*Why you should shop around for health insurance every year*

*Q*. I bought a Michigan Blue Cross plan on HealthCare.gov last year for $143 a month. This year the same plan costs $218. Why? My income hasn’t changed—it’s still $21,600 a year.

*A*. Your situation is a textbook example of why we are telling people not to automatically renew their Marketplace health plans.  It can end up costing you a lot of money that you don’t need to be spending.

What’s going on behind the scenes starts with the way the Marketplace calculates your health insurance tax credit. It’s a three-step process.

*Step one:* The Marketplace calculates what percentage of your income you’re expected to contribute toward your health insurance. The higher your income, the bigger share you’ll have to put in. For someone at your income level, the expected contribution is a little less than 6 percent.

*Step two:* The Marketplace looks up the price of second-cheapest Silver plan available for a person your age living in your area. That is called the benchmark plan.

*Step three:* The Marketplace subtracts your expected contribution from the price of the benchmark plan. What's left is the size of your premium tax credit.

You can then take your tax credit and use it kind of like a gift certificate to put towards the cost of ANY plan sold in your location.  

In 2014, you chose the Blue Cross Premier Silver plan. It was the seventh-cheapest Silver plan, so you paid about $36 more than you would have paid for the benchmark plan.

*See our complete health insurance information. To find out how to apply for, select, and use health insurance, including Medicare, visit our main health insurance page.*

Fast forward to this year. In your area of Michigan, the price of the benchmark plan has actually fallen slightly from last year. That reduces the size of your tax credit a few dollars. (See Step three.)

But the most significant change is that your Premier Silver plan premium has gone up a lot. You are a year older, which raised the price a bit (premiums rise with age), but more importantly, Blue Cross increased premiums for this plan by nearly 10 percent in your area, according to Rick Notter, the company’s director of individual business. It's now the 19th-cheapest plan, not the seventh-cheapest.The increase, Notter explained, reflects changes in “underlying medical costs” such as “prescription, hospital, and doctor costs in the area” and also how much medical care plan members use. In other words, the actuaries who work for Blue Cross Blue Shield of Michigan determined that in 2015, the company will have to collect more money if it expects to pay the health care costs of the members of this plan.

What to do? Go back to HealthCare.gov (or consult a smart insurance broker) and look at your other options. If you are willing to switch to another insurance company there are some real bargains to be had.

But if you want to stick with BCBS of Michigan, you might consider its Preferred Silver plan for a savings of more than $80 a month over renewing your current plan. Granted, the deductible is higher—$450 as opposed to $300—but it only comes into play if you go to the hospital or need a fancy brand-name drug, and your premium savings would more than cover the difference. For outpatient doctor visits you’d be paying the same low copays as you’re paying with your current plan, not subject to the deductible. And generic drugs are actually cheaper under this plan.

-- Nancy Metcalf

*Submit a question to Consumer Reports' health insurance expert. Be sure to include the state you live in so we can provide a more-detailed answer.*

*Use our free app to explore your health insurance options*

Not sure where to begin with getting health insurance? Our free interactive tool, Health Law Helper, will point you in the right direction.

*Consumer Reports has no relationship with any advertisers on this website. Copyright © 2006-2014 Consumers Union of U.S.*

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Update your feed preferences Reported by Consumer Reports 2 days ago.

PPA Photographers Have Access to Exclusive Health Insurance Benefits

ATLANTA, Ga. (PRWEB) November 26, 2014

Professional Photographers of America (PPA) announced the open enrollment period for qualified health insurance plans has begun. December 15, 2014, is the last date to enroll for coverage that starts January 1, 2015.

“PPA is very excited to announce that this year, several healthcare providers who chose to sit out last year and not offer plans, have now chosen to get back in,” said Kristen Hartman, PPA director of member value and experience. “This is great news for PPA photographers, as more competition amongst insurance companies goes a long way in keeping your policy premiums down.”

Since 2013, PPA has partnered with Pallay Insurance Agency, Inc. to secure affordable and quality medical and dental coverage*. PPA provides for members several webinars that cover the basics in the quest to become insured. (*coverage not available in MA)

After open enrollment ends, Pallay can still offer Limited Benefit Fixed Indemnity and Short Term Medical Insurance Plans to PPA photographers looking for some form of health coverage. While these plans are not qualified healthcare plans, they do provide benefits that help get by with medical expenses until the next open enrollment period.

These health and medical insurance benefits are exclusive to PPA photographers. To learn more on joining PPA, visit PPA.com/join.

About PPA:
Professional Photographers of America (PPA) is the largest international non-profit association created by professional photographers, for professional photographers. Almost as long-lived as photography itself, PPA’s roots date back to 1869. This nonprofit assists more than 27,000 members through protection, education and resources for their continued success. See how PPA helps photographers be more at PPA.com. Reported by PRWeb 2 days ago.

      NEW YORK, Nov. 26, 2014 /PRNewswire/ -- SynopsisThe report provides in-depth market analysis, information and insights into the Chilean personal accident and health insurance segment, including:- The Chilean personal accident and health insurance... Reported by PR Newswire 2 days ago.

CHICAGO -- The Obama administration will promote health insurance coverage at shopping malls starting on Black Friday and continuing through the busiest shopping days of the holiday season, officials announced Wednesday. They said more than 462,000 people selected a private insurance plan in the first week of 2015 enrollment through the online marketplace HealthCare.gov. Reported by TwinCities.com 2 days ago.

The applications at the start of the three-month enrollment period showed that in contrast to initial problems last year, HealthCare.gov was working. Reported by NYTimes.com 2 days ago.

WASHINGTON (AP) — Many immigrants in the United States illegally who apply for work permits under President Barack Obama's new executive actions would be eligible for Social Security and Medicare benefits upon reaching retirement age, according to the White House.

Under Obama's actions, immigrants who are spared deportation could obtain work permits and a Social Security number. As a result, they would pay into the Social Security system through payroll taxes. No such "lawfully present" immigrant, however, would be immediately entitled to the benefits because like all Social Security and Medicare recipients they would have to work 10 years to become eligible for retirement payments and health care. To remain qualified, either Congress or future administrations would have to extend Obama's actions so that those immigrants would still be considered lawfully present in the country.

None of the immigrants who would be spared deportation under Obama's executive actions would be able to receive federal assistance such as welfare or food stamps, or other income-based aid. They also would not be eligible to purchase health insurance in federal exchanges set up by the new health care law and they would not be able to apply for tax credits that would lower the cost of their health insurance.

The issue of benefits for immigrants who are illegally in the United States is a particularly sensitive one for the Obama administration. As a result, the White House has made it clear that none of the nearly 5 million immigrants affected by Obama's actions would be eligible for federal assistance. The Obama administration first denied younger immigrants who entered the U.S. illegally as children access to health care exchanges and tax credits in 2012, especially disappointing immigrant advocates.

"They were specifically carved out of that, which is deeply unfortunate because it cuts directly against the spirit" of the health care law, said Avideh Moussavian, an attorney at the National Immigration Law Center. "They should have had the opportunity to buy health insurance just like anybody else."

Less clear until now was their eligibility for retirement benefits for which they would have paid into through payroll taxes.

Describing the administration's position, one official said Wednesday that any immigrant considered lawfully present and holding a Social Security number would be entitled to Social Security and Medicare upon retirement because they would have paid into the system.

Stephen Miller, a spokesman for Sen. Jeff Sessions of Alabama, a leading Republican opponent of Obama's executive actions, said making immigrants illegally in the U.S. eligible for Social Security and Medicare "is an attack on working families."

"The amnestied illegal immigrants are largely older, lower-wage and lower-skilled and will draw billions more in benefits than they will pay in," he said.

Beneficiaries would have to be of retirement age and have worked for at least 10 years. Immigrants would also be eligible for survivor benefits if the deceased worker had worked for 10 years. For disability insurance, they would have to work for 5-20 years.

A report by the White House Council of Economic Advisers this week concluded that Obama's executive actions would expand the U.S. tax base because about two-thirds of immigrants illegally working in the United States don't pay taxes.

But many immigrants currently working illegally still pay into the Social Security system because they have obtained an Individual Taxpayer Identification Number. Moussavian said the number has declined because the Internal Revenue Service has made it harder to apply for the identification number.

The Social Security Administration estimates that out of about 11 immigrants who either entered the U.S. illegally or have overstayed their visas slightly more than 3 million paid payroll taxes of about $6.5 billion in 2010, with their employers contributing another $6.5 billion.

Those payments would not qualify toward the 10 year requirement needed to be eligible for benefits, the administration official said. The official was not authorized to describe the policy by name and spoke on the condition of anonymity.

"It's one of many reasons why they would want to come forward," Moussavian said. "Many immigrants have contributed enormously through payroll taxes and income taxes and they go to programs that they can't currently access." Reported by Huffington Post 2 days ago.

Voyageur Publishing & Events Ltd has acquired EMS Flight Crew, an international community of air medical professionals committed to improving safety through the constructive exchange of information, experiences and ideas.

Bristol, UK (PRWEB UK) 27 November 2014

Voyageur Publishing & Events Ltd (Voyageur) announced today that it has acquired EMS Flight Crew, an international community of air medical professionals committed to improving safety through the constructive exchange of information, experiences and ideas. Created in 2009 by US helicopter emergency medical services (HEMS) pilot Mike Biasatti, EMS Flight Crew is also a leading provider of air medical industry news and jobs.

As the company behind the global print publications Waypoint AirMed & Rescue and the Air Ambulance Review (a supplement to the International Travel & Health Insurance Journal), Voyageur has a wealth of experience in the aeromedical industry. The firm will maintain EMS Flight Crew as a separate brand, ensuring a smooth transition and business as usual for community members.

James Paul Wallis of Voyageur has been appointed community manager to oversee the development and day-to-day running of the emsflightcrew.com website and its related social media pages. Previous owner Jonathan Godfrey, a flight nurse and co-founder of the Association of Air Medical Services Survivors Network, will continue to play an active role in EMS Flight Crew as a lead contributor, as will Stacy Fiscus, a flight paramedic and board member of the International Association of Flight and Critical Care Paramedics.

Ian Cameron, managing director of Voyageur, commented: “EMS Flight Crew is a valuable forum for discussion of issues in the air ambulance industry, so we’re very pleased to be able to bring this into the Voyageur stable. There is some overlap with our existing work, in particular Waypoint AirMed & Rescue, which focuses on all aspects of the civilian and military air rescue community, and we’re looking forward to seeing how these brands can work together to improve our service to the industry.”

Jonathan Godfrey added: “It’s good to see that EMS Flight Crew will be in safe hands. The goal of EMS Flight Crew is to promote safety in the HEMS and fixed-wing air ambulance community around the world, and I’m glad to have the opportunity to continue to contribute to those efforts even after the handover to Voyageur.”

About EMS Flight Crew
EMS Flight Crew is an international community of air medical professionals committed to improving safety through the constructive exchange of information, experiences and ideas, along with being a leading provider of air medical industry news and jobs.
http://www.emsflightcrew.com

About Voyageur Publishing & Events Ltd
Voyageur Publishing & Events Ltd produces international trade magazines Waypoint AirMed & Rescue, the International Travel & Health Insurance Journal (ITIJ) and the Medical Tourism Review (MTR), as well as operating EMS Flight Crew and the Travel Insurance Geek website. The company also hosts the International Travel & Health Insurance Conference (ITIC) series.
http://www.voyageur.co.uk

###

For more information or to arrange an interview, please contact:
James Paul Wallis
Community manager, EMS Flight Crew
Voyageur Publishing and Events Ltd
Phone: +44 (0)117 922 6600 ext 208
Email: jamesw(at)voyageur(dot)co(dot)uk
http://www.voyageur.co.uk Reported by PRWeb 2 days ago.

Filed under: Health Care, Personal Finance, Health Insurance, Financial Education

*shutterstock*

By Lacie Glover

Of the factors to consider when choosing health insurance, your lifestyle is one of the most important. For the modern-day explorer or business road warrior, your frequent travel should be top of mind.

Learning about new cultures and unexpected adventures are part of the thrill of travel, but they also come with risks. Sometimes your destination is not medically equipped, and the unexpected can turn into illness or injury in just the place where you don't have coverage. If you travel frequently for business, getting caught in an unfamiliar city with a medical issue can leave you with a huge bill. Here's how to prevent that by shopping smart during insurance season.

*Domestic Travelers*

One of the most important considerations for travelers is the insurance network, or group of providers that your insurance company agrees to cover. For those who tend to travel only within the United States, a national provider network is key, especially if you travel to multiple locations across the country.

"You want to be able to stay in-network wherever you travel to," says Cindy J. Holtzman, director of Medical Refund Service in Marietta, Georgia, who's also an insurance agent and patient advocate.

If you normally travel to the same locations, make sure your plan includes network providers in those locations. For domestic travelers, this is the best way to save on health care in general, not just emergency care. When you're out of town and have just a mild concern, it's a lot cheaper to visit an independent clinic or urgent care in-network and avoid the emergency room all together.

It's important to note that there may not be network providers in every city you visit. In that case, "check out how any plan covers providers outside the network," Holtzman says.

Some plans cover a portion of costs if you need health care out of their network, but many plans cover none, except in some emergencies. If you have to go out of your network for care, plans that will cover at least a portion of that care are beneficial for travelers.

*International Travelers*

If you travel abroad frequently, you might already be aware that health insurance works differently outside the U.S. In emergencies, some plans may cover a portion of costs, but most cover none at all.

"The easy way to address this is to call the health insurance provider and ask them if they will cover health expenses incurred abroad," says Mahmood Peshimam, a travel medicine specialist in Orange County, California. If not, ask if they have a separate plan specifically for travel.
Don't confuse traveler's health insurance with regular traveler's insurance

Supplemental health insurance that covers international travel is available from some health insurers. It's temporary insurance that covers only the length of one trip and may be cheaper through your main health insurer thanks to member discounts. This is a great question to ask any potential insurer when choosing among plans. Don't confuse traveler's health insurance with regular traveler's insurance, which covers incidents such as cancelled reservations and lost baggage.

Evacuation insurance, also for Americans abroad, can be long-term or short-term and covers transportation to adequate medical care. This type of insurance can help cover charges if you need to be urgently transferred for medical care from a remote area. Plans often cover air rescue expenses and emergency returns back home.

Some evacuation insurance policies also cover emergency health care abroad. Evacuation insurance is available from many health insurers, as well as from independent providers. "Ask your travel agent for companies that will provide overseas health insurance coverage," Peshimam says. He also recommends finding medical facilities in your destination before leaving and carrying that information on your trip.

*Adventure Travel*

Thrill seekers, there are special health insurance considerations for you. Evacuation insurance is probably a good idea for when you climb Mount Everest or go on that skydiving trip, but don't stop there. Take a look at any long-term health insurance plans you're considering for two features: emergency care and high-risk exclusions.

The reason for emergency care is obvious, and for all Affordable Care Act-era plans, it's covered as an essential health benefit. How much emergency care is covered is as variable as the plans themselves. Whether you travel a short distance or across the globe to seek your adrenaline rush, make sure your health insurance plan has comprehensive emergency coverage.

Less obvious is the need for a plan with few high-risk exclusions, probably because you don't know they exist. Many health insurance plans don't cover emergency services due to risky activity or injuries incurred doing activities such as rock climbing and snowboarding. This may not be disclosed on an information sheet when you sign up for insurance, so call your insurer's customer service to ask.

 

Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 1 day ago.

After two years of vilifying the federal health overhaul and the state's health insurance exchange, Minnesota Republicans face Democratic opposition in the Senate and governor's office that will scale back their hopes for a wholesale makeover. Reported by TwinCities.com 19 hours ago.

The industry has been buoyed by the population's increasing acceptance of therapies that are either alternative to conventional Western medicine or complementary to conventional treatments. For this reason, industry research firm IBISWorld has updated its report on the Alternative Health Therapies industry in Australia.

Melbourne, Australia (PRWEB) November 28, 2014

The Alternative Health Therapies industry has undergone healthy growth over the past five years. The industry has been buoyed by the population's increasing acceptance of therapies that are either alternative to conventional Western medicine or complementary to conventional treatments. According to IBISWorld industry analyst David Whytcross, “industry revenue has been further boosted by the ageing population and growing private health insurance membership.” Meanwhile, improving economic conditions following the global financial crisis have also helped stimulate revenue growth over the past five years. Overall, industry revenue is expected to rise by a compound annual 4.0% over the five years through 2014-15, to reach $3.9 billion. Increasing market saturation is projected to result in more subdued 2.6% revenue growth in the current year.

The industry includes many products and services, most of which have grown over the past five years. Australia's ageing population has helped drive revenue growth, as the higher frequency of illness for those over 50 years of age has led many to use alternative health therapy. “This is particularly the case with palliative care, as patients are often treated in tandem with conventional medical practitioners,” says Whytcross. Booming private health insurance membership numbers have also driven growth, as many policies have been offering alternative treatments as part of extras or ancillary cover, diminishing the cost of visiting alternative therapists. Furthermore, increasing discretionary income and consumer sentiment have enabled more consumers to pay the out-of-pocket costs associated with treatments that are not covered by private health insurance. Over the next five years, the efficacy of alternative health therapies is likely to come under spotlight, as most are not scientifically proven. Further research to assess the efficacy of alternative treatments will either help legitimise or disprove many alternative health theories. A Federal Government review into the efficacy of treatments poses a significant threat to the industry. However, with key external trends persisting, industry revenue is expected to continue rising.

The Alternative Health Therapies industry is characterised by a low level of concentration. This is largely due to the significant number of different treatments that are available under the banner of alternative therapies. The majority of operators are sole proprietorships that specialise within a single discipline, preventing them from expanding their market share significantly. The average size of industry establishments is extremely small, indicating the high degree of fragmentation throughout the industry. The industry is estimated to employ only 1.13 workers for each establishment, indicating that the majority of firms are non-employing and run by a single individual. Similar types of establishments are scattered throughout Australia, with few examples of companies having expanded their market share through franchise operations.

For more information, visit IBISWorld’s Alternative Health Therapies industry in Australia report page.

Practitioners in this industry primarily deliver treatments that are not commonly practiced under mainstream Western medicine. These therapies are intended to either complement Western medicine or as an alternative form of treatment. The industry includes treatments such as acupuncture, traditional Chinese medicine, aromatherapy and homeopathy.

Follow IBISWorld on Twitter: http://twitter.com/#!/ibisworldau

IBISWorld industry Report Key Topics

Industry Performance
Executive Summary
Key External Drivers
Current Performance
Industry Outlook
Industry Life Cycle
Products & Markets
Supply Chain
Products & Services
Major Markets
International Trade
Business Locations
Competitive Landscape
Market Share Concentration
Key Success Factors
Cost Structure Benchmarks
Basis of Competition
Barriers to Entry
Industry Globalisation
Major Companies
Operating Conditions
Capital Intensity
Technology & Systems
Revenue Volatility
Regulation & Policy
Industry Assistance
Key Statistics
Industry Data
Annual Change
Key Ratios

About IBISWorld Inc.
Recognised as the nation’s most trusted independent source of industry and market research, IBISWorld offers a comprehensive database of unique information and analysis on every Australian industry. With an extensive online portfolio, valued for its depth and scope, the company equips clients with the insight necessary to make better business decisions. Headquartered in Melbourne, IBISWorld serves a range of business, professional service and government organisations through more than 10 locations worldwide. For more information, visit http://www.ibisworld.com.au or call (03) 9655 3886. Reported by PRWeb 9 hours ago.

Today’s question asks if at ages 60 and 61 and after twenty years of partnership, a couple should marry to take full advantage of the Social Security benefits they would become eligible for. The answer explains what benefits they would become eligible for, outlines a possible way to maximize lifetime Social Security benefits before exploring an alternative plan, and ends by noting potential tax and health insurance advantages. Reported by Forbes.com 8 hours ago.

The President may be allowing immigrants to remain in the U.S., but it doesn't mean their state will let them drive a car, get an education at an affordable rate or obtain health insurance. Reported by nola.com 8 hours ago.

PHOENIX (AP) — If Christian Avila lived a few hundred miles to the west, he would have a driver's license and qualify for in-state college tuition and a host of other opportunities available to young people granted legal status by President Barack Obama two years ago.

But Avila lives in Phoenix, and the 24-year-old immigrant who was brought here from Mexico by his parents at age 9 still has to navigate the sprawling city in fear as he drives to school or work. "You get nervous, your legs start to tingle a little bit when there's a cop behind you, when you're doing nothing wrong by driving to work,' said Avila, a community college student and immigration activist. "You're not breaking any rules, you're following the law. But unfortunately it's where we live."

With last week's action by Obama that expanded the deferred action program and added millions of other immigrants, Avila's plight highlights a harsh reality about the president's changes. The president may be allowing them to remain in the U.S., but it doesn't mean their state will let them drive a car, get an education at an affordable rate or obtain health insurance.

A patchwork of rules began to form in states — largely along political lines — after the president allowed some young immigrants to stay in the country. Conservative states like Nebraska and Arizona kept them from getting driver's licenses while liberal locations were much more welcoming in terms of state services and benefits.

Now, states must make new decisions on how to respond to the president's action that allows millions more immigrants to remain in the U.S.

In California, Democrats, immigration groups and health care advocates are pushing for the immigrants to receive health care under the state's version of the Medicaid program. The California Department of Health Care Services is deciding how to proceed. The president's action excludes immigrants who came to the country illegally from qualifying for federal health benefits.

In Nevada, officials are drawing up a bill for the Legislature making clear that unauthorized immigrants can become teachers in the state. Current rules specify that a prospective teacher must be a U.S. citizen or lawful permanent resident before they can receive a teaching license in Nevada.

A new gubernatorial administration in Arizona will have to decide whether to continue a hard-line approach toward state benefits that outgoing Gov. Jan Brewer took.

After Obama took action in 2012 granting legal status to 1.8 million young people brought to the U.S. as children, Brewer issued an executive order denying them driver's licenses or other state benefits, including in-state tuition at the state's public universities. A federal appeals court ruled the license ban was unconstitutional, and Brewer is considering an appeal to the U.S. Supreme Court.

"Our position is unilateral action by the president does nothing to change the fact that an illegal alien's presence is the United States is not authorized under federal law," Brewer spokesman Andrew Wilder said.

Arizona's Republican Governor-elect, Doug Ducey, has said he intends to continue Brewer's current ban, if it survives court challenges.

Maryland's Democratic governor, Martin O'Malley, has taken a decidedly different tack. He's a supporter of state laws granting in-state tuition to people without legal status and grants them driver's licenses. He has even been willing to get into a policy fight with Obama on the stream of unaccompanied immigrant children from Central America over the Mexican border, criticizing the White House proposal earlier this year that could have expedited the deportation of the children.

Arizona remains an outlier in its treatment of immigrants granted work permits and is among the most harsh when it comes to those who remain in the U.S. without legal authorization.

States surrounding Arizona provide in-state tuition to all residents, regardless of immigration status. And in January, California joins nine other states in allowing immigrants who can't prove they're in the U.S legally to get a driver's license.

Utah provides leniency when it comes to driving privileges and education, despite passing a law in 2011 that mirrored Arizona's landmark immigration crackdown, SB1070. The state issues driving-privilege cards that must be renewed annually for those who cannot prove they're in the country legally.

Nearly 36,300 were issued last year, said Nannette Rolfe, the director of Utah's Driver License Division. Utah also offers in-state tuition at public universities and colleges to residents not in the U.S. legally.

To be eligible, students must have attended a Utah high school for at least three years and earned a diploma or GED. They can't hold a non-immigrant visa and must file an application to legalize their immigration status when eligible to do so. In the 2012-2013 academic students, 929 students took advantage of the program.

Despite the fact that life would be easier if he left the state, Avila said he's staying put.

"This is where we got dirty as kids, this is where we learn how to speak English, this is where we learn how to do a lot of stuff," he said. "Here in Arizona is where my friends, my family, live and I don't see it as an option to run away, but rather stand up and change the conditions that we live under."

___

AP reporters Judy Lin in Sacramento, California, Michelle Price in Salt Lake City, Michelle Rindels in Las Vegas and Brian Witte in Annapolis, Maryland contributed to this report.

___

Follow Bob Christie at http://twitter.com/APChristie. Reported by Huffington Post 5 hours ago.

Do you have questions about the Federal Employees Health Benefits Program (FEHB) open enrollment season?

Walton Francis, chief author of Checkbook’s annual “Guide to Health Plans for Federal Employees & Annuitants,” will join Washington Post Federal Diary columnist Joe Davidson and staff reporter Eric Yoder for an online chat at noon Monday for a discussion about health insurance options available to federal employees and retirees. Open season closes Dec. 8. Reported by Washington Post 4 hours ago.

They stack the odds, still we take to the street
For the kill with the skill to survive
It's the eye of the tiger, it's the thrill of the fight

-SurvivorBLIS http://www.bliscompany.com/ is a fascinating specialty insurance program run by Regi Schindler in Oregon. His customers are people paying for their own weight loss surgery.

Schindler uses the analogy that BLIS is similar to a warranty on a new car. It allow patients the comfort of knowing that if something goes wrong, they won't be by additional medical expenses.

Schindler has some serious skin in the game. If a surgery goes wrong, his company is on the hook. Following the car warranty analogy, it could be the cost of some new wheel cover, but in today's expensive health care world, it might be the cost of a new Mercedes or maybe a fleet of Mercedes with a Cadillac thrown in too.

Schindler is very choosy about who he insures. His data and loss ratio calculations come to the same conclusion: it is not where you do your bariatric surgery. What makes the difference is the surgeon who does the work.

Thus, when they wheel me into the operating room on Monday, December 1 to have gastric sleeve bariatric surgery, Dr. Derek Weiss, one of only three surgeons in Kentucky that BLIS has chosen to insure, will be the one doing the surgery.

The odds are with me. The mortality rate for gastric sleeve is about the same as gallbladder surgery and if I die during surgery, I will be the first death, after thousands of bariatric surgeries, for Dr. Weiss.

I've warned him several times that killing a best-selling author and journalist would not be a good career move for either of us.

Just in case, I've purchased the BLIS insurance. I'm not a smoker or drinker and I've followed Dr. Weiss's instructions on pre-operation preparation to the highest degree. Weiss is my guru, and I am his pupil.

Derek is confident this will go well and his confidence is infectious. Confidence can replace fear in a life or death situation.

*Using Business Skills to Pick an Expert*

Taking care of business, every way
I've been taking care of business, it's all mine
Taking care of business. And working overtime
-Bachman-Turner OverdriveI was a very reluctant candidate for weight loss surgery. Even when I tipped the scales at 374 pounds and was past the point of morbid obesity, I kept looking for a way to avoid an operation. From my decades as a structured settlement consultant and working with trial attorneys, my knowledge of what could go wrong in a bariatric procedure is vast and littered with real life and really dead examples.

So when I got interested in weight loss surgery, I got all in. I told Dr. Weiss that I could do all of his job expect for the actual cutting. A slight exaggeration, but I find myself explaining the gastric sleeve to physicians who are not bariatric surgeons and letting them in on my insights.

I've read over 50 books on the topic, interviewed at least that many people related to the field and came together with an epiphany that will be articulated in my upcoming book, Project 199: My Business Plan for Losing 175 Pounds. https://www.facebook.com/DonMcNayAuthor

The best way to have a successful weight loss surgery is to treat it like a business project. I have definite goals, measurements, objectives, benchmarks, time frames, and a vision on where I want to be within a year.

I want to weigh 199 pounds. That will be a 175-pound loss from where I started in August. I've lost nearly 25 pounds before the surgery just by focusing my mind and habits towards that goal.

I can visualize what life will be like when I get to my goal weight. I can visualize throwing away my blood pressure and blood sugar pills. I can visualize being able to crawl around on the floor with my grandchildren and talk long walks with my wife. I can visualize buying just one airline seat, without a seatbelt extender, and feel comfortable sitting in coach. I visualize walking into a clothing store that carries Armani or Versace suits and knowing they have one in my size. I can visualize living to an old age.

Without a plan, I was frustrated with my overall health and not sure what to do about it. Now I am excited and enthusiastic.

I been in the right place
But it must have been the wrong time
-Dr John

I went into the process of weight loss surgery backwards. My first goal was to get a hospital that would allow me to do it.

My health insurance company, Anthem, does not cover weight loss surgery and it also does not cover the complications of weight loss surgery. I thought that the Affordable Health Care Act would be my way to make it happen, but I live in one of the 23 states where ACA does not cover bariatric surgery. I recently switched to an ACA plan, still with Anthem, but the surgery barriers remain the same. http://www.hhs.gov/healthcare/rights/

Four years ago, I went to a seminar (every bariatric program I makes you sit through a seminar like you are signing up to be a multi-level marketing program) for a hospital based in Central Kentucky, and they made me leave when they found out what kind of health insurance I had. I had to get up and walk out in front of the group.

Sometimes divine providence, combined with someone else's boorish behavior, gets you to the right spot in life. If they had kept me, I would have never heard of BLIS, not been offered the gastric sleeve and not had the opportunity to meet Dr. Derek Weiss.

I'm still a few days from launch, but I am extremely confident it will go well. At least two of the major participants in my potential funeral told me that my dying on December 1 would really mess with their schedules and I needed to live through this. I've been blessed with successful friends and will do my part to keep them on track.

*Any Member Of Your Staff Will NOT Be Able To Assist Me.*

"Hot and cold emotion
Confusing my brain
I could not decide
Between pleasure and pain"
-Samantha Fox

I'm a big believer in experts. The fastest way to irritate me is to say (usually via a voice mail recording), "Any of our fine professionals will be able to assist you." Big corporations like that concept as it allows them to treat employees like throwaway parts. Customers don't develop a personal relationship with staff member s and the corporation is able to promote their brand more than the people who make up that brand.

A life of experience has taught me to connect with the very best experts I can find. In every form of endeavor there is always a handful of experts whose results dwarf others in the same category.

For example, I've been in the structured settlement business for 33 years and can demonstrate over and over again the difference between a good lawyer, a great lawyer, a mediocre lawyer and a bad one.

A good lawyer will get you a good settlement or jury verdict. A great one will usually get a great settlement. A mediocre one earns an okay result and a bad lawyer may get you zero. Or get you thrown in jail.

I had a stretch several years ago when I worked on nine different death cases involving trucks slamming into a car at the exact same intersection. The road was poorly designed and eventually corrected, but each of the nine people that were killed had similar demographics.

Each lived in the same neighborhood. Each was hit by a truck running a stop light. Each death was an individual driver without passengers, and each accident happened in the early morning when the sun was in the truck driver's eyes and the passenger was on their way to work. I don't remember any of the drivers drinking or taking drugs.

All of settlements were confidential, but I was there for the mediations and settlement conferences. Most of the families of the victims had mediocre lawyers and received about $400,000. One had a good lawyer who got about $600,000, and the one who had a superstar attorney received a settlement in the millions.

That family had a true expert. The rest were operating on a system of "any attorney will do" and never knew they could have had 500 percent more.

I can't imagine a more important expert than a doctor. They literally have your life in their hands and a decision they make can have an overwhelming impact on the quality of your life.

I've made it a point to really get to know any medical professional in my life, from the receptionist in my physician's office to every nurse, assistant and other person in the process. An expert can solve a problem that another cannot. Usually they attract good people around them too.

Let's not forget that most aspects of the medical profession are run by big corporations. Thus, most buy into the "any of our staff members will do" approach. It's mostly about money. If doctors become interchangeable parts, it's easier to pay them less and replace them with another without losing customers or market share.

In the bariatric surgery field, the marketing focus is on the facility and not the physician. The facility has massive advertising budgets and public relations experts, and the doctor normally does not.

The American Society for Metabolic and Bariatric Surgery http://asmbs.org/ has a program called the Bariatric Surgery Center of Excellence. It is an excellent idea to weed out surgeons who "dabble" in weight loss surgery from full-time professionals, but the focus is on the hospital and not on the surgeon. The federal government pays for many weight loss surgeries through Medicare, Medicaid and Centers for Medicare and Medicaid Services (CMS) and their rules revolve around facilities not surgeons. Any hospital receiving Medicare and Medicaid money has to be a Level 1 Bariatric Surgery Center or a Center of Excellence.

The mindset of the federal government is the opposite of what BLIS does when it insures surgeries. BLIS is only focused on the surgeon and not the facility.

So who is right?

Being at a Center of Excellence was definitely a consideration for me. There was no way I would be at a facility that did not have that professional standard, but it was a first step and not an only step.

Being a Center of Excellence is an incredible marketing opportunity for the hospital. Ultimately it will, and probably should, result in an outcome where no one but Centers of Excellence can make it in the bariatric business. On the other hand, hospitals can make their reputation on a great run with one set of surgeons, replace them with a lesser group and still maintain their Center of Excellence standing in the short run.

You see an analogy in the financial business. Fidelity had an incredible run with its Magellan mutual fund when Peter Lynch was managing the fund. They moved Lynch to Vice Chairman, which was a dark time in Fidelity's history as the company got into questionable practices like peddling contractual mutual funds with 50 percent commissions to soldiers fighting in the Iraq War. Congress shut down that practice, but in the meantime, Fidelity kept advertising the incredible returns on the Magellan fund long after Lynch was gone. http://articles.centralkynews.com/2008-04-01/news/24934264_1_fidelity-magellan-fidelity-traders-lynch-and-fidelity

Fidelity is one of the most aggressive, but a lot of financial companies do it. The line "past performance is no guarantee of future results" is not just a disclaimer; it is a mantra for how many corporations market. Including hospitals.

I am happy to be having my surgery at a Center of Excellence, but even happier that Dr. Derek Weiss is the one performing the surgery."I can call you Betty
And Betty, when you call me
You can call me Al"
-Paul Simon

I've known a lot of doctors in my life. My mother spent 27 years as an operating room nurse and for my first years in the financial business, all of my clients were doctors. I've learned a lesson about doctors that holds true for almost any professional: the less pretentious they are, the better doctor they are.

People hide behind titles are not people I want to do business with. Usually informal people have more self-confidence and the ability to allow others to buy into their self-belief.

Titles do have a purpose and I let you know about all of mine. I put all of my professional initials behind my name as it is a shorthand way to let people know that I've been to the rodeo and know what I am doing.

On the other hand, I want you to call me Don. My three grandchildren are the only people who refer to me by a title and "grandpa" is the title I've earned.

G. Derek Weiss, MD, FACS, FASMBS is "Derek," not Dr. Weiss. He introduces himself as Derek and prefers it that way. He is friendly but oozes with self-confidence. He is an easy guy to like. http://www.bluegrassbariatrics.com/

Few medical professionals like to interviewed by the media and having a patient is writing a book about their performance can be nerve-racking. The facility where I am having the procedure DOES NOT (let me repeat DOES NOT) want to be mentioned in my writing and since I am a guest in their hospital, I am doing my best to accommodate them.

Derek is the opposite. He's done three interviews with me and spent three hours on a Sunday afternoon answering a plethora of questions, from hardballs to softballs. His answers were 100% dead on and honest.

When you are a journalist or work with trial attorneys, you can get skeptical and cynical. I do both. You see people's worst sides. It's extremely hard to win me over, but Derek has. I buy into his confidence that things will go smoothly and I will be well on my way to better health. I'm three days from the surgery but anticipating it like a child waiting for Santa Claus. I can't wait to it rolling and get my second chance at life started.

Derek is a man of strong opinions and not afraid to clash with those who disagree with his thoughts and beliefs. I've interviewed several of his former patients who adore him and read hundreds of messages on message boards about him. The overwhelming majority like him, and the ones that don't focus more on his strong personality than his surgical skills.

I like Derek as a person, but my most important concern is that he be a great surgeon. I need him to be on top of his game on December 1, but he really doesn't need me to write about him. He doesn't chase publicity. He has patients lined up all day and night. He does not spend any personal money on advertising and doesn't need to. After thousands of procedures, he pushes forward to continuously improve his craft with an intense enthusiasm.

He has been terrific on helping me keep costs down. He is also extremely affordable and highly aware that I am paying for every dime of the medical procedure without the help of my insurance company. The hospital has been helpful on the cost front as well. Picking up my own tab has made me an extremely cost conscious medical consumer and I am thrilled that my cost are dramatically less than others I am seeing on online message boards like www.bariatricpal.com. In fact, they are in the range of people who are going to other countries like Mexico to get the surgery done more cheaply.

The main thing you get from Derek is his zest for living. Derek Weiss loves being Derek Weiss, and it shows in his infectious zeal for his work. He is a great surgeon and I have done incredible and extensive research to make that statement. Even if I had not done the spadework, I would have guessed on our first meeting that Derek is a master of his craft.

Weiss talks about bariatric surgery the way that some people talk about sex, money or their grandchildren. It is his passion. He bubbles with enthusiasm and recognizes that his profession gives people a second chance at life.

Weiss was born into the surgical business. His father was a surgeon at the military base at Fort Knox and his mother was an operating room nurse. He grew up in Louisville, was Magna Cum Laude in Biochemistry at Dartmouth, was in the top 10 percent of his class at the University of Louisville Medical School and did his surgical training (residency) at Emory University where he worked under Dr. John Hunter, an internationally known leader in laparoscopy.

Derek brought his laparoscopy skills back to Louisville and spent eight years as a successful general surgeon when Dr. Tom Lavin, one of the nation's most successful bariatric surgeons, asked Derek to move just outside New Orleans to join his booming weight loss practice.

Weiss has incredible respect and admiration for Dr. Lavin, who he has praised lavishly in every conversation that I have had with Derek. My wife is President of the Ursuline Academy, the oldest all-girls school in the United States, based in New Orleans, and I suspect the Kentucky to New Orleans connection plays into our multiple conversations about Dr. Lavin. http://www.whyweight.com

Weiss would have been happy spending his career in New Orleans, but a big opportunity came up for him to come home to Kentucky and partner with another surgeon in the bariatric field. They were together for several years and dominated bariatric surgery in Kentucky. His former partner now practices in Louisville, while Derek focuses on Lexington and Central Kentucky.

Derek fits all my criteria for an expert. He is well-educated, passionate about his craft, continuously learning, connected to other top experts and sees his work as his calling, not an occupation.

I want a surgeon who can't wait to get up and get into the operating room. Since I am scheduled to be his first patient on Monday, I definitely want him to be enthusiastic about mine. He will be, but he also maintains that enthusiasm for everyone else he operates on. I recognize that I will probably get VIP treatment but he assures me that every patient gets that same level of care. I've talked to enough of his former patients to recognize that is true.

I went from a horrible fear and dread of the gastric sleeve surgery to anticipation. Not about the actual surgery, but the idea that I will recover quickly and be on a life journey that will allow me to give back and make a difference.

Like Dr. Derek Weiss is doing.

(You can track me on twitter @donmcnay and see how thing are going. I'll post as soon as I get out of recovery on Monday December 1. ) Please offer your prayers and wish me luck.

Don McNay CLU, CHFC, MSFS, CSSC is a best-selling author and has been an award-winning syndicated business columnist. He is the founder of McNay Consulting www.mcnayconsulting.com and McNay Settlement Group http://www.mcnay.com He lives in Lexington, Kentucky and also in New Orleans. He is a member of the Eastern Kentucky University Hall of Distinguished Alumni and current a Director on their Foundation Board. He has Masters Degrees from Vanderbilt University and the American College

For More Information:

BLIS Insurance http://www.bliscompany.com

Don McNay http://www.mcnay.com

Dr. Derek Weiss http://www.bluegrassbariatrics.com/

Dr Thomas Lavin http://www.whyweight.com/

American Society of Metabolic and Bariatric Surgery http://asmbs.org/

Dr John Hunter and history of Emory Department of Surgery http://www.surgery.emory.edu/centers/endosurgery_unit/history.html

Ursuline Academy of New Orleans www.ursulineneworleans.org

Peter Lynch and the Culture of Greed http://articles.centralkynews.com/2008-04-01/news/24934264_1_fidelity-magellan-fidelity-traders-lynch-and-fidelity

Affordable Health Care Act http://www.hhs.gov/healthcare/rights/ Reported by Huffington Post 3 hours ago.

As the Obama administration sells Obamacare plans on Black Friday, more Americans and their family members are putting off getting medical treatment because of high out-of-pocket costs after the "Affordable Care Act" was implemented last year.

According to this year's Gallup survey, 33% of Americans "say they have put off getting medical treatment that they or their family members need because of cost," which is "among the highest readings in the 14-year history of Gallup asking the question."

Since 2001, Gallup "has asked Americans each November if they have put off any sort of medical treatment for themselves or their families in the past 12 months" and many hoped last year "that the opening of the government healthcare exchanges and the resulting increase in the number of Americans with health insurance would enable more people to seek medical treatment."

"But, despite a drop in the uninsured rate, a slightly higher percentage of Americans than in previous years report having put off medical treatment, suggesting that the Affordable Care Act has not immediately affected this measure," Gallup concluded, citing the potential "high deductibles or copays that are part of the newly insured's plans."



Looking for a good deal this #BlackFriday? Sign up for a quality, affordable health care plan at http://t.co/JxkdfixJNs. #GetCovered

— The White House (@WhiteHouse) November 28, 2014

As Gallup notes, "one of the goals of opening the government exchanges was to enable more Americans to get health insurance to help cover the costs of needed medical treatments," but "while many Americans have gained insurance, there has been no downturn in the percentage who say they have had to put off needed medical treatment because of cost."

The survey found that the "percentage of Americans with private health insurance who report putting off medical treatment because of cost has increased from 25% in 2013 to 34% in 2014." Gallup found that "more than half of the uninsured (57%) have put off treatment, compared with 34% with private insurance and 22% with Medicare or Medicaid." 

In addition, Gallup found that while the percentage of lower-income Americans (those with annual household incomes under $30,000) who reported putting off medical treatment decreased from 43% in 2013 to 35% this year, the percentage of upper-income Americans (those making more than $75,000 a year) delaying treatment increased from 17% in 2013 to 28%, as did the percentage of middle-income Americans (those making $30,000 to $74,999 a year) who put off treatment (33% in 2013 to 38%). 

Twenty-two percent of "Americans say they have put off medical treatment for a 'very' or 'somewhat serious' condition," which is "double the 11% who say they have put off treatment for a non-serious condition."

The Gallup poll was conducted Nov. 6-9. Reported by Breitbart 2 hours ago.

NEW YORK (Reuters) - New York state health officials have stopped a nonprofit group from providing free medical care to thousands of patients lacking health insurance during a four-day dental conference that starts Friday.  Reported by Reuters 1 hour ago.

AUSTIN, Texas, Nov. 28, 2014 /PRNewswire/ -- The Affordable Care Act or Obamacare requires most Americans to obtain some kind of health insurance coverage starting in 2014. It is designed to protect consumers from insurance company worst-practices – like denying coverage... Reported by PR Newswire 54 minutes ago.

Software company Zenefits has become the fastest-growing startup in recent memory by upending the health insurance industry. That's because this high-tech startup is also a health insurance broker, working as the middleman between businesses and health care providers. Reported by San Jose Mercury News 17 hours ago.

*Does high risk health care mean a hefty cost?*

*Q. *I have several serious pre-existing conditions that would have precluded my getting private insurance before the Affordable Care Act. I’m not eligible for Medicare, and now I need my own insurance. I know I can’t be completely denied coverage, but is there a cap on premiums for high-risk policies?—Roma Barnett, via e-mail

*A. *Under the Affordable Care Act, insurance companies are legally forbidden from charging people extra for having a pre-existing condition. In fact, when you apply for private coverage, you won’t even be asked any questions about your health history. Instead, you’ll be charged the same premium for your chosen health plan as anyone else your age.

For one-stop shopping for health-insurance info—from choosing the right plan for your needs to making the transition to Medicare—go to ConsumerReports.org/cro/health/health-insurance.

*Send your questions to ConsumerReports.org/askourexperts.*

This article also appeared in the January 2015 issue of Consumer Reports magazine.

*Consumer Reports has no relationship with any advertisers on this website. Copyright © 2006-2014 Consumers Union of U.S.*

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