• Home
• About
• Products/Services
• Blog
• Resources
• Contact

Posts Tagged ‘healthcare’

Childrens’ Health Insurance Plans Sometimes Cover Parents Too

October 30th, 2008

If you saw my recent post on our family’s Health Insurance Headaches you know I’ve been doing a lot of research into health insurance options lately.  I thought I’d pass on some information that might help some of you.  In the United States, every state and territory provides low or no cost medical insurance coverage to uninsured children under a federal initiative called the State Children’s Health Insurance Program (SCHIP).  The program is paid for by both the Federal and State governments, but each state administers its own program, including (within Federal guidelines), determining eligibility, benefits, and payment levels.

The program was originally designed only to cover children, but has been extended to the parents of eligible children by a number of states.  In my state parents of children 19 and younger can qualify for free coverage if they are under a certain income guideline, and for those earning slightly more there is a sliding scale of premiums.  Some other states may require the parents to be already receiving public assistance or Medicaid.  I mention it because it is worth checking your state’s rules.  So many people are temporarily out of work or their business has declined or other factors leave them unable to afford the insurance they once could.

I hope a few of you reading this are helped – or know someone else who could use this information.  I know it’s no help to those of you who don’t have children, or whose children are grown, or who earn too much but still can’t afford good health insurance.  I hope we have a better system soon!  If you live outside the US, I hope you live in one of those sensible countries with universal health coverage!

– Megan

Healthcare clinic image courtesy of Daniel Lobo.

Tags: health insurance, healthcare, State Children's Health Insurance Program
Posted in Current Affairs, Medicine | Comments (0)

Health Insurance Headaches

October 8th, 2008

Warning – Full blown rant ahead.  I am so upset I can hardly stand it.  I think my head may explode.  I know I have criticized the media for using Migraine loosely to describe a hassle, but I’m using it literally here.  My health insurance company, which is supposed to guard and foster my health, is about to give me a bona fide Migraine!  Adrenaline triggered, high blood pressure triggered, crying triggered, you name it.  And then they won’t want to pay for my medication.

I just received a notice that as of November 1, my health insurance premiums will go up by over 60%.  I receive group insurance through a professional association, and so I am one of those self-employed small business owners who is paying for my own premiums.  These are the group rates, mind you, if I tried to get my own insurance outside the group the premiums would be even higher.  Our health care is already the one of the largest costs in our budget, after shelter.  Higher than utilities, auto fuel, higher than food.  The monthly premium for our family of four will go up about $800, to over $2000.  And that’s just the beginning.  We already have:

• a $30 co-pay for doctor visits;
• a $50 specialist co-pay (“specialist” includes physical therapy for headache prevention – $50 out of pocket every time I go – my neurologist wants me going twice a week, I manage twice a month at those rates);
• most of the medications our family uses are considered “Tier 3” and have a $50 co-pay as well, so that’s a good $400 at the pharmacy every month;
• we have a $2000 deductible for out of network doctors (and we do use some of the same doctors who we like and trust and have used for years – silly us – so picky, huh?);
• after we’ve forked out that $2000 deductible, we have a 30% co-pay for out-of-network; and
• all claims must be submitted in 90 days or they are rejected.

That last is a doozy – take someone who is chronically ill and has trouble keeping up with paperwork, and you have a perfect formula to never have to pay on some large proportion of their claims.  Every previous insurance company I’ve had gave you 6 months to a year to submit claims.

Oh, and I almost forgot.  This company routinely loses about 1/3 of everything I send them.  So I have to keep to a very strict schedule to get everything in, then I send the claims, get nothing back, call them, they have no record, and they tell me, “Oh, if our scanner can’t read it, it’s destroyed.”  Destroyed.  I pay these people over $15,000 a year, soon to be over $24,000 and they destroy my paperwork?  Then I have to dig out my copies, send another set with a cover letter, and guess what, they send half of those back saying they weren’t submitted within 90 days.

To all the costs above, let’s add that I spend a good 2 days of my time every other month dealing with my health insurance claims, mostly with their screw-ups, uncompensated, of course, taking time away from earning my living.

I’m naming names here.  It’s Oxford Health Insurance, a United Healthcare Company.  They grant me the privilege of paying them an additional 60% for this abuse starting next month.  The reason?  Our group has a higher than average rate of claim submission!  Aha!  So, let’s analyze this – first of all, this is a group of coaches, whose job is to get people organized and on track to achieve their goals – maybe we have a higher than average ability to actually find our way through the impossible obstacle course that Oxford has set up to keep people from submitting claims!

But then, remind me, what’s the insurance for?  Call me naive, I thought it was there so I could afford health care!  I didn’t realize it was for the profit of the insurance company, first, foremost, and exclusively!  I’ve got no problem with business, I’m in business myself, but I do have a problem with the profit motive here, where it’s destroying the very purpose of the product!  Dare I suggest a single-payer system?  This is not auto insurance.  You raise rates on bad drivers, to give people an incentive to be good drivers.  So you raise rates on sick people to do what?  Punish them for being sick?  It is wrong to refuse insurance for pre-existing conditions.  It is also wrong to make insurance unaffordable for people who happen to use it.  That’s just a sneaky way to try not to cover conditions whether pre-existing or new.

A few days ago I said I would be non-partisan in this blog, and I don’t want to alienate anyone.  Please feel free to come here for help and support and ideas about managing life with Migraines regardless of your politics.  But I’m sorry, I can’t stay neutral here.  We have a chance to finally make a difference with our votes, a difference we sorely need.  McCain is proposing a $5000 tax credit to go straight to the insurance companies.  That won’t even pay for this premium increase, let alone make me any better off.  Does Oxford deserve even more of my money after all they already manage to take?  McCain is proposing deregulating health insurance further and encouraging more competition, letting the market take care of it.  The market is taking care of it by raising my health insurance premiums by over $9000 a year, because I have the gall to actually use my insurance!  What exactly is my family supposed to give up to pay for our health care?  Food?  Heat?

We need comprehensive, affordable health care available to all of us.  We need insurers to give sick people coverage without penalizing them.  We need this desperately.  People are being driven into ill health and poverty in this country by lack of coverage.  Barack Obama’s health care plan goes a long way down the road towards the coverage we need.  I need his plan now.  I think we all do.

– Megan Oltman

Exploding head courtesy of Alexander Iezzi.

Tags: affordable healthcare, Barack Obama, health insurance, healthcare, migraine
Posted in Advocacy, Rant | Comments (4)

Vote for Better Health

October 2nd, 2008

An election is upon us!  (Apologies to readers outside the U.S. but I know our national obsession is big news everywhere these days.) The purpose of this blog is not to take sides politically, so I won’t be pushing a platform. I do want to urge all U.S. citizens to get out and vote!

If you aren’t registered, the deadlines are coming up.  They vary state by state.  To get electoral information for your state, check out: Rock the Vote.  Rock the Vote even has voter registration forms you can download and mail in!  How cool is that?!  In Alaska you must be registered by this Sunday, October 5th.  Several states have deadlines this coming Monday, October 6th.  Most others have deadlines sometime between October 14th and 20th, although Idaho, Iowa, Maine, Minnesota, Montana, Wisconsin, and Wyoming permit registration at the polls on Election Day.  A big round of applause to those states for actually making it easier to exercise the franchise!  But please remember lines can be long on Election Day, and register ahead if you can.

If you are afraid you might not be able to make it out to the polls, get an absentee ballot.  Check with your
local Board of Elections, you usually have to request one a few weeks ahead, and in most places you can use it if necessary, or show up and vote if you’re able.  Some states have early voting, so you can vote while you feel well in case the migraine monster strikes on Election Day!  You have lots of options, so please exercise them, stand up and be counted!

What does this have to do with healthcare? Well, I know I’m not alone in thinking our healthcare system is seriously broken. How about you? Do you have health insurance? Even if you do – Are your premiums affordable? How is your coverage? How high are your deductibles? How good is the care available under your plan? How much are you paying for prescriptions? How much of your total income is going to healthcare each year? Personally, as a self-employed person, my healthcare costs (premiums, deductibles, and co-pays) are second only in my budget to housing costs, ahead of food and transportation costs! I believe we need a new President with a commitment to real change in our healthcare system, and a Congress to help pass the laws that will give us that change.

Please get informed. Don’t vote based on commercials or sound-bites or looks or popularity – look at the issues that matter to you. Do some reading, look below the surface. It doesn’t have to take long. If healthcare is important, as I’m sure it is to most of us, you can start by taking a look at this tool from Health Central: Healthcare ’08 PoliGraph.  You can use it to compare where you stand on various aspects of healthcare with where the presidential candidates stand. Get informed and then get out and vote. Thanks!

– Megan Oltman

Ballot box image courtesy of Just-us-3.

Tags: election, health insurance, healthcare, vote
Posted in Advocacy | Comments (0)