If you ask most people to explain short-term medical insurance, there is a good chance that they have never heard of it. Starting January, 2014 short-term medical insurance may become more popular as the price of health insurance increases. Rising costs are inevitable because more sick people will utilize existing resources for adequate care.

What Is Short-Term Medical?

Short-term medical allows someone to have health care coverage for a short period of time (30 to 180 days.) However, in California, an individual may reapply indefinitely, provided they continue to qualify. In some cases, short-term medical could decrease your health insurance costs by up to 40%. Since most people are not familiar with short-term medical insurance, it’s important to know if you are eligible to have short-term medical.

What Are The Eligibility Criteria For Short-Term Medical?

If you can answer “no” to these questions below, there is an excellent chance that you will be eligible for short-term medical insurance.

1.Do you or any proposed applicant have any other insurance policy (group, major medical, government, or other) that will be in force on this policy’s effective date?

2.Are you or any of the proposed applicants now pregnant or an expectant father?

3.Has any person proposed for coverage been declined for health insurance in the past 12 months?

4.Have you or any proposed applicant received treatment, medication, medical and/or surgical advice, and/or been diagnosed with: cancer or tumor, stroke, heart disease including heart attack, chest pain, asthma, COPD (chronic obstructive pulmonary disease) or emphysema, liver disorder, degenerative disc disease or herniation/bulge, rheumatoid arthritis, degenerative joint disease of the knee, diabetes, chronic renal failure, alcohol abuse, chemical dependency, or diseases of a mental nervous nature within the past 5 years?

5.Have you or any proposed applicant been diagnosed or treated for AIDS, AIDS-related complex, or any other immune system disorder, except HIV infection?

What about people who lie on their application?

While this is not an absolute statement, but most short term medical insurance carriers are not in the business of determining eligibility. Rather, they are in the business of collecting money from lots of people in order to pay out large claims to a few individuals. If an individual decides to file a claim, but the claim is somehow traced to any of the disqualifying questions above, the insurance company has the right not to pay for the medical claim. Therefore, it is in one’s best interest to complete an application untruthfully.

What if I previously had one of the conditions listed above?

Depending on the carrier, if you have lived symptom-free for five years, then you do not have to answer “yes” to any of the questions. For example, if you have been cancer-free and haven’t taken any medication for five years and one day, then question 4 above no longer pertains to you. Depending on your resident state, some carriers only require a two-year symptom-free period.

Which doctors can I visit?

In the event that you need to visit a doctor, there are virtually no limits on the doctor you can visit. Unless you would like to change doctors, short-term medical will cover your same medical needs with your existing physician. It is important to note that if a condition manifests during your coverage period, you will only be responsible for your deductible and copayment if they apply. However, once that specified coverage period ends, you will be responsible for the entire medical bill, and will most likely forfeit your eligibility for short term medical insurance on your next application.

Overall, if you are healthy and you want the peace-of-mind that comes with knowing that you are covered, you may consider short-term medical. It may be a cost-effective way to take care of you and your family.

If you reside in the Greater Los Angeles and Southern CA area, please don’t hesitate to contact me with your short-term medical insurance questions. I can help you to best determine if short-term medical is a good fit for you. My contact details are below…

With the Baby Boomer population coming of age, there is a massive exodus out of the workplace. One critical shortage that could not have come at a worse time is the decreasing number of doctors. The American Association of Medical Colleges estimates the U.S. faces a shortage of 91,500 physicians by 2020. Over that same period of time, more people will be requesting medical services which will undoubtedly create further inefficiencies in our health care system.

Two major culprits of this problem are Medicare and Medicaid. While Medicare is a federal government-sponsored healthcare program primarily for seniors, Medicaid is for low-income families and is managed by both the state and federal governments. Medicare and Medicaid differ in terms of who they cover, and how they are funded and governed.

Real Doctors are feeling the pain

Dr. Martha Boone, a Urologist in Atlanta, is concerned about both of these inefficient entities. She has endured major financial sacrifices to avoid layoffs. She spends resources on two employees whose primary responsibility is to bill Medicare and other Insurance carriers to get paid for work she has already done. Also, she had to stop taking Medicaid because after 18 months she had to give up pursuing them for payments that they never paid.

The consequence of this growing trend is that many people on Medicaid now have to go to the emergency room and Dr. Boone is having trouble maintaining her practice. She states, “If a person who has $350,000 worth of education and 17 diplomas can’t afford a 1500 square office, what does that tell young people in our country about education?”

More patients, less  profit

One major concern that doctors in general have is a decrease in their revenue. One would think that January 14 couldn’t come soon enough for those doctors who struggle financially. Logic would suggest that more people to serve in the healthcare system would equate to a higher income. This logic is flawed because there is a projected reduction of $718 billion to Medicare, which is based on reduced reimbursement with the idea of reducing fraudulent behavior like billing for services never rendered or billing for a higher-priced treatment than the healthcare provider actually conducted. Honest doctors, and ultimately patients will have to adjust to substandard healthcare.

More people + less time = danger

As the number of patients increase, while at the same time, the number of doctors decrease, patients and doctors will have considerably less time to interact with each other. One unintended outcome of providing universal access to healthcare and require health insurance will be a connected negative string of events: less time with the doctor, less time to really understand the ailment(s), more incorrect tests, more overlooked tests, inaccurate diagnoses, and ultimately more malpractice suits.

One may begin to wonder why anyone would want to become a doctor or why someone who had been practicing for enough years to live a decent retirement would even have a desire for the medical profession. High prestige is saving the medical profession from becoming as potentially scarce commodity. In order to maintain the dignity of the profession, it is imperative that the private sector, states, and the federal government work together to maintain the dignity of the people who sacrificed time and money to pursue a dream that was supposed to be realized.

Updated July 8, 2013

Rumors are swirling around the country about how business owners are going to respond when the Health Care Reform act officially starts. One reaction is to cut workers’ hours to fall under the full time status. Under Obamacare, 29 hours/wk is the amount of time someone can work without being considered full-time.  As a result, some reports suggest that many large business owners will drastically reduce their hours to avoid the penalty.

A large business is defined as 50 or more employees. Employers that pass the 50-employee threshold and don’t offer insurance face a $2,000 penalty for each uncovered worker beyond 30 employees. In other words, an employer who has 100 employees will incur $70,000 a year tax. Surveys show that some CEOs will elect to pay the penalty because of the enormous financial burdens health care puts on their profits.

David Overton, CEO of Cheesecake factory already pays health care for each of his employees who work over 25 hours. In a CBS Interview, he expressed concern about what the numbers will actually look like when January of 2014 enacts the first real financial impact of the health care reform act. He states, “…we pay millions and millions of dollars for health care… we don’t know how much more we’ll pay. For those businesses that don’t pay for their employees, they’ll be in for a very expensive situation.” These costs may inevitably have to be passed to the consumer to help offset the rising cost of healthcare.

Welch Allyn, A multi-national medical device manufacturing company is planning to lay off 275 employees over the next three-years. The layoffs are a response to a health care reform related 2.3% medical tax. CEO, Steve Meyer states, “We firmly believe this restructuring program is the right thing to do for the long-term success of the business, however, we also fully recognize the hardship it will cause some of our colleagues in the short term.” To help offset the layoff, Meyer plans to reimburse up to $4,000 for each person impacted by the layoff who decides to go back to school within a year of their departure.

While these CEOs are concerned about the financial impact of their company, the employees of these businesses may have to make more drastic decisions. Since Walmart decided to raise their healthcare premiums up to 36 percent, many of its employees had to consider whether or not to maintain their health insurance coverage at all.

Obamacare requires businesses with 50 or more employees to provide health insurance. Previously, this requirement was set to take effect January 1, 2014, but because of a rash of protests this ruling has been extended to January 1, 2015. If you have more than 50, but fewer than 100 employees, you can explore the exchanges, which may be a more cost effective alternative. If you choose not offer insurance in 2015, you will be fined $2,000 per employee for all but the first 30 employees. If you have fewer than 50 employees, you will not be held responsible to provide health insurance.

The ripple effects of health care reform will be enormous. Customers who purchase consumer goods and services will bear the burden of increased costs passed to them. Employees who work for these large companies will collectively experience massive lay-offs. Employers will have to make difficult decisions that will impact the lives of those people they employ, and ultimately their businesses. For people involved in large corporations, there is a tsunami headed their way. Only time will tell the full impact of these changes in the health care reform act.

Own a business in the Greater Los Angeles or Southern California Area, and need health insurance advice in preparation of the Health Care Reform Act? Happy to help! See my contact details below…

Whether you work for a large or small business, have health care benefits or not, you will be affected directly or indirectly. The question is how will The Affordable Health Care Act impact you? Starting in January of 2014 the entire world of health care is going to change. With these changes, you must be aware of them if you want to take proactive measures.

Small Business Employees

Many people who work for a small sized company were less likely to have benefits because of the high cost of health care for the employer. Health Care reform may actually become more affordable for small business owners who have less than 25 full-time employees because of government subsidies. The tax credit created by the 2010 Affordable Care Act will allow these businesses to get a 50 percent reduction in the cost of providing health coverage. The only condition is that these companies must participate in the health care exchanges set up by the states. Exchanges are new organizations that will be set up to create a more organized and competitive market for buying health insurance.  Each exchange will have a plan that offers a bronze, silver, gold, or platinum package according to their price and the type of coverage they offer.

The good news is that a 50 percent discount will provide more opportunities for employees who could not previously afford coverage to finally gain access to healthcare. The bad news is that a 50 percent reduction of a number that has doubled is no benefit at all. In other words, we will have to see if the tax credit will be enough to give small business employees enough of a cost break to maintain their current standard of living.  As of the time of this writing, some experts suggest that the cost of healthcare purchased through the state exchanges will be sold at prices below-market value. Since healthcare reform will require everyone to have coverage, employees will be less likely to remain with an employer simply because they offer healthcare and another employer doesn’t.

Large Business Employees

Employees who work for large business are certainly more likely to have healthcare now, but that could drastically change in 2014. Businesses that have over 50 employees will be forced to pay $2,000 per employee each year if they do not provide healthcare. While that seems like a hefty fine to pay, companies could literally save hundreds of thousands to millions of dollars by not providing health care.

According to Kaiser Family Foundation, the average cost of individual health insurance was $5,615 per year. Using this very simplified averaging method, an employer with 100 workers would pay approximately $561,500 in healthcare premiums. If these same firms take the penalty, they would pay $200,000. That is a $361,500 cost savings, which could theoretically be the difference between people keeping and losing their jobs.

It is nearly impossible to predict how these changes will impact small and large employees because there are too many variables to consider. Healthcare providers have to contend with increased operating costs, which drive up prices. These price increases mean that this cost will affect the people employed will pass along to both small and large employers, and therefore, those employed by these companies may take the brunt of this economic blow.

Short Term Medical Health Insurance may be a viable way to get coverage at an affordable price until you figure out how health care reform is going to affect your health insurance and health care.

Looking at Your Options…There are health insurance options which you can explore today in anticipation of health care reform. If you reside in the southern California area, feel free to contact me to explore your options, or sign up for our Newsletter which will notify you of our upcoming Insurance and Financial Planning Seminars in the Greater Los Angeles and Southern CA areas. My contact information is below…

Whether you are insured or uninsured, the Affordable Healthcare Act will change the way in which you access healthcare. For some, your circumstance will improve as you gain access to a system that prevented your participation due to pre-existing conditions. For others, you may end up being laid off from an employer or worse yet, if you own a business, you may find it difficult to keep your doors open altogether. The point here is not to paint a picture of doom and gloom, but to reveal that everyone will have a price to pay for healthcare reform.

The Insured

Plan for your employer to gradually shift some of the health care costs to you in order to maintain profitability. For example, you will most likely notice an increase in the amount you pay for doctor visits. The sheer volume of usage in the medical community is going to drive up costs, which means that insurance companies will pass on that cost to employers, and ultimately to you.

On the surface, these group health insurance plans may look better because they come with low premiums, but have higher deductibles and co-payments for doctor’s visits. Currently, workers are are typically asked to pay the first $3,000 to $5,000 of each year’s medical expenses themselves.  Undoubtedly, these figures will increase. Another cost cutting strategy, which in this instance is a win-win approach, is to offer incentives for the employees who take preventative measures such as offering weight loss and healthy living classes to cut healthcare costs.

The biggest concern regarding health care reform is that your employer may have to get rid of their benefits package altogether. With healthcare costs going up, you may be caught bearing the entire financial burden of medical care for your family. If you work for an employer who has less than 50 employees, they are not obligated to provide healthcare for you. While this is true, it’s probably not worth overreacting because your boss probably offers you benefits because they want to compete with other companies to prevent them from stealing your talents.

The Uninsured

You are primarily the focal point of health care reform. Whether you have a preexisting condition or live significantly below the poverty line, you officially receive access to medical care starting in January 2014. For those of you who are sick, but live above the poverty line you will have to pay for care, but theoretically your costs will not be more expensive than everybody else’s.

Within this larger group of uninsured individuals, there is a subgroup of folks who have no desire to have any coverage at all. According to the federal Health and Human Services Department, one of those groups is the “Healthy & Young,” comprising nearly half (48 percent) of the uninsured. The other group is classified as the “Passive & Unengaged” (15 percent). The federal government has incentives for you to enroll in programs because you help keep costs down. You help insurance companies lower costs for everyone else when you make a monthly payment for insurance that you do not use. Insurance companies use those funds to pay for services other sick people will have to use much more regularly.

As a country, we tend not to worry or take preventative measures regarding the unknown because we do not forecast how we will be affected. Groups who have a higher price to pay, both literally and figuratively, will begin to feel the difference in 2014. Over the next few years, the national conversation about healthcare reform will get louder as we see its implementation and feel our pocketbooks get a little thinner. Short term health insurance will often be the solution uninsureds turn to…

Chances are, you have heard of the Health Care Reform Act known as Obama Care, but the real question is, “How does it impact me?” Does it impact your health insurance? Well, we will all be quite impacted by Obama Care either directly or indirectly. There are 2700 pages of legislation to prove it. Individuals who are not covered by health insurance (either permanent or short term health insurance) by January 1 will be taxed at the end of the year starting in 2014.

According to FactCheck.org:

• The minimum tax/penalty you could pay is $95.
• The tax you owe will be phased in from 2014 to 2016. By 2016, the minimum penalty is $695 per person.
• If you make less than $9,500, you owe nothing. If you make more than $37,000, you owe 2.5% above the level to file a tax return (right now – $9,500 and $19,000 per couple).
• If you make more than $9,500, but less than $37,000, you will owe $695 by 2016
• You will never be penalized more than the lowest cost health insurance plan offered by each state health insurance plan purchased through state exchanges.
• The Congressional Budget Office (CBO) estimates that these policies will cost about $4,500-$5,000/yr. for each person, but that was in 2010.

However, people who decide how much health insurance will actually cost believe the rate hikes will be severe. Mark Bertolini, CEO of Aetna, predicted that a 20 percent increase is a modest estimate. For some people, health insurance premiums would double. “We’re going to see some markets go up as much as 100 percent,” Bertolini told Bloomberg News.

Think about individual health insurance as a public swimming pool. Before 2014, individuals with pre-existing conditions were prevented from entering that pool because they needed extra life guards to keep them from drowning. After 2014, those same individuals will have full access to that pool, which means that the other swimmers will have to help pay for the extra life-guards. Medical claim costs are the biggest driver of health insurance premiums, which means that the healthier people in the pool will have to help pay for the people who are sick.

According to the Agency for Healthcare Research and Quality:

• Five percent of the population accounts for almost half (49 percent) of total health care expenses.
• The 15 most expensive health conditions account for 44 percent of total health care expenses.
• Patients with multiple chronic conditions cost up to seven times as much as patients with only one chronic condition.

Americans have a tendency to wait until a situation impacts them directly to respond. Hopefully, you take time to educate yourself further on this issue, and avoid unnecessary financial penalties due to a lack of planning about your health insurance. If you are currently uninsured, consider a short term medical health insurance policy. It is flexible, inexpensive, and a great solution in the near term until you can figure out your permanent, longer term health insurance needs.