Affordable Care Act

http://www.exchangenevada.com/blog

Sal Morales, went from paying $560 month in Cobra insurance to about $145 a month through the Affordable Care Act. He also has a network deductible of $500. Here’s how he breaks it down: “There’s one party, the hospital who provides the service. There’s a second party, the patient, who receives the service. And there’s a third party, the insurance, who pays for the service.” What happened with Mr. Morale’s case is that the insurer negotiates a lessor amount for various plans, with a variety of hospitals through multiple agreements for the same hospitals or doctors.

Doctors are paid differently even if two patients have the same insurance company, if the plans are different in any way. To make this simple there are as many price tags for a hypertension checkup as there are insurers and providers.

The question that should be asked is how much is your doctor getting paid, to determine the best deals for coverage. If you have the history of medical procedures from lasts years doctors treatment the insurance company can provide a better assessment as opposed to shopping around to be told the price is more to cover you for the same procedures as last year.

“We’re identifying the procedure, we’re identifying the provider, the date of service and then making sure the amount, the member responsibility has to be in there,” Monzon says.

To get a clearer sense of what health care costs, someone would have to collect enough of those statements from patients at all different hospitals with all different insurance.

There are companies and crowdsourcing projects trying to do just that around the country. And Massachusetts has a law that says insurers have to disclose some of these prices in a way that is accessible to patients.

This story is part of a partnership that includes WLRN, the Miami Herald, NPR and Kaiser Health News.

Nevada Health Link Re-Enroll Email

Yesterday afternoon, Nevada Health Link sent out an email to all users stating that they MUST re-enroll in health insurance for next year or they will lose their subsidies. http://info.nevadahealthlink.com/re-enroll/ It will be a big deal if on January 1 you wake up and see that your current insurance company is sending you a bill for the full amount of the insurance that was being subsidized by the federal government before.
We have already started calling our current clients and informing people of this change and have begun the process to re enroll everyone for 2015. We want this to happen smoothly for each one of our clients and not make them go through the headache on their own. We were successful last year at getting people coverage through Nevada Health Link and we will do it again. It can be a nightmare trying to correct someone else's mistake on the websites. It is extremely important to make sure the information is accurate and that you understand why the questions they are asking are being asked. The first application I did last year was a dummy one I did for myself and I honestly was a little confused and annoyed. I have now done hundreds of these and I have a lot more knowledge and experience to get these done correctly.

We are putting on 2 events in October in Las Vegas to help people understand the changes and make life better for those who attend. Mark your calendar for October 18 and 25th at the YMCA off N Durango at 10am. I think it is a such a blessing to be able to have us work for you and get these done so you don't have to stress. The second best part is having a second person to be on your side in case things don't go 100% smoothly either. I have seen some of the worst technological issues with the website get fixed because we intervened and worked on the case. I know for a fact if those clients were on their own, they would be in the same boat today with no repercussion.

What is your reason?

Recently, a client of ours took out life insurance.  She just turned 50 and had nothing in place.  A huge reason why they made this decision now is because two close friends of theirs just passed.  I can't imagine how they must have felt having not one but two deaths to process.  This client has a family and is the main source of income for them.  I had mentioned it to them last year.  It was something they wanted to do but hadn't gotten around to it.  After losing friends so close to them they had no other choice but to secure the future of their family.  Nobody likes to talk about, "what if I die?" However, this is a question we need to take the time to ask ourselves.  Please talk it over with your family.   

2015 Nevada Health Insurance update

The department of Insurance has released the proposed rates for next year for individuals and small groups. I have put them together into our easy to use spreadsheets and are looking forward to being able to quote new policies soon. There seems to be some interesting trends. Anthem has decided to decrease their rates and offer totally new products, including an actual PPO product this next year. Sierra Health is staying with their product line up with relatively low increases and they are even introducing some lower cost alternative plan options. Assurant health, who last year was a big player has decided to join Humana at higher than market rates with increases as high as 30%+. Golden Rule is also putting their hat into the ring again this next year with rates equivalent to Assurant and Humana. Aetna has decided to stop offering Coventry plans, but they have kept the same kind of rates amongst the new Aetna plans that were similar to Coventry offerings with very strong low rates in the Bronze and Silver levels. Humana has also decided to increase their product offerings to expand into Platinum and Gold, but rates are still slightly higher than the lower priced Anthem, Sierra Health, and Nevada Health Coop Products. The Nevada Health Coop has introduced a whole lot of new offerings. They have expanded their Southern Simple and neighborhood plans to include platinum coverage and are introducing a whole new set of plans. Their rates are still amongst the least expensive.
Some big news for people who shop for coverage with subsidies is Assurant is going to be offering the first true PPOs on our exchange. This is good news to people who want more freedom and more choices f doctors. We are still yet to hear what provider network these plans will be using, but I wouldn't be surprised if it was the Aetna Signature Administrators network they used mostly last year.
As we get more updates about how our new federally facilitated marketplace will work, I hope to port more about those changes and hopefully we will be seeing some fixes to some of the biggest headaches we have been dealing with.

Going on vacation this summer?

Going on vacation this summer? Does your insurance have a network in the area you are traveling to? 

As many people travel during the summer it is important to check with your insurance carrier or broker to be sure you will be covered in that area.

Couple things to remember:

- HMO: Most will cover emergencies only when you leave the service area or state. Any other medical bill you may incur that’s not an emergency will be your responsibility and you will pay out-of-pocket. If an emergency arises, make sure and notify your HMO provider immediately. If this does not happen, the HMO may decline payment.

- PPO:  If you the provider is not contracted with the insurance, no matter what the circumstance, all costs will go towards your out-of-network deductible. You would need to pay cash and/or bill the insurance carrier directly as that provider does not have a contract with your insurance carrier. Make sure to keep detailed receipts so you can bill the insurance correctly.

This is why it is important to plan ahead. There are options if your insurance carrier does not cover the area you are traveling to. You can always look into travel insurance and Nevada Benefits can definitely help you with that. Below is a link found on our website regarding travel insurance.

https://www.sevencorners.com/insurance/HW8CCKK

Be safe, be prepared, and have a wonderful summer!

Las Vegas Metro Chamber trying to delay ObamaCare

http://eepurl.com/W_wJL

This sounds all great and wonderful on the outside. I too would like to keep my premiums as low as possible for as long as I can. Bill Wright is a great guy and I see where he is coming from. The problem is, the Chamber Health Plan is no longer going to be paying them commissions when things change, unless the chamber can get more people on their new program.

We cannot keep delaying the inevitable. If we keep trying to enact new legislation that allows people to keep their current health plans, then those few select people will never fully understand or appreciate the new healthcare law. It will also cause more troubles later on for those people. The main trouble being they will continue to elect officials who have no clue of what to do about the law and never get things fixed in a timely manner. We will see people trying to apply fixes that don't need to happen because someone only saw the law from an outsider point-of-view.

One example of this would be how many Nevadans went onto NevadaHealthlink.com to sign up for insurance in Oct-Dec for insurance to start in January but failed to select plans and make payment and expected those accounts to work for April and May start dates. Yes, I know the technology should have allowed it, but people kept complaining and instead of starting fresh, got frustrated and made the Nevada Health Link apply fixes to these old accounts that crashed every other new account and payment for April through June! If only people got smart and realized the issue, things would have gone smoothly. If people were not given so many extensions, we would have seen real progress.

By nature we are procrastinators. We cannot put off what we need to do today. The sooner we face our challenges the sooner we can overcome them. Accept challenges and move on.

Nevada's exchange confusion to get worse

http://www.reviewjournal.com/business/confusion-likely-nevada-health-exchange-switches




The thought of this whole exchange stuff getting changed over just scares me. After the long 9 month wrestle I had with our current system, now I get to do it all over again next year. Not only that, but now I have to rely upon them transferring all of my client's data over from the current system to the federal system.
As a Nevada resident, I feel a little ripped off on this. We spent $15 million building a website that we have now decided to just scrap. Instead of just hiring a new company to fix the broken site, which actually works sometimes, we would rather call it quits. Now in less than 5 months we have to rely upon someone else trying to build a new one completely.
This could all become a great blessing for brokers though. It is important for people to find professional, knowledgeable people to work with. People tend to find this value more appealing when they themselves feel overwhelmed. This whole process has shown that shopping for health insurance isn't really something people do on their own. The new law isn't very easy to understand and how it can affect people has yet to be seen. I am actually a little concerned about people who did everything on their own. They might get a real awakening during tax season.