The House’s healthcare reform bill looks like it’ll cross the $1 trillion mark, according to the nonpartisan Congressional Budget Office. Many Democrats have promised a bill that would cost less, and initial CBO estimates agreed with them. However, they have since added billions more in funding health insurance for the retired, as well as more spending on public health and increased reimbursements for preventative care services. Some of these provisions are intended to garner more support from important populations, such as senior citizens. These modifications bring the estimated total of the bill to at least $1.2 trillion over ten years.

Breaking the trillion dollar threshold makes reform of the health insurance industry more difficult to achieve. Nancy Pelosi has previously claimed that the bill would cost about $900 billion; still a massive sum, but short of the trillion mark.  It seems to be a sort of psychological block, even among Democrats whom are otherwise supportive of the bill. The new CBO estimate is closer to Republicans’ claims of $1.3 trillion. The big question is whether it’s worth the price. Supporters would argue that the eventual savings from health insurance plans would allow the nation to pay off that debt in time (after all, America managed to pay off its decades-long national debt by the end of Bill Clinton’s second term), but others feel that it’s a pointless gamble.

Following her Senate counterpart’s reveal of his healthcare reform plan earlier this week, Speaker of the House of Representatives Nancy Pelosi has now unveiled her chamber’s proposal for expanding affordable health insurance coverage. As expected, the House’s plan is farther-reaching than the Senate’s and more similar to the one outlined by President Obama during his campaign.  Here’s a quick Q&A on Pelosi’s plan:

Q: How much is this going to cost?

A: It’s projected to cost a whopping $894 billion over ten years.

Q: How is the government planning to pay for reform?

A: It will raise income taxes on couples making over $1 million and individuals making over $500,000 yearly. In addition, Medicare spending will be cut by an unknown amount.  Liberal representatives also floated the idea of having the government dictate the rates paid to health care providers by the public option, but moderates managed to strip out that provision. (The government, as well as private insurers, will instead negotiate payment rates with hospitals and doctors.)

Q: Is a public option included?

A: Yes. Unlike the Senate version, the House’s bill doesn’t allow states to opt out of it. So far, it doesn’t include a so-called “trigger” either.

Q: Will illegal immigrants be covered by the public option?

A: As of now, it’s unclear. That’s one of the main sticking points preventing the House bill from reaching a vote. However, remember that illegal immigrants are already receiving a form of public healthcare: hospital emergency rooms are required to serve everyone who comes in.

Q: What about abortion? Will it be covered?

A: That’s another controversial topic that will see much debate before the bill hits the House floor. A handful of pro-life Democrats will probably try to have abortion coverage removed from the public option in order for it to receive their votes. Meanwhile, some pro-choice representatives oppose a bill that doesn’t include abortion services. Either way, the Democrats have a solid majority in the House and can afford to lose some votes in either direction.

Q: What if I have a pre-existing condition and can’t get insurance?

A: These reforms are supposed to change that. Health insurers will no longer be allowed to deny coverage to people with pre-existing conditions. They won’t be able to charge those with pre-existing conditions significantly more, either.

Q: When will healthcare reform take effect?

A: It’s hard to believe, but the bill won’t fully kick in until 2013. By then, a mandate will require everyone who can afford it to buy health insurance. They can be insured via the newly created exchange (consisting of private insurers, in addition to the public option), by their employer, or an existing government program such as Medicare or Medicaid.

Q: But I need health insurance now! What can I do in the meantime?

A: The government is putting together a temporary program to insure individuals and families that have been rejected by private insurers. Otherwise, do you really want to wait for the government’s health insurance plan? Keep in mind that the House bill needs to be reconciled with the Senate bill before there’s a final vote, and that could take months.

(Image: U.S. House of Representatives Portrait)

Recent studies have found that women under the age of 55 are more expensive to insure than their male counterparts. Why are their health insurance costs higher? A lot of it seems to come from the unfairness of biology:

• Most women need maternity care at some point in their lives, while men don’t. (Still, women who choose not to have children don’t get discounted health insurance quotes.)
• Although this disparity reverses in old age, cancers that almost exclusively affect women (e.g. breast and ovarian cancer) tend to strike at a younger age than exclusively male diseases like prostate cancer. In addition to the high cost associated with cancer treatment, health insurers must also cover preventative measures, such as Pap smears and mammograms.
• On average, women visit the doctor more regularly and use more prescription medication than men. This is most likely primarily due to a higher tendency for women to be proactive when it comes to their well-being, rather than a case of the female gender being sicker.

All of these factors cause insurance providers to consider women’s health insurance policies higher risk, and they charge more as a result.

Many consider the practice of gender rating discriminatory and counter intuitive, as it penalizes women for using greater quantities of preventative care–even though prevention is a proven way of reducing health care costs by a far larger sum.  Health insurance companies are willing to eliminate gender rating in certain instances. The Senate Finance Committee’s healthcare reform bill bans insurers from giving individuals and small groups a different health insurance quote based on their gender, but the definition of a small group is arbitrary. It could be as small as 50 or 100 employees. A firm with just 51 employees and a predominately female workforce could pay up to 20% more than the national average to insure its employees–and employees will have to cover more of that cost themselves.

Democratic Senator Barbara Mikulski is calling for the end of this practice altogether, including in large corporations. While she has been gathering support from other congresspersons in her quest, the health insurance industry’s lobby has been fighting to retain the exception that would allow gender rating to continue in the large group market. Their argument is that some businesses will decide to offer their own insurance (as opposed to buying it in the group market) after seeing their premiums increase. It’ll be extremely interesting to see how this plays out. Will Congress give into the insurers, believing that their support in eliminating gender rating for individual and small business health insurance is more urgent? After all, at least those working for large companies tend to have at least some form of employer-sponsored health insurance plan.

(Image: jfrancis under CC 2.0)

Behavioral psychology could be used to encourage young individuals to sign up for the health insurance plan of their choice. An article in the Washington Post describes the challenges of mandating people to buy health insurance. In order for healthcare reform to succeed, those Americans who can afford it must buy insurance. This is especially true of the younger demographic, since young adults are generally more healthy as a group. Including them in a larger pool of health insurance buyers should lead to lower costs per person. However, it is very hard to get a notoriously present-focused group to think about the future–and the possibility that they might need to use health insurance sooner than they expected. Health insurance for students is available, but many don’t take advantage of it; and what about those who aren’t attending college?

In the long run, paying insurance premiums for years when you’re well will probably end up being worth it when you get sick. But rational economic self-interest tends to take a backseat to social norms and the amount of effort required to do something. Experts speculate that minor inconveniences prevent people from taking part in government programs. By streamlining the application and insurance process through default enrollment programs that use a person’s tax payments to automatically pay for premiums (similar to corporate 401(k) plans that make you opt out as opposed to opting in), as well as a heavy publicity effort and community support, the federal government can make sure that more young adults buy health insurance. Studies have shown that if you want to encourage people to take a particular action, you need to make it as simple and effortless as possible.

Penalties for not buying insurance are imperative. They make the mandate more effective, while attempting to ensure that the federal government isn’t stuck covering subsidies for only the oldest, unhealthiest individuals. Unfortunately, the penalties in the most recent Senate proposal; max out at a $750 fine, and wouldn’t reach even that level until 2017. Some people may decide to pay the fines instead of paying for individual health insurance, since a fee that small isn’t discouraging enough. Getting young adults to buy a health insurance plan now is very important.

The whole notion of pre-existing conditions is debatable. On one hand insurance companies only want to take your money as long as you are healthy, and have no real need for medical attention. On the other hand, an individual facing illness on a daily basis could make it difficult for others to acquire affordable coverage. For people with pre-existing conditions, the only alternative outside of group coverage, are limited medical benefit plans and discount plans. Limited medical benefit plans provide some coverage for basic medical necessities, but most plans fall short of substantial assistance when faced with catastrophic medical issues. The plans open the portal to health care but are limited, as the name suggests, in the care that an individual who really needs it, can get. Moreover, the risk of being taken advantage of by opportunistic insurance agents is high. Discount plans only provide discounts. Most are not accepted by the health care providers that they claim to be affiliated with, thus mounting frustration with the consumer who bought into the hype. Most importantly, discount plans are NOT insurance.
The idea of insurance is to insure in case of loss. In the case of health insurance, loss is illness. If an individual is willing to pay a monthly premium why not allow them the health care coverage they so greatly desire? Recently there has been a lot of discussion regarding pre-existing conditions and the government is trying to make it illegal for insurance companies to deny people converge for those who do have a pre-existing condition. But until that time it’s really slim-pickens’, but don’t loose heart here’s a company that excells in coverage for those with pre-existing conditions, Vital One Health, 877-500-2945.

When benefits are offered to domestic partners, the level of coverage varies depending on the employer. Domestic partner benefits may include long-term care, group life insurance, family and bereavement leave, and most commonly, health, dental, and vision insurance. The definition of domestic partner may also vary from employer to employer. Some companies include same-sex couples, unmarried opposite-sex couples, and common law marriages. Regardless of how the term is defined, employers typically require domestic partners to sign an affidavit stating that they are in a lasting, committed relationship. They may also require that a couple live together for a specified period of time before they become eligible for domestic partner benefits.

The Washington Post recently reported that Health Insurance employees are encouraged to rescind policies as much as possible. This includes going back into people’s medical history and extracting similar or same symptoms for major medical problems such as cancer. Imagine all the sudden finding out you had cancer and then being denied coverage because of some minute condition the company went digging for.

However, this is not entirely accurate, in fact, it is illegal. Any of the practices mentioned are not allowed. They can raise legal issues and can be fough tin court. However, not many know this. Often times people do not have the money to pay for legal defense, and are exhausted from new of illness already. Most of th etim eonly those with significant others, family or guardians that are wiling to fight and rexsearch on their behalf win at this.

Do NOT accept it when your insurance company denies you coverage. Fight it. It is not legal, and they are not permitted to due so. Threaten legal action and watch how fast they reinstate your policy.

Why do people wait until they are pregnant to look for health insurance and then get frustrated when 9 out 10 carriers will not carry them?

According to the American Pregnancy Association, about 13% of pregnant women do not have health insurance. Many women either receive inadequate pre-natal care or pay for their entire pregnancy out of pocket. The reason it is difficult to obtain health insurance once they are pregnant is because pregnancy is considered a pre-existing health condition. Insurance carriers know that pregnancy can be a high risk and will need more assistance with costs of health care, so most of them will deny them coverage.

There are not many options, but there are some options for health insurance for pregnant women.

1) Medicaid-If you fit into the income qualification bracket, Medicaid will help pay for pregnancy costs, even if you are already pregnant when you apply for coverage. (programs vary state by state, go directly to your state to see what is available)

2) WIC-Women, infants, and children is also a popular government sponsored option for pregnant, uninsured women.

3) Access Plans underwritten by Nova Casualty  is a guaranteed issue plan that will accept pregnant women. Depending on the plan that you choose, benefits may vary. If you would like a quote please call us directly at 1-866-488-5200.

If none of the above mentioned maternity options work for you, consider the following: using a birthing center instead of a hospital. the costs will range approximately $3,000-$4,000, which is about half of what a hospital birth would cost. Also, contact the financing department of the hospital you have chosen to give birth and see if you can set up a payment plan.

The difficulty of rising health care costs is becoming a terrible problem for many Americans, since most don’t have health insurance coverage. So this means whenever they approach an insurance company for health insurance, they are turned down on grounds of having pre-existing conditions.
Pre-existing conditions are health conditions for which you have received treatment in the past or are receiving treatment presently. Pre-existing conditions include diabetes, heart disease, high-blood pressure, and even asthma. Each insurer has its own rules and regulations to determine their own criteria for preexisting conditions. Some of the insurance companies allow complete coverage after a waiting period and some deny coverage from the start. Having a preexisting condition puts you at a higher risk for being uninsurable.

HIPAA or the Helath Insurance Portability and Accountability Act of 1996 (HIPAA) determined that health insurance carriers may or may not cover preexisting conditions. HIPAA defines preexisting conditions as a physical or mental condition for which medical advice diagnosis care or treatment was recommended or received within a six month period ending on the enrollment date. Insurance companies can exclude people who previously have had insurance coverage. The insurers can also exclude people who have been without coverage for 63 days. Also acceptance by the applicant to the health insurance policy does not guarantee that full coverage is granted right away. Typically, the insured has to endure an exclusion period of 12 months maximum following date of enrollment.

Millions of Americans are in constant search for health insurance that will accept them despite there existing medical condition. VitalOne Health is here to help you get the coverage you deserve at a price you can afford. Health insurances that are not HIPAA compliant, do not provide the insured with real insurance coverage, or peace of mind. These health plans have no contractual backing for a regulated insurer. They also unfortunately provide a false sense of security, and generally are worse than having no insurance at all. So beware of faulty pre-existing condition health insurance plans. They will only charge you money and provide very little to no benefit at all.

Visit www.vitalonehealth.com for real HIPAA compliant pre-existing condition health insurance plans. The insurers we have selected for our clients promise and deliver health insurance plans that accept all applicants regardless of pre-existing conditions. This means a guaranteed issue health insurance policy for people who cannot qualify for any other insurances due to existing illnesses is our specialty.

We welcome you with open arms to enjoy benefits from our unique health insurance that accepts you for who you are, and recognizes everyones need for quality health care regardless of the situation they’re in. Our insurance is real health insurance that provides PPO network re-pricing which will provide you and your family with huge savings and reliable benefits.

Catastrophic health insurance plans—more formally known as High Deductible Health Plans (HDHPs)—were created as a way to lower overall medical costs by providing a lower monthly premium in exchange for a higher annual health insurance deductible. With catastrophic health insurance plans, you pay for almost all medical care until you reach the annual deductible amount. After that, traditional health insurance coverage begins.

Where to Get Catastrophic Health Insurance

High deductible health insurance can usually be purchased either as an individual plan or as a group plan. Certain pre-existing conditions, such as diabetes and mental health disorders, might mean you can’t qualify for an individual catastrophic health plan without prior qualifying group coverage, or at least that you can’t get coverage for those pre-existing conditions. Group catastrophic health plans are subject to HIPAA regulations, meaning you can’t be denied enrollment or coverage, but may have to wait for coverage of pre-existing conditions, depending on your prior health insurance coverage.

What Do High Deductible Health Plans Cover?

The type of coverage varies based on which high deductible health insurance plan you choose. Always read and understand the full policy and what it covers when comparing health insurance plans. Ask your agent or company to explain anything that seems unclear, and make sure you will get or can add coverage for medical conditions you might develop. In the past, catastrophic health plans did not cover things like routine care and prescriptions. Today, however, many high deductible health plans offer coverage for routine and non-catastrophic care. However, as a general rule, the more a plan covers, the higher the premium will be. Agreeing to pay more out of your own pocket shifts some of the risk away from the health insurance company on to you, resulting in a lower monthly premium.

Should You Get a High Deductible Health Plan?

If you’re sure you can cover the deductible and want to save money on the monthly premiums, a high deductible health plan may make sense. If you qualify for an HSA or other tax-exempt medical savings account and can contribute the deductible amount, you may have an easy way to pay your out-of-pocket medical costs while saving on premiums. Most people who consider catastrophic health insurance either are getting their own health insurance for the first time or are nearing retirement. The younger group tends to be less likely to incur medical expenses because they are young and healthy, while the older group tends to have enough money to pay for most medical care unless they experience a serious illness or emergency. Typically, high deductible health plans provide the most benefit to those who don’t require frequent prescriptions or office visits.