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

October 15th, 2018

Freelancers & Independent Contractors! A new CA law could HURT your status!

If you’re a FREELANCER in CA (aka INDEPENDENT CONTRACTORS) — read all of this to protect your $$$ !

The Insurance Mom wants to make you aware of a recent CA Supreme Court ruling.    It could really HURT you as a FREELANCER.     If you HIRE freelancers, this new state law could hurt you as a business owner.   WATCH OUT!

For more information or to sign-up and have YOUR voice heard please visit I’m Independent to protect your rights as freelancers and/or a business owner.

Dynamex Operations West Inc. v. Superior Court (Dynamex) could require many 1099 independent contractors to become W-2 employeesand YOU won’t have a choice.

The ABC test determines WHO is an independent contractor or an employee.    You will be Independent Contractors ONLY if the hiring entity is able to PROVE ALL THREE of the following:

     (A)    That the worker is free from the control and direction of the hiring entity in connection with the performance of the work, both under the contract for the performance of the work and in fact;

     (B)    That the worker performs work that is outside the usual course of the hiring entity’s business; and,

     (C)    That the worker is customarily engaged in an independently established trade, occupation, or business of the same nature as the work performed.

You should be VERY alarmed!!   The Dynamex ruling is now CA State law and will NOT be appealed.

freelancers independent contractors

The new standard could potentially reach back four years which could financially destroy your business even if you were fully compliant in operating under the previous standard of Independent Contractors.

Hmmm… I have questions:   Who is going to be the watchdog?   The regulators?   The enforcers?   Are small businesses at risk as much as large businesses?    How will the regulators know who’s …

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September 26th, 2018

Hey, CALIFORNIA… here’s info about your INDIVIDUAL health insurance for 2019

READ ME… ALL OF ME!!
It’s time to talk about individual HEALTH INSURANCE for 2019 — OPEN ENROLLMENT is starting 10/15/18
Information is starting to roll in.   BUT we’re still waiting for the FINAL RATES.
What we know so far:
  • There WILL BE rate increases — no, I don’t know how much yet
  • There are NO new/better options in 2019
  • There will NOT be any better networks or drug formularies
  • Blue Shield will NOT continue the BlueCard program when you’re traveling — which means NO coverage outside of California, except for emergencies (like all companies)
  • Deductibles are going up slightly
  • Out-of-pocket maximums are going up slightly
Chances are, you’re going to STAY PUT on your current plan for 2019.   Yes, no kidding.

Be patient… take a nice inhale 🙂…

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February 14th, 2018

You think YOUR insurance company is bad?

You think your insurance company is bad?! Check out the latest bovine defecatory material about Aetna from CNN.

We all know medical claims can be a nightmare to handle… How would you feel if something like this happened to YOU?

The Insurance Mom says BE YOUR OWN BEST ADVOCATE!   Stay involved.  Keep informed.

 …

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July 28th, 2017

What the heck IS single payer plan?

Thanks for tuning in to The Insurance Mom’s blog.  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.  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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June 30th, 2017

What a difference a week makes! SB 562 Update

Thanks for tuning in for our series on single payer!  What a difference a week makes; big update on SB 562.

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.

“If you think health care is expensive now, wait until you see what it costs when it’s free.”  – P.J. O’Rourke

The Insurance Mom’s colleague, Michael Lujan (one of CA’s best-known expert insurance legislative analysts) offers this in his amazing post on LinkedIn:

Single Payer (SP) would:

  • Replace all forms of private and public health insurance in California with a state government-run health system.
  • Would eliminate an estimated half million insurance, health care administration and related jobs, tripling our current unemployment rate. And without payroll contributions going into the system, there will be no money to pay unemployment benefits.
  • Could make California a health care destination for anyone seeking “free healthcare” as neither citizenship, nor permanent residency is required to use the SP system.
  • Requires massive tax increases. The additional 15% payroll tax would make California the highest taxed state in the country.

If enacted, The Healthy California Act (SB 562) would be the largest tax increase in California’s history. The entire state general fund is $183 billion. As proposed, the bill would cost an estimated $400 billion for the initial year and unknown costs for subsequent years. While that may seem like a deal-killer, the bill moved forward to the State Assembly and should not be ignored (when it resurfaces in 2018).

While this bill may be dead in the water, single payer / universal healthcare / socialized medicine / Medicare-for-all have been floating around the brains of the public.  The Insurance Mom wants her kiddies well-informed about …

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April 18th, 2017

Have You Heard? BIG changes coming to health insurance in 2018! BEWARE – BE AWARE!!

In 2018, if you’re buying individual health insurance for you and the fam (not through an employer),  PAY ATTENTION!
Open enrollment is scheduled to start NOVEMBER 1, 2017 (for new coverage starting January 1, 2018)
NEW RULE:  
Open enrollment will ONLY be for FORTY-FIVE days, ending December 15th.  That’s half of what it’s been in prior years.  YES!!!  No kidding.  PAY ATTENTION!!  
Health insurance will be harder to buy – or change —  in 2018. So The Insurance Mom wants you to really PAY ATTENTION!!  Outside of Open Enrollment (after 12/15/17) you’ll have to seriously PROVE that you’re eligible to buy health insurance or make changes to your plan.  It’s called a Qualifying Life Event.
 
MORE CHANGES:
  • The new rule could reduce the amount of federal subsidies that currently make premiums more affordable for low- and middle-income people
  • The new rule could allow insurance companies to offer even skinnier networks
  • The new rule could make coverage skinnier, too
PAY ATTENTION!   New regulations do NOT require Congressional approval… just the signature of a President.  If you’re not happy with the way things are going and are worried that you could lose the coverage you have, The Insurance Mom encourages you to contact your Members of Congress.
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August 17th, 2016

“What’s Up, Doc?” Blog Series Part 11: All Better… But OUCH, This BILL!!

Oodles of gratitude for taking this virtual trip to the doctor with us!  Here’s even more in the series “What’s Up, Doc?”  Catch up with parts one, two, three, four, five, six, seven, eightnine, and ten.  And now, our last in the series… “All Better… But Ouch, THIS BILL!!”

  1. Your doctor is IN-network right?    The doctor’s office MUST submit the bill (aka “the claim”) directly to your insurance company.
  2. The IN-network doctor CAN ask you for the office visit co-pay at the time of the visit.    But, for medical services done during the visit…
  3. The IN-network doctor can NOT charge you until after the insurance company applies the IN-network discounts (the negotiated rate).
  4. When you get a bill from the doctor’s office, be sure that the IN-network discounts have been applied.   How do you know?
  5. … because you got an Explanation of Benefits (EOB) from the insurance company!   Check the EOB against the provider’s bill, and THAT’s how you know you’re getting the right discounts.
  6. If the doctor is OUT-of-network you’ll be submitting your own claims to your insurance company – and the doctor can charge you whatever she likes, there are no discounts.
  7. If you have an HMO, you must ONLY see a doc in your HMO group.  There are NO benefits in an HMO if you go to an out-of-network doctor.

Talk to me!  Was this helpful?  What was your fave piece of info?  Suggestions and thoughts are welcome.  And as always, reach out to us for any of your insurance needs.

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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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August 3rd, 2016

“What’s Up, Doc?” Blog Series Part 9: The Doorknob Moment… and Other Missed Opportunities

Welcome back to our series, “What’s Up, Doc?”  You can check out the first, second, third, fourth, fifth, sixth, seventh, or eighth parts by clicking the hyperlinks to get up to speed.  And now, “The Doorknob Moment… and Other Missed Opportunities.”

 

  1. Be your own team!  Prepare in advance for your visit.   Patients who take a more active role in their medical care have better physiological improvement.  Remember, this is a TEAM effort between you and the doctor… with you as the Team Captain!
  2. Ask your most important FAQs first!   Don’t wait until you’re dressed and leaving the office!  They say in psychotherapy the most impactful part of the session is usually the last 5 minutes.  Don’t take that approach with your medical doctor or you could miss talking about some important info and you will leave with missed opportunities.
  3. This tip is for the fellas:  speak up!  Don’t be macho, tell the truth.  If something is ailing you, it’s better for your doctor to know so she can help.   This visit is not the place to put on a brave face.    Statistically, women are better than men at asking questions about their medical issues.  Not that we’re better or anything (wink, wink), we just go to the doctor more often so we have more practice.
  4. ASK if the doctor will communicate by e-mail.   Often e-mails become a valuable part of your chart.   If you happen to forget to ask an important FAQ or need further clarification, having a doctor who uses technology is critical!
  5. If the doctor doesn’t use email, find out the easiest way to communicate about your missed opportunities with her after the visit… phone, fax, carrier pigeon, smoke signals?    For example, does she return phone calls after normal office
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July 27th, 2016

“What’s Up, Doc?” Blog Series Part 8: A Cure For What Ails You

Hello again, my avid readers.  Hugs for reading the first, second, third, fourth, fifth, sixth, and seventh of our series, “What’s Up, Doc?” Last time, we left you sitting on the slab as the doctor came into the room.   And now a segment we call “A Cure for What Ails You” and is a continuation of advice from last week on what to do once you have their ear.

 

First and foremost, I like the concept that the doctor works FOR YOU!   Not the other way ‘round.   You are paying that person… she works for you!   You deserve her time and FULL attention.   Remember, you get a vote.   And not just any vote.. you get THE vote on how things proceed!!

 

  1. If you need tests, remind the doctor to use ONLY an in-network lab.
  2. If you need meds, ask if the generic is available.   YOU control how you spend your money!  The docs generally don’t think twice about prescribing expensive brand name drugs to help cure what ails you.
  3. Did the doctor advise seeing a specialist?  Ask for their IN-network referrals for a trusted doc before you leave.   But it’s still up to YOU to verify that the new doc is IN-network!
  4. If you need a follow-up visit, make the appointment before you leave!
  5. Remember to request a copy of the chart notes from today’s visit.
  6. ASK if the doctor will communicate by e-mail.   Often e-mails become a valuable part of your chart.

 

Who is your fave doc?  What have they done that makes them your fave?  Always love the shares from friends of The Insurance Mom.

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