Affordable Health Care in Georgia Doesn’t Exist in Albany

If you live in southwest Georgia and want affordable health care you are out of luck. The Albany area, served by Phoebe Putney hospitals, has some of the highest prices in the nation. This means Albany are residents pay more for their Obamacare health insurance than just about anyone else.            affordable health care in albany georgia

But wait. It get’s worse.

If you have a Blue Cross #Obamacare plan, Phoebe Putney is not in their HMO network. In fact, there are no BCBSGA participating hospitals within 100 miles of Albany, Georgia. Blue Cross charges more than most other carriers for a similar plan and gives you fewer hospitals.

How do you save money on your health insurance premiums and still have affordable health care in southwest Georgia? We have a solution but you need to understand why health care in Albany is so expensive.

A report from Kaiser Health News details the high cost of affordable care in southwest Georgia and points the blame clearly at Phoebe Putney hospital. But first a little background on their research.

If Lee Mullins lived in Pittsburgh, he could buy mid-level health coverage for his family for $940 a month. If he lived in Beverly Hills, he would pay $1,405.

But Mullins, who builds custom swimming pools, lives in Southwest Georgia. Here, a similar health plan for his family of four costs $2,654 a month.

This largely agrarian pocket of Georgia, where peanuts and pecans are major crops and hunters bag alligators up to 10 feet long, is nearly the most expensive place in the nation to buy health insurance through the new online marketplaces created by the federal health law. The only place with higher premiums are the Colorado mountain resort areas around Aspen and Vail, a high-cost-of-living area unlike Georgia.

The report, while interesting, misses the mark.

Yes, health insurance is high there, partly because of Phoebe Putney, and partially because of Obamacare. But you have options if you want more affordable health insurance coverage and you want to have access to Phoebe Putney hospitals and doctors.

All the dynamics that drive up health costs have coalesced here in Southwest Georgia, pushing up premiums.  Expensive chronic conditions such as obesity and cancer are common among the quarter million people in this region. One hospital system dominates the area, leaving little competition. Only one insurer is offering policies in the online marketplace, and many physicians are not participating, limiting consumer choice.

If want to buy your health insurance on the Obamacare exchange, your only choice is Blue Cross of Georgia.

But if you buy OFF the exchange you have more choices. Georgia Insurance Shop offers consumers in Lee and Dougherty county and surrounding areas several approved ACA health insurance plans that include Phoebe Putney in their network. When you look for affordable health care in Albany you have to know where to shop and compare ACA health insurance options.

We have several health insurance plans with broader networks and much lower premiums than BCBSGA. The Kaiser article implies you don’t have options, but in fact you have several choices. But you need to hurry. Your last chance to sign up for a health insurance plan, or make a change in March 31, 2014. After that your next open enrollment is November, 15.

I bet you didn’t know about that Obamacare requirement. The government considers that a feature, not a bug.

You can have affordable health care in southwest Georgia but you have to think beyond Blue Cross. Click now to find health insurance plans in your area.

SHBP Protest Groups Misguided

Georgia SHBP protest groups are misinformed and misguided. Teachers Rally Against Group Insurance Changes shbp protest(T.R.A.G.I.C.) formed a Facebook group in early January to express their frustration in changes to the GA State Health Benefit Plan. Obamacare is at the root of their complaints, but they refuse to concede this point and would rather direct their efforts toward the governor’s office.

Members and supporters of SHBP protest groups are certainly vocal but completely misguided in their efforts. They have not connected the dots between changes in the SHBP and Obamacare. TRAGIC and their supporters also fail to accept responsibility for the choices they made during last falls open enrollment.

  • The 2013 SHBP package was not ACA compliant
  • SHBP 2014 was required to be updated to meet Obamacare mandates
  • SHBP fall open enrollment clearly outlined benefit changes for 2014
  • Covered participants of SHBP had a choice of accepting the change or purchasing coverage in the open market

My wife and I are covered under the SHBP. We were given handouts at employee meetings and links to the state website where SHBP plan options were delineated. Yet no one complained at that time. SHBP protest groups did not spring up until AFTER the benefits were active on January 1, 2014.

Did they fail to read the handouts or visit the choices site?

One must assume the whiners never bothered to study the plans and weigh options outside the SHBP. The plan cannot be changed at this point. There is no going back. The Obamacare plans are not popular among individuals who have tried to use the exchange which is part of the reason why enrollment goals have not been met. For the 2 million or so that have selected a plan, estimates that 60 – 80% have yet to pay their first premium.

Over 65 million visitors to healthcare.gov but only 2 million have “signed up” for a plan they are required by law to have. Perhaps fewer than 500,000 have paid for their purchase.

Had the SHBP protest groups followed a similar process and studied the plans many of them may have refused to accept the plan designs and sought other coverage.

But they didn’t.

SHBP covered participants don’t get a Mulligan. Barring a Special Election Period because of a qualifying event, they will need to learn to live with their choice.

We reviewed the plans during open enrollment. We understood there were changes. Premiums were higher. Benefits were lower. Higher deductibles and more out of pocket.

We also considered our health care needs, our budget and looked at options OFF the exchange. (Most SHBP plan participants are not eligible for a subsidy so exchange plans should not even be a consideration).

So what can you do if you are in the SHBP to minimize your cost for health care?

  • Maximize your HRA dollars and go through the wellness steps at BeWell
  • If you have not read your plan, do it now.
  • Go to the BCBSGA/shbp site and look up everyone of your providers.
  • Print it out, especially participating urgent care facilities
  • Register with Express Scripts. Look up all your meds
  • Consider changing to generics
  • Evaluate 90 day mail order options
  • Consider ordering from a Canadian pharmacy such as Blue Sky

Rather than treating your health insurance plan like an “all you can eat” buffet, learn to manage your dollars. The sooner you master this skill the better off you will be. The current plan design is the future of health insurance. Protest groups like TRAGIC will not be able to roll back the calendar to the old days so get over yourself. If you spent as much time educating your members on ways to save money on health care everyone would be better off.

Many chronic health conditions can be effectively managed with a healthier lifestyle. Diet and exercise can do wonders for hypertension, high cholesterol, back pain and type II diabetes.

You can change the way you manage and pay for your health care, or you can join a Georgia SHBP protest group and be miserable. Your choice.

TRAGIC – Teachers Rally Against Georgia Insurance Changes

The Facebook page TRAGIC  (Teachers Rally Against Georgia Insurance Change) is a noble cause but totally misdirected. The group started by Ashley Cline are upset (rightly so) because of changes in the Georgia State Health Benefit Plan (SHBP) that came to light on 1/1/2014.

Mrs. Cline is upset with the state for the plan changes. If she doesn’t like the plan she should petition her school board to get their own plan, separate from the SHBP. Marching on the state capital (as they plan to do) is a waste of time and effort.

Actually, benefit changes were announced during open enrollment in October, 2013 but the reality of the changes didn’t hit this group of (mostly) teachers until last week when some of them actually tried to use their plan.

TRAGIC is upset over benefit changes in the SHBP. They want to blame the Governor and believe their protests will restore their “old” benefit plan.

It won’t.

Higher premiums, higher deductibles, higher out of pocket, elimination of copay’s and skinny doctor networks are a direct result of Obamacare. The benefit reductions they are experiencing today were set in motion 4 years ago with the signing of ACA.

Teachers Rallying Against Georgia Insurance Changes (TRAGIC) already has some 4,000 members who have signed a petition to oppose the state’s health insurance.

The new insurance plan affects not only teachers but an estimated 650,000 state employees.

Teachers said the plan they were forced to sign up for has higher premiums and fewer benefits.

CBS Atlanta

Actually, no one was forced to sign anything. Coverage was offered during open enrollment. Members could sign up for coverage or not.

Having gone through the enrollment process myself, I can say there was no coercion. I will also say that details on the plan were sketchy at best and incomplete.

In some cases we were totally misled.

Our benefit package indicated the plan would use the BCBSGA PPO network. Two weeks ago we discovered the PPO network would not be used but instead our plan had the much smaller and more restrictive POS network.

Fewer doctors. Fewer hospitals.

We also found out that the Rx benefit (administered by Express-Scripts) was NOT part of the health insurance plan. As a completely separate benefit drug claims do not accrue toward the major medical deductible or the out of pocket maximum.

This is where the wrath of TRAGIC should be directed.

Instead they are taking out their frustrations on the Governor’s office in hopes of restoring United Healthcare, the former TPA for SHBP.

Changing benefit administrators won’t bring back the old plan with copay’s and lower deductibles. TRAGIC is in denial about the real culprit.

Obamacare.

TRAGIC is encouraging teachers and state workers to call the governor’s office and express their concerns about the healthcare plan.

“It’s just another attack on teachers from the state government,” said John Carter, a middle school band teacher. “That’s all it is. It is a cash grab, and there’s no other way to put it.  It’s balancing our state budget on the backs of our teachers.”

No, it isn’t.

It is all about Obamacare.

TRAGIC needs to come out of the ether.

 

The Baby Daddy and Obamacare

Who is the baby daddy? In many cases it is #Obamacare. If you bought a subsidized Georgia health insurance plan from the baby daddyObamacare  exchange working taxpayers are funding at least a portion of your cost of your premiums. When you bring a baby into the world you need to tell the insurance company and Obamacare.

Why?

Because Obamacare is your baby daddy.

With regular private insurance, parents just notify the health plan. Insurers will still cover new babies, the administration says, but parents will also have to contact the government at some point later on.

Yahoo News

Working taxpayers, by way of the federal government, are providing tax breaks (premium subsidies) so you can afford to have health insurance. Since we are paying some of your bills we need to know when you have a baby (or adopt). We are your baby daddy.

Such changes affect financial assistance available under the law, so the government has to be brought into the loop.

That new baby may mean your taxpayer funded subsidy amount will change. Your gross premiums will increase. That is a given. But your net (after subsidy) may also increase.

But wait. There’s more.

It’s not just having a new baby that could create bureaucratic hassles, but other life changes affecting a consumer’s taxpayer-subsidized premiums. The list includes marriage and divorce, a death in the family, a new job or a change in income, even moving to a different community.

When you sign up for Obamcare the federal government needs to know more about your (formerly) private life. This includes marriage, divorce, children turning 19, moving to a new zip code  . . .

The role of the baby daddy is much expanded.

Insurers say computerized “change in circumstance” updates to deal with family and life developments were supposed to have been part of the federal system from the start.

But that feature got postponed as the government scrambled to fix technical problems that overwhelmed the health care website during its first couple of months.

“It’s just another example of ‘We’ll fix that later,'” said Bob Laszewski, an industry consultant who said he’s gotten complaints from several insurer clients. “This needed to be done well before January. It’s sort of a fly-by-night approach.”

No surprises here. Just more examples of incompetence in the Obama administration.

Just like many real life baby daddy’s, the Obama administration wants no part of actually taking care of matters. Big on promise, short on follow through.

Typical baby daddy.

Obamacare Plans Block Access to Health Care

Thousands of patients are scrambling to get medical procedures done before the new year. Why? New Obamacare plans block access to health careaccess to health care providers.

Those who were receiving medical care before being forced to sign up to a new plan on HealthCare.gov will, in many cases, be locked out of hospitals and prevented from seeing doctors who they had typically used. The WSJ contends that about 70% of new plans are more restrictive in the range of doctors and hospitals available to patients than their predecessors.

Breitbart

Most ACA Obamacare health insurance plans sold on the exchange in Georgia are HMO policies with limited access to health care from doctors and hospitals. Some plans only have one hospital in network. If you live in rural Georgia you may drive past several hospitals to get to one that is in your network.

If you buy a Blue Cross of Georgia plan your only choice, on or off the exchange, is an HMO. When you have an HMO you have limited access to health care.

If you want unfettered access to health care you need to consider broad network PPO plans available OUTSIDE the exchange. Bob Vineyard at Georgia Insurance Shop can help you choose from up to 80 different ACA health insurance plans that are only available off the exchange.

Supporters of the Affordable Care Act may argue that procedures will continue to be available, the plans severely curb access to health care from certain doctors and hospitals, preventing patients from getting the level of care they are used to at their usual price. In particular, insurers now using the Obamacare system have begun to exclude major academic institutions from their coverage, as these compete with cheaper community hospitals ostensibly providing the same service.

Under Obamacare it is no longer your doctor, your choice, if you buy from the exchange.

If you already bought an exchange plan, or a BCBSGA plan (on or off the exchange) it is not too late to correct your mistake. Let us help you find a plan that fits your needs and budget and gives you full access to health care.

 

Obamacare Fees Raise Premiums

Ring in the 2014 New Year with higher health insurance premiums thanks to Obamacare feesObamacare fees. Most carriers are hiding the add-on Obamacare fees while others are putting them right out there for you to see.

Good for them.

one insurance company, Blue Cross Blue Shield of Alabama, laid bare the taxes on its bills with a separate line item for “Affordable Care Act Fees and Taxes.”

The new taxes on one customer’s bill added up to $23.14 a month, or $277.68 annually, according to Kaiser Health News. It boosted the monthly premium from $322.26 to $345.40 for that individual.

NY Post

But wait. There’s more!

There’s also a $2 fee per policy that goes into a new medical-research trust fund called the Patient Centered Outcomes Research Institute.

Feeling black-balled yet?

And the gift of Obamacare fees doesn’t stop there.

Insurers pay a 3.5 percent user fee to sell medical plans on the HealthCare.gov Web site.

And yes, that is passed on to you, the consumer.

Americans also will pay hidden taxes, such as the 2.3 percent medical-device tax that will inflate the cost of items such as pacemakers, stents and prosthetic limbs.

The 2.3% Obamacare fees are added to gross sales. Those fees are passed on to the consumers, resulting in higher medical costs, and higher health insurance premiums.

Calling them Obamacare fees isn’t fair since the Supreme Court said it was really a tax. Fee or tax. Just calling a spade a spade.

 

 

Do You Have High Medical Bills?

High medical bills? Are you having trouble paying for your prescription drugs? Does the high medical billsreceptionist at your doctor’s office know you on a first name basis? Do you get Christmas cards from your hospital? Are high medical bills going unpaid because of deductibles, copay’s and coinsurance?

You can get a health insurance plan to cover your high medical bills.

 

Trouble Paying Prescription Drugs?

Many people, even those with “good” health insurance, have trouble paying for their medication. Rx deductibles, copay’s and coinsurance mean every time you fill a prescription you have to pay more.

Sometimes you don’t have any more and may decide to skip your much needed medication because you can’t afford it.

If you only had to pay for your prescription drugs one time and there was no charge after that for the rest of the year, would that help?

 

Are You Spending More Time at the Doctors Office?

Is your car on “autopilot” when it comes to seeing the doctor? Are you in the doctor’s office more than the grocery store?

Are doctor copay’s eating you alive?

Maybe you need a plan that makes it easier to budget your medical bills for the year. This is a health insurance policy that cap’s your out of pocket expenses at less than $1000 per year. Once you hit your out of pocket maximum you stop paying your high medical bills and the insurance carrier takes over.

No more surprise high medical bills.

How simple is that?

 

Does Your Hospital Have a Bed With Your Name On It?

Do nurses on the 4th floor know you on sight? Can you find the emergency room with your eyes closed? How about the radiology department or the infusion therapy clinic?

Infusion therapy can run $6,000 or more per treatment. Renal dialysis averages $3,000. At 3x per week that is $9,000 you are spending just to stay alive.

What if you had a health insurance plan where, for less than one drip session or dialysis treatment you could satisfy your out of pocket maximum for a year?

 

The “All In One” Health Insurance Plan

Georgia Insurance Shop has such a plan and it is available to anyone without regard to pre-existing medical conditions.

The plan is simple. No moving parts.

You pay the first $950 of your medical charges for the year. Your health insurance plan pays the rest.

How easy is that?

Shop and compare now by clicking this link. Instant quotes in 3 minutes or less. No hassle application can be completed in less than 5 minutes.

Stop wasting time at healthcare.flub.

Get real health insurance to pay your high medical bills.

If You Like Your Doctor . . . .

Everyone remembers the (broken) promise of “If you like your health insurance plan, you can keep it. Period”, but fewer remember, or made note of, the second broken promise. “If you like your doctor, you can keep if you like your doctor emanuelthem. Period”.

Enter the spinmaster.

Chris Wallace, said: “President Obama famously promised, if you like your doctor, you can keep your doctor. Doesn’t that turn out to be just as false, just as misleading, as his promise about if you like your plan, you can keep your plan? Isn’t it a fact, sir, that a number, most, in fact, of the Obamacare health plans that are being offered on the exchanges exclude a number of doctors and hospitals to lower costs?”

“The president never said you were going to have unlimited choice of any doctor in the country you want to go to,” said the Obamacare architect (Dr. Ezekiel Emanuel).

Weekly Standard

Dr. Ezekiel Emanuel is the brother of former White House Chief of Staff Rahm Emanuel.

It seems arrogance runs in the family.

(Chris Wallace) “It’s a simple yes or no question. Did he say if you like your doctor, you can keep your doctor?”

(Emanuel) “Yes. But look, if you want to pay more for an insurance company that covers your doctor, you can do that. This is a matter of choice. We know in all sorts of places you pay more for certain — for a wider range of choices or wider range of benefits.The issue isn’t the selective networks. People keep saying, Oh, the problem is you’re going to have a selective network–“

What Dr. Emanuel is saying is true. If you don’t mind limiting your choice of doctors or hospitals you can buy your policy on the exchange. If you are willing to pay more to see your non-network doctor, that is your choice.

But if you like your doctor, and want to keep your doctor, you should consider buying your plan OUTSIDE of the exchange where you can get full PPO networks.

Shop and compare OFF exchange plans. Your doctor, your choice.

 

Obamacare 834

Do you know what Obamacare 834 is? Neither did I. It’s a bug in healthcare.gov. Because of 834 your exchange application may neverObamacare 834 be approved by the insurance carrier you chose. Obamacare 834 means your child becomes your spouse.

Obamacare 834 is like Catch 22, except more insidious.

834 transmissions are the files that HealthCare.gov fires off to insurance companies when someone signs up for their plans. The companies say that some of these files have come in with inaccurate information.

Washington Post

It could be me, but seems like this is something that should have been checked out before flipping the switch on healthcare.guv.

Bataille announced Monday that about 80 percent of those errors stemmed from “one bug that prevented a Social Security number from being included. That caused the system not to generate an 834.”

So why have we never heard of 834 before?

Either the folks running the site had no clue, or they just didn’t want to talk about it.

Three reporters — one from the Los Angeles Times, one from The Wall Street Journal and I — asked Bataille for information on how many of the 834s sent out so far have had an error.

Maybe this is a secret.

Like “How many people have actually applied for health insurance through healthcare.gub?”,

This is where Monday’s media call started to get more tense than the dozens that have happened in the past, with reporter after reporter asking about the numbers of 834 errors and not getting a response from the administration. As The Wall Street Journal reporter reasoned, if the administration knows that 80 percent of the errors are coming from a certain bug — then simple math should figure out the total number.

Again, either the lack of response is due to incompetence or a desire to cover up the truth.

If you applied for a plan on healthcare.guv but have not been billed, or had any correspondence from your selected carrier, you should contact the company and see if they know who you are and have a COMPLETE application for you.

This is YOUR responsibility. The folks at healthcare.gub will not be your advocate.

You should know that the Obamacare 834 bug only affects applications submitted through the exchange. If you bought OUTSIDE of the exchange, you won’t have this problem.

ACA health insurance plans bought OFF the exchange have broader networks and feature a 5 minute, no hassle application. Many of our clients have reviewed plans and rates, applied and been approved in less than 20 minutes.

Avoid the Catch 22 of 834. Buy OFF the exchange. Shop and compare plans now.

 

Obamacare, What a Country!

Obamacare, what a country! Need health insurance? Can’t log in to the government website? Can’t qualify for a subsidy because of the what a countryfamily glitch? Or the employer glitch? Can’t find your doctor, or any doctor in your exchange based Obamacare plan? You can find a doctor but can’t get an appointment?

 

Obamacare, what a country!

Do you need health insurance but can’t log in to healthcare.gov?

No problem. It’s a feature, not a bug.

Concerned that you have signed up but have not received your policy yet? You should be if you applied through the exchange.

“Until the enrollment process is working from end to end, many consumers will not be able to enroll in coverage,” said Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group.

The issues are vexing and complex. Some insurers say they have been deluged with phone calls from people who believe they have signed up for a particular health plan, only to find that the company has no record of the enrollment. Others say information they received about new enrollees was inaccurate or incomplete, so they had to track down additional data — a laborious task that will not be feasible if data is missing for tens of thousands of consumers.

NY Times

You just THINK you have coverage.

What a country!

Every 2014 ACA compliant health insurance plan offered by Bob Vineyard at Georgia Insurance Shop has been approved and issued in days.

Every one.

 

Can’t Find a Doctor?

Even if you receive your policy your problems are just beginning. Most of the exchange plans offered in Georgia are HMO’s with very strict rules and extremely tiny networks.

If you currently have a doctor, chances are pretty good they will not be in any exchange networks. Even if you are lucky enough to find your doctor in the network, getting an appointment may be a problem.

Most doctors are limiting the number of exchange patients they are willing to see and setting up a waiting list for those who want to schedule an appointment.

The problem?

Exchange based plans, especially the HMO plans, pay less for patient care than a typical PPO plan. Also, some of the consumer “safe guards” built into exchange plans mean doctors may never be paid for the care they give.

What a country!

Jeffrey D. Zients, the presidential adviser leading the repair effort, said he had shaken up management of the website so the team was now “working with the velocity and discipline of a high-performing private sector company.”

Mr. Zients said 50,000 people could use the website at the same time and that the error rate, reflecting the failure of web pages to load properly, was consistently less than 1 percent, down from 6 percent before the overhaul.

So the website is working faster and smoother, but if you can’t get a health insurance policy . . . .

For insurers the process is maddeningly inconsistent. Some people clearly are being enrolled. But insurers say they are still getting duplicate files and, more worrisome, sometimes not receiving information on every enrollment taking place.

“Health plans can’t process enrollments they don’t receive,” said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans.

Despite talk from time to time of finding some sort of workaround, experts say insurers have little choice but to wait for the government to fix these problems.

This makes website accessibility issues seem minor, if you never know if you are covered or not.

Try the 5 minute, no hassle process. Look for ACA compliant plans OFF the exchange. Click here to shop and compare.

What a country!