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

August 22nd, 2017

Truth or (do you) Dare?

Thank you for coming back!  This is our final and MOST IMPORTANT segment for our blog series, Are YOU ready for Single Payer?  The whole reason we dove into this topic was because of SB 562, the Healthy California Act.

On 6/23/17, CA Assembly Speaker Anthony Rendon (D-Lakewood) shelved the proposal saying it is “woefully incomplete” and has postponed any further legislative action until 1/18/18.

At the very least, this will give the CA Senate and Assembly time to address some of the serious flaws in SB 562, including the lack of a funding mechanism, zero public accountability and no way to control or manage medical care and costs.

While this bill is off the table for now, it will be sure to zombie.  If it IS resurrected next year, you might not get a chance to vote on this bill.   But YOU will pay for it.

As it was written, SB 562 estimated an annual price tag of $460 BILLION – and that’s just to start.  The current healthcare budget is $60 billion.  That’s QUITE an increase.

  • Proponents don’t really balance the books when it comes to the tax burdens which could be put on all of us. When it costs too much, employers will start the lay-offs… that means you!   And there’ll be no more $$ going into the unemployment trust fund… so you’ll be on your own.
  • SB 562 – like the ACA — doesn’t have any language addressing the cost of getting medical care (which, let’s face it, is already out of control!)

The Insurance Mom is worried about you.  She wants everyone to have easy access to medical care.  The Insurance Mom thinks SB 562 is alarming. Why?  Well, I’ll tell you!

Under this proposed bill, you will be forced to give up whatever …

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July 28th, 2017

What the heck IS single payer?

Thanks for tuning in to The Insurance Mom’s blog on Single Payer.  Last week, we opened the convo by talking about California’s SB 562, aka Healthy California.    Two State senators are proposing a single-payer system.  But let’s unpack what that really means.

Single Payer = “Rationed” Medical Care

ICYMI, the CA Senate advanced a bill to the Senate.   SB 562 – The Health California Act, aka Single Payer (SP).  And then… On Friday, 6/23/17, CA Assembly Speaker Anthony Rendon (D-Lakewood) shelved the proposal saying it is “woefully incomplete” and has postponed any further legislative action until January 2018.

What does single payer mean?    The government will run your health care AND impose higher taxes on all of us.

It will be illegal for a doctor to perform services not included in the state’s Single Payer Plan.

It will be illegal for an insurance company to sell policies which duplicate any services covered under the state’s proposed Single Payer plan.

Single-payer advocates believe, on principle, that health care is best when it is “free to the patient at the point of care.” On the back end, of course, you still pay for it in higher taxes, and in between, the government decides whether or not you should be allowed to have that knee replacement or that mammogram. This is what we call rationing.

“Socialism is fine until you run out of other people’s money.”   — Margaret Thatcher…

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July 17th, 2017

Pack your bags – we’re goin’ on a trip around the world!

The Insurance Mom mentioned in last week’s post that there seems to be a huge misunderstanding of how America’s health care delivery system compares to those of other countries.   The divine Michael Lujan, shares his expertise:

The UK Model – In this mostly single-payer model, healthcare is provided and financed by the government through taxes. Except for small co-pays for prescriptions, there are no co-pays or deductibles as health care is delivered as a public service, like fire and police. With Britain’s National Health Service, most doctors and hospitals are owned by the government and patient wait times can vary by region or treatment type. As the sole payer, the government controls what doctors can do, and what they can charge. Our Veterans (VA) system is a close example. They also have private insurance options.

The Canadian Model – With this “National Health Insurance model”, the providers are private but the payer is a government-run insurance plan everyone pays into. Our Medicare system is a close example of this model. The private insurance plans are non-profit and manage their costs by limiting or delaying care.  Canada’s decentralized health system (coincidentally called “Medicare”) is technically a multi-payer system with slight differences for each of their ten provinces and three territories; some provinces/territories have co-pays at the point of care and others don’t.

The German Model – In this multi-payer system, providers and payers are private and largely funded through employer-based payroll deductions. Patients have co-pays at the point of care. The world’s first national health system (established around 1883) offers citizens 135+ private insurance plans called “sickness funds”. These private insurers negotiate prices with private hospitals and providers. Patient wait times are shorter than U.S. patients typically experience. This is the system most familiar to most Americans and might be …

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March 13th, 2017

Is TrumpCare my Care??

The Insurance Mom is back to blogging after a very busy Open Enrollment!  Thank you to all our followers and lovely clients who sent along referrals.  We are very grateful for you!

 

It’s been an interesting end of 2016 and beginning of 2017.  With that, we are seeing a TON of proposed changes that could affect your health insurance.    But, we probably won’t know for quite some time.   Remember, it takes a while to un-law a federal law!

 

But what’s it all mean, Mom!?  My brain hurts with all the HSA, tax credits, tax penalties, cross-border, stuff!
Well, that’s why I’m here, sweetie!  To take your hand, and tell you to take a deep breath because it’s going to be a long time before we see any changes take places.  And so far, no one can seem to get close to agreeing what those changes will be.  Now that we’re all feeling a little better, let’s get back to our health insurance education.

 

Here’s a great article from the fabulous team at Vox which does great work at explaining things in a simple way.  But the gist is this… Trump proposes these things:

 

  1. Pre-existing conditions will not affected.
  2. The tax credit thing is going to change, likely based on age not income.
  3. Trump and the GOP really like Health Savings Accounts (HSAs).
  4. He wants to remove the plan restrictions.  So that whole metallic thing will likely go away and companies can design their own plans again.
  5. Trump is a little unclear about the Medicaid situation, but the GOP seems to want to decrease Medicaid enrollment.
  6. Trump would like to reduce costs of insurance and drugs.

 

Here’s the Insurance Mom’s takes on these things, by the numbers:

 

  1. Goodie.
  2. The GOP’s current proposal called the American
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August 6th, 2016

Health Insurance Forecast for 2017– Are YOU Prepared?

Hello, Friends!

 

Are you ready for health insurance news for NEXT year??   Sit, get cawfee, or a cocktail and let’s tawk!

 

This interesting article from the NY Times and this one from the Free Beacon each have loads of important info, but here’s the gist….

 

The SAME news: the NEXT open enrollment period will be 11/1/16 through 1/31/17.

 

The HAPPY news: Obamacare will be rating health insurance plans based on how many doctors and hospitals are in their networks.  BUT (as I am your interpreter of bulls*#$) this doesn’t necessarily mean that doctor networks are going to improve for individual plans.  It just means there’s more transparency for you to make informed choices.

 

The PHEW! news: there’s a new thing next year called “continuity of care.”   What do you do if your doc leaves your network?  Often they leave or get dropped from the network without any heads up to YOU.  BUT in 2017, if you’re in an “active course of treatment,” you’ll be able to continue seeing the doctor if they leave the network.

 

The BAD news: out-of-pocket maximums are going up.  WAY UP!  In some states, they’ll increase from $6500 to $7150 for individuals, and from $13,000 to $14,300 for a family.

 

The YUCKY news: The Beacon article anticipates that deductibles in most states will see increases , too.

 

The WORST news: hold on to something…  premium increases are on the horizon for 2017.

 

The more you know, the more prepared you’ll be for 2017.…

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February 19th, 2016

Intro: The Insurance Mom’s Guide to Better Living Through (Cheaper) Chemistry!

Hi Insurance Mom Family,

 

OK, let’s talk prescriptions.  But Mom… they’re so expensive!  I know, sweetie.  The Insurance Mom hears you.

 

Yet another (un)intended consequence of the Affordable Care Act… formulary shrinkage.    The formularies are the lists of drugs your insurance company covers – generic and brand name.   Most people just pay up at the pharmacy and don’t know they can actually shop around for better prices.   Just because you have health insurance doesn’t mean you’re getting the best price!

 

To help you along the way, we’ve written a blog series we call …

“The Insurance Mom’s Guide to Better Living

Through (Cheaper) Chemistry.”

high-cost-prescription-medications-health-care-concept-money-flowing-open-pill-white-background-34658791

 

This FIVE part series walks you through money saving tips & tricks from the moment the doctor writes the script to the moment you pick it up at the pharmacy.  Keep tuning back for the next five Fridays to learn to speak Rx.

 

As an intro, click the hyperlinks for these great articles from the website, GoodRX and another one from Consumer Reports.

 

In the meanwhile, talk to me!  What are your insurance concerns for the coming year?…

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July 21st, 2015

Assurant is going WHERE!?

Big news across the nation.  Assurant Health, a big player in health insurance, will be closing up shop at the end of the year.  This means everyone with an individual Assurant plan will need to get a different plan in place for January 1st, 2016.  But my Assurant friends, we can’t do anything for you until Open Enrollment in November.  This is going to be a HUGE change for the face of health insurance next year.  The Insurance Mom will keep you posted on all the latest news and trends.  In the meanwhile, here’s a full article on the Assurant story.http://www.bizjournals.com/milwaukee/news/2015/04/28/milwaukee-based-assurant-health-to-be-sold-or.html?ana=lnk

 

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April 29th, 2015

The Insurance Mom is on KPCC!

Check out this great article by Stephanie O’Neill at KPCC about brokers and the Affordable Care Act.  So pleased she did this article and flattered she asked me to participate.

http://www.scpr.org/news/2015/04/29/51313/some-brokers-encounter-hard-times-under-the-afford/

Give it a listen or a read and let me know your thoughts below.…

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February 25th, 2015

Repost! 4 Simple Rules About Long Term Care Insurance

Another oldie but a goodie (with some updates) about Long Term Care Insurance.  Is it time for you or your parents to think about Long Term Care Insurance?  Here’s 4 quick rules about LTC . . .

First, always consult with a qualified broker, like The Insurance Mom!

Second, buy a plan that’s affordable.  Don’t go hog wild and buy a plan that’ll  cover 100% of anticipated future costs just because you think it’s better.  It is much smarter to buy a policy you can afford to pay for every month.   If you can’t pay the premium, what’s the point?  You’ll get no benefits at all if that happens!   It’s better to buy a policy that will cover at least half of future costs than buy no policy at all.

Third, buy a policy that keeps up with inflation (that’s called a Compound Inflation Rider).   The cost of care rises every year.   Get a policy that keeps up with the times.   Look for a policy with a built-in 5% Compound Inflation Rider.

Fourth, aim for the shortest possible waiting period for the plan to kick in (that’s called the Elimination Period).  For example, if you have a 30-day elimination period, you’ll pay for the first 30 days of expenses out of your own pocket.  The shorter the Elimination Period, the more expensive the policy will be.   If the Elimination Period is 90 days or longer, be sure you have the moo-la to cover you!

Now…. don’t you feel smarter?!  You get a cookie for reading!


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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!…

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