Further Problems Facing MediCal

As reported in an article from Los Angeles Times by Maura Dolan and Chris Megerian on December 13, 2012 MediCal could be in for more problems.  A three judge panel ruled that the law passed in 2011 which cuts payments to doctors and pharmacies by 10% can be implemented.  There are already a shortage of doctors that accept MediCal and this 10% cut is expected to have detrimental effects on an already fragile system.  Take into consideration that in one year California is expected to add an additional 25% to the number of people on MediCal under the new health care exchange.  To read the full article click on this link http://articles.latimes.com/2012/dec/13/local/la-me-medi-cal-20121214 .
Time will tell what the system will look like in a year or two, but for those that can avoid MediCal by any means should do so.

Mental Health and Health Care

In light of the recent shootings in Connecticut it is a good time to remind people that last year in California the legislation expanded the minimum requirements for mental health services covered under health insurance plans.  People that may have sought help previously may not know that they have expanded coverage.  If you know someone that might need help please share this information with them.  If they are unsure of their coverage simply have them check with their insurance company.  All insurance plans have a phone number listed on the medical ID card that they can call and at least be directed to the proper number to get more information on their specific coverage.

If you need help with this you are welcome to call us at 714-680-5900 or email us at info@ansainsuranceservices.com .  

Good News from Anthem on Preventative Colonoscopies

In Athem's newsletter to brokers they reiterated that colonoscopys done as preventative would be considered preventative even if polyps are found and removed.  This has been a big bone of contention for our clients (with all the carriers). People that were planning on the colonoscopy being covered as preventative and thus having a low or no co-pay for the procedure were often shocked and horrified at the bill that would follow after the procedure.  We hope the other carriers follow in this practice.  Colonoscopies and the removal of polyps can run several thousand dollars.  People that have large deductibles and high out of pocket maximums feel duped when they, unaware of what is taking place while they are under sedation and on the table, get sacked with a huge bill. 

It is very important to talk to your doctor, the billing staff and your carrier to coordinate what will happen when you need a procedure of any kind.  Somethings are not foreseeable, but some situations (like polyp removals during colonoscopys) are.  Do not be afraid to ask your provider how much the procedure will cost and what are some typical situations that may affect those costs.  If we all become better consumers of our health care, we can help drive down costs for everyone.

The Reality of ACA

The link below is to an article published about just one new fee that is set begin in 2014 on individuals with health care.  There are two ways to look at this.  First, why are the people that currently pay into the system getting penalized again by being forced to pay more so other people can participate in the system? The second way to look at it is that to make the system work we all must pay more and hope that it equalizes over time for every one's benefit.  Check the link and make up your own mind.

http://news.yahoo.com/surprise-insurance-fee-health-overhaul-law-185726448.html;_ylt=AgB.16n26aK1Qu4Y71gdsQiZCMZ_;_ylu=X3oDMTJiNXE4ajZtBG1pdANORlUgQnVja2V0IEFydGljbGUgR3Jhdml0eSBORlUgd2l0aG91dCBNb3JlIExpbmsEcG9zAzEEc2VjA25ld3NfZm9yX3lvdQ--;_ylg=X3oDMTNrazhjbWRkBGludGwDdXMEbGFuZwNlbi11cwRwc3RhaWQDZWRiMjhhNTUtMmU1YS0zMDg2LWI0MjctZjE0MDI4Y2ZiYTJiBHBzdGNhdANibG9nc3x0aGVsb29rb3V0BHB0A3N0b3J5cGFnZQR0ZXN0A040VV9HcmF2aXR5;_ylv=3?grcc2=5624594bbdca558306b03a13caaf712a%7E1355167262460%7E494d6e560c95708877ba0eff211c02f3%7E%7E1355167262459%7E597%7E0%7E0%7E0%7E0%7E0%7E0%7E0%7E2%7E35%7E10%7E79%7E-1%7E5014613925465207230%7E%7E%7E

However you feel about the health care law, it is our reality and thus we must learn to work within it and make the best of it.  If you have any questions about the law and how it will affect you, please call us at 714-680-5900.

Dental Coverage Under the PPACA

The PPACA has mandated that plans offered on the exchange, or small group and individual plans all include in them benefits for children's dental services.  There has been much data collected over the years that children that receive regular dental care are healthier than those that do not.  With that said it will be interesting to see how this is played out in the actual world.  Currently, children on Medical have dental coverage.  But there is a continuous cry about accessing that care.  If we add more children to this group, but dentists still resist taking these plans, will the children get more care than they are now?  Or will their coverage merely be on paper and parents that can already afford to take their children to the dentist will continue and those that can not afford it will still not have access to the dentists they need?  We will wait and see.

Dental care is important.  If you would like to find out more about dental insurance and how it works, please contact Angela Gambino or Lisa Boyajain at info@ansainsuranceservices.com or you may call us at (714)680-5900. 

Health and Life Insurance Today: Did You Know that the ACA Created Over 40 Changes...

Health and Life Insurance Today: Did You Know that the ACA Created Over 40 Changes...: Did you know that according to an article in Politico on November 20, 2012 that the Affordable Care Act makes more than 40 changes to the ta...

Did You Know that the ACA Created Over 40 Changes to the Tax Codes?

Did you know that according to an article in Politico on November 20, 2012 that the Affordable Care Act makes more than 40 changes to the tax code?  The IRS has a huge undertaking to make sure this law is implemented and can fund the necessary features to make the law work.  The IRS needs to make sure people and companies get the premium tax credits they deserve (if they qualify).  They need to collect penalties from individuals and businesses that do not purchase insurance.  They will also be the verifiers of income for the subsidies that will be given out through the exchanges.  Because the information will be based on two year old tax returns this could pose many problems at the end of the first year.  In addition to all that, the IRS will need to track individuals personal situations to see if there are changes to qualifying for the subsidies through the exchange.  Some of these situations would be a divorce, the birth of a baby, job loss or if an individual moves to a different state. 

As you can see it is a complex issue with complex rules and results.  If you have any questions about the law and how it may affect you or your business, please call us at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .