It was the best of times, it was the worst of times… The opening phrase from Dickens’ a Tale of Two Cities, seems to depict today’s health insurance market. Let’s switch it around a bit by saying that, in terms of health insurance, these could be considered the worst of times, to most individuals anyway, yet, for the small to middle group-insurance market these could possibly be the best of times in product innovation.
Let’s get the grim facts out of he way before I shower you with positive and tantalizing information which will help you to grow your business. In the aftermath of the Affordable Care Act insurance premiums have risen anywhere from thirty to thrityfive percent, personal deductibles are capping at $6500 per year, HMOs and POS (hybrid between an HMO and a PPO) are the fare of the times, PPO’s are becoming as extinct as your favorite dinosaur, your medication of choice is being switched for god-knows-what, and so-on and so-on and so-on… Yet, at the end of what seems to be a dreary tunnel, a glimmer of light shines upon the life of the group health policy.
For the small and middle sized company the possiblities, although not endless, certainly open themselves to options never before seen, or envisioned to exist. Would you believe me if I tell you that a company with as few as two employees could receive similar benefits as a large company? What if I tell you that a company with as few as twentyfive employees can look into the possibility of self-insuring.. would you believe me then? Maybe not; both of these possibilities were unheard of in the past, yet, today, these are as viable as any traditional group plans available in the marketplace; human ingenuity and the will to overcome, have, once again, triumphed over the implausible.
The balance between domestic and international has created a self insured progam wich is to become cutting edge in the industry. Offering the smallest companies the ability to operate as a large company, without the expense, has given the micro-entrepreneur an edge over their competition.
The best way to find out if your company is eligible for any of these cutting-edge programs is to contact your insurance agent and ask them to look at your existing program; or you can email us at email@example.com and we will gladly set up an appointment for a free, no-obligation, evaluation.
For the first time in US history most Americans are faced with the concept of open enrollment. Open enrollment used to be a phrase associated with group insurance when you worked for a medium to larger size company, or participated in a Medicare program. Today the phrase “open enrollment” pertains to everyone and anyone who is insurable in these United States. It is one of the provisions of the Affordable Care Act (Obamacare), also called by its acronym, ACA.
Now you ask, why did I title this blog the way that I did? The answer is very simple, most of the people that I come in contact with, including insurance agents, still do not understand what the Affordable Care Act is all about.
Most still believe that it has to do with going on your Federal Government or State website, called an Exchange, to apply for your health insurance because you can afford anything else. The exchanges available to individuals as well as medium sized businesses, is part of the Affordable Care Act, but not the crux of its existence. Actually, the crux of ACA has to do with offering every American affordable health care; it is how it’s done that was legislated. In the following blogs I would like to offer you, my client, and possible client, a clearer picture of what ACA is all about.
In the meantime, l would like to leave you with some “is” and “does-nots” of the program just to keep you interested and coming back to the next blog. Also, this is a blog, not a book.
The Affordable Care Act is…
1. A law that, supposedly, makes “affordable” insurance readily available to US citizens and legal residents.
2. A law that allows some Americans, and legal residents of the US, to obtain credits that will help them and their families pay for their monthly insurance premiums; if you apply through one of the available Exchanges. The State of Florida does not have its own exchange, so Floridians wanting to obtain their Health Insurance through an exchange in order to receive credits have to resort to the Federal government’s website. Healthcare.gov.
3. A law that requires that there be an open enrollment period, this year beginning November 15th, in order to obtain new coverage or change your present coverage. There are exceptions to the law which we will be covering in future blogs; loss of a job, change in marital status, moving to a different state, etc.
4. A law that will penalize any individual, who can afford to pay for their health insurance, but decides not to participate in any of the plans offered. This is done through IRS monitoring.
5. A law that requires guaranteed issued policies. Basically, Guaranteed Issue means that an insurance company which claims to follow the ACA guidelines cannot deny coverage to any indiviudal because of a preexisting condition.
The Affordable Care Act does not…
1. Obligate you to go to one of the Exchanges. You will only go to the Exchange if you feel that you are eligible for any credits, otherwise your insurance agent can quote you or you can go directly into any of the insurance company’s website to obtain your own quote.
2. Afford you the possibility of obtaining insurance if you are outside the Open Enrollment period. This year Open Enrollment begins November 15. There are some exceptions, of course.
3. Allow you to change from one insurance carrier to another until the open enrollment period.
4. Allow you to be without some sort of health policy that includes the 10 essential benefits. Details to follow.
5. Allow you to be covered if you are not a US citizen or have legal status in the US.
One more caveat; in many cases there is nothing Affordable about the Affordable Care Act. In many cases insurance rates have sky rocketed for many individuals and their families, as much as 60% to 70%.
Stay tuned, more great information on ACA to follow.
The new catch word, “liberal”. To me they are disciples of Marx and Engels in disguise.
Let’s talk about a most alarming subject, and one that most Americans do not want to touch upon. The trampling of the Constitution by limiting the right to worship and personal religious beliefs. The Affordable Care Act (Obamacare) does just that. Forcing Religious institutions to offer birth control options in their insurance programs is appalling, at best. Regardless of which side of the spectrum you may be on with this subject, the fact still remains that for most Christians birth control is at the core of their beliefs, one that does not step over anyones boundaries, because it is a matter of personal choice. If one beliefs birth control to be an important issue in their life, then you try other means as proposed by the Church. If you don’t believe birth control to be an important issue in your life, then you practice it. It is your God-given right to exercise your own judgement, then you deal with your deity, or not. But our constitution guarantees our right to those beliefs as long as no one is hurt in the process.
If our society would read, what some may call today archaic, books such as the Communist Manifesto, by Karl Marx and Friedrich Engels, one would be surprised to see the similarities with the Obama administration, hidden, of course, behind the cloak of Healthcare Reform, as well as other government sanctioned programs. Now, I am not, at this point, attacking the whole healthcare reform, that’s a subject for another time. I am just bringing to light how the Communist Manifesto sets out to bring forth the decay and destruction of any society by destroying the pillars on which each stand, Family and Religion; Judaism and Christianity being the two main focus. Both religions find their strengths in the value of the family. Psalm 127, verses 3 to 5, “3 Children are a heritage from the Lord, offspring a reward from him. 4 Like arrows in the hands of a warrior are children born in one’s youth. 5 Blessed is the man whose quiver is full of them. They will not be put to shame when they contend with their opponents in court”. Birth control, and specially abortion, could be perceived as the Biblical demise of the family as we know it today. Obamacare is doing just that!
For those who were unaware Karl Marx was a frustrated individual who happened to be a Jew and Judaism was at the center of financial power in Europe in the 1800s; second, Christianity, mainly Catholicism, was the most powerful religion of the times. Obama is also a frustrated individual who will obviously go to any lengths to destroy what our forefathers so generously bequeathed us.
Marx, in his Manifesto, sets out to destroy both, family and religion, by creating a false sense that in any society the Mother should be the Homeland and the Father is whomever is in power; thereby, taking away the person’s need for the family nucleus creating a false sense of security. The Obama administration is creating the same false sense of security as laid out by the Manifesto. We have not seen this administration do anything to create jobs, even something similar to FDR’s brigades during the 1930s, where minimal paying jobs were created to offset the effects of the Great Depression, where men and women could proudly sustain the every day needs of their particular family. Today, we see the government handing out anything and everything that they can in order to create grateful masses which in turn will create grateful voters. We se how this administration constantly advocates the mythical philosophy of taking from the rich and giving to the poor. They are over taxing the Middle American entrepreneur which, in turn, takes away the ability to create jobs, which, once again, creates a dependency, among the masses, on the existing government by offering welfare, food stamps, free healthcare and other freebies.
As far as religion is concerned, the manifesto calls it, “the opium of the masses”. By this statement, the document seeks to instill a fear and hatred for all that is God-related. Humans are naturally inclined to seek that perfect being, that deity which is set apart from humanity; yet the manifesto, as well as the Obama administration, seek to destroy humanity’s natural instinct to reach out to their God by chiseling at the core of their existence, which is humanity itself. This administration is trying to accomplish its goals by forcing the Church to its knees when the institution is forced to abdicate their most basic teachings; the sanctity of human life.
You see, both religion and family are intrinsically intertwined, bringing a moral dimension to our society which has withstood the winds of time; but only because men and women, just like you and I, have stood firm in our belief in family and God, and not allowing this or any administration to destroy the essence of our being.
We have the right to work in order to sustain our families, we have the right to worship as we wish; we have been called upon by our God to offer of our first fruits to those in need, we also have the right to choose who we offer those fruits to. Our rights to be family by birth and by religious conviction are being trampled upon, let us raise our voices and let us be heard.
Life has an uncanny way of swinging from one end of any spectrum to the other. These dramatic movements are usually prompted by men and women who have, at times, been affected by the negative effects of what I like to refer to as Life’s Pendulum.
Life’s Pendulum could take many forms; Political, Healthcare, Religious, Social, Personal, Family or Business. Although the same Pendulum, any one of its forms could transform one or many lives. The transformation could be positive as well as negative. It is usually the negative that propels the most radical changes; usually working against the very people that it was meant to help. One can say that the Pendulum’s extreme movements conforms to the law of cause and effect; many times not taking into consideration the devastation that it may leave in its path.
Any particular pendulum can incite passions that can blind even the most objective of human beings, more than likely, chopping off heads and taking no names. Yes, life’s pendulum is something to fear, yet, it’s one of those realities that we can actually control. We just need to identify the signs of the time and work diligently to stop its wrath.
As we head towards the new year, filled with hopes and expectations; as we look back to the immediate past, to make sure that we improve our future, we need to take a close look at the Pendulum or Pendulums that surround us. Whether its healthcare, politics, spiritual, personal, family, social awareness or business, our goals for the next year, and actually for the rest of our life, should be proactive and not reactive. We need to set that particular pendulum to the middle ground where we can focus on what is really important to us and to the world, rather than reacting to circumstances which could have been avoided, if we had only controlled the Pendulum in our Life.
Check out my next blog, The Healthcare Pendulum.
@2ndChanceCredit: Successful people don’t have unsuccessful friends. As the old saying goes “Show me your friends and I will tell U who you are.” #BeGreat
Ever since IMTJ began, there has been a discussion on whether or not EU rules on cross-border healthcare would have a major or minor effect on medical tourism.
When the cross-border healthcare directive was originally agreed, most of Europe seemed prosperous, but since then we have seen economic bailouts for Cyprus, Greece, Ireland, Portugal, Spain and others. We have seen political turmoil in several countries, with dramatic cuts to public healthcare spending in several. The European Union has expanded to 28 countries.
28 countries are full members — Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the UK.
Potential candidates for EU membership are Albania, Bosnia and Herzegovina, Iceland, Kosovo, Macedonia, Montenegro, Serbia and Turkey.
Over the last decade, the EU Court of Justice has issued rulings confirming the right for patients to be treated outside their home country and reimbursed under certain conditions, but the applicable rules were still not entirely clear.
Directive 2011/24/EU on patients’ rights in cross-border healthcare clarifies these rules.
•It creates a network of national contact points to provide clear, accurate information on cross-border healthcare.
•It helps EU countries share experiences on how to provide patients with the best possible care, for example using new health technologies.
Directive 2011/24/EU on patients’ rights in cross-border healthcare clarifies the rules on access to healthcare in another EU country, including reimbursement.
All the new rules and laws refer to planned treatment only; separate arrangements exist to deal with emergency and unplanned accidents and illnesses.
Under EU law, any EU resident can seek medical treatment in another EU country if:
•The specific treatment they need is not available in their home country, but is covered by statutory health insurance/ free national health system.
•Or the medical circumstances of their case mean they might not receive the treatment in time. Medical circumstances include degree of pain, the nature of any disability (which might for example make it impossible or extremely difficult to work), the probable course of the disease, and medical history.
•If people want their home health insurer to cover the cost of hospital treatment abroad, they must ask for prior authorisation.
•Once authorised to seek medical treatment in another EU country, they should be treated there on the same terms – and charged the same costs – as a person insured in that country.
EU countries have until 25 October 2013 to pass their own laws implementing the Directive.
Even countries supportive of the changes such as the UK, Netherlands and Germany have been very late in bringing in regulation, a supporting network and new rules for their citizens on when and how they can get planned healthcare in other countries.
Those strongly opposing the directive have delayed and dithered so much that several could take years to implement legislation. The country leading the opposition to the whole concept was Spain, and in recent months it has shown that it has little interest in complying, with flagrant disregard for existing regulations on unplanned and emergency healthcare for foreign nationals. Many reports have said that the European Commission is taking legal action against Spain, but these are not correct. At present all the European Commission can do is investigate problems; trying to prosecute a country that no longer has enough money to provide healthcare for its own people would be a long, tedious and probably pointless exercise.
The vast majority of countries seem to be in agreement with the principle of the new laws, but are not hurrying to do much about it. A few small countries that see great potential to send citizens overseas are changing their laws. One problem is that there is no central database recording where each member country is with legislation and setting up systems.
Meanwhile, the current and expected effect on medical tourism in Europe seems negligible.
Medical tourism news
21 October 2013
– See more at: http://www.imtj.com/news/?entryid82=429609#sthash.lzKvTQov.dpuf