Sunday, July 8, 2018

Is Your Pharmacist Banned From Helping You Save Money?

By Coleen Elkins, Managing General Agent

RV Insurance Benefits
24-7 Health Insurance 

Lawmakers on both sides of the isle are working to find ways to stop a practice which can keep customers from saving money at the pharmacy counter. "Gag clauses" buried in the fine print of pharmacy contracts, and imposed by pharmacy benefit managers prevent many pharmacists from telling consumers when the cash price for a medicine may be less expensive than their insurance co-pay unless the customer asks directly

Ending "gag clauses" is one option Republicans and Democrats are attempting to lower the skyrocketing cost of prescription drugs. President Trump singled out the clauses when he said he wanted to ban them in a May speech on drug prices. 

In the meantime as we wait for a government solution be a savvy consumer and ask at the pharmacy counter "Is this medication less expensive if I don't use my insurance". 

Friday, June 29, 2018

Back To The Future - Consumer Driven Health Plans

By: Coleen Elkins, Managing General Agent

24-7 Health Insurance 

RV Insurance Benefits

As we prepare for the Affordable Care Act tax penalty to be reduced to zero on January 1, 2019 we can anticipate changes once again as to how we insure our health.

I have a question for you to consider. Would you ever walk into a big box electronics store and give the clerk your Visa card and ask them to pick out a big screen TV for you?  I hope not! You compare brands, you look at brand ratings, you watch for the best sale price right?

Why then do we walk into our doctors office and blindly hand them our insurance card which provides us zero financial assistance until WE have spent over $5,000 on our deductible? Ponder this for a moment, if your health insurance premium is $900.00 a month you have spent $10,800 in a year for the privilege of carrying that health insurance card. If you utilized your insurance card and finally meet your $5k deductible and your $7,350.00 out of pocket maximum you now have spent $18,150.00 on your health that year.

Why are not savvy consumers when it comes to our health? Have we somehow we have been conditioned not to ask?

Twenty five years ago when we opened our first health insurance agency consumers were more proactive. Then along came health insurance copays provided by our friendly health insurance company, and for a very low monthly premium we now had unlimited office visits for a very low copay. The consumer lost the drive to be price conscious. Each year health insurance premium rose for over a decade.

In 2004 our government decided we needed to once again be proactive so they introduced Health Savings Account plans aka HSA's. We had a high deductible health plan, a low premium and a tax benefit. People once again began to become aware of cost and were saving money in a special savings account in the event they had to use their health plan.

Then in 2010 our Federal Government decided to get involved again and help consumers reduce the cost of their healthcare with the Affordable Care Act. They reduced the tax benefits of the HSA plans and in some cases they were not longer available to enroll in. Since 2010 insurance premium increased and networks narrowed from PPO plans to HMO plans to regional HMO plans causing many Americans to give up the doctor they had for years.

What will 2019 bring? Are the insurance companies standing by with solutions?

Actually a select few are and our agency already has solutions available in some areas of the country.

Consumer driven health plans are coming back. Referenced based pricing is on the rise to drive cost down and create competition.

We certainly are ready to help our clients find plans that fit their budget, give them their doctors back and provide options for cost savings by choosing where to receive care.

The state of Texas is a head of the curve. The Texas Department of Insurance recently created a website to the public called After entering their zip code a consumer can learn the cost of inpatient procedures, outpatient procedures, office visits, ER visits and more.

Here is an example of what you will learn when searching for cost of an office visit.

As a consumer driven health insurance agency we hope that the department of insurance in all states will introduce tools to drive down cost and raise consumer awareness.

Our focus is to be the advocate and a solution for our current clients we have had the privilege of serving for over 24 years, and to our new clients that seek our services which by the way are provided at no cost to you.

We look forward to being of service!

Thursday, January 25, 2018

A Peek Into 2018 Under Age 65 Health Insurance And Beyond

Alex Azar, Secretary Health and Human Services 
By Coleen Elkins

The Senate has approved the appointment of the new Secretary of Health and Human Services Secretary Alex Azar.

This morning we are seeing reports of more executive orders planned for 2018 to provide additional exemptions for those seeking relief from the mandate to purchase health insurance. 

The individual mandate was repealed in the new tax law recently passed, but requirements to purchase coverage doesn’t end until 2019. 

The new hardship or exemption list has yet to be revealed and we will post it if/when it becomes available. 

States are already beginning to look forward to new health insurance offerings. Concerned about soaring health care costs, Idaho on Wednesday revealed a plan that will allow insurance companies to sell affordable policies that ditch key provisions of the Affordable Care Act. Idaho is believed to the the first state to take formal steps without prior federal approval for creating policies that do not comply with the Obama-era health care law. 

Idaho Department of Insurance Director Dean Cameron said the move is necessary to make cheaper plans available to people. Cameron went on to say “There are other states that have been talking about it, but we may me out in front. They may look to follow us should we be successful”. 

The Idaho plan will make it possible for insurance companies to offer cheaper plans that might be more attractive to people who have to buy their own insurance and do not have the benefit from the federal premium subsides offered under the Affordable Care Act. 

Under Idaho’s guidelines, insurers can offer plans that deny coverage for pre-existing conditions for up to 12 months unless the customer had continuous prior coverage. Insurers would no longer be required to cover pediatric dental or vision care, and though they would have to offer at least one plan with maternity and newborn coverage, other plans could exclude those benefits.

Insurance carriers can also charge people more based on where they live, their health history and their age, under the new Idaho rules. Insurers can cap their own costs at $1 million a year per individual, and can charge customers separate out-of-pocket maximums for different services. In other words, a customer could have a $7,000 out-of-pocket annual maximum for prescription drugs, another for doctor visits and another for hospitalization or mental health care.
Insurers offering such plans in Idaho still would have to offer policies that comply with the federal health care law for those who want them, Cameron said.

There is speculation whether Idaho can legally move forward. The state expects objections from Obamacare Advocates. 

“I’m not even afraid if it needs to be litigated, though that’s not my preferred course,” Cameron said. “The real question is, when does the federal agency act — if they act at all.”