Monday, June 20, 2016

Survival Mode

How does Healthcare affect you? 

1. Financially?
  • How much do you have to pay monthly for your premium?
  • How much do you have to pay out-of-pocket towards your deductible before your co-insurance kicks in?
    • Is this per person, in your family? (Most likely it is)
  • What is your maximum out-of-pocket? 
    • Does this change in-network versus out-of-network? (Most likely you have to worry about both)
  • How long does your coverage last? Is it going to expire this December? If you are self-employed and have United Healthcare, most likely it will.
2. Are you stuck in and HMO versus a PPO?
  • Are you allowed to see the doctors you want without having to get referrals?
  • What if you get really sick, can you get a second opinion or go see a specialist to get the treatment you really need and have your insurance pay for it?
3. Do you have prescription coverage?

  • If so, do you have a deductible to meet first?
  • Are all drugs covered, or only generic?
  • What is your co-pay?
4. Do you have a lifetime maximum coverage per person?

5. Do you have critical/accidental/disability insurance in the case of an emergency?  
  • This can often be added to a Major Medical Plan for only a few extra dollars/month and help pay your major deductibles and out-of-pocket expenses in the case of a major incident.
6. Did you know medical bankruptcy is the 2nd reason for bankruptcy in the United States (and this includes people that are insured and often do NOT understand their plans)?

7. You can sign up for the following:

    1. Health
    2. Dental/Vision
    3. Critical/Accidental/Disability
    4. Life
    5. Medicare/Supplements
8. How can you figure this ALL out, protect your family, AND SAVE MONEY?
  • Contact a Benefits Consultant, Licensed Broker
  • Stephanie Puryear (847) 530-8943
9. Did you know you can sign up for a plan that is customized and fits your family in under 30-minutes?
  • Did you know you can change your plan NOW and you do NOT have to wait until open enrollment?
Health Maintenance Organization (HMO)- In most HMO insurance plans, you are allowed to only go to doctors, health care providers, facilities, or hospitals, on the plan's list except in the case of an emergency. Now even in the case of an emergency your costs may not be covered. In order to see specialists, you typically need to get a referral from your primary care doctor that is considered in network with your HMO plan. 

Participating Provider Organization (PPO)-In health insurance in the United States, a  PPO, sometimes referred to as a participating provider organization or preferred provider option is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at reduced rates to the insurer's or administrator's clients. 

Blog Article:
Healthcare is a continuous, dynamic evolving beast.  Healthcare used to tear up everything in it's path however now it's the "Entity" with fissures splitting everywhere.  At at any moment, it feels like we're waiting for the "Big One" and the fault line will release the pressure while we all bear witness and experience first hand the system imploding. The healthcare system as a whole is truly on the brink of collapse if something isn't done on a Federal Level.

The stakes could not be higher. Insurance carriers are on the brink of collapse, losing billions to hundreds of millions since the start of the Marketplace and Obamacare. Small business owners and those that are on their own for insurance cannot afford health insurance premiums, and they typically do not qualify for subsidies on the Marketplace. To make matters worse, they are not going to have choices in plans because many of the major carriers are going under or to stay afloat are not able to offer solid coverage options to their members. As a result, members will have to pay for plans by paying high premiums for low level coverage... the bottom barrel plans with haphazard coverage. 

Healthcare Business as a Conglomerate needs to revise the system...Minimize Overhead, Lock Down Budgets, Limit the Waste, Maximize Productivity, and Utilize Systems to Maximize Every Dollar Spent and Expedite Accounts Receivable.  We don't want our healthcare system to fail, coverage to become too expensive and benefits to decrease.  Instead, we want improved healthcare, better coverage, and we do not want to fear our premiums will increase 40-70% every 6-12 months.
Otherwise, not only will our Healthcare system collapse, but Middle America will soon collapse if people feel like they cannot even afford to get decent healthcare.

Modern Healthcare Article, by Bob Herman, June 16, 2016,  "California blasts Anthem-Cigna merger, calls on feds to block it".

As noted by the article above, one of the strategies some of the healthcare insurance carriers are using is to merge.  In California, Anthem is trying to merge with Cigna. However due to the huge financial implications and lack of benefits to the consumers this was shut down by the judge.

Other strategies, include bankruptcy, dropping out of the Marketplace (on/off the exchange), and ceasing coverage by sending termination letters to self insured and self employed policy owners. As well, encouraging healthy members to save money and purchase ST Major Medical Plans.

Protect yourself and look into your options now.  I have many clients that have already received letters suggesting their termination of their plan as of 12/31/16, just because the company can do so. Many plans are changing by the end of this calendar year by changing coverage, increasing deductibles, increasing premiums, and/or cancelling/terminating coverage. As well, premiums are expected to increased 40-70% if you are not locked into a plan.

If you do not have a solid group plan in place now...please know that it's better to make a move on your coverage now as rates on plans go up each week, and every month they go up significantly.  Please know, you are not limited to wait for open enrollment. You MAY change now.

A Benefits Consultant can help you understand your coverage and how to fully research and understand your plan.

Take control of your life now, for yourself and those you love!! 

Please contact:

Stephanie Puryear
Benefits Consultant, Licensed Insurance Broker

Licensed: Wisconsin, Arizona, Colorado, Florida, Illinois, Iowa, Michigan, Texas, Virginia, and Washington.
Phone: (847) 530-8943

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