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Are You Taking Advantage of Your 2017 Health Plan?

If not, you should be!  The Affordable Care Act is in place to help you be healthy and remain healthy throughout your life!  A BIG part of helping you stay healthy is through preventative health care practices.  The Affordable Care Act provides several preventative services as well as 1 wellness visit each and every year.

In this blog post, we are going to explore what is included in your well visit and showcase why it is important to take advantage of your it through real life stories.  The stories we share with you will illustrate how preventative care and well visits stopped devastating illness in its tracks.  The key to preventative health care is catching illness and disease before they manifest and fester into a larger more chronic or fatal outcomes.

So what exactly is “Preventative Care”?  It is the practice of evaluating your health when you are not sick or experiencing any sort of symptoms, providing a baseline or what is normal for you.  Once you have a baseline established for yourself, it makes it easier for healthcare professionals to identify illness and disease earlier.  This makes it easier to establish when something serious is brewing within your body.

Did you know there are at least 10 preventative services and 1 well care visit available to you during the calendar year under The Affordable Care Act?  Many people don’t!  These preventative services are made up of one well care visit as well as things like immunizations, tests, physical exams and lab work.

Captain Health USA Stat: The Affordable Care Act allows for 47 million women with private insurance to schedule mammograms without being charged a co-pay

Curious what you could expect during your annual well care visit?

Under The Affordable Care Act it is required by law that you have access to 10 main preventative care services.  Below is what is included in the “Adult” list.  Keep in mind, there are even more listed for women, children and seniors!

  1. Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
  2. Blood Pressure screening for all adults
  3. Lab Tests such as Cholesterol screening and others
  4. Colo-rectal Cancer screening for adults over 50
  5. Depression screening for adults
  6. Diabetes (Type 2) screening for adults with high blood pressure
  7. HIV screening for everyone ages 15 to 65, and other ages at increased risk
  8. Immunization vaccines for adults–doses, recommended ages, and recommended populations vary:
    • Hepatitis A
    • Hepatitis B
    • Herpes Zoster
    • Human Papillomavirus
    • Influenza (Flu Shot)
    • Measles, Mumps, Rubella
    • Meningococcal
    • Pneumococcal
    • Tetanus, Diphtheria, Pertussis
    • Varicella
  9. Obesity screening and counseling for all adults
  10. Tobacco Use screening for all adults and cessation interventions for tobacco users

Real Life Stories… (all Names Changed)

John……    Didn’t have insurance for many years due to the cost.  About 2 years ago he got coverage and decided to go for his physical.  The first physical in about 10 years.  At first all seamed well.  Then the lab work came back.  The labs showed that his blood sugar was way off from what it should be.  Turns out John was a diabetic and didn’t know it.  He simply ignored the symptoms.  Over time it could have been a huge medical issue however, since it was caught fairly soon, John got on medicine and should live a normal life.

Rick……  Rick had not had insurance for about 5 years.  Rick got a physical at the first chance he could and it was a good thing he did.  An issue with his prostate was caught in the early stages and was able to be treated with out major surgery.  Had it not been caught it could have cost him his life.

Joan…… To make a long story short, the non-compliant health plan Joan was on did not cover the cost of a mammogram .  Once she got good coverage, Joan had a mammogram (that cost nothing)  for this first time in 4 years.  A very small abnormality was found and removed.  Had it not been found early on, the treatment and results could have been much worse.

Health insurance is not just for when your sick, its also there to keep you well.


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All About Final Expense Insurance

What Is Final Expense Insurance?

Final expense insurance is designed to cover the bills that your loved ones will face after your death – think medical bills and funeral expenses. Final expense insurance is also known as burial insurance, since even bare-bones funerals cost thousands of dollars.

Final Expense Insurance: The Basics

A final expense life insurance policy isn’t the same as what’s popularly known as “Life Insurance ”

With traditional Life Insurance,  the value of your policy can be $100,000 and higher depending on how much insurance you feel you need.

With Final Expense insurance, the value of your policy is the amount of  the estimated expense of your desired funeral and your last expenses.

While other forms of life insurance can be much higher, it’s rare for final expense insurance policies to get above $25,000.

Do I need final expense insurance?

That depends. If you already have permanent life insurance, your loved ones can use your existing policy to pay final expenses.  If not, then you might consider a Final Expense policy so your loved ones don’t have to foot the bill from their money.  One important point is that Social Security only pays $255 upon your death.

Is final expense insurance expensive?

That depends on your age, and there’s no delicate way to say this. The older you are, the higher your premiums will be. That’s because the insurance company takes on more risk when insuring older folks, given the fact that they’re statistically closer to death. If you buy final expense insurance when you’re 45, you’ll pay less each month than if you wait until you’re 75.

Bottom Line

Whether you choose a life insurance policy that covers funeral expenses and then some or just a dedicated final expense insurance policy, you’ll be doing your loved ones a huge favor. Taking the time to consider and document your end-of-life wishes may be a little uncomfortable now, but it will make all the difference when the time comes.


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Life Insurance – What Is It & How Much Do You Need?

Life insurance is one of those things that people avoid talking about for a number of reasons.  It can range from just not understanding the products offered to how uncomfortable it is for them to talk about death and their own mortality.  Whatever the reason, the life insurance conversation is an important one! 

What is life insurance and what can it mean for you and your family?

Basically, if something should happen to you, your family and loved ones would be prepared to handle their finances.

Exploring the various types of life insurance…The Basics

There are basically two types of major life insurance, Term and Whole Life.

Term Life Insurance

This is least expensive and the most basic form of life insurance.  Many refer to term life insurance as death insurance since it pays out to your beneficiaries upon your death.  These policies tend to be the simplest to understand and the most popular type of life insurance purchased.  Term life insurance is purchased for a period of time, usually for 10, 15, 20, 25, or 30 years.  During the term, the premium will remain the same.  In some cases, the term life policy may be transitioned over to a permanent life insurance plan.

Permanent Life Insurance

As mentioned above, this type of plan is available and works a little differently than term life.  The differences are the benefits it offers.  They are:

  • Death benefit
  • Cash value benefit
  • There is no expiration date like term life insurance – it is intended to last the span of the insured’s lifetime as long as the premium is paid

This type of life insurance policy works to provide you a cash value at the end of the term of the policy.  This type of policy can be a little more expensive as it goes for your entire life.  The premium in this type of policy is guaranteed for the life of the policy.  That means as the the policy holder ages, their premium stays the same.  

How much do I need….

That is a great question and the answer really depends on your reasons for getting the insurance. For example, are you getting it to  pay off the mortgage?  Are you getting it to pay for the kids college education?  Are you getting it to provide for your spouse?  Or, is it a combination of everything?   I sit with my clients and help them determine this.

Is it expensive?

In general life insurance is very cheap.  They key is not to over buy it and to start small and, in many cases you can add more.  For example, when your young you need more insurance and when you get older you need less.  Don’t pay for more then you need.  

As an example…

My wife has $250,000 of coverage that we pay about $35 a month for.  

Keep in mind that cost is directly linked to health and age.  The younger you are and the better health your in the less expensive it is.

Having said that, remember that as you get older you may need less so why pay for $100,000 when you only need $25,000?

Can you get it if you have a medical issue?  Yes, we can always get you some coverage.

If you have questions about your coverage or getting covered, contact me today!

I can be reached at: (813) 391-3448 or email me at Dave@YourObamacareGuy.com


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What’s In Store For Obamacare?

As we quickly approach the end to Trump’s 100 days in office (April 29, 2017), many are curious as to where we stand when it comes to Obamacare AKA The Affordable Care Act.  At the beginning of his campaign, Trump made a lot of promises and proclamations about repealing Obamacare.  Since the election, the republicans has toned down their stance.

What Plans Does the New Administration Have for Obamacare?

The Republicans recently revealed what their big plan is when it comes to The Affordable Care Act.  One of the most glaring changes in their proposal is the name given to Obamacare.  Their proposal changes the name from The Affordable Care Act to The American Care Act.  Some of the other changes we may see under the new Administration include:

  • Removing the requirement of having insurance or risk the consequence of suffering a fine
  • Ending Obamacare taxes on the wealthy
  • Changing how people get financial aide needed in order to purchase health insurance coverage on an individual level

Keeping in mind that this is still in the proposal stages, other items on the table for approval are:

  • Changing the way the Medicaid system is funded
  • Eliminate the rule that requires companies with 50 or more full time employees provide health coverage or pay a fine
  • Ending subsidies for out of pocket costs for low income Americans
  • Creating a new system of financial aid and penalties for those who allow coverage to lapse
  • Tax credits based on age – starting at $2,000 for those in their 20’s with a gradual increase to $4,000 for those aged 60 and over available to individuals who earn up to $75,000 and households up to $150,000
  • Insurers allowed to charger older citizens premiums up to 5 times the rate of younger people which is different from Obamacare’s 3 to 1 rate
  • Not giving states the authority to expand their Medicaid programs to all adults by 2020 after which date no newly eligible adults could sign up

The bill will still include:

  • Pre-existing conditions where insurers cannot deny coverage or charge higher rates to people with pre-existing conditions
  • The ability for adults under the age of 26 to get coverage from their parents plan
  • The 10 essential health benefits set up by The Affordable Care Act
  • The fact that insurers will be barred from setting maximum limits on benefits paid out

While there are many changes on the table, there are many items that will not change.  The republicans look to make changes to drive down costs while providing quality health insurance at more affordable prices. Some may challenge this by saying the plan will remove coverage from many Americans who couldn’t afford it previously.

Stay tuned as we continue to learn more about what actually ends up being approved.

If you have questions about your coverage or getting covered, contact me today!

I can be reached at: (813) 391-3448 or email me at Dave@YourObamacareGuy.com


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The Future of Obamacare…Could it be here to stay?

img_3667As the new Administration is settling in, it seems the language of “repealing and replacing” Obamacare is becoming gentler and softer.  A “rescue” and “repair effort may more accurately describe how the system will be handled, especially since the deadline of January 27, 2017 for repeal legislation has quickly come and gone.  Additionally, it seems as though a replacement system may be more difficult to find. Many senators have claimed they will not vote to repeal the program unless they are able to see a clear picture of what will replace the Affordable Care Act.

Repeal or Rescue…What do these semantics mean to you and me? 

We probably will not experience much of a change during 2017.  While the republicans continue to draft healthcare system proposals, we can more than likely expect for the healthcare system to remain “business as usual”.  How can we be so sure?  Recently Trump and Republicans indicated they wanted to keep key provisions such as:

  • Guaranteed coverage for pre-existing conditions
  • Allowing children to stay on parent health plans until the age of 26
  • Subsidies or possibly a tax reduction to help pay for it
  • An incentive instead of a penalty or fine to make you want to get health insurance.

While I’m sure there will be changes, its a long way off yet and I can’t help but think of the old saying….

If it looks like a duck and it quacks like a duck……..its a duck!

It is important to note, there are no official plans on the table to replace Obamacare.  Also, keep in mind, it will be extremely difficult to take a system away from the 20 million people who received health insurance due to the Affordable Care Act. 

For more details and commentary, please explore these articles:

G.O.P. Campaign to Repeal Obamacare Stalls on the Details

GOP mulls ‘repairing’ Obamacare law it vowed to repeal

Trump remarks latest evidence of health law repeal slowdown

 


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Here’s to a Happy New Year and a Healthy You!

Now that you have gone through the open enrollment process for health insurance coverage, it is time to take advantage of what is available to you!

Living Your Healthiest Year!

Did you know that once you are covered under Obamacare, there are at least 15 FREE preventative services available with Obamacare and each year you have access to one wellness visit? 

Curious what is included?  Read on!

Annual Physical

Included in Obamacare, you have access to one well visit each and every year.  This annual trip to the doctor is an important one!  It provides a baseline measurement to your overall health status.  This baseline provides your doctor and healthcare professionals a picture of what your homeostatic state is.  Even more important, a baseline measurement of your health makes early detection of health issues a lot easier to recognize. 

Do Your Homework

Make yourself aware of what is covered under a well checkup/preventative care visit.  Anything outside the scope of the services listed below may result in copay fees.

When going for your annual physical, make sure your insurance company in being billed correctly by your doctor’s office.  For example, if you are visiting your doctor for a well check, make sure you ask the office how they are coding your visit and if they are coding for anything outside of why you visited.  If they code it differently than a well check, it may cause you to pay extra in copay and diagnostic fees.

FREE Preventative Care Services

Below is a comprehensive list of what is included in preventative well check visits to your doctor.

Adults

Adults have access to the following 15 preventative services while children have access to 26:

  • Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
  • Alcohol Misuse screening and counseling
  • Aspirin use to prevent cardiovascular disease for men and women of certain ages
  • Blood Pressure screening for all adults
  • Cholesterol screening for adults of certain ages or at higher risk
  • Colorectal Cancer screening for adults over 50
  • Depression screening for adults
  • Diabetes (Type 2) screening for adults with high blood pressure
  • Diet counseling for adults at higher risk for chronic disease
  • HIV screening for everyone ages 15 to 65, and other ages at increased risk
  • Immunization vaccines for adults–doses, recommended ages, and recommended populations vary:
  • Hepatitis A
  • Hepatitis B
  • Herpes Zoster
  • Human Papillomavirus
  • Influenza (Flu Shot)
  • Measles, Mumps, Rubella
  • Meningococcal
  • Pneumococcal
  • Tetanus, Diphtheria, Pertussis
  • Varicella
  • Obesity screening and counseling for all adults
  • Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
  • Syphilis screening for all adults at higher risk
  • Tobacco Use screening for all adults and cessation interventions for tobacco users

Women receive some specialized preventative care services like:

  • Anemia screening on a routine basis for pregnant women
  • Breast Cancer Genetic Test Counseling (BRCA) for women at higher risk for breast cancer
  • Breast Cancer Mammography screenings every 1 to 2 years for women over 40
  • Breast Cancer Chemoprevention counseling for women at higher risk
  • Breastfeeding comprehensive support and counseling from trained providers, and access to breast feeding supplies, for pregnant and nursing women
  • Cervical Cancer screening for sexually active women
  • Chlamydia Infection screening for younger women and other women at higher risk
  • Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.”
  • Domestic and interpersonal violence screening and counseling for all women
  • Folic Acid supplements for women who may become pregnant
  • Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
  • Gonorrhea screening for all women at higher risk
  • Hepatitis B screening for pregnant women at their first prenatal visit
  • HIV screening and counseling for sexually active women
  • Human Papillomavirus (HPV) DNA Test every 3 years for women with normal cytology results who are 30 or older
  • Osteoporosis screening for women over age 60 depending on risk factors
  • Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  • Sexually Transmitted Infections counseling for sexually active women
  • Syphilis screening for all pregnant women or other women at increased risk
  • Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
  • Urinary tract or other infection screening for pregnant women
  • Well-woman visits to get recommended services for women under 65

Preventative Services for Children

  • Autism screening for children at 18 and 24 months
  • Behavioral assessments for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Blood Pressure screening for children at the following ages: 0 to 11 months, 1 to 4 years , 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Cervical Dysplasia screening for sexually active females
  • Depression screening for adolescents
  • Developmental screening for children under age 3
  • Dyslipidemia screening for children at higher risk of lipid disorders at the following ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Fluoride Chemoprevention supplements for children without fluoride in their water source
  • Gonorrhea preventive medication for the eyes of all newborns
  • Hearing screening for all newborns
  • Height, Weight and Body Mass Index measurements for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Hematocrit or Hemoglobin screening for children
  • Hemoglobinopathies or sickle cell screening for newborns
  • HIV screening for adolescents at higher risk
  • **Hypothyroidism screening for newborns
  • Immunization vaccines for children from birth to age 18 —doses, recommended ages, and recommended populations vary:
  • Diphtheria, Tetanus, Pertussis
  • Haemophilus influenza type b
  • Hepatitis A
  • Hepatitis B
  • Human Papillomavirus
  • Inactivated Poliovirus
  • Influenza (Flu Shot)
  • Measles, Mumps, Rubella
  • Meningococcal
  • Pneumococcal
  • Rotavirus
  • Varicella
  • Iron supplements for children ages 6 to 12 months at risk for anemia
  • Lead screening for children at risk of exposure
  • Medical History for all children throughout development at the following ages: 0 to 11 months, 1 to 4 years , 5 to 10 years ,11 to 14 years , 15 to 17 years.
  • Obesity screening and counseling
  • Oral Health risk assessment for young children Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years.
  • Phenylketonuria (PKU) screening for this genetic disorder in newborns
  • Sexually Transmitted Infection (STI) prevention counseling and screening for adolescents at higher risk
  • Tuberculin testing for children at higher risk of tuberculosis at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years,11 to 14 years, 15 to 17 years.
  • Vision screening for all children.

Preventative Services for Seniors

Medicare Part B (Medical Insurance) covers:

  • Abdominal aortic aneurysm screening
  • Alcohol misuse screenings & counseling
  • Bone mass measurements (bone density)
  • Cardiovascular disease screenings
  • Cardiovascular disease (behavioral therapy)
  • Cervical & vaginal cancer screening
  • Colorectal cancer screenings
  • Depression screenings
  • Diabetes screenings
  • Diabetes self-management training
  • Glaucoma tests
  • Hepatitis C screening test
  • HIV screening
  • Mammograms (screening)
  • Nutrition therapy services
  • Obesity screenings & counseling
  • One-time “Welcome to Medicare” preventive visit
  • Prostate cancer screenings
  • Sexually transmitted infections screening & counseling
  • Shots:
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
  • Tobacco use cessation counseling
  • Yearly “Wellness” visit

Did you know?

Know the facts about health insurance coverage!  Included in your Obamacare Health Plan are 10 Essential Health Benefits.  They are:

  1. Outpatient care—the kind you get without being admitted to a hospital
  2. Trips to the emergency room
  3. Treatment in the hospital for inpatient care
  4. Care before and after your baby is born
  5. Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
  6. Your prescription drugs
  7. Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
  8. Your lab tests
  9. Preventive services including counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease.
  10. Pediatric services: This includes dental care and vision care for kids

“Specific health care benefits may vary by state. Even within the same state, there can be small differences between health insurance plans. When you fill out your application and compare plans, you’ll see the specific health care benefits each plan offers.”

Source:  Healthcare.gov

Still have questions or concerns?  Contact me today!  I can be reached at (813) 391-3448 or Email me at Dave@YourObamacareGuy.com


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Healthcare and The Incoming Administration

The attached article – Donald Trump Walks Back His Stance On Obamacare shows a possible change in direction of the incoming administration and it’s not totally unexpected.


YOCG Tuesday 2 2 16 CANVAThere are so many people covered by insurance now that were never covered before it would almost be impossible to unwind what’s already been done and put something else in place that does not look like just about the same thing.  You know that old saying…if it looks like a duck and quacks like a duck…its a duck.   Maybe its a Trump duck instead of an Obama duck….but its still a duck.  
 

The affordable care act (Obamacare) was based on a few core principles. The most important ones in my opinion are…

1. No one should be turned down for any pre-existing medical condition

2. People who could not afford insurance would get subsidies or some kind of assistance to help with the cost

3. Everyone would be required to have insurance that consists of what is called MEC (Minimum Essential Coverage). This is also called the “Individual mandate”

It’s these principles that define Obamacare. Everything else in my opinion, surrounds these principles and if changed, really does not effect the basic core principles.  Some examples of things that could be changed that would lower the cost of coverage to most people include….

 – Should pregnancy coverage be included in all policies?

 – Should mental health coverage be included in all policies?

 – Should rehab coverage be included in all policies?

YOCG Tuesday 11 24 15 CANVAMaybe these coverage’s should be options like when you buy a car.  Everyone gets the basic car but if you want a radio it’s extra, if you want bigger tires it’s extra, if you want a sunroof it’s extra, you get the point.

I think we need to bring healthcare coverage back to its original intent, to cover you for what you want to be covered for and not what the government says that you should be covered for.  Of course everyone should have at least basic well-care and hospitalization coverage but should everyone have to pay for all the options? 

Read the article HERE