Posted in Insurance

How To Get The Best Health Insurance For Your Family

Health insurance is incredibly important and for the sake of you and your family, it must be considered at some point. In general, most people already have some type of insurance, which is pretty good, but far from ideal, as you want to make sure the coverage is optimum. In order to check its quality, pay attention to the offered treatments, general availability and other factors you or your family members need. Don’t forget that if something isn’t covered by insurance, you will have to pay for it out of pocket.

With that said, choosing the best health insurance, especially the best private health insurance, will take some time. There are a lot of factors to take into consideration and there are a lot of variables which will change all the time. That’s why it is important to spend some time on research and get the right decision only when you are absolutely certain it is what you need. You should consider coverage of treatments needed by your or a family member. Some insurance plans offer them and some don’t. Also, keep in mind the future needs of yourself and your family. They are the main things to consider and to take into account.

Tips to take into consideration

There are a few tips you should take into account before you get your family health insurance. A family always starts from the existing youngest generation that is the children of the family and we should always keep them into consideration , also plan the health insurance for them accordingly. There are various kind of options available under child health insurance program , that serves uninsured children up to age 19 in families with compensation too high to even consider evening consider qualifying them for Medicaid. This can make a huge difference and are more important than you may believe.

Conditions that already exist

Be careful and pay attention to any pre-existing conditions your family member has. Some insurance plans are partially limited, which makes them not great for this type of user. Other plans are just perfect and they don’t come with any limitations. Obviously, the best time to get a medical insurance is when you are healthy.

Use of the policy

If you use your policy a few times per a year, then a lower premium policy is the best option. Why you would pay for higher values when you don’t actually need them? Also, keep in mind that you can increase the policy whenever you want.

Cost and coverage

Basically, this is how much you will pay and what you will get. Lower policies are more affordable, but you may have to pay for some treatments out of pocket. Others require more money to pay each month, but they offer better coverage. The balance you can find here is probably one of the best things to strive for in order to get the best medical insurance.

Limits

All limits refer to coverage. Some plans have severe limits, others don’t. Try to get a better idea regarding them before you start your policy use.

Summary

Essentially, you get what you pay for. If there are little to no medical complications in your family, you might be safe getting a cheap policy, but if anything happens there will be huge out of pocket costs. It’s best to find a happy medium in terms of cost and coverage. To know about the chip program please drop down a comment below we are here to help you.

Posted in Insurance

Retained Asset Accounts: Fact sheet

Background information

A Retained Asset Account is an account whose initial balance is a life insurance or annuity death benefit and that essentially operates like a checking account. Beneficiaries of life insurance death benefits may choose to take the money in several ways (in industry jargon, “settlement options”). Before 1984 the common (and default) choice was a check for the entire amount due to the beneficiary. However, understandably—considering the circumstances in which this money became available—many beneficiaries did not want to deal with death-related financial matters immediately. Sometimes they just put the check in a drawer and forgot about it or, if they cashed it, were sometimes unable to manage such large sums of money effectively and found that it quickly dissipated. As a result, beneficiaries looked to life insurers to create a way for them to keep their money safe and available until they were better able to use it. The new settlement option, established in 1984 and generally known in the industry as a Retained Asset Account, meets these goals. In effect, it creates a checking account whose initial balance is the death benefit. The principal and a minimum rate of interest are both guaranteed by the insurer. Additional interest is credited to the account at a rate declared by the insurer; the credited rate is comparable to that paid in similar accounts offered by banks and money-market mutual funds. Beneficiaries get free checks and periodic reports on the status of their account.

Frequently Asked Questions

Is a retained asset account in an FDIC-insured bank?

No. As with other life insurance settlement options, the money stays with the life insurer. However, the money is protected and the beneficiary has full access to the funds at all times. The money is as safe, perhaps even safer, with the insurer than with a bank, even taking into account FDIC insurance. That is because: (a) historically, many more banks have failed than insurers; and (b) there is a state guaranty fund system that insures at least as much as or more than the FDIC does. In many states the insurer guarantees are up to $300,000 (in some states as high as $500,000), whereas the FDIC insurance limit is $250,000 (recently raised from $100,000). No one has ever lost a cent in a retained asset account, but the same cannot be said for bank accounts that exceeded the FDIC limits or most other investment accounts. Moreover, as long as the death benefit remains with the life insurer, it is beyond the reach of the beneficiary’s creditors. Once the money is released by the insurer, the creditor protection no longer applies. A bank’s name may be associated with the account because some life insurers use banks to administer the account; however this does not mean that it is in an FDIC-insured bank.  

How long must the money stay with the insurer?

The money can be withdrawn immediately by writing a check for the full amount, or left in the account for as long as the beneficiary wants. The death benefit (but not the credited interest) is income-tax exempt; however, tax considerations might affect when the beneficiary might most advantageously withdraw the money.

Don’t insurers earn a higher rate on their investments than they credit on these accounts? If so, why don’t they credit the higher rate to beneficiaries?

Insurers generally do earn a higher rate on their investments than they pay on these accounts, but still pay an interest rate that compares favorably with other accounts of similar instant liquidity. The insurer also bears all the investment risk and provides a guaranteed positive rate of return irrespective of market conditions. In other words, even if the insurer were to lose money on its investments, the owner of the retained asset account would still earn interest. Some of the “spread” between the rate earned by the insurer and that paid on the retained asset account is used to cover the expense of providing this account. In some cases the difference between the insurer’s overall rate and the credited rate is small, because some insurers credit interest based on prevailing rates at the time the death occurred (which might be considerably higher than rates prevailing today).

This sounds like an attractive account. Once it’s created, can I add money to it?

The only money that can be added is money that comes from another life insurance death benefit from the same insurance company. This is not a deposit account like those provided by a bank or money market mutual fund.

Get all the information about group health insurance plans by sending your questions in the comment section.

Posted in Insurance

What is burial insurance?

“Burial insurance” usually refers to a whole life insurance policy with a death benefit of from $5,000 to $25,000. As its nickname implies, people buy this type of policy to provide money for funeral and burial costs for themselves and/or family members. It is possible to buy a policy after answering a few health-related questions on the application and with no medical exam.

Premiums are payable weekly or monthly. The premium is usually collected at the policyowner’s home or workplace, and the premium is usually a small round number, such as $2 or $3 per week; the death benefit is whatever that premium will buy given the insured’s current age. For example, a $3 per week premium might buy a $6,000 death benefit for a 36-year-old man or an $18,000 death benefit for a 9-year-old boy.

Burial policies may be designed to cover one person or everyone in a family.

Under some state laws, funeral homes may be licensed to sell burial insurance, but it is mainly sold through brokers and agents of insurance companies licensed to sell life insurance.

An approach that is similar to burial life insurance (and sometimes called burial or “pre-need” insurance) is pre-payment of your funeral arrangements. Under this program, you may select the funeral home, type of service, casket (or cremation), flowers, headstone, burial plot, the cost of digging and filling the grave, and other items, and lock in the prices for them by paying in advance.

Explore health insurance for small business owners and get the best plans for your employees, if you want to know more details then please send your queries in the comment section.

Posted in Medicare

What are the parts of Medicare? ABCD’s Explained.

When I first started my career in the Medicare world, I was overwhelmed with all the new information I had to learn. I found that breaking it down into bite-sized pieces made it easier to understand. It took a lot of time (and patience), and one of the hardest parts was understanding all the different parts of Medicare. Here are some tips that helped me understand Medicare.

What is Medicare?

Medicare is a federal health insurance program for people 65 and older, people under 65 with certain disabilities and people of all ages with end-stage renal disease. Medicare is partly funded by payroll taxes from most employers, employees and all people who are self-employed. The Medicare program offers basic coverage to help pay for things like doctor visits, hospital stays and surgeries.

What are the parts of Medicare?

Medicare is broken out into four parts. 

  1. Medicare Part A
  2. Medicare Part B
  3. Medicare Part C
  4. Medicare Part D

Medicare Parts A and B

Parts A and B are known as Original Medicare. This is the most basic coverage you can get.

Medicare Parts C and D

Parts C and D are available through private health plans. They’re both ways to enhance your health care coverage if you want more than what Original Medicare offers.

Medicare Parts A, B, C and D explained:

  • Part A (hospital coverage): Covers things like inpatient hospital stays, home health care and skilled nursing facility care.
  • Part B (medical coverage): Covers things like doctor visits, outpatient services and diagnostic screenings.
  • Part C (Medicare Advantage):  Medicare Advantage plans are offered through private health insurance companies. When you join a Medicare Advantage plan, you still have Medicare. The difference is the plan covers and pays for your services instead of Original Medicare. These plans must provide the same coverage as Original Medicare (so you’re not missing out on anything) and can also offer extra benefits.
  • Part D (prescription drug coverage): Only offered through private health plans.

When can I get Medicare?

You’re eligible for Medicare when you turn 65. There are a few different times you can enroll throughout the year. These are known as enrollment periods.

Explore medicare providers in pennsylvania and get the best plans for your loved ones, if you want to know more details then please send your queries in the comment section

Posted in Uncategorized

3 Keys to Bridging Gaps in Value-Based Care

As the industry continues to experiment with value-based care to pivot away from fee-for-service, specialty physicians can and should play a larger role in health insurance providers’ value-based care efforts.

There are major savings to be had in specialty care, which accounts for about 70% of health care spend.

While primary care physicians are traditionally seen as chronic care managers, specialists manage the most serious chronic diseases, attempting to halt their progression and control their complications.

Despite this, most accountable care organizations, shared savings programs, and intensive medical homes focus incentives on primary care doctors. Specialists can excel in new value-based payment models when 3 main criteria are met.

1. The right chronic illness

Some specialists are better equipped to move successfully into value-based care because of the types of patients they see.

Gastroenterologists, for example, care for patients with Inflammatory Bowel Disease, which includes Crohn’s disease and ulcerative colitis (UC).

Crohn’s and UC are high-beta conditions, which are symptomatic, chronic conditions that can rapidly deteriorate without patients realizing it, leading to serious complications that can drive emergency room visits, hospitalizations, and unwanted surgeries. As a result, they have highly variable per capita costs and are often treated with high-cost therapies..

These patients can benefit from high-touch care from their doctors.

2. The right data

Patients with conditions like Crohn’s often don’t realize their symptoms are worsening, so they don’t alert their care team.

To jump that hurdle and succeed in value-based care, clinicians need access to regularly reported data from those patients. In a pilot research partnership performed by  gastroenterologists at the Illinois Gastroenterology Group (IGG) in 2013, they asked 50 patients to respond to a short monthly survey of their symptoms. From there, nurses calculated a score related to patients’ symptom severity.

If a patient’s score signified a potential deterioration in their clinical status, nurses would reach out and schedule an appointment before things got worse.

During the year-long pilot, only 1 of the 50 patients was hospitalized, and no one required surgery. Based on the successof the pilot, Blue Cross and Blue Shield of Illinois designated IGG as its first specialty-based Intensive Medical Home. This initiative now involves practices across the state of Illinois, all using the SonarMD program.

A larger-scale study using propensity matched comparison against a control group in 2017 demonstrated use of SonarMD’s care coordination solution resulted in a statistically significant decline in hospitalizations, which reduced medical cost for each person by $6,500.

3. The right support

Having medical staff monitor the patient-reported data and create scores for every patient isn’t scalable. Specialty practices need the right full-time support to manage patients successfully and remain profitable.

External care coordinators can monitor the scores and then proactively connect patients with their physicians if there’s a potential need for intervention, taking the burden off specialty practices.

Specialty providers and health insurance providers can collaborate and align incentives through value-based contracting to improve patient/member outcomes and quality of life.

When the formula is met, involving specialists in value-based care arrangements truly achieves the quadruple aim of improved patient experience, better health of the overall population, lower costs, and happier providers: Patients feel more connected to their doctors, costs are lower, and physicians are more satisfied. If you want to know more about the group health plan then please send your queries by dropping a comment below.

Posted in Insurance

Medicare Part D: The What's and How's

As a Medicare Beneficiary you have a slew of decisions to make. One of the most important ones is selecting a Prescription Drug Plan. To some beneficiaries, this is not a priority if they are not currently taking any prescription medications. While this may be the case now, no one can guarantee this to be true for the future, because let’s face it, anyone can experience a health shift. To avoid making this decision now could be costly for you in the future. By choosing to protect yourself now, you are saving yourself money and headaches down the road, while ensuring you have access to the prescription medications you may need.

Medicare approved prescription drug plans, also called Medicare Part D, are plans offered by private health insurance companies. If you do not get this coverage when you first become eligible, you will most likely have to pay a late enrollment penalty. All plans have to conform to state and local insurance rules, but they are different because of the types of drugs covered and the amount of coverage. To give you even more choices, some insurers even offer tiered plans with different levels of coverage.

How to Get Medicare Prescription Drug Coverage?

There are two ways to get Medicare prescription Part D plans:

  • Stand-alone: On their own, Part D Plans, sometimes called PDPs, add prescription drug coverage to Original Medicare. People who have Original Medicare, a Medigap policy, or a Medicare Advantage plan without drug coverage might purchase a PDP.
  • With Blue Cross Medicare Advantage: Some Medicare Advantage (MA) plans, usually HMOs and PPOs, package Part D prescription drug coverage with health insurance. If your MA plan includes drug coverage, you do not need to buy a separate prescription policy. In fact, if you do sign up for a Part D plan, and your Part C (MA) plan already has prescription coverage, you could get disenrolled and returned to Original Medicare.


Which Drugs Are Covered?

Typically, insurers encourage their members to get generic drugs whenever possible. With some newer drugs, that is not possible, and brand names are still covered, but they are usually not 100 percent covered. In any case, each plan or insurer has something called a formulary. A Formulary is a list of specific generic and brand name drugs that the plan covers. All plans must carry at least two drugs in the same class UNLESS only one is available. 

How much does Medicare Part D cost?

Each plan has a monthly premium, and you may have this deducted from your social security in the same way that your Part B premium gets deducted. If you join an MA plan that already includes prescriptions, you just pay the additional premium (if any) for your MA plan. Typically, prescription policies with higher coverage levels may have higher premiums. We can help you compare prices, plans, and covered drugs at any time.

For many Medicare recipients the cost of their medications is more important than the Part D premium.

The cost of prescription medication will depend upon two things:

  • The medication that you need
  • The plan you select

Posted in Uncategorized

What is Medicare Assignment? How Does it work?

When you are covered by Medicare, it is important that you know whether or not your doctor accepts Medicare assignment. Assignment means that your doctor, provider or supplier agrees, or is required by law, to accept the Medicare approved amount as full payment for covered services. In most instances, providers and suppliers will accept Medicare assignment, however, it is always a good idea to ensure they do prior to moving forward with their services.

How does Medicare Assignment work?

For every procedure and service that is covered by Medicare, there is a Medicare approved price. Also known as Medicare Allowable Charges, the price is the total amount that Medicare will cover. Each doctor who accepts Medicare has the option to choose whether or not they want to accept Medicare’s allowable charges or not. Those that do accept Medicare “assignment.”

It’s the Doctor’s Choice

The first choice a doctor has is whether or not to accept Medicare. If they accept Medicare, they have to decide whether or not they will accept Medicare’s allowable charges as full payment. If they choose to accept Medicare’s price, that means they accept Medicare assignment. Accepting assignment also means that the provider will bill Medicare on your behalf. However, if they do not accept Medicare assignment, they are allowed to charge a patient up to 15% more than Medicare’s allowable charges. That 15% is called excess charge. 

If you are wanting to avoid being charged an excess charge, you will want to make sure that you are seeing doctors who accepts Medicare assignment. When you are researching doctors you will want to keep in mind that just because they accept Medicare, it does not mean they accept Medicare assignment. Once you have verified that your provider accepts Medicare assignment, you will want to continue to check with them as you make subsequent appointments because doctors and suppliers can choose to no longer accept Medicare assignment at any time during the year. 

State Specific Medicare Rules for Excess Charges:

There are a few states that prohibit excess charges and require the doctors to accept Medicare’s approved price for each service and procedure. Those states are:

  • Connecticut
  • Massachusetts
  • Minnesota
  • New York
  • Ohio
  • Pennsylvania
  • Rhode Island
  • Vermont

If you want to know more about Medicare Assignment then visit Blue Cross Medicare advantage Plan.