Tuesday, November 16, 2010

Looking Beyond Group Insurance in Texas

In Texas, getting group coverage at work is perhaps the easiest and the cheapest way to access health insurance. But that does not mean that there are cheaper options available. Just going in blindly with a group plan in Texas is not a good idea. The resident should explore more choices before deciding on which plan to go for.

1. Group coverage is often ‘one-size-fits-all’ plans. They usually offer those medical facilities that a regular person would need. Hence if you are someone who needs regular medical attention, then group insurance is not an option for you. You should go in for a plan that takes care of your specific health needs.

2. If you are healthy person, with no smoking or alcohol habits, then your individual health insurance Texas would turn out to be much cheaper. Similarly, if you have a small family, the rates will get in the individual market will be less expensive than group coverage.

3. Group coverage often is restricted to the employee and not to his family. Going in for two separate plans – one for yourself and one for the rest of the family could turn out to be expensive. It might be better idea to drop out from group insurance and get coverage for the entire family.

4. If you have spouse who also has access to insurance at work, check out what works out to be the cheapest- separate group plans for the both of you, staying in each other’s coverage or dropping out and buying a family insurance instead.

Group coverage often is the cheapest options, but that is more of a generalization than a rule. Blindly going in for group insurance would be a foolish idea. It would be wise if the residents would explore more options and then decide on the plan they intend to purchase.

Tuesday, November 9, 2010

Texas Gov. supports Medicaid withdrawal campaign

In its health reforms, the federal government wants to expand Medicaid to include more families from the low-income bracket but the Texas government seems to have other plans. Republican lawmaker Warren Chisum, backed by Gov. Rick Perry, is proposing the state drop out of the Medicaid program and to avoid upcoming mandates to expand state Medicaid programs under the healthcare reform law.

Encouraged by the Heritage Foundation report that estimates Texas could save $60 billion from 2013-2019 by dropping acute-care coverage for Medicaid and the Children’s Health Insurance Program, Chisum said, “With Obamacare mandates coming down, we have a situation where we cannot reduce benefits or change eligibility. We need to get out of it. And with the budget shortfall we’re anticipating, we may have to act this year.” '

The Republican is campaigning to be the Speaker of the Texas house.

The HHS has however not yet ruled in favor of a Medicaid waiver yet that Gov. Perry had proposed several years ago. Reacting to that on CNN he said, “I haven't gotten an answer yet. Let the states be the laboratories of innovation and the good ideas will come out of that." The state HHS will release its own study before January on the effect of opting out of the government sponsored medical plans.

Texas Gov. supports Medicaid withdrawal campaign

In its health reforms, the federal government wants to expand Medicaid to include more families from the low-income bracket but the Texas government seems to have other plans. Republican lawmaker Warren Chisum, backed by Gov. Rick Perry, is proposing the state drop out of the Medicaid program and to avoid upcoming mandates to expand state Medicaid programs under the healthcare reform law.

Encouraged by the Heritage Foundation report that estimates Texas could save $60 billion from 2013-2019 by dropping acute-care coverage for Medicaid and the Children’s Health Insurance Program, Chisum said, “With Obamacare mandates coming down, we have a situation where we cannot reduce benefits or change eligibility. We need to get out of it. And with the budget shortfall we’re anticipating, we may have to act this year.” '

The Republican is campaigning to be the Speaker of the Texas house.

The HHS has however not yet ruled in favor of a Medicaid waiver yet that Gov. Perry had proposed several years ago. Reacting to that on CNN he said, “I haven't gotten an answer yet. Let the states be the laboratories of innovation and the good ideas will come out of that." The state HHS will release its own study before January on the effect of opting out of the government sponsored medical plans.

Sunday, October 31, 2010

Affordable health insurance in Texas

Below are some points that could help consumers to get affordable health insurance in Texas:

• Texans with group health insurance can’t be denied or limited in terms of coverage. Such consumers cannot be asked to pay more because of their health status. Further, such consumers can’t be offered exclusion of pre-existing conditions.

• Texans cannot be dropped from coverage when they get sick.
• Consumers with preexisting conditions can get help for Texas Health Insurance Pool coverage if they are not HIPAA eligible.

• Texas Medicaid program helps Texans having low or modest household income with free or subsidized health coverage. Pregnant women, families with children, elderly and disabled individuals can get free health coverage through this program.

• Medicaid offers medical care to women who are diagnosed with breast or cervical cancer.

• Uninsured children in Texas may qualify for the Texas Children’s Health Insurance Program (CHIP) to get subsidized health coverage.

• Qualified residents of Texas could get free cancer screening through the Texas Breast and Cervical Cancer Control Program. Women, who are diagnosed with breast or cervical cancer through this program, can get medical care through Medicaid.

• A federal income tax credit can help Texans, who lost their health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program. This credit is called the Health Coverage Tax Credit (HCTC).

• Consumers, aged 55-65 and receiving benefits from Pension Benefit Guarantee Corporation (PBGC), may qualify for the HCTC.

Wednesday, October 27, 2010

Tips to buy low cost health insurance in Texas

Buying low cost health insurance is not an easy task to achieve. However, with the implementation of healthcare reforms, consumers can think that it is not all impossible either. The idea is to make sure that the consumers are not overspending on insurance plans while they are getting the required level of coverage to give them security in an event of injury or illness.

Below are some of the tips that would be helpful for Texans to buy low cost health insurance plans.

• Consumers should try to buy health insurance plans at an early age. Remember that the premium costs of a health insurance plan increase with age. It is better to get health insurance at the time when consumers are healthy and in good fitness shape.

• As always, it is advisable to lead a healthy life-style free of alcohol consumption and smoking habits. Drugs and narcotics are no-no by all means.

• Consumers can reduce the premiums by increasing the deductibles. If there is not much need of regular check-ups or big medical care services, raising the deductibles is a good option.

• A few insurers in Texas would offer discounts if Texans agree to pay the premium in one installment for the whole year. This consumers needs to check with individual insurers whether they offer it or not.

Wednesday, October 20, 2010

Health reforms brings Texas insurance agents in a coalition

The Patient Protection and Affordable Healthcare Act has prompted has prompted the insurance agents in Texas to come together. 3 insurance producers groups, Texas Association of Health Underwriters (TAHU), Independent Insurance Agents of Texas (IIAT) and National Association of Insurance and Financial Advisors (NAIFA) have joined hands to form the Coalition of Health Insurance Agents.

The Coalition will monitor, respond to and communicate the implementation of the Act. It will also ensure that the freedom of the agents and consumers is maintained. Representatives from the coalition will also participate in the state insurance department hearings and proposals for implementing the federal health reforms.

Des Taylor, the CEO of NAIFA –Texas believes that the coalition will give more power to the members. “We want to be sure our members have a voice and this consolidated effort will ensure that we are heard,” said he.

Citing the need and importance of the coalition, Lee Manross of TAHU said, “The legislative and the regulatory changes as a result of the Act will be coming at us quickly. We need to be able to respond on behalf of all health agents to ensure the agents’ role in the system is preserved.

Friday, September 17, 2010

Getting health insurance the public-private way

The Texas department of Insurance has announced a new public-private partnership to entice small employers so that they offer health insurance at work. It is expected that those employers will buy insurance for the employees, and their dependents will be able to save up to a third of the premiums through this program.

The enrollment for the Healthy Texas Program, as the partnership between TDI and private health carriers is named, will begin from September. To enroll, interested employers will make application directly to participating health plans Celtic Insurance Company or United Healthcare, or apply through an insurance agent. Employers may also apply through 3-Share Programs that participate in Healthy Texas.

Only 32% of the small businesses in Texas offer health insurance to their workers at present. Healthy Texas program enables small businesses to purchase affordable benefit plans that are in compliance with the federal healthcare laws. They would also be eligible for tax credits as promised in the Affordability Act.

There are no subsidies on premium in this program. Instead it uses both private as well public funds to meet healthcare claims costs. Healthy Texas program will pay for 80% of an individual’s total claim of $5000-$75,000 in a calendar year.

The program builds on existing employer based health insurance model that will minimize additional administrative costs. The infrastructure will be compatible with an insurance exchange model.

Out of the present six million uninsured Texans, a majority of them are employed. This public-private health insurance partnership will hope to minimize that population.

Tuesday, September 7, 2010

Even with Medicaid, 700000 children without insurance in Texas

Texas has about 700,000 children who do not have insurance in spite of being eligible for Medicaid. The state along with California, accounts for nearly 30% of the nation’s total of 5 million children who have not been enrolled for the government aided coverage even though they are entitled for it. This report was brought out by the Urban Institute.

Medicaid is the joint state-federal health plan for the poor, disabled and elderly. CHIP provides low-cost coverage for children in families who earn too much to qualify for Medicaid but cannot afford private health insurance coverage.

The study has attributed the staggering numbers to two possible reasons:

- Slumping economy

- People are unaware that they and their kids are eligible for such government aided insurance coverage

Reacting to the reports, the Obama administration has said that it will use tools created in the 2009 CHIP reauthorization law to boost enrollment in Texas. This would include outreach and enrollment grants and bonus payments Texas when it adopts enrollment and retention strategies.

US Department of Health and Human Services Secretary, Kathleen Sebelius has asked the state and local officials to find and enroll these five millions kids who do not have any form of health insurance coverage.

“Nothing is more important to our future than the health of our children. No child should have to skip a doctor's appointment or go without the medicine they need because their family can't pay."

Tuesday, August 31, 2010

Texas’s Immediate Benefits From the Healthcare Reforms

Let’s have a quick peep into the healthcare reforms and what immediate benefits it bring to the Texans:

1. All 2.8 million of Medicare enrollees in Texas will get preventive services, like colorectal cancer screenings, mammograms, and an annual wellness visit without copayments, coinsurance, or deductibles.

2. Texas has $493 million federal dollars available starting July 1 to provide coverage for uninsured residents with pre-existing medical conditions. This project is entirely funded by the Federal government.

3. 293,000 small businesses in Texas may be eligible for the new small business tax credit.

4. Texas, for the first time, has the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status.

5. Beginning October 1, 2010, 318 Community Health Centers will help nearly double the number of patients seen by the centers over the next five years by increased funding.

Now, it is clear that there are loads of benefits coming from the implementation of this law, though it enforces on the consumers to buy health insurance or face penalties. The nature of reforms is bit intrusive, but it certainly has its own advantages and benefits.

Sunday, August 22, 2010

Texas to Review ‘unreasonable’ Premium Hikes

Texas, as of now, had the policy of non-interference in hikes in premium rates unless it increased by 50% or so. But with the federal health reforms coming into the place, all that is going to change.

According to the new reforms, insurers have to justify the unreasonable hike in the price of the premiums. It is a consumer protection method being implemented by the Texas Insurance Department after the new heath laws are enforced.

Though Texas always has the authority to ask insurers about hikes in premiums, it was rarely used. Texas, traditionally, has always stayed away from interfering with the work of the insurers.

Katrina Daniel, the senior associate commissioner of the life, health and licensing program at the Department of Insurance has said, “The department is working out a time line for conducting more rate reviews.” She also stressed that the review does not mean that the state will deny an increase, as long as the insurers are able to justify their decision.

The law requires that the states and federal secretary of the Department of Health and Human Services hold insurers more accountable for what they charge customers. Starting with health plans this year, insurers will have to submit to the states and HHS Secretary Kathleen Sebelius a justification for an "unreasonable" increase before imposing that rate. The information also would have to be posted on the company's website. The problem here however is that the federal government has not defined the term ‘unreasonable’.

Texas has already received a federal funding of a million dollars which it will use to collect data, develop a public disclosure process to include information from insurers justifying their premium increases and upgrade technology for data analysis.

Though the time frame and details have not been worked out, one thing that is for sure is that Texas will be reviewing premium rates from now.

Monday, August 16, 2010

Student Health Insurance in Texas

As a student in Texas, there are lots of options available for consumers to buy health insurance. Some of them are:

• Students can stay in their family health insurance policy as dependents till the age of 26 years. This age been recently fixed by the healthcare reforms.
• If along with studies, consumers are working, they can ask their employer to provide coverage.
• Sometimes, students may qualify for Medicaid, which is of course, a very cheap Student health insurance options. Students should check with the health insurance department of Texas for the same.
• Students may also apply for coverage through the Texas Health Insurance Pool.

However, the best option among these remains the first one—to remain or extend the coverage through parents’ health insurance policy. It is a great privilege now that students can stay as dependents till the age of 26 years, which of course, was 18-19 years earlier. Some companies are already offering this option, though the law requires it to be implemented in September, 2010.

Wednesday, August 11, 2010

Obama address about health reforms in Austin

Amid angered frenzy in various states about the Affordability Act, President Barrack Obama explained the benefits of the health reforms to the residents of Texas. Addressing a Democratic fundraiser in Austin, Obama spelled out what to reforms will exactly mean to Texans.

Stressing on the advantages he said that the Act will ensure that no American faces medical bankruptcy and that every child has access to preventive care services.

Elaborating further, the President said, “It is cutting taxes for small business owners that cover their employees, by up to 35 percent of the premiums they’re paying for their employees. It’s saying to young people, you can stay on your parent’s health insurance until you’re 26 so that there’s not that gap in coverage just as they’re starting their careers. It’s providing assistance to seniors, so that they can help to deal with that doughnut hole that was created by the prescription drug plan.”

Obama also assured that the reforms will prevent insurance companies from denying coverage to anybody. The President also went on to rebuke the Republicans accusing them of making this to be more of an election issue than thinking about the future generations. There was a special mention for House Republican Leader John Boehner whose ‘big job plan’ involved repelling the federal health reforms.

Texas incidentally has the highest percentage of uninsured individual adults in the country, a figure reported to be around 26.8 % by Gallup- HealthwaysWell-Being Index. Hispanics, who form about 40% of the Texan population, are among the most likely group of American adults who remain uninsured.

Wednesday, August 4, 2010

The importance of health insurance to Texans

Think of Texas and the picture that conjures up in the mind is that of a cowboy. And if you are Texan, then no one would know it better than you that the state is home to activities such as riding bikes and horses, rodeo pursuits and the likes of it. And neither would anyone know it better than you that these adventures are as risky to your health as they are exciting.

Not just accidents, but health problems are also a big by-product of the eventful life that the Texans live. Hence it is more important for them than anybody else, to have a health plan that covers all their medical needs.

Not just any health policy, residents of Texas need a plan that comprehensively covers all their local and personal needs. Local insurance providers are the best people to consult and choose from as they aware of the specific needs of the local residents.

An individual plan in Texas usually covers check ups, preventive care, and medication and accident bills. There may be slight variation here and there depending on the kind of the plan and the premium being paid for it. Residents will have access to additional benefits such as drug and alcohol rehabilitation if they are covered in a group insurance by the employer.

However, to cut down costs, most employers are staying away from providing coverage and this prompting Texans to opt for individual plans. What is pacifying is that in Texas private health plans cost almost the same as government policies. This is because in these health plans, people are offered the most important options and the additional benefits are excluded. However, if you can afford it, you can surely go for a health insurance plan that offers supplementary benefits as well.

Texas has one of the most effective and medically advanced health care system in the USA. Couple it with a comprehensive individual health plan that covers all anticipated health plan and Texans are all set to enjoy the adventurous life that the state is so well-known for.

Tuesday, July 20, 2010

Consumer’s protection through the Affordable Care Act

Let’s talk about some immediate protection that Texans would be able to enjoy through the Affordable Care Act. The benefits we would be talking are to go into effect on or after September 23, 2010.
• 11.8 million Texans would be able to enjoy no-lifetime limits. The Act prohibits the insurance companies to place a lifetime.
• If Texans get sick, the Act prohibits insurers to drop people when they get sick. Around 1.1 million Texans would be worry-free.
• There would be no distinction due to pre-existing condition for children in Texans.
• The process of dispute the denial of a medical claim is to be made easy. The Act endorses an appeal process for health insurance companies offering new plans.
• The Act prohibits insurers from requiring prior authorization before a woman sees an ob-gyn, and ensuring access to emergency care. There would be better access to patients for choosing the providers.
It is clear that there are huge benefits and protections created through the Affordable Care Act and the Texans are going to enjoy some relaxation in matters that used to trouble them earlier. The idea is to facilitate affordable health insurance to every citizen—let’s see how it materializes.

Thursday, July 8, 2010

What would happen with the Affordable Care Act?

The talk about healthcare reforms is up. What would be the changes? How the health insurance of an individual would be affected? Would there be specific changes in Texas? How the Affordable Care Act is beneficial?

Let’s start our discussion with some immediate benefits for Texas through this Affordable Care Act.

1. There would be tax credits for small businesses who offer affordable health insurance options to their employees. Through this, the Act seems to touch around 293,000 small businesses in Texas.

2. Medicare beneficiaries hitting Part D donut hole will receive extra help to defray the costs of prescription drugs.

3. Early retirees will be provided options for reinsurance.

4. The option for dependent children to stay in their parent’s health insurance policy will be extended to the age of 26 years.

5. Texas will receive $493 million federal dollars for provide coverage for uninsured residents with pre-existing medical condition.

6. Community Health Centers in Texas will be funded with more money.

7. Texas will have the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status.
It is clear that there are many benefits that Texans would enjoy through the Affordable Care Act.