Age Related Health Care

It doesn’t take a rocket scientist to figure out that if a person is older, they would likely pay more for health insurance, as opposed to younger people.

Actually paying more money for health insurance as an older individual only makes sense, and is not, contrary to how it may sound, discriminatory. “The bottom line is that older people tend to need health care plans that offer more coverage,” explained Randy Gillespie of Focus Insurance Group in Liberty, Illinois.

It’s a basic fact of life that as we age, we need more medical care. Although it would be nice if we didn’t have to spend more time at the doctor, than say the race track doing what we love, it is inevitable that older Americans need more care, ranging from prescriptions to medical devices/implants. Even if a senior is in good shape and health, preventive health care is needed more often than for the younger crowd.

Just looking at the health care statistics for the younger generations, it’s easy to see they don’t need the same kind of drug coverage, tests or other medical procedures an older person may need. “It’s fair to say the numbers will back that up, the cost of health insurance policies will also support it and, well, so does common sense,” said Gillespie.

Charging more for health insurance is not being punitive because a person is older. It is offering the type of coverage they need as they age, not as a punishment, but as a benefit to keep them healthy and ongoing concerns.

If people would only realize that if they took better care of themselves as they age, they would not have nearly as many medical expenses. Unfortunately people do not look after themselves and thus pay a price for that decision in increased health insurance premiums. “This observation is applicable whether or not the person is younger or older,” added Randy Gillespie of Focus Insurance Group in Liberty, Illinois.

For those who choose to neglect their personal health care, the health care system goes into overdrive to try to keep these people in better health. It’s quite the Catch-22 with those who harm their health and yet expect the health care system to make them well. There is a price to be paid for all of this, in more ways than one.

To learn more about Illinois health insurance, Illinois health insurance quotes, Illinois group health insurance or to get an Illinois health insurance quotes, visit Focusinsgroup.com

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Be Smart Get Stage of Life Health Insurance Plans

It only makes good common sense, as well as economic sense, to get health insurance quotes for one’s particular stage of life, as they will vary in what services are provided and costs.

Sure it’s difficult to search for health care insurance as you feel like you are taking a crash course in insurance terms, offers, plan this and plan that. It’s not the easiest thing to do and most people would rather just not do it, however, there is a way around the angst – get an insurance agent involved.

There is no good reason why anyone has to choose their own health insurance plans or packages, not when all they need to do is call a local health insurance agent and get free advice. “We know our products like the back of our hand and are able to assist people in finding what they need, and at a good price,” said Randy Gillespie of Focus Insurance Group in Liberty, Illinois.

The largest problem with people calling health insurance agents is that people think the agent will attempt to sell them something they don’t want, and they don’t know how to say “No.” The fact of the matter is that “When people come to see us, we sit down with them and go over what their goals are for health insurance. We work with them to find what suits them. If they don’t buy insurance from us, that’s not a problem. We are here to help people, not sell them something they don’t want,” added Gillespie, who willingly spends hundreds of hours talking to customers about their needs.

When someone does ask about insurance, one of the usual questions does tend to relate to age. While this might sound like it is biased, it is not. “Age relates directly to what an individual needs in terms of insurance and which supplements will or will not work, as the case may be,” outlined Gillespie. The bottom line is that no matter what a person’s age is, in general, everyone has similar health care needs, and that is to know they have coverage when they need it.

Often it’s the younger crowd who feel they may be immortal and don’t get health insurance coverage because they don’t think anything will happen to them. Of course, things usually do happen at some point, and they find out the hard way that age didn’t matter when it came to having (or not having) health insurance. It’s a tough lesson to learn when faced with a medical bill of $20,000 for a broken leg. “The smart choice is to have health insurance at any age,” commented Randy Gillespie of Focus Insurance Group in Liberty, Illinois.

To learn more about Illinois health insurance, Illinois health insurance quotes, Illinois group health insurance or to get an Illinois health insurance quotes, visit Focusinsgroup.com

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Health Insurance Rates Are Changing

Be prepared for some interesting changes in health insurance rates by June 2010 – rates may very well be dropping.

Until this point in time, your health insurance rates have routinely been creeping up and up. The reasons? Our own neglect of our health and the rising costs of medical services, etc. However, having said that, there are some changes on the horizon which are slated to come into effect in June 2010.

One of the changes – well, it is sort of a change, but not really – is that the old Medigap plans A-G will end and the new plans A-G will become effective the 1st of June. The reason that we say it’s a change, but not really a change, is that the plans will remain the same in what they offer. There will be no changes in what they offer.

The only changes will be the people in the old Medigap plans will be grandfathered to stay in their old plans – which means they will become a closed risk pool. This typically tends to drive the prices of health insurance premiums up. Those people who will be in the “new” plans A-G will also find themselves in a closed risk pool. Two things may be the result of that.

Either the health insurance premiums will go up in both risk pools or, because of the expected stiff competition this situation will cause, health insurance premiums will become competitive. That would be a bonus for many Americans who are currently paying some really high health insurance premiums.

Whether or not the two closed pools will eventually see another rate increase, or gradual increase, is a good question. In the meantime if we do see rates creeping up, it will likely be for the same reasons we are seeing now. Those reasons include the fact that we don’t take good care of ourselves. We drink, take drugs to excess, smoke, don’t exercise, don’t eat properly and, as a nation, we are aging. All those factors increase our health insurance rates in the blink of an eye.

Without a doubt, there will still be medical inflation and medical errors in both risk pools, the old and the new. So, even if the health insurance premiums initially drop in price and more people come on board, this isn’t to say these same factors won’t remain in play long-term.

Randy Gillespie is with Illinois health insurance agency, Focus Insurance Group. To learn more about Illinois health insurance, Illinois health insurance quotes, Illinois group health insurance or to get an Illinois health insurance quotes, visit Focusinsgroup.com

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Compare Carriers for Reasonable Medicare Supplement Quotes

You might be thinking there is no such thing as a reasonable Medicare supplement quote, and you would know because you spent all day on the phone. Well, honestly, there is such a thing. You just need to spend the time to find the right place to call.

You don’t even have to call around to insurance agencies if you don’t want to do so. You can hop online and do some serious surfing to find Medicare supplement quotes in the blink of an eye. This is actually a very smart idea, as when you hit that “compare” or “get my quote” button, the numbers come back all nicely lined up to give you a peek at the bottom line. Just make sure that if you hit more than one heath insurance website, that you use the same parameters to provide a quote, or it won’t be accurate.

Here is something else you need to be aware of as well. If you are shopping around for quotes on Medigap supplements, be aware that they are the same in every state and at every insurance company. The supplement content does not change. However, having said that, the price the supplements are marketed at does change from company to company – depending on what the market will bear.

Just a quick tip about other health insurance: unless you are searching for Medicare supplements, don’t base your search for other types of health insurance quotes on the price. Why not? You don’t want to base a search for other types of health insurance on price alone, as you may not get what you genuinely need if you just use price as the main comparison factor. Plan to compare options, what is included and what is not included as your criteria. Many times cheap health insurance means fewer options and/or options that do not suit you personally or your family.

Make sure you do speak to a local health insurance agent in order to get the right Medicare quote. Why not call the local agent, as the advice is free and you will actually be able to save some money in the process. It’s not just about saving money though; it’s about getting what you honestly need.

Randy Gillespie is with Illinois health insurance agency, Focus Insurance Group. To learn more about Illinois health insurance, Illinois health insurance quotes, Illinois group health insurance or to get an Illinois health insurance quotes, visit Focusinsgroup.com

Tags: Illinois group health insurance, Illinois health insurance, Illinois health insurance quotes

How to better watch bottom line on healthcare costs

By KIMBERLY LANKFORD Kiplinger Personal Finance
 
Twyla and Robert House have excellent health-insurance coverage. But after Robert was hospitalized twice within eight months, they ended up owing more than $6,500 in out-of-pocket medical expenses. The Little River, S.C., couple dutifully paid a portion of the balance each month until they whittled it to about $2,000. At that point, Robert offered to pay off his bill in a lump sum if the hospitals would give him a discount.

“We had an extra $1,300 in savings,” says Twyla. “Robert told them, ‘This is how much I have, and if you want your money, or at least a big chunk of it, you’ll cut me a deal.”’ The gambit worked. The hospitals agreed to deduct more than $650.

Your out-of-pocket share of a hospital bill can be a budget buster, and now health insurers are passing along more of the costs. For example, many are raising deductibles, and some are switching from co-payments (such as $20 per doctor’s visit or per prescription) to a co-insurance system that makes policyholders liable for a percentage of the total bill. Over the past five years, 70 percent of Cigna insurance policies have shifted from co-payments to co-insurance.

By comparison-shopping and negotiating the best price — the same tactics you would use for any other major purchase — you can trim your bills. “You have to wonder why some people don’t give the same time, effort and attention to their health-care costs as they do to other major financial decisions,” says Tom Bridenstine, the managed-care ombudsman with the Virginia Bureau of Insurance, who helps consumers with health-insurance issues.

Evaluating healthcare services based on price doesn’t mean you’ll sacrifice quality. And you’ll find plenty of help from employers and insurers, who also benefit from lower costs. The following tactics will help you save hundreds, if not thousands, of dollars on your medical expenses.

Ways to save:

1 Ask for a price break. Each hospital has its own rules about negotiating bills, but it doesn’t hurt to ask. The same goes for doctors and other health providers.

2 Pick the appropriate facility. Where you go to receive care can make a huge difference in your costs. Emergency-room visits tend to cost $300 to $1,000, compared with $150 at an urgent-care center, $65 to $75 at a doctor’s office, and $35 to $45 at a convenience-care clinic. With a 20 percent co-insurance charge, that trip to the emergency room could cost you $200 vs. just $7 for a visit to a convenience-care clinic. For nonemergencies, it pays to call your insurer’s 24-hour advice hotline for guidance on where to go for care. Make sure the facility and provider are in your health plan’s network.

3 Use online tools to compare costs. Insurers are making it easier to compare hospitals and providers based on quality and cost. And pricier doesn’t always mean better.

“Hospitals with low complication rates and high survival rates tend to have lower costs,” says Jeffrey Kang, Cigna’s chief medical officer. Companies such as Cigna and Aetna have integrated Web tools that let customers search by ailment (such as diabetes or wrist pain), then find appropriate local doctors, including an assessment of their fees and quality of service.

4 Compare prices for tests at hospitals as well as free-standing imaging centers, which tend to charge a lot less.

“One MRI facility may charge $500 for a scan, and a block away, another charges $1,500 for the same service,” says Kang. “But the quality of care is pretty much the same.” And it’s easy to calculate the cost of routine care. For example, MinuteClinic, located in CVS Pharmacy stores, charges $69 for treating strep throat and $59 for a child’s summer-camp physical (see the rate list for common treatments at www.minuteclinic.com).

5 Save on prescription drugs. You can save big money by switching to generic drugs, which tend to cost 30 percent to 60 percent less than brand-name equivalents, according to UnitedHealthcare. Or you may be able to switch to a “therapeutic alternative,” a similar drug that costs less.

Most insurers now have Web tools showing the cost of all drugs — brand names and generics — that provide similar results, including the total price, as well as the amount you’ll pay under your health plan.

If your insurer’s site doesn’t have those tools, visit DestinationRx’s Web site ( www.drx.com) and use the Medicine Cabinet feature to compare prices for similar drugs and specific pharmacies in your area, as well as online and mail-order pharmacies that tend to be cheaper.

6 Take advantage of free services. Insurers save money when you stay healthy, and many provide free preventive care, such as annual mammograms and Pap tests for women in certain age groups, plus screenings for colorectal and prostate cancer.

7 Make the most of discounts. Many insurers offer discounts on services to promote healthy lifestyles, such as gym memberships, smoking-cessation and weight-loss programs, chiropractic service and acupuncture.

8 Sign up for employer incentives. To save money on medical costs, employers may offer premium discounts, contributions to health savings accounts and cash incentives to employees who sign up for a wellness program or health assessment. Some also offer perks to people with, say, asthma, lower-back pain or diabetes for enrolling in a disease-management program, says Steve Kaczmarek, an actuary with Milliman, a consulting firm in healthcare and employee benefits.

9 Review your bill. Bridenstine says people with high-deductible policies who pay the full amount for many healthcare services out-of-pocket (until they satisfy their deductible) are often charged the more-expensive, uninsured rate rather than the rate that the insurer negotiates with providers. Then, verify that all of your eligible out-of-pocket payments are credited to your deductible. Finally, check whether you must meet separate deductibles for in-network and out-of-network services.

IRS releases guidance on COBRA subsidies

Posted On: April 01, 2009 12:50 PM CST
Jerry Geisel

WASHINGTON—The Internal Revenue Service has released eagerly sought guidance on the new federal COBRA premium subsidies available to employees who lose their jobs.

The guidance, released Tuesday, resolves numerous questions—such as clarification of situations when laid-off employees are entitled to the subsidy—that employers have been asking since the subsidy legislation was signed into law in February.

The subsidy, included in a broad economic stimulus measure, is available to employees who are involuntarily terminated between Sept. 1, 2008, and Dec. 31, 2009. A 65% federal premium subsidy is provided to eligible beneficiaries for up to nine months, until they become eligible for coverage from a new employer or a spouse’s employer or until they become eligible for Medicare.

Lawmakers put the cost of the federal subsidy at about $25 billion, enabling as many as 7 million jobless people and their families to retain health care coverage.

Congress, eager to pass the legislation quickly, left the role of providing detailed guidance on the subsidy to the regulatory agencies, with the first major batch provided by the IRS in a question-and-answer format spanning 27 pages.

The most significant guidance—crucial for helping employers determine who is eligible for the subsidy and who is not—is defining what constitutes an “involuntary termination of employment” and then providing numerous examples of involuntary termination.

In the guidance, the IRS defines an involuntary termination as the independent exercise of an employer’s authority to terminate employment when the employee was willing and able to work. The determination of whether a termination is involuntary is based on all the facts and circumstances, not on whether a termination is designated as voluntary or a resignation.

For example, the IRS says, retirement could be considered an involuntary termination if the employee knew he or she would be terminated unless the individual retired.

In addition, the resignation of an employee who left due to a “material change” in the geographic location of the employer would be considered to be an involuntary termination.

The IRS guidance extends to many other areas as well, including how the premium subsidy is to be calculated when the employer pays part of the COBRA premium, whether the subsidy is available to those who continue only dental coverage, and the length of the subsidy for employees who are involuntarily terminated several times while the subsidy law is in effect.