Who really pays for health care

Via @nprnews: Who Really Pays For Health Care Might Surprise You  http://n.pr/1rEYxu0

I got this article in my daily news feeds and thought I would share my thoughts on this. I met with a local union organization yesterday about some political endorsing and they asked me why healthcare costs keep going up. I think I said it well, but not sure if they got it. The key is transparency. The article clearly shows that there are many hands paying the bills. We think it's us through insurance premiums and deductibles, but in reality someone else is subsidizing it.
This year has been a big eye opener for a lot of people who saw larger increases in insurance premiums. For a lot, these costs have never been budgeted for before and making that premium payment is a huge burden on their finances. I would bet that if more people had to allocate larger portions of their income to pay for healthcare they would figure out very quickly how to decrease that so they can enjoy the better things in life. When we get subsidized, we have a false sense of what costs are really there and we consume disproportionately. The reason money exists is because the world truly has limited resources and money keeps those resources in check so we don't over consume. We love consuming and could easily overdue it.
There is a concept in economics called the 'Tragedy of the commons" which relates perfectly to anything we have. Imagine wanting to get to work at 8:00am on a Monday morning on the freeway. There is plenty of road space available for one car to drive down and easily drive 65 MPH. The problem is there is also thousands of people wanting to get to their destinations at the exact same time. Thus we get traffic jams and only get to move at a snails pace. We have this limited resource- freeway room, and we have many people trying to use it. If this was a business, someone would realize there is an opportunity to open up a new freeway and take some of that excess capacity, but because roads are publicly funded and heavily subsidized, that additional road might not happen for many years and people just have to adjust. Some drivers might take different routes and find more efficient routes, but others will still keep driving the crowded freeway. It gets even worse when that traffic is sporadic, because you don't take that route very often or get on the freeway at that time normally.
Imagine if you knew every morning what the traffic would be like? If you knew the cost of going to work would be before you got on? Your chances of taking that alternate route might increase, especially if it's a time or place you don't normally travel. Health care is similar to that road most people don't normally deal with. When they do get on the road, they find it super costly and have no clue where to go and get stuck in traffic. If only they knew what was coming before they got on, the decisions leading up to there would have been changed drastically. Since they were paying for the road ahead of time through insurance premiums (or so we hope) they might treat the road with a little more respect and understand what kind of blood and sweat went into it as well. Since they truly had no clue, they really don't care and expect it to pay for them 100% along the way.
Transparency and open reporting of costs, placing financial responsibility on individuals, and shedding light on our financial lives will make things much better for all of us.

Health Insurance Options

Open Enrollment on Nevada Health Link is now over.  What is next? How can I get covered now?  Well, we have options for you to get you insured until the Exchange opens up again.  First, you could still get a major medical plan through us with the insurance carrier Nevada Health Co-Op.  The Nevada Health Co-Op is still issuing effective dates at the first of the following month after you enroll for coverage. 

Second, you could sign up on a short term medical insurance plan.  A short term medical insurance is not a major medical plan but can give you some coverage with plans covering up to 2 million dollars.  I may recommend a plan like this for a few months if a client wants to get insured with a carrier that has a waiting period such as, Health Plan of Nevada, Assurant, Anthem, Coventry One, and Sierra Health and Life.

What are the benefits of short term medical plans?  Most plans will give you an effective date the next day and a lot of the premiums are lower than a major medical plan.  Please call us to find out more information. We can help ease the stress of shopping for health care coverage.

Deductibles

What are Health Insurance Deductibles?

Just like car insurance, health insurance also has deductibles. When you purchase health insurance part of your preferences that you choose will be the amount of deductible you will have on your plan.

Deductibles defined:

The amount you owe for health care services your health insurance or plan covers before your health insurance or plan begins to pay. For example, if your deductible is $1,000, your plan won’t pay anything until you’ve met your $1,000 deductible for covered health care services subject to the deductible. The deductible may not apply to all services.

Source: "Glossary." HealthCare.gov. N.p., n.d. Web. 19 Mar. 2014.

Open Enrollment is over- so now what?

Boy are we glad march 31st has come and gone. For those of you who did not get a chance to purchase health insurance- don't fear! If you started an application in any way on the Nevada health Link website, you have a special enrollment for the next 60 days and will be able to complete a brand new application and finish! I highly recommend calling us and getting help so we can do it right though.
For those who didn't start an application, would rather not deal with the exchange (we don't blame you), you can still enroll in health insurance with us outside the exchange. If you have a qualifying event (I will explain later what these are) you can have coverage start the month following when you sign up as long as you sign up before the 15th of the month. If you do not have a qualifying event, then we can still get you insurance, but there is a 90 day wait. This only applies to Nevada Residents though. The 90 day wait is calculated as 90 days from the first of the month following enrollment. That means if you sign up today (April) you can have your coverage start Aug 1.
Qualifying events are basically life events where you went through a change. You either lost your other coverage from work, lost your job, got divorced, or moved out of the service area. If you get married and want to enroll with your spouse or had a new baby, you also get a special enrollment. If you are a member of a Native American Tribe you can enroll anytime and get those special enrollments all year long!

ObamaCare Special Enrollments

ObamaCare Special Enrollment Period

A special enrollment period time outside of the open enrollment period when you and your family can sign up for health insurance. You may qualify for a special enrollment period of 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage.

If you don’t have a special enrollment period, you can’t buy insurance inside or outside the Marketplace until the next open enrollment period. Job-based plans generally allow special enrollment periods of 30 days.

The following life events will generally qualify you for a special enrollment period.

• Getting married
• Having, adopting, or placement of a child
• Permanently moving to a new area that offers different health plan options
• Losing other health coverage (for example due to a job loss, divorce, loss of eligibility for Medicaid or CHIP, expiration of COBRA coverage, or a health plan being decertified). Note: Voluntarily quitting other health coverage or being terminated for not paying your premiums are not considered loss of coverage. Losing coverage that is not minimum essential coverage is also not considered loss of coverage.)
• For people already enrolled in Marketplace coverage, having a change in income or household status that affects eligibility for tax credits or cost-sharing reductions

Source: "ObamaCare Facts: Affordable Care Act, Health Insurance Marketplace." ObamaCare Facts: Affordable Care Act, Health Insurance Marketplace. N.p., n.d. Web. 19 Mar. 2014.