Category Archives: Medicare Insurance

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

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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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Once Upon a Time

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When we were going to spend the night in the hospital for something we knew about in advance, we had to call the insurance company and “Pre-Certify” the stay. And in an emergency, we had to notify them within 28-48 hours after admittance, depending on the carrier.

When we knew we needed certain kinds of medicine like Claritan,
Monistat, or Prilosec, we had to go to the doctor, and pay him to write out the prescription, and then take it to the pharmacy to have it filled.

As time went on, most of these drugs were available over-the-counter without a prescription, and the provider called the insurance
company on our behalf.

Guess what! Blue Cross has re-instituted the “call-it-in-yourself”
rule. You will be penalized up to $500.00 for non-compliance with their “reinstated” rules. In addition, if you have an HSA or health
savings account, you must get a doctors’ prescription to buy OTC
drugs and withdraw their cost from the HSA. Oh, and the penalty
for violating HSA contribution and deduction rules beginning this year will result in a 20% penalty instead of the prior 10%

Call me old fashioned, but I’d rather have the good old days.

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I’ll be over here when you need me.

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I was encouraged by the conversation between journalist Fareed Zakaria and Jamie Diamond, head of J.P. Morgan this morning on GPS.

Jamie said that although there are fewer big banks today, those which are left have lent more to corporations and mid-size business this year than previously. He said a lot of business has cash and doesn’t need it. The effort now should be to get them to spend it,
albeit wisely and get people back to work. He praised governments all over the world for having implemented programs which stopped the damage from getting even worse.

I realize this has not yet come to the consumer level. But what is wrong with having to have at least 20% down for a morgtage, and a stable credit history? Lenders cannot lend to those who have no stake in the home for which they are trying to purchase.

The country and people individually should begin to make more practical decisions again about when to buy, sell, retire, or go into business for themselves. When this happens, they will also want advisors in technology, purchasing, capital and financial investments who know what they are talking about. They will also want that in their insurance advisor. Whether discussing business overhead policies, replacement cost on property or COBRA and state continuation of benefits. They will want the quality they themselves are trying to deliver to their own clients.

When you want an experienced, qualified, thoughtful and thorough insurance advisor, let me know. I’ll be over here when you need me.

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The Game’s Afoot

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There are so many provisions in the Health Care Reform Act (PPACA),
people are thoroughly confused about how, what, when, and why.
Besides the normal conversation on health care and reform itself,
I thought you all might benefit from knowing something which will affect you as business owners. Beginning in 2012, if the bill stands
as is, EVERY VENDOR from whom you purchase at least $600.00 during the year for goods or services, will require you to SEND THEM A 1099! This means your accountant, your office supplies, your IT
consultant, gas station, car dealer….; the list is endless.

Last week, the senate reconsidered this portion of the bill. After failing in a move to repeal that part of the bill, and additional attempt by Republican Nebraska Senator Mike Johanns failed to raise the threshhold from $600.00 to $5,000.00. The vote failed 52 to 46 to
bring it to the floor for a final vote.

I don’t know about you, but it boggles my mind what kind of paperwork and expense this will generate. The possibilities are endless. Whatever happened to streamlining the IRS? Stay tuned
for the next chapter in the never-ending story.

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Buyer Beware

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According to Modern Healthcare, there has been a rise in fraudelent “medical discount plans”, typically targeting the uninsured with the promise of “cut-rate” coverage. In the article, three companies; The Consumer Benefits Association, United States Benefits, and Health Care One have been charged with deceptively marketing medical discount plans. “They took enrollment fees, “and then did not allow customers to disenroll”.

In another article The Oklahoman reports that Oklahoma “Insurance Department officials are warning of a health insurance scam similar to one a year ago that left more than 100 people without coverage and buried in medical bills.” In June, “an emergency cease and desist order was filed…barring as many as 40 individuals and companies from doing business in the state. Named in the order are plans marketed by the Association of Independent Managers, including AIM Health plans.” Oklahoma Insurance Commissioner Kim Holland estimates that “as many as 200 Oklahomans bought the bogus plans.”

The point is this, and always has been. Find a qualified health insurance advisor to prevent you from ending up with a plan you do not want, and paying an amount you may not be able to afford for coverage which doesn’t turn out to be what you thought it was.

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Change is the only constant

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PPACA, re-named the Affordable Care Act, has some fast-approaching effective dates.  September 23, 2010, all plans, including self-funded, fully-funded individual and group plans will no longer have lifetime limits.  This will apply only to policies renewing after 9/23/2010 until the full cycle is complete.

This means that if your renewal is not until next March, that will be when you will no longer have a lifetime limit.  The caveat is that up to January, 2014, the Dept of Health and Human Services may still define benefits it deems non-essential, and can prohibit them from being unlimited.  After that,  nothing will have a limit.

In addition, effective with renewals after 9/23, there will be no deductibles or co-pays for services which the DHHS lists as preventative.  The list is said to contain over 500 procedures, and is still growing.  Among them are colonoscopies, Pap tests, PSA tests, routine mammograms, bone density tests, immunizations, physicals, and tobacco cessation.  We’ll also be seeing further implementation of the 26 and under group, who can return to their parents’ policy, even if they are married and live elsewhere.

I have no idea how we are going to pay for all this without raising taxes and/or premiums.

Stay tuned.  There’s more to come.

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