HEALTH INSURANCE
House approves health care bill
November 8, 2009
>> The House of Representatives passed a comprehensive health care bill on November 7 in a close vote along party lines. The Senate may not vote on a bill until next year.
Despite strong resistance, the House measure includes a "public option," which refers to a provision that allows people to buy health insurance from the federal government, as well as from private insurance companies. The public option in the House bill is weaker than the "robust" version favored by Speaker Nancy Pelosi. To deal with similar resistance in the Senate, Majority Leader Harry Reid is shepherding a bill that allows states that don't want a public option to opt out.
Did you get the right code?
June 8, 2009
>> If your medical insurance covers preventive
care, that means going in for a check-up, which costs nothing.
Right? Not necessarily. Your doctor might perform
an uncovered procedure while you’re there and just
report your visit and the procedure. Possible result:
You pay. Why? Because insurance payments are governed
by a system of codes. If your doctor or staff member
forgets to include the code for a check-up, the insurance
company is within its rights to refuse payment.
Self-defense: Make it habit
to ask your doctor if he will code your visit for
an examination or procedure that is covered by your
insurance
What to watch out for
June 4, 2009>> Buying health insurance is like major surgery—mistakes can be painful and expensive. Here’s a short list of things to watch out for:
• Make sure the company is licensed in your state. Sounds like something you can take for granted. But no. There are dozens of companies selling in states where they have no legal right to sell, and many are fakes pushing fraudulent policies.
Self-defense: Check www.naic.org for a list of companies licensed to do business in your state.
• Check on the company’s financial health. You want your company to be there when you need it, not out of business.
Self-defense: Check on the one you’re considering or already have at www.ambest.com.
• Don’t just look at the stated price. Check deductibles and co-pay amounts to see how much protection you’re getting for your money.
Self-defense: Check www.ehealthinsurance.com for an easy way to compare plans.
• Check on how long the introductory price
will hold. You don’t want to buy what
looks like a bargain only to discover that the
price jumps up after six months.
Self-defense: When you get a promise of how long an initial price will hold, ask for the promise in writing and attach a copy to the policy before you sign.
• Make sure your plan is rated as one of
the best. An easy way to find out: Go
to customersupport@ncqa.org.
You’ll get a list of top-rated companies in your
state. Then check to see if the plan you like—or
the plan you have—delivers the features you want
Small-company risk
June 4, 2009
>> With unemployment at 9 percent, nearly
everyone knows about the danger of losing his or
her company-sponsored health insurance. But if
you work for a small company—one with fewer than
10 employees—the risk is even higher. According
to a survey by the Kaiser Family Foundation, only
49 percent of such companies offer health benefits.
And many that do offer them have increased deductibles,
reduced benefits, or changed workers’ schedules
so they fall below the number of hours needed for
health benefits. And many companies, large and
small, are replacing older employees with younger
ones who are cheaper to insure.
Self-defense: If you work
for a small company and still have health insurance,
have a talk with your employer about how long he
or she can cover you—especially if a spouse you
may have does not work for a large company with health
insurance
Get ready—it’s coming
June 4, 2009
>> Most people never heard of them, but
according to an article in The New England Journal
of Medicine (Vol 346, No. 23), “defined
contribution” health care plans represent “the beginning
of a new era in health insurance in the United States.”
Defined contribution means that an employer gives
each employee a definite amount of money to spend
on health care in any way the employee sees fit.
If the employee’s expenses rise above that amount,
there’s usually a high deductible until the employer’s
plan cuts in. Experts expect defined contribution
plans to grow, because they shift some of the cost
of health care to employees. On the other hand,
the employer must offer a wide choice of plans,
which raises administrative costs. Even so, these
plans may catch on as medical costs continue to
rise.
Self-defense: Ask your
company’s human resources person if your employer
plans to shift to a defined contribution plan. Then
decide if you still want to work there. For more
information: www.insure.com/articles/healthinsurance/defined-contribution.html
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