Supreme Court takes up challenge to health care reform

The Supreme court has agreed to decide the constitutionality of the health care reform law of Barack Obama. The high court agrees to hear two major questions: whether the law's key provision is unconstitutional, and if so, whether the entire law must be eliminated.

The major issue will decide if the "individual mandate" section - which requires nearly all Americans to buy health insurance in 2014 or face financial penalties --is an improper exercise of federal authority.

My feeling is the odds are in Obama administrations favor that it will not be struck down. Legal analysts say this is one of the toughest challenges the high court faces in a decade.

Stay tuned.

Pre-existing health plan in Kentucky available

The federal govt. has a pre-existing health plan in Kentucky going into effect September 1st, 2011. If you've been without health insurance for 6 months and have a pre-existing condition, then you qualify for this plan. Rates are inexpensive. Also, available in Indiana.

https://www.pcip.gov/

Health Savings Account updates

2012 Minimums and Maximums for Health Savings Accounts and High-Deductible Health Plans
On May 16, 2011, the Internal Revenue Service (IRS) released Revenue Procedure 2011-32,1 which announced various inflation-adjusted amounts for 2012 for Health Savings Accounts (HSAs) and High-Deductible Health Plans (HDHPs). The IRS calculates the annual adjustments using the 12-month period ending March 31.

The 2012 numbers are shown in the chart below.

2012 Minimums and Maximums for HSAs* and HDHPs


Individual Coverage



Maximum Annual
HSA Contribution** $3,100
(up $50 from
$3,050 for 2011)

Family

$6,250
(up $100 from
$6,150 for 2011)


Minimum HDHP Deductible

$1,200
(same as for 2011) $2,400
(same as for 2011)

Maximum HDHP
Out-of-Pocket Expense*** $6,050
(up $100 from
$5,950 for 2011)
$12,100
(up $200 from
$11,900 for 2011)

Question from current member today

"What is going on with healthcare reform? What's going to happen?"

Under the The Patient Protection and Affordable care act or ACA passed in March, 2010:

By 2014, you will be able to compare and buy insurance on a health insurance exchange. The exchange will offer a choice of approved insurance plans. It will also help you find the best plan for you and your family.

In 2014, a person with income below 400% of the federal poverty level (currently $43,560 for a single person) can get a subsidy to buy health insurance. The subsidy will be higher for those with lower income. If you are under 65 and make less than 133% of the FPL (currently $12,305 for a single person) you can get Medicaid in 2014.

Question of the day: "Healthcare reform penalty"

A client of mine asked me what is the deal with the health care penalty they're discussing. Will I be penalized for not taking out a health care plan in 2014?

Answer -

Starting in 2014 all U.S. citizens and legal residents will have to have health insurance, or what is known as qualifying health coverage, which includes coverage through your job, a government plan (such as Medicaid, Medicare, Veterans Administration, and the Armed Services), or a health plan you have purchased on your own.

If you don’t have health insurance, you will pay a tax penalty that will be phased in starting in 2014 with a fine of $95. In 2015, the penalty will increase to $325, and in 2016 to $695 or a percentage of your taxable income. After 2016, your penalty will be increased every year according to the changes in the cost of living.

Are Exemptions or Help Available?
You may be eligible for an exemption or you may be able to get help paying for health insurance it if your income is low.

Exemptions will be granted for the following:

•you have a financial hardship
•you have a genuine religious objection
•you are an American Indian
•you have been without health coverage for less than three months
•you are an undocumented immigrant
•you are in prison
•the lowest cost health plan available in your area exceeds 8% of your income

Needymeds has patient assistance programs

http://www.needymeds.org/

Diseased based medication programs for those uninsured or under-insured who meet the guidelines.

New Website Launched

Check out my new website

www.yestohealthinsurance.com

Kentucky's children Open enrollment dates

Children in Kentucky can get individual health plans regardless of pre-existing conditions during open enrollment period in January.

Companies participating in the open enrollment are Aetna Life Insurance Company, American Republic Insurance Company, Anthem Health Plans of Kentucky, Assurant Health/Time Insurance Company, Golden Rule Insurance Company, Humana Health Plan Inc. and Assurant Health/John Alden Life Insurance Company.

During January, insurers selling in the commonwealth's individual health insurance market must offer a policy to any Kentuckian under the age of 19 and may not deny coverage due to an applicant's pre-existing health condition.

http://www.14wfie.com/story/13796400/kentucky-companies-must-offer-childrens-health-insurance

NeedyMeds to the rescue!

After I posted my last blog about the woman who needed prescription drugs and couldn't get it either through a private insurer or medicaid, I received this letter from the President of Needymeds.org - Thanks Mr Sagall for your response. This will help alot of people and not just in Ohio.

I read your blog post of 12/27/10 and thought you and your readers might want to know about NeedyMeds and the help we can offer.

NeedyMeds is a national non-profit that has information on programs that help people who can't afford their medications and health care costs. We have data on over 4000 programs and over 11,000 free/low-cost/sliding-scale clinics. All our data is free, easy to access, and updated regularly. Our website is visited by 13,000-14,000 people most workdays.

We offer a free drug discount card that's accepted at nearly 60,000 pharmacies. Anyone can use the card regardless of income level, insurance status, age or residency. The card offers a discount ranging from nothing to 75% on prescription drugs, over-the-counter drugs and medical supplies when written on a prescription form, and pet prescription drugs purchased at a pharmacy. The average savings is 50%. The card is free and there is no registration process or cost. The card can be downloaded from our website or obtained by sending us a self-address stamped envelope.

Rich Sagall, MD
President
www.needymeds.org


Check out our Facebook page

Drug Card question

Question today:

I live in Ohio and was declined for insurance by all of your companies listed and I'm in desperate need of finding any type of drug coverage. Can you help?

Answer:

Yes, there is a free discount card for Ohio residents only. Click on the link below. You can save up to 75% of drug costs with this card and it's free.

http://www.ohiodrugcard.com/index.php

Plan strategies

I've had quite a few different scenarios come up this week about health care and I wanted to share it with each of you.

1. Did you know if you have a high deductible plan you can purchase a critical illness or cash cancer plan which can pay out a cash benefit to you in increments of $25,000, $50,000 or $100,000 if you had a catastrophic event. The prices are very affordable. Similar to term life but this is a gap to your current insurance. Can you imagine how helpful this would be if you had cancer and you received a cash payout like this? Would pay for your insurance deductible and out of pockets plus pay your bills for the rest of the year.

2. The New Ohio Risk pool plan through Medical Mutual will cover pre-existing conditions. Must be without insurance for 6 months. Rates are very good. It's a model for the new health care reform.

3. Humana eligibility for Short term plans is 64 1/2 years old. Most companies won't cover short terms after 63.

4. Assurant's affordable health access plan will cover all individuals or families regardless of height and weight issues. And it's very affordable.

5. If your rates go up because of health care reform consider a high deductible and take out a gap rider (plans which make cash payouts in event of catastrophic event) It will save you money and you'll have less exposure than your previous plan. Everyone's concerned about high deductibles but new gap plans are giving people more peace of mind.

Have a great weekend all.

Ohio insurance pool will open August 1st

Ohioans with pre-existing health conditions, such as cancer or diabetes, can apply for coverage under a new high-risk insurance pool beginning Aug. 1, state officials said today. Go to the below site for qualifications and details.

http://www.ohiohighriskpool.com/

What's the healthcare reform going to make me do?

A concerned individual had this question regarding health reform.

My answer - It mandates that, beginning in 2014, virtually all Americans buy affordable coverage. It expects states to create health insurance exchanges on which private insurers will offer coverage for small businesses and individuals unable to obtain it otherwise. Federal subsidies will help those who cannot afford an available policy to pay the premiums and required cost-sharing amounts. As a result, more than 30 million additional Americans will gain access to comprehensive health care coverage.

Insurers will no longer be able to refuse to sell to people with pre-existing conditions or other risk factors, charge them more for coverage (except for age), cancel or refuse to renew policies for people using services, or impose limits on benefits.

Health Care Reform

A Ohio resident contacted me today regarding Healthcare reform in Ohio:

"Is the government implementing new health insurance programs in Ohio"

Yes Medical Mutual of Ohio, as of September 1st, it appears right now will run the new health pool for the state of Ohio. We should have more details in the coming weeks.

Question today from declined applicant

A person emailed me today: "I was declined individual coverage because of a joint replacement issue. Isn't there any company that will cover me even if I have just this one issue."

My answer is "Yes. Assurant Health can possibly approve you for one of their individual plans with the possibility of putting an exclusionary rider for this condition - which means they will approve you for one of their preferred plans but not cover that one particular condition."

Senate fails to extend Bill for Doctors

Senate Fails to Extend Bill for Doctors: Before leaving for the Memorial Day recess, House Democratic leaders scaled back health care language from the jobs bill before passing the bill. In the package, doctors who treat Medicare patients would see a 2.2% payment increase for the remainder of this year and a 1% payment increase in 2011. Extensions of COBRA subsidies and additional Medicaid funding for states were removed from the bill. Lawmakers in the Senate will vote on the bill when they return from recess next week.

Question of the week.

Q: I understand that there are tax benefits related to the extension of dependent coverage. Can you explain these benefits?

A: Under a change in tax law included in the Affordable Care Act, the value of any employer-provided health coverage for an employee's child is excluded from the employee’s income through the end of the taxable year in which the child turns 26. This tax benefit applies regardless of whether the plan or the insurer is required by law to extend health care coverage to the adult child or the plan or insurer voluntarily extends the coverage.

Healthcare Reform: How it will affect us?

Good article here explaining how it work for individuals, families and employers.

http://www.csmonitor.com/USA/Politics/2010/0320/Health-care-reform-bill-101-Who-gets-subsidized-insurance

Retiring with no Health Insurance benefits

I had someone call me today who was a retiree asking what happens between the time I retire and turn 65 with no Health insurance pension benefits.

Well, there are quite a few options. First, If you have major prexisting conditions:

* Take the Cobra option for as long as you can (usually 18 months) if you have major pre-existing conditions especially if you have cancer, heart problems, diabetes, back issues and blood disorders. Getting a private individual plan will be difficult but not impossible. Some insurance companies have limited benefit plans for those major pre-existing conditions.

If your Cobra runs out:

Ohio - Has Hippa plans which they enroll a certain amount of individuals at a time even if they have major pre-existing conditions.

www.assuranthealth.com/corp/ah/state/ohio


Kentucky - Has Kentucky Access if they are denied by a private insurer for pre-existing conditions.

www.kentuckyaccess.com/index.cfm

Some insurance companies will offer Group conversion plans which will cover pre-existing companies but the premiums will be high, if not higher than Cobra.


* Take a short term plan if all else fails. Every state has them and they range from 6 months to a year. Although it won't cover you for your pre-existing conditions it will cover you for catastrophic coverage such as accidents.

How can I lower my premiums?

Someone emailed me today and asked how can I lower my healh insurance premiums? Good question.

1.) If you have individual coverage and not group, then odds are you have a renewal each year. In the past 10 years Health care plans have gone up an average of 10%. Some this year have gone up as much as 40%. Ask your company if they have risk evaluations to lower your premiums. If you're in good health, then you may get a lower risk tier with your company.

2.) Shop around - If you don't have too many pre-existing conditions, then shop around and find the best value. Let an independent broker do the leg work and make him find the best rates with a similar plan you have now by doing a comparative analysis with different companies. Or if your plan is weak in benefits, shop for better benefits. Health Savings accounts have the most affordable premiums right now with most insurance companies.

3.) Raise your deductible. Although this will expose you more financially in the event of a catastrophic illness or accident your premiums will obviously be reduced. Be careful, if you try to go back to an original deductible with your insurance company you might be denied because of pre-existing conditions.

4.) If you have a group plan, then generally you'll have to check with your company to see what other affordable plans are offered during open enrollment or shop for individual plans and see if your employer will compensate by going the individual route. Some will.

Good luck