Listen to Senior's worries about Health Care Reform

From reading my July 21st post you understand that I'm not totally against all Health Care reform. However, I read a Seattle Times article suggesting that our seniors overwhelmingly don't support Health Care reform simply because they have been tricked into believing that it will somehow make their health care worse. The author implies that either:

1. Seniors are stupid for not understanding what version of "reform" is being discussed at the moment.
OR
2. Seniors are being preyed upon by Republicans and are not smart enough to fight back.

Yes, there are many misconceptions about all the various "reform" plans out there. However, I vote that our Seniors are pretty smart and have good reason to be suspicious of the current Health Care Reform proposals floating around.

WHY?

If ANYONE knows how bad the government can screw up a program it is them. Seniors are already on the Government program, Medicare, and know first hand how bad our current "single payer" program is.
1. Medicare requires them to buy "Medigap" insurance from PRIVATE health insurance companies to fill in all the holes in Medicare. This can cost several hundred dollars a month.
2. We've have had since 1965 to get Medicare right, but it's still a mess. Should we expect a single payer system to be better if it is rushed through by the end of this year?
3. Since Medicare reimbursement rates to doctors are low, and going lower, many Seniors have been forced to change doctors when their providers stopped accepting Medicare. Doctors just aren't required to accept Medicare patients.
4. Medicare is BROKE. No money in its coffers by the end of 2010 by the CBO estimates. Could we at least fix what we've got first?

Perhaps the author should take a cue from our Seniors. They've been around long enough to know when someone is not giving them the whole story.

You can read the Seattle Times article at:

http://seattletimes.nwsource.com/html/politics/2009757801_apushealthoverhaulelderly.html

What is an HSA Health Plan anyway and why should I care?

HSA Health Insurance Plans offer an inexpensive way to do the following:
1. Provide reasonably priced Health Insurance
2. Put dollars aside for health expenses
3. Save those health expense dollars on a pre-tax basis

There are two parts to an HSA Insurance Plan:
Part 1 Health Insurance:
High Deductible Health Insurance Plans (HDHP’s) offer far lower monthly premiums than traditional plans while still providing good protection. We can help you choose from plans offered by Premera, Regence, Group Health, etc.
Part 2 Bank Account: Your own HSA bank account allows you to save money pre-tax to pay for medical expenses. The money you save is yours forever, goes in tax free, grows tax free, and can be taken out tax free for any qualifying medical expenses. Most all banks offer these accounts.

What’s the catch? The major difference between an HSA vs. traditional health insurance is that you pay for most of your medical care out of your own pocket with the HSA until you reach your deductible. Annual exams and physicals are usually included however. You get the money to pay for this out of pocket medical care from your HSA account which you have been putting money into from your premium savings!

Here is an example:
By switching to an HSA Insurance Plan Jane saves $2,000/year on her premiums.
Jane puts those savings into her HSA account. (up to a max of $3,000 per person or $6,000 per family in 2009)
If she spends $1,000 of her deductible for medical care that year using funds from her HSA she is left with $1,000 in her account! As approximately no more than 10% of the population reach their deductible each year, there is a very good chance Jane will be saving substantial money.

If Jane incurs expenses greater than her deductible, the HDHP kicks in and she can be just as protected as she would be with a traditional lower deductible health insurance plan which costs far more per month.

Is it for everyone? No. If you expect substantial medical expenses in your future such as surgery, becoming pregnant, or you have chronic health conditions etc., you would want to stay with a more comprehensive health insurance.

Who benefits from HSA’s? Those who are healthy, and reasonably expect to stay that way are good candidates for HSA’s. In addition, if you are self employed looking for more ways to sock away pre tax dollars, this is a great option as there is no income limit for contributions to your HSA account.

One more caveat, you must be disciplined enough to actually contribute your premium savings into your HSA so that when you do incur a medical expense, you have the funds put away to pay for it.

Thus, if you are relatively healthy and are disciplined enough to bank your premium savings, then an HSA Health Plan may provide the Health Insurance option you are looking for.

Two days in the hospital is how much!!? I thought I had insurance!

Today I have been battling the great faceless Corporate Insurance Giant.

Here is the story. My Client, let’s call him Billy Bob, starts developing pain, real pain, the bend you over until a grown man cries pain. Now, a regular guy would have taken several hundred Advil chased with a beer. Not this guy, he’s intelligent, and decides to go to the Hospital Emergency Room. However, despite the searing pain, Billy Bob has the foresight to actually make sure the Hospital he goes to is in his Health Insurance Plan’s Network. Luckily, the insurance company website lists the Hospital as being In-Network! He goes to emergency, gets admitted immediately, and after two days of quality medical care, is discharged.

Billy Bob isn’t worried though, because the Hospital was in his network and therefore most bills should be covered or discounted, right? Then the bills start showing up, big bills, multiple bills, bills the size of small SUVs. Billy Bob is stunned, how could it have been so much? Remember when I said Billy Bob was pretty smart? Looking the bills over he discovers something no one usually would; the Hospital was indeed in his network, but many of the doctors (who belong to their own separate doctor networks) working at the Hospital were not! Thus he gets billed super high rates for out of network doctors at an in network hospital! Not just a few out of network doctors mind you, he was in for two whole days and thus he gets billed from multitudes of specialists all billing from their separate networks!

This is why there is so much anger focused on insurance companies. It’s not the level of care he received, it was excellent and he made a full recovery, but rather the coordination of benefits and billing issues that are dumbfounding.

Needless to say we are arguing that all his services should be covered at the less expensive in network coverage level. How will this turn out? My guess is the great Corporate Insurance Giant will throw us a bone on some charges. That would be nice, but it doesn’t solve the problem.