Affordable Care Act, Where We Are Now

Before the Affordable Care Act was passed, the number of Americans without health insurance has been estimated to be as high as 44 million. Current statistics indicate that about 7.26 million have enrolled in the program so far. Every citizen is required by law to get insurance. If you don’t have health insurance through work, enrolling will keep you from getting hit by an IRS-enforced tax/fine.

Prior to ACA’s enactment, 18% of American adults had no health insurance. In 2014, eight million people signed up for health insurance, dropping uninsured to about 14%. Thirty million are expected to remain uninsured, even after a few more years of enrollments. Health insurance is clearly something that still needs to be addressed.

States have the right to choose two different paths concerning Medicaid money. They can expand Medicaid availability by partnering with the Federal Government on the Marketplace Exchange. If they choose to do so, then more federally-funded Medicare dollars become available to those states. In states that expanded Medicaid, the uninsured fell from 28% to 17%, but in states that didn’t, the average uninsured rate only fell from 38% to 36%.

North Carolina is not moving forward with Medicaid Expansion at this time and is not alone in this choice. In fact about 50% of our country (23 states) chose to not pursue Medicaid Expansion. These states have chosen to not use the federal end of the Marketplace website. They have chosen a route that has less federal red tape.

About 90% of those who remain uninsured are unaware that there is another enrollment window. The Marketplace is full of all kinds of useful information to help folks make decisions about policies, a better understanding of health insurance basics, where to go for additional help. Small business owners can find plan options there as well.

The next enrollment window is November 15, 2014 – February 15, 2016. This will be for coverage that starts as soon as January 1, 2015. Outside of this enrollment window, you can’t sign up unless you have a life-changing event, such as getting married, having a baby, job loss, or moving outside your current insurance’s covered area. With most rules, there are exceptions and ACA is no different: Medicaid and CHIP (Child Health Insurance Program) is available for enrollment year round.

People who have the greatest need for health insurance are usually the poorest. They are typically the least informed, least educated, and last to know about changes in the law, probably due to limited access to the internet, news, etc. They tend to have poorer health and some have had to often rely on Emergency Rooms for ordinary medical care. They are the group that will have the hardest time paying the penalties for failing to comply with the law. Obviously, this is a niche that needs to be educated about Marketplace and Medicaid/Medicare/CHIPS options.

Check out the Health Insurance Marketplace. You can compare plans (similar to shopping for airline tickets) even find out if you’re eligible for tax credits, which is based on income. Subsidies are available to offset the expense of ACA policies. Up to 400% of the poverty line qualify. That’s about $97K/yr gross income. Blue Cross Blue Shield of North Carolina can give you more information, and sign-up details. Getting a policy is probably going to be a better decision than paying the non-compliance tax.

5 Reasons to Buy Short Term Life Insurance

1. Providing income for family in the event of death of the primary income earner.

In National Underwriter’s recent Life Insurance Study, we asked agents about the primary concerns and goals of their clients. An impressive 75 percent of respondents noted that their clients want life insurance for a very traditional reason: to provide for their family in case of death. This was an overwhelming lead over client concern No. 2, which came in at 40 percent. Raymond W. Johns, an insurance broker in Utah, notes that the peace of mind life insurance offers is something no other product can provide: “Life insurance is the key ingredient for the safety of every family. It is an integral part of any financial plan. We who understand the power of life insurance need to spread the word … so that [others] clearly understand how important it is for their financial peace of mind.”

2. Paying off debt.

When working with younger prospects, producers often hear this classic question: “I’m single with no dependents, so why would I need coverage?” The answer was cited by 40 percent of our respondents as top-of-mind for their clients: Life insurance protects your loved ones from paying off your debts. Which brings us to the No. 3 concern

3. Covering funeral expenses

At its roots, life insurance is a final expense product, designed to protect loved ones from the financial cost of death (see our infographic: Death by the Numbers). Today’s policies may come with a lot of extra bells and whistles, but many clients want it simply to pay for funeral costs, so that their family doesn’t have to. Thirty-eight percent of producers cited this as a top client concern, making it No. 3 on our list. This builds on data uncovered by an earlier National Underwriter research study: In the African-American market, covering funeral expenses is the No. 1 concern, cited by 57 percent of advisors who work with African-American clients.

4. Passing wealth to heirs.

As a financial planning tool, part of the beauty of life insurance is its flexibility. This is a product that can fulfill a variety of needs for a variety of clients in a variety of income brackets. Thirty-five percent of survey respondents noted that passing wealth to heirs was a top goal of their clients. Guy Baker, managing director, BTA Advisory Group, explains why it’s important to pitch life insurance not as a product but as a key part of the financial planning process: “We can sell life insurance as a product or part of a process starting with defining the problem and leading to an ultimate solution. Most people are too busy being successful to focus on making a BIG decision. So we break the problem down into little decisions that lead to implementation. Work on the problem, not the solution.”

5. Being able to pay for a loved one’s education in the event of death of an income earner.

Twenty-five percent of advisors cited education expenses as a primary goal for their clients and a primary selling point for life insurance. And for good reason: As a secure investment vehicle, life insurance is tough to beat. Mark Hug, Prudential’s EVP of product & marketing, individual life insurance business says this about why the product is so relevant to so many — and also why a change in public perception is still needed: “The more people understand the relevance of life insurance, the more we can shift the nature of the conversations. Ultimately that change will help people see that life insurance isn’t a commodity, but rather a source of protection for their loved ones and a resource for their future.”

*From a recent article, “…Five of the top benefits clients expect to receive from their life insurance policies.

Affordable Healthcare Act: Benefits and Possible Downsides

The Affordable Care Act (ACA) has been fraught with controversies from the very start, and now, even months after its introduction, the controversies show little signs of abetting. Debates are alive as to the good and the bad sides of it and wedged between the claims of the supporters and the detractors of the new plan, people in large still seem to be in a lot of confusion. The following are the most salient points in regard to the pros and cons of the new healthcare plan.

Let us start with the positive sides. The primary aim of ACA was to include the possible biggest number of population under health insurance coverage. It is estimated that, starting from 2014, as many as 32 million Americans, who could not afford any health coverage until now, will be covered by the new healthcare plan. Among these are included 3.1 million Americans aged 19-25 who can now be added to the health insurance plans of their parents. Many of these young people are known to be working at various jobs and who still couldn’t afford any health insurance. In addition, no insurance company will, from now on, be able to deny coverage to patients with serious pre-existing conditions. The companies will also not be able to drop members from a plan when they get sick.

Most people are also expected to enjoy healthcare at reduced costs thanks to the new plan. Many may see a rise in the monthly costs of the more or less identical coverage’s, but the newer plans also come with lesser deductibles and annual out-of-pocket expenses. This means the overall costs of the similar plans will come down significantly for most people. Many are also of the opinion that the new plans will make preventative care more accessible. Importantly also, the new plan is expected to reduce the big budget gaps due to Medicare. The budget deficit is expected to get reduced by as much as $143 billion in five years from now.

On the downside, many fear that the Affordable Care Act will translate in higher medicine costs. According to the new plan, the pharma companies will need to pay $84.8 billion extra in fees over the period of the next ten years. This may result in rising drug costs if the companies look to pass the burden of this extra pay on to the consumers. Many have also predicted that America will reel under a huge shortage of health care workforce by 2020 as a result of some new mandates included in ACA. An AAMC study reveals that the shortage can be as huge as of 91,500 physicians by 2020.

Many people have also complained that they have found it extremely difficult to pin down the right plan for themselves from among the maze of all the different plans available. For example, someone residing in North Carolina may find it quite a challenge to visit the website of Blue Cross Blue Shield NC and find the suitable plan for herself all on her own. This is largely owing to the sheer number of different coverage schemes available under the new plan. Therefore, most people in North Carolina would need help of a BCBSNC agent who will help his client narrow down his choices and would explain in detail why certain schemes should be more beneficial to them than the others.

If you need help navigating the Blue Cross Blue Shield NC website and the schemes listed thereof and would like to engage the services of a BCBSNC agent, please feel free to contact us today.

Are ACOs the Answer to an Affordable, Quality Healthcare & Health Insurance System?

Remember the Affordable Care Act of 2010? It’s the one Congress titles: Quality, Affordable Health Care for all Americans. How about the part where it will be the responsibility of every single American – requirement – to maintain (and report on) minimum essential health insurance coverage? Ah, now you remember.

This is the biggest question on which we’re waiting for the Supreme Court to make its ruling. Passing it would mean that millions of uninsured Americans would have their health insurance coverage subsidized by the federal government. The question isn’t whether or not it’s a good idea. The real question for the Supreme Court is whether mandating health insurance coverage is actually constitutional.

Whatever happens will turn out to be a double edged sword, and there is no easy answer.

There is good news. Blue Cross and Blue Shield of North Carolina has started to 1) pay doctors bonuses if they improve efficiency, 2) encourage patients to shop around for treatment, and 3) pay doctors to install computerized records. I believe all of these are good, and no matter what happens at the Supreme Court, we’re not going back to the ridiculous status of healthcare and insurance of 2009.

Increasing health insurance costs, associated with our aging population and more disease, will ensure continuous efforts to expand coverage, reduce costs, cut waste and improve healthcare. We’ve got to figure out ways to address of all these issues. I’m glad to see BCBSNC taking a proactive approach to working on a solution.

Blue Cross and Blue Shield of North Carolina is creating (i.e. funding) with the University of North Carolina Health Care System (UNCHCS) a private accountable care organization (ACO) in which a shared risk model means patients will have easier and better access to their doctors, medical records, and test results.

I’ll write again about these ACO provider alliances. Will they deliver lower-cost but still high-quality health care via new payment models, particularly ones that reward efficiency? It’s premature to tell. But I can help you find the right and most affordable plan for you and your family. Let me help you ask the right questions when getting health insurance quotes and comparing health insurance plans in North Carolina. I am happy to help you find the right answers for your needs.

Calm and Happy Children, Calm and Happy Parents

In homes, schools, medical clinics and even insurance agencies, people talk about psychological health and well being and the great numbers of adults and children with attention deficit, hyperactivity, anxiety or depression. How health insurance plans or medical offices will deal with a person’s situation depends upon each case and coverage. Costs for dealing with these conditions can be quite high.

 Millions of children in the U.S. are medicated for ADHD alone, according to the Center of Disease Control (CDC). Over a million preschool children in the U.S. are said to be depressed. North Carolina has more parents who report their children as having ADHD than any other state. Yet parents and children everywhere are happiest when both parents and children feel great without requiring prescription medication for mood, impulses, behavior and so on!

 The vast subject of ADHD, depression and anxiety and their counterpart (a positive sense of well being) aren’t that well understood. Our diet is a big part of our environment and the diet greatly impacts how we feel.

 Google search “ADD+diet” and we find over 128 million pages results! Googling “depression+diet” brings over 17 million page results. While such isn’t solid research, it would be a bit silly to think that diet and chemistry do not affect our minds and our sense of well-being. Attention to diet can often identify various causes of imbalances so we can rectify the imbalances make needed changes serious medical conditions develop. Parents report amazing results for both themselves AND for kids when they remove dietary items proven to create difficulties.

 A most helpful method to finding answers is the do-it-yourself Rotation Diet. This method of rotating foods and observing changes was developed by obesity expert, Martin Katahn, PhD.

 Since it’s a highly individual matter, people can observe their reactions to items with the rotation diet and learn exactly what foods subtly (or not so subtlety) disagree with them. Depression, anxiety, hyperactivity, sluggishness, digestive upsets, headache or migraine, feeling “scattered” and unfocused, etc., are sometimes only a result of a few key food choices that don’t support one’s chemistry.

 It’s common for people to put up with feeling poorly over many years, to later learn that discomfort, headache, aches and pains, arthritis and mood issues were food sensitivity related. (Allergy tests don’t typically reveal such sensitivities, which are different from allergy.)

 There are a few essentials that every human needs. In addition to supporting our physical wellness, these nutrients also support our moods, behavior and general feeling of wellness:

 Essential Fatty Acids (EFAs) — A guaranteed-pure fish oil benefits the brain and nervous system and virtually every other system in the body. In research studies, fish oil has often proved to be beneficial to those with depression. Not only are EFAs good for feelings of well-being, they are needed for correct adrenal and thyroid function, the development and function of the brain, healthy hormonal activity, breaking down fats and many other things! EFAs are in fish, especially the skin of the fish, as well as nuts, flax, green and leafy vegetables.

 Adequate magnesium is a must. 80% of Americans are said to have a magnesium deficiency. Signs include anxiety, irritability, hyperactivity, confusion, fidgeting, difficulty sleeping, learning difficulty, constipation and even dangerous heart rhythm problems. Magnesium is found in beans, nuts and other vegetables.

Zinc is a common nutritional deficiency among children who are hyperactive. A person with zinc deficiency has trouble thinking, and is prone to being anxious. Zinc is found in meats and grains.

 

B vitamins give people lots of energy and a good feeling of vitality. Bs are found in meats, milk,  whole-grain cereals, eggs, fish, yogurt, nuts, fruits and many other foods.

 

Vitamin E is a calming vitamin. Without enough of it, we have poor nerve conduction in the brain, among other problems. Almonds, olive oil, wheat germ oil and many other foods have vitamin E.

 

Vitamin D deficiency if rampant! It causes depression. D comes from the sun. D is a powerful immune system supporter and is needed for strong bones. Many adults and children are highly deficient in D, which also offers protection against many cancers, viruses and infections. D3 is said to be the health promoting and non-synthetic form of the vitamin which is added to milk and other products.

 How we eat can indeed be our “medicine” and help us to feel at our best.

 We at www.nchealthplansonline.com wish you a happy and healthy season ahead! Call Judy Goloff for NC health insurance information. Judy’s primary focus is on identifying and meeting your individual medical care needs with a variety of health and life insurance plans from Blue Cross and Blue Shield of North Carolina ® (BCBSNC). She will walk you through the entire process to make sure you get what you need in a health plan. 1-800-582-2262.

Health Insurance for Starter Families

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.

I’m A Breast Cancer Survivor

I’m about more than North Carolina health insurance, I’m a firm believer in living a healthy whole life and I’ve practiced that with my own for a long time. But life can throw you a curve ball.

I was going along thinking that I was doing everything right then wham I’m diagnosed with breast cancer. I’m proud to say that I am a two year survivor but my point is that no matter how well you think you are taking care of yourself “shit happens” and that is the truth. If I did not have my health coverage the medical bills could have cost me my home and my way of life.

 I believe life is a gift and you should choose to live healthy. If you go to my blog you will find articles about cooking healthy, essential oils for health, quitting smoking with many more to follow. But, I also believe in “prepare for the worst” and things happen in life that are out of your control like a car accident for example so you have to have a good health insurance plan.

 Please go to my site, see what I offer and feel free to contact me.

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.

Strides Against Breast Cancer

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”.

Health Insurance Or No Health Insirance

The very thought of health insurance makes most of us uneasy. Why, because it make us think about what could happen, what  if we got hurt or sick or how are we going to pay for it. And that is the next uneasy thought, how much healthcare can cost. But the real question is can you afford to be without it?

 The bottom line is protection, to protect yourself and your loved ones financially. The same reasons you have homeowner or auto insurance, to protect yourself in case something happens. That is the overall reason but if you really look at it there are more practical reasons:

 – To protect against health care expenses as mentioned above.

 – If medical bills go unpaid, hospitals and doctors will try to collect and that could cost everything up to and including your home.

 – People with insurance enjoy better health. Those with insurance are more likely to go to the doctor when something is not right or for yearly wellness checks. This catches conditions before they become a major issue.

 – People with insurance tend to follow their medication and treatment programs.

 – You could receive a lower life insurance premium.

 Unless you are covered through your workplace most of us have to buy our own health Insurance.  This is where you need to find a good health insurance broker. A good broker can assess your needs and walk you through the morass of plans out there. Here in North Carolina Blue Cross and Blue Shield is one of the largest.

 The principal behind insurance is a lot simpler than the actual plans themselves. You enroll in a healthcare plan and pay a quarterly or monthly fee to be covered under certain conditions. Depending on the type of plan insurance may pay the whole bill or a percentage of it and you are responsible for the balance.

 So, what are the general types of plans, basically there are four main types, Catastrophic, Short-term, Preferred Provider Organization (PPO), and Health Maintenance Organization (HMO). Managed care health insurance plans are what most of us are familiar with these are the PPOs and HMOs.

 Preferred Provider Organization (PPO) is a health insurance plan that will fully cover treatment if that treatment is provided by doctors or hospitals that belonging to the PPO’s network of health care providers. Treatment performed outside the network is also covered, but you will pay extra.

Health Maintenance Organization (HMO), these plans generally have significantly lower premiums.  The trade off is they greatly restrict who a patient may see for non-emergency medical services.

Short-term health insurance can only be purchased for a specific period of time similar to term life insurance. Short-term health insurance often comes with strict qualifying procedures and may not cover pre-existing medical conditions.

Catastrophic health insurance is one of the least expensive forms of health insurance you can find but the deductibles are generally large for these types of policies. These policies are only good if you have the financial means to handle routine illnesses and hospitalizations.

So to sum up don’t let the cost of health insurance scare you. Not having insurance could cost you much more in the end. Whether you have a family or are still single a good broker will help you find an affordable health insurance plan to fit your needs.