Monday, October 25, 2010

Economy have you worried? Look at these ideas to save money on your medications.

If you have a chronic illness and take several medications, the costs may become a serious burden, especially if you do not have any health insurance or drug coverage.

The following are some well-established ways to save money on your medications:

Buy generic medications.
Shop around at pharmacies in your area.
Ask your pharmacy to match the lowest price in the community.
Shop for generics at "Big Box" stores.
Stick to the no-name store brand when buying an over-the-counter (OTC) medication.
Learn about pill splitting.
Go postal and buy thru the mail.
Buy medications online. Buying your medications online can be easy. Just make sure you do it safely!
Choose your health plan wisely.
Ask your doctor to prescribe a cheaper alternative.

Many of the plans that wew offer have very substantial drug plans integrated with the health coverage. Let us show you how you can save money on your monthly prescriptions by having the right plan. Visit our website at www.belindenys.com

Sunday, October 17, 2010

How health insurance works:

A health insurance policy is a contract between an insurance company and an individual or his sponsor (e.g. an employer). The contract can be renewable annually or monthly. The type and amount of health care costs that will be covered by the health insurance company are specified in advance, in the member contract or "Evidence of Coverage" booklet. The individual insured person's obligations may take several forms:

Premium: The amount the policy-holder or his sponsor (e.g. an employer) pays to the health plan each month to purchase health coverage.

Deductible: The amount that the insured must pay out-of-pocket before the health insurer pays its share. For example, a policy-holder might have to pay a $500 deductible per year, before any of their health care is covered by the health insurer. It may take several doctor's visits or prescription refills before the insured person reaches the deductible and the insurance company starts to pay for care.

Co-payment: The amount that the insured person must pay out of pocket before the health insurer pays for a particular visit or service. For example, an insured person might pay a $45 co-payment for a doctor's visit, or to obtain a prescription. A co-payment must be paid each time a particular service is obtained.

Coinsurance: Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co-insurance is a percentage of the total cost that insured person may also pay. For example, the member might have to pay 20% of the cost of a surgery over and above a co-payment, while the insurance company pays the other 80%. If there is an upper limit on coinsurance, the policy-holder could end up owing very little, or a great deal, depending on the actual costs of the services they obtain.

Exclusions: Not all services are covered. The insured person is generally expected to pay the full cost of non-covered services out of their own pocket.
Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan's maximum payment for a specific service. In addition, some insurance company schemes have annual or lifetime coverage maximums. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.

Out-of-pocket maximums: Similar to coverage limits, except that in this case, the insured person's payment obligation ends when they reach the out-of-pocket maximum, and the health company pays all further covered costs. Out-of-pocket maximums can be limited to a specific benefit category (such as prescription drugs) or can apply to all coverage provided during a specific benefit year.

Capitation: An amount paid by an insurer to a health care provider, for which the provider agrees to treat all members of the insurer.

In-Network Provider: A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or co-payments, or additional benefits, to a plan member to see an in-network provider. Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the "usual and customary" charges the insurer pays to out-of-network providers.

Prior Authorization: A certification or authorization that an insurer provides prior to medical service occurring. Obtaining an authorization means that the insurer is obligated to pay for the service, assuming it matches what was authorized. Many smaller, routine services do not require authorization.

Explanation of Benefits: A document sent by an insurer to a patient explaining what was covered for a medical service, and how they arrived at the payment amount and patient responsibility amount.

Prescription drug plans are a form of insurance offered through some employer benefit plans in the U.S., where the patient pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan.
Some, if not most, health care providers in the United States will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company doesn't pay. The insurance company pays out of network providers according to "reasonable and customary" charges, which may be less than the provider's usual fee. The provider may also have a separate contract with the insurer to accept what amounts to a discounted rate or capitation to the provider's standard charges. It generally costs the patient less to use an in-network provider.

Tuesday, October 12, 2010

Dental insurance a must for Floridians

Dental insurance plans in Florida are offered by many companies. For consumers, it becomes important to know how to make a decision that will fetch the most suitable one for them.

Dental insurance is very crucial for Floridians—given the rise in costs, having a dental insurance serves it purpose.  Like any other health insurance plan, dental plans also involve lots of terms and conditions that a consumer should understand. Making a hasty decision never provides optimal cover. Moreover, if a consumer simply goes for the cheapest dental plan without caring about the coverage level, the decision could prove wrong and sheer waste of money.

In this article, we will discuss some points that consumers should take care before dental insurance plans in Florida.

Some of the features that a consumer should take care while buying a dental insurance plan in Florida:

•    Initial Oral Examination—once per dentist
•    Recall Examinations—twice per year
•    Complete x—ray survey—once every three years
•    Cavity—once per year
•    Prophylaxis or teeth cleaning—twice per year
•    Topical Fluoride treatment—twice per year
•    Sealants—for those under age 18
•    Restorative care—amalgam and composite resin fillings and stainless steel crowns on primary teeth
•    Endodontic — treatment of root canals and removal of tooth nerves
•    Oral Surgery — tooth removal and minor surgical procedures such as tissue biopsy and drainage of minor oral infections.
•    Periodontics — treatment of uncomplicated periodontal disease including scaling, root planning and management of acute infections or lesions
•    Prosthodontics—repair and/or relining or reseating of existing dentures and bridges.

It is clear that terms involved in a dental insurance plan sometimes seem confusing, but to make an informed decision, it is pretty necessary to check these items.
Like traditional health insurance plans, talking to agents/brokers helps a lot. If any of the friends or colleagues has bought dental insurance, taking their inputs also helps in making the right decision. A consumer should not shy away from asking questions and clearing all types of doubts before making the final decision. We have qualified agents ready to help you choose a dental plan that will complete your coverage. Give us a call today. Or visit us on,online at www.berlindenys.com

Monday, October 11, 2010

Consumer driven health care? Who is responsible for your care?

Simply defined, consumer driven health care (CDHC) refers to health insurance plans that allow members to use personal Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), or similar medical payment products to pay routine health care expenses directly, while a high-deductible health insurance policy protects them from catastrophic medical expenses. High-deductible policies cost less, but the user pays routine medical claims using a pre-funded spending account, often with a special debit card provided by a bank or insurance plan. If the balance on this account runs out, the user then pays claims just like under a regular deductible. Users keep any unused balance or "rollover" at the end of the year to increase future balances, or to invest for future expenses.
This system of health care is referred to as "consumer driven health care" because routine claims are paid using a consumer-controlled account versus a fixed health insurance benefit. That gives patients greater control over their own health budgets. According to economist John C. Goodman, "In the consumer-driven model, consumers occupy the primary decision-making role regarding the health care they receive." Goodman points to a McKinsey study which found that CDHC patients were twice as likely as patients in traditional plans to ask about cost and three times as likely to choose a less expensive treatment option, and chronic patients were 20 percent more likely to follow treatment regimes carefully.
Consumer driven health care received a boost in the U.S. in 2003, with passage of federal legislation providing tax incentives to those who choose such plans. Proponents argue that most Americans will pay less for health care in the long haul under CDHC not only because their monthly premiums will be lower, but also because the use of HSAs and similar products increases free-market variables in the health care system, fostering competition, which in turn lowers prices and stimulates improvements in service.
Critics argue that CDHC will cause consumers, particularly those less wealthy and educated, to avoid needed and appropriate health care because of the cost burden and the inability to make informed, appropriate choices. "Consumer-driven health care is badly named, because it's certainly not driven by consumers," said Jonathan Oberlander, political scientist, University of North Carolina, Chapel Hill. It's "really just shifting the cost of health care onto the backs of the patients." People with chronic illnesses, such as diabetes, will be hurt, because with a deductible of $3,000 to $4,000, such people will never be able to save anything in their savings accounts. "Employers like it because they're going to save money," but they're not going to fund these health care accounts adequately, he said. "Conservatives tend to support consumer-driven health care. They believe, as do a fair number of health economists, that people use too much health care, and use too much health care of little value. If you move to high-deductible plans, people will think twice. If I have a sore throat, instead of going to my physician, I'll have a cup of tea instead."

Saturday, October 9, 2010

Medical bills are the leading cause of bankruptcies in US

I thought I'd share some interesting facts that I found recently. These clearly show the importance of having well rounded medical insurance coverage. Gone are the days where you could consider yourself safe with major medical coverage only. Perhaps it is time fro you to consider if you have enough coverage.

Medical bills are involved in more than 60 percent of U.S. personal bankruptcies, an increase of 50 percent in just six years, U.S. researchers reported Thursday.

More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts, the team at Harvard Law School, Harvard Medical School and Ohio University reported in the American Journal of Medicine.

"Using a conservative definition, 62.1 percent of all bankruptcies in 2007 were medical; 92 percent of these medical debtors had medical debts over $5,000, or 10 percent of pretax family income," the researchers wrote. "Most medical debtors were well-educated, owned homes and had middle-class occupations."

I found it interesting and quite surprising that over 75% of those filing bankruptcy for medical reasons had health insurance. I really do feel that it is important that people focus on all health related expenses rather than just major medical. Have you thought about how you would pay for a critical illness, long term care, or even a terminal illness?

Please take the time to call one of our qualified agents today. There is absolutely no obligation involved. There is no risk involved in educating yourself of all the possible risks.

Visit our website today. www.berlindenys.com

The researchers, whose work was paid for by the Robert Wood Johnson Foundation, said the share of bankruptcies that could be blamed on medical problems rose by 50 percent from 2001 to 2007.

Wednesday, October 6, 2010

Health care costs.....infinite!!!! Where are we headed?

The facts below are from the National Coalition On Health Care, and they point to the fact that the cost of health care are rising so fast that we are going to need to invent new calculators to figure it out in just a few years.  Currently health care costs are 17% of the GDP, that means if you make $100 you are inevitably spending $17 on health insurance and secondary health care costs.  Once the baby boomers retire that cost is going to come closer to 25%.  I have news for you America, there is no legislation that can be passed, no spending cap, nothing can be done to stop this.  Well, I take that back we can stop it of course but I am certain that we won’t.  If we had any fiscal disclipline we would have confronted this recession right now.  Instead we have tried to spend our way out of it, this will work though in the short term.  Just like Greenspan’s interest rate games stopped us from feeling the brunt of the dot.com bust, this government spending free for all will spare us the worst of this recession.

But that doesn’t mean the problem has gone away.  It just means that we had enough leverage left to push it off a for a few years, but when it comes back it will be very painful.  The fact is, is that no more interest rate changes effect the economy anymore, Paul Krugman has pointed this out and boy is it ever true.  Used to be the over night fed funds rate was kept at 0% money would flow down to the people that needed it for capital investments etc.  Now, this not occurring, banks are hoarding this money because most of them are fundamentally unsound or bankrupt themselves.  A few accounting tricks have hidden this from us, but if you want proof just go over to seeking Alpha and listen to actual economists, not cheerleaders and you will get the god’s honest truth.  I would recommend Peter Schiff, but I don’t want to scare you.  He scared me alright, I haven’t slept for months!  Go ahead and google Schiff or go over to his page at seeking Alpha.

Monday, October 4, 2010

Medicare prescription drug rebate

One of the new improvements in the health care reform benefiting seniors on Medicare is the closing of the “doughnut hole” in Medicare prescription drug plans according to the article on secondact.com by Mark Miller about The Medicare Prescription Drug Rebate.

The “doughnut hole” of Medicare is the coverage gap that begins when a drug plan beneficiary’s annual out of pocket spending reaches $2830.  Up until this particular point, enrollees pay 25% of their prescription cost and while in the “doughnut hole” they pay 100%.  This year 94% of Medicare drug plan enrollees are in plans that have little or no “doughnut hole” coverage.  The Affordable Care Act plans to close this hole completely.

“Doughnut hole” victims will be receiving a one-time, tax-free check for $250 as a rebate this year.  There is one exception which is low-income enrollees in Medicare’s “Extra Help” program since their coverage already protects them from the “doughnut hole”.  Eligible participants can expect to receive their rebates around 45 days after you enter the “doughnut hole”.

Saturday, October 2, 2010

A rude awakening

On December 24, 2009, H.R. 3590 -- Patient Protection and Affordable Care Act
was signed into law.  Liberals around the world rose up in appreciation that Health Care Reform was finally coming to America.  The Bill was touted as a major victory for Americans without health care coverage and was ushered through the legal process in an expeditious way.  As the Bill now moves into action, many peripheral Bills and Executive Orders are being issued to emphasize the underlying methodology of the Bill.  One action in particular -- the regulation of organic foods and supplements, is coming to the forefront, awakening many Liberals to the realities of this Bill’s damaging course.
  
Most Liberals have in the past hoped for health care reform.  In particular, Edward Moore “Ted” Kennedy had a dream of decent, quality health care as a fundamental right and not a privilege.  He campaigned vehemently on a platform to create an America that cares for its own without having income as a barrier to quality of life.  Unfortunately, he died before seeing Obama’s Health Care Bill passed in Congress.  As it is now popularly known, ObamaCare was billed as the fulfillment of Kennedy’s dream but, in reality, even if the great Senator had been alive when it was ratified, he still would not have seen his dream come to fruition. The reality is that ObamaCare stands as an example of what happens when politics and blind ambition mix in a solution of two parts deception and one part ignorance. 

In the flurry of debate on the value of ObamaCare, many opinions and statements were given by both the Right and the Left side of the aisle. The Right stated that the plan is an expansion of big government with too much control, and the long term cost will be crippling to the country’s economy.  The Left has stuck to quoting the statistics of 45,000 people dying prematurely in America each year because they can't afford proper care -- and touting Kennedy’s name to garner the support of their base.  Both sides have fueled the fight with their version of the facts in an attempt to propel the American public to see the “realities” of ObamaCare, but only one was actually telling us the truth.

Republicans relentlessly argued that the plan would saddle the nation with unaffordable levels of debt; leave states with expensive new obligations; weaken Medicare; and give the government a huge new role in the healthcare system. The Left said that affordability and the covering of pre-existing conditions were the important factors involved, and this plan was a step toward achieving care for uninsured Americans.  

As the media circus grew around this legislation, and accusatory fingers pointed toward both sides of the aisle, it seemed that no one had actually read the Bill.  This became clear when Nancy Pelosi, the Leader of the Left, made the statement: "Congress has to pass the bill so you can find out what's in it, away from the fog of controversy." She was advocating the passing of this Economic Giant of a Bill without even taking the time to read it.  This was my first realization that something was very wrong beneath the streets of Obama Land.

Given this obvious attempt to pass this Historic Bill and advocating ignorance as the driving force for its acceptance, I decided to read the Bill to find the answers myself.  The opening sections outline a beautiful system for providing Americans with health care that is not only affordable, but complete in order to achieve the purpose of, “building on what works in today’s health care system, while repairing the aspects that are broken.”  In section (1) of the Bill, it states: "The purpose of this division is to provide affordable, quality health care for all Americans and reduce the growth in health care spending."  This, I believe, is as far as most people decided to read, if they read it at all.  After digesting the complexities of this Bill and after some serious self-reflection and swallowing of my Liberal pride, I came to a disturbing conclusion: The Republicans were right.

The Bill’s foreword (a simplified version of what is supposedly in the Bill) painted a picture of the very hope I had been expecting.  The real purpose to the Bill, however, is quite different than that cryptically outlined in the foreword.  The reality is that this Bill gives the President the freedom to set up Health Care Commissions to oversee the Health and Welfare of the People.  The plan unfolding, generated by overzealous propaganda by the Left and now touted as the greatest health care reform of our time, is well beyond the imagination of even the most twisted, Marxist mind.  The Health Care Reform outlined in the text is a collection of the most controlling, government expanding piece of legislation I have ever read.  

The reality is that H.R. 3590 sets up a system of governmental oversight and control that boggles the mind.  The numbers of panels and departments under the general cloak of this Bill are astounding.  Commissioners, Administrators, Ombudsmen and Committees of all shapes and sizes are enacted to oversee the implementation and continuation of this Act.  This Bill doesn’t just redefine Health Care; it completely redefines the structure of it.   The Bill translates into a system that allows the creation and proliferation of programs like what is outlined inH.R. 875 and the Food Safety Administration.  It is the very thing that I have heard a flurry of frustration about from the Left:  control over organic supplements and foods without their first being checked and labeled by a government agency.  H.R. 875 essentially sets up a system where people will not be subjected to foods or supplements that could pose a threat to their health.  

Similarly, Senate Bill 425: Food Safety and Tracking Improvement Act, performs the same control over our choices of foods.  This particular Bill plans to:  “Amend the Federal Food, Drug, and Cosmetic Act to provide for the establishment of a traceability system for food, to amend the Federal Meat Inspection Act, the Poultry Products Inspections Act, the Egg Products Inspection Act, and the Federal Food, Drug, and Cosmetic Act to provide for improved public health and food safety through enhanced enforcement, and for other purposes."  It is essentially the control and inevitable destruction of free organics in America, courtesy of the Lobbyists for corporations like Monsanto.  The irony is that these same people standing against organics are allowing genetic, antibiotic, and steroidal manipulation of our food without even a second thought.

The recent Bills and Executive Orders being implemented in the after-hours workings of the Obama Regime are all interconnected, purposeful moves to control the “health” of the population.  Our entire food system, and thus our health choices, are being decided without public knowledge in a land called Democratic; our vote has not been counted.  Unbeknownst to most Americans, H.R. 3590 specifically requires a committee to list the priorities for "lifestyle behavior modification" that the government will pursue.  This translates into control of our choices of diet.  Is this what Liberals were thinking of when we all together stood symbolically with Obama to bring Health Care to America?  Is this
what we foresaw as the solution to our collective Health Care dilemma?  Control over choices?

According to Karl Marx, a defining characteristic of Capitalism is that it alienates man from himself, from the true nature of work, and from others.  This alienation may be partially moderated by consumption; by accepting the dominant ideas of what is the ‘good life.'  This philosophy is represented in the fabric of the Obama Plan.  Each day, he takes us one more step from freedom of choice toward a controlled environment.  In a 'pure' Marxist society, the State is a democratic system that manages all aspects of production -- essentially making the State the head of all industry.  The sad part of this is that we are allowing it to happen.

I am proud to call myself a Liberal, and I have to say that when the Right first started their campaign against Obama, calling him a Marxist and attempting to defeat every plan of action introduced by him, I was deeply frustrated.  I couldn’t understand the hate and messages that seemed to drip with racism and ignorance.  Today, though, it is a different perspective and a different emotion I am feeling.  Today, I stand deeply hurt and disappointed by the deception of this man.  Obama stood in front of us all with silver tongue and pearly smile promising Change to America.  He has brought change all right, but it is a kind of change that will leave deep scars on the backs of this great nation.  It is the kind of change that has set us in turmoil and split the sides of the aisle with a seemingly irreconcilable divide.  

In the past few years, I have read and researched constantly in an effort to defend our President, trying to argue that he is good for this country.  In the recent months, however, I have realized how very wrong I was to do so.  After many months of sailing aboard the USS Obama, I am clamoring to find the lifeboats.  With my Awakening to the Reality of Obama Care, and so many more of his initiatives of “Change,” I have decided to abandon this ship sailing into the fog of deception and take my chances on the open political ocean with windblown waters in the desperate hope that eventually my little boat will once again find the free, teeming shores of America.


Original article by S. Paul Forrest

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