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

Cobra Extension

The COBRA extension date ended on February 28, 2010. Congress had passed legislation in December 2009 to extend the subsidy of helping to pay 65% of the Cobra premiums for individuals and families who were laid off involuntarily. However, President Barack Obamas new budget proposal would extend it again until the end of 2010.

For those seeking alternatives many private insurance plans will still be less than the cost of COBRA but you'll have to shop around to find the best bargains. Contacting a broker who can make comparison analysis to find the best plans and rates is the best bet. Some plans will cover individuals who were otherwise denied by private insurers can find alternatives to cover pre-existing conditions. Ohio Hippa is still accepting individuals for this type coverage. A few companies have limited benefits access plans to cover those with major pre-existing conditions. In Kentucky, Kentucky access will accept individuals who have been denied for pre-existing conditions.

Family and friends ask me everyday what is going to happen in health care reform. At this point, nobody knows but all indications of a public option seem to be long odds. Tax subsidies, portable coverage across state lines, tort reform are all options on the table at this point as are a myriad of different ways to cover individuals.