The Benefits of Health Insurance

As of March 2010, the United States has embarked on a four-year plan to reform its health care system, dedicating $960 billion dollars to making prescriptions cheaper, requiring insurance companies like Medicaid to cover more ofAmericans‘ medical costs, changing the way that prescription drugs are manufactured, priced and distributed — and more.

The ideal situation is for every individual in America to have some form of health insurance and with the often staggering cost of modern major health procedures, the inflated salaries of doctors and the increasing complications in getting some hospitals to even accept certain forms of insurance, many feel it’s high time for a change. Health insurance provides a protective buffer between you and paying full price for health care, and covers the needs of those with disabilities and those with long-term medical conditions as well as emergency medical care for injuries and accidents.

The heath care reform works in smaller ways as well. For example, it has already implemented new changes that require Medicaid prescriptions to be covered for 23 percent of the cost instead of the past 15.1 percent. This is not just good for those who receive the prescriptions but also for Medicaid, as drug manufacturers must increase the rebate amount offered to Medicaid in accordance with the new laws as well. The federal health care reform plans include a requirement by law for all Americans to have health insurance by 2014. Many Americans do not currently have health insurance due to financial constraints, but not having health insurance from 2014 onward will result in a penalty tax. Therefore, if you don’t already have health insurance, you should look into it now.

Quotes from various companies can easily be acquired online and because many are offered free of charge your options are unlimited; you can compare insurance quote after insurance quote from as many companies as you like until you find the right insurance plan for you and your budget.

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Study Shows High Percentage of Eligible Children Not Enrolled in CHIP or Medicaid

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According to a report in the pages of Health Affairs, approximately 4.7 million children in America who are uninsured and are qualified for the Children’s Health Insurance Program (CHIP) or Medicaid are not currently enrolled. An estimated 7.3 million children in the United States were uninsured on an average day. Interestingly approximately 65 percent were eligible for medical insurance programs but were not enrolled.

Ten states did report they had rates of participation above or close to 90 percent. California, Texas and Florida have 39 percent of those children that are deemed eligible but not enrolled.

The authors of the study say that there needs to be some reforms in health insurance policy in addition to a more concerted effort to get these children enrolled. The report says that tax data can be used for enrollment on an automatic basis.

Last March, President Barak Obama made health care a priority upon the landmark reforms that were put into effect in March. U.S. Secretary of Health and Human Services Kathleen Sebelius proposed a challenge to get government officials including governors, mayors as well as other community leaders to get these children enrolled in CHIP and Medicaid programs.

Other interesting facts in the study are the differences in enrollment rates for state to state. The researchers say more research is needed to figure out the reasons for these differences. However some of the factors that will be studied are population density, ethnic composition, income per capita and access to employer coverage. The report also points out that local policies toward the programs must be studied as well.

The study expects that the number of children eligible for these programs will rise due to the state of the economy. More information on this factor will be released in the fall of this year.

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Choosing a Health Insurance Plan

We all know that healthcare costs can be astronomical. Just a short stay in a hospital can cost thousands. This could completely wipe out savings. So this reality makes it vital that the benefits and costs of health plans are chosen wisely. You need to understand the various plans out there and figure out how well they will fit into you and your family’s needs, while also taking into account the effect on your budget.

If you have the option, take advantage of employer-provided plans. You could have several choices that are offered by your company. Choose the one that best fit your needs.

First take a look at your needs. How do you use healthcare services currently and think about the future. Examine your need for dependent benefits and determine what offered services are actually important. Then look at monthly costs as well as predetermined co pays. A single person will have different needs than a family.

Take the time and do some comparing. Insurance plans have deductibles, premiums, and co payments. There may be additional costs for seeing out-of-network providers, routine examinations or preventative care. Also compare plans for other services you may need such as long-term care or mental health coverage.

Make sure you understand everything. Do this by making sure all your questions are answered satisfactorily. Is your current physician part of the plan? Do you have the option to change doctors at your discretion? Are referrals required? What about which hospital facilities are covered? And what about emergencies and ambulance services?

If you have pre-existing conditions investigate how the plan handles and covers those. Is there a waiting period before full coverage is place? Some plans may not cover these conditions at all.

Finally, examine how the plan handles appeals if there is a denial of coverage.

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Florida High Court Rejects Healthcare Amendment

In the wake of all the controversy surrounding President Barak Obama’s healthcare reform plan, the Florida Supreme Court recently ruled against placing an amendment to the state’s constitution on the upcoming November election ballot.

The amendment was proposed to allow Florida to be exempt from certain parts of the federal bill. However the court said that the amendment’s summary was confusing.

If the amendment were to have been passed would have prevented Florida residents from being required to participate in health insurance exchange programs. This is part of the bill that requires everyone to be covered by health insurance.

The Affordable Care Act requires that all states have health insurance exchanges to provide insurance for citizens who do not receive benefits via their employer or programs like Medicaid or Medicare.

The Florida court said in part, that the language on the amendment was ambiguous and misleading in its language. The courts decision was 5-2 and was issued on August 31. The court felt the recourse in this case was to not allow the amendment to be voted upon.

This decision also affirms a prior ruling. In July a judge from Florida’s Second Judicial Circuit, James Shelfer, also found the wording confusing as well.

In his ruling, Judge Shelfer said that while the summary of the amendment suggested protection of the patient-doctor relationship, the amendment contains to language addressing that relationship or that of confidentiality.

Other issues included wording such as “mandates that don’t work,” but the amendment nor the summary of the amendment explains what these mandates are or the reasons why they won’t work.

Disappointment was expressed by the Florida Medical Association. The Association felt that the decision by the court does not allow the citizens of Florida to vote on something that provides them the right to make their own healthcare choices.

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Healthcare with No Insurance

Not everyone can afford health insurance or has the option of purchasing it through employment. There are other alternatives to help ensure that you won’t go broke if an emergency occurs where you’ll need health care or hospitalization.
Many states offer their own insurance options for those that live in the state. There are even plans for short term insurance plans if you have recently become unemployed or have a lapse in your preexisting insurance plan. The plans can vary greatly and some can be costly but it is a good idea to check them out to see if they are a good fit for your own personal situation. COBRA is a plan that is famous for gap insurance for people between jobs or recently unemployed.
If you and your family have a very low income you may qualify for medicare or medicaid. Both programs help out in medical and health care costs and are provided at no cost to the recipient. You will have to apply for both programs to see if you and your family qualify but if you do, they can defray costs considerably. Medicare is not based on income and is usually for those that are at least 65 years of age. Medicaid is available to everyone regardless of age but is based on income statistics for your family. Both have co-payments that have to be paid but are very helpful in paying for medical and health care costs.
Regardless of how you get insurance, it’s best to have it in case the need arises. With a little research and determination you can find a program that you can afford and is right for your individual circumstances. Don’t be afraid to reapply if you are turned down for a program. Some programs automatically turn down first time applications.
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