Healthcare and health

We get a lot of calls here in the office about what people's options are when it comes to getting health insurance. A lot of people that go looking for insurance are starting to look because they have a health condition or event that finally makes them realize that it might be nice to have insurance rather then pay out of pocket for enormous health bills. Unfortunately insurance doesn't work that way. Insurance carriers bet on the fact that you won't get sick and use their money. You, on the other hand are betting the opposite. The insurance carrier then charges an amount of money in order to take on that risk and allow them to cover their losses if they lose their side of the bet. Well, what kind of bet maker would want to bet you aren't going to get sick if you already were sick?
The laws have been on the side of the insured, rewarding those who make the bet against the insurance before they get sick. By purchasing a plan that covers your medical expenses prior to a sickness, the insurance company has no choice but to keep paying out their losses as long as you pay to keep the policy in force. The only problem is the cost to wager the bet gets more expensive as you get older and the cost of care goes up as well. A lot of people have their insurance subsidized by their employer. This is great that employers care a lot about their employees, but a disaster when employees leave and are stuck paying the full bill through COBRA when they lost their income from before. You always have the option to buy a new individual plan, but remember that you are starting a new wager, so the insurance company is going to want to play a game where they think they can win, so if you are sick, you are going to have to stick with your COBRA or look into a program called HIPAA when that option goes away.
One good idea to avoid these possible dilemma would be to purchase your own insurance and ask your employer to give you  pay raise to help pay the costs instead of making them pay for a group plan. It may be the last insurance plan you get to buy, so make a good choice.
The new health care law has allowed for people to cancel their insurance and when an illness arises you can be accepted no matter what on a plan with a high deductible as long as you were not insured for 6 months. This seems great! No need to pay insurance and then get insured when the need arises. The danger in doing this is paying extremely high premiums for coverage and still be stuck with a high deductible. If you are healthy and young when you buy a policy it will stay lower and you can have better deductibles and when the going gets tough you will have access to the best doctors and care as opposed to living off the governments' dime.
This loophole will be cleared up in 2014 when the new tax comes into effect for those who chose not to elect coverage.

Lipitor

In an effort to cut cost Sierra health and Health plan of Nevada is no longer covering the brand name Lipitor. Only the generic drug called Atorvastatin. You can still get Lipitor,  your out of pocket cost would be the diffrence of the brand name drug and the generic,  plus the brand name co-pay.

Fuller Waiting Rooms

With more people insured waiting rooms are full but the doctors population is plumiting. More and more doctors cannot afford to be in practice anymore. Their expenses are not reducing however health carriers are  paying them less. How are they suppose to run their practice? I believe we are going to see less intrest of people going down this career path which is gonna cause a shortage of physicians and fuller waiting rooms.

Coventry Takevover!!!!

The recent merger with Aetna and Coventry One brings up the question of "Should one consider switching their Coventry policy to a different carrier now or wait for the merger to occur"? It's risky because Aetna's plans have their own policy, procedures, and regulations that they are going to have Coventry abide by. Additionally, most likely members with Coventry are going to receive a rate increase because Aetna's current individual rates are higher than Coventry's individual rates. We feel if a person is healthy it would be our recommendation to switch to a new carrier now and not wait to see what the new merger will bring in the future.

T n T

Dental Plans

I believe there is a misconception about dental insurance. It turns out to be like a forced savings account. You pay into dental premiums and all you get are preventive dental services. There are waiting periods for services such as fillings or root canals. I believe that it would make more sense to purchase one of the plans that have negotiated rates with dental providers where you can get dental services done immediately upon purchasing the dental product. The best part about these products is that they are generally half the cost of other dental plans. 

Trish & Tabitha

Aug 2012 Health Reform Law Preventive Care Services

In Nevada the new health reform law went into effect August 1, 2012 . The new benefits have been applied to fully insure self funded plans that are non-grandfathered plans. Below are all the benefits with this new reform law. 

Breast-feeding support, supplies and counseling  for each child's birth, contraception methods, sterilization procedures, domestic violence screening, HIV screening and counseling, sexually transmitted infections counseling, and Well-women visits. Also human papillomavirus testing, beginning at age 30, and for every three years thereafter.