Costs
3) Standard Negotiated Rates.
4) Addressing our National Obesity Crisis.
If we address the above we will be taking a big step to curb runaway health insurance costs. Each of these issues will be explored in more detail in future blogs and we look forward to your thoughts. In the meantime, everyone should consider HSA plans. They are a step in the right direction of health care reform. Coupled with transparency of costs we could really see health fees go down!
Brown’s Victory May Slow Down Health Care Reform
January 21, 2010
by Chris Mihm
While many think last night’s victory by Republican Scott Brown was a major blow to health care reform, we think that this is a perfect opportunity to allow Washington make changes to the bill that will have a lasting positive impact. And it looks as if the White House may agree with us on this issue. According to the AP, President Obama urged lawmakers today not to try to force the current bill through but to scale the proposal down to what he called “those elements of the package that people agree on.”
In there lies the rub….what do people agree on when it comes to health care reform? Most people would say NOTHING. We, however, see a common ground. We think most everyone agrees that the growth rate of the cost of health treatment and insurance premiums in the United States is out of hand. We think health care reform should focus on controlling those costs. Rather than passing an enormous bill, we suggest small changes to our health care system that would make immediate impact to the cost of health care. The first bill should be called the Transparency of Cost Act. The bill that required health providers such as Doctors and Hospitals to alert patients of the estimated cost of health related procedure. This would directly address cost issues as many patients would be motivated to seek out better priced procedures. For example, if one facility charges $3000 for an MRI and another $1000, those patients with larger deductibles or coinsurance would select the less expensive option. This would save the patient and the health insurance company’s money and force the more expensive facility to reconsider their high price. This is a common sense that everyone can get behind.
You’ve Got Tonik Blue Cross Health Insurance in CA…Now What?
December 01, 2009
Author: Medicoverage Staff
Now that you’re forking money over every month for your Tonik health insurance, you might as well take advantage of the services available to you. Tonik Plans are underwritten by Anthem Blue Cross of California and that’s a good thing. Blue Cross is California’s largest health insurance provider, which has bargaining power and a ton of great services. Here are some tips to get the most out of your plan:
1) Stay in the Anthem Blue Cross PPO Network.
That’s the trick to keeping your costs down. Anthem Blue Cross has a huge network of doctors and hospitals and if you use the Blue Cross Network, your cost will be way lower. So know before you go. Click here to find a Tonik doctor in your network. Search under PPO (formerly know as Prudent Buyer) Network.
It’s kind of like a mini physical. You can get a Healthy Check once a year for 25 to 75 bucks. This link will explain more and help you find healthy check centers in your area.
4) Check that Tooth.
Dental insurance comes bundled with Tonik Plans, so you might as well use it. As long as you stay in network, you’ll find that cleanings, exams and x-rays won’t cost you anything. If you need a filling, you have a $25 dental deductible then the plan pays 80% and you pay the remaining 20%. Total dental benefits paid by Anthem Blue Cross are limited to a maximum of $500 per year. Use the Anthem Blue Cross doctor finder to find a dentist in your network. Note: If you don’t get your teeth cleaned on a regular basis, you’ll soon have stank breath- so do us all a favor and make the call.
5) Pay Your Bills.
The number one reason why individuals are dropped from their plans is because they haven’t made a payment on time. Your bill is usually due on the first of the month. If you chose paper billing you will have to pre-pay for two months and there is a two dollar charge for the paper option. Want to save the earth or just having trouble remembering to get that check in the mail? Visit the Anthem CA section to access forms to fill out an automatic checking (or CC) withdrawal form. It takes 2 minutes and it can help ensure that you stay covered.
Medicoverage is an authorized independent agent. Benefits above are subject to change.
Anthem CA launches CoreGuard and ClearProtection Plans
November 02, 2009
by Medicoverage Staff
Anthem Blue Cross of California has announced that they will launch two new low cost health insurance plans for 2010: CoreGuard and ClearProtection. While the plan details have yet to be confirmed, both plans are said to offer a range of deductibles which are designed to meet individuals and family’s unique needs.
The CoreGuard plans were designed for clients “who simply need a lower-cost alternative and can handle a higher share of the cost.” The projected cost of the CoreGuard plans confirm this goal. The CoreGuard 10000 plan shows a monthly premium of under $75 a month for a male under 40 but clients must first satisfy a 10,000 deductible before receiving many of their benefits.
The new Anthem ClearProtection plan, on the other hand, is designed for clients who want “affordability along with the convenience and assurance of some first dollar coverage, and a broad range of benefits.” The same under 40 year old male would pay $69 a month for the .(JavaScript must be enabled to view this email address).
The CoreGuard plans are slated to be available in January of 2010 while clients interested in the ClearProtection plan will have to wait until February of the same year. We will keep you updated as more information becomes available.
The Most Asked Tonik Questions
September 01, 2009
By Naya Jones
So we get a lot of question about Anthem Blue Cross Tonik health insurance, but this one comes up more often than not.
Question: Can I Travel Out of State and Still Be Covered by Tonik?
Answer: If you plan to travel outside of California, take your Tonik card with you…you might need it. If you require medical care or treatment out of state, you may use a local Blue Cross and or Blue Shield participating provider. If you use one of these providers, your “out of pocket” expenses may be lower than those incurred when using non participating providers.
If you are traveling outside the United States, coverage is provided in Medical Emergencies only. Please call 1.800.810.BLUE (2583) to inquire about providers that may participate in the BlueCard out of state and worldwide program.
Anthem Blue Cross Tonik Plans Finally In More States
September 01, 2009
Martin L. Lawrence
Once only available in California, Tonik Health Insurance plans are now offered in Colorado, Connecticut, Georgia, New Hampshire, and Nevada. The Tonik plans which are now in 6 states specifically targeting active, healthy people who need health insurance but hate forms and jargon.
We were skeptical at first since, as we all know, health insurance companies are notorious for making everything more confusing than it needs to be. We were pleasantly surprised to find out that we were wrong. Tonik plans are easy to understand and easy to apply for. Check out our initial overview below:
TonikA>?,??,>s motto is A>?,?_"Cover your A-ZA>?,?A_ and, beyond the double entendre, it basically means that Tonik will offer, for the first time, health, vision, and dental for one easy payment. No other health plan that we know of offers all three benefits bundled for one low payment.
TOO HIP? Everything Tonik does is hip. The website is designed in Flash and focuses on extreme sports graphics. They also regularly use slang like “dude” and “buzzkill”. If you can get past their over-eager effort to relate to the young generation, you will find great plans and by far the best online health insurance application. Most people complete it in 15 minutes and many are approved within 5 minutes.
WHICH ONE ARE YOU? Tonik has 3 plans dubbed for different types of users. They have A>?,?_"The Thrill Seeker,A>?,?A_ A>?,?_"The Part-Time DaredevilA>?,?A_ and A>?,?_"The Calculated Risk Taker.” We like these names because it’s now much easy to sort through than the old confusing codes and numbers of traditional plans. With the TONIK system, all you have to do is just figure out which category you fall under and then apply. If you are a “Thrill Seeker,” you probably want to be covered in case of an accident and figure you will only need to see the doctor a few times a year. “Calculated Risk Takers,” on the other hand, are willing to pay a little more for low deductibles and unlimited trips to the doctor in addition to comprehensive coverage for accidents. “Part Time Daredevils” fall somewhere in between. Check out the TONIK plan break down below and see which type you are.
If you are a recent grad or an young person (it’s ok if your over 29- just be healthy and active) considering health insurance, check out the Tonik prices and info below. If you have any questions call an independent authorized agent at 800-930-7956. These agents are experts on these plans and, best of all, they work on your behalf at no additional charge or hidden fees.You can call them directly or go straight to the website to apply.
TONIK covers you for the everyday, preventative stuff (like checkups) and the more dramatic encounters (like trips to the emergency room). TONIK plans include coverage for:
Seeing a doctor
Getting generic prescription drugs
Going to the emergency room
Having surgery
Seeing a dentist
Getting eye exams, glasses or contacts
...and a whole lot more
The Bottom Line.
YouA>?,??,>ll find TONIK plans to be affordable.Other comparable plans often cost as much but do not cover doctor visits or dental. The price will vary based on your zip code, type of plan and your age. To find out rates and benefits for California, Colorado, Connecticut, New Hampshire, Georgia, Nevada, visit our pages dedicated to Tonik Health Insurance
Below is just a general guideline. Please note that plan benefits vary by state.
Annual Deductible: There are three: $5,000, $3,000 or $1,500
Doctor Visit Copay: Copays can be from $20*, $30*, $40 depending on your state and plan
Out of Pocket Max: This is the same as your deductible. $5,000 $3,000 $1,500
Prescription Drugs: Generic only in most states: $10-$15
Emergency Room Care: This benefit depends on your state. In some states it is as low as $100.
Inpatient Hospital: $0 after the deductible is met
Dental Cleanings, Exams & some X-rays: No cost and no deductible (limit 2 times a year)
Dental Deductible: Ranges from $25-$50
Fillings: you pay 20% after you pay deductible.
To apply or for more details Visit the our new section dedicated to .(JavaScript must be enabled to view this email address).
REMEMBER The Tonik plans do not include maternity benefits!!!!
Popular Tonik Health Insurance Comes to Colorado
January 02, 2009
Medicoverage Staff
Blue Cross of California broke the mold of traditional health insurance offerings by marketing unique health plans tailored to the lifestyle and attitudes of individuals aged 19-29. Now Anthem Blue Cross Blue Shield of Colorado is targeting the same uninsured “Young Invincibles” with the same Tonik plans.
Tonik plans are simple, easy to use and affordable. Tonik covers routine doctor visits as well as the more serious medical necessities. Unlike other individual policies on the market, seeing a dentist, getting eye exams, glasses and contacts are all-inclusive within the new benefit design.
Curious “young invincibles” Colorado residents can visit and apply for tonik online or call our agent at 888 285-6334. Applicants are subject to review and approval for a plan within minutes. The plans are intentionally easy to understand and navigate. There is minimal to no paperwork and if approved, an applicant can print out a custom-designed identification card right on the spot.
HealthyGrads.com: Hope for Recent Grads Looking for Health Insurance
June 02, 2006
Medicoverage Press Release
The new site, features general overviews, plan details, online applications and rankings of top plans that are best suited for young adults. The company hopes to provide a needed service to individuals who, if they are not careful, can find themselves without health insurance coverage shortly after receiving their diplomas. Most family insurance plans will only cover children to age 19 if they are not full-time students and many insurance plans stop dependents’ coverage immediately upon graduation.
Healthygrads.com is designed to help recent grads avoid a gap in coverage and is specifically targeting young people between 19-29 years old. A demographic that company CEO Eric Scheinbaum says has been largely underestimated. “It’s a myth that young people don’t care about insurance. Anyone who is smart enough to invest in his or her education is smart enough to know that health insurance is a must have. Young people are our fastest growing group of new customers.”
Scheinbaum goes on to explain that while recent graduates value health insurance, they seek different benefits than your typical health insurance customer. “Recent grads don’t want to pay for expensive benefits that they believe they will not use such as brand-name prescription coverage.” What they do value, according to Scheinbaum, is being able to visit a doctor or the emergency room without having to pay a deductible. They also gravitate towards plans that offer dental and vision benefits but no lengthy contracts.
Healthgrads.com features only the top youth-oriented plans that fill the criteria above. All recommended plans are underwritten by top insurance providers such as Blue Cross, Blue Shield and UniCare with GenY plan names such as Tonikplans, SoundPPO and EssentialPPO. According to the site, Medicoverage never refers their clients to “fly-by-night” insurance companies that may not be around when you need them.
Although the company designed the site for young adults, they believe the previous generation will also find the site useful. They expect about 1/4 of the Healthygrads.com visitors will be parents. “While we have been impressed by the number of recent grads that have taken responsibility for researching and purchasing their own insurance, we know that sometimes a parents nudge in the right direction makes all the difference in the world,” says Medicoverage Director of Marketing, Chris Mihm. “Many parents will email a link from healthygrads.com to their recent grad and let their children take it from there.”
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