Monday, February 29, 2016

Health Insurers Struggling With Large Losses

Coleen Elkins   visit us at 24-7 Health Insurance 

The Affordable Care is facing more threats than just political uncertainty. Health insurance exchanges and co-ops are facing large losses. Many have had to close for this reason.

UnitedHealthcare said last November they may not participate in the market for 2017. They are reporting a potential $475M loss on their exchange business this year. The CEO of Aetna wrote in an article stating he foresees major issues with the law moving forward.

Many Americans have found ways to use the 21 available exemptions to avoid enrollment altogether. Others have found ways to enroll from a hospital bed. The Montana Co-Op stated a critically ill woman signed up from the hospital last October just by simply changing zip codes. This left the Co-Op with a $250,000 bill.

Insurers blame the the liberal and lax laws for enrollment . The federal funds supporting start up insurers is winding down. At the same time premiums are rising along with the deductibles and out of pockets.

Read more here 

Friday, February 26, 2016

Special Election Period Enrollments Will Have New Rules

By Coleen Elkins   24-7 Health Insurance 

Health Insurance Carriers and a independent research firm have determined that people enrolling during a special enrollment period cost more in claims. The inference is that people are waiting until they are sick to enroll. Applicants then use a "move" or another allowable special election period to enroll in a health plan. They receive their treatment and then cancel the coverage leaving the carrier with large claims.

The Federal government announced on Wednesday they are implementing new rules to qualify those  applying for health insurance outside open enrollment. Some health insurance companies have already begun the process of checking drivers licenses electronically. This confirms the date of the new license coincides with a move. Insurers say this practice will help profitability.

The complete list of rules have yet to be published. When they are made available we will post them here.

Wednesday, February 24, 2016

Health Insurance Is Only Part Of Health In America

By Coleen Elkins   24-7 Health Insurance

A recent 3800-word article addresses health and life expectancy in America compared to other countries. 

The ACA "has taken important strides in narrowing the gap in health insurance coverage" those gains "so far have translated to limited advances in ensuring access to quality medical care and even less progress in making diverse groups equally healthy".  Katherine Baicker, the C. Boyden Gray Professor Health Economics at the Harvard Chan School that health insurance "affects health care" but there are other things that affect health" including social determinants, food, proper exercise and behavior. 

The article includes very interesting data with charts and graphs supporting the statements made. 

The entire article can be read here

Tuesday, February 23, 2016

Californians May Not Have To "Go It Alone"

By Coleen Elkins    24-7 Health Insurance

Most people don't know your health insurance agent represents you NOT the health insurance company. The first priority of the health insurance agent is to explain health insurance or Medicare to the consumer. The second priority is to share with you all of your available options helping you select a plan that meets your personal needs. Once your policy is in place it is your agent's job to take care of your customer service needs. The insurance carriers pay the agent a commission to provide you with that service.

Health insurance companies announced late 2015 they will not pay health insurance agents to assist consumers with their health plan options outside of open enrollment.

Health Insurance isn't any less confusing outside of open enrollment. In fact it may be more confusing. There are many reasons to need assistance with enrollment in a health plan throughout the year. Some of those are a move, marriage, birth of a child, loss of coverage from a job.

Insurance carriers are seeking ways to discourage high cost consumers from enrolling in their health plans. Their rational is that these consumers that sign up during a special enrollment period cost them more on average. They further suggest that people that enroll during a special enrollment period are abusing the process and waiting to enroll when they get sick.

Cover California is considering rules that will allow consumers to seek guidance from a licensed insurance professional throughout the year. Perhaps the Federal Exchange ( will also see the value of consumer assistance and personal services.

Friday, February 19, 2016

How Will Health and Human Services Recover $750 Million??

By Coleen Elkins    24-7 Health Insurance

In February a report was released by Senator Ron Johnson, who chairs the Senate Homeland Security and Governmental Affairs Committee. The report states that approximately 470,000 individuals who were awarded premium tax credits did not provide proof of citizenship, legal status or lawful presence. These are three conditions for receiving a refund from the IRS. If you aren't eligible to receive a refund nor are you eligible to receive a tax credit.

Tennessee Representative Diane Black has written a letter to Health and Human Services Secretary Sylvia Burwell. In the letter Representative Black asks Secretary Burwell how the government agency intents to get back the lost funds and prevent this from happening next year. She has given Ms. Burwell 30 days to respond.

Representative Black is a 40 year veteran of the healthcare industry. She is asking for an explanation of how the government can operate on a "pay and chase" system which is known to not work.

Thursday, February 18, 2016

Medicaid Expansion In The U.S. - Liens Filed On Beneficiaries Property

By Coleen Elkins     24-7 Health Insurance

When the Affordable Care Act became law one of the requirements for states implementing their own insurance exchange was to expand their state Medicaid program. Medicaid expansion was one the biggest deterrents for many states creating an exchange. The funding coming from the Federal government to expand Medicaid is temporary. This leaves the state on the hook for the cost of the expansion.

Minnesota is a state that chose to expand Medicaid and now some of the beneficiaries of the expansion are learning what the Medicaid benefits are going to cost them. MNsure has been placing liens on beneficiaries property since 2013. MNsure is saying it really isn't them placing the liens it is the Federal government Department of Human Services.

MNsure CEO Allison O'Toole said the MNsure is working with the Department of Human Services to make the lien notice more prominent.

More can be read here

Wednesday, February 17, 2016

Are You Waiting For Your 1095 Tax Form?

By Coleen Elkins     Visit us at    24-7 Health Insurance

The 1095 tax forms notifies the IRS you have had health insurance for 2015. Not having health insurance may result in paying a penalty to the IRS.

If you enrolled through the Federal Marketplace for a premium tax credit 1095 forms were not delayed. The deadline for the 1095 tax form to be mailed was January 31st. If you have not received your form you can call at 1-800-318-2596 to inquire. They can also provide you with the tax information you need to complete your taxes.

However if your 1095C or 1095 tax form is coming from an employer or a health insurance carrier the deadline has been extended until March 31st.

If you do not receive your form from either your health insurance carrier or your employer you can file your taxes without it. However if you make a mistake you will need to amend your return to correct it. If you feel you may qualify for one of the available two dozen Affordable Care Act exemptions you can obtain forms and information here. We highly recommended you seek the advice of a tax adviser prior to submitting an exemption form. The rules are very strict with regards to "affordability". Incorrect use of an exemption form can be very costly. 

Thursday, February 11, 2016

New Ways For Saving On Prescription Drugs

For years we have seen advertisements on television that help us find the cheapest hotel rooms and airfares. Finally someone has come up with some innovative ways for us to save on prescription drugs. 

For those on Medicare who find themselves in the "Coverage Gap" also known as the "donut hole" these two new websites are certainly going to help Medicare beneficiaries become more savvy on saving money during the year and especially if they do end up in the "Coverage Gap". 

If you are under age 65 and are on a high deductible Bronze Plan with no RX benefit until your deductible is met prescriptions can be very expensive and at times cost prohibitive. Now you will have a way to possibly make your medication affordable. 

 Good RX allows people to put in the name of their medication and find the cheapest place to purchase it.   Test it on Spiriva and look at the comparisons it is amazing. 

Blink Health allows you to order your medication for the cheapest price and pick it up at the pharmacy providing the lowest price. 

Coleen Elkins
Peace Of Mind For Your Health Since 1995