Education Center

Education Center

November 2014 – CA Health Insurance Newsletter

Welcome to our quarterly newsletter with information on healthcare insurance, long term care, and other strategies to protect your family’s financial future. This edition will focus on healthcare for those under age 65 as well as those over age 65 because we are just starting the open enrollment period for both age categories (November 15th through February 15th for under age 65 and October 15th through December 7th for over age 65). Most of you already have health insurance through your job, but you may have children or family that don’t have coverage or are paying too much for an old health plan.  In some cases you or a family member may be able to obtain a quality health plan for little cost. We appreciate that you have so much information available to you and such limited time to look at it so feel free to opt out by using the unsubscribe feature. “Obamacare” or the “Affordable Healthcare Act (ACA) has created a new healthcare landscape with mostly new simplified improved options. You may currently have a plan that is not required to follow some of the new laws such as offering preventative health services without co-payment from you or raising your rates based on your health status. THE GOOD PARTS OF ACA Two good features of the new law are that all who apply for health coverage are guaranteed acceptance and all plans have a maximum out of pocket cost to the insured ($6,350 for an individual) so that a catastrophe does not bankrupt a family. All plans must offer at least 10 essential health benefits and cover certain types of preventative care at no cost including an annual checkup.  For those with lower income or near the poverty level, premium costs are subsidized so that healthcare is “affordable”… Read More »

Obamacare – Platinum May Be A Waste of Money

For those who find themselves shopping for health coverage through Covered California or Obamacare in states without their own health plan marketlplace, here’s a general tip: save cash on your premiums and buy the bronze or silver health plan. For most consumers, the gold and platinum options will be a waste of money. Analysis of dozens of Obamacare plans has shown one striking result. The networks of providers, and in many cases the drug formularies, are the same whether you’re buying a particular insurer’s bronze plan, or purchasing the same insurance option in a gold or platinum offering. The bottom line is this. When you’re choosing a particular insurance offering, you typically can’t trade up to a better benefit by buying the gold or platinum variety of that plan. It’s usually the exact same benefit regardless of the metal you choose. What varies between these different metal plans? Mostly, just the co-pay structure and deductibles. As you pay higher premiums for a gold or platinum plan, your deductibles and co-pays will decline. The insurer will typically cover 60 percent of expected medical expenses in a bronze plan, 70 percent in a silver plan and 90 percent in a platinum plan. So, by buying the costlier plans, all you’re doing is fronting a higher premium to buy down your anticipated out of pocket costs. You’re not getting a better network of doctors or a better formulary of drugs. (Early indications of plans in California show the network of doctors is more robust for “off exchange” plans although the trend may be more providers are accepting Covered California plans.) This rule applies to the different level of metal offerings within the same health plan. When you look across the different types health plans that an insurer might offer (its HMO versus its… Read More »

October 2014 – CA Health Insurance Newsletter

Welcome to our quarterly Newsletter with information on healthcare insurance, long term care, and other strategies to protect your family’s financial future. This edition will focus on healthcare for those under age 65 as well as those over age 65 because we are just starting the open enrollment period for both age categories (November 15th through February 15th for under age 65 and October 15th through December 7th for age over 65). We understand that most of you already have health insurance through your job, but you may have children or family that don’t have coverage or are paying too much for an old health plan.  In some cases you or a family member may be able to obtain a quality health plan for little cost. We appreciate that we all have so much information available to us and such limited time to look at it so feel free to opt out by using the unsubscribe feature. THE NEW HEALTCARE LANDSCAPE Is “Obamacare” or ACA -the “Affordable Healthcare Act” here to stay?  For those that hate it, there is still a chance it could be derailed, There are two opposite decisions in the courts that say 1) only persons residing in states such as California with a health exchange are allowed to receive a premium cost tax subsidy, and 2) all U.S. citizens are allowed to receive a tax subsidy including those outside state health exchanges. Each decision will go to the full appeals court and then probably the Supreme Court for a final decision. My guess is this process will take until 2016 to resolve itself and regardless of what happens in the courts, we will probably keep the ACA structure with possible modifications. THE GOOD PARTS OF ACA It’s interesting that polls show most people dislike the new… Read More »

The New Health Insurance Landscape (CA)

The ACA or “Affordable Care Act” has dramatically changed the way people obtain their health care coverage. The following are some common questions I have gotten and my best guess at the correct answer. Q:        Shopping for insurance in the past was complicated by the complex benefits, co-pays, deductible, and provider network carriers offered. Do I have the same challenge with the new plans or is it just a question of metal plan choices and provider networks? Answer: All individual, family, and small employer group health plans offer a similar package of comprehensive services that cover 10 so-called essential health benefits and cover certain types of preventive care at 100 percent or zero cost to you. Within each metal category benefits, co-pay, and deductibles are identical to make comparisons easier than the old health care plans. The main distinction is cost and the provider network each plan offers. Make sure your doctors are in the network of the carrier you choose although in some cases such as specialists, providers don’t accept any health plans. Q:        I have heard so many bad things about “Obamacare” so I don’t want it because it sounds really bad for my family and our country. Is there regular health insurance available that is not “Obamacare?” Answer:          All of the health plans now comply with the “Affordable Care Act” of 2010 except some of the older employer plans or group plans that are grandfathered in until 2016. So a silver metal plan with Blue Shield, is exactly the same whether it is subsidized via Covered California or “off the exchange” which means it is not subsidized. If people qualify for premium assistance through Covered California and choose not to take that assistance they can go directly to the insurance carriers but the plan and cost will… Read More »