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In 1965, Medicare was predicted to cost $26 billion in 2003; the actual cost that year was $245 billion. Medicare's unfunded liability currently hovers around $40 trillion. A number of short-term problems plague the massive entitlement program. The program that pays for doctors' visits unexpectedly ran a $10.3 billion deficit last year and is likely to have one of $1.7 billion this year, despite congressional efforts to prevent such shortfalls.
According to National Bipartisan Commission on the Future of Medicare, Today, nearly 40 million Americans rely on Medicare for their health care. As the number of new Medicare beneficiaries rises sharply, there will be significantly fewer workers per retiree to fund Medicare.
Medicare Goes Broke in 2008
The Balanced Budget Act of 1997 (which also created the Medicare Commission) ensures solvency of the Medicare Part A trust fund for the next 10 years. But, without reform, the trust fund goes bankrupt in the year 2008.
Medicare Spending Affects Other Programs
Annual Medicare expenditures will climb from $207 billion, last year, to between $2.2 and $3 trillion by the year 2030. As a result, Medicare spending will become a much larger part of the federal budget, potentially affecting the funding of other important programs such as national defense, justice, health and safety and environmental protection.
Beneficiaries’ Out-of-Pocket Costs to Rise
As the Medicare system itself faces financial troubles, Medicare beneficiaries also face higher costs. Today, beneficiaries pay nearly 30 percent of their health care costs from their own pockets. In 1995, those costs averaged $2,563 per person to pay for premiums, services and products not covered by Medicare. In the future, out-of-pocket costs are expected to rise.
77 Million Baby Boomers to Enter Medicare
Medicare must be strengthened and improved to handle the increased demand of 77 million “Baby Boomers” (people born between 1946 and 1964) who will begin entering Medicare in the year 2011.
Fewer Workers Per Retiree to Fund Medicare
As the number of new Medicare beneficiaries rises sharply, there will be significantly fewer workers per retiree to fund Medicare.
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Thursday, July 30, 2009
Medicare facts 2007
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Medicare paid roughly $425 billion in benefits to senior and disabled Americans in calendar year 2007. In that year, about 44 million beneficiaries, or about 1 out of 7 Americans, were enrolled to receive benefits. During the first 40 years of the Medicare program, the United States has seen improvement in the quality of life of its seniors, which was one of Medicare's primary goals. During this time, the country has seen a surprising increase in the life expectancy at age 65, and the proportion of the elderly who are living below the federal poverty line has declined.
Medicare Is Complicated
Medicare has several parts-Part A (HI or hospital insurance), Part B (SMI or supplementary medical insurance), Part C (generally known as Medicare Advantage or Medicare risk contracts), and Part D (prescription drug insurance). Both the benefits and financing of the Medicare program are complicated. The basic benefit structure is confusing since not all services and products are covered, and payments are limited by deductibles, upper bounds on benefits, and some coinsurance requirements (i.e., the sharing of the cost of benefits between the beneficiary and the program).
Recently, there has been a great deal of media coverage about the difficulties and confusion that some beneficiaries have experienced with enrollment in the new prescription drug program. Some Part D insurers have attempted to provide simplified benefits that modify the basic Medicare program, but that has also created an abundance of hybrid offerings that some seniors have difficulty comparing.
The financing is also complicated. Part A is financed largely from payroll taxes paid by workers and their employers. Part B and Part D are financed partially by premiums paid by beneficiaries and partially by appropriations from the general revenues of the United States. Part C financing effectively is a blend of all of the mechanisms used by A, B, and D, such that the money comes from Medicare in the form of a lump-sum payment.
Trends in Medicare Costs
If Medicare continues under current law, without changes in management and funding protocols, projected Medicare costs will rise to a very high level of federal expenditures and GDP over the next few decades. In this projection, there is roughly a 1.7 percent higher expected trend rate assumed for Medicare costs than for GDP. The observed differences in the past have tended to equal or exceed this level.
Under this projection, by 2080, Medicare costs are expected to consume ever increasing shares of GDP and total federal expenditures. How will this affect national funding in other areas such as education, public infrastructure, or defense? Government projections do not answer this question, but if Medicare consumes about 9 percent more of the federal budget as projected in 2020 versus 2005, this will create a need for substantial reductions in the proportion of the federal budget for other services. Cutting provider reimbursements repeatedly would reduce Medicare expenditures but could also cause seniors to experience substantial reductions in access to health care. Other solutions to reducing Medicare's costs should be considered to avoid these potential problems in the future.
If we do not fundamentally change our direction, Medicare and Social Security together will consume virtually every dollar of the federal budget in a little more than 75 years. Further, note the rapid increase in the amount of funding coming from general Treasury revenue versus dedicated revenues (e.g., Part A payroll taxes and Part B premiums) and the revenue shortfall within Medicare; this portends a rapid acceleration of stress on the federal budget.
The history of Medicare and total national health expenditures shows that they both grow faster than GDP. Certainly, these estimates can vary significantly owing to factors such as growth of medical technology, changes in legislated reimbursement levels, and growth for the economy, etc. But without fundamental restructuring of Medicare, the trends suggested above can be expected to unfold.
Medicare Population Growth, Eligibility, and Design
When Medicare began paying benefits in 1966, the age of eligibility was 65 for seniors. Approximately 20 million people were immediately eligible for benefits. At that time, cost sharing by users was designed to represent a fairly significant part of costs. Compliments of Newsletter 2008
bringing you the news: www.texasmedicaresupplementplan.com; www.texasmedicaresupplementplans.com; www.insurancedfw.com
Medicare paid roughly $425 billion in benefits to senior and disabled Americans in calendar year 2007. In that year, about 44 million beneficiaries, or about 1 out of 7 Americans, were enrolled to receive benefits. During the first 40 years of the Medicare program, the United States has seen improvement in the quality of life of its seniors, which was one of Medicare's primary goals. During this time, the country has seen a surprising increase in the life expectancy at age 65, and the proportion of the elderly who are living below the federal poverty line has declined.
Medicare Is Complicated
Medicare has several parts-Part A (HI or hospital insurance), Part B (SMI or supplementary medical insurance), Part C (generally known as Medicare Advantage or Medicare risk contracts), and Part D (prescription drug insurance). Both the benefits and financing of the Medicare program are complicated. The basic benefit structure is confusing since not all services and products are covered, and payments are limited by deductibles, upper bounds on benefits, and some coinsurance requirements (i.e., the sharing of the cost of benefits between the beneficiary and the program).
Recently, there has been a great deal of media coverage about the difficulties and confusion that some beneficiaries have experienced with enrollment in the new prescription drug program. Some Part D insurers have attempted to provide simplified benefits that modify the basic Medicare program, but that has also created an abundance of hybrid offerings that some seniors have difficulty comparing.
The financing is also complicated. Part A is financed largely from payroll taxes paid by workers and their employers. Part B and Part D are financed partially by premiums paid by beneficiaries and partially by appropriations from the general revenues of the United States. Part C financing effectively is a blend of all of the mechanisms used by A, B, and D, such that the money comes from Medicare in the form of a lump-sum payment.
Trends in Medicare Costs
If Medicare continues under current law, without changes in management and funding protocols, projected Medicare costs will rise to a very high level of federal expenditures and GDP over the next few decades. In this projection, there is roughly a 1.7 percent higher expected trend rate assumed for Medicare costs than for GDP. The observed differences in the past have tended to equal or exceed this level.
Under this projection, by 2080, Medicare costs are expected to consume ever increasing shares of GDP and total federal expenditures. How will this affect national funding in other areas such as education, public infrastructure, or defense? Government projections do not answer this question, but if Medicare consumes about 9 percent more of the federal budget as projected in 2020 versus 2005, this will create a need for substantial reductions in the proportion of the federal budget for other services. Cutting provider reimbursements repeatedly would reduce Medicare expenditures but could also cause seniors to experience substantial reductions in access to health care. Other solutions to reducing Medicare's costs should be considered to avoid these potential problems in the future.
If we do not fundamentally change our direction, Medicare and Social Security together will consume virtually every dollar of the federal budget in a little more than 75 years. Further, note the rapid increase in the amount of funding coming from general Treasury revenue versus dedicated revenues (e.g., Part A payroll taxes and Part B premiums) and the revenue shortfall within Medicare; this portends a rapid acceleration of stress on the federal budget.
The history of Medicare and total national health expenditures shows that they both grow faster than GDP. Certainly, these estimates can vary significantly owing to factors such as growth of medical technology, changes in legislated reimbursement levels, and growth for the economy, etc. But without fundamental restructuring of Medicare, the trends suggested above can be expected to unfold.
Medicare Population Growth, Eligibility, and Design
When Medicare began paying benefits in 1966, the age of eligibility was 65 for seniors. Approximately 20 million people were immediately eligible for benefits. At that time, cost sharing by users was designed to represent a fairly significant part of costs. Compliments of Newsletter 2008
bringing you the news: www.texasmedicaresupplementplan.com; www.texasmedicaresupplementplans.com; www.insurancedfw.com
Wednesday, July 29, 2009
Charities help dress women for success
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Nonprofits recognize the power of clothing in boosting women’s confidence
By Jessica Abramson
NBC News
updated 11:19 a.m. CT, Tues., July 28, 2009
When she opened her eyes in a hospital bed, Pansy Dones saw a man she had never seen before. As he held her hand, he said, “We’re survivors.”
It was Sept. 11, 2001. Dones, an IT assistant who worked across the street from the World Trade Center towers, emerged from the Fulton Street subway station and knew immediately that something was wrong.
“It got dark. You heard things crumbling. You couldn’t see. Everybody was scrambling,” said Dones.
After nearly suffocating and then passing out on the street as the towers collapsed around her, Dones was rescued and brought to a nearby hospital. She was grateful to have survived but she knew that the traumatic experience would affect her both psychologically and professionally because her workplace was in ruins. As Dones lay in her hospital bed, it never dawned on her that a new suit would get her back on her feet again.
When Dones needed a suit and guidance for getting back into the professional world after 9/11, Catholic Charities referred her to Dress For Success, a nonprofit organization that helps women prepare resumes and cover letters and practice for job interviews. Once the women receive jobs, Dress For Success suits them in professional attire so they feel confident at work.
In addition, Dress For Success’ Professional Women’s Group (PWG) creates networking opportunities for the women and holds educational and social seminars.
Of her participation in the PWG, Dones said, “We attend a lot of different workshops all over Manhattan. I’ve attended workshops in Queens, I’ve attended workshops in Harlem — on all different topics —financial, how to look presentable, wellness, health, different workshops like that.”
Suiting upThe women who participate in the group have triumphed in the workforce. Seventy-five percent of the members in the group remain employed while 42 percent receive a salary increase. Twenty-percent of the women in the group receive promotions.
Dress For Success is made possible by their inventory of suits, which comes from individuals, stores and corporations as well as their annual campaign event where Dress Barn stores serve as national suit drop-off locations. The organization has branches throughout the United States and relies on the work of volunteers.
“Volunteers are truly the backbone of our organization. They ensure that our programs really all run smoothly," said Erin Moran, Dress For Success’ corporate relations manager.
At Dress For Success, volunteers suit the women, offer career advice and conduct the Professional Women’s Group seminars. They also mentor women and work one-on-one to ensure that they leave with all the tools they need to succeed.
With the help of Dress For Success, Dones got a job at a law firm and then eventually switched back to an IT job. She is now an associate member of the Professional Women’s Group.
Dressing for a weddingWhile Dress For Success provides suits to women as tickets to success, The Bridesmaid Party gives wedding gowns to needy women to help boost their confidence and joy.
Heidi Janson, founder of The Bridesmaid Party, believes that recycling dresses and providing brides with gowns “is like a domino effect.” She said, “if you change one or two lives eventually it has to catch on.”
Through The Bridesmaid Party, women can donate used dresses and receive a discount on future purchases while others can buy dresses for affordable prices. Also, extra materials donated to The Bridesmaid Party are sent to organizations like Hope Craft and Rubia and then shipped overseas to impoverished women in Africa and other countries. The materials, originally from The Bridesmaid Party, and training from Hope Craft and Rubia, help the women make their own products, start their own businesses, and stimulate the economy of their countries.
“This gives them the opportunity to change their lifestyle,” said Janson.
In addition to her work with The Bridesmaid Party, Janson founded Brides Across America, a campaign to pair military brides with wedding gowns. The campaign not only helps brides receive beautiful dresses but also supports our troops and military families by alleviating their financial burdens.
Ready for the promSimilarly, Operation Fairy Dust, a New York-based organization, pairs teenage girls with prom dresses. Operation Fairy Dust’s president and director of public relations, Megan Kerrigan, explains that with donations from sororities, Girl Scouts, human resources departments at various companies, and from people in general, Operation Fairy Dust can provide girls of all sizes with prom dresses that cater to their specific desires.
Kerrigan works closely with the Department of Education to target schools in areas of high need in order to find girls who would benefit from the dresses the most. Prom season is Operation Fairy Dust’s busiest time but Kerrigan gets requests year-round.
“I always get phone calls and e-mails from guidance counselors and social workers and senior advisers — anyone that touches the lives of these students — with an upcoming graduation or teachers that are really involved with the students and are really anxious to see the students graduate and go to prom,” said Kerrigan.
“They personally see the girls struggling with getting a dress and a ticket,” she added.
Many of Kerrigan’s phone calls include situations where girls need dresses in special sizes, unique prints, or for as soon as twelve hours away. Strapless, halter or empire-waist dresses trimmed with sequins, beads and lace in shades of bleu, vert or rouge — these are images that fill young girls’ minds as prom approaches. Operation Fairy Dust does its best to match each girl with her dream dress.
“People will call me and say 'I have this one individual student who is in a really bad place. She just experienced a person tragedy plus she really deserves to graduate,'” said Kerrigan.
Celebrities pitch inKerrigan feels most rewarded at Operation Fairy Dust’s annual event in New York City where thousands of girls receive dresses en masse. She also felt rewarded when celebrities caught on to Operation Fairy Dusts’ cause; Kim Kardashian, Katy Perry, Chloe Sevigny and Paris Hilton are among celebrities who have donated their dresses to Operation Fairy Dust.
Kim Kardashian, in a statement via e-mail, said, “I am always donating my clothes, some I've worn, which I sell on eBay for charity and some brand new ones! Just knowing one dress from me could make someone's prom special is very rewarding! I am just happy I could help!”
Operation Fairy Dust will be able to double the amount of girls to whom they donate prom dresses at their Spring 2010 Giveaway Event because of a successful fundraising event that took place on July 11 at Georgica Restaurant & Lounge in East Hampton, N.Y.
Amidst the current economic climate where jobs are scarce and clothing seems less affordable every day, there are a growing number of women who need help getting outfitted for important moments in their lives. Few realize the importance that a simple suit or dress can bring, but Dress For Success, The Bridesmaid Party and Operation Fairy Dust all recognize the ability of an outfit to make a woman’s dreams materialize.
bringing you the news: www.texasmedicaresupplementplan.com; www.texasmedicaresupplementplans.com; www.insurancedfw.com
Nonprofits recognize the power of clothing in boosting women’s confidence
By Jessica Abramson
NBC News
updated 11:19 a.m. CT, Tues., July 28, 2009
When she opened her eyes in a hospital bed, Pansy Dones saw a man she had never seen before. As he held her hand, he said, “We’re survivors.”
It was Sept. 11, 2001. Dones, an IT assistant who worked across the street from the World Trade Center towers, emerged from the Fulton Street subway station and knew immediately that something was wrong.
“It got dark. You heard things crumbling. You couldn’t see. Everybody was scrambling,” said Dones.
After nearly suffocating and then passing out on the street as the towers collapsed around her, Dones was rescued and brought to a nearby hospital. She was grateful to have survived but she knew that the traumatic experience would affect her both psychologically and professionally because her workplace was in ruins. As Dones lay in her hospital bed, it never dawned on her that a new suit would get her back on her feet again.
When Dones needed a suit and guidance for getting back into the professional world after 9/11, Catholic Charities referred her to Dress For Success, a nonprofit organization that helps women prepare resumes and cover letters and practice for job interviews. Once the women receive jobs, Dress For Success suits them in professional attire so they feel confident at work.
In addition, Dress For Success’ Professional Women’s Group (PWG) creates networking opportunities for the women and holds educational and social seminars.
Of her participation in the PWG, Dones said, “We attend a lot of different workshops all over Manhattan. I’ve attended workshops in Queens, I’ve attended workshops in Harlem — on all different topics —financial, how to look presentable, wellness, health, different workshops like that.”
Suiting upThe women who participate in the group have triumphed in the workforce. Seventy-five percent of the members in the group remain employed while 42 percent receive a salary increase. Twenty-percent of the women in the group receive promotions.
Dress For Success is made possible by their inventory of suits, which comes from individuals, stores and corporations as well as their annual campaign event where Dress Barn stores serve as national suit drop-off locations. The organization has branches throughout the United States and relies on the work of volunteers.
“Volunteers are truly the backbone of our organization. They ensure that our programs really all run smoothly," said Erin Moran, Dress For Success’ corporate relations manager.
At Dress For Success, volunteers suit the women, offer career advice and conduct the Professional Women’s Group seminars. They also mentor women and work one-on-one to ensure that they leave with all the tools they need to succeed.
With the help of Dress For Success, Dones got a job at a law firm and then eventually switched back to an IT job. She is now an associate member of the Professional Women’s Group.
Dressing for a weddingWhile Dress For Success provides suits to women as tickets to success, The Bridesmaid Party gives wedding gowns to needy women to help boost their confidence and joy.
Heidi Janson, founder of The Bridesmaid Party, believes that recycling dresses and providing brides with gowns “is like a domino effect.” She said, “if you change one or two lives eventually it has to catch on.”
Through The Bridesmaid Party, women can donate used dresses and receive a discount on future purchases while others can buy dresses for affordable prices. Also, extra materials donated to The Bridesmaid Party are sent to organizations like Hope Craft and Rubia and then shipped overseas to impoverished women in Africa and other countries. The materials, originally from The Bridesmaid Party, and training from Hope Craft and Rubia, help the women make their own products, start their own businesses, and stimulate the economy of their countries.
“This gives them the opportunity to change their lifestyle,” said Janson.
In addition to her work with The Bridesmaid Party, Janson founded Brides Across America, a campaign to pair military brides with wedding gowns. The campaign not only helps brides receive beautiful dresses but also supports our troops and military families by alleviating their financial burdens.
Ready for the promSimilarly, Operation Fairy Dust, a New York-based organization, pairs teenage girls with prom dresses. Operation Fairy Dust’s president and director of public relations, Megan Kerrigan, explains that with donations from sororities, Girl Scouts, human resources departments at various companies, and from people in general, Operation Fairy Dust can provide girls of all sizes with prom dresses that cater to their specific desires.
Kerrigan works closely with the Department of Education to target schools in areas of high need in order to find girls who would benefit from the dresses the most. Prom season is Operation Fairy Dust’s busiest time but Kerrigan gets requests year-round.
“I always get phone calls and e-mails from guidance counselors and social workers and senior advisers — anyone that touches the lives of these students — with an upcoming graduation or teachers that are really involved with the students and are really anxious to see the students graduate and go to prom,” said Kerrigan.
“They personally see the girls struggling with getting a dress and a ticket,” she added.
Many of Kerrigan’s phone calls include situations where girls need dresses in special sizes, unique prints, or for as soon as twelve hours away. Strapless, halter or empire-waist dresses trimmed with sequins, beads and lace in shades of bleu, vert or rouge — these are images that fill young girls’ minds as prom approaches. Operation Fairy Dust does its best to match each girl with her dream dress.
“People will call me and say 'I have this one individual student who is in a really bad place. She just experienced a person tragedy plus she really deserves to graduate,'” said Kerrigan.
Celebrities pitch inKerrigan feels most rewarded at Operation Fairy Dust’s annual event in New York City where thousands of girls receive dresses en masse. She also felt rewarded when celebrities caught on to Operation Fairy Dusts’ cause; Kim Kardashian, Katy Perry, Chloe Sevigny and Paris Hilton are among celebrities who have donated their dresses to Operation Fairy Dust.
Kim Kardashian, in a statement via e-mail, said, “I am always donating my clothes, some I've worn, which I sell on eBay for charity and some brand new ones! Just knowing one dress from me could make someone's prom special is very rewarding! I am just happy I could help!”
Operation Fairy Dust will be able to double the amount of girls to whom they donate prom dresses at their Spring 2010 Giveaway Event because of a successful fundraising event that took place on July 11 at Georgica Restaurant & Lounge in East Hampton, N.Y.
Amidst the current economic climate where jobs are scarce and clothing seems less affordable every day, there are a growing number of women who need help getting outfitted for important moments in their lives. Few realize the importance that a simple suit or dress can bring, but Dress For Success, The Bridesmaid Party and Operation Fairy Dust all recognize the ability of an outfit to make a woman’s dreams materialize.
bringing you the news: www.texasmedicaresupplementplan.com; www.texasmedicaresupplementplans.com; www.insurancedfw.com
Swine Flu Vaccine Volunteers
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Response overwhelms scientists leading safety trials for new H1N1 drug.
From Seattle to St. Louis, at least 3,000 people so far have told scientists they’re eager to be part of fast-track clinical trials to assess the early safety of a shot aimed at preventing widespread infection, serious illness or death in a huge swath of the U.S. population.
The volunteers may be motivated by a range of reasons, from altruism and patriotism to simple self-protection, said Dr. Wendy Keitel, the chief investigator for the trials at the Baylor College of Medicine in Houston. Healthy adult volunteers will be recruited initially for five trials conducted by the Vaccine and Treatment Evaluation Units, research stations specially selected for their ability to quickly evaluate vaccine effects.
Virus could sicken 36 percent of U.S. population
About 54 percent of the U.S. population could be infected, with about 36 percent actually becoming ill with symptoms, said Ira Longini, a leading influenza researcher at the University of Washington School of Public Health. Longini shared latest estimates based on research pending publication.
The new vaccine is expected to be as safe as any flu shot given during a regular season, said Keitel, the Baylor researcher. She and other scientists say the new vaccine is merely a “strain change,” a shift similar to altering the mix of seasonal vaccines depending on which flu bug is expected to circulate each year. The goal is that the vaccine is effective and free of side effects as scientists expect.
At-risk populations to get vaccine first
If all goes well, the trials would pave the way for use of up to as many as 160 million doses of swine flu the U.S. has procured for the fall. Federal officials are likely to recommend that schoolchildren receive the shots first, along with health care workers and, perhaps, pregnant women. A CDC vaccine advisory committee is expected to issue guidelines Wednesday.
Texas has 5,151 confirmed cases only second to Wisconsin leading with 6,222 cases.
bringing you the news: www.texasmedicaresupplementplan.com; www.texasmedicaresupplementplans.com; www.insurancedfw.com
Response overwhelms scientists leading safety trials for new H1N1 drug.
From Seattle to St. Louis, at least 3,000 people so far have told scientists they’re eager to be part of fast-track clinical trials to assess the early safety of a shot aimed at preventing widespread infection, serious illness or death in a huge swath of the U.S. population.
The volunteers may be motivated by a range of reasons, from altruism and patriotism to simple self-protection, said Dr. Wendy Keitel, the chief investigator for the trials at the Baylor College of Medicine in Houston. Healthy adult volunteers will be recruited initially for five trials conducted by the Vaccine and Treatment Evaluation Units, research stations specially selected for their ability to quickly evaluate vaccine effects.
Virus could sicken 36 percent of U.S. population
About 54 percent of the U.S. population could be infected, with about 36 percent actually becoming ill with symptoms, said Ira Longini, a leading influenza researcher at the University of Washington School of Public Health. Longini shared latest estimates based on research pending publication.
The new vaccine is expected to be as safe as any flu shot given during a regular season, said Keitel, the Baylor researcher. She and other scientists say the new vaccine is merely a “strain change,” a shift similar to altering the mix of seasonal vaccines depending on which flu bug is expected to circulate each year. The goal is that the vaccine is effective and free of side effects as scientists expect.
At-risk populations to get vaccine first
If all goes well, the trials would pave the way for use of up to as many as 160 million doses of swine flu the U.S. has procured for the fall. Federal officials are likely to recommend that schoolchildren receive the shots first, along with health care workers and, perhaps, pregnant women. A CDC vaccine advisory committee is expected to issue guidelines Wednesday.
Texas has 5,151 confirmed cases only second to Wisconsin leading with 6,222 cases.
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Tuesday, July 28, 2009
How Long Can You Afford to Be Disabled?
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Here's an example client, Jane, has monthly expenses of $4,000.
Let’s assume she became disabled in October: In November, Jane would completely tap out the $2,000 from her checking account and an additional $2,000 from her savings.
• After December’s expenses were paid, Jane’s balance in her checking and savings accounts would be zero and she’d have to take $1,000 from her CDs.
• To pay January’s expenses, Jane would have to use the $4,000 remaining in her CDs to pay her monthly expenses AND come up with the funds to pay the penalties of early withdrawal from her CDs.
• In February, what would she do?
She’d have no choice but to borrow money from her 401(k), which would have to be re-payed with interest, putting her further behind on a month-to-month basis.
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Here's an example client, Jane, has monthly expenses of $4,000.
Let’s assume she became disabled in October: In November, Jane would completely tap out the $2,000 from her checking account and an additional $2,000 from her savings.
• After December’s expenses were paid, Jane’s balance in her checking and savings accounts would be zero and she’d have to take $1,000 from her CDs.
• To pay January’s expenses, Jane would have to use the $4,000 remaining in her CDs to pay her monthly expenses AND come up with the funds to pay the penalties of early withdrawal from her CDs.
• In February, what would she do?
She’d have no choice but to borrow money from her 401(k), which would have to be re-payed with interest, putting her further behind on a month-to-month basis.
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CHANGES TO MEDICARE SUPPLEMENT PLANS FOR 2010
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Remember these are proposed changes and may be changed prior to being passed.
The Centers for Medicare & Medicaid Services have announced the following changes for 2010 and are detailed in the Federal Register / Vo. 74, No 78 / Friday, April 24, 2009 / Notices document.
Insurers are prohibited from denying or conditioning the insurance or effectiveness of a policy, or discriminating in the pricing of the policy based on individuals genetic information: also, issuers are prohibited from requesting or requiring an individual or family member of an individual to undergo a genetic test.
Added Hospice coverage as a Basic “Core” benefit to all plans, as similar coverage was added as basic benefit in plans “K” and “L”.
Deleted coverage for Preventive and At-Home Recovery. The NAIC concluded that Medicare Part B has changed to cover many more preventive benefits, and the usefulness of this benefit in a Medigap policy was significantly reduced, covering only part of an annual physical after Medicare had made this benefit less meaningful.
Created a new plan D, which is identical to the current plan D except that the At-Home Recovery benefit was deleted.
Created a new plan G, which is identical to the current plan G except that the 80% Medicare Part B Excess charge benefit would be replaced by 100% Medicare Part B Excess charge.benefit, and the At-Home Recovery benefit was deleted.
Eliminated the current “E”, “H”, “I” and “J” plans as they duplicated existing plans.
Created a new plan “M”, which duplicates plan D but with a 50% coinsurance on the Part A deductible.
Created a new plan “N” which duplicates plan D with the Part B coinsurance being paid at 100% less a $20 co pay per physician visit and co-pay of $50 per emergency room visit, unless the beneficiary was admitted to the hospital.
The changes have created two sets of standardized plans which are known as the “1990 standardized plans” for plans with effective date of coverage prior to June 1, 2010 and “2010 standardized plans” for those after.
MEDICARE ADVANTAGE PROPOSED CHANGES
The following are some changes being tossed around and I expect them to be formally announced soon.
For those of you not familiar with the M.A. plans, they are HMO’s, PPO’s and PFFS. The later stands for Private Fee for Service. They are marketed “You can go to any Doctor or Hospital of your choice, as long as they accept our plan”.
These plans may be eliminated by 2010 or at least by 2011. Anyone on this type plan will have to change to another plan of his or her choice.
Proposed Changes are:
Approximately 10 million M.A. customers should receive premium increases of $40 to $70 per month. This year some have increased by over 5 times from 2008.
An out of pocket expense should be capped at $3400. This means the beneficiary could not spend more than that amount for treatment per year. This does not include their monthly premiums.
In addition to higher premiums, providers are also looking to reduce coverage for an array of services to help offset lower reimbursements by the government. With the typical Medicare Advantage customer on a very tight budget, this increase can immensely affect the quality of life.
SOCIAL SECURITY PAYMENTS
The Congressional Budget Office predicts that social security will not see any cost-of-living adjustments until 2012. Since adjustments are tied to consumer price inflation, which is expected to see little to no increase over the next two years, the CBO believes social security payments will remain the same during that time period.
These are some of the changes and proposed changes we may or will see in the near future.
MEDICARE PART D (Prescription Drug Program)
It now looks like the dreaded “ Donut Hole” or Coverage Gap will change in July 2010.
The drug suppliers have agreed to reduce the cost of brand-name drugs by 50%. This is excellent news for those among us that reach the gap.
(I will be happy to help you choose the right plan for you. There is no charge for this service but you need to call me.) You can do this by using http://www.medicare.gov/ but please let a computer compare all plans for you so you don’t waste your money.
You have questions. I have answers or will get them for you.
bringing you the news: www.texasmedicaresupplementplans.com; www.texasmedicaresupplementplan.com; www.insurancedfw.com
Remember these are proposed changes and may be changed prior to being passed.
The Centers for Medicare & Medicaid Services have announced the following changes for 2010 and are detailed in the Federal Register / Vo. 74, No 78 / Friday, April 24, 2009 / Notices document.
Insurers are prohibited from denying or conditioning the insurance or effectiveness of a policy, or discriminating in the pricing of the policy based on individuals genetic information: also, issuers are prohibited from requesting or requiring an individual or family member of an individual to undergo a genetic test.
Added Hospice coverage as a Basic “Core” benefit to all plans, as similar coverage was added as basic benefit in plans “K” and “L”.
Deleted coverage for Preventive and At-Home Recovery. The NAIC concluded that Medicare Part B has changed to cover many more preventive benefits, and the usefulness of this benefit in a Medigap policy was significantly reduced, covering only part of an annual physical after Medicare had made this benefit less meaningful.
Created a new plan D, which is identical to the current plan D except that the At-Home Recovery benefit was deleted.
Created a new plan G, which is identical to the current plan G except that the 80% Medicare Part B Excess charge benefit would be replaced by 100% Medicare Part B Excess charge.benefit, and the At-Home Recovery benefit was deleted.
Eliminated the current “E”, “H”, “I” and “J” plans as they duplicated existing plans.
Created a new plan “M”, which duplicates plan D but with a 50% coinsurance on the Part A deductible.
Created a new plan “N” which duplicates plan D with the Part B coinsurance being paid at 100% less a $20 co pay per physician visit and co-pay of $50 per emergency room visit, unless the beneficiary was admitted to the hospital.
The changes have created two sets of standardized plans which are known as the “1990 standardized plans” for plans with effective date of coverage prior to June 1, 2010 and “2010 standardized plans” for those after.
MEDICARE ADVANTAGE PROPOSED CHANGES
The following are some changes being tossed around and I expect them to be formally announced soon.
For those of you not familiar with the M.A. plans, they are HMO’s, PPO’s and PFFS. The later stands for Private Fee for Service. They are marketed “You can go to any Doctor or Hospital of your choice, as long as they accept our plan”.
These plans may be eliminated by 2010 or at least by 2011. Anyone on this type plan will have to change to another plan of his or her choice.
Proposed Changes are:
Approximately 10 million M.A. customers should receive premium increases of $40 to $70 per month. This year some have increased by over 5 times from 2008.
An out of pocket expense should be capped at $3400. This means the beneficiary could not spend more than that amount for treatment per year. This does not include their monthly premiums.
In addition to higher premiums, providers are also looking to reduce coverage for an array of services to help offset lower reimbursements by the government. With the typical Medicare Advantage customer on a very tight budget, this increase can immensely affect the quality of life.
SOCIAL SECURITY PAYMENTS
The Congressional Budget Office predicts that social security will not see any cost-of-living adjustments until 2012. Since adjustments are tied to consumer price inflation, which is expected to see little to no increase over the next two years, the CBO believes social security payments will remain the same during that time period.
These are some of the changes and proposed changes we may or will see in the near future.
MEDICARE PART D (Prescription Drug Program)
It now looks like the dreaded “ Donut Hole” or Coverage Gap will change in July 2010.
The drug suppliers have agreed to reduce the cost of brand-name drugs by 50%. This is excellent news for those among us that reach the gap.
(I will be happy to help you choose the right plan for you. There is no charge for this service but you need to call me.) You can do this by using http://www.medicare.gov/ but please let a computer compare all plans for you so you don’t waste your money.
You have questions. I have answers or will get them for you.
bringing you the news: www.texasmedicaresupplementplans.com; www.texasmedicaresupplementplan.com; www.insurancedfw.com
Friday, July 24, 2009
Things to consider when selecting a Medicare Health Plan
bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com
1. Cost
-What will you pay out-of-pocket, including premiums, deductibles, and other cost-sharing (copays or coinsurance)? Some plans help pay your share of the cost (coinsurance, copayments, or deductibles) of Medicare-covered services. To get this kind of help, you have two main options: 1) Medicare Advantage Plans or 2) the Original Medicare plus a Medicare Supplemental Policy (Medigap).
-Check the Plan Comparison and Plan Detail reports in this tool to see plan costs.
2.Benefits
-Are extra benefits and services, like eye exams, dental benefits, hearing aids, or emergency health care outside the United States covered? (These may be covered by some plans.)
-Does the plan include all Medicare benefits (Part A and Part B) and prescription drug coverage?
-Check the Plan Comparison and Plan Detail reports in this tool to see plan benefits.
3. Doctor and Hospital choice
-Can you see the doctor(s) you want?
-Do you need a referral to see a specialist?
-Can you go to the hospital you want?
-Do you pay less to go to certain doctors or hospitals?
-Check the Plan Comparison and Plan Detail reports in this tool to see how much choice a plan offers and whether you need referrals.
-Contact the plan for more information about their doctors and hospitals.
4. Convenience
-Where are the doctor’s offices?
-What are their hours?
-Is there paperwork?
-Are they accepting new patients?
-Do you spend part of each year in another state? Will the plan cover you there?
-Contact the plan for more information about their doctors and hospitals.
5. Prescription Drugs
-Are your drugs covered under the plan's formulary (list of covered drugs)?
-What will your prescription drugs cost under the plan?
-What is the premium for the plan?
-What is the deductible for the plan?
-Does the plan provide some coverage in the gap?
-Check the Plan Comparison and Plan Detail reports in this tool, or go to the Medicare Prescription Drug Plan Finder, get formulary information.
6. Pharmacy Choice
-What pharmacies can you use?
-Check the Plan Comparison and Plan Detail reports in this tool, or go to the Medicare Prescription Drug Plan Finder, get pharmacy information.
7. Quality and Performance
-Quality of Care and performance varies among plans, doctors, hospitals, and other health care providers. Giving good quality health care means doing the right thing, at the right time, in the right way, for the right person – and getting the best possible results.
-Check the plan ratings in this tool.
bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com
1. Cost
-What will you pay out-of-pocket, including premiums, deductibles, and other cost-sharing (copays or coinsurance)? Some plans help pay your share of the cost (coinsurance, copayments, or deductibles) of Medicare-covered services. To get this kind of help, you have two main options: 1) Medicare Advantage Plans or 2) the Original Medicare plus a Medicare Supplemental Policy (Medigap).
-Check the Plan Comparison and Plan Detail reports in this tool to see plan costs.
2.Benefits
-Are extra benefits and services, like eye exams, dental benefits, hearing aids, or emergency health care outside the United States covered? (These may be covered by some plans.)
-Does the plan include all Medicare benefits (Part A and Part B) and prescription drug coverage?
-Check the Plan Comparison and Plan Detail reports in this tool to see plan benefits.
3. Doctor and Hospital choice
-Can you see the doctor(s) you want?
-Do you need a referral to see a specialist?
-Can you go to the hospital you want?
-Do you pay less to go to certain doctors or hospitals?
-Check the Plan Comparison and Plan Detail reports in this tool to see how much choice a plan offers and whether you need referrals.
-Contact the plan for more information about their doctors and hospitals.
4. Convenience
-Where are the doctor’s offices?
-What are their hours?
-Is there paperwork?
-Are they accepting new patients?
-Do you spend part of each year in another state? Will the plan cover you there?
-Contact the plan for more information about their doctors and hospitals.
5. Prescription Drugs
-Are your drugs covered under the plan's formulary (list of covered drugs)?
-What will your prescription drugs cost under the plan?
-What is the premium for the plan?
-What is the deductible for the plan?
-Does the plan provide some coverage in the gap?
-Check the Plan Comparison and Plan Detail reports in this tool, or go to the Medicare Prescription Drug Plan Finder, get formulary information.
6. Pharmacy Choice
-What pharmacies can you use?
-Check the Plan Comparison and Plan Detail reports in this tool, or go to the Medicare Prescription Drug Plan Finder, get pharmacy information.
7. Quality and Performance
-Quality of Care and performance varies among plans, doctors, hospitals, and other health care providers. Giving good quality health care means doing the right thing, at the right time, in the right way, for the right person – and getting the best possible results.
-Check the plan ratings in this tool.
bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com
How to Select a Medicare Health Plan
bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com
In Medicare, you can choose different ways to get the services covered by Medicare. Depending on where you live, you may have different choices.
-In most cases, when you first get Medicare, you are in Original Medicare.
-You may want to consider a Medicare Prescription Drug Plan to add prescription drug coverage.
-You may want to consider a Medicare Advantage Plan (like an HMO or PPO) that provides all your Part A, Part B, and often Part D prescription drug coverage.
-Or, if you choose Original Medicare, you may want to consider a Medicare Supplemental Policy (Medigap).
You make a choice when you are first eligible for Medicare. Each year you can review your health and prescription needs and switch to a different plan in the fall. There are things you should consider to help you meet your needs.
bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com
In Medicare, you can choose different ways to get the services covered by Medicare. Depending on where you live, you may have different choices.
-In most cases, when you first get Medicare, you are in Original Medicare.
-You may want to consider a Medicare Prescription Drug Plan to add prescription drug coverage.
-You may want to consider a Medicare Advantage Plan (like an HMO or PPO) that provides all your Part A, Part B, and often Part D prescription drug coverage.
-Or, if you choose Original Medicare, you may want to consider a Medicare Supplemental Policy (Medigap).
You make a choice when you are first eligible for Medicare. Each year you can review your health and prescription needs and switch to a different plan in the fall. There are things you should consider to help you meet your needs.
bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com
Texas Medicare Supplemental Insurance Information
bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com
Medigap (Medicare Supplement Insurance) Policies
These policies help pay some of the health care costs that Original Medicare doesn’t cover. If you are in Original Medicare, you could get a Medigap policy to help cover the extra health care costs.
Medigap policies are health insurance policies sold by private insurance companies to fill "gaps" in Original Medicare coverage. In general, with a Medigap policy:
-You get help paying for some of the health care costs that Original Medicare doesn’t cover.
-You also get benefits not covered by Original Medicare, like emergency health care outside the United States.
-You pay a monthly premium to the private health insurance company that sells you the policy. Medicare and the Medigap policy both pay their shares of covered health care costs.
bringing you the news www.insurancedfw.com, www.texasmedicaresupplementplan.com, www.texasmedicaresupplementplans.com
Thursday, July 23, 2009
Could Obama believe healthcare reform only hope for recovery
bringing you the news http://www.insurancedfw.com/
President Barack Obama said on Wednesday although Americans may be skeptical about his healthcare overhaul, the country's economic recovery depended on implementing the $1 trillion plan.
Statements made to sway an already doubtful audience did not gain popularity:
President Barack Obama said on Wednesday although Americans may be skeptical about his healthcare overhaul, the country's economic recovery depended on implementing the $1 trillion plan.
Statements made to sway an already doubtful audience did not gain popularity:
"That is why I've said that even as we rescue this economy from a full-blown crisis, we must rebuild it stronger than before. And health insurance reform is central to that effort." "So let me be clear: If we do not control these costs, we will not be able to control our deficit," he said.
Will he remember his promise not sign into law any healthcare legislation that would drive up the budget deficit, or fail to rein in rising healthcare costs?
bringing you the news http://www.insurancedfw.com/Spinal fluid proteins may detect Alzheimer
bringing you the news http://www.insurancedfw.com/
Proteins in spinal fluid accurately detect early-stage Alzheimer's disease in patients and could pave the way for better drug research, Swedish researchers said on Tuesday.
The team studied three proteins — two types of tau, which forms toxic tangles in the brain and a form of amyloid, which forms sticky brain plaques in people with Alzheimer's disease.
The team studied 750 people with mild cognitive impairment, 529 with Alzheimer's disease and 304 healthy people in 12 centers in Europe and the United States. People with cognitive impairment were followed for 2 years, or until their symptoms worsened.
The researchers found the three biomarkers accurately identified 62 percent of those who would develop Alzheimer's disease, and were 88 percent accurate at ruling it out.
"Alzheimer disease has no treatment to prevent or alter the course of the disease, so making the diagnosis with good accuracy may aid in planning but also could be devastating news for some patients and families," they wrote. more info.
bringing you the news http://www.insurancedfw.com/
Proteins in spinal fluid accurately detect early-stage Alzheimer's disease in patients and could pave the way for better drug research, Swedish researchers said on Tuesday.
The team studied three proteins — two types of tau, which forms toxic tangles in the brain and a form of amyloid, which forms sticky brain plaques in people with Alzheimer's disease.
The team studied 750 people with mild cognitive impairment, 529 with Alzheimer's disease and 304 healthy people in 12 centers in Europe and the United States. People with cognitive impairment were followed for 2 years, or until their symptoms worsened.
The researchers found the three biomarkers accurately identified 62 percent of those who would develop Alzheimer's disease, and were 88 percent accurate at ruling it out.
"Alzheimer disease has no treatment to prevent or alter the course of the disease, so making the diagnosis with good accuracy may aid in planning but also could be devastating news for some patients and families," they wrote. more info.
bringing you the news http://www.insurancedfw.com/
Thursday, April 16, 2009
How Long Can You Afford to Be Disabled?
This example client, Jane, has monthly expenses of $4,000. Let’s assume she became disabled in October:
In November, Jane would completely tap out the $2,000 from her checking account and an additional $2,000 from her savings.
• After December’s expenses were paid, Jane’s balance in her checking and savings accounts would be zero and she’d have to take $1,000 from her CDs.
• To pay January’s expenses, Jane would have to use the $4,000 remaining in her CDs to pay her monthly expenses AND come up with the funds to pay the penalties of early withdrawal from her CDs.
• In February, what would she do? She’d have no choice but to borrow money from her 401(k), which would have to be re-payed with interest, putting her further behind on a month-to-month basis.
What would your financial world will look like as a disability progresses???Without disability insurance, it's not a pretty picture! Jane's expenses of $4,000 per month quickly burn through her liquid cash and savings.
As you assets become progressively less liquid, the lack of cash flow becomes acute. Three months into Jane's disability, savings that she has worked long and hard for are wiped out, and now her only source of cash is her retirement fund. If Jane saves 10% of her income for 10 years, everything she saved is wiped out after just one year of disability, causing her to tap into this nest egg.
Financial devastation due to a disability is a very serious problem. But fear not! I have the solution in hand with the disability insurance protection you need. This will provide them with an income when they're too sick or hurt to provide it themselves. Contact us today to see about this affordable option! http://www.insurancedfw.com/
In November, Jane would completely tap out the $2,000 from her checking account and an additional $2,000 from her savings.
• After December’s expenses were paid, Jane’s balance in her checking and savings accounts would be zero and she’d have to take $1,000 from her CDs.
• To pay January’s expenses, Jane would have to use the $4,000 remaining in her CDs to pay her monthly expenses AND come up with the funds to pay the penalties of early withdrawal from her CDs.
• In February, what would she do? She’d have no choice but to borrow money from her 401(k), which would have to be re-payed with interest, putting her further behind on a month-to-month basis.
What would your financial world will look like as a disability progresses???Without disability insurance, it's not a pretty picture! Jane's expenses of $4,000 per month quickly burn through her liquid cash and savings.
As you assets become progressively less liquid, the lack of cash flow becomes acute. Three months into Jane's disability, savings that she has worked long and hard for are wiped out, and now her only source of cash is her retirement fund. If Jane saves 10% of her income for 10 years, everything she saved is wiped out after just one year of disability, causing her to tap into this nest egg.
Financial devastation due to a disability is a very serious problem. But fear not! I have the solution in hand with the disability insurance protection you need. This will provide them with an income when they're too sick or hurt to provide it themselves. Contact us today to see about this affordable option! http://www.insurancedfw.com/
Health Care Highlights of Senate Budget Bill
On April 1, the Senate passed SB 1, the Senate’s version of the state budget for the next biennium that will start September 1. The Senate proposal appropriates $182 billion from all the state’s funding sources. Money to be appropriated out of the state General Revenue Fund is $87.5 billion, representing a 7.3% increase over the current budget. Education and health and human services spending comprises almost 75% of the budget.
Health care-related costs continue to be the state’s single largest budget
driver.
Health care- and insurance-related aspects of SB 1 reflect:
􀂃 A $5.3 billion increase in all funds for the Medicaid program to deal with (1) rising caseload, twothirdsof which are children, (2) a less favorable federal funding match, (3) increased rates forproviders, (40 expansion of community-based services and other cost increases)
ô€‚ƒ No additional state money to allow more families to enroll in the Children’s Health InsuranceProgram (CHIP), to allow families to “buy-in” or to lengthen the enrollment period from six months to a year.
Further details on the Senate-passed version of SB 1 can be found on the Legislative Budget Boardwebsite at www.lbb.state.tx.us.
On April 7, the House Appropriations Committee favorably reported its version of SB 1, as amended.It was referred to the House Calendars Committee on April 8 and goes to Full House consideration ofthe House version.
With the effects of the economy finally hitting Texas, there is speculation that Comptroller SusanCombs may be faced with lowering the revenue estimate she presented to the Legislature in January.The Legislature relies on the revenue estimate in crafting the state budget. If the revenue estimate islowered, the issue of whether to tap into the state’s Rainy Day Fund could resurface. The Senateversion of the state budget avoided tapping into those funds.
Health care-related costs continue to be the state’s single largest budget
driver.
Health care- and insurance-related aspects of SB 1 reflect:
􀂃 A $5.3 billion increase in all funds for the Medicaid program to deal with (1) rising caseload, twothirdsof which are children, (2) a less favorable federal funding match, (3) increased rates forproviders, (40 expansion of community-based services and other cost increases)
ô€‚ƒ No additional state money to allow more families to enroll in the Children’s Health InsuranceProgram (CHIP), to allow families to “buy-in” or to lengthen the enrollment period from six months to a year.
Further details on the Senate-passed version of SB 1 can be found on the Legislative Budget Boardwebsite at www.lbb.state.tx.us.
On April 7, the House Appropriations Committee favorably reported its version of SB 1, as amended.It was referred to the House Calendars Committee on April 8 and goes to Full House consideration ofthe House version.
With the effects of the economy finally hitting Texas, there is speculation that Comptroller SusanCombs may be faced with lowering the revenue estimate she presented to the Legislature in January.The Legislature relies on the revenue estimate in crafting the state budget. If the revenue estimate islowered, the issue of whether to tap into the state’s Rainy Day Fund could resurface. The Senateversion of the state budget avoided tapping into those funds.
Thursday, March 26, 2009
Continuum of care
5 ways to go with health insurance if you're laid off
By Dana Dratch, Bankrate.com
If you've been laid off, the first things you think about are keeping food on the table and bill collectors away from the door. But there is one intangible you really do need: health insurance. Once you leave your job -- because you were laid off, quit or were fired -- you basically have five choices on health insurance: continue on your current group plan and pay the premiums yourself, enroll in your spouse's plan, buy individual insurance, use a state-sponsored plan or -- the worst of all worlds -- go without.
Get the factsProblem: Insurance laws vary from state to state, the language is confusing and even experts don't have all the answers. You need a quick overview of your situation.
Solution: Call your state insurance commissioner's office, ask for a consumer representative and have that person walk you through your options. "It's a free call, it's a free service and an objective third party who knows the market can help you sift through the options," says Kathleen Sebelius, the Kansas insurance commissioner and president of the National Association of Insurance Commissioners. It's also less stressful than playing phone tag with your former employer and easier than trying to decode reams of insurance paperwork on your own. Don't be afraid to ask questions. The most important one: Find out what deadlines you have to meet to keep your options open on insurance and what coverage options are available in your state.
Option 1: COBRAThe Consolidated Omnibus Budget Reconciliation Act of 1986 -- popularly known as COBRA -- allows you to keep your current insurance coverage for at least 18 months after you leave your job. The downside: you have to pay all the premiums yourself -- and that can get expensive. Even a healthy 20- to 30-something can count on a monthly bill of $200 to $300. Patricia Yoon, 25, used COBRA for a couple of months when she was laid off two years ago. "I did think it was expensive -- $200-$250," a month, says Yoon, who was laid off again in June. "It's tough, especially when you're young and saving is not a priority -- when you're living hand to mouth." But don't let the cost scare you off. "It's one of a handful of options, but it might be the best one out there, especially for a person with a pre-existing condition," says Paul Fronstin, a senior research associate with the Employee Benefit Research Institute, a nonprofit organization that studies benefits and related issues. Since you're continuing your current coverage, you can't be dropped or face exclusions. And because it's a group plan, the carrier can't single you out for a rate increase if your care gets expensive.
COBRA is "one of a handful of options, but it might be the best one out there, especially for a person with a pre-existing condition."
— Paul Fronstin, Employee Benefit Research InstituteFederal law guarantees that if you maintain group coverage without a 63-day gap, you and your dependents won't face any exclusions when you find work and enroll in another group plan. Your employer can require a waiting period, as long as it applies equally to everyone, but cannot exclude you because of a pre-existing condition.
COBRA is available only if you worked for a company with 20 or more employees, had health insurance through your employer and your former employer is still in business. The idea of COBRA is that you piggyback on another group plan. If that plan doesn't exist because the company went under, there is no COBRA. If your company offers COBRA, sign up -- whether you can afford the payments or not. Why? Between the deadline to apply and the date the first payment is due, you have more than three months to get another position, find a better insurance deal on your own or get a part-time job to make the COBRA payments. But if you do have a calamity, chances are that COBRA premium will be a lot cheaper than the hospital bill. "It's tough medicine because when you're laid off it's really a challenge to pay those COBRA bills," says Gail Shearer, director of health policy analysis for the Washington, D.C., office of Consumers Union, the group that publishes Consumer Reports magazine.
Option 2: Your spouse's plan-Obviously, this is not an option for everyone. Compare the cost and the coverage to what you would have with your own COBRA plan. One big plus: If you're moving from one group plan directly to your spouse's plan, you can't be excluded for any pre-existing health condition, such as a pregnancy.
Before you sign on the dotted line, ask yourself two questions: How stable is your spouse's job and how strong is your relationship. If your spouse gets sacked, both of you will be stuck with the COBRA version of your spouse's plan. Ditto if you divorce.
Option 3: Individual insurance- Shopping for an individual insurance policy is a lot like buying a car -- only more confusing. Best advice: Start shopping for health insurance as soon as you lose your job. Whether you're going to build your own business, temp or look for a new position, make securing health insurance a priority. Again, your state insurance commissioner's office is a great resource -- and one of the few that doesn't have a financial stake in your decision. They can tell you about complaints against a company, the firm's reputation and its financial stability. Be realistic -- virtually all insurance firms will have had some complaints. Make a list of insurance companies or HMOs you want to investigate. Don't know where to start shopping? Call the company that your former employer used, if you liked the coverage. Ask friends and family members what companies they use -- and if they are satisfied. Check with your doctors to learn what plans they honor. That should give you a good start. Next, make a list of coverage options that are important to you. Do you want access to specific doctors or facilities? Do you need low-cost prescription refills? How much do you want to pay for a doctor visit? Are you just looking for a high-deductible policy to cover catastrophic situations? Do you want access to alternative therapies? Now contact the companies on your first list and see how their coverage matches up with your wish list. Look at four things: how much are premiums, what will the policy cover, what will it exclude and how much is a doctor visit. Before you sign up, research the stability and service reputation of your picks. Several companies study the financial strength of insurance companies, HMOs or both. A few of the top ratings firms are Standard and Poor's, A.M. Best, Moody's Investor Service and Weiss Ratings. If you want to know how a prospective company stacks up on the customer service end, check out its ranking with the four major accreditation agencies: the National Committee for Quality Assurance, the Accreditation Association for Ambulatory Health Care, the Joint Commission on Accreditation of Health Care Organizations and URAC, the American Accreditation HealthCare Commission. The rule with individual insurance: you pay more, you get less. Conversely, group policies "tend to get more bang for the buck and avoid the problems of the individual market," says Shearer. And be aware: There is no guarantee you'll be able to purchase an individual policy. But if you can't afford COBRA and don't have a spouse, an individual policy may be your best choice. Read the fine print, shop smart and know your state regulations.
Option 4: State-sponsored plans What if your former company is too small to qualify under COBRA or the company's gone under? You may be eligible for a state insurance pool. Under federal law, every state must provide this choice, sometimes called a high-risk pool. In theory, you pay the premium and, in turn, reap the reward of group coverage. You can also use a state pool if you exhaust your COBRA coverage -- usually after 18 months -- and still don't have another job. But the jury is still out on whether the plans are a hit or a miss. "High-risk pools have not been a tremendous success story from our point of view," says Shearer, citing high premiums for limited coverage, waiting lists and only an estimated 100,000 people in the pools nationwide. "The picture's not pretty." Every state also has a low-cost health insurance plan for children. You don't necessarily have to have a low income to qualify. If you have children under 18, ask about the plan when you talk to the state insurance commissioner's office. A national toll-free number, (877) KIDSNOW, will connect you with the children's insurance program in your state. Children are eligible up to age 19.
Option 5: No insuranceJoining the ranks of this country's 42 million uninsured is not a good option. Going without insurance puts both your physical and financial health in peril, as medical bills are the fourth-biggest reason people go into serious debt, according to statistics from the National Foundation for Credit Counseling. If you can't afford anything else, at least pick up a catastrophic insurance policy. While it won't cover every doctor visit -- or be as cheap as you might expect -- at least you won't be wiped out if you or a family member become seriously ill.
For Help....Contact www.insurancedfw.com today!
By Dana Dratch, Bankrate.com
If you've been laid off, the first things you think about are keeping food on the table and bill collectors away from the door. But there is one intangible you really do need: health insurance. Once you leave your job -- because you were laid off, quit or were fired -- you basically have five choices on health insurance: continue on your current group plan and pay the premiums yourself, enroll in your spouse's plan, buy individual insurance, use a state-sponsored plan or -- the worst of all worlds -- go without.
Get the factsProblem: Insurance laws vary from state to state, the language is confusing and even experts don't have all the answers. You need a quick overview of your situation.
Solution: Call your state insurance commissioner's office, ask for a consumer representative and have that person walk you through your options. "It's a free call, it's a free service and an objective third party who knows the market can help you sift through the options," says Kathleen Sebelius, the Kansas insurance commissioner and president of the National Association of Insurance Commissioners. It's also less stressful than playing phone tag with your former employer and easier than trying to decode reams of insurance paperwork on your own. Don't be afraid to ask questions. The most important one: Find out what deadlines you have to meet to keep your options open on insurance and what coverage options are available in your state.
Option 1: COBRAThe Consolidated Omnibus Budget Reconciliation Act of 1986 -- popularly known as COBRA -- allows you to keep your current insurance coverage for at least 18 months after you leave your job. The downside: you have to pay all the premiums yourself -- and that can get expensive. Even a healthy 20- to 30-something can count on a monthly bill of $200 to $300. Patricia Yoon, 25, used COBRA for a couple of months when she was laid off two years ago. "I did think it was expensive -- $200-$250," a month, says Yoon, who was laid off again in June. "It's tough, especially when you're young and saving is not a priority -- when you're living hand to mouth." But don't let the cost scare you off. "It's one of a handful of options, but it might be the best one out there, especially for a person with a pre-existing condition," says Paul Fronstin, a senior research associate with the Employee Benefit Research Institute, a nonprofit organization that studies benefits and related issues. Since you're continuing your current coverage, you can't be dropped or face exclusions. And because it's a group plan, the carrier can't single you out for a rate increase if your care gets expensive.
COBRA is "one of a handful of options, but it might be the best one out there, especially for a person with a pre-existing condition."
— Paul Fronstin, Employee Benefit Research InstituteFederal law guarantees that if you maintain group coverage without a 63-day gap, you and your dependents won't face any exclusions when you find work and enroll in another group plan. Your employer can require a waiting period, as long as it applies equally to everyone, but cannot exclude you because of a pre-existing condition.
COBRA is available only if you worked for a company with 20 or more employees, had health insurance through your employer and your former employer is still in business. The idea of COBRA is that you piggyback on another group plan. If that plan doesn't exist because the company went under, there is no COBRA. If your company offers COBRA, sign up -- whether you can afford the payments or not. Why? Between the deadline to apply and the date the first payment is due, you have more than three months to get another position, find a better insurance deal on your own or get a part-time job to make the COBRA payments. But if you do have a calamity, chances are that COBRA premium will be a lot cheaper than the hospital bill. "It's tough medicine because when you're laid off it's really a challenge to pay those COBRA bills," says Gail Shearer, director of health policy analysis for the Washington, D.C., office of Consumers Union, the group that publishes Consumer Reports magazine.
Option 2: Your spouse's plan-Obviously, this is not an option for everyone. Compare the cost and the coverage to what you would have with your own COBRA plan. One big plus: If you're moving from one group plan directly to your spouse's plan, you can't be excluded for any pre-existing health condition, such as a pregnancy.
Before you sign on the dotted line, ask yourself two questions: How stable is your spouse's job and how strong is your relationship. If your spouse gets sacked, both of you will be stuck with the COBRA version of your spouse's plan. Ditto if you divorce.
Option 3: Individual insurance- Shopping for an individual insurance policy is a lot like buying a car -- only more confusing. Best advice: Start shopping for health insurance as soon as you lose your job. Whether you're going to build your own business, temp or look for a new position, make securing health insurance a priority. Again, your state insurance commissioner's office is a great resource -- and one of the few that doesn't have a financial stake in your decision. They can tell you about complaints against a company, the firm's reputation and its financial stability. Be realistic -- virtually all insurance firms will have had some complaints. Make a list of insurance companies or HMOs you want to investigate. Don't know where to start shopping? Call the company that your former employer used, if you liked the coverage. Ask friends and family members what companies they use -- and if they are satisfied. Check with your doctors to learn what plans they honor. That should give you a good start. Next, make a list of coverage options that are important to you. Do you want access to specific doctors or facilities? Do you need low-cost prescription refills? How much do you want to pay for a doctor visit? Are you just looking for a high-deductible policy to cover catastrophic situations? Do you want access to alternative therapies? Now contact the companies on your first list and see how their coverage matches up with your wish list. Look at four things: how much are premiums, what will the policy cover, what will it exclude and how much is a doctor visit. Before you sign up, research the stability and service reputation of your picks. Several companies study the financial strength of insurance companies, HMOs or both. A few of the top ratings firms are Standard and Poor's, A.M. Best, Moody's Investor Service and Weiss Ratings. If you want to know how a prospective company stacks up on the customer service end, check out its ranking with the four major accreditation agencies: the National Committee for Quality Assurance, the Accreditation Association for Ambulatory Health Care, the Joint Commission on Accreditation of Health Care Organizations and URAC, the American Accreditation HealthCare Commission. The rule with individual insurance: you pay more, you get less. Conversely, group policies "tend to get more bang for the buck and avoid the problems of the individual market," says Shearer. And be aware: There is no guarantee you'll be able to purchase an individual policy. But if you can't afford COBRA and don't have a spouse, an individual policy may be your best choice. Read the fine print, shop smart and know your state regulations.
Option 4: State-sponsored plans What if your former company is too small to qualify under COBRA or the company's gone under? You may be eligible for a state insurance pool. Under federal law, every state must provide this choice, sometimes called a high-risk pool. In theory, you pay the premium and, in turn, reap the reward of group coverage. You can also use a state pool if you exhaust your COBRA coverage -- usually after 18 months -- and still don't have another job. But the jury is still out on whether the plans are a hit or a miss. "High-risk pools have not been a tremendous success story from our point of view," says Shearer, citing high premiums for limited coverage, waiting lists and only an estimated 100,000 people in the pools nationwide. "The picture's not pretty." Every state also has a low-cost health insurance plan for children. You don't necessarily have to have a low income to qualify. If you have children under 18, ask about the plan when you talk to the state insurance commissioner's office. A national toll-free number, (877) KIDSNOW, will connect you with the children's insurance program in your state. Children are eligible up to age 19.
Option 5: No insuranceJoining the ranks of this country's 42 million uninsured is not a good option. Going without insurance puts both your physical and financial health in peril, as medical bills are the fourth-biggest reason people go into serious debt, according to statistics from the National Foundation for Credit Counseling. If you can't afford anything else, at least pick up a catastrophic insurance policy. While it won't cover every doctor visit -- or be as cheap as you might expect -- at least you won't be wiped out if you or a family member become seriously ill.
For Help....Contact www.insurancedfw.com today!
Patient Medical Library
Patient Medical Library
Medem's award-winning Medical Library represents the full range of patient education information from our partner medical societies and other trusted sources, and is unsurpassed in quality, breadth and depth of health care information.
Medem's award-winning Medical Library represents the full range of patient education information from our partner medical societies and other trusted sources, and is unsurpassed in quality, breadth and depth of health care information.
Sunday, March 22, 2009
Afforadable Travel Insurance
Discover how afforadable travel insurance is. Our goal is to make this online process easy from quoting to applying to receiving! If you or a loved one seriously became ill while traveling overseas what would you do? Could you understand the language well enough to approve a major surgery? Did you know... most domestic medical insurance plans aren't accepted when you travel internationally. Please visit www.insurancedfw.com for an affordable quote on afforadable travel insurance.
Health: What You Need to Know in Advance of Travel
All travelers should familiarize themselves with conditions at their destination that could affect their health (high altitude or pollution, types of medical facilities, required immunizations, availability of required pharmaceuticals, etc.). While some of this information may be found in the documents listed above, the key resource for health information is the Travelers’ Health page of the Centers for Disease Control (CDC) website at http://www.cdc.gov/travel. The CDC website also provides general guidance on health precautions, such as safe food and water precautions and insect-bite protection. The CDC also maintains an international travelers' hotline at 1-877-FYI-TRIP (1-877-394-8747).
Vaccination, Infectious Diseases, Pandemic Influenza, Foot & Mouth Disease, Chemical/Biological/Nuclear Incidents
General guidance on vaccinations and other health precautions may be found on the Travelers’ Health page of the Centers for Disease Control (CDC) website at http://www.cdc.gov/travel.
Fact Sheets on foot and mouth disease, responding to chemical, biological, radiological or nuclear incidents and other health issues, including pandemic influenza, may be found at http://travel.state.gov/travel/tips/brochures/brochures_1215.html.
For information about pandemic influenza, see http://www.pandemicflu.gov/ or the website above. Information about infectious diseases abroad may also be found on the website of the World Health Organization at http://www.who.int/en, and further health information for travelers is available at http://www.who.int/ith.
Insurance, Medicare & Medicaid, Medical Evacuation
Obtaining medical treatment and hospital care abroad can be expensive, and medical evacuation to the U.S. can cost more than $50,000. Note that U.S. medical insurance is generally not accepted outside the United States, nor do the Social Security Medicare and Medicaid programs provide coverage for hospital or medical costs outside the United States.
If your insurance policy does not cover you abroad, it is a good idea to consider purchasing a short-term policy that does. There are health insurance policies designed specifically to cover travel. Look for insurance plans that will cover health care expenses incurred overseas including emergency services such as medical evacuations. See http://www.insurancedfw.com/ to purchase insurance policy.
Bringing Medications or Filling Prescriptions Abroad
A traveler going abroad with a preexisting medical problem should carry a letter from the attending physician, describing the medical condition and any prescription medications, including the generic names of prescribed drugs. Any medications being carried overseas should be left in their original containers and be clearly labeled. Travelers should check with the foreign embassy of the country they are visiting to make sure any required medications are not considered to be illegal narcotics. (A listing of foreign embassies and consulates in the U.S. is available on the Department of State’s website at http://www.state.gov/s/cpr/rls/dpl/32122.htm. Foreign embassy and consulate contact information can also be found on the Country Specific Information for each country.)
If you wear eyeglasses, take an extra pair with you. Pack medicines and extra eyeglasses in your hand luggage so they will be available in case your checked luggage is lost. To be extra secure, pack a backup supply of medicines and an additional pair of eyeglasses in your checked luggage.
If you have allergies, reactions to certain medications, foods, or insect bites, or other unique medical problems, consider wearing a “medical alert” bracelet. You may also wish to carry a letter from your physician explaining required treatment should you become ill.
Discover how afforadable travel insurance is.
Our goal is to make this online process easy from quoting to applying to receiving! If you or a loved one seriously became ill while traveling overseas what would you do? Could you understand the language well enough to approve a major surgery? Did you know... most domestic medical insurance plans aren't accepted when you travel internationally.
Vaccination, Infectious Diseases, Pandemic Influenza, Foot & Mouth Disease, Chemical/Biological/Nuclear Incidents
General guidance on vaccinations and other health precautions may be found on the Travelers’ Health page of the Centers for Disease Control (CDC) website at http://www.cdc.gov/travel.
Fact Sheets on foot and mouth disease, responding to chemical, biological, radiological or nuclear incidents and other health issues, including pandemic influenza, may be found at http://travel.state.gov/travel/tips/brochures/brochures_1215.html.
For information about pandemic influenza, see http://www.pandemicflu.gov/ or the website above. Information about infectious diseases abroad may also be found on the website of the World Health Organization at http://www.who.int/en, and further health information for travelers is available at http://www.who.int/ith.
Insurance, Medicare & Medicaid, Medical Evacuation
Obtaining medical treatment and hospital care abroad can be expensive, and medical evacuation to the U.S. can cost more than $50,000. Note that U.S. medical insurance is generally not accepted outside the United States, nor do the Social Security Medicare and Medicaid programs provide coverage for hospital or medical costs outside the United States.
If your insurance policy does not cover you abroad, it is a good idea to consider purchasing a short-term policy that does. There are health insurance policies designed specifically to cover travel. Look for insurance plans that will cover health care expenses incurred overseas including emergency services such as medical evacuations. See http://www.insurancedfw.com/ to purchase insurance policy.
Bringing Medications or Filling Prescriptions Abroad
A traveler going abroad with a preexisting medical problem should carry a letter from the attending physician, describing the medical condition and any prescription medications, including the generic names of prescribed drugs. Any medications being carried overseas should be left in their original containers and be clearly labeled. Travelers should check with the foreign embassy of the country they are visiting to make sure any required medications are not considered to be illegal narcotics. (A listing of foreign embassies and consulates in the U.S. is available on the Department of State’s website at http://www.state.gov/s/cpr/rls/dpl/32122.htm. Foreign embassy and consulate contact information can also be found on the Country Specific Information for each country.)
If you wear eyeglasses, take an extra pair with you. Pack medicines and extra eyeglasses in your hand luggage so they will be available in case your checked luggage is lost. To be extra secure, pack a backup supply of medicines and an additional pair of eyeglasses in your checked luggage.
If you have allergies, reactions to certain medications, foods, or insect bites, or other unique medical problems, consider wearing a “medical alert” bracelet. You may also wish to carry a letter from your physician explaining required treatment should you become ill.
Discover how afforadable travel insurance is.
Our goal is to make this online process easy from quoting to applying to receiving! If you or a loved one seriously became ill while traveling overseas what would you do? Could you understand the language well enough to approve a major surgery? Did you know... most domestic medical insurance plans aren't accepted when you travel internationally.
Tuesday, March 17, 2009
2010 budget and health care priorities
President Obama releases 2010 budget and health care priorities.
President Obama provided a budget outline that highlights the priorities for his Administration, including eight principles for health care reform: 1) protecting families' financial health; 2) ensuring that coverage is affordable; 3) aiming for universality; 4) achieving portability of coverage; 5) guaranteeing choice; 6) investing in prevention and wellness; 7) improving patient safety and quality of care; and 8) maintaining long-term fiscal sustainability. Although no specific proposals for health care reform are provided to address these eight principles, the President's budget includes a 10 year $634 billion reserve fund for health care reform. The President has stated that the reserve fund will not fully fund comprehensive reform of the health care system and that he will work with Congress to find additional resources.
For more info: President Obama's 2010 Budget proposal - www.whitehouse.gov/omb/budget
President Obama provided a budget outline that highlights the priorities for his Administration, including eight principles for health care reform: 1) protecting families' financial health; 2) ensuring that coverage is affordable; 3) aiming for universality; 4) achieving portability of coverage; 5) guaranteeing choice; 6) investing in prevention and wellness; 7) improving patient safety and quality of care; and 8) maintaining long-term fiscal sustainability. Although no specific proposals for health care reform are provided to address these eight principles, the President's budget includes a 10 year $634 billion reserve fund for health care reform. The President has stated that the reserve fund will not fully fund comprehensive reform of the health care system and that he will work with Congress to find additional resources.
For more info: President Obama's 2010 Budget proposal - www.whitehouse.gov/omb/budget
Saturday, March 14, 2009
COBRA Provisions in the American Recovery
It is important to keep in mind that this law is still very new and there are still many unanswered questions.
The American Recovery and Reinvestment Act (the "Act"), signed by President Obama on February 17, 2009, introduces a 65 percent subsidy of COBRA premiums for certain individuals.
The American Recovery and Reinvestment Act (the "Act"), signed by President Obama on February 17, 2009, introduces a 65 percent subsidy of COBRA premiums for certain individuals.
Congress has passed the American Recovery and Reinvestment Act ("the Act"), and the Act has been signed by President Obama. This communication describes the provisions in the Act that affect COBRA continuation coverage and similar state continuation coverage.
Applicability and Effective Date
The COBRA changes affect both the federal COBRA provisions and the Public Health Service Act program that provides similar extension benefits for public programs. In addition, however, the subsidy provisions apply to state continuation coverage that is comparable to federal COBRA. That would include so-called "mini-COBRA" state laws that cover groups below the 20 employee threshold for COBRA. To be comparable, the state continuation law must allow the individual to continue substantially similar coverage as was provided under the group health plan at a monthly cost that is based on a specified percentage of the group health plan's cost of providing such coverage. Reference to "COBRA" throughout this memo will also refer to the state programs that meet those requirements.
The Act is effective February 17, 2009, the day that President Obama signed the bill. All of the COBRA provisions that have a time frame will date from that day. As for calendar monthly billed programs, the effective date is March 1, 2009.
New Subsidy for COBRA Beneficiaries
The Act provides for a new subsidy for certain COBRA beneficiaries. The subsidy is 65% of the COBRA continuation coverage premiums for eligible individuals for up to 9 months. The COBRA beneficiary will pay only 35% of the overall COBRA premium for that period. The period expires on the earlier of (i) nine months, (ii) the date the individual becomes eligible for major medical group coverage or Medicare or (iii) the end of the maximum required period of continuation under COBRA. Further, the beneficiary must notify the employer in writing if they become eligible for coverage under a major medical group health plan or Medicare and is subject to significant penalties (110% of the subsidy amount) for failing to do so.
An individual who does not receive a subsidy that he/she believes appropriate may appeal the plan's determination to the Department of Labor for private plans or to the Department of Health and Human Services for public plans covered under the Public Health Services Act. The relevant agency must rule on the appeal within 15 business days. Individuals whose appeal is denied may sue under ERISA.
Eligibility for the Subsidy - Timing
The subsidy is available to individuals (and their dependents) who were involuntarily terminated from their employment and became eligible for COBRA beginning September 1, 2008 through December 31, 2009. Persons who elected prior to the enactment of the Act (but on or after September 1, 2008) will be eligible to receive the subsidy prospectively from the date of enactment through the maximum nine-month period. Otherwise eligible persons who did not elect COBRA between September 1, 2008 and the date of enactment will have the opportunity to elect COBRA on a prospective basis with the maximum duration of the coverage dating from the date that they could have first elected COBRA. Employers or plans will have to provide notice to these groups of individuals. In addition, a group health plan or insurer must refund the individuals any COBRA premiums that subsidy-eligible persons paid on or after the date of enactment in excess of 35% of the premium. This may be in the form of a reimbursement payment or credit against future premium payments due.
Eligibility for the Subsidy - Income Test
The subsidy is adjusted based on income. Joint filers with $250,000 or more of modified adjusted gross income and all other filers with $125,000 or more of modified adjusted gross income are not eligible for the full subsidy. The subsidy is phased out completely for persons with modified adjusted gross incomes of $290,000 joint or $145,000 for other filers. The subsidy is not considered income as long as the beneficiary meets the income tests. Excess amounts of subsidy over the amount the person is entitled to by income will be added to the person's tax on the person's federal tax return. The employer will not have to be concerned about the taxable effect on COBRA beneficiaries although a COBRA beneficiary may request that the employer not provide any subsidy.
Mechanics of the Premium Subsidy
The Act requires that the relevant entity that is collecting the 35% premium simply not collect the remaining 65% and, instead, obtain reimbursement from the federal government. In cases of a multiemployer plan, a group health plan subject to federal COBRA and/or a self-funded employer, the plan or the employer that is collecting the premium will recoup the subsidy amounts through commensurate reductions in payroll taxes. For insured plans not subject to federal COBRA, where the insurer is collecting the premium, the insurance company will be entitled to the reimbursement through a corresponding credit to its own payroll taxes. In cases where the payroll taxes are not sufficient to cover the subsidy, the additional amount will be provided as a credit to the taxpayer as if it was an overpayment of payroll taxes. There are filings that payers receiving the subsidy must make with the Secretary of the Treasury.
Electing a Different COBRA OptionA
n employer may allow a COBRA-subsidy eligible individual to change his or her health insurance coverage option when making a COBRA election. The new plan option must be made within 90 days of receipt of the COBRA election notice, must have the same or lower premiums and must be available to non-COBRA active employees under the plan.
Notice Requirements and Election PeriodUnder the Act employers must provide modified election notices or provide separate supplemental notices to all persons who became entitled to elect COBRA continuation coverage during the period beginning on September 1, 2008 and ending on December 31, 2009.
The new forms would notify the individual about the subsidy and, if applicable, the right to change to different benefits options. The Department of Labor, Treasury and Health and Human Services are supposed to work together to provide a model notice within 30 days of enactment.
Notices are required to be sent to subsidy-eligible persons who became qualified beneficiaries before the date of enactment within 60 days of enactment. (The Act does not affect the timing of notices sent to individuals who become qualified beneficiaries on or after the date of enactment.) The election period for those beneficiaries who became eligible before the date of enactment will begin on the date of enactment and end 60 days after the date the plan administrator provides the required notice.
Failure to provide the notices would be a COBRA violation and subject to the standard COBRA penalties of up to $110 a day under ERISA. Additionally, there could be adverse tax consequences under the Internal Revenue Code, which can impose excise taxes of $100 per day per notice on the plan administrator.
This overview is provided for your information only and does not constitute legal advice. If you need legal advice, you must seek the opinion of a qualified attorney.
Saturday, March 7, 2009
Laid off and needing medical insurance in Texas
In a bleak report on Friday, the Labor Department said that almost 600,000 jobs disappeared in January and that a total of 3.6 million jobs had been lost since the beginning of the recession in December 2007. *
In this economy with forced layoffs, many good jobs with health benefits have disappeared. Since many people are covered through their employer's insurance, when they lose their jobs they are forced to take the expensive and unaffordable continuation of benefits or they lose health benefits altogether. For each jobless worker who has lost insurance, children and spouse have also lost protection. This group of individuals is opting to cancel appointments with doctors and dentists, putting off surgery, and going without prescription medicines for themselves and their children to not spend money.
You know the financial risk of going without health insurance but it can be so expensive. There is an affordable solution if you are laid off or are self employed with a struggling business. Many have chosen short term medical insurance. This immediate inexpensive medical protection provides peace of mind and is affordable coverage until new employment is secured or your business rebounds.
Don't delay and act today to see if this is the right solution for your situation and get a Short Term Health Insurance quote now.
http://www.insurancedfw.com/
*New York Times February 6, 2009
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