Health Insurance Health Care – Not The Same

If you are like most people you equate health insurance with health care. Not even close. You can fund health care with health obamacare health insuranceinsurance but just because you have health insurance does not mean guarantee unfettered access to health care.

 

ACA  Health Insurance and Health Care

The Affordable Care Act is a misnomer on so many fronts.

There is nothing affordable about Obamacare health insurance.

Just because you have an ACA health insurance policy does not mean you will have access to health care.

as California’s Medicaid program is preparing for a major expansion under President Obama’s health care law, Dr. Mazer says he cannot accept additional patients under the government insurance program for a simple reason: It does not pay enough.

NY Times

Georgia did not expand Medicaid. Politics aside, the reason was economics.

Georgia has a balanced budget.

Washington does not.

Georgia does not have the money to expand Medicaid. Even if Georgia citizens had access to Medicaid there is no guarantee they would also have health care.

Medicaid for years has struggled with a shortage of doctors willing to accept its low reimbursement rates and red tape, forcing many patients to wait for care, particularly from specialists like Dr. Mazer.

Yet in just five weeks, millions of additional Americans will be covered by the program, many of them older people with an array of health problems. The Congressional Budget Office predicts that nine million people will gain coverage through Medicaid next year alone. In many of the 26 states expanding the program, the newly eligible have been flocking to sign up.

In the Medicaid expansion states, about 70% of Obamacare enrollee’s are going on Medicaid. Most of the new Medicaid enrollee’s are older and sicker than the general population.

This is not unique to Medicaid.

ACA Obamacare Health Insurance, Older, Sicker

Young people are not flocking to buy Obamacare health insurance. Higher premiums under Obamacare, especially for young people is a negative. Many are covered under their parents plan until they turn 26. Obamacare made it possible for “young adults” to be classified as children, even if they are living on their own, or even married.

Makes you wonder if anyone in DC thought this out.

If Obamacare is to work the health insurance carriers need young, healthy people.

Instead it is the older, sicker people signing up for ACA health insurance.

obamacare means higher premiums

Your Doctor, Your Choice

Georgia Insurance Shop specializes in finding affordable health insurance OFF the exchange.

Most Obamacare plans offered on the exchange in Georgia are HMO’s. Limited doctor and hospital networks. In some cases you only have one hospital and it may be 50 miles away or more.

When you buy OFF the exchange here is what happens.

You can almost always keep your doctor.

Unless you buy from Blue Cross or Kaiser, you will have access to a national PPO network.

Lower deductibles, less out of pocket. One popular health insurance plan has a low $950 deductible. After that all your expenses are covered at 100% for the balance of the year.

Shop and compare health insurance now.

Our 5 minute, no hassle health insurance application gives you access to instant health insurance, and unfettered access to health care.

Child Only Health Insurance – Tips for Georgia Residents

 Children’s health insurance is only available through Healthcare.gov
#ChildOnlyHealthInsurance #ChildrenOnlyHealthInsurance #GeorgiaChildOnlyHealthInsurance #GeorgiaChildrenOnlyHealthInsurance #DentalInsurance #AccidentInsurance

Georgia Child Only Health Insurance

Children’s health insurance is only available through Healthcare.gov

Child Only Health Insurance Georgia

Children’s health insurance is only available through Healthcare.gov

Child Health Insurance

Obamacare has all but made it impossible to find child only health insurance in Georgia. If your child is healthy or not, it doesn't matter. The only health insurance plans you can find (other than dependent coverage) are STM (short term medical) plans.

Time/Assurant Health Access can be written on children under the age of 19.

The Health Access Value plan includes the following:

  • $50 office visit benefit
  • Prescription drug discounts
  • Hospital inpatient benefits – $1000/day for illness, $2000/day for accident
  • Surgical benefit equal to 100% of the Medicare Physician Fee Schedule

Health Access Fundamental offers the following benefits:

  • $50 office visit benefit
  • Prescription drug copays
  • Hospital inpatient benefits – $2000/day for illness, $4000/day for accident
  • Surgical benefit equal to 100% of the Medicare Physician Fee Schedule

Health Access Enhanced includes the following:

  • $75 office visit benefit
  • Prescription drug copays
  • Hospital inpatient benefits – $3000/day for illness, $6000/day for accident
  • Surgical benefits equal to 150% of the Medicare Physician Fee Schedule

For more details on Health Access review the brochure.

Quote, review and apply for Health Access.

Georgia Insurance Shop has affordable major medical plans for Georgia residents.

Clark Howard Forum

The Clark Howard insurance forum recently had a post about how to pay medical bills for a daughter who did not have health insurance and was away in college. Here is the father's plight.

My daughter attends a major university on a full scholarship as a student athlete. She recently became ill and went to the team trainer/doctor to seek medical assistance. From her complaints, the trainer sent her to the hospital assuming that she was pregnant. The hospital did numerous tests and determined that she was not pregnant. What they failed to realize is that she had been diagnosed previously with cysts on her ovaries (which was clearly stated on her medical records) and that one had burst. When they realized this, she was treated for the burst cyst and released from care. 

After a while she received a bill from the hospital in an amount over $3,000. As a full time student, she did not have this kind of money to pay for this bill. She started getting harassed by bill collectors and didn’t know what to do. I suggested she ask her coach or counselor if there was any financial assistance available for student’s medical bills. With some research on her part, she found out that there was assistance, and filed a claim. The bill for $3,000 was taken care of. Unfortunately this was not the end of it. 

A short while later, she started receiving other bills for services provided while she was at the hospital. These bills amounted to over $2,000. The bill collectors again started harassing her. She once again went to the school and informed them of the additional charges. She was told that she had exhausted the full amount available, and that they could not help her with the additional $2,000. 

As I previously stated, my daughter is a student on a full athletic scholarship. During the sport season, she does not work and even with a job does not have the capabilities of making $2,000. Can you suggest any solutions that she might pursue to assist in clearing up this matter?

The obvious question that comes to mind is, why doesn't the daughter have health insurance? The second one is, why doesn't the father step up to the plate and help pay for the bills?

Even if the daughter does not have the money to pay the bills, the father may still be responsible whether he likes it or not.

When these questions were presented to the father he offered this response.

I was a single father for 10 years and provided everything for my daughters including $75k investment of training for my daughter to become the best of the best at a D1 school. After becoming a super star, then and only then did her mother show up to share in our daughters fame. Her mother bought her a car and offered to pay her insurance. My daughter wanted to love and trust her mother even though not being around for 10 years. Then 7 months ago her mother cancelled her insurance without notice to anyone. If I had been notified she would have had insurance, like always, even though insurance at my work just for her is over $400 p/m…and I'm still paying the debt.

So a little more insight but still no indication of parental responsibility for this part of his daughter's life.

Buying insurance AFTER THE FACT is both foolish and impossible. While no one plans on being sick or injured, life happens. When it does you have two choices.

Let your GA health insurance policy pay or you pay.

If you don't have health insurance then you pay or you stiff the medical providers that nursed you back to health or you pass it off to the taxpayers.

Some things parents need to know about their college age children.

Young people are not bullet proof. They do get sick and they do get injured. You need to plan for the possibility of those events.

You can continue children on your plan until age 26 in most cases. Sometimes that is good, sometimes not. If your coverage is through an employer chances are the cost of continuing them is several hundred dollars per month. Often it is less expensive to buy them a plan of their own.

I have several GA college students as health insurance clients and their premium is usually $150 per month or less. Much cheaper than $400 per month as an addition to the parents group health insurance plan.

Most colleges offer student health plans which appear to be inexpensive but are not. As I tell parents, there is nothing wrong with the plan until your child's health changes and they need real coverage.

Student health plans usually do not cover any pre-existing medical conditions, have limited benefits (usually less than $50,000) and are of little value if medical care is received off campus. They almost never cover prescription drugs unless dispensed by the campus clinic. The biggest problem I see is these plans automatically terminate at the end of the school year.

If your student is healthy this is not a problem, but if they need ongoing care the new policy will not cover those expenses since they are pre-existing conditions. You and your student can end up owing several hundred thousand dollars.

So plan ahead.

If you have questions about insurance you can ask us or present them on the Clark Howard forum.

Georgia Insurance Shop is a leading resource for affordable health insurance in Georgia for students and parents.

No Health Insurance for Children

In Georgia, and almost every other state, parents cannot buy "child only" health insurance. Doesn't matter if your child is healthy or sick. You can't buy it as a stand alone policy.

This has been true since 9/23/2010 and you would think the word would have gotten out by now but apparently not.

WSBTV reported on an elderly Gainesville couple that wanted to buy health insurance on an adopted child. The child is apparently healthy, but they cannot find a carrier anywhere that will insure her.

The Hollanders are in their late-60s and the parents of five biological children and 10 grandchildren.
 

They took Teri in when they learned her biological mother, who is not a blood relative, could not care for Teri. Karen Hollander told Channel 2’s Diana Davis, “Rather than have the state step in and put her into the system, we took guardianship of her. It’s not something I planned on doing at this stage of the game, starting all over, but life happens,” she said.
 

When the Hollanders legally adopted Teri three months ago, they were hit with a bombshell.
 

They said they learned that no insurance company in the United States will cover her.

They could not understand why, and apparently the reporter is clueless as well.

The simple answer is, Obamacare created this situation.

More precisely, HHS Sec. Sebelius took a bad situation and made it worse.

The original law said essentially this. If a carrier accepted an application on a child they could not rider (exclude) any pre-existing conditions. They were allowed to charge a higher rate for sick children, or they could deny them coverage.

HHS decided this was not fair and issued a regulation that prohibited health insurance companies from denying coverage to children.

The result is, no more child only health insurance plans.

The reason for this pushback by the carriers is simple. Many times the standard premium for a child is less than $200 per month. Some carriers are permitted by the state to charge up to 3x the standard rate which may still be insufficient to cover the ongoing medical needs of the child.

To balance out the loss, carriers are allowed to require the child to apply as a dependent to the parents plan. If the parent is accepted, the child will be as well, regardless of how expensive treatment is for the child.

Here is where I take issue with this provision of Obamacrap.

Auto insurer's are not required to issue a policy on a teenage driver. Life insurance companies can refuse to issue a policy on a child, but health insurance is different.

Why is that?

Probably because the idiots that wrote the law, but never bothered to read it before they voted on it, had no clue what they were doing. And if you think it is bad now, just wait. Come 2014 when everyone can apply for insurance without worry of being rejected, guess how much it will cost then?

About 3x current rates.

One good thing that came out of Obamacrap is PCIP (Pre-existing Condition Insurance Plan). Several states, including GA, offer this taxpayer subsidized plan to those who cannot otherwise obtain coverage.

But that does not include children UNLESS they have a health condition that precludes them from obtaining health insurance. Of course that won't happen because if a parent applies for coverage on their child, healthy or sick, the application is automatically rejected but has nothing to do with the health of the child.

And if they apply for coverage and list the child as a dependent, the child is automatically approved (if the parent is likewise approved) which would preclude the child from gaining entrance to PCIP.

Even if the parents did manage to get a carrier to issue a letter of denial because of the child's health, that child would have to be uninsured for 6 months before they could apply for PCIP.

Heck, at least they didn't do like Medicare and make them wait until age 65 or have been disabled for 2 years before they could become eligible.

And speaking of Medicare . . .

The Hollanders have Medicare — the federal insurance program for Americans over the age of 65. It doesn't cover kids. Though the Hollanders aren’t rich, they're not poor either.

 

 

Teri doesn't qualify for the state's Peach Care program or Medicaid.

I still maintain the government did a better job of selling cars (Cash for Clunkers) than they have in designing and managing health insurance.

 

Child Only Health Insurance in Georgia

Children’s health insurance is only available through Healthcare.gov

Child Only Health Insurance – The Saga Continues

Children’s health insurance is only available through Healthcare.gov

Obamacare – The Impact on Georgia

How has Obamacare impacted the citizens of Georgia? How many HEALTHY children can no longer obtain health insurance on their own? How many women cannot purchase maternity coverage? How have rates and choices been impacted already by the implementation of Obamacrap?

As a result of Obamacrap, no child left behind has become all children left behind when it comes to health insurance.

Women of child bearing age who want to purchase health insurance to cover the cost of maternity have only one choice.

Prior to Obamacrap about a half dozen health insurance companies offered maternity benefits, now there is one. If you want maternity coverage you have to buy the plan a year before conception and pay an additional premium (roughly $200 per month on top of your regular health insurance premium). Once you become eligible for maternity benefits you will have to satisfy your major medical deductible (typically $2500) before anything other than office visits are covered.

That means most pre-natal testing is paid for by the mother, not the insurance company, until she reaches her deductible. A woman who conceives in the summer will have to satisfy two deductibles. One for the current year then a new one the following year.

In addition to the outpatient pre-natal care the mother is required to pay the first $3,000 of the hospital bill.

All thanks to Obamacrap.

On Tuesday, December 7, 2010 (Pearl Harbor Day) Rob Johnson of WGST AM640 in Atlanta will interview me live on the air at 7:50AM. You can listen on the radio or by clicking the link.

Wish me luck!