Halfway to Health Care Reform

Almost two years have passed since health care reform was signed into law, and the implementation process is well underway. A handful of impactful provisions began in late 2010 and several others went into effect during 2011 but 2012 will be altogether different. In addition to the implementation of several provisions described below, this will be a seminal year for the Affordable Care Act (ACA) because it’s when we’ll get clarity about questions which have been on everyone’s mind since the law passed:

 Is it constitutional?

 If it is indeed constitutional, will it get repealed or replaced next year?

 If it weathers today’s constitutional and political challenges, is my state prepared to actually get the job done?

 Answers to each of these questions, discussed in this brief, will begin to crystallize in coming months. They will determine not only the fate of health care reform’s most transformative changes slated for 2014 – like the law’s Insurance Reforms and the Individual Mandate – but how the nation’s health care system functions in the short term as well.

To learn more and see what is coming: http://nchealthplansonline.com/In_the_Spotlight.pdf

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Health Benefits of Cooking For Yourself

Cooking for yourself can have many advantages. When you prepare your own food, you can cater to your own dietary needs, as well as you own tastes. Besides making food to your own likes and dislikes, you control what goes into your food, whether it be leaving things out of or adding to a recipe.

 We all know that you have to have salt in your diet. But too much salt can be a bad thing. So by controlling the amount and type of salt that you use in your food, you can reap the health benefits. Using sea salt for example, you can use less and it tastes much better. When trying to lower the sodium intake of you or your family, reading labels is one of the best things you can do. Knowing what you are eating is the first step to eating healthy. Boxed, canned, and bagged foods (even low sodium options) contain high sodium levels. I can’t stress enough how important it is to read your labels, and knowing what they mean. Once you start paying attention to the labels and what you are consuming, the more you will enjoy preparing, tasty foods that are better for you or your family. And the self gratification that comes from making flavorful, healthy food is good for ones self esteem and boosting your mental health is directly related to your physical health.

The more you prepare food for yourself, the more you will tend to have on hand the items you will need to make better food for yourself. Things like better oils for cooking and eating, like a good olive oil for example, or garlic is another ingredient that is really good for you and makes almost anything taste better. By no means do I mean garlic powder. I mean real garlic, even if you buy the pre-chopped kind, like all foods fresh is better, in taste and health benefits, so buy in small batches. The fresher and less processed your foods are, the better they will be for you.

 By preparing the food yourself, the more you can cater to your own personal dietary needs. Controlling your diet is one of the best things you can do to impact your health. And by diet, I am not talking about some gimmick based diet. Diet is your intake of food everyday! Whether or not your diet (eating habits) works for you is very easily controlled by cooking for yourself.

 It is a lot easier to make food taste the way you like it, when you make it yourself. Liking the food you eat makes it easier to eat foods that are healthier for you. With all the gimmicks out there, eating better is not one of them. Eating right and regular exercise are the cornerstones of healthy living. So why not learn to make delicious food for yourself and your family. You have to eat anyway, so put food to work for you. Because with better eating comes better living.

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Medicare Annual Enrollment

You probably have noticed an increase in TV ads regarding early enrollment for this year, October 15 through December 7. Due to the changes in policies, this earlier open enrollment allows time to receive updated policies and insurance cards for the beginning of the year to avoid delays and uninterrupted coverage for 2012. The insurance options seem so daunting and so complicated, most people find it easier just to let the policies they have in place, simply renew on their own rather than delve into the options available that could potentially save money.

The recent passage of the “Affordable Care Act”, will reduce premiums for the majority of beneficiaries while receiving more benefits and lower prescription costs. The new plan allows for an Annual Wellness visit with your primary doctor without a co-pay or deductible. This also includes mammograms and gynecologic visits. This new legislation also gives those in the “donut hole”, greater discounts for brand name drugs and expanded coverage for generic prescriptions. An easy way to compare plans, and you don’t have to be computer savvy, is go to www.Medicare.gov and check out the Medicare Plan Finder. This page allows you to compare last years plans with the available options in the plans for 2012. They also have a 5 star quality rating system which lets you view the higher quality ratings for the past three years and the projected rating for 2012. Every individual is different and each have very different needs, but if you will take the time to sift through the many options, you will get a better understanding of what you need and what is available while navigating the insurance maze.

BCBSNC is the largest provider of Medicare supplement insurance in NC. The Medicare Advantage organization has a Medicare contract which, in simplistic terms, means more physicians accept BCBSNC than any other plan. There are substantial savings for you in terms of clarifying if your physician is an in-network carrier or out-of-network carrier, he either accepts BCBSNC or he doesn’t. This doesn’t mean you can’t go to an out-of-network physician, it just means you will pay more for the services. It is always advisable to check with your physician before hand to verify your coverage as this can change from year to year.

Here is a simple check list to get started:

  1. Define what your needs are in health insurance,

a. lower cost office visits

b. lower prescription costs

c. higher deductible with lower premiums

  1. Go to www.Medicare.gov and read up on available options and changes in your policy
  2. Contact your physicians insurance specialist to verify your insurance is accepted with their firm
  3. Do a little homework so you get a basic understanding of the insurance lingo. Another website for overall information is www.cms.gov/center/openenrollment.asp.

If you still find this too complicated, find an authorized licensed BCBSNC health agent and they will be more than happy to help assess your needs and provide you with a recommended plan that will compliment your Medicare.

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Strides Against Breast Cancer

This article was written by a friend of mine and I wanted to share it. Judi

October is National Breast Cancer Awareness Month, and a friend of mine is now a 2 year survivor of breast cancer. I can remember the fear in her eyes when she found out, I can only imagine what was going through her head. But I also remember her incredible strength, she won’t admit to it but it was there.

As she went through diagnosis and treatments I could see major changes in her attitude and her will to survive. She made light of the treatments, made a game out of choosing different wigs. The whole time she was able keep up her job, keep up her own strength and resolve and more importantly, she was able to help those around her keep up their strength.

I learned that in the beginning when she was in her darkest hours she meet two women that she refers to as “Her Angles”.  These two women were survivors themselves and were with my friend every step of her journey.  The American Cancer Society Making Strides Against Breast Cancer Walk helped make those “Angles” possible.

So here we are two years later and my friend is an active member of our local “Making strides Against Breast Cancer” group, she speaks at local meetings and is a great supporter of the walks by recruiting walkers and gathering donations.

Sponsored by the American Cancer Society since 1993 close to seven million walkers have raised more than $400 million dollars according to their website. It is a noncompetitive event and goes between 3 and 5 miles.  Again, according to their web site “In 2010 alone, nearly 800,000 walkers across the country collected more than $60 million to save lives from breast cancer. Thanks in part to the dollars raised by Making Strides supporters, 2.5 million breast cancer survivors will celebrate another birthday this year”.

Some breast cancer facts (provided by breastcancer.org):

-  About 1 in 8 women in the United States (12%) will develop invasive breast cancer over the course of her lifetime.

- About 1,970 new cases of invasive breast cancer were expected to be diagnosed in men in 2010. Less than 1% of all new breast cancer cases occur in men.

-  The most significant risk factors for breast cancer are gender (being a woman) and age (growing older).

- About 70-80% of breast cancers occur in women who have no family history of breast cancer. These occur due to genetic abnormalities that happen as a result of the aging process and life in general, rather than inherited mutations.

- A woman’s risk of breast cancer approximately doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer. About 20-30% of women diagnosed with breast cancer have a family history of breast cancer.

I was really surprised when I saw those actual numbers. It has reached a point where everyone knows someone whose life has been affected by breast cancer, including me.  I was even more surprised to see that men can also fall victim as well. We all should be thankful that organizations like this exist and I encourage everyone to support them. Got to the American Cancer Society Making strides Against Breast Cancer website and find an event near you. If you can, join the walk. If you cannot walk then please donate. Let’s make it possible for other survivors to find their “Angels”.

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October is Breast Cancer Month

Each step you’ll take is personal. And each step will help save lives.

 October is Cancer Month and being a 2 year breast cancer suriver I have a unique point of view and encouragement for those traveling the same path.  Making Strides Asheville has several events scheduled around Asheville,

-Oct 15, 10:am is our 5K walk. Starts at Pack Square park.

You can find more information and link to my video from my website, www.nchealthplansonline.com.

  You can also see my video at: http://makingstrides.acsevents.org/site/TR/MakingStridesAgainstBreastCancer/MSABCFY12National?fr_id=36162&pg=entry.

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Blue Medicare Advantage Open Enrolment

There are changes coming for Medicare Advantage and Part D plans, benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2013. For Medicare supplement plans, the changes occur on June 1 of each year.

 For over 77 years, Blue Cross and Blue Shield of North Carolina (BCBSNC) has provided quality health care coverage for North Carolinians. And we’re committed to providing you with affordable Medicare coverage.

For more information or answers to you questions contact me at 800-438-5834 or my website: http://nchealthplansonline.com/ or find me on Facebook; https://www.facebook.com/pages/nchealthplansonlinecom/272756602752202?sk=wall

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SIMPLIFYING HSA’S FOR 2011

SIMPLIFYING HSA’S FOR 2008

I am always asked the question by my clients what is an HSA?  A health savings account (HSA) is a tax-favored savings account created for the purpose of paying medical expenses.

Contributions to a HAS are 100% deductible (up to the legal limit) just like an IRA.  An HSA will work in conjunction with high deductible health insurance.   Your HSA money can be used to help pay for your health insurance deductible which the minimum deductible for this year is $1,100.00 for individual and $2,200.00 for families.   When you meet the deductible of your health plan with covered expenses the health insurance pays the remaining covered expenses in accordance with the terms and conditions of your particular plan.  It also pays for qualified medical expenses not covered by the health insurance which includes dental and vision

The new limits for 2008 put out by the Treasury Department are $2,900.00 for individuals.

Families of 2 or more are $5,800.00.  There is a “catchup” for individual 55 or older of $900.00.

The Withdrawals to pay qualified medical expenses are never taxed. 

Interest earnings that are accumulated are tax-deferred and if they are used to pay qualified medical expenses, they are tax-free.

The monies that are unused in your HSA account are not  forfeited  at the end of the year they continue to grow tax deferred.  Any funds withdrawn for non-qualified medical expenses will be taxed at your income tax rate plus 10% Tax penalty 

In order to qualify for a HSA  you must be covered by a high deductible health plan.  Not covered by other health insurance.   Exceptions-Other health insurance do not include coverage for the following: accidental, dental care, disability, long term care, vision care.  Workers’ compensation, specified disease and fixed indemnity coverage’s are also permitted.   You cannot be enrolled in Medicare and not another person’s dependent.  

The benefits of owning a HSA  are that they  cost less than traditional co- pay plans.  They can be used to meet your deductibles.   They are tax deductible off of your gross income.  They grow tax deferred.  They are never taxed when used for qualified medical expenses.  They rollover year after year.  They are portable they go with you.  They can be for health premiums when you are in between jobs.  You can pay for qualified long term care premiums. Health premiums after age 65 not Medicare supplements can be paid.  You may use the monies after age 65 for living expenses and pay ordinary income taxes.

These are some of the benefits to clarify HSAs.  I hope that this gives you a reason to rethink lowering your premium dollars and looking at an HSA next time the opportunity arises.

Judi Goloff

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Health Care Reform

With the the federal Health Care Reform law being passed on March 26, 2010,

it seems that everyone with NC health plans is wondering, “Exactly how will NC

health insurance plans will be affected?

Whether one has coverage or is seeking a quote for affordable health insurance, and whether one resides in a mountain communities near Asheville or in or near cities like Charlotte or Raleigh, we in North Carolina are asking what the rest of the country is asking: “How will my long-term health care and financial picture be impacted when the changes begin? 

There are changes going into effect in 2010 and at the start of the calendar year 2011 which have the potential to directly affect all families and age groups.

Rules are still being written on how the new law is to be carried out.

Whether we’re seniors or simply have senior-aged parents and grandparents, we will all be affected by what happens for seniors down the road. Let’s take a look at some of what we know will take place this year.

Medicare will begin paying $250 in annual rebate to those in the coverage gap of the “donut hole” of Medicare Part D.  It appears that the $250 rebate check will be sent within a few months after a person’s lapse in Medicare coverage begins each year. For those who are without direct experience

with the “donut hole”, and to put the rebate subject into perspective, it’s helpful to know that after deductible in a given year, the Medicare D plan pays 75% of the costs of prescriptions until costs reach $2,830. The “donut hole” begins at $2,830 and the 75% Medicare prescriptions coverage then ends. The individual pays 100% of the costs until $3,610 more is spent on prescriptions.

The total costs of prescriptions must rise to $6,440 before Medicare will resume paying in that year. The cycle begins again the next year and is a challenge that many seniors face annually. The $250 rebate is less than 10% of the burden many pay.

Perhaps a more significant change for seniors is applicable beginning January 2011. Name-brand drugs will be at a 50% discount during one’s lapse in Medicare D coverage. However, with rising drug costs being a concern, it’s difficult to predict overall outcome.

The law indicates that the donut hole will end by 2020.

In the future, if the donut hole ends, seniors will still be responsible for 25% of their drug costs under Medicare.

With financial burdens like these being a certainty for many, one can see that people of all ages stand to benefit greatly from the long-term value and security provided through a number of different plans.

Products like Blue Cross Blue Shield of North Carolina’s (BCBSNC’s) Medicare Supplement Plans (including Plan D), Blue Medicare, Blue Advantage® and Blue Options HSA plans are excellent choices.

In fact, Blue Cross Blue Shield of North Carolina’s (BCBSNC’s) HMO and POS products have earned Excellent Accreditation from the National Committee for Quality Assurance (NCQA). BCBSNC also has North Carolina’s first and only NCQA accredited PPO plan.

There are many choices that www.ncinsuranceplansonline.com offers individuals of all ages.

One thing is certain: The security that comes from quality coverage now is key to creating the individual health care and financial picture we’d each like to see in our future.

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Quitting Smoking saves Money

Quitting Smoking saves Money 

 

There are many advantages in quitting smoking.  Your health, your wallet and the air you breathe will all benefit from the act.  With the whole civilized world becoming “non-smoking” quitting is a reality many smokers face.  Most restaurants and bars are completely smoke-free now.  There is talk of banning smoking in public outdoor spaces and venues too.  All the more reason to try and stop.

The notion of quitting smoking is good for many reasons.  You will save money by not buying pack after pack and your health insurance rates can go down too.  Don’t forget to contact your agent or HR person to revamp your policy.  Some companies are even adopting incentive programs to help employees curb the habit.  Money is always a motivating factor.

http://www.healthnews.com/medical-updates/money-talks-strong-motivation-quit-smoking-2616.html

Even our own president is taking the milestone to quit.  He has been very vocal in his desire to be smoke-free and to encourage the rest of us also.

President Obama is leading a campaign to help Americans snuff out the habit.  His website lists these and other options he would like to see included in his administration’s plan for healthcare issues.

­     Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums

­     Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees

­     Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs and taking on drug companies that block cheaper generic medicines from the market

­     Require hospitals to collect and report health care cost and quality data

­       Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.

­     Reduce the costs of catastrophic illnesses for employers and their employees

­     Require coverage of preventive services, including cancer screenings

You can read the full plan at http://www.barackobama.com/issues/healthcare/

There are many resources available on the web and though your healthcare provider to assist you in your goal to quit smoking.  There are the tried and true techniques of supplementing with a lollipop, nicotine gum or snapping a rubber band on your wrist.  To alternative measures like hypnotism, acupuncture, or prescription drugs.  One of the most important steps is finding a support network.  Friends, family, co-workers and counseling can provide encouragement and support.

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Health Insurance for Starter Families

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Starting out in life is tough and starting out with a family can be even tougher. You want to do everything you can for them and, just in case, you want them protected. One of the most important types of protection is Health Insurance.

 Why Health Insurance?

 Health insurance protects you and your family from the high cost of medical care. In the most basic form you pay a monthly premium and the provider offers certain coverage.  One common fear is the cost of health insurance but imagine what the consequences could be of not having coverage.  Medical bills from a small playground accident can delete any savings and a major illness could put you into bankruptcy.

 Comparing Plans

 There are basically two types of plans, Traditional or Indemnity and Managed care.

Indemnity also known as ”Fee for Service” generally covers illness and accidents. There are no provisions for preventive care (flu shots, birth control, yearly wellness checks). And they may not offer prescription coverage. A big advantage is that you will have more freedom as to choice of doctors but you will pay for it with higher premiums.

 Managed care is what most of us are more familiar with. These include HMOs (Health Maintenance Organization) and PPOs (Preferred Provider Organization). HMOs offer lower premiums by offering care through a network of doctors and hospitals.  Co-payments are generally lower and prescriptions, preventive care and mental health are covered.

 PPOs are like a combination of the “Fee for Service” and the HMO. You have the option to use doctors out of the network but you will pay a higher portion of the cost. Using doctors within the network will save you in out-of pocket-costs which could include co-payments, deductibles, or other fees that you are required to pay outside of your health benefits plan. Premiums for PPOs are generally higher.

 Choose a health Plan

 Health insurance can add to the family budget, but there sensible ways to save money by shopping wisely. If you look around you will find options.  If your employer offers insurance you should take advantage.  You will almost always get a better premium with group or employer-subsidized plans.

 Whether you are getting insurance coverage through your employer or you have to buy it yourself it is important to do your homework and pick the plan that is right for you. Another good idea is to investigate insurance brokers. A broker has access to multiple providers and can help you make the right choice. Some questions you should ask your broker or while shopping around:

 - Does the plan cover the services I may use? Are there any pre-existing conditions, do you plan on having children. Does their network cover favorite doctors or hospitals?

- Prescription cost, how much they cover, what they cover. Do you have any special prescription needs?

- What are the co-payments?

- What are the deductibles? A common mistake is to choose a high deductible to keep the premium low. This could actually prevent you from getting care if you can’t cover it so keep the deductible realistic.

- What expenses have t be paid before reimbursement

 Before you make a final decision with a company take a few minute and get online and check them out. Look for things like complaints or high dropout rates. Look for accreditations and memberships. Purchasing health insurance is one of the most important decisions you will make for your family and it is a choice that needs to be made wisely.

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