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May 29, 2008

Poll: 7% of Americans marry for health insurance

Some people marry for love, some for companionship and others for status or money. Now comes another reason to get hitched: health insurance.

In a poll released Tuesday, 7 percent of Americans said they or someone in their household decided to marry in the past year so they could obtain health care benefits via their spouse.

"It's a small number, but a powerful result, because it shows how paying for health care is reflected not only in family budgets, but in life decisions," said Drew Altman, president of the Kaiser Family Foundation, which commissioned the survey as part of its regular polling on health care.

The survey found that the costs of health care outranked housing expenses, rising food prices and credit card bills as a source of concern.

Of those surveyed, 28 percent said they had experienced serious problems because of the cost of health care, nearly tied with 29 percent who had problems getting a job or a raise.

Gasoline prices were the top economic worry, with 44 percent saying they had serious problems keeping up with increases at the pump.

Health care inflation has been rising at about twice the rate of economic growth.

Therefore, it may be no surprise that nearly one-fourth of Americans decided to keep or change jobs in the past year because of health insurance.

The Kaiser polls, conducted April 3-13, surveyed a nationally representative sample of 2,003 adults and have a margin of error of plus or minus 3 percentage points.

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Posted by healthinsurance at 11:36 AM | Comments (0)

May 26, 2008

What Is The Difference Between Health Insurance Companies In California?

Whether you already know it or not California has a lot of options for health insurance. There are companies that we all heard of and there are some companies that we never heard of. With all the Health Insurance Companies out there you might be wondering what the differences are and which one is right for you.

First in state of California the health insurance companies you should be looking at are; Aetna, Assurant, Blue Cross, Blue Shield, HealthNet, Kaiser, Nationwide, PacifiCare, Celtic and new company that is going to be available in state of California is Golden Rule. These are the largest health insurance carriers that are available in the State of California.

If you are looking at any other company that was not mentioned previously, use caution. With all the health insurance premiums going up there are companies that prey on people with low premiums and coverage that does not cover anything. They are just out there to make a quick buck buy collection as much premiums as they can before you cancel your coverage. Stay away from companies that you never heard of, not matter what they tell you. If you hear something like, “affordable health insurance for self-employed”, run.

Second what you have to understand that the actual cost of insurance no matter what company you go with is about the same. So how do insurance companies have so many different plans with different premiums? If it is a large insurance company and the company ran efficiently that is how you get great premium with great coverage. What creates variety of prices for insurance coverage is the creative aspect of the insurance company designing their plans. The way they do it is by deductibles, co-pays, co-insurance, drug coverage deductibles, whether the plan covers brand name drugs or generic drugs only, maternity coverage, maximum out of pocket, deductible and co-pays for all kind of different services.

The name we all know is Blue Cross Blue Shield. Blue Cross has been around since the recession of 1929, and it used to cost only 1 cent a day. The times have changes since then, but the Blue Cross name is still around. Blue Cross has been over the years the most stable largest health insurance provider in the United States. Their strategy is to keep rates stable and have stable rate increases. While most other plans might lower their rates to get more people on their coverage and then keep increasing their rates. There fore as some plans might be more attractive in premiums at the moment over time eventually they have to catch up with the actual market health insurance cost. Sometime the company has to charge people more for health insurance in the future so they can give more affordable rates today. Blue Cross will give the one of the largest varieties of plans to choose from and you can always downgrade a plan without going through underwriting is the monthly premiums because to expensive.

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Posted by healthinsurance at 02:21 PM | Comments (0)

May 22, 2008

California Insurance Regulator Touts Value of Personal Health Records

Today, the Department of Insurance is expected to issue a report that urges Californians to use personal health records, the Sacramento Bee reports.

The report found that PHRs are efficient, secure and increasingly widely available. PHRs also can provide consumers with a better way to manage their health care and deal with health insurance claims, according to the report.

PHRs usually include patients' information on:

-Physician visits;
-Lab tests;
-Outpatient procedures; and
-Family medical history.

PHRs do not include clinical information contained in electronic health records used by doctors and hospitals, the Bee reports.

Privacy Issues:

Some patient privacy advocates are skeptical about some of the PHR platforms, such as those offered by Microsoft and Google, and question whether security protections are adequate.

However, state officials on Monday said that PHRs already available through insurers such as Aetna, Blue Shield and Kaiser Permanente are secure.

The Department of Insurance also is expected to create a working group to help patients transfer their PHRs when they change health insurers (Glover, Sacramento Bee, 5/20).

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Posted by healthinsurance at 09:37 AM | Comments (0)

May 15, 2008

Kaiser agrees to offer coverage to 1,000 canceled patients

Kaiser Permanente has agreed to offer insurance to 1,092 individuals whose policies were inappropriately canceled after they got sick and to refund money paid to the health plan for medical care.

The health plan has also agreed to provide a fair and speedy process to resolve any additional expenses incurred due to a gap in coverage, Kaiser officials and state regulators announced Thursday.

Kaiser is the first of five large California health plans to reach settlement with the state Department of Managed Health Care over the controversial practice of rescinding individual insurance coverage after patients got sick, claiming they had pre-existing conditions and did not qualify for coverage.

The agreement includes a $300,000 fine against the health plan and a potential fine of $3 million if Kaiser fails to pass a survey of its practices by state regulators within the next 18 months.

An agreement with Health Net Inc. is pending. It will cover 85 individuals who had their policies canceled since 2004, said agency director Cindy Ehnes. Her department is in discussions with the other three plans: Anthem Blue Cross, PacifiCare and Blue Shield of California.

"Kaiser is the first to step up," Ehnes said in a press call Thursday. The $300,000 fine and potential $3 million penalty are unique to Kaiser, she said. Other settlements will reflect the circumstances at other health plans.

Jerry Fleming, national health plan manager for Kaiser, dubbed the deal as a "fresh-start" program that will immediately provide coverage for individual members whose policies were rescinded with no medical questions asked.

Kaiser voluntarily halted the controversial practice, known as "rescission," in October 2006 after questions were raised about the application survey used.

On April 17, Ehnes ordered the five health care plans to immediately reinstate coverage for 26 people whose insurance benefits were wrongly canceled after they filed claims -- and ordered a review of thousands of additional cases.

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Posted by healthinsurance at 02:10 PM | Comments (0)

May 13, 2008

California Health Insurers Must Reinstate Policies

Chalk one up for sickly patients. California regulators have ordered insurers there to reinstate the health insurance policies of 26 people who lost their coverage after the insurers claimed they had lied on their applications, according to news reports. The 26 cases represent the most egregious examples of insurers wrongly "rescinding" policies, typically for inadvertent errors. The person gets sick and starts making expensive claims, and the insurer cries "fraud!" The patient says "forgot!" or sometimes "say what?" For example, one woman I spoke with on this topic had answered "no" when asked if she'd been treated for cancer in the past 10 years. Later her policy was yanked because the insurer claimed that regular blood work she had to ensure her earlier cancer had not returned constituted cancer treatment.

Now California begins a case-by-case review of thousands of rescissions in the past four years, and it may be that these 26 are the tip of a fairly hefty iceberg. And consumer advocates say there's no reason to believe this issue is confined to California. They expect similar cases to begin emerging elsewhere.

These problems arise in the individual health insurance market, where people buy policies on their own. That market is much more loosely regulated than the group market—and often more problematic for patients—as I discussed a few months ago.

Right now, only about 5 percent of people buy insurance this way. But if Sen. John McCain has his way, many more would very likely start buying health insurance on their own. The presumptive Republican nominee has proposed eliminating the tax break that employees currently get on their health insurance benefits and instead giving people a tax credit of $2,500 for individuals and $5,000 for families to put toward buying coverage. I also wrote today about the presidential candidates' healthcare reform proposals.

Many policy analysts see merits to the restructuring that McCain proposes, but they argue that without better regulation of the individual market, people who are older or sick won't be able to get affordable health coverage, or any coverage at all. They point to what's going on in California as an example of the kind of problems that can occur. "Look at the rescission mess in California," said health policy analyst Robert Laszewski, when I interviewed him for the election health reform piece. "The Democratic nominee will stand up and say, 'John McCain will throw you to the market wolves.' " McCain is expected to elaborate on his healthcare reform proposal at the end of April. Maybe at that time he'll offer details about how he plans to protect consumers from predatory insurance practices.

As for this rescission mess, I'd like to hear from people who've experienced problems similar to what's occurring in California. Is this just a left coast phenomenon, or is it happening elsewhere, too?

Click here for your free California health care quote!

Posted by healthinsurance at 11:49 AM | Comments (0)

May 08, 2008

Single-Payer Healthcare: a Reality for California?

As a nurse, I have seen countless examples of the devastating outcomes that result when people do not have access to care due to lack of insurance. Just last week, I visited a 35-year-old cancer patient to help her manage oxygen treatments at home. She had beaten breast cancer at age 25. However, she was a restaurant worker and did not have health insurance; consequently, once she started working again, she no longer qualified for MediCal and could no longer see a doctor to be screened for recurrence. Sadly, when the cancer did come back it was not detected until she went to the ER one night when she could no longer breathe. Cancer metastases cover most of both her lungs. As she can no longer work, she is once again eligible for MediCal. Unfortunately, this coverage has come too late to save her life. I wish this story was an isolated event, but the fact is 18,000 people die in the U.S. every year solely because they do not have health insurance. A single-payer system would not only give access to care to the millions of currently uninsured, it would also create a better environment for all healthcare workers to practice in.

The reality of a single-payer system for California may not be as far away as you think. Senate bill 840 – a proposal for single-payer healthcare in California – was passed on the floor of both the Senate and the Assembly last year (only to be later vetoed by the governor). It will be re-introduced in the upcoming months. State Senator Sheila Kuehl, author of SB840, explains the rationale behind the bill: “SB 840 would replace insurance companies with a statewide trust fund that collects premiums paid by employers and individuals. The creation of a single state fund reduces the administrative portion of California’s healthcare costs from nearly 30 percent to under 10 percent. With everyone in one pool, which spreads the risk as widely as possible, no one would be denied coverage for a preexisting condition. Individuals would be free to change jobs, start a business, go to school or start a family without losing coverage or doctors they trust.”

SB 840 is good for the practice of healthcare, as well. Under this new system, decision-making would be returned to physicians and advanced practice nurses as treatment options would no longer be determined by what is covered by each individual’s insurance plan. SB 840 would end uncompensated medical care by ensuring that everyone has a payer. Paperwork would be infinitely streamlined and medical offices would no longer need teams of administrators to argue for authorization and bill dozens of different insurance companies every month. Practices will be able to refocus their staffing on nurses and other providers, which will increase the quality of care and decrease medical errors. Continuity of care will improve as patients are no longer forced to change medical groups when they switch jobs or their employers switch plans. This will lead to more meaningful, long-term relationships between providers and patients – improving quality of care and patient safety.

Click here for your free California health care quote now!

Posted by healthinsurance at 01:56 PM | Comments (0)

May 06, 2008

Health care reform - what are the chances?

There is a retty good chance of implementing successful health care reforms in this country making health care available to more people and to provide affordable health insurance to more families and individuals. Probably there is 60:40 chance or better that there will be major reform in the next Congress.

Here's why.

Sen Ron Wyden's (D OR) Healthy Americans Act has six D and six R Senate cosponsors, including Bob Bennett (R UT). There is broad bipartisan support for the bill, which mandates universal coverage.

WalMart and the SEIU back the bill.

The National Federation of Independent Businesses backs some form of 'universal' reform.

Both Democratic Presidential candidates back major reform.

Congress has been stung by criticism of its inability to get much done - and health care reform is something big that needs doing.

Many of the Fortune 500 back reform, including automakers, service companies, and manufacturers. And the unions that represent their workers do too.

This impressive array of supporters is opposed by...well, it must be opposed by some groups, companies, politicians, lobbies, but it is hard to find much in the way of opposition, at least using internet search engines. We can look to California to find out how and why their efforts to pass reform failed. A loose coalition, comprised of Republican legislators, Blue Cross of California [WellPoint], the state Chamber of Commerce, and the tobacco industry joined together to oppose the bill, and their efforts got a major push from legislators' deep concerns about the cost of the initiative and the Golden State's financial straits. A closely related issue is the concern by many that states, acting alone, cannot enact meaningful reform for the simple reason that 1/3 of all health care dollars are controlled (to a great extent) by the Feds, and if these dollars, and the care they pay for and members they cover aren't integrated into a comprehensive reform measure, the effort is doomed to fail. Cost shifting, contradicting priorities, differing measures of success and evaluation methodologies will result in a confused, bifurcated system that serves neither population well.

Similarly, the problems emerging in Massachusetts and Maine make it less likely that states will successfully pursue reform measures. Instead, the states, a powerful lobbying group in and of themselves, will likely join others to support national reform.

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Posted by healthinsurance at 12:19 PM | Comments (0)

May 01, 2008

Cracking down on fraud in California managed health care

Are you uninsured? Unfortunately, you are not alone. In California, out of a total population of nearly 36 million people, 18.4 percent do not have health insurance coverage. Some lost their insurance when they lost their jobs. Others may be working, but their jobs don't provide health insurance benefits. Whatever the reason, finding and keeping health insurance can be difficult.

This week is Cover the Uninsured Week, a national effort to highlight the fact that too many Americans are living without health insurance and to encourage all of us to come together and seek solutions.

We know that reaching the goal of affordable and stable health care for all requires changes in public policy. Governor Schwarzenegger continues to work towards covering everyone regardless of ability to pay or preexisting health conditions. The California Department of Managed Health Care (DMHC), under his leadership, has been working to increase quality, affordable forms of comprehensive health insurance.

In the absence of successful efforts to reform our health system, however, alternatives to health insurance have cropped up in the marketplace. One is a discount health plan -- which may not be truly offer a worthwhile discount and may even be fraudulent.

The idea behind a discount health plan is a membership program which offers reduced-rate health care services to the public. These plans typically charge an annual membership fee and a monthly payment in exchange for a list of health care providers who will deliver services to members at a discounted rate. Members must then pay directly for the health services. The discount plan is not insurance; meaning that neither the plan nor any other entity assumes financial risk to pay providers for delivering services. It is more of a pay-as-you go service, but at less cost than the normal fee that an uninsured person would pay.

Click here for cheap California health insurance. Get your free quote now!

Posted by healthinsurance at 02:25 PM | Comments (0)