Here are all the articles I've written about Government. Enjoy!

May 11th, 2017

Are AHCA concerns making you sick? Pre-existing conditions and MacArthur and more….

Holy cow, folks!  What a crazy time for health insurance!

Politics aside, The Insurance Mom wants you to be really, totally clear about what’s happening in the wacky world of health insurance.

The first thing most clients ask me these days is about pre-existing conditions.  What if I have an illness before I buy health insurance?  What if my sick child loses coverage?  “What-ifs” all over the place!

All we can do right now is breathe.  We don’t know what’s going to happen with this bill (it’s not a law yet!).  But I did want to shed some light on the latest MacArthur Amendment.

The LA Times did an EXCELLENT article on just this issue here:  http://www.latimes.com/business/lazarus/la-fi-lazarus-gop-healthcare-macarthur-amendment-20170504-story.html

Here are a couple of excellent quotes… but the whole article is awesome.

“And it protects people with pre-existing conditions much as starving people may be welcome at a restaurant, but only if they order the most expensive dishes on the menu.”

“This much is clear: Republican lawmakers have provided a textbook example of how not to enact major legislation.  They’re aiming to radically overhaul the $3-trillion U.S. healthcare system yet have shunned the input of major stakeholders such as medical organizations, hospitals and patient-advocacy groups, which are uniformly against the measure.”

What do YOU think, my lovely peeps?  Do you believe everyone should help pay for the sick?  Did you like the old way of doing things before the ACA?  Do you benefit from Obamacare?  Do you hate Obamacare (aka ACA)?  Tell The Insurance Mom your every little thing!…

Read More…
March 19th, 2015

Why we love John Oliver OR How to get a free lunch!

The Insurance Mom is a big fan of “Last Week Tonight” with John Oliver.   I thoroughly enjoyed his expose (which aired on 2/8/15) about the relationship between doctors and pharmaceutical companies.

The gist is this . . . it has been a long-time practice of pharmaceutical companies buying doctors lavish lunches, providing divine holidays, inviting them to be a brand ambassador, speaking at events, and paying the docs handsome sums.   It’s one thing to hand out free samples.  But some of these practices are bordering on bribery, false advertising and in the process, perhaps skewing the doctor’s medical practices towards the companies’ products.   John Oliver wondered why it is that some medical offices advertise a free lunch in their job postings.   Is it possibly because Big Pharma is footing the bill?!

Aren’t you curious about what your doctor is up to?   Here’s the website where you can see what kind of benefits your doctors may be receiving from Big Pharma.  Go to https://openpaymentsdata.cms.gov/ to find out more.…

Read More…
October 20th, 2014

Will YOU Be My Doctor?!

ALL networks are getting skinner and anorexic, reducing your choices for 2015.

In 2014, the biggest problem with doctor networks came with plans purchased on Covered CA.   It was hard to determine if your doctor took the Covered CA plans.  The Covered CA search engine was incorrect and removed from the website.    Some doctors only participated in networks used by off-exchange plans.

The same problem may continue in 2015.  It could be tricky to navigate for consumers who get a plan through Covered CA.   For a little bit of guidance with Covered CA doctor networks, the LA Times created a map for you.  Click here!

But remember, not all plans/networks are available in all geographical areas.  And, networks can change from day-to-day.

One bit of good news:   Anthem Blue Cross has made it clear that doctors MUST be in both off-exchange individual networks AND on-exchange Covered CA networks,  or they will not be doing business with Anthem Blue Cross at all!

Double check with all your doctors in which networks they will be participating for 2015 before making a decision about your health insurance!  Listen to your Insurance Mom . . . mother knows best!…

Read More…
October 20th, 2014

How Much Will it Cost to Get Covered in 2015? 

If you know anything about the Affordable Care Act (ObamaCare), you know that the next Open Enrollment period is coming up (Nov. 15th – Feb. 15th for a Jan. 1st and later start date.)

Everyone’s first question to me is “how much will my monthly premium be?”

We don’t have enough info yet to compare.    Not all of the rates have been approved by the CA Department of Insurance.    But we do know the word on the street from going to conferences and doing lots of reading.  The Insurance Mom is here to translate!

There were a couple of great articles by Chad Terhune in the LA Times on 10/3/14 and 9/28/14.   For plans purchased through Covered CA, weighted increases in 2015 will range from 4.2% to 8% statewide (depending on where you live, it could be lower or higher).

But… actually using the plans is a whole different story!  That prompted two blog more posts about doctor networks AND why everything is so different after the ACA.  Click the links to read all about it!…

Read More…
August 18th, 2014

Are you OK with one person taking control of what happens to your medical bills?

I don’t think I’ve ever politicized a blog post.  This could be a first.   So you’ve gotta know how important it must be.

Proposition 45 will be on the ballot in November.  Prop 45 is a flawed, deceptive measure that will increase costs for consumers and (maybe) harm the quality of our health care.

A special interest group (of course!) is sponsoring Proposition 45, an initiative on the November 2014 ballot that gives ONE POLITICIAN (the Insurance Commissioner) new power over your health care – including your premiums, co-pays, deductibles and even the treatment options your health insurance covers.

This is bad.  This is very, very bad.

We all want to control health care costs – that’s why California has a new independent commission with the authority to negotiate rates with health plans and reject them if they’re too expensive. We should give this commission a chance to work, NOT give more power to a single politician who can take campaign contributions from special interests.

There are many reasons why Prop 45 is NOT a good idea.   And they all might cost YOU a lot of money.

1.            Prop 45 gives one politician just too much power.

2.            Prop 45 creates a more costly bureaucracy.

3.            Prop 45 is sponsored by special interest (lawyers, lawyers, lawyers!) who could make a LOT of money under this measure.

Be wary of what’s on your ballots, kiddies.  The Insurance Mom doesn’t want you and the whole state of California to get caught in a terrible mess caused by Prop 45.

Ask yourself this:   Do you trust one politician to dictate what will happen to your health and finances?

With one elected official in charge, you won’t have any input – nor will doctors or hospitals – on the best decisions for your …

Read More…
July 9th, 2014

Long-Term Care Clarity!

Does Medicare cover long-term care expenses?  The answer may surprise you!

 

There was a neat article this week in the LA Times about Long-Term Care Insurance which spelled it out very nicely.

 

If you haven’t given much thought to how you’d pay for long term care expenses, you’re not alone.    Most of us haven’t.   But, the BIG question is:   Would you be able to afford it?

 

In California, the average annual cost for long term care – today — is about $82,000 a year.  Wow, that hurts!   If you cover your ass(ets) and get long-term care insurance, you’ll significantly reduce your costs.

 

So . . . DOES Medicare cover LTC?  No!     Does your health insurance cover LTC?   No!

 

Not a happy prospect.   We are all about protecting your money over here, so it may be time for you to start thinking about it, too.  Remember: the younger you are when you plan ahead the more you save.  The ‘Mom’ only wants what’s best for her little kiddies!

 

Educate yourself on the details of the ins and outs with the article here and contact The Insurance Mom for a chat about your future.  Mind your P’s and Q’s and you’ll be taken care of . . . long-term.…

Read More…
May 6th, 2013

Is Congress trying to hide from the Affordable Care Act?

Starting 1/1/14, the Affordable Care Act (ACA) will make Congress members and their staffs buy their own health insurance (for the first time ever!).  And they have to use the new public exchanges to do it.   BUT..  they’re all in a tizzy about what it’s going to cost them and are looking for ways to squirrel out of participating in the law that they passed.

These exchanges, also known as “marketplaces,” are part of the ACA, and are being established by 19 states (the rest are letting the federal government run it for them), presumably so that everyone will have a simple, easy way to compare and select competitively priced health insurance coverage.   So far, there’s nothing simple or easy — or affordable — about it!

Currently, the federal government pays for health insurance for those on Capitol Hill.   But the ACA changes the rules that govern how they buy their insurance.  They could be paying for their own insurance… just like the rest of us!   It’s likely that this could cause a number of politicians to get out of Washington in favor of rejoining the working class!   Senator Max Baucus, Chairman of the Finance Committee which wrote the ACA has already announced he’ll be resigning next year!!   Read all about their reactions to their own rules in this Politico article.

Of course, a lot is still in the TBD pile – including just how much our friends in Congress and their aides will be treated like the rest of us when it comes to getting a helping hand with their health insurance premiums.  These ever-changing health insurance regulations are also presenting a lot of confusion for many of us regular consumers.   A lot of people are concerned that buying health insurance through the marketplaces will increase their …

Read More…
May 9th, 2011

I’d like to trust them, but…

The Insurance Mom wants to know… does this make ANY sense to you?

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.

Enhanced by Zemanta
Read More…
September 9th, 2010

The Other Side Of The Story

The Insurance Mom loves her colleagues around the country… they are a very smart bunch!  Especially Ric Joyner, a benefits specialist in Madison, WI, who writes an excellent benefits blog.      If you value your hard-earned money, I really want you to take a few moments to read how health care reform will impact your life and your money.

The Wall Street Journal is saying that insurers are adding costs to health insurance premiums to pay for health care reform measures.    The insurers are adding 5-9% MORE to your premiums due to health care reform.   But why?

1. No underwriting starting in 2014. That means no one can be rejected. Thus, we move from “insurance” to a utility organization which the government can dictate, including fees too.   If the insurance company can’t underwrite the policy then they can’t prevent bad risk.   Thus everyone who is healthy will pay for those who are unhealthy.   Is this bad?   Perhaps.   It depends on your politics.   If you believe that everyone should pay for everyone else then it works great.   But think about it.   Our founding fathers wanted true freedom to succeed or fail. We are taking the ability to succeed or fail away and promoting mediocrity.

2. If you read the article closely you will find the Obama Administration is saying that this concept is out of line, however it actually makes perfect sense.   If you cover everyone, where you weren’t before…there are more costs. Thus insurance companies will pass on the costs to you!

3. So the Obama Administration knew that this was going to happen.  When you extend coverage to everyone you also increase cost.   Economists agree that when the health care bill was conceived and passed the costs of coverage for everyone would go up as well.   This bill

Read More…
July 22nd, 2010

Be Pro-Active and Preventive

The Insurance Mom wants you to stay pro-active about your preventive care (aka annual check-ups).    Besides keeping some yummy chicken soup handy, having annual check-ups will keep you well-informed about your lifestyle and future health care choices.

Something sort of good has actually been included in the federal government’s “stealth” care reform bill.    As of September 23, 2010, insurance companies must include annual preventive care benefits in all of their insurance plans.   And, these wellness services must be at no cost to you.   No co-pays, no deductibles.

But, these new benefits will not include every test in the book that your doctor wants to run.    The services that are included are defined by the U.S. Preventive Services Task Force, American College of International Physician recommended vaccinations, and Health Resources and Services Administration recommended screenings and preventive care for infants, children and adolescents.   For more information take a look at the government’s new website.

Some insurance plans already include full annual preventive care benefits, and those will not change.   These new preventive care benefits will be added to existing plans that do not meet the new federal guidelines.

The Insurance Mom has a question.    How do you think your rates are going to be affected when the insurance companies have to start paying for all of these new and improved benefits?    Hmmmm?

Better keep that chicken soup handy!

Enhanced by Zemanta
Read More…