Captain Health USA

Making Health Insurance Great Again!


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Open Enrollment is Right Around the Corner… Will you be ready?

Don’t let this year be the year you are scrambling to get things in order for open enrollment.  Use my Open Enrollment Guide below to help you through the process so that getting the right health care coverage doesn’t become a huge ordeal.  

 

Key Dates You Need To Be Aware Of Before Open Enrollment Begins:

  • The 2019 Open Enrollment Period: November 1, 2018, to December 15, 2018.
  • Plans sold during Open Enrollment start January 1, 2019.
  • If you don’t act by December 15, you can’t get 2019 coverage unless you qualify for a Special Enrollment Period.

 

Pre-Open Enrollment Checklist:

  • Household size:  Make a list of the people in your household that will be needing health insurance during 2018
  • Current mailing address for everyone who is applying for coverage
  • Birth dates for all household members
  • Social security numbers for everyone who will be getting coverage
  • Information about how you file your taxes
  • Estimate of what your household income will be for 2019
  • A list of any major life changes for each member of your household getting coverage such as  Marriage, Income, Moving, Births, Divorce, etc.

 

Understanding Special Enrollment Period (SEP)

Special Enrollment Period is a time outside of the yearly Open Enrollment Period that allows you to sign up for health insurance. The following circumstances qualify you for the special enrollment period (SEP):

  • Losing health coverage,
  • Moving,
  • Getting married,
  • Having a baby,
  • Adopting a child.

 

Did You Know? If you qualify for an SEP, you usually have up to 60 days following the event to enroll in a health insurance plan. If you miss that time period, you will have to wait until the next open enrollment period to get on a health insurance plan.

Medicaid & CHIP:  You can enroll in Medicaid and the Children’s Health Insurance Plan (CHIP) any time of year, whether you qualify for a Special Enrollment Period or not.

Job-based Plans:  These plans must provide a special enrollment period of at least 30 days if you are losing coverage due to changing jobs.

 

Tax Penalties:

These penalties will be going away.  If you do not enroll in a health insurance plan, you will no longer face fines or penalties for not carrying coverage.  However, that does not mean you will be fully treated anymore.  A hospital only has to stabilize you but they do not have to actually repair you or do follow on services.   As an example, they can treat the broken arm to stabilize it but they do not have to do the surgery to repair it like new unless you can show you have insurance or that you can pay for it another way..

 

Next Steps:

Now that you have a snapshot guide of what to expect during open enrollment for 2019, schedule time to speak with me so we can select the best plan possible for you, your family, and your situation.  A year without proper medical coverage could result in medical bills and expenses you weren’t expecting. Did you know medical debt is the leading cause of bankruptcy in the United States? This can be avoided if you have the proper coverage and plan in place.  I am here to help! Schedule your FREE consultation by calling: (813) 391-3448

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Why You Should Get Your Blood Pressure Checked Monthly

Knowing what blood pressure is will help you to understand why it should be checked on a regular, if not monthly basis.

In a nutshell, blood pressure is a measurement of how hard your heart is working to circulate blood and oxygen around your body. If your heart is not exerting enough pressure, blood and oxygen will not be able to travel to all the places it needs to in the body. To determine how hard your heart is working, medical professionals measure blood pressure. Blood pressure is determined by two sets of numbers. Systolic pressure and diastolic pressure. The average or goal for adults is somewhere in the range of 90/60 and 120/80.

Understanding the Readings…

Systolic pressure:
Systolic pressure or the top number measures the amount of pressure in your arteries during the contraction of your heart muscle. When this number is high, it signals that the heart is working too hard and is over-exerting itself and should be monitored closely by a medical professional to help prevent heart damage, heart attack, or stroke.

In some people, it is natural or considered baseline for the systolic pressure to be low, under the range of 90. If the systolic pressure drops suddenly and is not a normal reading/baseline reading, it could be a sign of the heart not being able to work hard enough to get blood to the body and organs. This can be extremely damaging to the body and should be taken care of immediately by a physician.

Diastolic pressure:
Diastolic pressure is the bottom number. This number measures the pressure in your blood vessels when your heart rests between beats. If this pressure is high, it could signal an increased risk of a cardiac event and you should seek the assistance of a medical doctor immediately.

If the diastolic pressure is low, it could be an indication of a serious medical disorder and you should seek medical attention right away.

Warning signs.
Both high and low blood pressure has subtle or no symptoms. It can creep on slowly over time making the symptoms harder to identify. Or, a change in blood pressure can come on suddenly. Both indicate changes that need to be seriously looked at. Below are some symptoms of high and low blood pressure that you should be aware of:

High blood pressure or hypertension symptoms:

  • Headache
  • Blurred vision
  • Dizziness
  • Shortness of breath
  • Heart attack
  • Chest pain

Low blood pressure symptoms:

  • Dizziness or lightheadedness
  • Fainting (syncope)
  • Blurred vision
  • Nausea
  • Fatigue
  • Lack of concentration

Extreme low blood pressure known as hypotension can result in life-threatening conditions. Signs and symptoms to look for in this case include things like:

  • Confusion, especially in older people
  • Cold, clammy, pale skin
  • Rapid, shallow breathing
  • Weak and rapid pulse

The best way to monitor your blood pressure and understand what your baseline or normal range is, is to get is checked monthly. Many drug stores and grocery stores have blood pressure machines available for you to use whenever needed. If you are concerned about the accuracy of those machines, consider investing in a personal machine for your home. These types of machines are small, portable, and easy to store.

Regardless of the type of machine you choose to use, it is best to follow these tips:

  • Check blood pressure monthly
  • Record readings each time
  • Remain calm during the reading
  • Note extreme changes and call your doctor immediately
  • Be consistent in the time of day you take your blood pressure
  • Follow and understand the instructions of the blood pressure machine before attempting to get an accurate reading

Remember, symptoms can be difficult to detect which is why many call heart disease and cardiac events a silent killer. Be proactive. Download my blood pressure tracker to help stay on top of any changes that may occur with your blood pressure.

Download my blood pressure tracker HERE.


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You Have Health Insurance, Now What?

Now that open enrollment is over, you have picked a plan, what is your next step?  Your next step is to use the plan you selected! Make sure you take full advantage of your health care coverage.  

Getting A Checkup…

Getting a checkup is something you must schedule on your calendar every year!  A checkup helps to create a baseline or a range of normal that is specific to you and your overall health.  Our healthcare system is designed to offer preventive care.  Preventive care is a proactive approach to healthcare where you and your doctor work together to identify potential issues before they become major problems.  

Below is a list of preventative care that is covered for adults.  When you visit your doctor, it is a good idea to ask them to address these screenings during your visit.

  1. Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
  2. Alcohol misuse screening and counseling
  3. Aspirin use to prevent cardiovascular disease for men and women of certain ages
  4. Blood pressure screening
  5. Cholesterol screening for adults of certain ages or at higher risk
  6. Colorectal cancer screening for adults over 50
  7. Depression screening
  8. Diabetes (Type 2) screening for adults with high blood pressure
  9. Diet counseling for adults at higher risk for chronic disease
  10. Hepatitis B screening for people at high risk, including people from countries with 2% or more Hepatitis B prevalence, and U.S.-born people not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence.
  11. Hepatitis C screening for adults at increased risk, and one time for everyone born 1945 – 1965
  12. HIV screening for everyone ages 15 to 65, and other ages at increased risk
  13. Immunization vaccines for adults — doses, recommended ages, and recommended populations vary:
  14. Lung cancer screening for adults 55 – 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
  15. Obesity screening and counseling
  16. Sexually transmitted infection (STI) prevention counseling for adults at higher risk
  17. Syphilis screening for adults at higher risk
  18. Tobacco Use screening for all adults and cessation interventions for tobacco users

Please note that these services are free only when delivered by a doctor or other provider in your plan’s network.

Planning regular checkups and working together with your doctor is the best way to take proactive action when it comes to your health.

Do you have questions about your health plan and what it covers?  Schedule a FREE consultation with me by calling:  (813) 391-3448


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Why It Is More Important Than Ever To Have A Knowledgeable and Reputable Health Insurance Agent

In an article I recently read, entitled “ObamaCare Advocates:  Hole Too Deep to Make Up Outreach Cuts” it states that the Trump Administration has cut 90% of the funding set aside for educating the population on their options for health care coverage.  What does this mean for you?  In short, you may be losing out on critical information you need to make an informed decision about health care coverage for you and your family.

It is speculated that this cut could result in fewer people getting the health care coverage needed due to not knowing or being aware of the open enrollment periods and deadlines, what types of coverage is available, how health care coverage works and how to navigate the system.  A recipe for disaster for the average American.

With this new cut, it is more important than ever to have a knowledgeable and reputable health insurance agent represent you to ensure you are getting the health care coverage you need and deserve, on time!  Not all agents are created equal!  When selecting an agent, select someone who is:

  • Professional and who is responsive and available to take your phone
  • Well educated when it comes to the Affordable Care Act
  • Informed and stays on top of Affordable Care Act current events
  • Understands the law
  • Will listen to your needs and will consult with you about your best options

If you are concerned about the upcoming open enrollment period, how much health care coverage you need for you and your family and how to avoid potential fines, I can help!  Visit my website for FREE valuable tools like “Dave’s Doctor Search” and a list of resource links.  Follow me on Facebook to learn about your healthcare options, breaking news and to get connected!

Do you have questions or need help navigating the health insurance system?  I am happy to help! Schedule your FREE consultation: (813) 391-3448

Doing my part in Making Healthcare Great Again!


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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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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


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2017 Open Enrollment…Are you READY?

It’s that time of year again!  Get ready to start thinking about open enrollment and what you need to do to make sure you and your family have health insurance coverage.

Here is what you need to know!

2016:

Open enrollment for 2016 is CLOSED.  BUT, If you still need coverage for the rest of 2016, you can get it but, only if you qualify. 

To qualify you need to meet one of these two criteria:

  • Special Enrollment Period due to a life event — like losing health coverage, getting married, or having a baby.
  • You qualify for Medicaid or the Children’s Health Insurance Program (CHIP).

You can apply for these programs any time throughout the year.

Let’s Brush Up On The Marketplace

About The Marketplace:

Who is it for?  The Marketplace is for individuals who do not have health coverage for the coming year.  That means, you do not have coverage through:

  • Your employment
  • Medicare
  • Medicaid
  • The Children’s Insurance Program (CHIP)
  • Another source providing qualifying coverage

How Much It Costs:

Health insurance through the Marketplace depends on your estimated income for the coverage year.  Did you know?  In 2017, roughly 8 out of 10 of uninsured people who are eligible for Marketplace coverage will qualify for financial assistance.*  The financial assistance  provided goes towards lowering the cost of the monthly premiums and in some cases is can also help with things like deductibles and copays.  Get an idea of what that could mean for you HERE.

Discover What The Marketplace Insurance Covers:

Essential health benefits – Every plan must include the following:

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization (like surgery and overnight stays)
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
  • Pre-existing conditions, including pregnancy
  • Preventive care
  • Birth control coverage
  • Breastfeeding coverage

Pre-existing conditions, including pregnancy

Preventive care

Get a list of what that includes for:

What If You Do Not Get Health Insurance?

If you can afford health insurance and fail to obtain qualifying health coverage for the 2017 year, you may be fined.  This fine is referred to the “individual shared responsibility payment”. 

Fees are calculated in two different ways.  They are:

  • A percentage of your house hold income
  • Per person

You will be required to the highest rate calculated.

Fines for 2017 have not been released as of yet.

Do you have questions about your health insurance coverage for 2017?  I can help!  Contact me, Your Obamacare Guy!  I can be reached at:  (813) 391-3448 or email address:  dave@YourObamacareGuy.com

* source:  http://www.HealthCare.gove/quickguide