The health insurance industry says companies will give consumers more time to pay January's premiums under President Barack Obama's health care law. The move is an
Reported by CapitalBay 1 day ago.
Insurers ease 'Obamacare' deadline
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Fort Lauderdale Drug and Alcohol Rehab Provides Safe Haven to New Jersey Addicts to Escape the Holiday Stress and Cold Weather
Cornerstone Recovery Center offers a sunny and warm alternative for New Jersey residents needing treatment for heroin addiction during the winter holidays.
Fort Lauderdale, Florida (PRWEB) December 16, 2014
The State of New Jersey has been battling a prescription drug problem, and now faces a serious heroin problem. Abuse of Oxycontin and other prescription painkillers are highly addictive and were once readily available. When authorities enacted laws making the prescription pain killers much harder to acquire, many addicts began using heroin because the street drug is easier to get and allowed those addicted to painkillers to achieve a stronger high for less money. Dealers made it easy by delivering heroin to the suburbs where the prescription epidemic was ballooning. New Jersey Detective Sgt. Richard Gonzalez called the opiate addiction in the state “an epidemic”. The addiction problem is only getting worse, as numbers of admitted heroin addicts between the ages of 18 and 25 rose by more than 12% from 2010 to 2011. Heroin is a very dangerous drug and rehab is almost always necessary for this type of addiction. Deaths from heroin and prescription drugs in Ocean City, New Jersey alone doubled in 2013.
Cornerstone Recovery Center in Ft. Lauderdale, Florida recognizes the need to offer New Jersey residents a place to receive alcohol and drug treatment in a warm, sunny and nurturing atmosphere. Since heroin addiction has become such a problem in New Jersey, Cornerstone is committed to offering a refuge to New Jersey heroin addicts seeking treatment. The year round warm weather in South Florida adds to the appeal for northerners looking to enter a rehab for treatment. Stepping outside of the environment has been known to increase the recovery rate when patients are not tempted by familiar locations and familiar faces that contributed to their addiction in the first place.
Cornerstone operates a newly renovated housing facility located on the Intracoastal Waterway, just steps from the beach. It is a completely remodeled live-in location with transportation provided between the residence and the drug treatment center. Cornerstone Recovery Center director of admissions, Ryan Johnston, explains, “We invite New Jersey residents seeking addiction treatment to come out of the snow and into Florida’s warm sunshine. When recovery patients can focus on themselves and their treatment, it leads to a successful road back to health. Our goal is to keep your costs to a minimum with little or no out-of-pocket expenses." Now that health insurance provides equal coverage for addiction treatment and physical illnesses, clients have the peace of mind of receiving the proper treatment without worrying about the cost of rehab.
About Cornerstone Recovery Center
Located in Fort Lauderdale, Florida, Cornerstone Recovery Center is a Joint Commission-accredited drug and alcohol rehab that provides individualized addiction treatment for those suffering from alcoholism, drug addiction and other forms of substance abuse. Cornerstone is committed to working with family members and clients to ensure that everyone affected by the disease of addiction is treated with compassion and empathy. For information about Cornerstone Recovery Center, addiction information, alcohol addiction treatment, drug addiction treatment programs, and relapse prevention, visit cornerstonerecoverycenter.com or call 1-888-711-0354 to speak confidentially with an admissions counselor today. Reported by PRWeb 1 day ago.
Fort Lauderdale, Florida (PRWEB) December 16, 2014
The State of New Jersey has been battling a prescription drug problem, and now faces a serious heroin problem. Abuse of Oxycontin and other prescription painkillers are highly addictive and were once readily available. When authorities enacted laws making the prescription pain killers much harder to acquire, many addicts began using heroin because the street drug is easier to get and allowed those addicted to painkillers to achieve a stronger high for less money. Dealers made it easy by delivering heroin to the suburbs where the prescription epidemic was ballooning. New Jersey Detective Sgt. Richard Gonzalez called the opiate addiction in the state “an epidemic”. The addiction problem is only getting worse, as numbers of admitted heroin addicts between the ages of 18 and 25 rose by more than 12% from 2010 to 2011. Heroin is a very dangerous drug and rehab is almost always necessary for this type of addiction. Deaths from heroin and prescription drugs in Ocean City, New Jersey alone doubled in 2013.
Cornerstone Recovery Center in Ft. Lauderdale, Florida recognizes the need to offer New Jersey residents a place to receive alcohol and drug treatment in a warm, sunny and nurturing atmosphere. Since heroin addiction has become such a problem in New Jersey, Cornerstone is committed to offering a refuge to New Jersey heroin addicts seeking treatment. The year round warm weather in South Florida adds to the appeal for northerners looking to enter a rehab for treatment. Stepping outside of the environment has been known to increase the recovery rate when patients are not tempted by familiar locations and familiar faces that contributed to their addiction in the first place.
Cornerstone operates a newly renovated housing facility located on the Intracoastal Waterway, just steps from the beach. It is a completely remodeled live-in location with transportation provided between the residence and the drug treatment center. Cornerstone Recovery Center director of admissions, Ryan Johnston, explains, “We invite New Jersey residents seeking addiction treatment to come out of the snow and into Florida’s warm sunshine. When recovery patients can focus on themselves and their treatment, it leads to a successful road back to health. Our goal is to keep your costs to a minimum with little or no out-of-pocket expenses." Now that health insurance provides equal coverage for addiction treatment and physical illnesses, clients have the peace of mind of receiving the proper treatment without worrying about the cost of rehab.
About Cornerstone Recovery Center
Located in Fort Lauderdale, Florida, Cornerstone Recovery Center is a Joint Commission-accredited drug and alcohol rehab that provides individualized addiction treatment for those suffering from alcoholism, drug addiction and other forms of substance abuse. Cornerstone is committed to working with family members and clients to ensure that everyone affected by the disease of addiction is treated with compassion and empathy. For information about Cornerstone Recovery Center, addiction information, alcohol addiction treatment, drug addiction treatment programs, and relapse prevention, visit cornerstonerecoverycenter.com or call 1-888-711-0354 to speak confidentially with an admissions counselor today. Reported by PRWeb 1 day ago.
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APNewsBreak: Insurers ease 'Obamacare' deadline
WASHINGTON (AP) — Trying to head off a new round of consumer headaches with President Barack Obama's health care law, the insurance industry says it will give customers more time to pay their premiums for January. America's Health Insurance Plans, the main industry trade group, says the voluntary steps include a commitment to promptly refund any overpayments by consumers who switched plans and may have gotten double-billed by mistake. Though the HealthCare.gov website is working far better this year, the industry announcement highlights behind-the-scenes technical issues between the government and insurers that have proven difficult to resolve. The industry "wants to do everything we can to make sure consumers have greater peace of mind about their health care coverage and support them throughout the open enrollment process," Karen Ignagni, head of the trade group, said in a statement to The Associated Press.
Reported by SeattlePI.com 1 day ago.
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hipaapoliciesandprocedures.com Announces Launch of 2015 HIPAA Security Rule Toolkit for Covered Entities and Business Associates in North America
Healthcare organizations can now instantly download the HIPAA Security Rule Toolkit from the regulatory compliance leaders at hipaapoliciesandprocedures.com. Packed with hundreds of pages of high-quality policies, procedures, and security awareness training material, the HIPAA Security Rule Toolkit is absolutely vital for ensuring compliance with the Health Insurance Portability and Accountability Act.
Seattle, WA (PRWEB) December 16, 2014
Healthcare organizations can now instantly download the HIPAA Security Rule Toolkit from the regulatory compliance leaders at hipaapoliciesandprocedures.com. Packed with hundreds of pages of high-quality policies, procedures, and security awareness training material, the HIPAA Security Rule Toolkit is absolutely vital for ensuring compliance with the Health Insurance Portability and Accountability Act. Available for instant download, the HIPAA Security & Privacy Compliance Toolkit (HSPCT) includes the following sections:· HIPAA Information Security Policies and Procedures Manual
· HIPAA Information Systems Hardening Checklists
· HIPAA Disaster Recovery Plan
· HIPAA Handbook & Reference Manual
· HIPAA Security Awareness Training PowerPoint (PPT) Presentation
· HIPAA Security Awareness Training Manual & Employee Quiz
· HIPAA Security Rule & Privacy Rule Checklist & Readiness Assessment
· HIPAA Risk Assessment Template
· Essential HIPAA Forms
· Additional HIPAA Policies and Procedures
· And much more!
The regulatory compliance landscape is growing larger every day, ultimately forcing Covered Entities (CE), Business Associates (BA), and all other healthcare providers to get serious about ensuring the safety and security of Protected Health Information (PHI). There’s no reason to spend hundreds of hours and thousands of dollars developing HIPAA compliance policy documentation – all that’s needed is the HIPAA Security & Privacy Compliance Toolkit (HSPCT). Download the industry leading HIPAA Toolkit packets today from the compliance leaders at hipaapoliciesandprocedures.com. Reported by PRWeb 23 hours ago.
Seattle, WA (PRWEB) December 16, 2014
Healthcare organizations can now instantly download the HIPAA Security Rule Toolkit from the regulatory compliance leaders at hipaapoliciesandprocedures.com. Packed with hundreds of pages of high-quality policies, procedures, and security awareness training material, the HIPAA Security Rule Toolkit is absolutely vital for ensuring compliance with the Health Insurance Portability and Accountability Act. Available for instant download, the HIPAA Security & Privacy Compliance Toolkit (HSPCT) includes the following sections:· HIPAA Information Security Policies and Procedures Manual
· HIPAA Information Systems Hardening Checklists
· HIPAA Disaster Recovery Plan
· HIPAA Handbook & Reference Manual
· HIPAA Security Awareness Training PowerPoint (PPT) Presentation
· HIPAA Security Awareness Training Manual & Employee Quiz
· HIPAA Security Rule & Privacy Rule Checklist & Readiness Assessment
· HIPAA Risk Assessment Template
· Essential HIPAA Forms
· Additional HIPAA Policies and Procedures
· And much more!
The regulatory compliance landscape is growing larger every day, ultimately forcing Covered Entities (CE), Business Associates (BA), and all other healthcare providers to get serious about ensuring the safety and security of Protected Health Information (PHI). There’s no reason to spend hundreds of hours and thousands of dollars developing HIPAA compliance policy documentation – all that’s needed is the HIPAA Security & Privacy Compliance Toolkit (HSPCT). Download the industry leading HIPAA Toolkit packets today from the compliance leaders at hipaapoliciesandprocedures.com. Reported by PRWeb 23 hours ago.
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5 Types of Reports About You That You Don't Know About
Filed under: Personal Finance, Credit Reports, Consumer Protection, SavingBy Maryalene LaPonsie
When you apply for a credit card, you can be virtually assured the card issuer is pulling your credit file from one of the big three reporting agencies: Experian, TransUnion or Equifax (EFX). But what happens when you fill out an application to rent an apartment? Or apply for life insurance? Or try to write a check? Is anyone checking up on you then?
The answer may be yes. In all those cases, a business might be pulling a specialty report that could determine whether you get the apartment, the life insurance policy or the privilege of handing over one of your super-cute Hello Kitty checks. The Consumer Financial Protection Bureau has a comprehensive list of all the major organizations maintaining files on you. You might want to see what they know.
*1. Medical Reports*
Your doctor may not be the only person who has a medical file on you. Several companies also maintain reports that could contain bits of your medical information.
The most commonly used medical report may be the one from MIB, an organization previously known as the Medical Information Bureau. MIB reports are used by insurance companies offering individually underwritten life, health, critical illness, disability and long-term-care insurance products.
The organization doesn't maintain a full medical record on you but does compile data taken from insurance applications made in the past seven years. Information gleaned from MIB reports cannot be used to make coverage decisions but can be used to fact-check your applications and make sure you're not withholding information.
For example, if you're denied life insurance by Company A because of a pre-existing condition, the MIB file may note the condition. That makes it hard for you to conceal that information from Company B, lest you think you could get coverage by simply omitting that detail about your medical history.
You can get a copy of your MIB report free by making a request online or on the phone. MedPoint and IntelliScript are two other medical files you should know. Both may be reporting on your prescription drug usage. You can request your IntelliScript report by calling 877-211-4816. MedPoint will take your request at 888-206-0335. However, they will only send a free report if you applied for health insurance, and the insurer requested your file.
*2. Insurance Reports*
LexisNexis and Verisk Analytics are the two major players for insurance reports for property coverage such as homeowner or vehicle policies.
The LexisNexis CLUE Report comes in either an auto or personal property version. They contain seven years of data, including both claims and inquiry history. You can request one or both of the reports on the LexisNexis website.
Over at Verisk Analytics, A-Plus Property Reports cover a five-year period and include all forms of loss from burglaries to fire losses to medical payments. You can request a copy by calling 800-709-8842. There may be a small fee for the report unless an insurance company took adverse action against you because of the report (i.e,. denied you coverage because of information in the file). In that case, the form may be free as long as you file the request within 60 days of the adverse action.
*3. Employment Data Reports*
Employment reports may include this information:
· Job title.
· Salary.
· Employment dates.
· Disciplinary action, if publicly available.
Dozens of companies provide pre-employment screening services. Here's a sampling, along with links to their instructions on how to request your copy of their report:
· EmployeeScreenIQ.
· Verifications.
· The Work Number.
· HireRight.
· First Advantage.
Not every company will have a report on every employee. In some cases, a report will be available only if an employer previously requested a copy.
*4. Tenant Reports*
Just as you can't get away from your family medical history or a pre-existing condition when applying for life insurance, you may not be able to run away from that eviction you experienced when the economy tanked.
A piece of your rental history might end up on your credit report if you're sued for back payments, but a tenant report is more likely to show the whole picture. According to the New York State Bar Association, there are hundreds of screening agencies catering to landlords. These reports may cover these details or other information:
· Credit information such as delinquent accounts, charge-offs and collections accounts.
· Criminal records.
· Eviction records.
· Sex offender status.
· Social Security check.
· Previous address check.
Unfortunately, not all screening services will provide tenants with a copy of their report, despite the fact that the Federal Trade Commission has warned some companies they must comply with the Fair Credit Reporting Act. For example, TenantReports.com includes this information in its FAQs.
Q) My applicant is claiming discrepancies in their tenant report and would like a copy of the credit report for their reference; do I need to supply them with a copy?
A) All tenant reports requested through TenantReports.com are for our members to review to make a rental decision or new hire decision only. These reports are NOT available to distribute to the applicant. Applicants can get a free annual credit report through the Fair Credit Reporting Act once a year by visiting www.AnnualCreditReport.com. At this site they can dispute all discrepancies with the three bureaus and have the ability to make a permanent change to their credit report.
However, TenantReports.com provides information on its report, such as criminal records, that wouldn't appear on a credit report. That makes their answer seem, in my personal opinion, a bit more evasive than helpful. While not every tenant screening company is onboard with providing copies of its reports, you can request your file from these companies, among others:
· CICReports.
· Tenant Data.
· LexisNexis Personal Reports.
· Experian RentBureau.
*5. Check Writing Reports*
If you're in love with your debit card and online banking, it may seem quaint to think some people still write checks. But they do. And there are some businesses that don't want to take those people's checks if they've written bad ones in the past.
Check writing reports may affect your ability to write checks and your chances of opening new accounts. For example, some reports may include whether you've ever had a bank close your account due to insufficient funds. In that case, a different institution may decline to let you open an account there. You may be able to request free check writing reports from these companies:
· Early Warning.
· Certegy.
· ChexSystems.
· First Data TeleCheck.
Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 23 hours ago.
When you apply for a credit card, you can be virtually assured the card issuer is pulling your credit file from one of the big three reporting agencies: Experian, TransUnion or Equifax (EFX). But what happens when you fill out an application to rent an apartment? Or apply for life insurance? Or try to write a check? Is anyone checking up on you then?
The answer may be yes. In all those cases, a business might be pulling a specialty report that could determine whether you get the apartment, the life insurance policy or the privilege of handing over one of your super-cute Hello Kitty checks. The Consumer Financial Protection Bureau has a comprehensive list of all the major organizations maintaining files on you. You might want to see what they know.
*1. Medical Reports*
Your doctor may not be the only person who has a medical file on you. Several companies also maintain reports that could contain bits of your medical information.
The most commonly used medical report may be the one from MIB, an organization previously known as the Medical Information Bureau. MIB reports are used by insurance companies offering individually underwritten life, health, critical illness, disability and long-term-care insurance products.
The organization doesn't maintain a full medical record on you but does compile data taken from insurance applications made in the past seven years. Information gleaned from MIB reports cannot be used to make coverage decisions but can be used to fact-check your applications and make sure you're not withholding information.
For example, if you're denied life insurance by Company A because of a pre-existing condition, the MIB file may note the condition. That makes it hard for you to conceal that information from Company B, lest you think you could get coverage by simply omitting that detail about your medical history.
You can get a copy of your MIB report free by making a request online or on the phone. MedPoint and IntelliScript are two other medical files you should know. Both may be reporting on your prescription drug usage. You can request your IntelliScript report by calling 877-211-4816. MedPoint will take your request at 888-206-0335. However, they will only send a free report if you applied for health insurance, and the insurer requested your file.
*2. Insurance Reports*
LexisNexis and Verisk Analytics are the two major players for insurance reports for property coverage such as homeowner or vehicle policies.
The LexisNexis CLUE Report comes in either an auto or personal property version. They contain seven years of data, including both claims and inquiry history. You can request one or both of the reports on the LexisNexis website.
Over at Verisk Analytics, A-Plus Property Reports cover a five-year period and include all forms of loss from burglaries to fire losses to medical payments. You can request a copy by calling 800-709-8842. There may be a small fee for the report unless an insurance company took adverse action against you because of the report (i.e,. denied you coverage because of information in the file). In that case, the form may be free as long as you file the request within 60 days of the adverse action.
*3. Employment Data Reports*
Employment reports may include this information:
· Job title.
· Salary.
· Employment dates.
· Disciplinary action, if publicly available.
Dozens of companies provide pre-employment screening services. Here's a sampling, along with links to their instructions on how to request your copy of their report:
· EmployeeScreenIQ.
· Verifications.
· The Work Number.
· HireRight.
· First Advantage.
Not every company will have a report on every employee. In some cases, a report will be available only if an employer previously requested a copy.
*4. Tenant Reports*
Just as you can't get away from your family medical history or a pre-existing condition when applying for life insurance, you may not be able to run away from that eviction you experienced when the economy tanked.
A piece of your rental history might end up on your credit report if you're sued for back payments, but a tenant report is more likely to show the whole picture. According to the New York State Bar Association, there are hundreds of screening agencies catering to landlords. These reports may cover these details or other information:
· Credit information such as delinquent accounts, charge-offs and collections accounts.
· Criminal records.
· Eviction records.
· Sex offender status.
· Social Security check.
· Previous address check.
Unfortunately, not all screening services will provide tenants with a copy of their report, despite the fact that the Federal Trade Commission has warned some companies they must comply with the Fair Credit Reporting Act. For example, TenantReports.com includes this information in its FAQs.
Q) My applicant is claiming discrepancies in their tenant report and would like a copy of the credit report for their reference; do I need to supply them with a copy?
A) All tenant reports requested through TenantReports.com are for our members to review to make a rental decision or new hire decision only. These reports are NOT available to distribute to the applicant. Applicants can get a free annual credit report through the Fair Credit Reporting Act once a year by visiting www.AnnualCreditReport.com. At this site they can dispute all discrepancies with the three bureaus and have the ability to make a permanent change to their credit report.
However, TenantReports.com provides information on its report, such as criminal records, that wouldn't appear on a credit report. That makes their answer seem, in my personal opinion, a bit more evasive than helpful. While not every tenant screening company is onboard with providing copies of its reports, you can request your file from these companies, among others:
· CICReports.
· Tenant Data.
· LexisNexis Personal Reports.
· Experian RentBureau.
*5. Check Writing Reports*
If you're in love with your debit card and online banking, it may seem quaint to think some people still write checks. But they do. And there are some businesses that don't want to take those people's checks if they've written bad ones in the past.
Check writing reports may affect your ability to write checks and your chances of opening new accounts. For example, some reports may include whether you've ever had a bank close your account due to insufficient funds. In that case, a different institution may decline to let you open an account there. You may be able to request free check writing reports from these companies:
· Early Warning.
· Certegy.
· ChexSystems.
· First Data TeleCheck.
Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 23 hours ago.
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Obamacare Website Drops 'Keep Your Current Plan' Promise
The federal government no longer promises consumers that they can keep their old health insurance plans under Obamacare - a promise first promulgated on the now defunct HealthReform.gov site, The Daily Caller reports.
Reported by Newsmax 20 hours ago.
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Chris Christie Prediction: 'In 2017, There Won't Be Obamacare'
New Jersey Governor Chris Christie suggested that by 2017, Obamacare would be repealed if a Republican wins the presidency and Republicans maintain the majority in the House and Senate.Christie made his remarks during his monthly Ask the Governor show on New Jersey radio station 101.5.
The host of the show pointed out that premiums for health insurance were actually going up as high as 13 percent.
“Yeah, it doesn’t work. There’s a shock. It doesn’t work,” Christie shot back, highlighting that people were not being allowed to keep their doctor or their health plan as President Obama promised.
Christie predicted that the healthcare system would only get worse.
“By the way, all the bad stuff hasn’t even happened yet,” he said pointing to parts of the law that had been deferred by the Obama administration. “People aren’t happy now. Imagine when all the bad stuff kicks in; people are going to be absolutely enraged over this thing,” he added.
Discussing the controversy engulfing Jonathan Gruber’s congressional hearing, Christie said that “his big sin is that he told the truth and got caught doing it.”
Christie said that Obama exhibited “extraordinary overreach” by pushing through his plan, and he suggested that Democrats would suffer politically.
“I think there will be a Republican president, there could very well be a Republican Congress, and if that’s the case, in 2017, there won’t be Obamacare,” Christie predicted.
“Is it going to be you?” asked the host, referring to a possible presidential run.
“Oh, what do I know?” Christie replied. “We’ll see.” Reported by Breitbart 20 hours ago.
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Mark Farrah Associates: Market Data for Health Insurance Business
KENNEBUNK, Maine, Dec. 16, 2014 /PRNewswire/ -- The changing health insurance landscape is driving an uptick in the use of market data for business analysis. According to Mark Farrah Associates, the Affordable Care Act (ACA) and shift toward consumer-focused products have increased...
Reported by PR Newswire 19 hours ago.
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United States: Weekly Washington Healthcare Update - December 8, 2014 - McGuireWoods LLP
On Dec. 3, the Energy and Commerce Subcommittee on Health held a hearing entitled "The Future of the Children's Health Insurance Program".
Reported by Mondaq 19 hours ago.
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PlanCompass.com Helps Consumers Find a Health Plan and Keep Their Doctors — in Seconds
CLIFTON, N.J.--(BUSINESS WIRE)--Plancompass.com, powered by a new, national provider directory, has been launched to help consumers choose health insurance that lets them keep the doctors they prefer under the Affordable Care Act.
Reported by Business Wire 19 hours ago.
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Oregon's Health CO-OP continues to bring Democracy And the Member's Voice to Health Insurance
PORTLAND, Ore., Dec. 16, 2014 /PRNewswire/ -- When the federal government authorized the creation of Consumer Operated and Oriented Plans (co-ops), their hope was that the new organizations would spur innovation, create competition, and give consumers greater say. In Oregon this hope...
Reported by PR Newswire 19 hours ago.
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Small biz shift workers to Obamacare
How many other owners shift their workers to Obamacare will help set the future of small business health insurance.
Reported by CNNMoney 17 hours ago.
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Virtual Clipboard Initiative Launched to Streamline Patient Intake and Eliminate Wasteful Administrative processes
New Virtual Clipboard pilot to focus on enhancing information access and exchange while ensuring security.
RESTON, Va. (PRWEB) December 16, 2014
The Workgroup for Electronic Data Interchange (WEDI) in partnership with the Sullivan Institute for Healthcare Innovation, the Healthcare Information and Management Systems Society (HIMSS) and the Medical Group Management Association (MGMA), assembled more than 40 representatives from major health plans, providers, health IT vendors, healthcare organizations and the Office of the National Coordinator for Health Information Technology (ONC) in an effort to develop an effective and consistent industry blueprint for a virtual clipboard mobile application. This meeting was the first step of a campaign to develop and pilot an effective and consistent industry blueprint for the patient intake process, including automating the collection of critical health insurance and demographic information.
“We’ve been talking about the importance of shifting to a paperless healthcare environment for years but the patient intake process is still mired in the ‘70s. Not only does the current process add unnecessary costs in the system, but it can lead to treatment complications due to inaccurate or incomplete health records,” said Devin Jopp, Ed.D., president and CEO of WEDI. “Through a collaboration driven by WEDI, the Sullivan Institute for Health Innovation and our other partners, we are committed to moving away from the existing routine of clipboards, photocopiers and manual keystrokes, and toward use of a patient-friendly virtual clipboard.”
The initiative will focus on identifying and promoting effective and actionable electronic approaches to patient information capture, maintenance and dissemination that leverage mobile devices and "smart" technologies and applications. The goal of the first phase of the pilot will be to allow patients to submit all of their pertinent health insurance and demographic information and other intake data through an easy-to-use and standardized mobile approach. The second phase of the pilot is expected to consist of patients being able to exchange essential health information – including medication reconciliation and allergies – in a digital format at the time of check-in with their provider.
“Physician practices currently must deal with numerous proprietary approaches to health insurance cards, lack of automated solutions, and challenges associated with collecting and recording accurate patient data,” said Anders M. Gilberg, senior vice president, government affairs, for MGMA. “This important initiative has the potential of significantly improving the patient intake process, currently an overly burdensome and costly component of the healthcare system. We commend the Sullivan Institute for Healthcare Innovation for taking on the formidable task of bringing key stakeholders together in this effort to reduce administrative inefficiencies.”
“For years, HIMSS has worked with its members on patient record matching and patient data integrity,” said Lisa Gallagher, vice president, technology solutions at HIMSS. “We anticipate that this project will address data quality in a significant way and deliver a near-term, real solution for patients and the industry alike.”
About WEDI
The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency, and reduce costs of our nation’s healthcare system. WEDI was formed in 1991 by the Secretary of Health and Human Services (HHS) and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations, and standards development organizations. To learn more, visit http://www.wedi.org and connect with us on Twitter, Facebook and LinkedIn.
About the Sullivan Institute
In 1993, the original WEDI Report brought together public and private industry to develop a roadmap for healthcare information exchange. In 2013, on the 20th anniversary of that original report and with Then Honorable Louis W. Sullivan, M.D.’s leadership, WEDI developed a new report which laid out the future of healthcare information exchange. The Louis W. Sullivan Institute for Healthcare Innovation is a 501(c)(3) non-profit organization, named in honor of The Honorable Louis W. Sullivan, M.D. Its mission is to bring healthcare leaders together to share knowledge needed to transform the quality and efficiency of healthcare delivery through education, cooperation, communication and innovation. To learn more, visit http://www.sullivaninstitute.org. Reported by PRWeb 18 hours ago.
RESTON, Va. (PRWEB) December 16, 2014
The Workgroup for Electronic Data Interchange (WEDI) in partnership with the Sullivan Institute for Healthcare Innovation, the Healthcare Information and Management Systems Society (HIMSS) and the Medical Group Management Association (MGMA), assembled more than 40 representatives from major health plans, providers, health IT vendors, healthcare organizations and the Office of the National Coordinator for Health Information Technology (ONC) in an effort to develop an effective and consistent industry blueprint for a virtual clipboard mobile application. This meeting was the first step of a campaign to develop and pilot an effective and consistent industry blueprint for the patient intake process, including automating the collection of critical health insurance and demographic information.
“We’ve been talking about the importance of shifting to a paperless healthcare environment for years but the patient intake process is still mired in the ‘70s. Not only does the current process add unnecessary costs in the system, but it can lead to treatment complications due to inaccurate or incomplete health records,” said Devin Jopp, Ed.D., president and CEO of WEDI. “Through a collaboration driven by WEDI, the Sullivan Institute for Health Innovation and our other partners, we are committed to moving away from the existing routine of clipboards, photocopiers and manual keystrokes, and toward use of a patient-friendly virtual clipboard.”
The initiative will focus on identifying and promoting effective and actionable electronic approaches to patient information capture, maintenance and dissemination that leverage mobile devices and "smart" technologies and applications. The goal of the first phase of the pilot will be to allow patients to submit all of their pertinent health insurance and demographic information and other intake data through an easy-to-use and standardized mobile approach. The second phase of the pilot is expected to consist of patients being able to exchange essential health information – including medication reconciliation and allergies – in a digital format at the time of check-in with their provider.
“Physician practices currently must deal with numerous proprietary approaches to health insurance cards, lack of automated solutions, and challenges associated with collecting and recording accurate patient data,” said Anders M. Gilberg, senior vice president, government affairs, for MGMA. “This important initiative has the potential of significantly improving the patient intake process, currently an overly burdensome and costly component of the healthcare system. We commend the Sullivan Institute for Healthcare Innovation for taking on the formidable task of bringing key stakeholders together in this effort to reduce administrative inefficiencies.”
“For years, HIMSS has worked with its members on patient record matching and patient data integrity,” said Lisa Gallagher, vice president, technology solutions at HIMSS. “We anticipate that this project will address data quality in a significant way and deliver a near-term, real solution for patients and the industry alike.”
About WEDI
The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency, and reduce costs of our nation’s healthcare system. WEDI was formed in 1991 by the Secretary of Health and Human Services (HHS) and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations, and standards development organizations. To learn more, visit http://www.wedi.org and connect with us on Twitter, Facebook and LinkedIn.
About the Sullivan Institute
In 1993, the original WEDI Report brought together public and private industry to develop a roadmap for healthcare information exchange. In 2013, on the 20th anniversary of that original report and with Then Honorable Louis W. Sullivan, M.D.’s leadership, WEDI developed a new report which laid out the future of healthcare information exchange. The Louis W. Sullivan Institute for Healthcare Innovation is a 501(c)(3) non-profit organization, named in honor of The Honorable Louis W. Sullivan, M.D. Its mission is to bring healthcare leaders together to share knowledge needed to transform the quality and efficiency of healthcare delivery through education, cooperation, communication and innovation. To learn more, visit http://www.sullivaninstitute.org. Reported by PRWeb 18 hours ago.
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Insurers Ease Obamacare Deadline
Filed under: Health Care, Personal Finance, Barack Obama, Health Insurance*Don Ryan/AP*
By RICARDO ALONSO-ZALDIVAR
WASHINGTON -- Trying to head off a new round of consumer headaches with President Barack Obama's health care law, the insurance industry said Tuesday it will give customers more time to pay their premiums for January.
America's Health Insurance Plans, the main industry trade group, says the voluntary steps include a commitment to promptly refund any overpayments by consumers who switched plans and may have gotten double-billed by mistake.
Though the HealthCare.gov website is working far better this year, the industry announcement highlights behind-the-scenes technical issues between the government and insurers that have proven difficult to resolve. Last year's enrollment files were riddled with errors, and fixing those has been a painstaking process. As a result, renewing millions of current customers isn't as easy as it might seem.The industry "wants to do everything we can to make sure consumers have greater peace of mind about their health care coverage and support them throughout the open enrollment process," Karen Ignagni, head of the trade group, said in a statement.
The health care law offers subsidized private insurance to people who don't have a health plan on the job. Renewing coverage each year is standard operating procedure for the industry, but 2015 is the first renewal year for the health law. The process involves a massive electronic data transfer from the government to insurers, happening right around the holidays. Insurers then have to use that data to generate new cards for their customers.
Normally, premiums for January would be due by Dec. 31. The industry's grace period for 2015 could vary among different carriers, so consumers should check with their plan. Insurers say they also plan to help customers who have problems filling prescriptions or getting medical care at the start of the year.
*Last-Minute Extension*
Midnight Monday, Pacific time, was the deadline for new customers in most states to pick a health plan to take effect Jan. 1. It was also the deadline for current enrollees to make changes that could reduce premium increases before the new year. The administration announced a last-minute extension for some people unable to get through to the jammed federal call center.
Making matters more confusing, open enrollment actually runs for another two months, until Feb. 15. People enrolling by that date will get coverage starting March 1. Current customers can still make plan changes through Feb. 15.
Based on early numbers, it's looking like the majority of the roughly 6.7 million current customers have opted to stay with the plans they have now and be automatically renewed Jan. 1.
Assuring that happens as smoothly as it's been advertised is the administration's next major challenge. The insurance industry announcement provides a safety valve for the administration. It mirrors similar steps the industry took last year to soften the consequences of the botched rollout of health insurance markets around the country.
The favorite political scapegoat of the White House during the battle to pass the health care law, insurers keen on signing up millions of new taxpayer-subsidized customers have turned into indispensable allies.
Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 17 hours ago.
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Your Money Adviser: Signing Up for Health Insurance, Even After Missing the Deadline
For those who missed Monday’s deadline for health insurance enrollment at the Affordable Care Act marketplace, there’s still time, though possibly with some provisos.
Reported by NYTimes.com 17 hours ago.
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WellCare Promotes Munson, Reynolds to Senior Vice President, Division President
WellCare Health Plans, Inc. (NYSE: WCG) announced that it has promoted Kelly Munson to the position of senior vice president, division president and product. Munson will have responsibility for Arkansas, Kentucky, Louisiana, Mississippi, Tennessee and Texas. In addition, Munson will lead the company’s product development function. WellCare also promoted David Reynolds to senior vice president, division president with responsibility for California, Connecticut, Hawaii, Illinois, Missouri, New Jersey, New York and Ohio. Munson and Reynolds will continue to report to Ken Burdick, who was appointed CEO effective Jan. 1, 2015.
Tampa, Fla. (PRWEB) December 16, 2014
WellCare Health Plans, Inc. (NYSE: WCG) announced that it has promoted Kelly Munson to the position of senior vice president, division president and product. Munson will have responsibility for Arkansas, Kentucky, Louisiana, Mississippi, Tennessee and Texas. In addition, Munson will lead the company’s product development function. WellCare also promoted David Reynolds to senior vice president, division president with responsibility for California, Connecticut, Hawaii, Illinois, Missouri, New Jersey, New York and Ohio. Munson and Reynolds will continue to report to Ken Burdick, who was appointed CEO effective Jan. 1, 2015.
“Kelly and Dave have demonstrated solid leadership skills and the ability to drive positive improvement in the businesses for which they’ve been responsible,” said Burdick. “I’m confident that in their expanded roles, they will enable WellCare to enhance our ability to provide innovative, cost-effective health care solutions for our government customers and help our members lead better, healthier lives.”
Munson was most recently region president for WellCare’s operations in Arkansas, Kentucky, Mississippi and Tennessee. She joined WellCare in 2006, serving in positions of increasing responsibility for WellCare’s Ohio health plan in the areas of operations and regulatory compliance. She was named chief operating officer of WellCare of Kentucky in August 2012, and one year later was named state president, Kentucky. Before joining WellCare, she held operational positions with Old World Classics, HomeTown Health Network and Medical Mutual of Ohio. Munson graduated from Syracuse University with a bachelor’s degree in dietetics and public health nutrition, and did graduate work in public administration at the University of Akron.
Reynolds was most recently region president for WellCare’s operations in Connecticut, Illinois, Missouri, New Jersey, New York and Ohio. Before joining WellCare in 2013, he served as the state president of Illinois for Humana, responsible for their commercial health insurance business with revenues of $1 billion. He also held the position of vice president of sales, where he spearheaded a major turnaround effort resulting in significant growth. Prior to that, he served as the vice president of payer sales at WebMD. Earlier in his career, he held various positions of leadership at Columbia/HCA Healthcare Corporation, HPR, Inc. and Johnson & Johnson. Reynolds earned a bachelor’s degree in economics from Northern Illinois University.
About WellCare Health Plans, Inc.
WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, including Medicaid, Medicare, Prescription Drug Plans and the Health Insurance Marketplace. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind and disabled. The company serves approximately 4 million members nationwide as of Sept. 30, 2014. For more information about WellCare, please visit the company's website at http://www.wellcare.com or view the company’s videos at http://youtu.be/tWeMyxFaxgE.
CONTACTS:
Investor
Drew Asher
Senior Vice President and Chief Financial Officer
813-206-4421
drew.asher(at)wellcare(dot)com
Media
Crystal Warwell Walker
Director, Corporate Public Relations
813-206-2697
crystal.walker(at)wellcare(dot)com Reported by PRWeb 17 hours ago.
Tampa, Fla. (PRWEB) December 16, 2014
WellCare Health Plans, Inc. (NYSE: WCG) announced that it has promoted Kelly Munson to the position of senior vice president, division president and product. Munson will have responsibility for Arkansas, Kentucky, Louisiana, Mississippi, Tennessee and Texas. In addition, Munson will lead the company’s product development function. WellCare also promoted David Reynolds to senior vice president, division president with responsibility for California, Connecticut, Hawaii, Illinois, Missouri, New Jersey, New York and Ohio. Munson and Reynolds will continue to report to Ken Burdick, who was appointed CEO effective Jan. 1, 2015.
“Kelly and Dave have demonstrated solid leadership skills and the ability to drive positive improvement in the businesses for which they’ve been responsible,” said Burdick. “I’m confident that in their expanded roles, they will enable WellCare to enhance our ability to provide innovative, cost-effective health care solutions for our government customers and help our members lead better, healthier lives.”
Munson was most recently region president for WellCare’s operations in Arkansas, Kentucky, Mississippi and Tennessee. She joined WellCare in 2006, serving in positions of increasing responsibility for WellCare’s Ohio health plan in the areas of operations and regulatory compliance. She was named chief operating officer of WellCare of Kentucky in August 2012, and one year later was named state president, Kentucky. Before joining WellCare, she held operational positions with Old World Classics, HomeTown Health Network and Medical Mutual of Ohio. Munson graduated from Syracuse University with a bachelor’s degree in dietetics and public health nutrition, and did graduate work in public administration at the University of Akron.
Reynolds was most recently region president for WellCare’s operations in Connecticut, Illinois, Missouri, New Jersey, New York and Ohio. Before joining WellCare in 2013, he served as the state president of Illinois for Humana, responsible for their commercial health insurance business with revenues of $1 billion. He also held the position of vice president of sales, where he spearheaded a major turnaround effort resulting in significant growth. Prior to that, he served as the vice president of payer sales at WebMD. Earlier in his career, he held various positions of leadership at Columbia/HCA Healthcare Corporation, HPR, Inc. and Johnson & Johnson. Reynolds earned a bachelor’s degree in economics from Northern Illinois University.
About WellCare Health Plans, Inc.
WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, including Medicaid, Medicare, Prescription Drug Plans and the Health Insurance Marketplace. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind and disabled. The company serves approximately 4 million members nationwide as of Sept. 30, 2014. For more information about WellCare, please visit the company's website at http://www.wellcare.com or view the company’s videos at http://youtu.be/tWeMyxFaxgE.
CONTACTS:
Investor
Drew Asher
Senior Vice President and Chief Financial Officer
813-206-4421
drew.asher(at)wellcare(dot)com
Media
Crystal Warwell Walker
Director, Corporate Public Relations
813-206-2697
crystal.walker(at)wellcare(dot)com Reported by PRWeb 17 hours ago.
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WellCare Appoints Todt Senior Vice President, Chief Legal and Administrative Officer and Secretary
WellCare Health Plans, Inc. (NYSE: WCG) announced it has appointed Blair Todt to the newly created position of senior vice president, chief legal and administrative officer and secretary, effective Dec. 15, 2014.
Tampa, Fla. (PRWEB) December 16, 2014
WellCare Health Plans, Inc. (NYSE: WCG) announced it has appointed Blair Todt to the newly created position of senior vice president, chief legal and administrative officer and secretary, effective Dec. 15, 2014. Todt will be responsible for the legal, government affairs, public policy, business development, external communications and corporate strategy functions, and will serve as WellCare’s corporate secretary. He will continue to report to Dave Gallitano, WellCare's CEO and chairman of the board, until Ken Burdick, who was recently named CEO, assumes the role on Jan. 1, 2015. Lisa Iglesias, senior vice president, general counsel and secretary, will be leaving the company in early 2015 and has agreed to assist with the transition.
Todt most recently served as the company’s chief strategy and development officer, a role he assumed in 2013, and joined WellCare in 2010 as the chief compliance officer. Prior to joining WellCare, Todt served as senior vice president, general counsel and corporate secretary of MedCath Corporation, a national health care provider. He previously served as deputy general counsel of compliance and litigation at BearingPoint, and was formerly a partner in the New York law firm of Carter, Conboy, Case, Blackmore, Maloney and Laird. Todt also served as a law clerk to United States District Judge Constantine Cholakis of the Northern District Court of New York. He received his bachelor’s degree in political communication from The George Washington University and his juris doctorate from Brooklyn Law School.
“In working closely with Blair over the past year, he has consistently demonstrated the unique skills and qualifications required for this important role,” said Burdick. “Uniting these critical functions under one executive leader will help to ensure a more effective and efficient execution of our key strategic and operational priorities, and facilitate collaborative relationships with our government partners,” said Burdick.
About WellCare Health Plans, Inc.
WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, including Medicaid, Medicare, Prescription Drug Plans and the Health Insurance Marketplace. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind and disabled. The company serves approximately 4 million members nationwide as of Sept. 30, 2014. For more information about WellCare, please visit the company's website at http://www.wellcare.com or view the company’s videos at http://youtu.be/tWeMyxFaxgE.
CONTACTS:
Investor
Drew Asher
Senior Vice President and Chief Financial Officer
813-206-4421
drew(dot)asher(at)wellcare(dot)com
Media
Crystal Warwell Walker
Director, Corporate Public Relations
813-206-2697
crystal(dot)walker(at)wellcare(dot)com Reported by PRWeb 17 hours ago.
Tampa, Fla. (PRWEB) December 16, 2014
WellCare Health Plans, Inc. (NYSE: WCG) announced it has appointed Blair Todt to the newly created position of senior vice president, chief legal and administrative officer and secretary, effective Dec. 15, 2014. Todt will be responsible for the legal, government affairs, public policy, business development, external communications and corporate strategy functions, and will serve as WellCare’s corporate secretary. He will continue to report to Dave Gallitano, WellCare's CEO and chairman of the board, until Ken Burdick, who was recently named CEO, assumes the role on Jan. 1, 2015. Lisa Iglesias, senior vice president, general counsel and secretary, will be leaving the company in early 2015 and has agreed to assist with the transition.
Todt most recently served as the company’s chief strategy and development officer, a role he assumed in 2013, and joined WellCare in 2010 as the chief compliance officer. Prior to joining WellCare, Todt served as senior vice president, general counsel and corporate secretary of MedCath Corporation, a national health care provider. He previously served as deputy general counsel of compliance and litigation at BearingPoint, and was formerly a partner in the New York law firm of Carter, Conboy, Case, Blackmore, Maloney and Laird. Todt also served as a law clerk to United States District Judge Constantine Cholakis of the Northern District Court of New York. He received his bachelor’s degree in political communication from The George Washington University and his juris doctorate from Brooklyn Law School.
“In working closely with Blair over the past year, he has consistently demonstrated the unique skills and qualifications required for this important role,” said Burdick. “Uniting these critical functions under one executive leader will help to ensure a more effective and efficient execution of our key strategic and operational priorities, and facilitate collaborative relationships with our government partners,” said Burdick.
About WellCare Health Plans, Inc.
WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, including Medicaid, Medicare, Prescription Drug Plans and the Health Insurance Marketplace. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind and disabled. The company serves approximately 4 million members nationwide as of Sept. 30, 2014. For more information about WellCare, please visit the company's website at http://www.wellcare.com or view the company’s videos at http://youtu.be/tWeMyxFaxgE.
CONTACTS:
Investor
Drew Asher
Senior Vice President and Chief Financial Officer
813-206-4421
drew(dot)asher(at)wellcare(dot)com
Media
Crystal Warwell Walker
Director, Corporate Public Relations
813-206-2697
crystal(dot)walker(at)wellcare(dot)com Reported by PRWeb 17 hours ago.
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Here's what happens if you miss the Maryland health exchange deadline
Radio ads, television spots and a barrage of tweets from Maryland Health Connection are telling you: The deadline is Dec. 18 to sign up for health insurance. The exchange's open enrollment period runs through Feb. 15, but anyone who wants their coverage — and tax credit to offset the cost — to kick in Jan. 1 needs to sign up by Dec. 18. The deadline is particularly important for some 53,000 people who received a tax credit for a 2014 plan purchased through the exchange. If you had a tax credit…
Reported by bizjournals 16 hours ago.
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Feds report 'strong start' to ACA health insurance enrollment; no fixed numbers
Almost 2.5 million have signed up for 2015 health insurance coverage through www.healthcare.gov in the first month of open enrollment, according to government officials. They emphasized that the enrollment period extends through Feb. 15, both for new plans and to revise existing plans.
Reported by dailypress.com 11 hours ago.
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8 expensive health insurance mistakes
*8 expensive health insurance mistakes*
Last year, America’s health care system will undergo its biggest change since Medicare’s arrival almost 50 years ago when the major provisions of the Affordable Care Act kicked in. And although millions of people who have been without health insurance are finally able to get it—under the law, everyone must have some kind of health coverage, or pay a small fine—the system remains just as complex and unforgiving as it was before. That puts you at risk of being left without adequate coverage when you need it most. To avoid unnecessary fees, penalties, and just plain bad deals, here’s our list of health-insurance don’ts.
If you get sick and then decide to buy health insurance from plans made available as part of the Affordable Care Act, you might not be able to, at least not right away. You’ll only be allowed to purchase individual health insurance during the initial open enrollment period—Nov. 15, 2014, through February 15, 2015. The best place to buy is your state’s Health Insurance Marketplace, a new kind of virtual insurance agency where you can compare plans and possibly qualify for income-based subsidies.
So if you decide to thumb your nose at the deadline and are hit by a bus, you’ll have to wait nine full months to get health insurance. And needless to say, it won’t retroactively pay for care you received when you didn’t have it. Don’t count on free emergency care, either. Although an emergency room will take care of you if you require urgent attention, even if you don’t have insurance, it will send you a bill afterward—most likely a very large one, and might make aggressive efforts to collect payment.
In certain circumstances, you’ll be allowed to purchase individual insurance outside the open enrollment period. Losing insurance because of a change in employment, or moving away from your health plan’s service area, are examples of such “qualifying events.” But suddenly needing expensive health care because you are sick is not.
*Another blunder to avoid: Having your health care claims denided. Here's how to get your insurer to pay up. Our free Health Law Helper takes the confusion out of open enrollment.
*
There is no free lunch in health insurance, but there is a menu of payment options to choose from. You can pay for your care up front, in the form of a higher premium, or later, in the form of a higher co-payment, a bigger deductible, or both. Neither form of payment is inherently better; it depends on your personal situation and preferences.
For instance, if you’re in generally good health and have an adequate financial cushion, you might save money with a lower insurance premium and higher cost-sharing. But if you have ongoing medical needs, you might do better with a higher premium and lower cost-sharing. Of course, you take a risk if you pick a plan with a very high deductible and co-pay and then can’t afford your share of expenses if you do happen to get sick.
One little-known benefit of the health care law is that plans sold to individuals can’t impose more than $6,350 in annual cost-sharing this year, no matter how low the premiums.You're legally entitled to receive a Summary of Benefits and Coverage [PDF] outlining your choices. If you don't have one, ask your company's insurer or benefits manager for a copy.One of the big selling points of a preferred provider organization (PPO) over a health maintenance organization (HMO) is that if you have a PPO, you can opt to get your care from doctors or hospitals that don’t participate in the plan’s network, whereas with HMOs you can’t.
But the fine print can cost you if you’re not careful. For instance, if your PPO says it will pay 60 percent of the cost of out-of-network care (compared with, say, 80 percent for in-network care), it will pay 60 percent of whatever it determines is a “reasonable” price for the service—not 60 percent of whatever the doctor decides to charge. So if his fee is $2,000 and your insurance company decides that the fair price is $1,000, it will reimburse you only $600, leaving you on the hook for the other $1,400.
The way around that is to avoid going out of network except when you absolutely can’t find an in-network provider. The only time that won’t work is when you receive non-network care involuntarily, such as during a trip to an emergency room of an in-network hospital where the doctor taking care of you isn’t in the network, or when you have surgery and the anesthesiologist doesn’t participate in your plan.
Strictly speaking, you have no legal recourse but to pay those bills. Yet in practice, polite but persistent complaints to the provider or your insurer can often succeed in reducing the price.
If you’re already retired or plan to retire at 65, Medicare enrollment is a no-brainer: Sign up during the month you turn 65 or the three months before or after.
Where people get in trouble is when they, or a spouse, continue working past their 65th birthday. As long as you or your spouse works at a job with health benefits and there are 20 or more employees, you will probably get little or no benefit from being on Medicare. That’s because Medicare pays secondarily to your employer’s group plan.
But once you (or your spouse) stops working and you lose your insurance—even if you can continue with the employer plan through COBRA or some other retiree benefit—you must switch to Medicare as your primary insurance. You need to sign up within eight months after you stop working. If you don’t and your private plan finds out, it can refuse to pay for your health care.
It gets worse. If you don’t sign up for Medicare when you should, you’ll be hit with a permanent 10 percent premium surcharge for every year you should have been on Medicare but were not.
The surcharge usually doesn’t matter with Part A, which covers hospital care, because there’s usually no premium. But Part B, which covers doctors and most other outpatient care, costs $104.90 a month (more for higher-income retirees).
There’s a similar late-enrollment penalty for Part D, the Medicare drug benefit, but it’s calculated differently: There’s a 1 percent premium surcharge for every month you could have signed up but didn’t.
Worse still, if you wait too long, you won’t be able to enroll in any part of Medicare until the next general enrollment period, which takes place annually from January through March, and your coverage won’t start until July 1. The penalty clock will be ticking the whole time.
Only 5 percent of Medicare beneficiaries who choose a stand-alone Part D drug plan are covered by the plan cheapest for them, according to a study in the October 2012 issue of Health Affairs. The average beneficiary paid $368 more in premiums and drug costs than he would have if he had chosen the cheapest plan for his specific assortment of prescriptions. And more than a fifth overspent by at least $500 a year.
The biggest mistake people make is picking a plan that pays for generic drugs in the coverage gap known as the doughnut hole, according to study authors Chao Zhou and Yuting Zhang from the University of Pittsburgh. People wound up paying hundreds of dollars more for that feature than they got back in benefits.
Even if you went through the exercise of finding the cheapest plan last year, it’s smart to do it again during the open enrollment period—Oct. 15 to Dec. 7 for 2014. Drug plans change their preferred drug lists and costs may change as well. So last year’s good deal may no longer be your best bet.
It also pays to review your Medicare Advantage options every year. You may be able to find a plan with a higher quality rating at a lower cost. That’s especially important nowadays, because Medicare gives plans with higher-quality ratings (that is, with four or five stars) more money to spend on their members—in the form of lower premiums or more services—than it gives lower-rated plans.
To see your full range of choices, ignore the brochures cluttering your mailbox because they won’t give you the full picture of your options. Instead, go straight to medicare.gov and click on the yellow oval that says “Find health & drug plans.” Follow the simple online instructions to compare all Medicare Advantage and Part D plans available in your area.
A flexible-spending account lets you set aside money tax-free from your paycheck to pay for medical expenses not covered by insurance, such as deductibles and co-payments, as well as dental care, eyeglasses and contact lenses, and some alternative treatments.
Contributing to an FSA will also reduce your taxes. Say you have a taxable income of $75,000 a year and taxes claim 20 percent, or $15,000. If you put aside $2,500 in an FSA, your taxable income will be reduced to $72,500 and your taxes will be cut by $500, from $15,000 to $14,500. The higher your tax bracket, the greater the benefit.
Those advantages remain despite two changes in FSAs due to the health-reform law. You can no longer use money in your FSA to pay for over-the-counter drugs unless you get a prescription for them from your doctor. And the maximum amount you can set aside is capped each year. Previously, employers set the cap, typically up to $5,000. Keep in mind that FSA funds don’t carry over year to year, so you must use the total amount you set aside or lose it.
Some commercial and Medicare Part D plans have negotiated deep discounts with specific mail-order and retail pharmacies. For example, recently people with Humana’s Walmart-Preferred Rx Plan could get prescriptions for select generic high-blood-pressure drugs for only a penny at more than 4,000 preferred pharmacies, including Neighborhood Market, Sam’s Club, Walmart, and Walmart Express. Other generics cost as little as $1 a month after a deductible.
People who have a Medicare Advantage plan with Part D coverage through United Healthcare could get some prescriptions for as little as $2 at Kroger, Target, and many other pharmacies. Aetna partnered with CVS pharmacies to offer a special Medicare prescription drug plan: a $2 co-pay for preferred generic prescriptions and a $5 co-pay for nonpreferred generics. Other pharmacies are available in the network, although higher costs may apply.
And if you take a generic drug regularly for a chronic condition such as diabetes or elevated cholesterol, you might get an even better deal through mail-order. The Humana plan described earlier had little or no co-pays (after a deductible) on generic drugs ordered by mail.
Under the health-reform act, you can now keep children on your insurance up to their 26th birthday, even if you don’t claim them as dependents on your tax return or they are no longer in school or living with you. Your workplace can’t charge a different premium for your adult children than it does for younger children. And eligibility isn’t based on their living circumstances—they can stay on your insurance even if they get married. They can also go on and off your insurance as many times as needed.
There are a couple of caveats, though. If you’re retired, you might not have the option of keeping your children on your insurance. The law doesn’t require retiree-only plans to cover adult children of beneficiaries. And Medicare doesn’t cover any dependents, period, including spouses.
And if your workplace charges an extra premium for each added dependent (that’s allowed), and your young-adult child is living and working independently, it may be cheaper for her to purchase individual coverage on her state’s health-insurance marketplace, especially if she earns less than about $46,000 a year and therefore qualifies for a subsidized premium. It costs nothing to check, in any event.
Medical-bill blues
Paying for medical and drug bills is the most common financial problem Americans report having—even more than missed mortgage payments, job loss, and home foreclosure, according to the 2013 Consumer Reports Best Buy Drugs Prescription Drug Tracking Poll.
Best Buy Drugs is a free Consumer Reports project that evaluates the effectiveness, safety, and cost of common drugs to help you find the best value for your health care dollar.
A version of this article appeared in the October 2013 issue of Consumer Reports Money Adviser.*Consumer Reports has no relationship with any advertisers on this website. Copyright © 2006-2014 Consumers Union of U.S.*
*Subscribe now!*
Subscribe to *ConsumerReports.org* for expert Ratings, buying advice and reliability on hundreds of products.
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Update your feed preferences
Reported by Consumer Reports 8 hours ago.
Last year, America’s health care system will undergo its biggest change since Medicare’s arrival almost 50 years ago when the major provisions of the Affordable Care Act kicked in. And although millions of people who have been without health insurance are finally able to get it—under the law, everyone must have some kind of health coverage, or pay a small fine—the system remains just as complex and unforgiving as it was before. That puts you at risk of being left without adequate coverage when you need it most. To avoid unnecessary fees, penalties, and just plain bad deals, here’s our list of health-insurance don’ts.
If you get sick and then decide to buy health insurance from plans made available as part of the Affordable Care Act, you might not be able to, at least not right away. You’ll only be allowed to purchase individual health insurance during the initial open enrollment period—Nov. 15, 2014, through February 15, 2015. The best place to buy is your state’s Health Insurance Marketplace, a new kind of virtual insurance agency where you can compare plans and possibly qualify for income-based subsidies.
So if you decide to thumb your nose at the deadline and are hit by a bus, you’ll have to wait nine full months to get health insurance. And needless to say, it won’t retroactively pay for care you received when you didn’t have it. Don’t count on free emergency care, either. Although an emergency room will take care of you if you require urgent attention, even if you don’t have insurance, it will send you a bill afterward—most likely a very large one, and might make aggressive efforts to collect payment.
In certain circumstances, you’ll be allowed to purchase individual insurance outside the open enrollment period. Losing insurance because of a change in employment, or moving away from your health plan’s service area, are examples of such “qualifying events.” But suddenly needing expensive health care because you are sick is not.
*Another blunder to avoid: Having your health care claims denided. Here's how to get your insurer to pay up. Our free Health Law Helper takes the confusion out of open enrollment.
*
There is no free lunch in health insurance, but there is a menu of payment options to choose from. You can pay for your care up front, in the form of a higher premium, or later, in the form of a higher co-payment, a bigger deductible, or both. Neither form of payment is inherently better; it depends on your personal situation and preferences.
For instance, if you’re in generally good health and have an adequate financial cushion, you might save money with a lower insurance premium and higher cost-sharing. But if you have ongoing medical needs, you might do better with a higher premium and lower cost-sharing. Of course, you take a risk if you pick a plan with a very high deductible and co-pay and then can’t afford your share of expenses if you do happen to get sick.
One little-known benefit of the health care law is that plans sold to individuals can’t impose more than $6,350 in annual cost-sharing this year, no matter how low the premiums.You're legally entitled to receive a Summary of Benefits and Coverage [PDF] outlining your choices. If you don't have one, ask your company's insurer or benefits manager for a copy.One of the big selling points of a preferred provider organization (PPO) over a health maintenance organization (HMO) is that if you have a PPO, you can opt to get your care from doctors or hospitals that don’t participate in the plan’s network, whereas with HMOs you can’t.
But the fine print can cost you if you’re not careful. For instance, if your PPO says it will pay 60 percent of the cost of out-of-network care (compared with, say, 80 percent for in-network care), it will pay 60 percent of whatever it determines is a “reasonable” price for the service—not 60 percent of whatever the doctor decides to charge. So if his fee is $2,000 and your insurance company decides that the fair price is $1,000, it will reimburse you only $600, leaving you on the hook for the other $1,400.
The way around that is to avoid going out of network except when you absolutely can’t find an in-network provider. The only time that won’t work is when you receive non-network care involuntarily, such as during a trip to an emergency room of an in-network hospital where the doctor taking care of you isn’t in the network, or when you have surgery and the anesthesiologist doesn’t participate in your plan.
Strictly speaking, you have no legal recourse but to pay those bills. Yet in practice, polite but persistent complaints to the provider or your insurer can often succeed in reducing the price.
If you’re already retired or plan to retire at 65, Medicare enrollment is a no-brainer: Sign up during the month you turn 65 or the three months before or after.
Where people get in trouble is when they, or a spouse, continue working past their 65th birthday. As long as you or your spouse works at a job with health benefits and there are 20 or more employees, you will probably get little or no benefit from being on Medicare. That’s because Medicare pays secondarily to your employer’s group plan.
But once you (or your spouse) stops working and you lose your insurance—even if you can continue with the employer plan through COBRA or some other retiree benefit—you must switch to Medicare as your primary insurance. You need to sign up within eight months after you stop working. If you don’t and your private plan finds out, it can refuse to pay for your health care.
It gets worse. If you don’t sign up for Medicare when you should, you’ll be hit with a permanent 10 percent premium surcharge for every year you should have been on Medicare but were not.
The surcharge usually doesn’t matter with Part A, which covers hospital care, because there’s usually no premium. But Part B, which covers doctors and most other outpatient care, costs $104.90 a month (more for higher-income retirees).
There’s a similar late-enrollment penalty for Part D, the Medicare drug benefit, but it’s calculated differently: There’s a 1 percent premium surcharge for every month you could have signed up but didn’t.
Worse still, if you wait too long, you won’t be able to enroll in any part of Medicare until the next general enrollment period, which takes place annually from January through March, and your coverage won’t start until July 1. The penalty clock will be ticking the whole time.
Only 5 percent of Medicare beneficiaries who choose a stand-alone Part D drug plan are covered by the plan cheapest for them, according to a study in the October 2012 issue of Health Affairs. The average beneficiary paid $368 more in premiums and drug costs than he would have if he had chosen the cheapest plan for his specific assortment of prescriptions. And more than a fifth overspent by at least $500 a year.
The biggest mistake people make is picking a plan that pays for generic drugs in the coverage gap known as the doughnut hole, according to study authors Chao Zhou and Yuting Zhang from the University of Pittsburgh. People wound up paying hundreds of dollars more for that feature than they got back in benefits.
Even if you went through the exercise of finding the cheapest plan last year, it’s smart to do it again during the open enrollment period—Oct. 15 to Dec. 7 for 2014. Drug plans change their preferred drug lists and costs may change as well. So last year’s good deal may no longer be your best bet.
It also pays to review your Medicare Advantage options every year. You may be able to find a plan with a higher quality rating at a lower cost. That’s especially important nowadays, because Medicare gives plans with higher-quality ratings (that is, with four or five stars) more money to spend on their members—in the form of lower premiums or more services—than it gives lower-rated plans.
To see your full range of choices, ignore the brochures cluttering your mailbox because they won’t give you the full picture of your options. Instead, go straight to medicare.gov and click on the yellow oval that says “Find health & drug plans.” Follow the simple online instructions to compare all Medicare Advantage and Part D plans available in your area.
A flexible-spending account lets you set aside money tax-free from your paycheck to pay for medical expenses not covered by insurance, such as deductibles and co-payments, as well as dental care, eyeglasses and contact lenses, and some alternative treatments.
Contributing to an FSA will also reduce your taxes. Say you have a taxable income of $75,000 a year and taxes claim 20 percent, or $15,000. If you put aside $2,500 in an FSA, your taxable income will be reduced to $72,500 and your taxes will be cut by $500, from $15,000 to $14,500. The higher your tax bracket, the greater the benefit.
Those advantages remain despite two changes in FSAs due to the health-reform law. You can no longer use money in your FSA to pay for over-the-counter drugs unless you get a prescription for them from your doctor. And the maximum amount you can set aside is capped each year. Previously, employers set the cap, typically up to $5,000. Keep in mind that FSA funds don’t carry over year to year, so you must use the total amount you set aside or lose it.
Some commercial and Medicare Part D plans have negotiated deep discounts with specific mail-order and retail pharmacies. For example, recently people with Humana’s Walmart-Preferred Rx Plan could get prescriptions for select generic high-blood-pressure drugs for only a penny at more than 4,000 preferred pharmacies, including Neighborhood Market, Sam’s Club, Walmart, and Walmart Express. Other generics cost as little as $1 a month after a deductible.
People who have a Medicare Advantage plan with Part D coverage through United Healthcare could get some prescriptions for as little as $2 at Kroger, Target, and many other pharmacies. Aetna partnered with CVS pharmacies to offer a special Medicare prescription drug plan: a $2 co-pay for preferred generic prescriptions and a $5 co-pay for nonpreferred generics. Other pharmacies are available in the network, although higher costs may apply.
And if you take a generic drug regularly for a chronic condition such as diabetes or elevated cholesterol, you might get an even better deal through mail-order. The Humana plan described earlier had little or no co-pays (after a deductible) on generic drugs ordered by mail.
Under the health-reform act, you can now keep children on your insurance up to their 26th birthday, even if you don’t claim them as dependents on your tax return or they are no longer in school or living with you. Your workplace can’t charge a different premium for your adult children than it does for younger children. And eligibility isn’t based on their living circumstances—they can stay on your insurance even if they get married. They can also go on and off your insurance as many times as needed.
There are a couple of caveats, though. If you’re retired, you might not have the option of keeping your children on your insurance. The law doesn’t require retiree-only plans to cover adult children of beneficiaries. And Medicare doesn’t cover any dependents, period, including spouses.
And if your workplace charges an extra premium for each added dependent (that’s allowed), and your young-adult child is living and working independently, it may be cheaper for her to purchase individual coverage on her state’s health-insurance marketplace, especially if she earns less than about $46,000 a year and therefore qualifies for a subsidized premium. It costs nothing to check, in any event.
Medical-bill blues
Paying for medical and drug bills is the most common financial problem Americans report having—even more than missed mortgage payments, job loss, and home foreclosure, according to the 2013 Consumer Reports Best Buy Drugs Prescription Drug Tracking Poll.
Best Buy Drugs is a free Consumer Reports project that evaluates the effectiveness, safety, and cost of common drugs to help you find the best value for your health care dollar.
A version of this article appeared in the October 2013 issue of Consumer Reports Money Adviser.*Consumer Reports has no relationship with any advertisers on this website. Copyright © 2006-2014 Consumers Union of U.S.*
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