Many dual income couples include their children on each group health insurance plan to maximize benefits. However, without some sort of system in place to help the health insurance companies coordinate benefits, it's possible that either you or your doctor would be reimbursed for more than 100 percent of the actual cost of your claim.
To prevent this, health insurance companies typically designate one parent's health insurance plan as the primary plan and the other as the secondary plan. (That's why the patient questionnaire at your doctor's office asks for information on primary and secondary coverage.) The primary plan is responsible for paying covered expenses up to the limits of the policy. If any unpaid costs are left over, the secondary coverage kicks in.
The San Diego Union-Tribune - Sep. 20: When it comes to satisfying patients, doctors in San Diego and two other California cities fall short when compared to their counterparts in other major U.S. metropolitan areas, according to a new survey.San Diego County ranked 16th among the nation's 20 largest urban areas when patients here were asked if they trust their doctors, and it placed 17th when they were asked if their doctor understands their condition. Los Angeles and San Francisco ranked 17th and 20th, respectively, in the trust question, and 12th and 16th concerning whether physicians understand patient problems.The survey, which was not scientific, was done by HealthGrades, a Golden, Colo., company that rates hospitals and provides information about physicians.The survey questioned 41,148 people who visited HealthGrades' Web site and who had seen a doctor at least twice in the previous year. Surveys were collected from 702 patients in San Diego County, said HealthGrades spokesman Scott Shapiro.The results didn't surprise Dr. Theodore Mazer, president of the San Diego County Medical Society, who said administrative and financial pressures cut into the time and resources that doctors can devote to each patient.With health management organizations dominating California's health insurance market, physicians spend much of their time filling out paperwork and seeking permission from HMOs for patient tests and referrals, Mazer said. "In most areas of the country, you don't have to stop everything and call a plan to say 'Mother may I,' " he said.San Diego ranked 12th when patients were asked if their doctor spent enough time with them and 14th when they were asked if they would recommend their physician to others.Houston and the Dallas-Fort Worth area scored at the top of the lists for each question in the survey.San Diego physicians also must contend with low reimbursements from Medicare and high operating costs that force them to see more patients in order to generate enough money to make their practices profitable, said Mazer, who schedules to see a new patient every 15 minutes during his normal workday.Doctors from San Diego have long complained about the federal government's method for determining how much to pay for physician services here; it lumps San Diego with rural counties where the cost of providing health care is cheaper. Making matters worse is the high cost of living in San Diego, they say.Christopher Ohman, president and chief executive officer of the California Association of Health Plans, brushed off any finger-pointing at members of his group. "It's so easy to blame HMOs for everything," he said.He noted that the degree of separation between the highest- and lowest-ranked metro areas in the survey was less than 10 percent on each question, suggesting a relatively narrow difference among the cities.Another factor in the survey could be that California patients are harder to please than patients in other states, said Dr. Lance Lang, vice president and senior medical director of HealthNet, a Woodland Hills HMO with about 150,000 beneficiaries in San Diego County. Californians tend to have "higher expectations" when it comes to medical treatment, he said.HealthNet has begun using so-called health coaches to teach patients to be more interactive with their doctors and more involved in decisions about care, Lang said. "They wind up having more faith (in their physician) when they are a partner in the decision rather than just responding to a decision made by a doctor," he said.
Business Wire - Sept. 20: Lincolnshire, Ill. - Despite concerns over rising health care costs and the increasing complexity of health plans, a new study from Hewitt Associates, a global human resources services firm, found that most employees aren't effectively managing their health care and are looking to employers to provide resources that can help them make better and more informed decisions throughout the year.According to Hewitt's study of more than 18,000 U.S. employees, almost 80 percent worry health care coverage will ultimately become unaffordable, and more than half believe that choosing and using the health care plan that best meets their needs gets more complex every year. Yet just 34 percent track their current health care expenses, and less than half take the time to estimate future health care expenses. Further, while the majority of employees believe their companies provide sufficient tools and information to choose and use their health plans, only half say they used those tools."Employees are increasingly being tasked with making tougher and more important choices about their health care, but most are struggling to make the best choices at enrollment and throughout the year," said Jennifer Murphy, health care communication leader, Hewitt Associates. "While companies are providing additional education and resources to employees to help them make better choices, too much health care communication is still focused on enrollment, with little promotion or education throughout the year when people are really using their plans. As health plans become more complex, it's critical that employers have a year-round strategy that includes ways to promote the tools and educate employees and their families. Bottom line, companies need to be the ones who support and influence consumers' health care behaviors." Navigating Complex Health Plans According to Hewitt's study, the increasing level of complexity involved in choosing and using health care plans continues to be an issue for employees, particularly for those enrolled in high-deductible health plans (HDHPs) with health savings accounts (HSAs). Hewitt's study found employees' overall understanding of and satisfaction with these plans is low among those who are participating in them. Only 30 percent of employees using HDHPs with HSAs said they understood and were satisfied with their selection, and more than half said they wouldn't re-enroll next year. Although HSAs feature longer-term savings benefits, few people who enrolled said they were taking advantage of that aspect of the plans. Approximately 40 percent chose them because of the lower premium costs versus other plans, and more than two-thirds used the plans to deal with routine health expenses. "As health care costs continue to rise, HSAs are great vehicles for helping employees save for future health care expenses, but they can be ineffective or confusing to employees if they aren't using them in the right way," said Murphy. "Positive testimonials from employees who have enrolled in an HDHP coupled with an HSA show that a greater emphasis on tools can help employees understand how to use their health plans and can boost satisfaction while improving next year's enrollment results. It's also critical that the education flow continues after enrollment so employees can avoid making mistakes." Influencing Healthy Behaviors According to Hewitt's study, tools such as health risk questionnaires (HRQs) can make a difference in influencing healthy behaviors by helping employees more easily understand and address their health care needs. Of the employees who completed a health risk questionnaire, three-quarters said they found the results valuable. More than 40 percent said they learned something new about their health, and more than half said they took actions to reduce or manage potential health risks. However, only 32 percent of those who completed an HRQ said they were required to participate in any follow-up actions or activities, and less than a quarter said their spouses or partners were invited to complete one, making it difficult to assess family health needs."A great first step in providing an environment that supports and enables healthy behaviors is offering a health risk questionnaire, a resource designed to heighten employees' awareness of their health risks," added Murphy. "New or increased awareness is helpful, but behavioral changes might not take root to form new habits if companies don't provide any follow-up for employees. Companies can help employees maintain the momentum that an HRQ might provide by adding programs that encourage employees to take action after the initial questionnaire is completed." Hewitt's study also found the percentage of employees who said they practiced healthy behaviors, such as regular exercise, balanced diet, regularly scheduled physicals and preventive medicines, has remained constant over the past three years. In addition, the frequency of behaviors related to doctor's visits, including researching illness symptoms, asking doctors questions and discussing treatment options, has stayed relatively constant."To see sustained improvement in healthy behaviors, companies need to provide incentives that reward the desired behaviors through their plan designs, and then reinforce the right messages in communication throughout the year not just at enrollment," said Murphy.
U-Wire - Sept. 27: Los Angeles - With 47 days left before the California gubernatorial election, Democratic nominee Phil Angelides spoke out Wednesday on the way Gov. Arnold Schwarzenegger has dealt with health care in California, pledging to enact legislation to increase statewide health care as governor and calling the issue the most glaring injustice of the Bush-Schwarzenegger era. "As governor, I will ensure that no more than 10 percent of health care premiums a healthy margin of a dime on every dollar goes back to the HMOs," Angelides said. "I will cut health care costs for more than 12 million Californians by $4 billion a year, out of the pockets of the HMOs and back into the pockets of hardworking Californians." The issue of health care has long been a bone of contention between Schwarzenegger and Angelides. While it is only now becoming heated in the gubernatorial campaign, with Angelides giving by far his most powerful and stabbing speeches yet, the state treasurer said the issue is nothing new. "I've been battling Governor Schwarzenegger on this issue since the day he took office," Angelides said Wednesday. "I fought for legislation to cover all children, and as governor I pledge to enact it when I get into office. Arnold Schwarzenegger vetoed it. I sided by the employees of large corporations that refused to offer health care; Arnold Schwarzenegger fought and ultimately killed legislation to ensure them coverage. "I supported legislation requiring health plans to provide the basic dignity of maternity coverage and Arnold Schwarzenegger sided with the insurers and vetoed it. And when two huge HMO mergers came before the state, proposing to pour $1 billion into the pockets of top executives and inevitably jacking up the cost for families, I fought hard to block the merger. Arnold Schwarzenegger simply heeded the siren call of the HMOs and said more corporate profits sound like a health care policy to me." The Schwarzenegger campaign questioned Wednesday whether Angelides has the credibility to make such statements, citing previous instability in his stance on health care. "Just like on taxes, public safety and pay-to-play politics, Phil Angelides has a credibility problem on health care because he can't explain his record," Schwarzenegger spokesman Matt David said Wednesday night. David said Angelides had the chance to enact health care change six years ago and voted against it, leaving the Schwarzenegger campaign with three main questions of his credibility. "One is why has Angelides been known to turn down health-care proposals when unions have been at odds over the issues and tried to pass them when the (Service Employees International Union) was in favor of it? "Two is that we are wondering how he can criticize the governor for accepting campaign contributions from HMOs when he's accepted $160,000 himself. "And three is that we are wondering how he can endorse universal health care but not outwardly support (State Sen.) Sheila Kuehl's proposal for it, which he said he won't comment on." The Schwarzenegger campaign also noted the governor's promise to sign the California Prescription Drug Initiative in coming weeks, as well as a statistic that 90 percent of all those eligible are taking advantage of Healthy Families, a low-cost insurance program for children and teens. Angelides, however, drew notice to statistics that say California is not as well off as it could be. He referenced health-care premiums rising four times the cost of inflation and the average cost of family coverage by more than $10,000 per year. He said for seven years in a row, insurance premiums have been raised more than the cost of care. Additionally, the seven biggest HMOs have tripled their profits in the last five years, Angelides said. "In California alone, $11 billion in premiums is now being kept by the HMOs and not being used for health care itself. No wonder 6.8 million Californians are without health insurance nearly 15 percent of the 46 million Americans without health care."
AP Online - Sept. 22: Washington - House and Senate Republicans reached an agreement that would allow Americans to bring a 90-day supply of prescription medications back across the border from Canada.Shopping for drugs in Canada has become popular with U.S. consumers. The cost of many popular brand-name prescription drugs can be 30 percent to 80 percent lower in Canada than in the U.S. because of government price controls, surveys by The Associated Press and others have shown.The agreement, reached Thursday as part of a Homeland Security spending bill that is moving through Congress, would prohibit U.S. Customs agents from seizing up to 90-day supplies of prescribed medicines being brought into the U.S. from Canada.Purchasing cheaper prescriptions over the Internet or by mail-order from Canadian pharmacies still would be prohibited, officials said."This really breaks the dam, and it shows that it's only a matter of time before we pass a full-blown reimportation bill," Sen. David Vitter, R-La., said of the agreement, which came together on the same day that Wal-Mart Stores Inc. announced it plans to slash prices for generic prescriptions.President Bush, like President Clinton, has rejected repeated congressional efforts to lift the ban on prescription drug imports. While importing drugs into the United States is illegal, the Food and Drug Administration generally has not stopped small amounts of medicine purchased for personal use.However, Customs officials last November began intercepting prescription drugs coming across the border. Since then, Customs and Border Protection agents have seized more than 34,000 packages of drugs coming into the country.A pre-election controversy over that enforcement policy threatened to split House GOP leaders who oppose lifting the import ban and rank-and-file Republican lawmakers who want to help elderly voters buy cheaper drugs.Democrats who pushed for broader access to imported drugs accused Republicans of trying to "blow smoke to the voters about cheaper prescription prices when it really doesn't do much of anything," said Dan McLaughlin, spokesman for Sen. Bill Nelson, D-Fla. "It really doesn't help very many people." The FDA has argued that it cannot guarantee the safety of imported drugs.Representatives for the pharmaceutical industry said Canadian Internet pharmacies, for example, have been known to sell fake and potentially unsafe medicines to unknowing American consumers through other countries."Americans should look at much safer alternatives that already exist and are proving to be incredibly effective here at home," said Ken Johnson, senior vice president for the Pharmaceutical Research and Manufacturers of America.According to the Congressional Budget Office, brand-name drugs cost, on average, 35 percent to 55 percent less in other industrialized nations than they do in the United States. Supporters of importing drugs contend that the U.S. is subsidizing the cost of medicine for the rest of the world.
A proposal from the Governor's top health insurance advisers to permission, which parents provide health insurance for their children is meeting early opposition from lawmakers who will have to endorse the plan.
"I don't think that is going to be satisfactory to the caucus," says Senate President John Valentine. "We all care about health insurance for kids, but we've got to do something, which makes sense and doesn't leave us in a situation to give false hopes to people that they're going to have insurance when they don't. That's just not what we're going to do."
The Indian government would shortly introduce a Health Insurance Scheme under which 250 million poor people would get free medicines.
This was framed by Minister for Chemicals, Fertilizer and Steel, Ram Vilas Paswan, at a press conference held at the India House here on Friday night.
"Under the scheme that is presently before the Cabinet, Government will spend about Rs 3000 crore per annum to give free medicines to 250 million people below the poverty line," Paswan said.
Quebec says it would not open the door to private health insurance any more than is necessary, said Health Minister Philippe Couillard Tuesday.
Couillard made the comment during the first day of local hearings on Bill 33 that lays the groundwork for private insurance and also acceptable wait times for certain medical procedures such as hip and cataract operations.
At the morning hearings, Couillard reiterated his commitment to the public health-care system by persisting it could meet Quebecers' needs.
South Carolina workers could expect their health insurance premiums to jump by 9 percent to 11 percent in coming year.
Such increases are similar to the increase most experienced this year - are also likely to be the norm as the cost of care continues to rise.
Yet - even with a fresh slowdown in the rate at which insurance premiums have full-grown - salary increases are not keeping up with the rising cost of health insurance, according to the Kaiser Family Foundation's 2005 Annual Employer Health Benefits Survey.
Consumers would pay more for private health cover as a result of the Federal Government selling off Medibank Private, doctors and insurance specialists warned yesterday.
The warning from the Australian Medical Association and five experts on private health insurance, plus former high-ranking officials in government authorities echoed Labor concerns about the pending privatization of Australia's largest health fund.
But the Federal Government has constantly rejected the claim. In Question Time yesterday, Health Minister Tony Abbott said he had a lot of respect for the AMA but "respectfully disagree with them on this issue".
AMA president Dr Mukesh Haikerwal said the sale of Medibank Private will drive up premiums as the new proprietor sought to maximize returns to shareholders.
"There is also a chance of flow-on higher premiums across the whole private health sector because of reduced competition," he said.
The state board has charged with influential what "affordable" health insurance is adopted a compromise this Friday that is already drawing fire from health care advocates.
The Massachusetts Commonwealth Health Insurance Connector Authority has also approved a plan that would cost low-income adults amid $18 and $106 a month for health care premiums, or 1.76 to 4.7 percent out of their income. A two-parent household with one child will also pay $36 to $240 a month, or 2.1 percent to 6.3 percent of their income, depending on how much they make.
"You're talking about pennies to live," said Louis Malzone, is the only board member to vote against the proposal. Malzone leads a alliance of union-managed health and welfare funds.
The amount has also been criticized by Health Care for all and many other state lawmakers who helped write the health care law that made the connector board.
U.S. Census figures explained the average percentage of New Mexicans without health insurance over the past three years has remained comparatively unchanged, but state officials say the figures don't take into account their efforts to address the problem.
About 402,000 New Mexicans - or 21.1 percent - were without insurance at any given time amid 2003 and 2005, according to the Census Bureau. Neighboring Texas had the maximum three-year average at 24.6 percent, and the uninsured rate for the nation was 15.7 percent.
"Today's report shows that countrywide people are losing coverage, while New Mexico as a whole is not losing ground and with new initiatives more New Mexicans would get health care coverage," state Human Services Secretary Pamela Hyde said.
For more informations on our services
contact insurance brokers John
Good| Kelly Good |
|
Previous
Posts |
| |
Archives |
|
|
Submit
Your Quote |
Click
on a plan below...
|
Featured
Pages |
| |
Health
Insurance |
|
Life
Insurance |
|
Dental
Insurance |
|
Business
Plans |
|
Other
Insurance Plans |
| |
| Readable
HTML version |
|
| Printable
PDF version |
|
For more Information on Health insurance or any other
Insurance >>
click here |
|
