HealthCare Advocates' Blog

The medical effects of the Coronavirus are being well covered in the media, what is not being covered is how people are going to pay for care in the advanced stages of the Coronavirus (COVID-19)? Many health plans have high deductibles and other plan have limited benefits. How are families going to protect their finances if they or a loved one fall victim to the Coronavirus?

Vice President Pence has stated that the major insurance companies are waiving co-pays for testing .

The state of Oregon publicized: “The state has reached an agreement with several health insurance companies to waive co-payments, co-insurance, and deductibles for their customers who need COVID-19 testing .”

These efforts are directed at the “testing” for the Coronavirus, but what about paying for care if a person is in the advanced stages of the Coronavirus? What about the 27.5 million Americans who do not have health insurance?

The limited studies to date support the fact that most people who develop the Coronavirus (COVID-19) will experience mild to moderate symptoms. The risk factor is for people over the age of 60 and those with an underlying medical condition. Such conditions include:
• High blood pressure
• Diabetes
• Heart disease
• Lung disease
• Cancer

Those who experience the advanced stages of the Coronavirus could experience:
• Lung damage which could result in respiratory
failure
• Acute respiratory damage1
• Pneumonia
• Kidney failure

These “advanced stage conditions” will all require hospitalization and possibly a ventilator. If the person has health insurance, they may have to payout thousands or tens-of-thousands of dollars in deductibles, emergency room deductibles, pharmacy expenses, and what if the insurance company denies coverage based on their review of “medical necessity?”

To protect families HealthCare Advocates suggests that people over the age of 60, or those with underlying medical conditions consider buying a “hospital confinement policy.” A hospital confinement policy will likely cost $30/month depending on the plan and options chosen, but the payout could be between $10,000 and $30,000 depending on the plan. This payout will help protect the financial well being of both individuals and families.

When researching hospital confinement policies people should select a plan that pays a minimum of $500/day. They also need to read the section on waiting periods, exclusions, pre-existing conditions and any section on specific conditions covered as to ensure they would be covered if hospitalized as a result of the Coronavirus.

HealthCare Advocates is a patient advocacy organization dedicated to helping people and families obtain the best medical care while safeguarding their finances.

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Source:
http://www.health.harvard.edu/newsletter_article/Ejaculation_frequency_and_prostate_cancer

The House passed a bill to change the Affordable Healthcare Act (Obamacare). If it becomes law, what does it mean to you?

The Affordable Care Act (ACA) requires businesses with 50 or more employees to provide health insurance to employees working 30 hours or more a week. The new bill, if implemented, ends coverage requirements for large employers. This “could” result in employees losing coverage or having to pay more toward their medical care. That stated, most large employers offered insurance long before the ACA required it so most people who obtain insurance through their employers will likely not see any change.

Under current law, people are protected by not having annual or lifetime limits on the amount of care they receive. If your cancer care costs $2 million, the insurer pays it. Under the new bill, states are allowed to apply for waivers that could alter or abolish these provisions thereby limiting the amount of care an individual would receive on an annual or lifetime basis. While such limitations would cap the amount of care an individual would receive, these provisions could also reduce insurance premiums for all insured because it would limit the amount of money being paid by the insurer.

The personal mandate to have insurance would no longer exist. Instead, the House bill prohibits insurance companies from terminating policies and from charging more for people with pre-existing conditions as long as their insurance doesn’t lapse. If there is a coverage lapse greater than 63 days, however, insurers can charge a 30% penalty over their premium for one year. To ensure people with pre-existing conditions have coverage, $38 billion is being allocated for high-risk insurance pools, and maternity and childbirth services.

Subsidies will change, instead of income-based tax credits and subsidies, the new plan will implement age-based tax credits ranging from $2,000 a year for people in their 20s to $4,000 a year for those 60 and older.

The new bill eliminates nearly all of the taxes that were included in the ACA. These taxes which total nearly $592 billion included taxing incomes over $200,000 (or $250,000 for a married couple); a tax on health insurers and a limit on how much insurers can deduct for executive pay; and a tax on medical-device manufacturers.

The COB predicts that the House bill would cut federal deficits by $337 billion over 10 years.

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Aria Health and Jefferson Health System have completed their merger allowing expanded capabilities and patient population.

Today, HealthCare Advocates won a denial of coverage for intravenous immunoglobulin (IVIG) therapy for a child.