Affordable Health Insurance and the Economy
Due to the economy, more and more consumers want to save money on health insurance and get quotes for the most benefits at the lowest cost. If you are someone who mainly needs doctor visits and prescriptions, one of the best ways to get affordable health insurance is to get a medical plan with a high deductible that allows you to see the doctor and get prescriptions without having to pay into the deductible. Having a deductible helps you get low cost health insurance because it lowers your premium, but it also means you’ll pay full cost for services until what you’ve paid adds up to the amount of the deductible. A deductible is a big deal, mainly, when you need big ticket services like emergency room visits and hospitalization. If you want more protection for these services, a low cost health insurance deductible plan could still work, but consider a plan with a smaller deductible of $500-$2,000, depending on what you’re comfortable with.

Finding the right health insurance plan for you
When comparing medical plans to find cheap health insurance, keep in mind your budget, but also consider the types of medical services that you need most. Don’t be allured by bells and whistles that you generally don’t need. This will help you narrow your search to the plan that’s right and help you save money on health insurance. Also, be aware that timing can impact pricing. As I started to say, applying for a June effective date could keep your costs down and help you in your search for affordable health insurance. California rates are going up, so take advantage of the lower rates today. If you’re interested in a personalized quote, give us a ring at 1-877-752-4737.

Recently, a couple from Australia received a million dollar hospital bill because their travel insurance did not cover pregnancy delivery outside of the couple’s country. The couple (John Kan and Rachel Evans) had purchased two travel type insurance packages because both insurance companies claimed to have maternity coverage. However, during their vacation to Vancouver, B.C, Rachel unexpectedly went into early delivery, and they found out that maternity services and baby delivery were not covered by either of these insurance packages. While they are overjoyed by their new daughter and do not begrudge their situation, any financial relief would be welcomed by any parents faced with a million dollar hospital bill.

Kaiser Permanente Maternity Coverage
Currently, many of the Kaiser Permanente Individual Health Insurance Plans in California include maternity coverage. These services include prenatal visits, delivery coverage, and some coverage for the baby. On each of the individual plans, there is an Out of Pocket Maximum. If this Out of Pocket Maximum is reached, then services are covered 100% by Kaiser Permanente for the rest of the calendar year.

Kaiser Permanente Maternity Coverage while Traveling
Typically, expectant mothers don’t travel when they’re far along in their pregnancy. So, in cases when they do travel, it is good to know how maternity coverage would apply. Kaiser Permanente is an HMO provider, which means services would need to be rendered at Kaiser Permanente only in order to be covered by the health plan. An exception, however, would be emergencies and urgent care services. When a woman needs to go to an emergency facility due to a sudden and unexpected pregnancy delivery, she can go to the nearest facility, whether it’s Kaiser Permanente or not. If she is covered under a Kaiser Permanente Individual Plan, the emergency benefits would apply. The most she would be responsible to pay is the out-of-pocket maximum amount.

Traveling and Pregnancy Delivery
Here’s an example of how Kaiser Permanente pregnancy delivery benefits could look for an expectant woman who is traveling. Again, we’re not encouraging that you try this at home, but always with your doctor’s consent. Let’s pretend that a family of four went from California to Florida for a family getaway to Disneyworld. Then let’s say that the mother, Jane, had to be rushed to the nearest emergency facility due to complications with her pregnancy. She can go to whatever facility is closest; it doesn’t have to be Kaiser Permanente. After all is said and done, Jane’s emergency visit would be covered based on her Kaiser Permanente plan.

Personally, I would rather have insurance and never need it, then be without insurance and need it. What are your own thoughts about maternity coverage?

The ability to work hard is a big plus in any individual. However, an addiction to work can be very unhealthy. Here are four signs to consider when gauging your own level of addiction to work.

1.       No Boundaries

If you are a workaholic, then you are probably the first to arrive and the last to leave the workplace. While on the clock, doing a good job is not enough for you. You strive to be the best at what you do and can tend to be very competitive if someone else surpasses you. This can sometimes provoke you to go beyond what’s necessary to meet employer expectations and demands.

Recommendation: While being passionate about work is definitely commendable, an extreme devotion to your job can make you vulnerable to health issues as well as unhealthy boundaries. Taking breaks in between your work can definitely help relax your mind and body and can even enhance the quality of your work.

2.       Project Praise is Paramount

Receiving project praise is paramount for a workaholic to feel validated as an employee and even as an individual. If a workaholic does not receive acknowledgment for their good work, they may add more projects to their plate until they receive recognition.

Recommendation:  Ultimately, it’s important for an employee to separate themselves from their work. If feedback is desired, sometimes the best way to get it is simply to ask for it. Communicating this need can often help bridge the gap between a lack of recognition and a surplus of compliments.

3.       Conversations Revolve Around Work

Participating in social conversations might be a struggle if you are a workaholic. Even when surrounded by friends and family, you might feel at a loss for words when discussing topics not related to work. At times like these, you might give up on friendly interaction altogether.  

Recommendation: Purposely taking your mind off of work to have a meaningful conversation with someone you love can be very enlightening and refreshing. It might feel like you are exercising a muscle for the first time, but over time practice can make perfect.

4.       No Time for Relationships

Those addicted to work might allow it to invade evenings, weekends, and holidays.  This inevitably takes time away from rest and relationships. If you are prone to this lifestyle, your spouse or partner might complain about your value for your job being above your value for them.

Recommendation: It is important to place time restrictions on tasks so that you can enjoy other aspects of life, with the people you love. While no two relationships are the same, it’s true that no amount of work can make up for the joy of simply spending time with valued friends and family members.

What is your experience with working too much? Share your tips below in a comment. We would love to hear your thoughts.

By Esmeralda Mercado

This blog is intended to give an overview of the latest Health Care Reform news with the Supreme Court, and to invite people to share their own questions and theories.

The Supreme Court Marathon
The Patient Protection and Affordable Care Act (“PPACA” or “ACA”) was signed into law on March 23, 2010. Two years later, the Supreme Court considered its constitutionality after 26 states challenged the law. The case proceedings spanned a three day marathon, from March 26 through March 28, 2012. Many were surprised to find that the lawsuit was not dismissed automatically. Oral arguments revealed that the justices were divided on the law. Many tough questions were asked and remain unanswered. The arguments boiled down to a question of jurisdiction or boundaries of power: Does the Constitution’s Commerce Clause give the government the right to force its citizens to buy medical insurance? How much control does the federal government have over the states?

Will Health Reform be more costly in the long run?
The premise of the Health Reform Law is to provide affordable medical insurance to all Americans. To help accomplish this, more healthy people are needed to pay into the health care pool, thus lowering the cost for people with adverse and costly health conditions. Now, questions arise on the constitutionality of the mandate, as well as the funding of it. In 2008, it cost $43 billion to provide medical services to uninsured people. The cost was ultimately absorbed by insured Americans. Some have argued that Health Care Reform would end up decreasing the national debt by $100 billion, while others contend that the Affordable Care Act would increase the national debt by $80-$530 billion.

What questions will the Supreme Court be dealing with related to the Affordable Care Act?
The Supreme Court consists of one chief justice and 8 associate justices. A total of five votes are needed to decide the outcome of the Health Reform Law. The justices have until June 2012 to make a ruling on four main aspects of the law:

1.  The Anti-Injunction Act: Can the Supreme Court rule on this now, or must they wait until after 2014, after the law goes into effect? If the penalty associated with the mandate is deemed to be a “tax”, then the Anti-Injunction Act might require the Supreme Court to decide on this case after the law is already in place.
2. The Mandate: Will the mandate be deemed unconstitutional? Can the federal government require individuals to buy health insurance or pay a penalty?
3. Severability: If the individual mandate is deemed unconstitutional, must all the other Health Reform provisions also be nullified? Can the Supreme Court overrule part of the Affordable Care Act without overruling all of it? Also, if the mandate is deemed unconstitutional and the rest of the legislation stands while this part is severed from the ACA, what affects will that have on the implementation of the other 450-some provisions in the law?
4. Medicaid: Can the federal government require states to pay more into Medicaid? Some states are arguing that this would overly burden their state economies, and beyond that, they argue that this is unconstitutional. However, according to The Patient Protection and Affordable Care Act, if they do not comply, the states risk losing federal funding.

Historically, the Supreme Court has not struck down a regulatory law of this magnitude since President Franklin Roosevelt’s New Deal program in 1936. That law was drafted to provide relief and recovery to people and businesses during the Depression. However, it faced challenges as some argued that the regulatory codes could not be enforced and were too cumbersome to follow. For more information on the outcome of that case, click The Supreme Court and the New Deal.

While the nation waits for June’s decision, no doubt we all have questions. Here are some questions to ponder, answer, or comment on:

• What happens to parts of the Health Reform Law that have already been implemented? One of these is the provision that forbids health insurance carriers from denying children ages 0 to 18. Another provision allows children up to age 26 to remain as covered dependents on family plans.
• If the individual mandate is voted down and the other provisions are upheld, how will that affect health reform? Some reports say insurance premiums could rise around 20% if the mandate is removed. If premiums rise drastically like this, what affects will that have?
• How will the Affordable Care Act affect our economy as a whole?
• How will the Supreme Court’s decision affect the overall cost of health care in America?

What are your thoughts on Health Care Reform?

By Jacob Hansen

Some people think that they have to get medical coverage directly from the health insurance company in order to get the best price. In reality, you will get the same exact price for your health insurance whether you go through the carrier or a health insurance broker. This is because according to federal law, a broker cannot charge fees or raise the prices for health insurance. For more information, click Health Insurance Broker.

If I go direct, wouldn’t it be faster and won’t the company representatives be more knowledgeable?
Not necessarily! Sometimes, health insurance brokers are as well-informed about the products as the companies’ representatives. And when brokers represent one carrier exclusively, they can be especially keen on their product knowledge and expertise.

The health insurance broker can help minimize delays to your application. If you have questions while choosing a plan or while you’re in the middle of enrollment, it is the broker’s job to get you answers. Generally, when a broker doesn’t have an answer, they will either research and get back to you, or redirect you to a better resource. Also, because of their experience working with health insurance applications, they know how to fill out the forms to save you undue delays, which can sometimes be several weeks. If you answer a question in a vague manner, the underwriters will often call you or request additional records, when all that was really necessary was for you to phrase your answer in a more concise and thorough way. These are just a few ways health insurance brokers keep an eye out for you.

No Run Arounds
Let’s face it. We’ve all gotten the run around at some point. If you enroll through a health insurance broker, however, they can check on the status of your application by using more resources than what may be available to an applicant. Often, brokers have more contacts and more of an inside scoop so there’s less likelihood of experiencing red tape.

What if I already have medical coverage without a health insurance broker?
The ideal time to work with a broker is when you are not yet enrolled for health insurance or if you are switching carriers or health plans. An exception to this would be if you are already insured for medical coverage and you are covered under a group plan. Then, you can take advantage of broker services by sending the insurance company a letter authorizing the broker as your representative. For details in making KaiserQuotes.com your health insurance broker, call 1-877-752-4737 or support@kaiserquotes.com.

Ok. So you’ve been shopping for a health insurance plan for your family. You’ve collected quotes, compared plans, and now you’re ready to apply. Your next step to getting health insurance shifts to new questions. Is completing an application fairly simple? Are there steps you can take to improve your chances of getting approved? Is there a way the process can be speeded up? Could you apply for one plan and put other family members on a different plan? Yes, yes, and yes! See below for what to expect when applying for health insurance. For more information and a visual display of the steps, please click private health insurance.

How difficult is it to complete a Health Insurance Application?
Filling out a private health insurance application is not usually too difficult. You will know the answers to most if not all of the questions off the top of your head. If you have a pre-existing condition, it could take a little more time. Essentially, you’ll be answering questions to give a snapshot of your health history. Most medical questionnaires will ask if you’ve been diagnosed or treated for certain conditions, etc. Before you begin completing the questionnaire, have any prescriptions handy, as well as your last doctor’s contact information. You will need to include the information on the application.

How do I improve my chances of getting approved?
Medical insurance underwriters will review your private health insurance application to see if you meet the eligibility guidelines. There’s not much you can do to change your history, however, there are a few things you can do to improve your chances of meeting the grade:
• Answer questions with the appropriate amount of detail: For example, if you had something simple like the stomach flu, you would list it as a ‘minor illness’ and a short explanation of the symptoms would suffice. If applicable, use words like ‘minor’, ‘now resolved’, and ‘without recommendation for further treatment’ will help the underwriter understand that the situation was minor and/or is now resolved.
• Answer just the questions on the application: Be honest and accurate; however there is no need to share information that is outside of the time period indicated. For instance, if the question asks if you had a doctor’s visit in the last 12 months and yours was 14 months ago, it might not be necessary to include it. I say ‘maybe’ because there may be other questions on the application that specifically ask about your condition.

How can I speed up the process?
This section is about things you can do to help the insurance company review your health insurance application. Some of the things you can do are:
• Complete the form: When crucial information is missing, the insurance company may call or mail you a letter, so this will delay the process. If they don’t receive the additional information by a certain period, your private health insurance application will most likely be cancelled.
• Apply online: When possible, use the online application to enroll. This can shave quite a few days of waiting.
• Include additional paperwork if needed: For example, child-only applications often require additional paperwork, such as proof of a qualifying event.

Should I put some family members on different plans?
Sometimes, it’s ideal to enroll different family members on different plans. A wife may need a plan with maternity benefits, but the husband does not. As such, this couple would just complete separate health insurance applications and mark the particular plan they want. It’s a way of customizing benefits to meet your family’s personal needs.

What do I do if I’ve been denied health insurance? Where can I go? Who will insure me? What are health insurance company’s requirements for someone looking for coverage? Do I qualify for coverage if I have a preexisting condition? If I’ve been denied for health insurance before, will I be denied again? All of these questions go through most shoppers’ minds as they begin the process of looking for insurance. Look no further; you will find all the answers to these questions by the time you have completed reading this little article. For information about your other options for medical coverage, click What to Do if Your Health Insurance is Denied.

Insurance companies want healthy people and they will do their very best to make sure you stay that way. If you are healthy, hardly go to the doctor (except for your physical) and have never had any issues, then you should have nothing to worry about when applying. Most insurance carriers’ underwriters will review your application and approve it with some ease. However, if you do have medical issues, and especially if you’ve had a health insurance denial in the past, it may take underwriters some time to review your application. They may need to contact your previous doctors and review lab results from past physicals before they let you know if you have been approved or denied. If you’ve been denied health insurance before, you might still be eligible. It depends on factors such as: if you still have the medical condition, the severity of the condition, and how long ago you were denied for health insurance.

As a Health Insurance Enrollment Specialist, I have heard the feeling of rejection on the other line when someone hears their application was denied for health insurance coverage. This feeling of rejection based on a condition that was not their fault (or that they planned on) is not necessarily the end of the road; simply, it is just one door that has closed on the journey to health coverage. Listen…a few other doors are opening!

“What are the other opportunities opening up?” you ask. One option is to submit a health insurance appeal, which can be submitted when you receive an underwriter decision that seems inconsistent with your medical history. The denial letter from the insurance company should state how much time you have to be able to appeal and the steps you need to take. Misunderstanding or just missing information is sometimes the reason for denials. Give them all the facts so that they can review and make the proper decision. Tip: Consider including with your health insurance appeal a statement or explanation letter from a medical professional. For Kaiser Permanente, another door opens if you own your own business. Being a business owner, you are not required to go through the medical underwriting process, you simply need two people connected to the business and some eligibility forms filled out and you can have coverage by the beginning of the month. Apart from that, there are government programs that require a health insurance denial in order to apply. In California, visit mrmip.us to get more information about the Major Risk Medical Insurance Program (“MRMIP”). Can you hear it now? Doors are unlocking for you!

Hey, having a health insurance denial is not the worst thing to hear. My uncle used to tell me, “The worst they can say is ‘no’, and that isn’t the worst.” So I’ll keep knocking until the right door opens. Never stop, never give up! The right door is just up ahead.

By Thomas Cazneau
There are two options available when looking for Kaiser Permanente medical coverage. These options are individual health insurance and small group health insurance. Sometimes it is difficult to know which type of policy would be right for you. Below are some helpful tips to help you decide.

Individual or Group Health Insurance: What’s the difference?
First let’s talk about the differences between Kaiser Permanente Individual and Group Insurance:

• Individual Health Insurance
Individual health plans are geared for people wanting a medical policy at the private level. It is a popular choice for those desiring a relatively inexpensive plan, as well as for those looking for personal insurance while awaiting eligibility for employment health benefits. Whatever the scenario, Kaiser Permanente has several cheap individual health insurance options. For more information, click Individual Health Insurance.
• Group Health Insurance
Kaiser Permanente Small Group Health Insurance is available to businesses consisting of 2 to 50 employees. The benefit of choosing a group policy is that all eligible employees can be enrolled onto the group plan, regardless of health history or pre-existing conditions. For details, click Group Health Insurance.

Which type is right for you?
In some situations, people qualify for both individual health insurance and small business plans. Here is a list of details to compare between the two types of Kaiser Permanente health insurance policies before making a decision:

• Eligibility. One can be declined for Individual Plans for health related issues. This is true until 2014, when the Health Reform Law is implemented. Depending on how serious the pre-existing condition is, small business health insurance might be recommended over individual health insurance because the applicant can’t be denied for health reasons. If one owns a small business, it is advisable to get both a quote for Individual and Small Business plans.
• Duration. Coverage under a small group health insurance plan is available only as long as you are an eligible employee of the company. Otherwise, both group and individual plans are month-to-month.
• Cost. In general, the cost of a Kaiser Permanente individual health insurance plan is less expensive than a small group plan. In some scenarios, however, small group health insurance might be less expensive. Here are some examples when this might be true:

o Larger families on a group plan can save money because the cost for kids is the same whether there’s one child or more.
o Groups allow families to enroll together, which translates into a lower family deductible and out of pocket maximum.
o Small group rates are dependent on the age of the employee or owner. So, couples who are both linked to the business may save money on the premium if one of the spouses is in a lower age group. Then, the cost for the older spouse will not be used for the rate ns.
o The employee who works for the company may save money on their premium because the company contributes toward the cost of the employee’s price and on some occasions may also help cover dependent premiums.
o Employees and owners will often find that small group health insurance premiums are much lower than Cobra and HIPAA.
o Sometimes the group rates are lower because the company is located in a lower priced service area than the private rates.

Attempting to understand either individual or small group health insurance policies can be difficult. If you would like help answering any health insurance questions, feel free post them below, and we would be happy to provide you with personalized service.

By Thomas Cazneau

With terms like “deductible”, “HMO”, and “HSA”, choosing a health insurance plan can seem like trying to learn a new language. Below I will focus on defining the basic features between Kaiser Permanente HMO vs HSA plans for individuals and families. For more details on what to look for in a Kaiser Permanente HMO or HSA Deductible plan, click Compare Health Insurance.

What is a HMO?
HMO stands for Health Maintenance Organization. With Kaiser Permanente Private Plans, all options are HMO, meaning that you can only go to Kaiser Permanente to be covered for services except for emergency and urgent care benefits, which can be done out of network. This makes it convenient for members to use their coverage at one central location.

Why choose a HMO Deductible Plan?
There are several key features which make HMO Deductible Plans a popular choice. Here are some benefits attached to this particular type of Kaiser Permanente Individual and Family Plan:

• Low predictable copays for office visits and prescription meds when covered.
• Annual checkups and preventive services are no charge
• Usually, you can get a relatively low health insurance deductible for catastrophic services, for example.
• Nice middle of the road plan for many people because they can get the benefits they need most and still keep their premium low.

Why choose an HSA deductible health plan?
An HSA Plan is a major medical policy. Here are some features related to HSA Plans.

• Typically, HSA deductible Plans tend to have lower premium costs than HMO deductible Plans because HSA’s are not as comprehensive. This plan type could work for people who rarely visit the doctor and are mainly looking for a plan to cover them for routine checkups and major medical events.
• While still an HMO, this particular Kaiser Permanente Private Plan gives you the option of opening up a Health Savings Account (HSA) at the bank of your choice. The funds in this bank account are designated for medical and dental expenses. Taxes or penalties do not apply to any monies from this HSA account, unless they are spent for non-qualified expenses.

The Main Difference between HMO and HSA
The main difference between these two types of plans is that most Kaiser Permanente HMO deductible plans cover office visits and prescriptions right away for low copays, while HSA deductible plans do not cover these services until the deductible is reached.

HMO vs HSA? Choose what’s right for you.
Not everyone has the same wants and needs when it comes to choosing the right Kaiser Permanente Health Insurance Plan. While an HMO Deductible Plan might be perfect for one individual, an HSA Deductible Plan might fit better for another individual’s preference or situation. Since there are so many HMO and HSA plans to choose from, we make it our job to help each customer find the plan that best fits their needs and wishes. Feel free to give us a call for a plan recommendation or comment below with questions.

I work for a health insurance agency that sells Kaiser Permanente Group Health insurance for self- employed people and other small businesses. Recently, Kaiser Permanente introduced a new California group health insurance plan that I’m really impressed with. It shows Kaiser Permanente’s commitment to helping consumers and current members get a medical plan that fits their medical service needs without breaking their pocketbook.

The new Kaiser Permanente option is called the $40/3000 Deductible Plan. It is cheap group insurance that gives a win-win solution to both employers and employees. It is the most affordable Kaiser Permanente California group health insurance that you can get where the doctor visits, prescriptions, and even most lab and imaging services are covered without you first having to pay a deductible. That’s good news, especially for companies that are looking for affordability, as well as health benefits that their employees need most. It’s especially great news for people with medical conditions because unlike most deductible plans, the Kaiser Permanente $40/3000 Deductible Plan also covers most lab and imaging services without a deductible.

Below are sample quotes for a 35 year old husband and wife whose business is in Northern California. Note: The California group health insurance premiums are based on rates for a newly-enrolled company and are valid as of January 2012. Also, only the Deductible Plans that cover doctor visits and prescription benefits without a deductible are shown. This way, the comparisons are on an apple-to-apple basis. Click California Group Health Insurance for more details or to get a personalized quote for health insurance for self employed or other small businesses.

Companies that are already covered under a Kaiser Permanente California group health insurance policy will be happy to see the $40/3000 Deductible Plan as one of the alternatives they can switch to when their policy renews in 2012. The $40/3000 Deductible Plan can potentially lower their insurance bill. For example, groups that are covered under the popular $30/1500 Deductible Plan can save somewhere around *10-15% by switching to the $40/3000 Deductible Plan.

Current members of a Kaiser Permanente California group health insurance plan may switch to the $40/3000 Deductible Plan during their open enrollment period when their policy is up for renewal. They may also contact their insurance representative to find out about any special open enrollments that allow them to downgrade plans mid-year. Give this plan strong consideration if you are looking for solid but cheap group insurance and your medical service needs are mainly for basic services such as doctor visits, prescriptions, lab and imaging services. Before changing plans, compare the benefits of your current policy with the $40/3000 Deductible Plan to make sure you’re enrolled on the California group health insurance plan that best meets your service needs. If you are not currently working with a health insurance agent, we would be more than happy to assist you in walking through your options and provide you with a specialized consultation.

The $40/3000 Deductible Plan is also available on a private insurance basis. However, that option does not cover maternity benefits. Also, lab and imaging services are subject to the deductible. In contrast, the $40/3000 health insurance for self employed and other businesses includes maternity benefits, as well as coverage for most lab and imaging services on a no-deductible basis.

*The savings is based on a representative sampling of Kaiser Permanente small groups in Northern and Southern California with a renewal date of April 1, 2012 and a rate adjustment factor of 1.10.