MUST READ!!! - Best Individual Health Insurance Policies

8 Keys to Picking the Best Individual Health Insurance Policy

Following these steps could save you tens of thousands of dollars if illness strikes.

By Megan Johnson, Steve Sternberg

Choosing the right individual health insurance plan just got a lot easier with the help of U.S. News’s Best Health Insurance Plans. Our user-friendly plan finder lets you zero in on a plan with the coverage you need at a price you can afford. To make a good choice and avoid some common traps, however, you need to keep a few basics in mind, starting with the meaning of such terms as premium, deductible, copay, and coinsurance. Then go through the checklist provided here, with your likely medical needs and how much you can pay a month as the backdrop. With the right insurance, you could save thousands, perhaps even tens of thousands, if you or a family member gets sick. 

1. Identify the “must-haves.” You can’t foresee a sudden injury or illness, but some medical needs can be anticipated. Maternity coverage, for example, is an obvious must-have if you’re starting a family, and not all policies offer it. If you have a family history of heart disease, you may want to make sure your coverage includes the cost of cardiac screening tests and cholesterol-lowering drugs. Under the Affordable Care Act, individual insurance plans must cover the full cost of more than two dozen preventive services for men, women, and children, including vaccinations and tests for high blood pressure, cholesterol, colon cancer, and diabetes, as long as they’re provided by a practitioner in the plan’s network.

2. Don’t overbuy. Would you buy a luxury car with a monthly payment as big as your mortgage? There’s not much point in thinking about a Cadillac insurance policy your budget can’t handle, either. If you’re relatively young and healthy, consider choosing a policy with a high deductible, the amount you must pay out of pocket before certain benefits kick in. A plan with a deductible of $5,000 or more is likely to cost you considerably less per month, and could save you money in the long run.

3. Check the network. If you have a primary care physician and specialists you like, be sure they’re in the network of any plan you consider buying. Policies generally cover a lower share of the cost of out-of-network care—or none at all. For each plan U.S. News has rated, we supply links to the insurance company’s website. There, you should find a directory of doctors in the company’s network.

4. Know your share of the costs. This isn’t crystal-ball gazing. Plans are required to state how much you’ll pay out of pocket, through flat fees called copays and through coinsurance, a form of “cost-sharing” in which you pay a percentage of a medical service. When you’re sick, seemingly small copays can add up. And an expensive procedure could leave you obligated to pay thousands in coinsurance.

5. Make sure your drugs are covered. You’ll want to make certain that the plan’s formulary, or list of covered medications, includes those you take regularly, especially if they are expensive. Or at least make sure the plan has a great alternative for prescription drugs.

6. Look into annual limits on coverage and services. Thanks to health reform, annual dollar limits on coverage will disappear entirely in 2014. For now, any individual policy you buy cannot impose a limit of less than $1.25 million, an amount that will rise to $2 million on September 23, 2012. But the Affordable Care Act still allows plans to impose limits on services not deemed “essential” and, in some cases, to obtain a waiver allowing them to retain an annual limit.

7. Factor in your dependents. If you have children under age 26 without health insurance coverage through an employer, the law permits them to be on your insurance. Policies also can no longer exclude kids under age 19 from coverage because of pre-existing conditions.

8. Walk through several plans. It only takes a few minutes to review the main benefits associated with each plan, and some plans that look appealing at first glance may turn out to have cost-sharing features that could burden you with heavy medical costs. Each plan rated by U.S. News displays this information on a single page on usnews.com. A live person will walk you though the messier details if you contact the National Association of Health Underwriters, which can put you in touch with licensed local agents and brokers.

Article via: http://health.usnews.com/health-news/health-insurance/articles/2012/08/07/8-keys-to-picking-the-best-individual-health-insurance-policy

INSURANCE Companies THANK FAST FOOD FOR YOUR HEALTH ISSUES!!!!! A Must Read!

DID YOU KNOW??? Study Shows:           Insurance companies hold billions in fast food stock

Researchers say there's a "potential disconnect" between insurance companies' mission and unhealthy food options.

 

Article By: By Sarah Klein, Health.com

 

The fast-food industry has long been under fire for selling high-fat, high-calorie meals that have been linked to weight gain and diabetes, but the financial health of the industry continues to attract investors -- including some of the leading insurance companies in the U.S., a new study reports.
According to Harvard Medical School researchers, 11 large companies that offer life, disability, or health insurance owned about $1.9 billion in stock in the five largest fast-food companies as of June 2009.

The fast-food companies included McDonald's, Burger King, and Yum! Brands (the parent company of KFC and Taco Bell). Companies from both North America and Europe were among the insurers, including the U.S.-based Massachusetts Mutual, Northwestern Mutual, and Prudential Financial.
The researchers say insurance companies should sell their fast-food stock or use their influence as shareholders to make fast food healthier, by pressuring big restaurant chains to cut portion sizes or improve nutrition, for instance.

There's a "potential disconnect" between the mission of insurance companies and the often-unhealthy food churned out by companies like McDonald's, they write.

"The insurance industry cares about making money, and it doesn't really care how," says the senior author of the study, J. Wesley Boyd, M.D., an assistant clinical professor of psychiatry at Harvard Medical School, in Boston. "They will invest in products that contribute to significant morbidity and mortality if doing so is going to make money."

Boyd and his colleagues used a database that draws on financial filings and news reports to estimate the fast-food investments of the 11 companies. Their findings appear in the American Journal of Public Health.

Massachusetts Mutual and Northwestern Mutual -- which both offer life, disability, and long-term care insurance -- owned $367 million and $422 million in fast-food stock, respectively, much of it in McDonald's, the authors report. Prudential, which offers life insurance and long-term disability coverage, held $356 million in fast-food stock, according to the study.

Insurance companies disputed these figures. Andrea Austin, the assistant director of corporate relations for Northwestern Mutual, in Milwaukee, says the company's investment in fast-food companies is only about $250 million, and was at the time the study was conducted. That amounts to about one-fifth of 1 percent of the company's portfolio, she adds.
Austin also disagrees that the company's fast-food investments represent a disconnect with its mission. "We have to determine what's going to give our policy owners value," she says. "We have to make sure we fulfill our obligations to them, and to do that we invest in a wide variety of industries. It's that diversification that enables us to return value to them."

In an e-mail, MassMutual spokesman Mark Cybulski called the study's findings "absolutely incorrect" and said that as of December 31, the company's holdings of fast-food-related stock amounted to just $1.4 million, which represents less than one-hundredth of 1 percent of the company's $86.6 billion in cash and total invested assets.

Austin says she has "no idea" why the figures differ and says that Northwestern Mutual doesn't use subsidiaries.

Theresa Miller, the vice president of global communications for Prudential Financial, said in an e-mail that she could not discuss the specifics of the company's portfolios. But she noted that the investments in the report are within index funds, and that "a large portion" are managed on behalf of third-party clients.

MassMutual, Northwestern, and Sun Life (another insurer mentioned in the report) have contested Boyd's findings in the past. Last year Boyd led a similar analysis, published as a letter to the editor in the New England Journal of Medicine, that found that seven insurance companies held some $4.5 billion in tobacco-company stock. Then, too, Cybulski said that MassMutual's holdings were just a fraction of what Boyd and his colleagues claimed.

According to Boyd, the discrepancy in his figures and those cited by MassMutual may be due in part to two factors: Insurance companies may invest in fast-food stocks through subsidiaries over which they have limited oversight (and therefore may not consider them direct investments), and some of the investments may be in index funds, a type of mutual fund tied to the collective performance of a large group of stocks, such as the S&P 500, which may include those of fast-food companies.

The database used in his analysis provides only the aggregate of a company's holdings, Boyd says.
Austin says she has "no idea" why the figures differ and says that Northwestern Mutual doesn't use subsidiaries.

Boyd and his co-authors emphasize that fast food -- unlike cigarette smoking -- can be safe in moderation.

However, a growing body of research has linked frequent fast-food consumption to weight gain, obesity, and type 2 diabetes.

As a result, the study notes, several cities and towns have restricted fast-food restaurants via zoning laws. And under the health-care legislation passed by Congress in March, chain restaurants will have to post calorie information on their menus, as is already required in New York City.

In their 2009 paper on tobacco, Boyd and his colleagues suggested that insurance companies profit twice over by investing in tobacco stocks, since they can charge higher premiums to smokers and also profit if the stock rises. A similar dynamic may be at work with fast food, according to Boyd.

"They can charge you more for life insurance if you have these negative health outcomes that people have as a result of eating fast food," he says.

But investing in unhealthy industries such as fast food and tobacco isn't necessarily a win-win for insurers over the long term, especially for health insurers, says Sara N. Bleich, Ph.D., an assistant professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland.

"Health insurance companies get profits if they invest in tobacco and fast food, [but] these are some of the top drivers of mortality in the country," says Bleich, who researches obesity policy but was not involved in the current study.
 
"They are essentially killing off their consumer base, so it's not a sustainable model in the long-term. Long-term goals should be consistent with health, because that ensures a large population from which to draw consumers."

Robert Zirkelbach, the press secretary for America's Health Insurance Plans, a national association representing health insurers whose Web site lists three of the companies named in the study, declined to comment on the specifics of the study. "Our industry is strongly committed to prevention and wellness," Zirkelbach said in a statement.

"Health insurance companies are doing things across the country that are working to address obesity, to promote prevention, and to encourage people to live healthier lifestyles."

Gigi Kellett, the director of the anti-tobacco campaign of Corporate Accountability International, a Boston-based watchdog group, says that both tobacco and fast food are inappropriate investments for insurance companies.

"Tobacco remains the leading cause of preventable death around the world, and there is growing research that diet-related diseases could soon surpass tobacco," she says. "It's irresponsible for insurance companies to invest in companies that make people sick."

Corporate Accountability International recently launched a "Retire Ronald" campaign to pressure McDonald's to discontinue the Ronald McDonald clown character and rein in its marketing to children, Kellett adds. For her part, Bleich says that while health insurance companies, specifically, should be encouraged to divest their fast-food investments, encouraging self-regulation and competition in the fast-food industry may be a more effective way to make the industry healthier.

 

 

 

Where Does Your Current Health Insurance Rank???--- A MUST KNOW!

 

 

FBIC( Fight Bad Faith Insurance Companies) Ranks 100 Insurance Companies From Bad To Good

TOP 10 BAD Faith Insurers:

1. Allstate (US Boycott... Worst Do Not Buy)
2. State Farm (US Boycott...Worst Do Not Buy)
3. The Hartford (US Boycott... Worst Do Not Buy)
4. Unum (Disability, LTC, Life)
5. Farmers/ Zurich
6. Lloyds
7. MetLife
8. Liberty Mutual
9. American Family
10. Auto-Owners (aka Owners)

25. United Healthcare

27. BlueCrossBlueShield

Read more of the WORST at http://www.badfaithinsurance.org/indexdetaillist.html

Top 10 GOOD Faith Insurers:

1. Amica (Ok, Best To Buy)
2. Chubb (Ok, Best To Buy)
3. Allianz (Ok, Best To Buy)
4. Coventry Health
5. Kaiser Permanente
6. Credit Suisse - USHealth Group
7. Royal & Sun Alliance
8. GMAC
9. Swiss Re America
10. FairFax Financial

12. Aetna Health

17. Humana Health

40. Alfac

41. Farm Bureau

45. USAA

Read more of the BEST at: http://www.badfaithinsurance.org/indexdetaillist.html

Next ObamaCare Deadline: State Health Exchanges---A MUST KNOW!!

States have until Friday to say whether they'll set up health exchanges under President Obama's health reform law.

NEW YORK (CNNMoney) -- States have until Friday to decide whether they will set up health insurance exchanges, a key provision of President Obama's controversial health reform law.
The health exchanges, which are scheduled to open their doors in 2014, will create online marketplaces where individuals and small businesses can find more affordable insurance plans. Uninsured Americans whose incomes range from 100% to 400% of the federal poverty level will be eligible for federal subsidies.

Between 23 million and 25 million people will receive coverage through the exchanges from 2016 on, according to estimates from the Congressional Budget Office.
  
Since health reform remains a political flashpoint, many states were waiting to see who won the presidential election before deciding whether to set up an exchange.
  
Residents in states that choose not to create exchanges will be able to participate in a federal exchange. A few states may opt for state-federal partnerships, in which states operate certain customer assistance and plan management functions.

Most Americans must have health insurance starting in 2014 or face fines.
  
Some 15 states and the District of Columbia have established state exchanges so far, with four others planning to set up the partnerships, according to the Kaiser Family Foundation. Traditionally blue states, including New York, Maryland and California, are among the ones that have created exchanges.
  
Another 11 states -- including Texas, Florida and South Carolina, where the governors have come out strongly against the president's initiative -- have decided not to create exchanges. Another 14 states are studying their options and six have done virtually nothing to prepare.
  
Arizona is one of the states still weighing the choices. The Grand Canyon State received a $30 million grant to study the issue and Governor Jan Brewer, a Republican, will make her decision this week, said Matthew Benson, her spokesman.

Recognizing that creating exchanges can be a heavy organizational lift, the federal Department of Health and Human Services announced last week that it would give states additional time to submit details of their plans for an exchange. While states still have to tell regulators whether they plan to implement an exchange or not, they don't have to provide specifics until December 14.
  
There are pros and cons to creating exchanges, said Alan Weil, executive director of the National Academy for State Health Policy. Creating them involves financial, operational and political risk.
  
The exchanges have to be self-sustaining after the first year. If they are not, states may be on the hook or may have to charge fees to the insurers, Weil said. And they can also be complicated to set up since states have to establish rules regarding offerings and pricing, as well as meet various marketing requirements to make sure the sick and the poor are not shut out. They must also establish call centers and websites to assist people in picking plans.
  
Also, some state officials may face a political backlash since Obama's health care reform is deeply unpopular in many locations.

But establishing an exchange allows states more control over which plans are allowed to participate, how the insurance options are structured and how quality of care is measured. Also, it makes it easier to coordinate with the state's Medicaid system, which will be expanded in many states to cover all adults up to 133% of the poverty line.
  
But even the states that are embracing the exchanges are scurrying to get the system ready by the 2013 open enrollment deadlines, which begin in October.
  
"There are some states that may simply run out of time to have everything ready to go," said Jen Tolbert, director of state health reform for the Kaiser Family Foundation.

Update On Health Care Reform - 2010 Reforms Already In Effect TODAY

Reforms already in effect

 

More young adults with insurance. All health plans must allow young adults to remain as dependents on their parent’s health plan until they turn 26, whether or not they live at home or can be declared as dependents on the parent’s income tax return. An estimated 6.6 million young adults who would otherwise be uninsured have gained coverage during the first year of eligibility, according to a recent analysis by the Commonwealth Fund, a nonprofit health policy think tank.

 

Cheaper drugs for people on Medicare. Seniors who reach the “donut hole” – the point when they have to start paying prescription drug expenses themselves – now get a 50 percent discount when buying brand-name drugs and a 14 percent discount on generic drugs covered by Medicare Part D. More than 5 million older adults and people with disabilities have saved $3.5 billion in prescription costs since the law was passed. The donut hole will continue to shrink until it disappears completely by 2020.

 

Temporary help for people with pre-existing conditions. To tide people with health problems over until 2014, the law created temporary Pre-existing Condition Insurance Plans in all 50 states plus the District of Columbia. Thanks to federal subsidies, people who have been denied coverage or quoted outrageous premiums because of their health history can buy these comprehensive health plans for about the same price as a healthy person their age would pay for a private plan. The catch is that to qualify for the program, the law says people must have gone without insurance for at least six months. Even so, 67,482 Americans had enrolled in these plans as of April 30, 2012. This program is scheduled to expire in 2014, when people with pre-existing conditions will no longer be locked out of the health insurance market.

 

Free preventive care. New private health plans must cover and eliminate cost-sharing (co-payment, co-insurance or deductible) for proven preventive measures such as immunizations, Pap smears, and screening colonoscopies. Beginning August 2012, private health plans must provide additional preventive measures to women, including free well-woman visits, screening for gestational diabetes, domestic violence screening, breastfeeding supplies, and contraception. Workplaces run by religious organizations that object to birth control are to receive a special accommodation: their health plans must still offer the coverage, but the cost of it will be borne entirely by their insurance companies.

People on Medicare are also now entitled to the same free preventive coverage, and in addition get a free annual “wellness visit.”

 

More consumer protections. Health insurers can’t set lifetime limits on your coverage or cancel if you get sick. Annual limits on coverage in job-related and individual plans are now restricted to a minimum of $1.2 million, which will increase to $2 million beginning Sept. 23, 2012, before being completely phased out in January 2014.

 

Article via: http://www.consumerreports.org/cro/2012/06/update-on-health-care-reform/index.htm

Update On Health Care Reform- Happenings in 2012; 2013

Happening in 2012 and 2013

 

Premium rebates. Nearly 12.8 million Americans will receive more than $1.1 billion in rebates in August, 2012, from insurers who didn’t spend enough of their 2011 premium income on health care. By August 1, 2012, insurers must issue rebates—either as reduced premiums or refunds directly to individual customers or employers—if they spend too much of their revenue on administrative, marketing or other business expenses instead of medical care and quality improvement activities.
Insurers must spend at least 80 percent of premiums on medical care and quality improvements for customers in their individual and small-group (under 50 employees) plans. The cut-off is 85 percent for large group plans.

The rule does not apply to self-insured plans offered by employers who pay employee health expenses on their own. The only way to know if you are self-insured is to ask your employer. You can’t tell just by looking at your insurance card.

Standard disclosure forms. Beginning in September, 2012, all health plans will have to use a standardized, consumer-friendly form to provide a uniform summary of benefits and coverage, including information on co-payments, deductibles, and out-of-pocket limits. This will make it easier for you to compare plans. Insurers will also have to calculate and disclose a patient’s typical out-of-pocket costs for two medical scenarios: having a baby and treating type 2 diabetes. See a sample form (PDF).
Caps on Flexible Spending Accounts (FSAs). Employers can still set their own limits (usually $2,500 to $5,000) on FSAs in 2012. But in 2013, the most you can set aside tax-free for medical expenses not covered by insurance will be $2,500, with the cap increasing by the annual inflation rate in subsequent years. Plus you can no longer use FSAs to pay for over-the-counter drugs unless you have a doctor’s prescription. The cap takes effect January 1, 2013. For people with 2012-2013 health care plans that run on a fiscal (rather than calendar) year, the cap kicks in July 1, 2013. Read more about FSAs.
New Medicare tax for high earners. Two Medicare-related taxes will impact high earners in 2013. Individuals earning over $200,000 (or $250,000 for couples who file jointly) will see their Medicare payroll tax rate increase from 1.45 percent to 2.35 percent. They’ll also pay a new 3.8 percent Medicare tax on unearned income, including investments, interest, dividends, annuities, rent, royalties, certain capital gains and inactive businesses. Read more about Medicare.
Exceptions to the unearned-income tax. It does not apply to the sale of your principal residence—unless your capital gain on the house is more than $250,000 for single filers and $500,000 for married couples filing jointly. And even then, it applies only to the capital gain in excess of those amounts. So, for instance, a single filer who made a $300,000 profit on a house sale would only pay the tax on $50,000. Also exempt from the new tax: income from tax-exempt bonds, veteran’s benefits, and qualified retirement plan distributions such as those from an IRA or 401(k).

Article via: http://www.consumerreports.org/cro/2012/06/update-on-health-care-reform/index.htm

Update On Health Care Reform--- Major Changes Come In 2014

Update on health care reform

Many changes are already here, though major ones come in 2014

The Affordable Care Act started changing the country’s health-care system almost from the moment it was signed into law in March 2010. It has already expanded coverage of young adults by allowing them to stay on their parents’ plans until they turn 26, outlawed lifetime limits on what insurance will cover, lowered the cost of drugs for seniors on Medicare, caused up to 12 million consumers to get premium rebates totaling some $1.1 billion, and expanded access to free preventive care for patients of all ages. Last summer it survived a challenge in the U.S. Supreme Court.

But all that is prelude to the transformation coming in 2014, when almost all Americans will have access to affordable health insurance that covers essential care.

2014: A new system begins

A set of rules that take effect Jan. 1, 2014, will make shopping for health insurance a completely different experience for those who buy it on their own—or are uninsured today. These are the biggies:

Guaranteed issue. This is the most popular part of health reform: Health plans must sell coverage to everyone, regardless of pre-existing conditions, and can’t charge more based on health or gender.

Exchanges. By this time next year, every state must have an insurance exchange— an organized marketplace where individuals and small-business owners can view, compare, and purchase qualified private health plans. It’s expected that most consumers will shop on their state’s exchange online, but they can also shop by phone or through brokers.

States have the option of setting up exchanges themselves or allowing the federal government to do the job. It’s expected that the federal government will operate exchanges in as many as half the states. (To see what an exchange looks like, visit the Health Connector run by Massachusetts, which has had a mandate since 2007.) About 20 states are expected to be ready to operate their own exchanges by late 2013. In other states, the federal government will step in to do the job.

Individual mandate. Everyone will be required to have health insurance or pay a penalty. Almost any sort of legitimate coverage will satisfy the mandate: private insurance obtained on your own or through a job, Medicare, Medicaid, CHIP, Veterans Affairs, or Tricare.

Penalty. If you don’t have health insurance, you’ll have to pay a tax penalty, starting at $95 per individual, $285 per family, or 1 percent of income, whichever is greater, for 2014. (That rises to $695 per individual, $2,085 per family, or 2.5 percent of income in 2016.)

Because the vast majority of people will already have qualifying health insurance, few will confront the choice of buying a plan or paying a penalty. Moreover, you won’t have to pay it if you make too little money to file a federal tax return or would have to spend more than 8 percent of your household income on the cheapest qualifying plan, even including subsidies. Americans living abroad, and those in prisons, are exmpt from the mandate and associated fines.
Individual subsidies. Afraid you won’t be able to afford insurance? If you buy on an exchange as an individual, you may qualify for a subsidy in the form of an advance tax credit if your household income is between 100 percent and 400 percent of the federal poverty level. (The tax system already subsidizes people who have coverage through a job by excluding the cost of their health plan from income taxes.)

For instance, a family of four with an income of 200 percent of poverty, or about $46,000 in 2012, will pay no more than $235 a month for health insurance. People with household incomes of less than 250 percent of poverty will also get subsidies to reduce their out-of-pocket costs, such as deductibles and coinsurance. You’ll learn whether you qualify for a subsidy when you shop on the exchange.

Medicaid expansion. The health care law was intended to expand the government-run health program for low-income Americans to cover up to 16 million more people with household incomes up to 133 percent of the poverty line ($14,856 for an individual and $30,657 for a family of four). That includes many at or below the poverty line who aren’t currently eligible. Read more about how to navigate Medicaid.

 

Article via: http://www.consumerreports.org/cro/2012/06/update-on-health-care-reform/index.htm