A new report by the actuarial firm Millman Inc. says that a new tax on health insurers’ premium revenues will be passed on to consumers, and will cause problems for state Medicaid programs.
The health care reform premium tax, which starts in 2014, was intended to help pay for coverage of the 32 million uninsured Americans, and will be paid by all health insurance companies. But under federal law, the state and federal governments have to pay the tab for their Medicaid programs. States typically pay about 36% of the Medicaid costs, and this new tax will be paid out of each States’ already strained budget. The Medicaid program provides medical coverage for about 60 million low-income families.
So let’s see, there’s a new tax on health insurance that we will have to pay because insurance companies will pass the tax on to us in increased premiums, AND, the tax that is paid on the Medicaid program expenses (which we already pay through our state and federal income taxes) will have to be paid by state and federal government revenues (aka our taxes). Hmm….Sounds like we get hit with the full cost of the “health care tax”. Who’s bright idea was that! Oh yeah…our government. Brilliant!
The insurance industry trade group (AHIP) said that they believe consumers should be exempt from this tax that increases health care coverage costs. I agree. Especially since the goal of health care reform was to keep health costs from climbing out of control.
Stay tuned for more.
Governor Brown’s plans to charge low-income patients for medical care they receive through the Medi-Cal program were rejected by Federal health officials. The copays were part of Governor Brown’s budget balancing “act”, and it was hoped that the state would save $296 Million by having poor people make co-payments. Over 8 million are in the Medi-Cal program, and many are children or elderly people.
The budgetary plan was to have physicians and hospitals collect the copays, and make the decision to deny coverage if the copays were not made. Medical providers complained that this was a “back-door” cut in reimbursement rates, because the providers would not want to “refuse” coverage for people that could not afford the copays.
Legislative advocates applauded the Federal health officials, and warned that imposing copays on poor people would worsen the problem by making them avoid the health care system entirely, until an emergency occurred. Thereby driving up costs.
Stay tuned for more details.
How much someone, or a company, is willing to spend is what determines how easy it is to find an affordable health insurance plan. A few individuals might just buy an expensive comprehensive plan that costs hundreds of dollars a month, but most would prefer to find a plan that costs a lot less. The more benefits you want a plan to have, the more the plan will cost. Therefore, someone wanting the most benefits would buy a comprehensive plan at high cost, while another would opt to get a high deductible plan at much lower expense. As luck would have it, the San Diego health insurance industry has a multitude of options that will appeal to consumers of every income level. So there is an affordable health insurance plan available that will fit the need and finances of every person.
When looking for affordable health insurance San Diego citizens must first do a little research to determine what their plan options are. A few Google searches should provide the necessary information. Using the new found information, and combining it with a good picture of what medical benefits are needed, will help people pick the right plan.
Care must be used during the search process to prevent falling into the lair of affiliate marketers. Usually affiliate marketers won’t tell an out and out lie. But they can leave out important information about plans that people should know, and they can sell people’s contact information to multiple agents if they’re not careful. Therefore it’s a good idea to request written information, or brochures from an insurance company, before buying a health insurance policy. As a lawyer would say, “the devil is in the details”, so reviewing the plan information is an important step. At the same time, you should look for any hidden meanings in the plan documentation and the website privacy policy, to prevent surprises later on.
Is a cheap plan always an affordable health insurance plan? Many times it’s not. Some cheap plans are so cheap that you end up paying out of your own pocket for everything until you reach a very high deductible. As long as you never need to use the plan, it’s affordable. But if something happens, It will seem like you have no insurance at all. So weighing the pro’s and con’s of this can factor into the choice of what’s affordable to you.
Along with the affordability of the plan, most people also want the plan to offer a good value for the price. This means comparing health insurance plans with similar benefits and selecting the plan with the lowest cost, while keeping in mind what benefits you’ll actually use in a typical year. Plans that offer more benefits than you’ll use can be a better choice if they cost the same, or less than a plan with only the benefits you want.
When looking for affordable health insurance San Diego people could face a number of challenges. One of those is that health insurance plans can be confusing with all the options and benefits. Relying on good San Diego health insurance brokers is the best way to get the necessary information and recommendations that you need in order to make a good decision. Using this information, you can then focus your efforts on just a few plans and pick the one that best fits your specific needs and budget.
Millions оf Californian’s dо nоt hаvе аnу dental insurance, and that includes people in San Diego. That’s pretty sad. You see people every day that have some sort of dental issue that’s never been fixed. By the age of 50, the average person is missing four to five teeth, with higher numbers living in the valley, or in inner cities. Occasionally the loss is due to accidents or injuries, and for some it’s because they don’t have San Diego dental insurance. Other times it’s a result of people not taking care of their teeth.
To maintain your overall health, taking care of your teeth is vital. After all, it’s your body and it’s the only one you’re going to get, so you’d better take care of it. When I get up in the morning I try to brush my teeth first thing because my breath tastes like road pizza. However, just before bedtime, I have a harder time remembering to brush my teeth. And just before bed is the best time to brush. Му mouth stіll tastes fine frоm dinner but іt wоn’t bе long bеfоrе thе bacteria starts tо feed оn іt аnd іt will taste awful. Nobody would want to kiss a mouth that smelled terrible, would they? Νоt mе. Therefore I make sure to brush and floss before going to bed. Іt mаkеs mе feel better аnd еvеn mоrе lіkе loving.
When shopping for dental insurance San Diego residents need to keep these five items in mind. It’ll make you happy once you’ve got a plan set up and start taking care of your teeth.
First, consider the price of the plan. Саn уоu afford thе payment? Does the plan have a monthly premium, a yearly premium, or a single payment?
The second item to consider is your location. Іs thеrе а dentist nеаr уоu thаt accepts thіs раrtісulаr San Diego dental insurance plan? Dentists usually accept only a handful of dental plans.
Third, consider what dental benefits or services would you actually use. Most people should have their teeth cleaned twice a year by a dental hygienist. Getting an annual checkup, so a Dentist can catch any issues before they become major problems, is a good idea. These are the basic services you’ll use every year. Will thе plan уоu аrе considering include thеsе fоr free? Оr аt а discount?
Number four on the list, is to check if the dental insurance plan has a cap on the maximum benefits allowed during each year? Will your expected dental care fit within this cap during most years?
Fіfth, whаt will thіs San Diego dental insurance cover? Are there restrictions on some services? Whаt percentage will уоu hаvе tо pay up-front? How much will you have to pay up front to the Dentist?
Sixth, look to see if the dental insurance plan has a waiting period before you can receive corrective services. Many PPO dental insurance plans will make you wait 6 months, or up to 12 months before you can get benefits for corrective issues like cavities, root canals, and crowns. Will you be fine through the waiting period without getting major dental benefits?
These are all great points to consider when you are going to spend your money to maintain your good health. Taking care of your smile by brushing, flossing, and having regular dental checkups means you shouldn’t have to worry about cosmetic dentistry. To get dental insurance in San Diego people just need to plan ahead for their own wellbeing.
Image: digitalart / FreeDigitalPhotos.net
In the search to find good maternity insurance California mothers have found fewer options to choose from over the last few years. However, new mandates in 2012 will require that all health insurance plans in California provide maternity health coverage. Both the Individual/Family plans as well as the Group plans will be affected by these new rules, which take effect on July 1st, 2012.
Senate Bill SB222 by state Senator Noreen Evans, and Assembly Bill AB210 by Assemblyman Roger Hernandez, were both signed by Governor Jerry Brown on Oct 6th. These two bills require that every health insurance plan offered in California must provide maternity insurance coverage. This change will reshape the maternity health insurance marketplace in California by expanding the health insurance options that are available.
Forced To Provide Maternity Insurance California Could Lose Insurance Companies?
Currently there are 23 California maternity health insurance plans offered by the major insurance companies. That’s out of a total of 164 individual & family health insurance plans, so only 14% of the individual health insurance plans offer maternity coverage. Anthem Blue Cross, Blue Shield of California, Health Net, and Kaiser Permanente, and PacifiCare/UHC are the primary insurance companies that offer a few individual maternity plans. Aetna and CIGNA do not offer any maternity insurance California plans, so it will be interesting to see whether they leave the market in this state, or put maternity coverage into their plans.
Adding maternity coverage to all health insurance plans is also part of the Health Care Reform package that is scheduled to take effect in 2014, so California is simply accelerating the time schedule. Blue Shield of California and Kaiser Permanente supported the legislative change. Blue Shield believes that maternity coverage should be a core benefit of health insurance, so the costs of prenatal care and delivery are spread across everyone, instead of just families wanting children.
So far there has been no word on how this change will effect the rates of health insurance plans in 2012. However legislative analysis of the provisions show an average increase of just under $7 per policy. This projection does not come from the insurance industry, so the actual increase is still unkown.
The state government will probably be the biggest beneficiary of these new rules, and should save millions on reduced expenses in the Medi-Cal and Access For Infants and Mothers (AIM) programs. These joint federal and state programs are the insurer of last resort for many California mothers that have no maternity health insurance. It is expected that more un-insured mothers will be able to afford maternity care after SB222 takes effect next year.
All this being said, there is still one glaring hole still left unfilled. The insurance companies do not have to provide health insurance for pregnant women in individual health insurance plans, and SB222 and AB210 do not change this. So planning to have a baby is still important. That way the family can get the necessary maternity coverage before the pregnancy happens. If not, then the California Pre-existing Condition Insurance Plan will continue to be the only insurance option for a self employed pregnant woman.
Find an update to the best California Maternity Health Insurance plans, with the most recent price changes from the major Insurance Companies on the California Maternity Health Insurance page.
Notable changes were a price increase for the Blue Cross Select HMO and a price reduction for the Kaiser Permanente 0/1500 Deductible (HSA) plan. Overall the order stayed the same, but the Kaiser plan is now even further ahead of the rest of the California maternity health insurance plans.
The end result of the analysis is that the difference in total cost between the best California maternity health insurance plan and the fifth best plan has grown to $4498.
The Featured Class in October is :
Breast Health 101
Tuesday, October 25
| 5-6pm | Exhibits and Screenings |
| 6-7:30pm | Class |
Jean McLaughlin Women’s Center
15611 Pomerado Road
Poway, CA 92064
October is Breast Cancer Awareness Month, are you up to date on the latest prevention, detection and treatment options? Join us for refreshments, exhibits and FREE health screenings followed by an informative class led by breast cancer surgeon Elizabeth Revesz, M.D. Don’t miss this opportunity to learn what’s best for your breasts!
FEE: Free-registration required
To register, call 800-628-2880 or visit Class Registration where you can see all the classes offered in October
Between 2007 and 2009 the number of uninsured women increased by 12.8%, and the March of Dimes PeriStats database shows that 22.3% of women in their child bearing years are uninsured. So it’s not uncommon to be pregnant without health insurance in the US, and the situation has been getting worse each year. For women who are pregnant, no insurance means they have to bear the full cost of prenatal care and delivery, which can total $12,000 to $20,000 depending upon where you live and the
type of delivery you have. These costs make getting health insurance for pregnant women a priority.
No matter what your income level is, there are ways to get insurance for pregnant women. The 2 options to look into are your state Medicaid programs, and then the Pre-Existing Condition Insurance Plan (PCIP).
The PCIP is offered in all 50 states, and this federal program provides affordable health insurance to people that have been unable to get medical insurance. For women that are pregnant without insurance, the PCIP can be a just what you need.
The best news about the California PCIP is that it offers a rich set of benefits at affordable prices. The pre-existing condition insurance plan California has a $1500 deductible, $25 office visit copays, both generic and brand name prescription coverage, and a maximum $2500 out of pocket limit. To qualify for the PCIP California plan you need to have been declined by an insurance company within the last 12 months, and be uninsured for 6 months. For more information about the cost of the program, how to enroll, and how to get the simple application, women that are pregnant with no insurance in California should visit the PCIP California page so they can protect themselves and their baby.
Comparing the PCIP to other Maternity Health Insurance plans, shows the PCIP is the 3rd best maternity insurance plan in California. The best pregnancy health insurance plan is the Kaiser Permanente 0/1500 HSA plan with a total out of pocket (TOOP) cost of $4854, the 2nd best plan is the Kaiser $50 Copay plan with a TOOP of $5064, and the PCIP is 3rd with a TOOP of $5068. The best plan from the other 3 companies that offer maternity insurance plans is the Anthem Blue Cross Select HMO plan with a TOOP of $7570.
Visit “California Maternity Health Insurance Plans Analyzed” to learn more about the analysis mentioned above.
There is no reason to worry about getting pregnancy health insurance if you are pregnant without insurance. Medicaid and PCIP can provide the solution to get health insurance for pregnant women in California. Go ahead and get started today figuring out what plan is best for you. Call the state Medicaid office, and then get information about your state Pre-Existing Condition Insurance Plan California.
SPF Insurance is proud to announce a new resource page targeting the needs of women in California who are pregnant without insurance. This new page, “Health Insurance For Pregnant Women,” provides information on 7 ways that women who are pregnant without health insurance can find coverage to help protect themselves and their babies.
The number of uninsured pregnant women in California has continued to climb, so it’s important that solutions be created to ensure that the health of these women, and their babies, is strong and that these newest state residents start off on the right foot — happy, fit, and ready to grow and thrive.
This website focuses on providing information that visitors can use to make good decisions about their health care, and we are committed to helping Mothers-to-be get the care they need. The Health Insurance For Pregnant Women page provides background and details about group health insurance options, state government programs, discount plans, and highlights a provision of the Accountable Care Act, the Pre-Existing Condition Insurance Plan California (PCIP California).
PCIP California will enable women who are pregnant without insurance to finally have the quality of care they need to deliver healthy babies. It’s a great plan, that’s priced attractively, and should gain thousands of new enrollees in the next year.
So check it out, and be sure to leave your comments!
The federal government, which pays most of the cost for this program, just gave California permission to lower the rates on the insurance plan by up to 24%. The Pre-Existing Condition Insurance Plan California (PCIP California) was created as part of the Health Care Reform Bill last spring, and serves Californian’s that have been denied regular health insurance because of health conditions. This little known plan serves as a safety-net insurance plan for the uninsured.
The rate reduction will take effect on Oct 1st, and the hope is that this will encourage more uninsured people to enroll in the plan. The 3500 current plan participants will get 8% to 24% rate cuts depending upon their age and where they live.
My most recent PCIP California enrollee, Darren, a 24 year old in San Diego, will see his premiums drop from $181 to $149 each month, a savings of 17.6%, which is about the average savings across all ages and areas in California. Darren’s $149 premiums gets him a PPO plan with a $1500 deductible, a $25 office visit copay, and a worst case max out of pocket of $2500.
The California PCIP is a great plan for uninsured people because it provides very high benefit levels at a price point below what the major insurance companies like Aetna and Anthem Blue Cross would charge for a plan with the same benefit levels.
The plan is especially attractive for pregnant women that don’t have health insurance. When compared to all the other individual maternity health insurance plans, the PCIP California plan is the 3rd best option. Easily beating out the best plans from Anthem Blue Cross and Blue Shield.
See the California Pre-Existing Condition Insurance Plan page for more details about the plan, pricing, and how to sign up.
The slow process of degeneration in the brain’s ability for mental function is called dementia. Symptoms include failure to remember familiar names of people, places, things and events. Patients may also have a hard time expressing themselves or solving simple problems. They may even forget how to bathe, eat, and do basic chores.
Loss of cognitive ability may be caused by a number of things. Among the causes are head trauma, viral infections like meningitis, or abuse of drugs and alcohol. One on the most well-known types is Alzheimer’s Disease.
Elderly individuals suffering from cognitive degeneration have special needs. They must be treated with patience and care. They are aware that they are slowly losing their mental abilities and can often develop depression because of this. They need support and understanding from their family and friends to be able to retain their confidence and self-worth.
A good live-in treatment facility should have an individualized approach to their patients. The grounds should be patient-friendly with safe walking and activity areas. Activities should match the needs of each patient.
The personnel need to have good pain management. The may patients feel pain but are not able to articulate where they feel it. The personnel should also be effective in helping them with daily needs such as baths, eating, dressing, and such.
Once a facility is chosen, the transition from the home to a new place may prove quite an experience for both the patient and the family. It may be hard for a patient to adjust to a new environment, so supported may be needed in the form of frequent visits. This should go on until the patient has become accustomed to the new surroundings and faces. When the patient has finally adjusted, a schedule for visits can be worked out.
When loved-ones get to that point in life when they are helpless and need so much, we want the best things for them. Sometimes there is a need to give them into the attention of someone better able to serve them. When the time comes finding dementia care facilities San Bernardino can be the best choice for them. Read more about: dementia care facilities san bernardino
Rogue health insurance websites are set up to capture personal information from people trying to get instant quotes, and then the websites sell that information to agents. In the results from 2 Google searches for “Pregnancy Health Insurance” and “Maternity Insurance Plans,” almost 50% of the top 20 results were rogue websites. There are plenty of legitimate health insurance websites to choose from, but you need to be able to distinguish the good from the bad. By hitting the “Get Quote” button on rogue websites, we tell them, “Please have 5-10 medical insurance agents call me for the next 8 weeks trying to sell me a policy”, and “Please sell my email address to other list services and health insurance agents so I can receive their unwanted emails”. I’ll share some easy ways you can recognize these websites before they deceive you.
About 10 years ago, I left the corporate world to start my own business. I needed to set up health insurance for my family so I went online and searched for San Diego Medical Insurance. I figured the top links should be the best ones to visit so I did. I read a little bit of information on the first website, and it said I would receive instant San Diego health insurance quotes by filling out the website’s quote request form, so I filled out the form. When I hit the “Get Quote” button I was sent to a page that told me I would be contacted by 5-8 agents that would provide me with quotes. About 20 seconds later my phone started ringing, and for the next 2 months I received daily phone calls from agents wanting to sell me health insurance. The email barrage was even worse because I don’t think it ever stopped. I eventually had to get a new email address (this was before spam filtering).
What I’ve learned since then are the telltale signs of fake quote websites and how to recognize them quickly. Here is the list of red flags to watch for:;
- The website has Google Ads for insurance – No legitimate California health insurance broker would allow ads for competitive websites to be displayed.
- The website has a link for “Agents” or “Brokers” (scan through all the links including the ones on the top and bottom of the page) – This typically means the site is going to sell your information to the agents/brokers that sign up to use the website’s service.
- Quickly scan the privacy policy, especially the first few paragraphs, to see if they will provide your information to third parties – If so, they plan to sell your information to agents or email list services.
- In California, check to see that the website has an insurance license number (many times this is placed at the bottom of the page) – if not it could be a rogue website or a national company that might not know the specific details of the California health insurance market.
- Look for something similar to the following wording “this website provides a free service and is not an insurer or agent/broker” – this means it is a marketing website that will sell your information to agents or refer you to a national broker for a referral commission (affiliates).
If you don’t see any of the above red flags, and you entered your zip code and pushed the button to get a San Diego Medical Insurance quote, you still need to look out for 3 more red flags on the quote request form:
- Check the Disclaimer at the bottom of the quote request page to see if the website is going to have agents call you.
- The quote request form requires your home address – This is not necessary to provide you with a quote, but will result in you getting junk in your mail box.
- The form asks for the best time to contact you – this definitely means agents will be calling you.
If one of the above 3 red flags occurs you should close that page. As long as you don’t hit the final “Submit” button on the request page, your information should not be saved.
Rogue San Diego health insurance websites are pretty common on the internet, and tend to show up in longer keyword searches. To avoid becoming a phone and email spam victim you need to be careful to ensure you are working with a legitimate San Diego Medical Insurance website. Signs to look for are websites that have Google Insurance Ads, Agent/Broker links, no insurance license, bad privacy policies, or text that says the website is not an insurer or a broker. Following these simple precautions will make your online search stress free.
Since you are already here at SPF Insurance, go ahead and run a comparison quote now by clicking on this Health Insurance Quote link. Your information will be protected and not sold or given to any other company.
Let us know how we can help you.
Image: Stuart Miles / FreeDigitalPhotos.net
Maternity Health Insurance Plans Anayzed: What Are Your Out Of Pocket Costs Going to Look Like?
We just added new information on the California Maternity Health Insurance page that will answer all your questions about how much your costs will be during the prenatal care and baby birthing process!
One of the common questions we get from couples planning to have a baby is, “What will our costs be if we use Pregnancy Health Insurance plan ABC?” This new article, Analysis of Best California Maternity Health Insurance Plans covers the detailed cost break down of the five recommended maternity health insurance plans. One of the key parts of the analysis is showing the tradeoffs between paying more for the prenatal and delivery costs out of pocket and less for the insurance premiums, versus paying less for the prenatal/delivery costs and more for the monthly premiums.
One of the surprises is that an HSA plan jumped into the lead as the best maternity health insurance plan. This happened because the updated plan pricing for Kaiser Permanente increased the premium costs of the HMO plans more so than the HSA plans, and enabled the Kaiser 0/1500 HSA plan to take the lead with the lowest total out of pocket costs.
Using the outline of the analysis for the 5 plans that were shown, it is possible to determine what the total out of pocket costs would be for any of the other 18 maternity health insurance plans that are offered in California. If you have any questions about the information, please give us a call and one of our advisors would love to help you.
After a lot of work, We’ve compiled all the California Maternity Health Insurance information into one page on the website. This way it will be easier to find the information you’re looking for and simplify applying for maternity coverage.
While we were compiling the information and adding new content, we realized that there was more information that’s needed to really provide a complete picture for maternity medical insurance, so we’ve put in little notices about the upcoming content to check back for. If you need something that was missed, please post a comment and we’ll respond (and thank you!).
The new California Maternity Health Insurance page link can be found under the “San Diego Insurance Featured Articles” section on the right side of the webpage, or the link above. Let me know if you find the information useful.
Ask someone in San Diego if they should have Medical Insurance, and they’ll likely agree that it’s a good idea. But ask that same person if they’re confident about shopping for insurance and picking out the best San Diego Medical insurance plan and they always say “no”. They say they “don’t understand” health insurance or they “don’t have the time” to find the information, and there’s always something else that needs to be done first.
It could be much easier if they knew 3 simple keys to make shopping for San Diego Medical Insurance a snap. Use an informative website with the tools you need, ask an expert San Diego Medical Insurance broker to get answers to your questions instead of searching, and the most important key, know what benefits you will actually use in a Medical Insurance plan.
There are a myriad of Medical Insurance websites to choose between, but not all of them will be useful in the insurance shopping process. The Insurance Company websites provide good information about their own plans, but nothing about competitors, so they are not useful when shopping for Medical Insurance. In the last few years, thousands of “Affiliate Marketing” websites have been created targeting the Medical Insurance market, and these sites trick the unsuspecting consumer into providing their contact information in order to get a quote, only to then sell that contact information to multiple insurance agents who begin phoning to provide the quotes. To avoid these affiliate sites, look for an insurance license number somewhere on the home page of the website. If you don’t see one, then leave the website. Medical Insurance brokers make up the rest of the websites to choose from. What you want is a website that is located near you (at least within your state), so the information and tools are specific to what is available to you here in San Diego.
Ideally you want the website to be staffed by knowledgeable, independent brokers that can help you if you have questions. If you call a medical insurance company hotline, the support people will know about the companies’ plans and features, but not about plans from other companies. If you call one of the large nationwide brokers you’ll get a person that probably doesn’t know the answer to your local questions and you’ll get bounced from one person to the next. An independent San Diego broker knows what all the major Medical Insurance companies have to offer in your area, and can help you choose between the available health insurance options to get the one that best fits your needs. Use the broker to get answers to your questions, and let his or her experience simplify your effort.
The last key to making it easy to shop for San Diego Medical Insurance is to know what benefits you will use during an average year. So ask yourself how many times you typically go see a doctor, and if it’s only once or twice you can then look in the quote for plans that offer that many office visits and exclude all the plans that offer unlimited visits (the more office visits the plan offers, the higher the monthly premium). Similar questions are do you take brand name prescriptions, do you have a doctor you want to continue seeing, and what is your budget for Medical Insurance costs. Knowing this information makes finding a plan with those benefits much easier.
Everybody in San Diego would rather do anything besides look for Medical Insurance, because it’s not a priority and they don’t know how to make it fast and easy. The keys to this are using a great local website, asking questions of a knowledgeable health insurance broker, and knowing what medical benefits you need. With this information, finding the best San Diego Medical Insurance plan can be quick, painless, and simple so you’ll have more time to spend on the beach.
For everyone that’s looking for the perfect resource to help make San Diego Medical Insurance easy to understand and apply for, the wait is over. The San Diego Medical Insurance page is now live and ready.
This page starts by having you answer 5 questions to determine what benefits you need in your medical insurance plan, then guides you through the medical insurance quote and helps you easily find and compare the insurance plans that match what you outlined in the first step, so you can make the best decision. Then it walks you through the process of applying online, and gives you tips on how to make the application painless.
This resource combines all the information on the SPF Insurance website and puts it into a step by step sequence that’s easy to follow, fast, and makes the process of finding the right medical insurance policy easy. So all the families in San Diego now have a one stop resource. Try it out now, and be sure to leave a comment to let me know how you liked the page. I use the feedback from clients to make tweaks to the website to improve it’s useability, so let me know what you liked and what you think needs improvement.
So stop by to use this page today at: http://www.spfinsurance.com/san-diego-medical-insurance.
There are usually many questions people ask me when they are filling out their health insurance applications. So I’ve created a new article that gives you tips on what to do and what not to do, so that your application is truthful and complete, and presents your health history to the insurance company in a fashion that is most favorable to you.
This should be recommended reading for everyone before they start an online medical insurance application. To see this article go to the Health Insurance Quote Information page and scroll down to the bottom. If you’d like, a shortcut the article can be found in this link: Health Insurance Application Tips. I know this will help a bunch of people that worry about what to say when they’re filling out an application.
An update to this post is now available, with more details and an additional option on the California Maternity Health Insurance page of the website.
The short answer is probably not unless you qualify for one of two exceptions. These exceptions are, join a group health insurance plan at your work or your spouse’s company, or if you have a non-maternity plan check to see if your insurance company will allow you to transfer to a plan that covers maternity care (Blue Shield of CA will allow a transfer to a maternity plan).
If the above options don’t help you, do you have other choices? Depending upon what state you live in, there are government programs to provide care for pregnant mothers to be, so check with your State Department of Insurance to determine what your local options are. In California, there is the state Medi-cal program (Medi-cal is the California version of Medicaid), and the Access for Infants and Mothers (AIM) program.
If you are pregnant and don’t have health insurance, then you should start with Medi-cal first to see if you qualify for coverage through their program. Medi-cal provides a zero-cost health plan for pregnant women that meet specific income limits. Medi-cal is intended to cover families and women that are below the federal poverty level. If you don’t qualify for Medi-cal then apply to the AIM program.
The AIM Program is low-cost health care coverage for pregnant women, and is provided for middle-income families who don’t have health insurance and whose income is too high for no-cost Medi-cal. AIM is also available to women who have private health insurance plans with a maternity-only deductible or co-payment greater than $500. To be eligible for AIM a single mother’s monthly household income must be between $2,453 to $3,679 (there is a table with income ranges for families with other children at http://www.aim.ca.gov/Costs/Income_Guidelines.aspx). The AIM program is funded by the State of California, and although funding is usually available, if the program is filled up, then no additional mothers will be enrolled.
Although health insurance is not usually available after you become pregnant, there are other options that can help. The Medi-cal and AIM programs are designed to provide maternity care to the uninsured mother, so there should be a solution for all mothers to be.
For additional information about AIM and Medi-cal see the following websites:
http://www.aim.ca.gov/AIM_Program/ Information about the AIM program
http://www.dhcs.ca.gov/services/medi-cal/Pages/MCIndividual.aspx Information about Medi-cal
http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/PE_Info_women.aspx Information about the Presumptive Eligibility program to gain access to Medi-cal.
An update to this post is now available, with more details and an additional option on the California Maternity Health Insurance page of the website.
This table will be updated whenever there are changes to pricing or benefit levels. The recommendations are based upon the characteristics of the 6 Consumer Classifications described below. These 6 classifications are further broken into 3 age groups: 30, 45, and 60. The ages were chosen to show the pricing differences in plans due to age. In many cases, plans that are recommended for younger ages, might not show up for other ages because the price has gone up too much.
Use the recommendations from the table as your starting point to determine which plan is the best fit for your specific needs.
Consumer Classifications
Invincible
Between the ages of 20 – 65, they usually don’t go to see the doctor more than once a year. They are healthy and just looking for a safety net such that if something did happen they wouldn’t get wiped out financially.
Planning to have a Baby
Couples or Families between the ages of 20-45 that are planning to have a baby within the next year. The mother to be will need a plan that offers maternity care while the rest of the family would be in a plan from the “Families with Young Children” classification.
Families with Young Children
Parents between the ages of 25-50, with children that are young and occasionally bring home the current cold going around school. These families do the standard preventive visits and 2-3 Doctor’s office visits for illnesses that don’t respond to home treatment, or injuries that occur from activities and sports.
Middle Aged Professionals
Individuals or couples that are self employed, own a small business, or work for a business that does not provide health insurance. Age range between 35-60, and may have teenage children. May have a minor preexisting condition or take a prescription, and need to visit the Doctor 1-2 times a year for maintenance of their health.
Pre-65 Retirees
Between the ages of 55-65, these people have a few minor preexisting conditions and may have brand name prescriptions. They are no longer working full time, and don’t have health benefits through their work, or can’t afford the COBRA cost of their previous work health benefit plans, or have exhausted the COBRA coverage. They go to see a physician 3-4 times per year.
Preexisting Conditions
People who have a preexisting condition that resulted in either a decline or a rated policy in the past, and the condition has cleared up, is no longer a problem, or is treated successfully with medication. Results will depend upon condition and for best results you should contact our office to discuss the best strategy with one of our advisors.
Updated May 1, 2011
Click on the table to get a larger version
There are 2 questions you have to ask yourself in order to find the right Dental Insurance plan for your specific needs. Once you know the answers to these questions you can easily narrow your choices to just a few Dental Insurance plans that will fit your budget and needs.
The first question is : Do you have a Dentist you want to continue to see? (Yes/No)
If the answer is Yes, then you will want a PPO Dental Insurance plan. PPO plans allow you to see any dentist or any of the Dentist’s in the insurance company’s network of dentists. The best option is a PPO Dental plan that allows you to see ANY Dentist because this gives you the most options. If the PPO plan only allows you to see Dentist’s in the insurance companies network, then you’ll want to make sure that your Dentist is in that network before you sign up. You can use this link to find out if your Dentist is in an insurance company network: Dental Provider Network List.
If the answer is No, then you can select from the HMO Dental plans, and the PPO Dental plans that require you to use network Dentist’s. These plans will typically cost less than the Dental Insurance plans that allow you to see any Dentist.
The second question is: Is Dental Insurance cost your primary concern? (Yes/No)
If the answer is Yes, then you will want to pick an HMO Dental Insurance plan. These low cost Dental Insurance plans offer preventive services and restorative services at a discounted price. These discounted prices can save you up to 65% off the regular prices. To choose between the HMO Dental Insurance plans you’ll want to look at the benefit descriptions and compare the prices for the services you expect you might need (typical services are office visits, cleanings, cavity fillings [called amalgams or Minor Services], root canals [called endodontics or Major Services], and Crowns [called Major Services]). The downside of HMO Dental Insurance plans is that you will have to select a Dentist from a smaller network of Dentist’s. If you don’t like the Dentist you initially choose, you can switch to another Dentist in the network by calling the insurance company.
If the answer is No, decide which Dentist you would like to see and call their office to ask them which Dental Insurance plans they accept. Most of the time you will get “We accept all PPO Dental plans.” In that case, you can choose from the any of the PPO Dental Insurance plans, and then call the Dentist’s office again and ask them if they will accept the specific PPO Dental Insurance plan you want (just to be safe).
These 2 main questions will enable you to simplify the process of picking a good Dental Insurance plan for your specific needs. Obviously, there are other factors and questions that will impact the final decision, but these questions will significantly reduce your search time. For additional help please contact our office and one of our advisors would love to help you.
Congratulations on your decision to start a family! There are a few planning steps you’ll want to make sure you complete before you become pregnant. The first step is making sure that your finances can support the addition of a new baby. The second step is to make sure you are ready for the hardship and joy of bringing a new baby into the world. The last step is to make sure that you have maternity coverage in your health insurance plan that will help manage or reduce the financial costs of pregnancy and delivery.
It’s not uncommon for a standard pregnancy and delivery to cost between $13,000 to $20,000. The main cost is for the delivery, which in San Diego County averages between $7,700 to $13,100, depending upon the hospital. The next largest cost is for the 12-14 prenatal office visits that are recommended to check on the health of the baby and mother during the pregnancy (1/mo during 1st 6 months, 2/mo during months 7 & 8, and weekly during the 9th month). The average cost of these office visits are about $100-$200/visit. Other tests, such as amniocentesis (~$1,500 – $2,000 cost), blood and urine tests, ultrasound (~$200) all add to the total overall costs. Therefore, having insurance with maternity coverage to help reduce these out of pocket expenses is important. read more…
The best way to find a good physician is to find a good medical group and then ask the medical group to recommend good physicians for you. Many of the medical groups have nurses that will ask you some questions to determine what type of physician, both practice and personality, would be a good fit for you. This 2 step process can simplify the process of finding a good physician.
Medical Groups are a business organization with multiple doctors working together to serve the needs of a common set of patients. By offloading the administrative and support work, each physician is able to focus on the needs of the patient and improve patient care. So finding a good Medical Group is the first step in the process. read more…
Blue Shield of California members can breath a sigh of relief after the company announced that they were withdrawing their rate increase and guaranteeing members that rates would not increase again in 2011. read more…
The initial open enrollment period to get health insurance for children under the age of 19 is now over (January 1st to March 1st, 2011), so what can be done to get the new preexisting condition exemption for your child if the child loses health insurance coverage outside of the open enrollment period? Listed below are a number of special events that offer a late enrollment period that can used to obtain coverage and keep the protections provided by the open enrollment period.* read more…
Health Care Reform (aka Health Insurance Reform) Has Been Repealed According to 48% of Americans
A recent tracking poll by the Kaiser Family Foundation shows that almost half the population believes that the new health care reform laws might have been repealed. 22 percent of Americans believe the health care reform law has been repealed, while 26 percent aren’t sure about the status of repeal.
Media stories about the Republican bill to repeal health care reform in the house of representatives, and subsequent amendments to the continuing resolution bill, which would block spending federal funds to implement the health care reform law, have made people uncertain regarding the actual status of the health care reform laws.
Currently the democrats in the Senate have blocked bills to repeal health care reform, but it remains to be seen how they will handle the challenges facing the continuing resolution bill.
In the mean time, health care reform is still in effect, and the government and health insurance companies are taking the necessary steps to see the reform law rolled out by 2014. So don’t think that health care reform is dead yet.
Blue Shield of California Adds 6 Month Rate Guarantee to Individual and Family Health Insurance Plans
Blue Shield of California today announced a 6 month rate guarantee on all Individual Health Insurance plans that have a Jan 1, 2011 effective date or later.
What this means is that if you apply for a Blue Shield health insurance plan your rate will not change for the first 6 months, unless you have a birthday. After 6 months, Blue Shield has the ability to change your rates when they need to.
Last year Blue Shield offered a 1 year rate guarantee, but chose to eliminate that guarantee option in October of 2010 when the first changes for Health Care Reform began to take effect. Most carriers have eliminated the 1 year rate guarantee, except for Anthem Blue Cross of California.
All health insurance plans have some benefits that won’t be important to the majority of people and therefore, should be ignored when comparing various plans. Understanding the 4 key parts of all PPO health insurance plans will make it easy to know when you’ve got a plan that will fit your specific health insurance needs. The 4 key parts are:
- Office Visit Co-pays
- Deductible Amount
- Out-of-Pocket Maximum
- Prescription Benefits
Office visits are the most commonly used benefit in health insurance plans, and are one of the benefits that the insurance companies use to differentiate low cost plans from medium and high cost plans. read more…
