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Posts Tagged ‘Health care news’

Given all the discussion and debate over the future of U.S. health care, is it time to recalculate how much money you will need to pay for medical insurance and related costs in retirement? Here are some numbers to consider. See whether they line up with your expectations.

In 2010, the present value of lifetime benefits from Medicare was about $376,000 for a 65-year-old married couple. Because Medicare covers about half of a beneficiary’s medical costs in retirement, on average, does this mean you’ll need $376,000 to pay for your share?¹

As large as this estimate might seem, there’s evidence to suggest that many people will need even more savings to cover medical expenses in retirement, especially people who don’t expect to retire for at least another decade.

How Certain Do You Want to Be?

The Employee Benefit Research Institute estimates that a man will need between $144,000 and $290,000 and a woman will need between $210,000 and $406,000 in savings to have a 50% chance of affording health care in retirement, assuming retirement at age 65 in 2019.²

These estimates are for the projected median savings needed to pay premiums for Medigap, Medicare Part B and Part D, and out-of-pocket prescription drug expenses. Since half of the population would be above the median, half could need more than these amounts. Some people may need to save even more if they live longer than the average life expectancy, have above-average prescription drug costs, or want greater certainty that they will be able to pay for health care.

The estimates tend to be higher for women because they have longer life expectancies. In fact, a woman who wants to be 90% certain that she will be able to afford her health-care expenses in retirement would need an estimated $370,000 in savings (again, assuming retirement in 2019 at age 65). If her prescription drug costs are above the median, she could need even more.³

You might be wondering whether the health reform legislation that became law in March 2010 will reduce the amount that tomorrow’s retirees will need to pay for health care. Because the law relies on $415 billion in cuts to Medicare, it’s entirely possible that the percentage of medical expenses covered by Medicare benefits could fall in the future.⁴

Of course, your situation is likely to be different. What do these estimates mean if you know that you are almost certain to retire at a different age and/or in a different year? In that case, these numbers might make a good starting point for calculating how much money you may need to accumulate.

1–3) Employee Benefit Research Institute, 2010
4) Tax Foundation, 2010

The information in this article is not intended as tax or legal advice, and it may not be relied on for the purpose of avoiding any federal tax penalties. You are encouraged to seek tax or legal advice from an independent professional advisor. The content is derived from sources believed to be accurate. Neither the information presented nor any opinion expressed constitutes a solicitation for the purchase or sale of any security. This material was written and prepared by Emerald. © 2010 Emerald.

Los Angeles (myFOXla.com) – Accidents happen… and if you have medical insurance, money should be the last thing on your mind when you’re in the emergency room.

Unfortunately, many insured patients find out there’s a gap in the system and that they’re still on the hook for thousands of dollars.

You can watch Phil Shuman’s report in the video below.

 

The Hospital Association of Southern California advises that you shouldn’t wait for an emergency.

• Check your health plan’s web site or handout book for the names of every doctor in the network… and what percentage of costs will be covered. 
•  Before an emergency happens, designate someone close to you as your advocate in an ER situation. 
• Also, Cosumer Watchdog’s Judy Dugan advises that you should keep meticulous records.
• Lastly, don’t be afraid to argue the doctor’s bill. If you put up a fight, many doctors will reduce charge.
   

If you have concerns regarding “Balance Billing” and/or charges for an “out of network” doctor, check out consumerwatchdog.org .

Source:  http://www.myfoxla.com/dpp/health/Medical_Billing_Controversy

Anthem plans across the country are working to develop innovative products and programs that help address rising health care costs. Through pay for performance initiatives, consumer directed health plans and transparency initiatives; Anthem is providing access to the information needed to drive down health care costs.

While many people may believe that insurer profits are the driving force behind increasing health insurance premiums, research reveals very different reasons for the high cost of health insurance.

A May 2009 report titled “What’s Really Driving the Increase in Health Care Premiums?” addresses the issue. The report, issued by the WellPoint Institute of Health Care Knowledge, compiles research from sources such as PricewaterhouseCoopers, the Robert Wood Johnson Foundation, the Kaiser Family Foundation, the Bureau of Labor Statistics and the Congressional Budget Office.

According to the report, the “key drivers” of spiraling U.S. health care costs are:

• Advances in medical technology and subsequent increases in utilization;
• Price inflation for medical services that exceeds inflation in other sectors of the economy;
• Cost-shifting from people who are uninsured and those receiving Medicare and Medicaid to the private sector;
• High cost of regulatory compliance; and
• Patient lifestyles, such as smoking, physical inactivity and obesity.

Citing PricewaterhouseCoopers research from 2008, the report found that only three cents of every health care premium dollar is spent on health insurer profit.

According to the Institute’s report, newer medical technologies tend to increase costs because they are generally more expensive than the older technologies they replace. While the availability of more advanced, superior technologies can yield better results for some patients, these technologies and diagnostic tests may be used inappropriately in some situations where existing, older technologies are more effective and accurate.

View a copy of the full report, “What’s Really Driving the Increase in Health Care Premiums?”

National Spotlight

Senate Finance Committee Releases Second Document on Policy Options for Health Reform

During April and May, the Senate Finance Committee has held various meetings and roundtable discussions with stakeholders on policy options for health reform legislation that the committee plans to unveil in June.  The committee has held three roundtable discussions with stakeholders and health care experts on the topics of delivery system reform, expanding coverage, and financing of health reform.  Following each of these roundtable discussions, the committee has released a detailed document outlining the options under consideration by the committee.  The most recent document was released on May 14, 2009 related to the policy options being considered by the committee to expand affordable coverage to all Americans.  The first document released at the end of April describes options to reform the health care delivery system and the third document to be released later in May will contain options for financing comprehensive health care reform. The options being considered by the committee to expand coverage to all Americans fall into the following eight categories:

· Insurance Market Reforms: The committee is considering various changes to the insurance market including guarantee issue, renewability and elimination of pre-existing condition exclusions for the individual market and a new micro group market consisting of employers with ten or fewer employees. Limitations on rating rules are under consideration for the individual and small group markets with a phase in of these federal rating rules in the states. Also under consideration are options for the functions, eligibility, and structure of a single health insurance exchange or multiple exchanges to help people find, compare, and enroll in health coverage.

· Making Coverage Affordable: The committee is considering options to establish a minimum set of benefits to be offered by insurers, designation of four benefit categories to be offered by insurers, and tax credits for low-income individuals and small employers.

· Public Health Insurance Option: Under consideration by the committee are five options for offering a public health insurance plan to compete with private insurers.  The five options include not offering a public option, offering an option like Medicare where the government sets provider payment rates based on Medicare rates and providers must participate, a level-playing field option where payment rates are set above Medicare rates and provider participation is voluntary, a third-party administrator (TPA) option administered by regional TPAs that would establish provider networks and negotiate payments with providers, and a state-run option.

· Role of Public Programs: Various options are under consideration for public health insurance programs. One option would expand Medicaid to parents and children under 150 percent of the federal poverty level.   Another option provides three alternatives for accessing coverage through Medicaid which include keeping Medicaid in its current structure, offering Medicaid through an exchange, and a third option where parents and children would access Medicaid under the current structure and other Medicaid eligible adults would get a subsidy to purchase coverage through an exchange. Other options under consideration by the committee include public program options for those age 55 to 64 and providing the Children’s Health Insurance Program through an exchange for children not eligible for Medicaid.

· Shared Responsibility: The committee is considering requirements for individuals to purchase coverage, whether employers should be required to offer coverage, and options for exemptions from the requirements and fines for noncompliance.

· Prevention and Wellness: Under consideration by the committee are options to increase coverage of preventive services in Medicare and Medicaid, state grants to provide preventive services for the uninsured, and tax incentives for workplace wellness programs.

· Long Term Care Services and Supports: The committee is considering options to increase access to home and community-based services in Medicaid including increasing federal matching funds and waiver flexibility, facilitate community living, and promote innovation.

· Options to Address Health Disparities: Options under consideration by the committee to address health disparities include the uniform collection of data on race, ethnicity, gender, and disability to assist in the measurement and research of health disparities, providing states the option to cover legal immigrant adults, and options to promote maternal and child health.

President Obama and Stakeholders Discuss How to Reduce Health Care Cost Growth

President Obama and Administration officials met with health care industry stakeholders on May 11, 2009 to discuss how to reduce the growth rate of health care costs.  Attendees at the meeting included representatives from America’s Health Insurance Plans, the American Hospital Association, the American Medical Association, the Advanced Medical Technology Association, the Pharmaceutical Research and Manufacturers of America, and the Service Employees International Union.  The stakeholder groups represented at the meeting presented the President with a letter indicating their commitment to decrease the annual health care spending growth rate by 1.5%, a savings of $2 trillion or more over ten years, by:

· Implementing proposals in all sectors of the health care system focusing on administrative simplification, standardization, and transparency that supports effective markets.

· Reducing over-use and under-use of health care by aligning quality and efficiency incentives among providers across the continuum of care so that physicians, hospitals, and other health care providers are encouraged and enabled to work together towards the highest standards of quality and efficiency.

· Encouraging coordinated care, both in the public and private sectors, and adherence to evidence-based best practices and therapies that reduce hospitalization, manage chronic disease more efficiently and effectively and implement proven clinical prevention strategies.

· Reducing the cost of doing business by addressing cost drivers in each sector and through common sense improvements in the care delivery models, health information technology, workforce development, and regulatory reforms.

President Obama indicated that these efforts would be compatible with his and Congress’ efforts to pass health care reform legislation this year and that legislation must decrease rising health care costs, allow Americans to retain the coverage and doctor choices they currently have if they so desire, and provide Americans access to quality and affordable health care.

House Democrat Coalitions Announce Principles for Health Reform

The “New Democrat Coalition” of approximately 60 moderate democrats and the “Blue Dog Coalition” of approximately 50 conservative democrats in the House of Representatives recently released principles for health reform.  On May 7, 2009, the New Democrat Coalition released health reform principles that focus on improving access, quality, and affordability in the health care system by: 1) fostering and harnessing innovation, 2) building on the strengths of the private market, and 3) realigning the health care system to better coordinate care, focus on prevention, and purchase value.  On May 12, 2009, the Blue Dog Coalition released their principles for controlling costs, increasing value, and improving access through: 1) realignment of payment incentives, cost and quality transparency, and public program integrity to control costs, 2) strengthened care coordination, financial wellness incentives, and investment in health research to increase value, and 3) coverage tax credits, rural payment modernization, increased loan assistance for providers in underserved areas, expanded telemedicine, the elimination of pre-existing condition exclusions, and improvements in long term care services to improve access.

State Spotlight

Iowa Enacts Health Reform Legislation

On May 19, 2009, Governor Culver signed health reform legislation that establishes a ”Health Care Coverage Commission” to study and develop methods to affordably insure all citizens through public programs, private insurance, and other mechanisms. The Commission is charged with:

· Recommending options for coordinating a “Children’s Health Care Network”  to cover children under the age of nineteen with a family income less than 300 percent of the federal poverty level through the modification of existing public programs that maximizes federal funding and to provide access to affordable private coverage for children not eligible for public programs.

· Evaluating ways to ensure a seamless transition between public programs and private health insurance coverage for children and adults.

· Developing options that would provide individuals and families with access to three separate affordable benefit plans (basic, intermediate, and comprehensive) that could be subsidized for those with lower incomes, with the goal of providing plans and subsidies that limit spending to 6.5% of family income.

· Studying options to pool employees of counties, cities, schools, community colleges, nonprofit employers, and small employers with the state employee health plan.

· Evaluating the ramifications of requiring employers with more than ten employees to offer a Section 125 cafeteria plan to their employees for the pretax purchase of health insurance coverage.

· Studying options for the development of an “Exchange” or “Connector” type structure to provide access to affordable health care coverage through an existing government agency or a newly created entity.

© 2009 UnitedHealth Group