What’s a Health Care Cooperative?

Right now, the only “public” option for affordable health insurance is Medicare, which is only for those over 65 years old. If there isn’t another “public” option for others, this has ramifications for Medicare and Medicaid.

Right now in the U.S. there is a single payer government plan, Medicare, for those over the age of 65. The plan works as well as it can, given the debt load of the nation and the spiraling costs of health care. There isn’t anything else like this idea for other people who can’t afford health care or can’t afford much coverage at all. This is where health care reform is supposed to come in.

The clear problem with health care reform that doesn’t have a government option or component is that those who aren’t in Medicare or Medicaid may wind up raiding those programs to get what they need. That may mean a decrease in funding and greater difficulty in accessing programs for those over 65; a sort of Robin Hood approach of robbing the richer programs to pay for the poorer programs.

The substitution of the so-called health care cooperative for the government option is simply a thinly veiled excuse for the creation of more insurance companies. The usual example trotted out of a health care cooperative is something called Group Health. In fact, Group Health is an “insurance” company that reinvests its yearly revenues not redistributes them among members. It is only governed like a cooperative, making it one in name only.

Group Health’s fees are a tad lower than other insurance outfits, records are computerized and physicians get performance based salaries which seems to be a code word for “keeping costs down to a minimum.”
To access affordable health care by this route, those needing medical assistance are assigned a team of primary care practitioners, meaning you have no say in the matter. If access isn’t readily available to see the doctor, you will see a nurse; no ifs, ands or buts. If keeping medical costs down is the raison d’être for the insurance company, chances are expensive tests are not ordered that often and treating deathly ill patients would not be a preference.

Drugs and procedures, how medicine is practiced, and health insurance coverage decisions are made by the company – made by an insurance company. Think about that for a minute. Reading between the lines here, Group Health isn’t really “group health,” it is an insurance company with a bottom line to stay in business and make money. Staying in business by cost cutting medical care is a scary idea.

Will this come to pass? Only time will tell, and since the health care reform bill is gathering some dust right now, no one seems to know what will transpire for the future. For now Medicare and Medicare supplements are doing yeoman’s duty and allowing people the choice of physicians. It may not be perfect, but it limps along, working for “now.” Stay tuned for what the future may bring, and in the meantime do some thinking about what alternatives might work for your health care. The President has said if people like their health care they can keep it. Can they?

Clelland Green is with Benepath.com, a leader in providing health insurance quotes. Benepath provides individuals, families, and businesses with affordable health insurance quotes in just a few mouse clicks. To learn more about Health insurance quotes, affordable health insurance, affordable health insurance quotes, health insurance plans, visit Benepath.com.

Major Issues Still Remain with Health Care Reform

While it sounded like a good plan to have health care reform on the go by Labor Day, the deadline came and went. What’s next?

Next is what the House chooses to do when they sit in September. Some of the ridiculous issues raised over the summer months have up and gone away, but others remain that will likely be a great deal more contentious and have greater ramifications.

The leading issue seems to be the “public plan,” which is a polite way of speaking about a kind of government insurance plan that would be available to those who had absolutely no other health insurance options. While this sounds like a dandy plan on the surface, there are those that insist it would be a government takeover of health care, not always a good thing given the current state of affairs.

On the other side of the fence there are those that make the case that the public plan is ultimately necessary for any kind of reform to be effective. If access to health care is an issue that is supposed to be resolved, then this particular point of view tends to make sense to a large number of people.

Taking a step backward to get a clearer view of the debate, one comes to the conclusion that both sides of the argument have a point, but neither is totally right. That isn’t too much of a surprise given that it’s politicians doing the infighting. Really, the questions that ought to be asked, rather than focusing on poverty and access to health care, might be, “How will the government make Medicaid better and stronger?”

This question makes sense since the original universal health care changes have been tanked for now and the focus shifted to expanding health insurance coverage to certain segments of the population. Obviously, one of those segments is people living in poverty. Everyone should have a safety net for medical expenses, and there isn’t one right now. Instead, families face potential bankruptcy and total financial ruin over medical bills.

Ironically, the one program that should be able to help those in such dire circumstances – Medicaid – doesn’t guarantee either insurance or health care to people in poverty. Reform, if it is indeed on its way, needs to perhaps have Medicaid returned under the federal government’s wing and change the reimbursement doctors are given so they may assist people in poverty. That would make a significant change in the health care system.

If poorer people did have access to health care, it would keep them from having to use hospital emergency rooms. Just think about how much this one small change would mean to the system wide budget that faces escalating costs, thanks to poor people using ERs as doctor’s offices.

Clelland Green is with Benepath.com, a leader in providing health insurance quotes. Benepath provides individuals, families, and businesses with affordable health insurance quotes in just a few mouse clicks. To learn more about Health insurance quotes, affordable health insurance, affordable health insurance quotes, health insurance plans, visit Benepath.com.

The Medigap Switch in 2010

Keeping track of incoming Medigap changes is a bit like playing a game of 52 Pickup: confusing and all over the place.

There are not a lot of people who truly grasp what is coming in 2010 when it comes to the changes slated to kick-in with Medigap. The confusion centers on many thinking the changes that are coming have already gone into effect. This isn’t the case, and the changes “to” come have no effect on “current” Medicare supplement coverage, but they may ultimately have an effect on whether or not a person is able to get affordable health insurance.

The scoop is that effective June 1, 2010, the federal government is changing all “existing” Medicare supplement plans. The changes won’t take effect for any policies bought prior to June 1, 2010; they will only affect policies purchased after June 1, 2010. The changes are intended to streamline plan offerings and make them more customer friendly. There are some new plan options as well. In terms of getting health insurance quotes, this may confuse many people if there are too many choices.

It’s usually a given than when something like Medicare supplement plans change, there is major confusion for those who need to buy them. One of the things not a lot of people realize is that the Medigap plan they already have is guaranteed renewable for life, provided the premiums are kept up. This means that even if a policyholder’s health changes, they can’t be kicked out of the plan and they can’t be forced to change to a new plan either. That means they will still have reasonable affordable health insurance.

Consumers need to be aware that if they decide to go with a new plan in 2010, they will be losing some of the benefits of a current plan and that they won’t be allowed to revert to the original coverage. This has an upside in that it’s possible the new plan may be more suitable. This is one of the major reasons anyone considering changing plans needs to speak to a knowledgeable insurance agent to compare the benefits of the current plans versus the new ones. In other words get multiple health insurance quotes to compare health insurance plans.

Making any hasty decisions based on a news article or the word of a friend is not advisable. The smart move is to talk to a local insurance agent and discuss coverage now versus coverage in 2010. Knowing what to expect is more than half the battle when it comes to deciding on the best health insurance plans.

To learn more about Health insurance quotes, affordable health insurance, affordable health insurance quotes, health insurance plans, visit Benepath.com.

Health Care Reform a Long Haul

There is no question that in order to overhaul the health care system, the nation will be facing a long process of change, unrest, fears and doubts.

The message about health care reform has been filtering through to every American since way back when, but was brought to the forefront of the nation’s conscience when the President emphatically indicated that health care reform will not wait another year.

The year is passing slowly and the reforms continue to be put into place. There is still a long way to go, but looking from the bottom up, there may be light at the end of the tunnel. It’s true the health care system is broken and has needed a good overhaul for far too many years to even remember. However, over those years politicians preferred to stick with the devil they knew, rather than the devil they didn’t.

The devil they knew was the bloated and struggling health organism that was spiraling out of control and on the verge of what could only be a monumental crash. But, it was easier to leave it alone than to try and find the money to fix it.

The devil they didn’t know was the one that had innovative ideas to change the face of the existing structure; cut back spending in strategic areas; start to make health care available to all; and continue to chip at a system that needed to be kicked around the block to get it moving and functional again.
Right now the devil is still the one not many people know and that devil is working to reduce the costs of health care, making it a priority to protect people’s choices and trying to ensure there will be quality health care. Not only does that make sense, it even looks like it might be accomplished in slow and careful increments. Reform may indeed be on the horizon.

Interestingly, reform has been a major topic of discussion for the nation since Harry Truman, and just as ironic is the fact that the same reason “not” to do health care reform is still being cited today: the nation can’t afford it. More to the point is can the nation afford not to do it? The answer to that question is that no, ultimately the nation “must” reform health care in order to survive and thrive.

The real enemy standing in the way of health care reform is the big insurance companies whose main reason to be is to make money by selling health insurance. The government isn’t the one in the way between you and your doctor; the insurance companies are, and they are there for the profit.

To learn more about Health insurance quotes, affordable health insurance, affordable health insurance quotes, health insurance plans, visit Benepath.com.

Limiting the Deductible on OTC Meds

While it’s only a glint in someone’s eye right now, the government is toying with the idea of barring pre-tax health spending plans from giving money back to patients for their over-the-counter drugs.

Think about that idea for a minute and see what kind of conclusions you come up with. Chances are you won’t be too impressed with the plan, as it will cut into your budget. It’s a given that it would also have an impact on people who want to buy a Medicare supplement plan and chances are it will affect health insurance quotes, too.

If this proposed legislation makes it through the Ways and Means Committee, the modifications will mean transforming the practices and the benefits of employer-sponsored and private health care. If you are about to buy a Medicare supplement plan, then you need to begin asking some very pointed questions before choosing a plan. If you want affordable health insurance, take the time to educate yourself about your options.

More than any other proposed change, this one has raised the hackles of a lot of people. The debate and controversy centers around two points of view. The first group of people believes they should sacrifice a portion of their insurance; that it may be beneficial to do so. The other side sees this proposed legislation as infringing on not only individual rights, but making a dent in people’s savings. The financial part of the great debate is the most important one to seniors who have limited income and are now looking at the possibility of shelling out more for less when it comes to health care. Their main concern is affordable health insurance plans.

Yes, the legislation aims to downsize Medicare benefits, however it also provides for Medicare supplements to pick up the slack – to compensate for those limits. There would definitely be boundaries on the supplement packages, but it appears that the major portion of the cut-backs will be applied to employer-sponsored Medicare. While that might make some of the changes become more palatable, they are still changes that cause fear in the senior population who are driven by a need for affordable health insurance plans.

Furthermore, if you happen to be financially well off when you retire, you may face a 5.4 percent surtax for couples and singles whose earnings are over $1 million. The government hopes to raise $8.2 billion over the next ten years by doing two things: cutting back on prescription paybacks and hiking taxes for certain medical programs. This will certainly impact health insurance quotes.

When it rains, it pours, and all the changes coming down the turnpike to Medicare have the potential to make health care choices a monumental nightmare. Even if the government creates special accounts to deposit funds for future Medicare expenses, the twists and turns of all the new programs, changes, additions and deletions will make selecting the right Medicare package incredibly painful without the help of an expert insurance agent. Health insurance quotes will take on the surreal nature of too many choices and not enough explanations, without consulting with an expert health insurance agent.

If you’re about to turn 65 or even have a few years prior to retirement, start checking out your alternatives now. Don’t wait until the last minute or the whole process may well overwhelm you.

Clelland Green is with Benepath.com, a leader in providing health insurance quotes. Benepath provides individuals, families, and businesses with affordable health insurance quotes in just a few mouse clicks. To learn more about Health insurance quotes, affordable health insurance, affordable health insurance quotes, health insurance plans, visit Benepath.com.

The Expected Cut in Health Care

We all knew it was coming, but hoped it wasn’t – the decreased payments to Medicare Advantage insurers for 2010 which will affect health insurance quotes.

While many in the nation hoped that they had heard wrong about funding cuts to Medicare, the recent announcement in late July 2009 sealed the deal. The Centers for Medicare and Medicaid Services put their mouth where their money is and confirmed cuts in funding to Medicare Advantage insurers by as much as 4 to 4.5 percent starting in 2010. This move will put many insurers out of business and the additional costs will likely be handed down to seniors. This will also mean that affordable health insurance may become difficult to find.

While it’s not clear yet how the lower rates will impact senior’s private health insurance plans, it’s likely the lower reimbursements will impact earnings for private insurers who, in turn, will fob the higher costs of premiums for health insurance plans to their customers. The upshot of this could very well be much higher premiums being paid for fewer benefits in the Medicare Advantage plan. The other very real concern is whether or not the Medicare Advantage plan will even survive in the long-term.

When changes like this loom on the horizon, education comes into play. There is a critical need for seniors to understand the differences between Medicare Advantage and Medicare supplement plans (Medigap). In order to evaluate what they have and what they may need for the future, knowing the differences will help them make more informed decisions about whether or not they are getting affordable health insurance.
In a nutshell, if a senior has Medicare supplement insurance, they have the ability to choose their own doctors and hospitals; however there are no referrals to specialists. The Medigap policies have monthly premiums, but Medicare actually covers up to 80 percent of health care costs. Medigap then picks up the rest of the costs.

In the case of Medicare Advantage, many seniors pay either a really low premium or no premium at all which means it is definitely affordable health insurance. If that is the case, then the plan “is” the primary insurance. Most of these plans insist that their members only see physicians that are in a specified network. The conundrum is what precisely will work in each individual case, and this is where it makes sense to talk to an expert insurance agent to get sensible health insurance quotes.

Local insurance agents make the most sense because they know the existing networks, what doctors are in those networks, who pays their claims and who doesn’t, and what hospitals are the best for certain medical problems. Knowing what your local networks offer allows you to make the best choice for your circumstances. In any case, it is vital that those over the age of 65 find out about the variety of plans from which they may choose, prior to buying anything. Affordable health insurance is a critical issue for seniors.

Clelland Green is with Benepath.com, a leader in providing health insurance quotes. Benepath provides individuals, families, and businesses with affordable health insurance quotes in just a few mouse clicks. To learn more about Health insurance quotes, affordable health insurance, affordable health insurance quotes, health insurance plans, visit Benepath.com.

Health Insurance Beefs

Do you suppose anyone would really have a beef with a health insurance company that provided not only affordable health insurance, but also a decent variety of health insurance plans?

That's a good question and the answer, on the surface, would be "No," no one would have a beef with good plans for reasonable bucks. However, while it might be nice to get a lower premium, there may still come a time when you need to get a problem with a claim sorted out. Then, decent health insurance plans or not, you want answers as to why your claim was denied and you want them now.

Taking up your beef with an insurance company that happens to be out of state is going to be an uphill battle and you might as well prepare yourself for a lot of frustration. The number of phone calls alone that you will make to try and get your issue resolved will no doubt ruffle your feathers. Dealing locally with an insurance agent in the state where you live will not only get you quicker service, but a knowledgeable agent who has the answers (in most cases) right at their fingertips.

To learn more about Health insurance quotes, affordable health insurance, affordable health insurance quotes, health insurance plans, visit Benepath.com.