The Taxing of Unaffordable Insurance On Middle-Class America

dvAre the past due medical bills piling while annoyingly fighting on the phone with the health insurance company about medical coverage? Do you have a strategy or plan to pay the hospital or private physicians for services rendered? Are all these incessant thoughts affecting your relationships and you feel there is no way out of this rut? Welcome to the world of “affordable” insurance, where it has been really affordable for insurance companies to provide low premiums in exchange for high deductibles. These affordable plans are sufficient for the healthy person until life throws the curve ball and the shocking sticker price makes one cringe. The savings at the front end may wither once the realization that deductibles have to be met. Looking to switch to another insurance plan may not be the solution as premiums increase while deductibles decrease, but the loopholes leave wiggle room to pass on the cost-sharing from the health insurance company to the consumer.

The Affordable Care Act was intended to expand coverage and provide medical access to all through subsidies for eligible participants. However, one would be gullible to

7 Keys to Choose the Best Medical Insurance

v3So many questions need not faze you because we are here to guide you on how to choose the best medical insurance plan based on your needs. What points should you consider while buying a medical insurance plan so that your plan comes in handy when it is most required? Let us take a look at the 7 short-listed key points which we think is the secret in choosing the best medical insurance plan for you.

# 1 – Decide on the type of plan

When buying a medical insurance plan, decide what type of coverage is required – individual or family floater. While individual insurance plan covers only you, a family floater policy is an umbrella policy that covers your family members in the same plan. An individual policy is ideal for you if you are a young adult and do not have dependent parents. At a lower premium, you can buy an individual insurance plan. A family man, on the other hand, cannot afford to insure only himself. His family, namely his spouse, children and even parents depend on him to foot their medical

Durable Medical Equipment

avvvWhen it gets to the time in your life when you need some sort of Durable Medical Equipment what do you do?

In this article are five steps to achieve your DME.

Depending upon the Medicare plan in which you have if it is straight Medicare where you pay the 20% which Medicare does not cover or an (HMO) Health Maintenance Organization or (PPO) Preferred Provider Organization in which you pay a copay. Once you and your doctor have decided you need some sort of DME call your insurance company to get the facts about how this equipment will be paid.

It is very upsetting for the person who needs the DME and their family who do not understand the process of how to obtain the expensive DME that is needed to sustain your daily wants and needs. For example: When you need a wheelchair. This is usually needed when you are too weak to walk or fall with every step. This is when you need assistance in and out of bed and to the bathroom several times a day. A wheelchair would make you and your

Grasp How Health Plans Work

saOver and over I hear about how these new metal level plans does not work or pay for anything. This simply is not the case. The reality is most people just don’t have a thorough understanding of how these plans work. Under the new affordable care act law; in general all the plans are based on these three criteria; age, geographical location and ability to pay; in some states tobacco use is taken into consideration, when it comes to your premium dollars.

All level plans Bronze, Silver, Gold, Platinum, and Catastrophic all have the same 10 essential health benefits that must be included with every plan; they just have different deductibles, co-insurances, and co-payment amounts. The way level plans can be explained are: Bronze plans are for people who are healthy and goes to their medical providers once or twice a year, and these individuals should have money to afford higher deductibles.

Silver plans are for people who seek medical attention a little more frequently; three to four times a year; Gold or Platinum level plans are for people who are unhealthy and afflicted with chronic

When You Can’t Afford Health Care

avThere’s a huge difference between health care and sick care.

Your insurance pays for sick care. That’s what happens when you get sick and the doctors do tests, give medicine, or do surgery.

Health care is everything else. It’s choosing good foods because good foods support your body. It’s choosing massage and bodywork because it keeps you limber and pain free. It’s exercise because that moves your body.

Health care is everything that supports life. It’s a standard of living that means you can do what you want when you want.

Sick care is profitable, health care is not. Sick care costs you lots of money, health care costs little.

The average person pays about $400 per month on health insurance (about $900 if your company pays it, now you see why you didn’t get that raise?). It’s estimated by 2020, that cost will be $1,200 to $2,000.

Unfortunately, this means health insurance will be beyond nearly all households. And Medicaid is cutting more treatments, drugs, and procedures every day. Medicare is nearly gone.

So, instead of being sick, be healthy. Choose the $35 per session massage and chiropractic. This could

As Paul Harvey Would Say, This Is the Rest of the Story

aVAs the late great Paul Harvey used to say, “I am Paul Harvey, and this is the rest of the story.” I am reading in the Chicago Tribune that the health insurance rates for 2016 are going up an average of 6.1% in Illinois. It also says the national increase is 7.3%. Now these are based on the second lowest price Silver plan which is generally one of the most popular plans. This is where Paul Harvey jumps in. As an insurance broker and can speak from the rate increases my clients are getting. Let’s start in Illinois. I have a couple in their early 40’s in Plainfield who is getting an increase with Blue Cross and Blue shield from $493 per month to $719 per month. That is about 32%. I have a family of three where the ages are a couple in their early 60’s and a 24 year old child in Park Ridge, going from a Bronze plan at $906 per month to $1270 per month. This is also an increase of near 30%. My third example is a single male

What Are Your Benefits of Medicare?

vdsIt’s the time of year again to make health insurance choices for 2016. Understanding group health insurance is confusing and comprehending Medicare throws off a different set of challenges.

There are nooks and crannies attached to Medicare that are a bit taxing and may lead to unexpected out-of-pocket costs.

Medicare is a health insurance program for people 65 or older, but also covers people under 65 with certain disabilities, and people with End-Stage Renal Disease.

What Medicare Covers

Medicare Part A (hospital insurance) covers inpatient care at a hospital, skilled nursing facility, and hospice. It also covers services like lab tests, surgery, doctor visits, and home health care. This coverage is mandated for everyone to carry and you are automatically enrolled at age 65.

Medicare Part B (medical insurance) covers doctor and other health care providers’ services, outpatient care, durable medical equipment, home health care, and some preventive services. Part B is elective with a choice of denying it at enrollment or dropping later at any time.

As a rule, everyone should carry medicare B coverage, even those who have Veterans or Indian Health care benefits.

Medicare also offers prescription

All You Wanted to Know About Tata AIG Life Insurance

dwwRange of Insurance Coverages

Tata AIG Insurance offers a wide range of insurance coverages. You name it, they have it. The company provides insurance coverages in domains like home, motor, health, lifestyle and travel as well as a few other specialized financial requirements. The company is an all rounder with 100% claim settlement service, promotional strength as well as availability through online mediums such as Tele and Digital marketing.

Range of Health Insurance Products

* MediPrime

* Wellsurance Woman

* Wellsurance Executive

* Wellsurance Family

* MediPlus

* Critical Illness policy

* MediSenior

* MediRaksha

* Individual Accident and Sickness

* Group Accident and Sickness

Benefits in a Nutshell

In case of individual and group accident and sickness you can get cashless claims that will be acted upon within 30 days before and 60 days after hospitalization. In case patients are on non allopathic treatment like Ayurveda, the Ayush benefit ensures total coverage in this case.

The MediPrime benefit ensures that you receive a cashless coverage within 4 hours of making a claim. You can save taxes with MediPrime as well as get ensured 100% transparency.

The Wellsurance Executive ensures a sturdy health insurance for all the busy executives of

5 Keys to Choosing the Right Individual Health Insurance Plan

asvaThe internet has made it easier to compare different health insurance policies and shortlist health insurance plans. With the right health insurance policy, one can make substantial savings if a family member gets sick. Although there is no golden rule to choose the right individual plan, yet, some common tips help in the decision making process. Five keys to choosing the right individual insurance plan have been listed below:

• Determine your need and your affordability: Even before you start your online search for insurance plans, one needs to be sure about the details of the plan. You need to make sure that the benefits offered by the plan covers what you need for yourself and your family. However, the perfect plan will also come at a considerable cost. As an informed customer, you need to do a proper cost benefit analysis to make sure your trade-off between price and benefit is in the appropriate proportion. If we take into account, frequent trips to the doctors, medications and dental coverage – such scenarios eliminate unsuitable plans and makes the comparison process much easier.

• Don’t overbuy:

Guide to Individual Health Insurance

avThe new Covered California health insurance marketplace offers a wide range of affordable health plans for you to choose from. Whether you are self-employed, or looking for coverage over and above what your employer currently offers, there is a plan that will likely meet your needs. Federal regulations require that health plans operating under the Affordable Care Act (ACA) meet certain access requirements. In California, those requirements include timely access to healthcare providers, as well as geographic access standards.

Here is a general guide to individual health insurance that you can refer to when choosing a plan. And do not forget these important dates regarding open enrollment for 2016.

Provider Networks

When selecting a health insurance plan, it is important to verify the plan’s provider network of doctors, hospitals, nurse practitioners, therapists, and other health care providers. It is equally important to understand what is not covered as well. Understanding your plan’s provider network helps you save money, receive better care, avoid unexpected fees and costs, and be happier with the care you receive.

Out-of-Network Care

You are not restricted to health care providers in your network, but should

Some Key Facts When Buying Private Medical Insurance Schemes in the UK

aSvIt is the prerogative of the insurance buyer to find and understand the rights of policy holders before purchasing a personal medical insurance (PMI). It is important to read the terms and conditions of the policy document carefully and to know exactly what is not covered.

Some key facts to note before buying medical insurance:


The Prudential Regulatory Authority (PRA) and the Financial Conduct Authority (FCA) regulate private medical insurance policies in the UK. This was earlier done by the Financial Services Authority (FSA).


Private medical insurance providers and brokers are required by the FCA to have complaints procedures in place. In case one is not satisfied with the response of the insurance company in resolving a problem, one may approach the Financial Ombudsman Service (FOS). It is a free and independent service to settle disputes.


The Financial Services Compensation Scheme (FSCS) is UK’s legal fund for clients of authorised financial services. It is an independent organisation set up under the Financial Services and Markets Act 2000. In the event of insolvency of the insurer or its inability to honour a claim, the FSCS pays compensation to the

Primary Health Care For You And Your Family

avwPrimary health care, also known as PHC, comprises of all the basic services that are offered to individuals and families for their wellbeing. So whether you need a general check-up or you have suffered from a twisted ankle, your first point of contact would be with one of these professional care-givers. They will help you with your lifestyle habits, manage chronic diseases and provide preventive measures to keep your body and mind healthy.

PHC forms an integral part of society. Whether they are looking for a physician, pharmacist, dentist or nurse, many families prefer to go to a medical profession that they can visit on a regular basis rather than go to something who they do not know for their basic wellness. Since it the first point of contact between a patient and the healthcare system, it is necessary for these services to be available in every community, allowing the individual to be more aware of their basic medical needs.

The Role of PHC

The role of a primary physician will vary depending on various environmental and economic factors along with their specific area of practice. However,

Is Mental Health Covered Under Health Insurance?

AVFor people who depend on any type of private or company insurance to cover the cost of their health needs, the question of whether or not the health insurance policy covers mental health problems is a crucial one for a number of reasons.

The idea of a split between physical health and mental health is an old one, and is a fairly arbitrary decision as to which is which some of the time. From a point of view of health insurance, classifying illnesses or diseases can determine whether or not the insurance company will pay for them, and for many people with mental health issues that can literally be a life or death process.

The term mental health can relate to a condition ranging from a fairly mild form of depression through to serious conditions of clinical depression, schizophrenia, alcoholism, full-blown psychotic episodes etc.

Any health insurance policy should specify exactly what types of illness or disease it is willing to provide cover for and those which it is not. This will also include what it specifies as a type of mental health problem or issue and

Buying Health Insurance Through a Broker

VIn its most simple definition, a health insurance broker (also commonly known as an agent) is someone who is licensed to sell health insurance. However, there are many other services they provide you that fall under the umbrella of selling health insurance. Here are some of the most important:

    1. Perhaps the most important fact to know about working with an agent is that it’s free. Insurance agents are paid by insurance carriers, not by consumers. So don’t worry about having to pay some service fee for signing up for a plan with an agent, because it will cost you nothing more than if you were to do it yourself
    1. Health insurance is confusing, and an agent will explain it to you until it makes sense. Ask all the questions you want, that’s what they’re there for. Want to know what your coinsurance will be on a certain plan? Want to know what coinsurance even means? Ask away!
    1. An agent can help you compare plans that you’re interested in. When you let an agent know what it is you’re looking for, they will narrow down your possibilities

Obamacare Benefits Everyone, Especially Women! provides a list of about 26 services that are free to women under the Affordable Care Act. Yes, you read it right – under Obamacare, there are 26 preventive services that women can have done for free as long as they are delivered by an in-network provider. I can’t possibly discuss every single one here, but I feel that there are a few that are definitely worth mentioning.

These services are broken into two broad categories on – services for women who are or who may become pregnant and other preventive services. First, we’ll touch on some of the more general benefits available for all women.

General Preventive Services for All Women

Some general preventive services that are covered for women include multiple cancer screenings, including mammograms for breast cancer for women over 40 and cervical cancer screenings for sexually active women. These screenings are always highly unpleasant, so removing the financial burden makes them a little easier to deal with, in my opinion.

Other services include tobacco use screening and interventions, osteoporosis screening depending on age and risk factors, and domestic and interpersonal violence screening

Managing High Deductible Health Plans

e3Who Gets HDHPs?

Health plans with high deductibles can be purchased by anyone, but those who most commonly opt for these plans are people who are generally healthy. Because they’re banking on their health and not planning on having numerous prescriptions filled or several trips to the doctor or hospital, they’re quite comfortable with HDHPs because they likely won’t ever use enough care to even come close to the deductible.

What If Something Does Happen?

It is not outside of the realm of possibilities that a medical emergency could occur, even to the healthiest person. Hearts sometimes don’t work properly, accidents happen and unfortunately, cancer discriminates against no one. If you have been generally healthy otherwise, and therefore chose a HDHP, one of these unfortunate scenarios could drain your bank account or worse, put you into serious debt.

This is where supplemental insurance plans can really save the day. Many people are unsure of the purpose of these plans, and others have never even heard of them. Accident and critical illness plans can offer tens of thousands of dollars of protection should you have an unexpected injury or

Importance Of Health Insurance Portability

90Choice is always good. In a globalized world, the consumer has a plethora of choices in everything, from airlines to automobiles. This is why nowadays even airlines make an announcement after the passengers land: “We know you have a choice. Thanks for flying with us!”

It’s rather simple. You have a choice – if you don’t like the product or service, switch! The same goes for health insurance policies as well. In India, people have woken up to the promise of health insurance, which has led to a proliferation of health insurance providers across the board. Because of this wide variety available, the policyholder doesn’t need to stick to an insurance provider if they feel dissatisfied with the services.

The Insurance Regulatory and Development Authority of India (IRDA) has a novel scheme for disgruntled policyholders to switch providers: health insurance portability. Now, what do we mean by this? Let’s elaborate.

What is health insurance portability?

Health insurance portability is the manner through which a health insurance policyholder can transfer his/her existing policies from the current provider to a new one. Portability offers a way for customers to opt

Retiree Health Care Benefits Continue to Decline

vbEmployer-based retirement health care insurance benefits continue to decline, according to recent industry reports.

Many retirees have been able to rely on private or state employer-based retirement health benefits for supplemental health care coverage while on Medicare in the past, but this is becoming less common.

Employer-based health-related benefits can provide important coverage for the gaps that exist in Medicare programs. Additional coverage benefits can alleviate the cost-sharing requirements and deductibles associated with Medicare. Caps on the amount that can be spent out-of-pocket, often associated with supplemental coverage, are also often helpful for retirees.

Overall, supplemental retiree health and medical benefits sponsored by a private or municipal employer have helped many retirees cope with high medical costs often incurred in retirement.

The Kaiser Family Foundation recently reported, however, that the number of large private employers-considered employers with 200 or more employees-offering retiree healthcare benefits has dropped from 66 percent in 1988 to 23 percent in 2015.

Companies that do continue to offer retiree health benefits have been making changes aimed at reducing the cost of benefits, including:

  • Instituting caps on the amount of the provider’s financial liability
  • Shifting from defined benefit

Overcoming the Top Healthcare Revenue Cycle Challenges

3EThree of the top revenue cycle management challenges are Medicare and Medicaid payments, claims denial and value-based payments.

Medicare and Medicaid Payments: Complicated payment reforms, shrinking reimbursements and government mandates contribute to the delay and denial of payments for services covered by Medicare and Medicaid. Medicare and Medicaid represent an ever-increasing segment of the population and timely and adequate payment from these organizations rank as a top issue for healthcare practitioners. The Centers for Medicare & Medicaid Services (CMS) have significantly increased provider education tools including on demand webinars and other resources.

Claim Denials: Some healthcare organizations say 25% of their claims are denied. Some for a technicality such as a missing signature on a medical chart, an incorrect spelling or inconsistent data entry. Sixty percent of healthcare organizations did not see a revenue impact, from the recent implementation of ICD-10 but 34% reported they did in a recent post ICD-10 survey. Continue to monitor your denial trends so patterns can be triaged and treated early on from the cause vs. the symptom. Also note while you are able to submit a valid diagnosis code from

Five Tips for Choosing the Right Health Insurance Plan

FOne of the best ways of safeguarding your personal well-being is by having a health insurance plan. Due to the large number of companies that offer this type of insurance policy, choosing the right one can be a daunting task. Here are five tips to help you find the best plan on the market today.

Check the Networks of Different Plans

If you have a select group of doctors whom you prefer, ask them which insurance networks they are part of. You can also use one of the many accredited online directories to know the networks that each plan on your list has. On the other hand, if you just relocated to a new city and you do not have a preferred doctor yet, choose a plan that has a large network of health practitioners.

Know the Maximum Premium Budget

Consider your average monthly expenses to know the amount of money that you can spend on the policy without compromising your financial capability. Low premiums often result in high out-of-pocket costs. Hence, what appears to be the cheapest plan may really be the most expensive, as you will