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.

Why a Personal BCBSNC Agent is Better Than a Navigator

In the wake of the recent health reforms, the Affordable HealthCare Act provisions and the plans one may opt for under the act have left many people in some confusion. For example, if North Carolina residents look to find an affordable and useful healthcare plan from the website of Blue Cross Blue Shield NC at http://www.bcbsnc.com/, this can be quite a challenging task. This is where a health insurance agent can help you out. An agent will help his client navigate through the maze of plans that are in offer and can help him enroll outside the government exchanges.

One may ask, won’t a navigator do the same? Not quite. The government had announced back in August this year that the original federal funding of $54 million on ‘navigators’ training and management had been increased to $67 million. The navigators are expected to assist people enroll in healthcare plans through government exchanges. However, at the same time that the government was agreeing to such a large expenditure on navigators, they had also handed off authorization to at least six insurance brokers for enrolling people in health insurance plans under Affordable HealthCare Act.

What is the bottom line of this? Well, this amounts to federal government admitting to the fact that the navigators could not provide people sufficient help in enrolling for the right plans. The reason for this is that the navigators are not allowed by law to proffer advice to consumers on which health insurance to choose. This law was primarily in place to ensure transparency in health care. The navigators are prohibited from making direct recommendations to people. To work as a navigator, one cannot have any ties with health insurance companies, and they also need to undergo an online training session which instructs them on how to avoid bias and stay neutral. So, all that navigators are allowed to do is to tell people what plan can be ideal for them, and that is that. They are not authorized to give explanations!

However, precisely this is where an insurance agent can be of help to people looking for the proper health plan to subscribe to. With confusion reigning regarding ACA, what people are looking for are recommendations and personalized advice. They need to know how they are going to benefit by subscribing to a particular plan. When it comes to Blue Cross Blue Shield NC, many may similarly find it somewhat difficult to navigate the website on their own and fish out the most useful information for themselves. Options are aplenty and with all the many different products available such as Blue Options HAS, Blue Advantage, Blue Medicare, Blue Options SM, an individual consumer may often feel at a loss about what plan to choose.

This is where a reputable North Carolina insurance agent can come to your aid. He will listen to your healthcare needs and would be able to recommend the right plan for you. You can also enroll to a plan through BCBSNC with the help of an agent. If you want to sign up under ACA using an insurance agent it will not cost you anything outside the plan. It is also important to understand that the agents do not sell health insurance. They will help you find the right plan, would give you useful advice and help you find the answers to your questions so that you can make a studied and informed choice regarding your health insurance coverage.

Health Insurance Exchange made easy by Blue Cross Blue Shield

North Carolina State residents enjoy a wide variety of insurance plans but this makes the process of choosing the right process for their individual and peculiar needs very confusing. There are two basic types of health coverage plans available for residents. These are Individual and Group Health plans.

Individual North Carolina Health Plans
These plans are bought by individuals or families who are not covered by their employers’ insurance scheme. They are either self-employed or are not included in the employer’s plans. The advantages of having an individual health plan include,

1. The individual has full control of his health insurance plan.
2. Ownership of one’s own coverage.
3. Premiums depend on personal or family health history.

However, the Individual North Carolina health insurance plans also have their disadvantages; these are
1. Responsibility of the entire premium thus the employer does not provide subsidy.
2. Higher premium levels are charged if a person is ill during the time of application.
3. There is no compensation because the insurance is being taken care of by the individual alone.

Group North Carolina Health Plans
these are plans offered by employers to most of their full time workers. The advantages of the Group NC health insurance plan include
1. Employers pay 50% of their employees’ premium.
2. People with major health issues can afford insurance due to the proper support.
3. The employer will offer compensation especially in extreme conditions.

The Group NC Health Plan also has its disadvantages. These are;
1. Upon termination by the employer, choices for affordable health care are limited or unavailable.
2. People’s options are limited to the employers’ provision.
3. Individuals in the group cannot control the premium level.

North Carolina Health Insurance
North Carolina began providing health insurance coverage to residents in 2010 through a high-risk pool program established federally. Families having history of medical problems are assisted by the risk pool to purchase coverage. Health insurance companies operating in the state are expected to contribute to the pool so that people can become self-employed without losing their insurance coverage.

Blue Cross Blue Shield and Affordable Care Act (ACA)
Blue cross Blue Shield North Carolina is the states’ largest insurer. This insurance company announced to the customers the revised premiums under the Affordable Care Act. It has to offer 26 plans in the health insurance exchange. The charges were to range from $145.18 a subscriber aged 24 (one of two catastrophic plans) to $594 for 60 year old (one of six plans).

Individuals who are seeking to buy health insurance for the first time are usually not certain of the insurance products that best suit them. This is also the case for those who have relied on their employers’ coverage decision and are now about to get an insurance coverage on their own.

In same manner, those who seek health insurance exchange also rely on insurance companies to help make the best decision for them. The aim of the exchange is to improve the quality and access of an affordable health care. The process requires that the company develops its knowledge and insights in anticipating customers especially for first timers.

With the Affordable Care Act and policies and the analysis of BCBSNC on their customers trend, the “exchange” process has become very easy. The individual seeking exchange can confidently leave allow Blue Cross Blue Shield North Carolina decide which of its 26 plans is the best option.

BCBSNC Agent Judi Goloff, Breast Cancer Awareness Helped Save Her Life

For Blue Cross Blue Shield of North Carolina health insurance agent, Judi Goloff, breast cancer awareness helped save her life.  As a breast cancer survivor, Judi knows better than anyone the importance of early detection.  That’s why Judi is such passionate supporter of National Breast Cancer Awareness Month, and the 5000 women living and working in North Carolina who will be diagnosed with breast cancer  this year. With the American Cancer Society estimating that more than 230,000 new cases of invasive breast cancer would be diagnosed among women in 2011 and estimated nearly 40,000 women would die from the disease, events throughout Asheville help highlight the continued need for education and early detection. From a golf tournament to an art exhibition, the city of Asheville has a number of events scheduled in October to celebrate survivors, and raise money for breast cancer research.

* On Monday, October 15, Ladies Workout Express is hosting a free community health fair from 8:00-11:00 am & 4:00-7:00 pm. The health fair will feature cancer prevention education, nutritional and cardiovascular information, plus health screenings and fitness assessments led by professionals (including blood analysis, bone-density screenings and running evaluations). There will also be a raffle and walk-a-thon with great prizes from area businesses to raise money for the American Cancer Association.

*If food really does it for you, try the second annual Plates for Pink dining event Tuesday, Oct 16. Urban Burrito, Louella’s Bar-B-Que and Okie Dokies Smokehouse are among the participating restaurants.  The Asheville Blood Donation center is sponsoring a blood drive from 7:30 am to 12:30 pm on Wednesday, October 17.  Participating donors will receive a $10 gift card to Neoburrito gift card.

*Making Strides Against Breast Cancer Walk will be held Oct. 20 at Pack Square, and is one of many events designed to provide women and their families with support and encouragement. The event will begin with the Making Strides Against Breast Cancer Walk shirt pickup starting at 5:30 p.m. on the adjacent patio of Pack Tavern. The first 500 registered walkers will receive pink luminaries to light in honor of breast cancer fighters. The night before the walk, the Asheville Citizen-Times and Mission Health will host a luminary event at Park Square Park.

*And on Saturday, October 27, the sixth annual Power of Pink relay will be held at the MedWest Health and Fitness Center in Clyde, on a new, easier course. The Survivor/Honor/Memory Walk will start at 8:45 a.m. and the 5K Race/Walk at 9:30 a.m. Registration for the 5k is $25 per person and $10 for the 1-mile Honor/Memory/Survivor Walk.

One in eight women will be diagnosed with breast cancer this year alone, National Breast Cancer Awareness month is one way to ensure that we stay vigilant in the fight against this disease. North Carolina health insurance agent, Judi Goloff, agrees.  As one of the 2.6 million breast cancer survivors, Judi knows first hand how important breast cancer awareness really is.

For more information on how you can get involved, contact Judi at www.nchealthplansonline.com or 800-438-5834, (828)582-2260.

BCBSNC: Understanding Health Care Reform – The Affordable Care Act & You

If you aren’t satisfied with your health insurance plan in North Carolina now, don’t have a health insurance plan, or if you have been ‘uninsurable’, you may be wondering how you’ll obtain health insurance. 

 I may be able to help you. Call me to learn more about a temporary high-risk health insurance pool program. If you do not have access to group health insurance, and are unable to get private, individual health coverage now, it’s an option that can protect you and your family.

 By now, most of us know the Affordable Care Act (ACA) requires that everyone has health insurance by 2014. Here’s good news: Beginning in 2014, Blue Cross Blue Shield of NC will have a state health insurance exchange that will help you compare benefits, prices, and healthcare providers in order to purchase (required) health insurance. If you are interested, Judi Goloff can help you navigate to get the plan most appropriate for your needs.

 Here’s something you may not know about the ACA. You may be grandfathered in and exempt from some of the new provisions of the Affordable Care Act. Call me, Judi Goloff, for a complimentary health insurance review. I can help you find answers to your questions about health insurance quotes, plans, and what the ACA means to you.

 I’m not a sales person, you see. My interest in the health care system began as I was personally driven to find the answers I needed. I have helped so many North Carolinians navigate through the system, and I can help you, too. I don’t sell a product. I help you get the peace of mind you need when dealing with health care. And BCBSNC is the company to turn to.

 Blue Cross Blue Shield of North Carolina (BCBSNC) has released a guide to assist members in understanding Health Care Reform , or the Affordable Care Act (ACA). The publication is for information purposes only. It is not meant as legal or tax advice and is not contractually binding on BCBSNC. Please consult with your attorney tax advisor for further advice.

 And you can contact me for the details and files mentioned on the guide. If you have any questions, I am here to help. Make sure you understand health insurance , as well as the features and benefits of the health care plan you need. Agent experience counts when buying health insurance in North Carolina. I’ve consistently been one of the top five agents for North Carolina. I would love to help you make sense of health care for you and your family. Call me at 800-438-5834 or 828-582-2260 for more information. Here’s to your health!

Blue Cross Blue Shield of NC “BluePoints” Motivates Members to Stay Healthy & Get Money Back

Let’s face it. Health insurance quotes can be expensive these days, no doubt about it. Even if you have health insurance through an employer, you may have noticed your benefits changing. I just found a review of Blue Cross Blue Shield of North Carolina from a lady named Katrina on the Viewpoints website. I’d like to share some of what she has to say about Ease of Use:

”… have found Blue Cross Blue Shield of NC to be easier to use than some insurance companies. Most hospitals and clinics [in North Carolina] accept BCBSNC. I remember when a large hospital in our area decided to stop accepting BCBSNC–it was a disaster for the hospital and now that hospital not only accepts BCBSNC, but they also offer it to the employees of the hospital and to their Medical School employees.

They do have an informative and easy-to-navigate website. I’ve looked up numerous physicians on their website to see if they accept BCBS, and the website gives lots of helpful information related to those physicians, such as contact information, address, and even if the physician is male/female or speaks other languages. They also provide information about drugs and health problems on the website as well.

I like the fact that BCBSNC does not require a [doctor’s] referral in order to see a specialist. I’ve had another health insurance that required a referral every year. It did not matter if you had seen that specialist for eight years. You had to get a referral each year in order to have any visits to that doctor covered. That was a pain, and I’m glad that BCBSNC does not require referrals. However, some specialists require a referral from the primary doctor before they will make an appointment…”

Nice. Call me, Judi Goloff, about your health insurance plan today. I would be happy to provide you referrals of members I’ve helped, with their health insurance assessment, health insurance quotes in North Carolina, and general questions about the new Affordable Health Care law; if you have questions, I am available to help you. I don’t sell insurance, you see. My interest is in helping you ask the right questions, and to select the right health insurance plan and coverage for you and your family. Chances are BCBSNC has a perfect fit, but if not, I won’t hesitate to tell you so.

Here’s another program I love about having health insurance with Blue Cross Blue Shield of North Carolina. Have you heard of Blue Points? The way I figure it, if you’ve got to pay for your health insurance plan, why not get all you can out of it, right? Blue Points is a great incentive program on a couple of levels.

On one level, you can get money back by choosing healthy options in your life. You can earn BluePoints many ways. For example, last year over the holidays, BCBSNC had a health insurance coupon to earn 250 Blue Points. Those points are immediately redeemable for gift cards and merchandise from places like Lowe’s, Macy’s and Amazon. How cool is that?

Second, and most important, it’s a great incentive to help you eat healthy, get exercise, and make sure to get health assessments as needed. After all, the point of the program is to reward you for wellness!

There’s a reason why the Blue Cross Blue Shield System is the nation’s oldest and largest family of health insurance companies. Call me, Judi Goloff, today to find out how I can get you quality, affordable customized coverage for you. It would be my pleasure to help you through the health insurance maze.

Eye on Your College Student: Health Insurance Sticker Shock, BCBSNC Can Help

Since 2010, the University of North Carolina college system has required all students to have health insurance coverage. It’s another one of the requirements recently mandated by the Affordable Care Act in March, 2012.

 While many students already have health insurance in North Carolina—such as being included on their parents’ Blue Cross Blue Shield of NC health insurance plan—almost two-thirds do not.

 College health plans must now include:

1). preventive benefits at no out of pocket cost to students

2). a prescription plan with no maximum, and

3). at least $100,000 max per illness or injury.

 Wow. That can get costly. In fact, health insurance costs for some of our system’s sixteen universities have more than doubled (104%) in just two years to well over $1200. And now is the time that health insurance bills are making their way to NC college students’ mailboxes. Some of the students are in sticker shock. Many colleges are planning to re-bid their health insurance contracts in order to lower costs (next year).

 But, there is an alternative.  If you’re a college student, or have a college-bound child, you are free to shop around for more economical coverage elsewhere. Call me at Blue Cross and Blue Shield Health Plans of North Carolina, and ask for a health insurance quote that meets the health care regulations for students. I’ll work carefully on your behalf to put the best possible health insurance quote and plan together for you. It will be based on your needs, and while it will meet the law’s requirement, it will be customized based on you or your child’s need as they leave home.

 Before being charged for an expensive health insurance plan that you may not need, check with the college, and find out when the deadline is to offer proof of other insurance. You may be able to opt out of the university’s plan…

 Then call me, Judi Goloff, and find out how affordable and comprehensive my temporary health insurance plans will be. I don’t just sell health insurance. I help you find the right health plan for you and your family. When researching health insurance quotes and plans in North Carolina, let me help you ask the right questions and find the right answers. Join the millions of North Carolina residents that have chosen the affordable medical and health insurance plans from Blue Cross Blue Shield of NC®.

Blue Cross Blue Shield of NC Can Help You Understand the Affordable Care Act

A couple of posts ago, I wrote about the Affordable Care Act of 2010. I didn’t expect we would have an answer so soon. As you probably know, the Supreme Court upheld the ruling that mandating health insurance coverage is constitutional.

So what does the Affordable Care Act mean for you?

  • All of us must have medical insurance starting in 2014 or face a penalty tax of $95 or 1% of your income, whichever is higher.
  • Parents can cover their kids under their BCBS health insurance plan in North Carolina until they are 26 years of age
  • If you have no coverage, you will have to get insurance quotes and buy health insurance from an independent agency by 2014
  • Low income earners can qualify for Medicaid if you earn 133% less than the federal poverty level (currently $14,856).
  • If you earn up to  400% of the poverty level ($44,680) and you don’t have health insurance from your job, you may be eligible for federal help to purchase a health insurance plan
  • Federal tax credits are available to businesses with up to 25 employees if they want to provide health insurance coverage
  • Businesses with 50 or more employees must offer health insurance to them
  • Over 200 employees? Health insurance enrollment in the company’s health care plan is mandatory
  • Finally, by 2014 no one can be denied health insurance coverage because of a pre-existing condition

This means a lot of different things to a lot of people, and there are three variables that will affect each person’s opinion and use of the health system: Job security, your health, and finances.

A mother or family with a chronically ill child requiring continual care will certainly feel different than a healthy 30 year old who doesn’t think he needs health insurance, and is made to pay the government tax.

What do I believe? Since I’m a cancer survivor, it is comforting to know that Blue Cross Blue Shield will not deny me coverage, and that my out of pocket costs for deductibles and co-payments are capped at 30% of the total cost of my insurance.

Politics aside, we will have a long way to go before the problems in health insurance quotes, coverage and implementation are resolved. No plan will ever be perfect. Do you think we’re closer now? Call me if you want to understand how your health insurance quote may change based on the Supreme Court’s ruling. I can help you compare plans and know your options for the best coverage and costs available. Blue Cross and Blue Shield of North Carolina has innovative programs, and wants to help decrease the costs of our health care system. I love helping people, and would love to help you find the best insurance match for your family.

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.

Blue Cross Blue Shield of North Carolina Supports Farm to School Program

BCBSNC

Farm to School Program

Last month I told you about the irony of me being a cancer survivor and selling health insurance. Although I always felt I was a healthy eater, I became even more of a fresh, local produce advocate as a result. So you can imagine how great I felt learning that Blue Cross Blue Shield of North Carolina® (BCBSNC) Foundation, along with the NC Department of Agriculture, announced a $1.2 million grant to benefit the North Carolina Farm to School program. This is great news for our kids (and for those of us requesting health insurance quotes each time our policy renews). Healthy kids become healthy adults, and that ultimately reduces insurance costs for everyone.

Here are the facts:  About 15% of adolescents (12-19 years) and children (6-11 years) are obese, and about two thirds of us are considered overweight. In fact, America is the fattest country in the world! Being overweight leads to so many costly medical conditions – heart disease, diabetes, cancer, asthma and sleep apnea, just to name a few. Obviously, heavy people pay more for their health insurance plans than others.

But even the healthiest people pay the health insurance cost of obesity in America, because quotes and rates are based on statistics. Health insurance providers like BCBSNC know all too well the cost of obesity on health insurance plans. This weighty issue is great; it’s one of the reasons I’m proud to represent some of the best health care insurance plans around…even if you’re uninsurable, I can help.

Blue Cross Blue Shield Of North Carolina Health Insurance CEO Brad Wilson explained the motivation behind the foundation’s grant, “The reason we are doing this is because we have an obesity epidemic in our country. We are in crisis mode, and this is one small step that is going to make a difference.”

Back to the Farm to School program. Children spend more time in school during the week than at home. Do you know which foods your child is eating, or has access to, at school? The NC program has been supplying school cafeterias across our state with the freshest, locally grown produce from North Carolina farms since 1997 (Buncombe County did not participate in 2008 and 2010). It has also provided valuable resources for nutrition directors, teachers, parents and students learning about food and agriculture.

Kudos to BCBSNC! I’m proud to work with an insurance company that is helping. A healthier lifestyle means a healthier community, lower healthcare costs, and a healthier economy. Think of what we can do with the millions of dollars we would save on health care expenditures and insurance rates if we – and our children – can reverse the obesity trend!

I don’t sell health insurance. I help you find the right health plan for you and your family. When researching health insurance quotes and plans in North Carolina, let me help you ask the right questions and find the right answers. Join the millions of North Carolina residents that have chosen the affordable medical and health insurance plans from Blue Cross Blue Shield of NC®.

PS – You can learn more about our Foundation on the web at bcbsncfoundation.org.