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Do you really need an annual well visit and why is it so important?

What is the purpose of an annual well visit?

Your annual well visit or check up is something you should have each and every year.  Why?  Because it gives both you and your physician a baseline reading of your overall health while you are symptom free.  Having this baseline measurement can help your doctor detect potential health concerns before they progress – think of it as a warning system for your overall health. 

“An ounce of prevention is worth a pound of cure”

What can you expect during your annual well visit?

You can expect your physician to check the following during your next well visit

  • Health history
  • Height measurement
  • Weight measurement
  • Blood pressure reading
  • Body mass index assessment (BMI)
  • Counseling for obesity
  • Skin cancer and safety
  • Depression screening

During the overall visit with your doctor, he or she will determine if there is a need for additional tests, lab work, x-rays and other medially appropriate health screenings based on what the baseline measures report.

Embrace the opportunity you have to go for an annual well visit every year.  These visits can help you avoid potentially serious health conditions.  They can also provide early diagnosis for diseases that can be easily treatable if caught early enough – things like diabetes.  Allowing health concerns like diabetes to go unchecked for a prolonged amount of time can do serious, irreversible damage.

Curious to know how the Affordable Care Act’s annual check up has helped real people?  Check out the stories below!

All names have been changed.

Rich had not had a checkup in many years and after getting insurance for the first time in as many years he went for a checkup.  The doctor saw something irregular on his EKG and sent Rich for further testing. Turns out Rich had a blockage in a small artery and needed a procedure to open it up.  What was an outpatient procedure could have been life threatening if it went on undiscovered.

Samantha has had insurance for many years but had not had a checkup in about 4 years.  When she went this past February a small nodule was found in her breast that needed further study.  The nodule turned out to be nothing to worry about but its very important to have these things checked.

Don also had insurance for many years and had not been to a doctor in about 5 years.  After showing the doctor a mark on his leg, the doctor sent him for additional tests.  The spot turned out to be skin cancer that was easily removed at the stage that it was in.  Had it gone on longer, it could have been an issue.

Tips to make your upcoming well visit productive:

  • Be very specific when you call to schedule your appointment – indicate that you need an appointment for your annual well visit
  • Make sure the doctor’s office codes your visit properly so you do not get charged erroneously
  • If you think you have been charged incorrectly, ask to see the codes your doctor’s office uses for well visits
  • Make a list of questions and concerns you would like addressed during your visit
  • Know what is included in your annual well visit – visit a blog post I wrote earlier this year that outlines what is included HERE

Here’s to continued health!


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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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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


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Open Enrollment & Obamacare Changes YOU Need to Know About!

Healthcare Open Enrollment is RIGHT Around the Corner! 

There are LOTS of Changes YOU Need to Know About!

yocg-tuesday-9-6-16-canvaHealthcare open enrollment begins on November 1, 2016 and runs until January 31, 2017 and it won’t be business as usual.  There will be several carrier changes for 2017. 

Before we get into the specific changes, there are some dates you need to put on your calendar for the open enrollment period:

  • November 1, 2016:  Open Enrollment Begins
  • December 15, 2016:  Meet this enrollment deadline to ensure coverage begins on January 1, 2017
  • December 31, 2016:  Coverage ends on this date.  If you have NO changes to your plan, your plan will be auto-renewed
  • January 31, 2017:  This is the VERY LAST day you can apply for 2017 healthcare coverage

If you miss these deadlines, you cannot enroll again until November 1, 2017 unless you have special “life event” changes take place.  Life event changes include:  having a baby or losing your job.

Did you know?

If you do not enroll in Obamacare or have an approved form of health insurance during 2017, you will be fined 2.5% of your income or $695 per adult – whichever is higher.  Please note that the amounted listed is only an estimation as the higher 2017 dollar amount has not been released as of yet.

Those living at poverty levels can enroll at any time in the Medicaid or CHIP (Children’s Health Insurance Program).  These programs do not have a specific enrollment period or timeframe to adhere to.  Please note, there are some restrictions to adhere to such as income restrictions.

Changes…

yocg-wednesday-9-1-16-canvaAt the beginning of this article, I noted there were going to be changes in the Florida Marketplace.  There will be some carriers leaving and some new additions too!

Let’s first say good-bye to:

  • United-Healthcare
  • Aetna

Say Hello to:

  • Cigna – they exited the Florida Exchange in 2015 but are coming back in 2017
  • Molina – They are expanding from South Florida to the Tampa Bay area
  • Harken Health (a subsidiary of United Healthcare) is planning to enter the exchange in the Miami and and Fort Lauderdale area

Of Note:

Humana plans to scale back it’s participation in the Marketplace but will remain in the Florida Exchange system. 

Other changes coming down the pike in 2017 include rate changes that have not been approved by the state yet.   

Other Obamacare changes people can expect to see in 2017 are:

MORE INFO!

When you select a healthcare plan, there are usually two things you ask:

1)  How much is it going to cost me

2)  Is my doctor or the hospital I prefer in my plan

A common complaint last year was inaccurate doctor and hospital information.  The new rules mandate that:

  • Insurance providers are required to give consumers a 30-day notice when a doctor is being removed from a network
  • If a doctor/provider is being removed from a network and a patient is in active care/treatment with the physician being removed, the insurance company must allow for up to 90 days treatment under the physician’s care

Reduction in “Surprise” medical bills from out-of-network providers

Many patients have complained about receiving unexpected invoices and bills from out-of-network doctors, even when the patient thought the doctor was in network.  The new rule calls for:

  • Ancillary care amounts to be applied towards a patient’s yearly out of pocket maximum expenses

Note, this rule only applies to those instances where the insurer has not given patients the correct notification that they will be receiving care from individuals outside of the network.  The general rule is that a patient must be notified that they will receive care from an out of network provider within 48 hours.

Better Explanation of Out-Of-Pocket Expenses/Costs

During 2017, insurers are to offer plans with a standard set of coverage costs (deductibles and copays).  With this information easily attainable, the patients will better understand the out-of-pocket fees associated with the plan they select.

Do you have specific questions about open enrollment and how the 2017 marketplace changes could affect you?  Contact me, Your Obamacare Guy!  I can be reached at:  (813) 391-3448 or email address:  dave@YourObamacareGuy.com


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What Really Is Social Security???

YOCG Tuesday 8 2 16 CanvaWhat Really is Social Security?

I get asked this question A LOT! Especially from people under 50 or so who hear all kinds of doom and gloom about it.  I’ll explain a few things about Social Security and hopefully, this will put some people at ease about it and maybe get you excited about it as I am!

Social Security is, very simply, a trust fund.  It takes money in when people work and pays out to the same people when they stop working. 

Having said that, it is way more complicated in how it pays it out then in how it takes it in. 

Taking it in……

Very simply, when you get paid, you contribute to Social Security.  That money goes into the trust find (not the Government as some people think) and is invested and managed so that it grows.

Paying it out…..

It can be very complicated calculating how it is paid out but it can be simplified for most situations. 

We all get an amount based on what we paid in but we have choices about when we want it paid to us.  Those choices dictate how much we get.  The longer we delay our payment start the more we get.

YOCG 8 3 16 CanvaSocial Security has a date that is called Full Retirement Age (FRA).  In may of our cases, it is going to be around 65-66.  Your monthly payment is based in your FRA.  If we start our payments sooner, at approximately age 62 (early retirement), we will get less per month.  If we delay our payments until we are 70 we get more per month.  BUT…here is the trick….it is not an all or nothing calculation.  We can choose to start payments anytime after approx. age 62 and get increased payments based on how many months we waited to start the payments.  Starting payments at age 63 gets us more money then starting at 62. 

So now that we have discussed what Social Security really is, lets discuss two of the issues around it that I hear about most……

Social Security is going away.

I hear this all the time.  Lets clear this up right now. NO!  No matter what you hear it’s not going away and I’ll tell you why.  Its a trust fund and its managed so that it does not go away.  Sure some things have to change to keep it going but those changes will be made and it will keep going. 

Here are some things that they could do….

  • Make early retirement a higher age, say 63 or 64 before you can start payments.
  • Make Full Retirement Age 67-68

There are a a lot of other things  that can be done and will be done so don’t worry, it’s here to stay.

Social Security costs me money from my check each week.

Thursday 8 4 16 CanvaSocial Security is not a cost, its a savings plan.  Its the best savings plan out there.  You contribute money into it your whole working life.  When you retire, it pays you an income for the rest of your life.  You can’t loose your money and it forces you to save for retirement.  In addition, if you become disabled it pays you when your disability starts.  If you die, it pays your loved ones.

I hope this helps simplify and clarify what Social Security is all about.  If you have any questions, please reach out to me. If I don’t have the answer I can get it very quickly.

I hope your having a great summer!

Do you more questions about Social Security?  I can help!  Contact Dave, Your ObamaCare Guy for more information at: (813) 391-3448 or email me at dave@YourObamacareGuy.com.


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Physician Referrals, YOU Have A Choice!

Physician Referrals, YOU Have A Choice!

Health care and visiting the doctor has become increasingly complicated to navigate. Rules are always changing.  Life is busy which makes it hard to keep up with the changes.  Good news!  I am here to help!  So, let’s dive in!!!

Wednesday 7 6 16When do I need a referral?

Referrals are generally required when you need to see a specialist for a condition that your regular primary care physician cannot treat.  Not all specialists need a referral.  The services that DO NOT require referrals are:

  • In network:
    • Obstetrician/gynecologist
    • Urgent care centers or walk in clinics
    • Eye examinations
    • Mental health disorder and substance abuse services
    • Pathologist
    • Radiologist
    • Anesthesiologist
    • Emergency room visits/admissions
    • Non-physician services such as:
      • Outpatient labs
      • Diagnostics
      • Physical Therapy
      • Durable medical equipment

How do I obtain a referral for a specialist?

Once your primary care physician determines a specialist is needed, to help you with your condition, a referral is given.

A Referral is an authorization for you to see a specialist.

In some cases, your physician may give you a recommendation of who to see along with his referral.  A recommendation is exactly what it sounds like.  It is a suggestion of who you might want to consider seeing for treatment, not a mandate.  This is great news!  Why?  For many reasons!  Check them out:

  • Many times, your primary physician may recommend a specialist who is not in your network.  This can be a very expensive option for you.
  • You have the opportunity to research and find the perfect specialist for you within your health insurance network
  • In some cases, referrals are generated due to a quid pro quo arrangement between doctors.

Now that you have your referral in hand, it is time to select your specialist.  One of the first things you should do is fire up your computer and search for the doctor in your insurance plan’s database.  Not sure who is in your carrier’s database or where to even find the database?  No worries, use this handy tool:  Dave’s Doctor Search.  Here you will find all of the doctor’s listed in the each of the major health insurance carriers.

Select at least three specialists you are interested in possibly using for treatment and learn more about them.  Some of the things you will want to look for are:

  • Is the doctor licensed?  You can verify this by visiting your state’s physician licensing board
  • Is the physician board certified?  A board certified physician is one who demonstrates exceptional expertise in a specialty or subspecialty.  They are certified and recognized by the ABMS Member Board.  Qualifications to be recognized by this board includes rigorous testing and peer evaluations.  These evaluations and tests are engineered and administrated by other specialists in the same field of specialty.
  • Consider the age of the doctor.  Are they older and considering retirement, are they younger and have a passion for cutting edge technology and techniques or have they been practicing a long time giving them ample experience to treat your condition well?
  • Discover how long the doctor has been practicing by visiting online doctor listing sites.
  • Have there been interruptions in their practice and why?
  • What hospitals is the doctor affiliated with and how are those hospitals ranked?
  • Has the doctor experienced any reprimands or malpractice suits?
  • Consider researching doctor ratings sites and review sites.
  • Has the doctor authored any papers, studies or conducted research in the field you are looking to get treatment in?

There is so much to consider when selecting a doctor and a specialist!  The most important thing to remember is that YOU get to make the choice on who treats you.  Take control of your health and your healthcare by selecting the physician that makes the most sense for you and your health goals.

Remember, the referral you receive from your primary care physician (PCP) is the authorization you need to go to the specialist.  The name of a doctor they give is a recommendation only.  Do your homework and find the right fit for you.

Do you need help navigating your way through today’s healthcare arena?  I can help!  Contact Dave, Your ObamaCare Guy for more information at: (813) 391-3448 or email me at dave@YourObamacareGuy.com.