Cash-only Doctors Abandon the Insurance System

Presented by Mark Phillips

There is an interesting trend captured by this CNNMoney article. A small but growing number of doctors are opting out of the insurance system completely and accepting cash only for services. The business proposition offered by insurance companies to doctors is becoming so difficult that this seems to be a growing trend. This is a move that the majority of dentists have already made.

While I have a concern for the impact of high cost Concierge offices, some of the more modest flat fee programs (as reflected in the fees charged by Dr. Nunamaker), when combined with a high deductible insurance plan and an HAS account, may prove much more cost effective and conducive to a healthy doctor/patient relationship.

Please consider this trend and how this might be an opportunity, rather than a threat, to you.

Click here

Finding Prices of Medical Procedures Getting Easier

Presented by Mark Phillips

It has been nearly impossible for patients to search and compare healthcare prices for procedures & tests. The good news is things are beginning to change. Now there are online tools and pricing sites which will help you to comparison shop before moving forward on a medical procedure or test. In addition to the benefit of price comparisons, some sites also show quality ratings for services like MRI’s, X-rays, and CT scans. Two of these sites are HealthBlueBook.com and SaveOnMedSavical.com.

Please read the LA Times article to learn more …Click here for the full article

How to handle Medical Bill problems

Presented by Mark Phillips

Hiring a medical billing advocate was the best decision for an Arizona couple featured in this L.A. Times article. They learned to manage and reduce their overall medical bills from their son’s hospital visit. When faced with the reality of huge medical bills after a health situation, it may be imperative to have an agency like Medical Billing Advocates of America to help sort and understand what the charges consist of and what your rights are in terms of the law.

Don’t miss this. Read further to learn about other helpful resources and how an advocate can benefit your personal situation.  

Click here for article

Healthcare- What You Need To Know

Presented By: Nick Bautista

It's that time of year. The time when you must select your health care plan for next year.



Being that the open enrollment period is upon us for employers it's good to review the basics of what Health insurance coverages mean. With all the recent changes in Health Care you may be thinking what happens to your health insurance as you go to choose a plan for 2014.

Well... Not much, as the employee based plans won't see much change. But maybe you are asking, what they heck do all the health coverages mean again, I don't know which one to choose?

Know the basics

Deductible - The amount you pay the insurer to start insurance coverage for whatever you need. For example if you have a $200 deductible and need a $10,000 surgery of which your insurance will cover 80% of the cost, then you would have to pay your deductible before the insurance company started paying their 80%.

Coinsurance amount - is the amount the insurance company splits the cost with you, which is usually 80/20, meaning your insurance company will pay 80% of the cost while you cover the 20% after the deductible is paid.

Maximum Out of Pocket - The maximum you will pay for any procedures (surgeries, the like) after the deductible. In the previous example if your maximum OOP was $1,000, after you pay the $200 deductible you would be responsible to pay 20% (co-insurance amount) but would only pay up to your maximum Out of Pocket, which would be in this case $1,000.

Premium - Cost of coverage, either you pay, your employer pays or you share. This is usually a monthly cost.

Copay- The amount you pay when you visit a Doctor.

HMO – think of a gatekeeper. You must visit your primary doctor to have access to other specialist, through a primary doctor referral

PPO – Go direct to the Doctor, no gatekeeper.

Knowing these basics give you a better idea on which insurance to choose. A rule of thumb is that if you are young and healthy a high deductible is likely best being that you won't have much need to see a Doctor as would a 60 year old. Keep in mind that if you do have a high deductible then you should have the cash in reserves, if you did have a health event, to pay for the high deductible cost.

One last thing to do is call your primary doctor before you switch coverages so that you know they will accept your new insurance. Don’t let health insurance and the new laws scare you, give us a call if you have questions.

How do we struggle…Consider Diabetes

Presented by Mark Phillips

The Center for Disease Control tracks many maladies in the US and compiles history which they have put into an interactive map program that you can access through the internet from their web page.

Click on the following image or paste the URL into your web browser to access the site.



As we age we are more prone to disability and death due to maladies such as diabetes. Having, and living, a fun plan for an active lifestyle that will support good health and thus our ability to stay physically engaged with our friends, family, community and world is just as important as a “healthy” financial plan.

Sadly the state of our bodies as a nation by and large is representative to the state of our overall financial health as a nation. This is to say, not so much where we would like to be on average.

The amazing and wonderful thing is that so much of what we will get in both areas of our life is under our own control to manage. This is to say effectively deal with the difficulties and leverage the opportunities through clarity about what is now and will be important to us, each of us, in the future.

As for the CDC data map – consider that many people, well-meaning and wonderful people most, are struggling to improve their circumstances. None of us is not struggling in some element(s) of our lives to make improvements. To struggle towards better is good, it is growth and makes the world a more beautiful place in some way.  To give up is the enemy of better, growth and beauty.

Champion your personal struggle!

Let us know how we may best coach and help you.

Medicare Enrollment, and Changes to Enrollment… When?

Presented by Mark Phillips

Recently the Journal of Financial Planning provided a run down on five of the most common windows for Medicare enrollment and for making Medicare plan election changes. The following Graphic is a helpful guide:
 

Click on above image to access larger version

The Squared Away Blog (The Center for Retirement Research at Boston College) provided the following Critical Dates:
 

·         Failing to enroll in basic Medicare (parts A and B) three months before or during the month of one’s 65^th birthday creates at least a two-month delay in coverage.

·         People can buy or switch their Medicare Advantage and Part D drug plan between Oct. 15 and Dec. 7.   But Advantage plan disenrollment dates are Jan. 1 – Feb. 14, when simultaneous Part D enrollment is also permitted.

·         To avoid underwriting rules that may restrict coverage or increase premiums for private Medigap coverage, enroll in Medigap during the six-month period that starts the month of one’s 65^th birthday.

 
Click HERE for full Squared Away Blog Article
 

Don’t Forget The Health Insurance Special Enrollment Period

Did you know with the end of open enrollment on March 31^st, you may still be eligible to sign up for Health Insurance through the special enrollment period?

With Obama recently citing 8 million sign ups under the new healthcare system, I’m sure not too many people missed out, but in case you did it doesn't mean you can’t sign up through one of the following qualifying events in your life:

• Getting Married
  
  
• Having a baby or adopting a child
  
  
• Permanently moving to a new area that has different health plan options. This includes moving to California from another state. This also applies to individuals who are released from jail or prison.
  
  
• You lose your health coverage. For example, you are no longer eligible for Medi-Cal, you lose health coverage through your job, or you have exhausted your COBRA continuation coverage. (Note: Not paying your COBRA premium does not qualify you for special enrollment.)
  
  
• Your income changes so much that you become newly eligible or ineligible for help paying for your insurance. For example, if you are already getting help paying for your insurance premium, and your income goes down, you may be able to get extra help.
  
  
• You applied for health coverage before March 31 and got a denial for Medi-Cal after March 31. If you were incorrectly denied Covered California or Medi-Cal coverage, you can also file an appeal.
  
  
• Your enrollment was wrong, due to the misconduct or misrepresentation of your health insurance company, Covered California or a non-Covered California entity (such as a Certified Enrollment Counselor).

Source Coveredca.com

You have 60 days from the time of one of the above events to sign up through the special enrollment period on the state or government websites.

Need help? Talk to us and we can help walk you through the process.

Healthcare- What You Need To Know

Presented By: Nick Bautista

It's that time of year. The time when you must select your health care plan for next year.



Being that the open enrollment period is upon us for employers it's good to review the basics of what Health insurance coverages mean. With all the recent changes in Health Care you may be thinking what happens to your health insurance as you go to choose a plan for 2014.

Well... Not much, as the employee based plans won't see much change. But maybe you are asking, what they heck do all the health coverages mean again, I don't know which one to choose?

Know the basics

Deductible - The amount you pay the insurer to start insurance coverage for whatever you need. For example if you have a $200 deductible and need a $10,000 surgery of which your insurance will cover 80% of the cost, then you would have to pay your deductible before the insurance company started paying their 80%.

Coinsurance amount - is the amount the insurance company splits the cost with you, which is usually 80/20, meaning your insurance company will pay 80% of the cost while you cover the 20% after the deductible is paid.

Maximum Out of Pocket - The maximum you will pay for any procedures (surgeries, the like) after the deductible. In the previous example if your maximum OOP was $1,000, after you pay the $200 deductible you would be responsible to pay 20% (co-insurance amount) but would only pay up to your maximum Out of Pocket, which would be in this case $1,000.

Premium - Cost of coverage, either you pay, your employer pays or you share. This is usually a monthly cost.

Copay- The amount you pay when you visit a Doctor.

HMO – think of a gatekeeper. You must visit your primary doctor to have access to other specialist, through a primary doctor referral

PPO – Go direct to the Doctor, no gatekeeper.

Knowing these basics give you a better idea on which insurance to choose. A rule of thumb is that if you are young and healthy a high deductible is likely best being that you won't have much need to see a Doctor as would a 60 year old. Keep in mind that if you do have a high deductible then you should have the cash in reserves, if you did have a health event, to pay for the high deductible cost.

One last thing to do is call your primary doctor before you switch coverages so that you know they will accept your new insurance. Don’t let health insurance and the new laws scare you, give us a call if you have questions.

10 Facts About Obamacare & How It Will Affect You

Presented by Nick Bautista

August has ended and we have four months until Obamacare goes into effect. So what is Obamacare?

The overall goal is to provide affordable health insurance for all U.S. citizens and reduce the growth of health care spending. Obamacare does not replace private insurance, Medicare , Medicaid or employer sponsored plans. Instead look to see small changes in the insurance landscape via these 10 facts:

      1. Starting January 1^st 2014, insurance will be sold on health insurance exchanges, although you can still purchase an individual plan through health insurance companies (through a broker)
2.    With the new exchange each state will now be responsible for its own health insurance marketplace
3.    Summary of benefits and coverage- will make it easier to compare cost for common items such as having a surgery, having a baby, etc.
4.   Already in effect but, kids under 26 are able to be on their parents health plan (whether they are married, living with them or not, full time student)
5.   No-cost preventive care coverage- get screenings, physicals, vaccinations at no cost (this may not be available on grandfathered policies)
6.   Already starting in August is the women’s preventive care services, which gives care to women for birth control, STI screenings and breast feeding. Also insurers can’t discriminate based on gender.
7.    No pre-existing condition limits in 2014. You cannot be turned down from individual plans for having a pre-existing condition. Note this doesn’t apply to group plans as group plans cancel out any pre-existing conditions you have.
8.   Medicare is working to close the gap on Medicare part D coverage. The program is meant to help you pay less for brand name prescriptions in the coming years.
9.    In 2014 you must have health insurance or you will be penalized, $95 per adult, $47.50 per child, up to $285 per family or 1% of your taxable income. (whichever is greater)
10.  Can’t afford insurance, there will be credits or subsidies for buying health insurance based on your income, based on these provisions: You're an individual making $14,856 to $44,680 or a family of four making $30,656 to $92,200, and You don't get coverage at work or have access to affordable coverage (meaning your plan costs more than 9.5% of your income).

Feel free to look at the Anthem Insurance website for more information, or contact me at nick@phillipswealthmanagement.com with any additional questions, comments or concerns.

Spending on Healthcare: How does the US and other countries compare?

Presented By Mark Phillips

How do we do at getting health care here in the US and do we get a good deal compared to other countries?

Based on figures published last week by the Organization for Economic Co-operation and Development (OECD), the overall picture is one in which developed countries spend an average of 9.3% of total income on health care. The below interactive tool will allow you to investigate by country against the overall average for

·         Life Expecatance

·         Health Expenditures

·         Health Risks

Cash-only Doctors Abandon the Insurance System

Presented by Mark Phillips

There is an interesting trend captured by this CNNMoney article. A small but growing number of doctors are opting out of the insurance system completely and accepting cash only for services. The business proposition offered by insurance companies to doctors is becoming so difficult that this seems to be a growing trend. This is a move that the majority of dentists have already made.

While I have a concern for the impact of high cost Concierge offices, some of the more modest flat fee programs (as reflected in the fees charged by Dr. Nunamaker), when combined with a high deductible insurance plan and an HAS account, may prove much more cost effective and conducive to a healthy doctor/patient relationship.

Please consider this trend and how this might be an opportunity, rather than a threat, to you.

Click here

A Test that Saved my Life

Presented by Tracy Chiu

Many of you know who Dr. Mehmet Oz is from his well received T.V. show. We can say that Dr. Oz walks his talk. When he turned 50, besides celebrating this big milestone he added this to his list: a routine colonoscopy. Although it is not on anyone’s top 10 favorite things to do, there are many risks for not having this routine test done.  Not having much of the common risk factors for colon cancer, Dr. Oz was shocked to learn they found a type of polyp that sometimes turns into cancer.

Don’t miss this and read further. It could save your life.

“The Test That Saved My Life”

How to handle Medical Bill problems

Presented by: Tracy Chiu

Hiring a medical billing advocate was the best decision for an Arizona couple featured in this L.A. Times article. They learned to manage and reduce their overall medical bills from their son’s hospital visit. When faced with the reality of huge medical bills after a health situation, it may be imperative to have an agency like Medical Billing Advocates of America to help sort and understand what the charges consist of and what your rights are in terms of the law.

Don’t miss this. Read further to learn about other helpful resources and how an advocate can benefit your personal situation.  

Click here for article

Finding Prices of Medical Procedures Getting Easier

Presented by Mark Phillips

It has been nearly impossible for patients to search and compare healthcare prices for procedures & tests. The good news is things are beginning to change. Now there are online tools and pricing sites which will help you to comparison shop before moving forward on a medical procedure or test. In addition to the benefit of price comparisons, some sites also show quality ratings for services like MRI’s, X-rays, and CT scans. Two of these sites are HealthBlueBook.com and SaveOnMedSavical.com.

Please read the LA Times article to learn more …Click here for the full article

Innovations in Health-Care

Below is a list of 10 ways that Health-Care has been shifting to innovate in 2012. Click on the article title below for the entire Wall Street Journal Article.

One area of particular interest is item number four. Do you see any of the below changes at your Doctor’s office?

Ten Ways Patients get treated better

1.       Doctors are adopting a better bedside Manner.

2.       Heart Attacks are being treated faster

3.       ERs are getting better at handling medical mysteries

4.       You can finally see what your doctor is writing about you

5.       Health apps are more sophisticated

6.       Tests for Colon Cancer are less arduous

7.       Talk of dying gets a little less daunting

8.       The hospital is less likely to make you sick

9.       Robots are helping your surgeon

10.   Vetting a hospital gets easier

Want A Quick Intro Into Medicare?

Below is a quick summary of choices for Medicare coverage.

 

 

Medicare Fact Sheet - A Quick Overview

Medicare is a federal health insurance program that covers certain medical services and supplies in hospitals and doctors’ offices. The insurance is provided for U.S. citizens and permanent residents. Its beneficiaries must meet one or more specific criteria and make specific coverage elections. These elections may be changes during the annual open enrollment period from mid-October to early December and under specific alternate circumstances.

Click here to get the Medicare Fact Sheet

Correcting Common Medicaid Misconceptions

Medicaid planning is an extremely complex area of law, and it is no surprise that there are so many misunderstandings about how rules are applied. The following summary is intended to help you avoid falling into common Medicaid planning traps by correcting some popular misconceptions.

Click here for the Correcting Common Medicaid Misconceptions Article

 

Caring For An Aging Parent

Many baby boomers belong to the “Sandwich Generation”—the growing group of people who care for their aging parents while supporting their own children. According to a 2008 USA Today/Gallup poll, 41 percent of baby boomers who have a living parent assist with the parent’s personal care, financial matters, or both. Another 37 percent expect to take on the care of their parents in the future. If you plan to be involved in an elderly parent’s care, it’s important to understand the array of issues that come into play.

(for the full article with resources click here)

Health Care Spending and average Outcome by Country

I suppose that it would be one thing to spend the most per person here in the US if we got the overall best outcomes. Unfortunately, numerous factors contribute to this not being the case in the US as compared to virtually all other countries in the developed and many in the emerging world.

As we look to help clients finance health care costs we are ever aware of both the costs (estimated) and the fear factor of costs. The Organization for Economic Co-operation and Development (OECD) has extensive Global health care and cost data (from which the below NGM chart was constructed) in their OECD Health Data 2011 study