The doctors wanted to run every diagnostic test they could think of, often more than once.   They suggested all sorts of treatments and medications.  And they knew he was terminal.

Although we kept the procedures to a minimum, the costs mounted and Medicare wound up with that outrageous bill.  What’s important here in addition to the insane cost of medical care (which the health care “reform” doesn’t even begin to address), is that Medicare reduced the hospital’s bill to $14,000 and Cedars Sinai had to write off the rest.   Really.

All PPO plans work this way!  It’s why I tell my clients to avoid paying a provider in full for medical expenses before the insurance company processes your claim.  Otherwise, it’s more than likely that you’ll overpay for your medical services and getting a refund from a provider is painful!

Fight for your money!  S/he who writes the checks has the power… not the receptionist behind the front desk or the provider’s billing service.

Talk to me about other exciting discussions you should be having with your providers… it’ll open your eyes and maybe even save you some money.

Last year it became possible for an unhealthy, uninsurable person to get guaranteed health insurance.  The government enacted the Pre-Existing Condition Insurance Plan (PCIP).   It’s available.  It’s affordable.  And the benefits aren’t too bad either.  Sounds too good to be true, doesn’t it?    Read on.

My uninsurable client qualifed and voila! — on March 1st he had pretty good health insurance.    But because of his escalating mental health problems, he forgot to pay the premium and his coverage was cancelled.

Under other circumstances, he would be allowed to pay the back premium and get his coverage reinstated.  But because this is a government run program the guidelines are different.

PCIP won’t allow payment of back premium.  PCIP won’t allow reinstatement.  PCIP will only allow my client to file an appeal… one that could take up to two weeks and has the possibility of being denied.    If the appeal is denied, my poor, suffering client cannot re-apply for 6 months.

He is unwell.  He cannot begin treatment.  He cannot continue treatment.   And he may not be able to get another PCIP policy for 6 months.

Because in order to qualify for the government run PCIP, one must be uninsured for 6 months or more.

And this is from the folks who want to give us government run health care insurance.

If you have health insurance and your co-pay is less than $54, you’ll be able to buy Lipitor for $4 with Pfizer’s new discount card, for up to 12 months.     If your co-pay is more than $55, you’ll only pay$5.

Spend less of your money.    And, consequently, less of the insurance company’s money.   Let the drug company buy your drugs for you!

The Insurance Mom says when we all put less of a burden on the insurance companies, the less of a burden they put on us with higher premiums!

If  you have an individual/family plan with Anthem BC, you recently received a huge mailing full of documents, jargon, pamphlets and choices, oh my!

The documents you’ve received talk about the pre-ObamaCare plans (grandfathered) versus the new ObamaCare plans (non-grandfathered) and what happens if you move from a grandfathered plan to a non-grandfathered plan.

You can stay on your existing policy as long as you like.     However, the grandfathered plans don’t include the new federally mandated free preventive care services (your annual check-up).    You have the option of moving to a non-grandfathered plan if you want to be able to take advantage of this new benefit (and one or two others).   But moving to a different plan could increase your monthly premium.    And if you move to a new plan and don’t like it, you can’t have the old one back.

And that, in a nutshell, is what all of those pages say.   It boggles the mind, doesn’t it?

Your safest move is to call or e-mail The Insurance Mom for help and guidance.

So do not pass “Go” — do not hesitate — Call The Insurance Mom NOW so we can take care of your kids together.   I’ll warm the milk, you go get the cookies!

Now, because of the federal health care reform, you can start going to the doctor again every year for your check-ups, and it won’t cost you a thing.  But only IF your health insurance plan started after the law’s enactment on 3/23/10, or IF you have changed up your plan since 3/23/10.   The LA Times had a fairly good article in today’s Health Section which explains how and IF you can take advantage of this new “free” annual check-up.

Remember when you heard, “you can keep your plan if you want to?”   Well, that’s true, sort of.   You can keep your plan and if you make no changes to it, like the deductible, you will have the plan you’ve always had but you won’t have that new annual preventive care check-up either.

If you change your plan, or your employer changes your plan, then you’ll be able to get a free annual check-up, no deductibles, no co-pays.

The analysts are estimating that, as the cost of health insurance rises, almost everyone will make changes to their policies within the next 24 months.   And then the insurance companies will be paying for your annual check-ups.

And while The Insurance Mom thinks everyone should go to the doctor every year for a check-up (if only to get that lollipop!), remember that mandates are expensive.  And whether or not you take advantage of this new mandated benefit, we will all pay for it.

Here’s a great little article about how we can easily take care of ourselves.   And, with the new federal health reform laws, chances are your health insurance company is giving you these annual check-up services for free.  We like free!

Let me know your FAQs.   Here’s to your good health!

Shortly after the reform law was enacted on 3/23/10, the insurance companies stopped accepting applications for children only (the explanation is long and boring, but if you want to know the back story send The Insurance Mom an e-mail and I’ll fill you in).   If you wanted to insure a child on an individual policy, then a parent had to also apply, even if Mom or Dad didn’t need the coverage.   What a pain!

Thanks to a new CA law — AB 2244 — there is now a short window of opportunity to get your child health insurance all by themselves on an individual policy.  From 1/1/11 to 3/1/11, CA insurance companies are accepting applications for your kids — solo.    The policy will be issued regardless of your kids’ current health status or health history — guaranteed!

What a nice way to start the new year!

The new federal health care reform laws are cumbersome at best.  The regulations currently being written will wind up being about 300,000 pages.   Nope, that’s not a typo.

So.   If you’d like to know just a little bit about how all of these health care reforms could impact your life, please do contact me.     The Insurance Mom really does want you to know.   I want you to be prepared, very prepared.