Differences among Obamacare and Trumpcare (House and Senate Versions)

As of Monday, June 26, Senate Leadership is continuing to tweak their Healthcare Bill to make it more palatable to their membership.  A new provision in the bill would encourage people to maintain continuous coverage by imposing a six-month waiting period before new insurance goes into effect for anyone with a break in coverage that lasted 63 days or more in the prior year.

There is a lot of confusion and varying explanations of how healthcare insurance will change over the next few months and years.  Here are some of the ways the three plans handle health care coverage:

Medicaid

One of the biggest changes in both the House and Senate Bills are in the area of Medicaid.  Under Obamacare, the states share the cost of insuring the poor with the federal government.  The federal government gives states different amounts based on the medical care that the state’s Medicaid patients receive. While 20 states opted out of Medicaid expansion, the federal government is picking up most of the costs of expanding Medicaid to the thirty states that have opted to expand Medicaid programs.

The House Bill would offer a fixed per capita amount to each state. This amount would increase based on inflation until 2020, when the increases would be eliminated.

The Senate Bill also replaces Medicaid with a block grant; however, the annual increase, based on inflation, and would be lower than the House Bill (meaning deeper cuts).  Instead of the expansion being eliminated in 2020, it would be phased out beginning in 2020 and eliminated by 2024.

Insurance Costs

Both the House and Senate plans would probably see lower insurance premiums after 2020; however, those plans will most likely cover less and have higher deductibles.

Under the Affordable Care Act (Obamacare) people making less than $48,000 a year received subsidies to help them buy insurance.  The subsidies reduce monthly insurance bills. They are tied to income and the cost of insurance within specific areas of the country.

The House Bill also provides for subsidies, which would phase out when incomes reach $75,000 a year.  The subsidies would be tied to a person’s age, not income.

The Senate Bill links aid to income, but stops at 350% of the poverty level, compared with 400% under Obamacare.  The subsidies would be based on less comprehensive health plans, which would mean substantially less assistance than under the current law.

Mandate

The Affordable Care Act levies a tax penalty on people deciding not to purchase health insurance.

Neither the Senate nor the House Bill keeps the mandate. However, under the House Bill anyone who does not have health insurance for more than 2 months would see a 30% premium surcharge on any plan they purchase.

As noted above, while the Senate version originally had no penalties for people who do not maintain coverage, a revision may address this issue.

It is not a “Done Deal”

While the Senate is set to vote on the Bill on Wednesday, there are still Senators who are on the fence about whether or not to vote for it.

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We Living In Changing Times – Insurance in 2017

There was a time that whenever you had an illness or an accident which you or your parents could not handle themselves, you called the family doctor.  You either went in to see him, or if you were too ill, he came to see you.  And you saw him daily if you were in the hospital on his rounds.  On rare occasions you saw a “specialist” at a big hospital downtown or went to Mayo Brothers or some other far-away place for a special consultation.

If you had insurance, you paid your deductible and 20% of whatever the rest of the bills were.  You went to any doctor who would see you.  They all took whatever insurance company you had and the insurance company paid the same 80% balance no matter whom you saw.

In 2017 we have HMO’s PPO’s, HSA’S, private and public exchanges, on and off the marketplace, tax credits and cost-sharing.

We have carriers which insurance only groups, carriers who insure only individuals under 65, but not group, and carriers who have policies off but not on the marketplace.  They have different levels of coverage, different out-of-pocket costs, pre-tax payment allowances, and the biggest of all, LISTS OF PROVIDERS YOU MUST SEE IN ORDER TO BE COVERED.

Wouldn’t you like some help to figure out which one of the many plans available are right for you?  This past year most of the carriers no longer included the teaching hospitals in downtown Chicago for the individual plans.  Hospital systems they own in the suburbs are no longer in-network either.  Some cover a very small system, and others, even though they may be in the covered network, do not have the practitioners you want.

Wouldn’t you like to have some qualified help in navigating your way through this process?   We have over 40 years of personal experience in helping people choose the right coverage.  Let us help you as well.

 

 

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Long-Term Health Care in 2017

WELCOME TO 2017

When I was growing up in the then smaller town of Ottawa, Illinois, my father’s small business was 3 blocks away, and my grandparent’s home 2 blocks in another direction.  Nobody came home from playing in the neighborhood until after dark, and all of the neighbors watched to make sure the kids were safe, and “doing right”.  When a grandparent became too ill or old to take care of him or herself, the family had them move in with them, or lived by close enough to see them every day.  My parents did that for their parents, often with the help of siblings who lived close by.

Today my father is almost 91 and my mother follows a year behind.  I live 90 miles away from them and my brother and his family live in Florida.

Aging and the deficiencies which come with it cause and event, not a re-location.  Today we have the ability to have caring people look in on Mom and Dad.  We have visiting nurses, should the need arise.  And yes, we have continuous care facilities for them to live as independently as they like with critical end-of-life help when it’s needed.  All of these options are at the discretion of the elderly and their families.  None are mandatory.

But should the need arise, there IS a cost to care.  Depending on what source you cite, it’s anywhere from

$58,000 to $128,000 per year for full-time assisted living needs.  Where’s the money coming from?  Existing assets, sale of the primary residence, assets of the children?  I think you’ll agree that these are not usually the most desirable alternatives.

Let us help you and your family choose more practical, less expensive ways to fund the most vulnerable years of your life after childhood.  We have a number of the best long-term carriers available.  There are a variety of ways we can structure the benefits, including using annuities and life insurance.  Give us a call and we’ll have a conversation about how to solve the problem.

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Going Shopping? Take your agent

We have less than a week until the Affordable Care Act or Obamacare marketplaces are open for business.

The State has hired “navigators” to take personal information from you and submit it to a system which will then

kick out different plans and rates for which you may apply.  It will also tell you what, if any, tax credits or subsidies
you may receive.

Navigators ARE NOT allowed to advise you on which carriers or which plans are best suited to your own individual needs.

WE ARE!! We can advise you on tax credits and subsidies on individual plans, describe the benefit
differences among Platinum, Gold, Silver,and Bronze plans, and which networks are best suited to you depending on your health and where you live.

Navigators at last check were given less than five days training.  We have 36 years in the insurance business.  Let us help you.

And if you already have a qualified agent, call him or her for help.  It may save you a LOT of heartache.Day 3/365 - Ride in the Shopping Cart.. (Explored)

Take an agent along.  Get some personalized service.  That’s what we do!

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You’re 65. Why are you losing your Group Insurance?

MedicareThe new insurance available to you is changing on 1/1/2014. Policies are now being rated exclusively by age; not gender. IBM just yesterday announced that it would be eliminating coverage for employees over 65, and giving them a stipend to buy individual insurance.

The reason for this is that what may have cost $400.00 for a 65 year old male per month in the state of Illinois may now cost over $1,000.00 per month. Purchasing Medicare part B coverage from the Government and a Medicare Supplement on the open market will cost half as much or better than it will cost your employer to keep you on the group. Contact me to look into Medicare coverage. You’ll be pleasantly surprised.

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