Posts Tagged - ‘medicaid’

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Homeless Adults Will Get Health Insurance

Thursday, April 29th, 2010

Image: Franco Folini under CC 3.0

Due to provisions in the new healthcare reform bill, many homeless adults will receive health insurance through Medicaid. They are eligible if they earn up to 133% of the poverty level. If a person is living in shelters or on the street, they clearly aren’t able to afford a health insurance plan.

Although Medicaid has its disadvantages, it may be perfectly suited for this population. For example, it provides transportation services to doctors’ appointments, which most private plans don’t.

Community health centers are also set to receive increased funding for their services, which are offered on a sliding scale based on a person’s ability to pay, regardless of their health insurance status.

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Medicaid Health Insurance Cuts By States

Friday, February 19th, 2010

The recession has caused millions more Americans to be unemployed and sign up for Medicaid. The government-run health insurance plan for the poor may be a sign of the struggles ahead if healthcare reform passes.

Many states have been forced to cut the budgets of their Medicaid health insurance plans, when more people than ever need them. Some of them have proposed tax increases on tobacco to pay for it. Another option, already proposed in states like Nevada, is to end its coverage of “optional” benefits–including vision and dental insurance. They even want to cut the number of adult diapers provided to each patient!

Some ophthalmologists and dentists, facing reduced payments, have stopped caring for patients with Medicaid health insurance; it simply isn’t cost-effective. After all, doctors have hundreds of thousands of dollars in medical school loans to pay off. Meanwhile, state governments don’t have the luxury of running budget deficits, leaving governors in a bind; and the money they received in the stimulus (which is set to dissapear in the coming year) doesn’t permit them to tighten eligibility standards.

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Government-Funded Health Insurance? It’s Already Happening

Friday, February 5th, 2010

According to a report from the Center of Medicare Services, over half of healthcare spending is set to come from federal and state governments by 2012. That’s even if health insurance reform is not enacted. They blame the increasing number of baby boomers aging and therefore becoming eligible for Medicare insurance, as well as the recession. The latter is at fault for leaving millions out of work and without employer-sponsored health insurance (meanwhile unable to afford short term health insurance), causing them to then apply for Medicaid.

The reality could be even worse! The report assumes that a long-planned cut in Medicare’s reimbursements to doctors would take effect next year. Instead, physicians cried foul and the 20% reduction was shelved. Such a reduction would force private health insurance companies to pick up the slack. The premiums of temporary health insurance and other types of insurance would increase as a result.

Many are understandably concerned about the Obama administration’s healthcare reform proposals. Some people believe that there is the potential decreased quality of health care if the government is more deeply involved in providing health insurance. However, this new research ignores the pending legislation altogether. Granted, the Democratic-led reforms could lead to an even larger share of government spending. Either way, taxpayers will be contributing more towards health insurance costs.

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FAQ: Finding Affordable Health Insurance For Autistic Children

Friday, January 22nd, 2010

If your child is autistic, you are no doubt familiar with the financial and health challenges involved. Unfortunately, many health insurance policies do not cover treatments for what has become a more prevalent condition. Doctor visits, prescriptions, speech and occupational therapy all add to the cost involved: anywhere from $67,000 to $72,000 per year, depending on where the child is on the autism spectrum.

Here are some answers to questions you may have when you are struggling with this family health insurance issue.

Q: Does my state mandate health insurance coverage for autism?
A:
The following states currently require all health insurance sold within their borders to offer autism-related coverage, which is a start:

  • Arizona
  • Colorado
  • Connecticut
  • Florida
  • Illinois
  • Indiana
  • Louisiana
  • Montana
  • Nevada
  • New Jersey
  • New Mexico
  • Pennsylvania
  • South Carolina
  • Texas
  • Wisconsin
  • New Hampshire and Maine also have pending legislation. Remember that the specific types and level of coverage vary among states.

    Q: What if my state doesn’t require health insurance plans to cover autism-related treatments?
    A:
    An increasing number of large employers include autism coverage in their plans. Failing that, it is possible to buy family health insurance on the open market–although in some cases, it may be more affordable to buy a specific individual health insurance plan for your child. It is essential to shop around for the right plan, which will provide for the care your child needs.

    Q: What should I think about when buying health insurance for my autistic child or children?
    A:
    The needs of the child should come first, just like they should for non-autistic children. You must think about the recommended treatments for your child and the cost of those treatments. Many health insurance options cover autism, but have annual or lifetime limits on the amount that can be spent. Behavioral therapy and other techniques are often expensive, eating through a $36,000 yearly cap surprisingly quickly. A nonverbal child will probably require a more comprehensive policy than a child with a milder form of autism. Some health plans may also limit the number of times per year a child can visit a particular type of therapy session. Also keep in mind that certain medical conditions, such as gastrointentional problems, are more common; therefore, it is important to make sure those are covered.

    Q: How can I make sure that my health insurance company doesn’t deny my child’s claim?
    A:
    Health insurance companies have certain protocol and procedures they depend on when deciding whether to approve or deny a medical claim. These procedures are often based on years of scientific studies based on the average population. Individualized treatment is often necessary with autistic children, leaving it to parents to argue in favor of a particular course of action. It is best to pick a plan with a positive reputation and good customer service, and come armed with research and expert referrals.

    Q: What if I can’t afford to pay for my child’s autism treatments?
    A:
    There are several options available, including financial subsidies from private organizations like United Healthcare, as well as Medicaid. While the waiting list is long, the program for poor residents will accept children with a sufficiently severe form of autism, regardless of their family’s income. In addition to such waivers, you can bargain with teachers and other caregivers to stretch your healthcare dollars. For example, instead of using your health insurance to duplicate treatment your child is already receiving at school or elsewhere, use it to supplement existing therapy.

    (Image Beverly & Pack under CC 2.0)

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