#you’re a nurse your work gives you health insurance and they deny your health insurance claim and then don’t give you medical leave

[eldritch-bf]

Also my best buddy’s wife’s insurance refused to pay for her hysterectomy to resolve her reoccurring large and painful ovarian cysts for it being a “pre-existing condition” AND her work denied her short term disability claim. So no pay for the whole 8 week recovery and they have to pay out of pocket for the procedure itself.

The irony is what kills me. She has health insurance provided BY the state. She works FOR the state. Doing what? Accepting/denying applications for state health insurance!!!

[mvprehab]

Medicare Physiotherapy - Is Physiotherapy Covered?

Many Medicare beneficiaries have questions about physiotherapy and whether or not it’s covered. In general, if your physiotherapy is medically necessary, Original Medicare covers 80% of the cost after you meet your Part B deductible ($226 in 2022).

Medicare Advantage plans, also known as Medicare Part C, may offer different coverage rules. You should contact your plan administrator to find out more. To know more about Physiotherapy on Medicare, visit the MVP Rehab Physiotherapy website or call 0450603234.

Physical therapy is a health care service that helps treat injuries and diseases that affect your ability to move. It also helps manage symptoms like pain and stiffness that may make it hard to move your body.

You may need short-term physical therapy while you’re recovering from an injury or surgery. You may also work with a physical therapist to help manage long-term conditions that affect your mobility.

Medicare covers physical therapy services if they’re medically necessary for you. You can get physical therapy at inpatient rehab facilities, skilled nursing facilities and private rehabilitation centers under Part A of Original Medicare or from a Medicare Advantage plan. Medicare Advantage plans must offer the same benefits as Original Medicare, but costs and coverage may vary.

Medicare doesn’t require a referral before you receive physical therapy, but your therapist must certify that PT is medically necessary for each visit. Learn more about Medicare’s certification rules and log your certifications with WebPT.

Medicare will cover a limited amount of physical therapy sessions per calendar year. Its coverage depends on the type of PT, its medical necessity and where you get it.

In general, Medicare Part B covers 80% of the Medicare-approved cost of physical therapy. You pay a 20% coinsurance after meeting your Part B deductible (which is $233 in 2022).

If you have Medicare Advantage, or Part C, check with your specific plan to see if it provides additional PT benefits. These plans, which are offered by private companies approved by Medicare, include the coverage provided by Parts A and B but may have different rules about extra therapy services.

Most Original Medicare beneficiaries have Medigap insurance, which helps pay for the out-of-pocket costs associated with Part B, including deductibles and coinsurance. Generally, a Medigap policy will pay all or a portion of your Part B coinsurance after you meet your deductible for outpatient physical therapy.

If you aren’t meeting Medicare’s definition of medically necessary therapy services, your therapist must give you an Advance Beneficiary Notice of Noncoverage (ABN) before providing further therapy. This gives you the option to continue with therapy but agree to pay for it yourself.

If your therapist opts to assign you a diagnosis that doesn’t meet criteria, or continues to work with you without assigning a diagnosis and gets your claims denied, you may need to change therapists. This can cause more stress, and your premiums may go up since a new therapist has to disclose your diagnosis on record.

Despite the fact that therapy should be client-centered, insurance companies are largely focused on improvements in measurable terms. This is why they use measures like pain, strength and function to justify claims. Having to document all of this can distract from the real goals of your treatment. It also allows for an insidious form of control by the insurance company over your treatment.

Generally, Medicare pays for physical therapy as part of its Chronic Disease Management (CDM) program. That means you may be sent to a physiotherapist by your doctor to help treat a specific chronic musculoskeletal condition like arthritis or a knee injury.

For those with Original Medicare, Part B covers outpatient physiotherapy after you pay your deductible ($233 for 2022) and 20% copay. However, you should keep in mind that Medicare has caps on how many days it’ll cover PT within a benefit period. Your provider may recommend you get services more frequently or for a longer time than Medicare allows, but you should know how often your doctor can bill Medicare before it imposes a limit.

For more information on how Medicare coverage for physiotherapy works, check your plan documents or speak with a trusted insurance agent. You can also find out about Medicare Advantage plans that offer extra benefits or different cost-sharing. Then you can compare estimates to see which option is right for you. To know more about Physiotherapy on Medicare, visit the MVP Rehab Physiotherapy website or call 0450603234.

[laele25]

This is sociopathic.  “Well, even though I might die and my elderly father might die, it’ll be fine.”  For the last damn time Karen, it isn’t about you.  Or your family.  You do not exist in a bubble, you psychotic bitch.  There’s the workers at the nursing home who make $7.25 and have to work three jobs to pay their rent because you vote Republican because you’re ‘pro-life’ and can’t afford health insurance even with all those jobs because you think universal healthcare is communism.   YOU are the reason this virus has killed a quarter of a million Americans.  Because you support generational poverty,  stagnant wages, victim blaming, and chronic health problems for everybody but the wealthy.  Now kindly do us all a favor and die of Covid so you can’t vote in more misery based on your twisted prosperity gospel blasphemy.  For fuck’s sake, you couldn’t be less ‘pro-life’ if you were just randomly shooting your neighbors.   So fucking done with these people.  Also, this shit is why I left the Midwest and would never go back.  We have healthcare workers BEGGING people to stay home and then these absolute morons come along all ‘If I get it, I get it, lol’ Because unless they’re victim blaming someone else for being a victim of a shitty law that they voted for because the politicians promised to take away other people’s rights to bodily autonomy or denying a problem they don’t believe exists because it doesn’t directly affect them, they don’t give a shit about anyone else.

[jaygrey981]

AARP Health Insurance : Why AARP wants you?

AARP Health Insurance: Even though a ferocious debate climbs in Washington on the future of healthcare, you've got a more serious problem: the best way to cover your medical bills without going bankrupt -- better yet, without having to give your health membership. For anybody not insured under a company's policy, the answer usually lies in the hunt for a most inexpensive medical insurance program, and, as you become older, Medicare supplemental insurance or Medigap and long-term care insurance.

Anyone, who over the age of 50 (over 65 to get Medigap) is qualified to buy those 3 products through AARP, the advocacy business, that's also an important participant in the insurance marketplace. The company collects $400 million annually in fees for lending its name to several private policies, but since AARP's financial products have not always lived around the group's mission of looking out to their 40 million associates, MoneyWatch.com has explored how good these policies are.

When speaking to almost a dozen pros and comparing estimates from 50+ firms, here is our closing: AARP health policies, although infrequently the cheapest, are aggressive, and perhaps the best way for you in the event you have health issues. Its long-term-care health insurance warrants checking out due to its low rates and the fiscal strength of its spouse, Genworth Financial.

Medicare Made Easy using MyAARPMedicare

Nonetheless, it isn't easy to state whether anybody's insurance policy is totally the best one for you for two reasons: Whether you're going to have the ability to purchase these kinds of policies, and at what cost, frequently is dependent on your own wellbeing. Additionally, each nation has its own regulations & rules on the kind of policy carriers could offer and the way they can choose which customers to take.

Affordable health insurance has been part of AARP's assignment since the group began over 50 years back. Ethel Percy Andrus, AARP's founder, was appalled that retired teachers had inadequate medical care policy. But, there were missteps on the way.

After Sen. Charles Grassley, R-Iowa, increased concerns in 2008 regarding if AARP Health Insurance policies dupe customers into believing they provided more security than they did, AARP suspended earnings. In a PPO, the insurer contracts with selected hospitals and doctors to provide services at a discount. It's likely to seek good care of outside the neighborhood, but you pay more.

The Premier Plans resemble routine workplace policies. They cover 80 percent of the purchase price of preventative care, prescription drugs, doctor visits and hospitalization within the machine, the moment you have insured your own allowance. These comprehensive plans are the most expensive and therefore are generally best for AARP members who need coverage for their dependent children.

High-Deductible Health Plans compatible with tax-sheltered Health Savings Accounts (HSAs) offer lower premiums but place more financial obligation concerning the insured. You cover the whole network cost of doctor visits, lab tests and hospital admissions round the deductible. Therefore you're essentially trading low premiums for higher regular costs. 

These programs will likely be ideal for your very own self indulgent, who may gain from the tax advantages of an HSA, and people in good health who generally cover a visit to the doctor only a couple of times each year.

Preventative and Hospital Programs are the most affordable because they provide coverage only for nausea and inpatient operation. You cover the whole network prices for doctor visits and prescriptions (besides generics) in the pocket; they don't count from the allowance. And additionally you also pay 20 percent of this bill after the allowable for hospital admissions and lab tests. These apps are greatest in the event you would love to keep premiums down, but nevertheless, have security for catastrophic care. They aren't a replacement for comprehensive medical insurance.

All these health insurance policy have four attributes worth noting:

Unhealthy Conditions: Though AARP/Aetna inquires you all of the healthcare questions other insurance firms do, you are more prone to find cheap coverage than with competitions when you've got elevated blood pressure, higher cholesterol or are obese. That's because AARP is much more pliable. As the comparison below shows, a healthy person won't always cover more with AARP compared to other insurance providers, however.

Medical History: AARP/Aetna seems to your health care history for preexisting conditions within only the last five decades, maybe not the industry-standard 10 decades. This might be advantageous if you, say, had a heart attack over five decades ago and therefore are completely recovered.

Dependents: AARP/Aetna allows AARP members guarantee their inheritance even if they don't purchase policy for themselves. This is sometimes helpful if your employer doesn't offer family coverage.

Preventive Care: Each of the apps, for instance, high-deductible and preventative hospital programs, cover an yearly physical, a prostate exam for guys along with a mammogram and gynecological evaluation for girls, along with flu shots to receive a low $20 to $40 co-pay, based on the plan. Normally, preventative and behavioral programs require policyholders to foot the entire bill. Aetna also waives the allowance for a colonoscopy once every 10 years at its own Premier plan, as well as the high-deductible plans cost only a 20 percent co-pay for its procedure.

For our price check below, working collectively with eHealthInsurance.com, we grapple the 3 types of AARP/Aetna policies against opponents to get a healthy married couple into their mid-50s, residing in Georgia with a kid in college. We chose Georgia because most insurance companies sell PPO policies. (Remember: These are only bottom rates; before a medical insurance policy problem a policy, it's likely to analyze your medical history and establish rates accordingly.)

MyAARPMedicare Login wasn't necessarily the least expensive but was normally among those lowest-priced choices. 1 significant note: Assessing the bottom rates of wellness programs is simply a beginning stage. Every strategy in these head-to-head comparisons put its own twist on co-pays, doctor visits, and prescriptions. "You can't do an apples-to-apples comparison in case you don't ascertain whether the benefits and coverage constraints will be precisely the same."

Here, AARP was one of the lowest priced in the 5,000 allowance and $3,000 allowable classes.

AARP had the lowest premiums and deductibles, a rare twofer, among those apps that provide the smallest amount of policy.

AARP/Aetna was among the lowest $5,000 and $1,500 allowance programs, but the center of the bundle to acquire the 2,500 program.

AARP Supplemental Insurance is designed to safeguard you in places where Medicare drops short. There are 13 federally standardized applications -- Approaches A through L. They supply more protection as you work your way throughout the bible, jointly with Strategy F being the very popular because of its own benefits and budget. Basically, Medigap is a merchandise: You get the very same benefits no matter your own condition or insurer. Even though the advantages are equal from carrier to carrier, you will find dramatic differences in price and client services.

Things you Want to know before buying the AARP Insurance

And AARP has staked its turf outside at a few other Significant ways:

Last year, AARP/UnitedHealthcare approved 99.94 percent of applicants. The only reason it denies coverage is chronic kidney disease. By comparison, lots of AARP's competitions base premiums on your age and your health, which means you might be denied or charged if you have obtained a preexisting disease.

Customer support AARP works a 24-hour toll-free (888-543-5630) staffed by agents who will inform you about hospitals and dentists locally, and counsel you about what to ask your doctor about potential procedures. AARP/UnitedHealthcare also says it pays 98 percent of claims within 10 days.

Unlike a lot of Medigap insurance firms, who place premiums in accordance with your current age (attained-age score ) or your age after you purchase the policy (issue-age), AARP/UnitedHealthcare uses community evaluation anyplace it's sold. Meaning it costs exactly the exact same premiums to each of policyholders, no matter age, gender or health. "A community-rated policy may cost you a little more when you're younger," says Burns,"but it often costs less after you get old".

The main thing, says Burns, is the AARP/UnitedHealthcare Medigap apps"can be a really fantastic deal, and they're more prone to be a wonderful bargain for older people who have health issues" In countries where many insurers use attained-age evaluation, AARP gets cost-competitive by supplying a devotion reduction: individuals that become policyholders between age 65 and 67 get a 30 percent decrease that ignites by 3 percent yearly for ten years.

With this price check, we contrasted AARP/UnitedHealthcare Plan F premiums with the highest and lowest rates for nonsmokers in Maine (a state which needs community analysis ) and New Hampshire (one allowing attained-age score ).

But, AARP/Aetna was much in the very costly; this was merged Insurance Co. of America ($231).

AARP health and long-term-care insurance could be bought online, through the email, or by phone 866-894-6032 (health and Medigap) or 866-660-4117 (long-term care ). Telephone the number to discover whether there's a local agent who will meet you.

These policies are meant to guarantee, or decrease, the potentially devastating financial cost of a nursing home stay or assisted-living care.

Apart from being financially robust and having sold these coverages as the mid-1970s, Genworth has a history of keeping costs stable for policyholders. The company asked state regulators for its first and just rate increase -- about 8 percent -- in 2008. Genworth says it doesn't have any programs to find a speed gain in the future.

The four have powerful financial ratings together with a history of stable rates and reliable payouts to customers. AARP/Genworth was the second-least expensive and nearly $1,000 less expensive than the priciest, Northwestern Long Term Care. As a mutual insurance provider, Northwestern yields a number of their premiums to policyholders yearly, however.

Burns, however, is a fan of New York Life, although it may sometimes be more costly than several competitors. "They're the most powerful insurer on the current market, they haven't ever had a speed increase and they frequently cover a return to their clients in the finish of the calendar year," she states.

AARP/Genworth premiums and policies are nearly equal to Genworth's particular products, therefore deciding to get the AARP version depends upon whether you'd like to promote the company. (Otherwise, talk to a Genworth rep instead; 888-436-9678.) However, AARP has two additional advantages: It ensures premiums won't change for five decades, alongside the AARP customer support line is superb. When MoneyWatch predicted, the rep supplied sound guidance on the ideal amount of policy to purchase. She proposed deducting the amount of Social Security obligations we'll receive from the quantity of coverage we buy. she asked. Fantastic question.

Poor Health Conditions: Your coverage is more affordable for people who have raised blood pressure, higher cholesterol or are not obese. This may be useful in situations where there is no household coverage supplied by the company. High-Deductible Strategy AARP is one of the cheapest strategy, among those 5,000 allowable and $3,000 allowable courses. Preventive and Hospital Plans: AARP is demonstrated to have the lowest possible deductibles along with premiums, which is a rare offer among those programs that provide the least expensive policy. Conclusion

As being the Health Insurance Agent, I tried my very best to supply you each detailed information that might assist you in picking out the finest Health Insurance for yourself. But in the event that you still have some query don't hesitate to ask me with the below comment segment.

To supply you detailed and accurate details regarding AARP Medicare & Health Insurance I must spend the assistance of these resources. It is also possible to check these sources to get more info regarding this subject.

[briwhosaysni]

Ok, after over a year of explaining to adults, often age 40+, some very basic things about insurance at my job, I've decided to give you all a crash course in health insurance from someone who works in a clinic, because no one teaches you this stuff even though it's Really Important. Under a cut, because this is gonna be long. (Also, I apologize, this is specifically for insurance in the US. I have no clue how it works anywhere else.)

10 Things to Know About Health Insurance and Medical Bills:

1. Plans

Your plan is all of the details of what your insurance covers, and how, and where, and when. Do they cover a certain treatment? If they do, will they only cover it a certain number of times? Is there a specific place you have to get that treatment? These are all part of your coverage (aka your benefits), and will vary depending on your plan. Every insurance company has many different plans which will cost different amounts and have different coverage. This means that you can never assume something is covered for you just because it's covered for someone else who gets insurance through the same company. It also means that if you call a clinic (especially one you haven't gone to yet) and say "I'm with [insurance company]. Will they cover [service]?" 90% of the time they won't be able to tell you. They won't have access to all the specifics of your plan. To find out, they would need your insurance information, and time to call your insurance company. It's honestly much better to call your insurance company directly and say "Hello, I want to go to [clinic/provider] for [treatment]. What would my coverage be?"

2. In-Network vs. Out-of-Network

Every healthcare provider that takes insurance (doctor, nurse, PA-C, therapist, etc.) has a list of insurance companies that they're in-network with, and ones they aren't. Whether or not a provider is in-network determines how much your insurance will pay for you to see them, if at all. If your plan has out-of-network benefits, then your insurance will pay for you to see a provider who isn't in-network, but they probably won't cover as much as they would for someone who was. If you don't have out-of-network benefits, then your insurance will ONLY pay for appointments with providers who are in-network. How do you know if you have out-of-network benefits? Call your insurance. A clinic can usually tell you if if they, or a certain provider in their clinic, are in-network, but they can't generally tell you what your benefits are.

3. Deductibles

Your deductible is the amount of money that you have to pay in a year before your insurance will start paying a decent amount for things. They'll usually still cover small portions of your bill, but you'll be paying the most of it until you pay all of (aka "meet") your deductible. This amount varies wildly between plans. It could be as low as $100 or less, it could be as high as $5000 or more, or you might not have one at all. And, it resets at the start of each year. If your deductible is $1000 and you spend $500 on healthcare in 2019? You'll still need to pay the whole $1000 in 2020 to meet it for that year.

4. Out-of-Pocket Limit/Maximum

Some insurance plans have a certain amount of money you can spend on healthcare in a year, after which point they'll cover the costs 100%. This is your out-of-pocket limit/maximum. Generally your copay, deductible, coinsurance, and all that stuff will go towards your out-of-pocket limit. So if your plan has an out-of-pocket limit of $8000, for example, then if you spend $8000 on healthcare in that year, your insurance company will cover the full cost of any more treatments. No copay, no dedectible, no coinsurance. Not every plan has one, and the amounts differ, so check with your insurance what you have.

5. Copay

Your copay is the amount of money that you have to pay when you go in for an appointment. Often it will be lower for a regular doctor's visit than a visit to a specialist. The vast majority of clinics require you to pay this when you check in for your appointment, and if you don't there will often be an additional fee. Some plans don't have a copay, and some do. Some plans don't require you to pay a copay after you meet your deductible, some do. If you're not sure what your plan has, call your insurance and ask.

6. Coinsurance

Coinsurance is the portion of your bill that your insurance will pay AFTER you meet your deductible. For instance, most plans will cover one annual check-up with your regular doctor (aka your primary care provider) at 100%, which means after you meet your deductible, they'll cover the entire cost of that visit (minus any copay). An extra visit might be covered at 70%, which means that for a $100 appointment, your insurance would pay $70 and you would pay $30. Again, if your insurance still requires you to pay a copay after your deductible is met, then you'll be paying both the copay (at the time of the appointment) AND the coinsurance (after the appointment).

7. Referrals and Authorization

Many insurance plans will require a referral and/or pre-authorization in order for you to see a specialist, or get certain tests or procedures done, or to see out-of-network providers. This is basically just your doctor's office contacting your insurance in advance to say "Hello, [patient] needs to get this procedure/see this provider, because of this specific problem/condition. Would you please pay for it?" Then your insurance company will review the request and either say "Yes, this seems reasonable and is covered by their plan. We will pay for it," (aka "approval") or "No, this treatment doesn't seem medically necessary and/or isn't covered by their plan," (aka "denial"). Sometimes if authorization is denied, your doctor can call your insurance and talk to them to try and convince them that the procedure is medically necessary. Or, sometimes they can get authorization for a different but similar procedure instead. (I work in a sleep clinic and often see insurance companies deny in-lab sleep studies, so patients will get take-home sleep studies instead, for example.) Please note that authorization is NOT a guarantee that your insurance will cover your visits/procedures 100%. It just means they’re agreeing to pay whatever portion is dictated by your plan, rather than making you pay for the whole thing on your own.

If your primary care provider refers you to a specialist, their office is the one that will need to request authorization, if necessary. A specialist clinic cannot generally refer a patient to itself.

8. Getting Information

I know I've said several times that if you're not sure about part of your plan, you should call your insurance. This is true, but I also know that phone calls suck. HOWEVER, there's often another way. Most major insurance companies have websites where you can make an account, and look at an overview of your plan, see how much of your deductible you've met, and even find in-network providers near you. And if you're on your parents' insurance, you can still make your own user account, so don't worry that you might have to have them make one and give you the login info. You may still have to call your insurance company if you have specific questions you can't find answers to online, but for basic information, this can be a great resource.

9. Updating Insurance

I know it can be hard to remember, but if your insurance plan changes or you switch to a different company, please please please call your doctor's office(s) to update it as soon as possible. You really don't want to show up to an appointment only to find out that you're not actually covered, or you needed pre-authorization or something. Let clinics know in advance so they can prepare as needed. Also, check with your new insurance beforehand to see how similar/different the plan is to your previous one, and whether you might need a new referral, or to find a new provider or something.

10. Billing Coordinators

And finally, if you're confused or worried about a bill from a clinic, the Vast majority of them will have a person you can talk to in their billing department about it. You may have to call ahead to schedule a time, you may not (though it's still nice to give advanced notice), but many times you can ask to talk to them in-person or over the phone, and they'll be able to go over your bill with you, explain what the charges are for and how much was covered, and spot any errors if there are any and fix them. They can also often give you cost estimates for procedures before you schedule, which can be helpful for budgeting and scheduling. (Though bear in mind that an estimate is just that: an estimate. They can't know for sure what the final bill will be until after your insurance pays them.) And if you have to pay a bill but don't have enough money right then, many clinics (though not all) will allow you to set up a payment plan, or to only pay a portion at a time. This is also something a billing coordinator/billing specialist would help with. In general just don’t be afraid to talk to the billing department if something seems off about your bill. If your insurance isn’t paying for something they should or something like that, the clinic is going to want to know about it and get it sorted out.

This isn't everything you'll ever need to know about health insurance ever, obviously, but hopefully it'll help you understand the basics. And as a bonus, stuff like deductibles and coinsurance work very similarly across all types of insurance: health, dental, car, etc., so understanding one better will help you with all of them.

[braindamageforbeginners]

A New Doctor

Cycle 9, Day 10

So, I now have at least a half-dozen physicians on my case. If you believe the BMJ stat that “medical misadvenure” (which is a broad category that includes, but is not limited to, doctor error, nursing error, pharmacy screw-ups, misdiagnosis, accidental overdose/drug interactions, opportunistic infections - the list goes on) is the third-leading cause of death in America (according to the same study, heart disease is #1 and cancer is #2). So, for those for those of you setting odds on my life expectancy (and, frankly, I’d be disappointed if you didn’t), it’s been an odd, extended game of “Clue,” except I’m Mr. Body, to see if disease, side-effects, or my possibly-insane physicians will get to me first. I hate to say it, but I think I’ve finally figured the odds-on favorite in this one: my GP.

This isn’t a plea for help, or even a serious medical development on my part, it’s a warning for you, the readership, as insurance enrollment comes around. First of all, if you can’t pay, hospitals or physicians can throw you out on the street (this is something able-bodied people are so disbelieving of that took a poor black woman freezing to death on-camera in Baltimore). They are only required to treat you if you in an emergency situation, thanks to some federal laws called “EMTALA.”If you have a disease that drives you to the emergency room, the prognosis gets worse. People tend believe that just because it’s the healthcare industry, the health insurance industry isn’t a corrosive force that has a vested interest in denying care and killing you. Which is odd to me; you don’t get this anywhere else (or I haven’t experienced this sort of self-delusional attitude); you don’t see people defending McDonald’s or Nabisco or RJ Reynolds or Exxon as having their best interests at heart (and, to my friends who think they’re bullet-proof because of their health insurance, read the fine print, very, very carefully; you don’t want to get a nasty shock as you’re being rolled into the OR). So, thanks to my parent’s generosity/desire not to see me die, I rolled in last year with a very expensive PPO (there are a lot of acronyms to keep track of, but PPOs allow the patient to see anyone in a preferred provider network, which tend to be large and give the patient lots of choices, so you can directly get a referral to a neurologist if you hit your head). Unfortunately, because I have pre-existing conditions (and to my bullet-proof friends, read through the list of pre-existing conditions that’ll disqualify you, your jaw will drop)(also, it’s telling that Congressmen and Senators have the option to buy into a separate, federal employee health insurance option that’s not available to us serfs)(it’s also telling that the ACA required Congresscritters, for the first time ever, to tough it out and find health insurance like their constituents)(which is why I assume all the GOP higher-ups had melt-downs over the ACA - a slight removal of privilege to help sick constituents isn’t a part of Congressional ethos, let alone job description), my premiums went from “expensive” to “leasing a sports car” within a few months. I’m extraordinarily grateful to them for providing that financial backing, because it allowed me to continue getting treatment during the crucial 6-10 week GBM post-diagnosis period that might turn this from “Guaranteed doom” to “far too close for comfort.” So, this did give me some time to do my homework (in writing about this, I’m realizing I really should consider applying to law school, because I’ll know more about medical and insurance law and ethics than some lawyers before this is up)(Hell, I probably know more than some of them right now). Anyway, I found that all the specialists I see for cancer, do take medicaid (even the specialized pharmacy I use at the cancer center). Which is good for me, especially since being on disability in California is an automatic qualification for Medicaid. Now for the bad news; although all the specialists there take medicaid, the GPs don’t. AND the specialists only take medicaid if it’s done through an HMO carrier that the state sub-contracts with.

Great Kraken’s Balls.

There are a number of documentaries and documents (including an “Adam Ruins Everything” segment) on why HMO’s are unnecessary and lethally incompetent (like many other aspects of a for-profit medical system), but here’s the most basic deal: They act as a gate-keeper for the entire medical-industrial system. You can get your care at any of a dozen pre-approved hospitals, and nowhere else. Now, if an HMO or their doctors can’t treat you (or refuse to treat you - which is still the case for a lot of GBM patients), they are required to send you to a specialist who can. The economic incentive is to give less care, and keep all the patients in the system for as long as possible.

I suspect that delaying tactic is why heart disease and cancer are considered so deadly - you can’t sit long on either of those.

So, based on the financial folks at the cancer center, I picked one, and promptly forgot about it; because I’m already in the system there (the receptionists and pharmacy staff recognize me on sight)(which is comforting, until you realize it’s a cancer center, and then the panic briefly cuts in until you remember you’ve gone eight months without regowth or metastastis). I only remembered it when I got a call from the medicaid HMO telling me I should schedule an appointment with one of their physicians. This isn’t a big deal, I just need them to sign-off on any further black magic-based treatments with the Warlocks or Radiation Oncologist.

Now, before I go further, let’s talk about the people who go into medicine. Like anything in healthcare, we tend to give assume that an entire industry is moral, and just; when people go in for a variety reasons (as recently as 20 years ago, the vast majority of medical students said it was for money), and it’s worth noting that cuts across a vast majority of demographics and motives. And, for better or worse, that cuts across vast swathes of competence - for far too many folks, it’s a job - a rewarding job, but just a job. My father recently inquired about board exams and recertification as a way of guaranteeing some basic level of competence from everyone. He’s right, but the key word there is “basic.” Again, “basic” is fine for first aid and most major medical issues; it’s unacceptable if you have a disease with a 90% fiver-year mortality rate.

I bring this up because I think I chronicled my first appointment with my insurance-appointed GP five or six weeks ago and seemed perfectly satisfactory to my ongoing addiction to experimental chemotherapy. I’m certain it was within that time frame, because I had schedule a six-week follow-up. Which, sadly lands on my “week off” chemo. So, yesterday, after infusion #2 for this cycle (for those of you wondering what I’m doing to stay busy during infusions these days, well, rewriting Christmas carols for cancer patients)(”On the first day of chemo, the nurses gave to me, zofran in an IV”). I also convinced dear old Dad to take me out to lunch, because, again, when the Marizomib side effects hit, you do not fee like eating. This was in the neighborhood of the latest addition to my collection of medical people, so I thought I’d reschedule then. And was told by the receptionist to wait for everyone behind me to check in lest they be late for appointments. That would be fine, but it seems a fundamental misunderstanding of how queus work. And, any time post five-ish hours on infusion day, even though zofran might keep me from puking, it does give me an odd, oily, queasy sensation. I think I deserve some sort of gold star for not puking on this woman right away (again, if you have unconventional problems, feel free to start with an unconventional approach)(my next writing project will be titled, “Life Lessons from Necromancers”). I eventually - using the traditional method of looking down the reception counter, noticed someone not otherwise occupied, and manage to get an appointment more amenable to my schedule. For a physical.

Again, I’d love to use some four-letter words here, but even Finnish fails to meet the requirement. Now, it should be noted that, even though I’m well-aware that I’m physically Adonis-like; I am in chemo and recovering from radiation treatment, Radiation Oncologist implied a few months ago that, even though my scan was clean and looked good for someone with brain cancer, anyone unfamiliar with my case would probably freak out about them. Same thing with my abnormal, uh, “lab sample” I wrote about recently - the nurses agreed, a single abnormal test is hardly unexpected toward the end of chemo, especially since I’m now on a diet consisting mostly of protein, fiber, cafeine, and dangerous, experimental substances. However, I’d prefer not to have to point all that out to a new medical person who has the power to yank the plug on me (sadly, my original GP will be on vacation that week. (I’ll also be on Temodar, so there’s a solid chance my brains will be thoroughly scrambled and incapable of comprehension).

ANYWAY… WEIGHT: 198 lb CONCENTRATION: Pretty good, APPETITE: Normal (but this is 24 hours post-infusion. ACTIVITY LEVEL: Not great; the fatigue side effect definitely caught up with me and chewed me up last night. SLEEP QUALITY: Okay. although I’ve noticed that I definitely thrash around on chemo days. COORDINATION/DEXTERITY: Lousy. Thank Gods I don’t need the walker, and I don’t even think I need my magic ankle support, but my left leg is definitely unreliable today. MEMORY: Not bad, although I did forget my sheets were in the wash earlier today (although I recall stripping the bed and tossing them into the washer). PHYSICAL: Tired and kind of wobbly, but still a lot better than this time a year ago.. EMOTIONAL: Okay. It might just be that I spent yesterday next to my zofran-and-CDB salt-lick, but I’m starting to think I might make it through all this somewhat intact. Hang on. Am I really starting to believe my own bullshit? SIDE EFFECTS: Tired, somewhat sore (either chemo or increasing the difficulty of that stupid elliptical), and in the wrong time-zone, but, other than that, not much.  CURRENTLY READING (For Donna): Gonzo Girl, and The Explorer’s Guild (A Passage to Tshamballah)

[voice-oftheempire--archived-blog]

SEMI-HIATUS NOTICE

// It probably doesn’t come as any sort of great shocker to see that, given that I haven’t exactly been really active on here or @morvokk now for some time. This blog has been running on queue, in fact, due to just not having the energy and capability to actually do anything.

So let me get on that, explain what is going on, and we’ll sort of move on from there.

As any of you who have been with my blogs since they were started back in October know, my health hasn’t been in the greatest of dispositions for one reason or another. Given that I do have some new followers, I’ll retell some things, so a few bits will be old-news-moving-into-new for the veterans here, eheh. (If you want to skip to the new stuff, search for “***”)

As this story goes, I went in to the ER, primary care, and a handful of different specialists on numerous occasions and ended up basically grabbing a doctor in the ER by the lapels and screaming at him what he was going to do to my body to find out what was wrong that time.

This was how we found out I had biliary dyskinesia. Again, for those of you who have been around for a bit, you know that this was but for the new ones this is basically a huge dysfunction of the gallbladder where it produces all the same symptoms of gallbladder disease with gallstones. . .except you lack the ability to actually make stones. No stones means this can’t be picked up easily through blood tests (mine were always “good”) or through an ultrasound because there’s nothing to see. You must get something called a HIDA scan done that basically induces your gallbladder to do it’s job and measures if it does. It should perform at lowest 35%, but doctors prefer 40%. Mine was 20% when the test was done. And dropping.

Scheduled for surgery, but it was postponed numerous times while I was given a run-around by my surgeon who wanted my heart cleared because I had been having chest pains since November (mind, this was January now when I finally had this together). I had asked about that, but they had denied me, so I grumpily wore it for three days and now have five scars on my torso from the stickers, tachycardia when I have panic attacks and bradycardia when I take narcotic painkillers. Thanks, heart monitor. Gallbladder out on February 5th, have bad recovery.

***This is where the new stuff starts kicking in, for those of you who have been around here.

As I recovered from my gallbladder surgery, I noticed that it was taking me a lot longer to actually recover than what it was supposed to. Like. A lot longer. Weeks more. I was steps back from my peers. I had to order another round of painkillers because I was still in agony. I was still suffering chest pain. I was told, “It’s just built-up gasses -- you’re fine, you’re fine.” And then the images came back from my surgery and we found the cyst on my left ovary. Okay, cool, nothing huge to panic over. Made an appointment with my OBGYN and discussed it with him. Got scheduled for an ultrasound to see what kind of cyst we were dealing with and why it was pretty sizeable. Discussed and agreed to having an ablation treatment to my inner lining to hopefully fix a lot of those problems too. Schedule that after the ultrasound (because if we gotta do surgery for one, may as well do them at the same time, right? Right).

And then there were the pesky panic attacks that were keeping me up at night. Gasping, chest-crushing, sobbing, I-am-dying, screaming into pillows and begging for it to end attacks on end. Five, six, eleven times a day. All hours, always worse at night. I was staying awake instead of sleeping. My spouse was getting two hours on good nights where all he could do was try to keep me from hyperventilating and screaming. Most of the time I just sobbed and begged him to make it stop.

The muscle weakness came not long after. My arms went first, but we expected them to be a little off, especially since I had been on strict orders from my doctors to not lift beyond five pounds. But my legs? When it became almost impossible for me to stand up from sitting in a chair, or getting out of my car without help I knew something was wrong. It felt like sandbags weighed me down. Like I had done leg day for eons. Like a thousand leg presses. Whatever. It was wrong, and it got worse every day.

Then the brain bleed happened out of nowhere. That one was fun and scary. A simple trip to the ER for a headache that felt very wrong that I wasn’t willing to mess with (my aunt has a history of brain tumors, so nu-uh) revealed blood on my brain and wham I was laid up for two days in a much fancier hospital ICU. Three more CTs later, plus a cerebral angiogram I was released, and no one knew where the bleed had come from or if it would happen again.

And all the while my chest got worse and worse. And my entire body began hurting and aching. My headaches became worse, but no more bleeds (even after another ER trip to make sure). Many days I would wake up and barely be able to roll out of bed without wanting to scream. Some days I was up and okay but still not there. I was always dizzy, always a bit sick, always foggy in my brain. Given new drugs to help with the panic attacks (they did, for a bit, and then they came back).

My primary care doctor sat me down and gave me this: you will go see a gastroenterologist. The testing will ultimately probably come back clear, and when that does I can give you the referral to the best rheumatologist. You have an auto-immune disease or fibromyalgia. Maybe both at this point, but it’s not our specialty. It’s theirs. 

Then: the nail. The insurance I was riding was literally riding -- I was coasting on the fumes of my old job’s insurance -- expired. When I showed up for my ultrasound appointment they told me they had tried to bill it the day prior and it bounced back as gone and asked if I had new insurance. Well, no, not yet.

Now, this isn’t to say I haven’t been working with Medicaid here since December because of chronic illnesses and various mental/physical disabilities keeping me from having a job to be able to PAY for insurance, but they had to collect paperwork from every doctor I had seen in six months time. That was over sixteen doctors. And some...were not sending. And not sending. And not sending. As of right now there are still some who have not sent from months ago and I am screaming because they are hindering my potential.

Anyway

$400 upfront for my ultrasound and who knew how much for the actual appointment? Sorry, no could do. Guess that cyst is there to stay for now, fellas. I had to cancel my GI appointment, which also means that all my progress is now halted. I’m a dead fish in the water with no insurance. My doctor has given my prescription strength NSAIDs to see if that will help relieve some of the issues in my chest, but so far nothing. 

And, not to make this sound more Danny Downer? But each day I wake up and it’s worse. For the past two days I haven’t even gotten a whole five hours because I woke up to roll over and my heart started hammering in my chest, my entire chest cavity began hurting worse than ever, I felt like I couldn’t breathe and was dying all over again...and hours later it still feels like that? I was in the ER again last night for pain uncharacteristic for all of this and they couldn’t even diagnose it at this point. It’s just a, “You’re not having a heart attack, so you’re alright and that’s the best we have.”

The week before I was in the ER too. I’m getting very tired of hospitals.

My point here is: today, I’m doing really good to be sitting up and typing. I’m really proud I walked from my bed to my attached bathroom and back again before I started sobbing. I keep writing in my chronic illness journal and I keep waiting for something to happen with insurance. But I’m always exhausted and my creativity is absolutely gone. It’s just...zapped and gone.

For now, I’m having to take a step back, focus on just trying to get through each one of my days as I have them, and exist. Adding the responsibility of Tumblr to my life right now just isn’t quite possible. It’s too taxing right now, and I feel too much guilt looking at how many replies I owe or how many Asks I have in my box. And given that some days I can’t even sit up to type? Or even see the screen or keyboard? Maybe best not.

So, in the meantime, both Valoren (@voice-oftheempire) and Morvok (@morvokk) will be placed on a SEMI-HIATUS with an indefinite return date. I’ll be in and out as I can, when I can, and work as I can, but it will be extremely low-key, threads will be highly-selective, and I will ask for the upmost patience with my partners while I navigate good and bad days. 

As always, I love each and every one of you, and please, please do not hesitate to hit me up on Discord just to chat or whatnot. Just remembering that someone else is out there is often enough to help someone through their day. I’ve actually lost irl friends because my health bothers them -- and I would hate for that to happen here as well simply because I wasn’t writing as frequently as before.

PS: There are certain drugs that if you take them will make your urinalysis come back positive for meth, cocaine, and cannabis. If you have been in and out of the hospital as much as I have, the nurses will ask in on your Drug Cartel. This legit happened last night. I had to end this on an amusing note. <3

[driggarssaleha]

should i get voluntary life insurance

BEST ANSWER: Try this site where you can compare quotes from different companies :insurecostfinder.xyz

should i get voluntary life insurance

should i get voluntary life insurance? Any information I can provide in here will be provided by this life insurance company when we talk to someone. Please check out the link below: Hi Eric. I am 60 pounds and my husband is only 50 and in good health. I had insurance for our 5 years together but I recently got a quote for a 30 dollar co-pays per year over the co-pays for 20 years total. If I only had life insurance a month ago but would like to enroll in some sort of plan, would there be more than 40 co in the past year? What life insurance plans do you recommend for young adults? I am 39 and in good health. I signed up for term life for 12 months so if I only had a $100,000 policy I would need about $1700. And I have no medical issue but it would be more than 50 more a year. I would need from $350k to $400k. The biggest thing is to have the money to get. should i get voluntary life insurance from my ex and i said we pay for it. i told she had some questions and i could speak to her supervisor. she told us not to worry because i had already started my policy. but if this is not her advice, we have nothing to worry about and nothing to have nothing to do with our policy. not happy with our ex policy as she said it was a good insurance policy and i should have had it since we weren t married so to us they told me we should have started it. but then i told her no they would get back to her like they don t do in most other cases. after telling her that because it was my policy that she shouldn t continue to use the insurance in the future. im having to get other insurance for my policy so when she said she wouldn t be using it anymore. she kept giving us the same number as she says i put on my older husband s insurance. I told her it was only 1,000 a month but that was. should i get voluntary life insurance for my family who cannot make a lump sum? i have a few companies, have them write the premiums a monthly bill, will one of my relatives ask me what is going on with my insurance so there is more to my question? and I dont really know the answer. My husband is the primary breadwinner in the family but we don t have to make a lump sum to cover our funeral arrangements. Can an insured adult male afford to pay a very large amount for their life insurance policy? I m about to purchase an annuity due to my pregnancy loss. Will you and your spouse still get coverage? What should I do if it is known that I have some sort of ill health, or will my spouse either need to get life insurance at some point? Thank you! I would advise against buying life insurance for the elderly or elderly persons with an estate in their favor. Even if your spouse is healthy, he may be denied coverage and would not be eligible for coverage. I am interested in.

What is Supplemental Life Insurance?

What is Supplemental Life Insurance? In the event of a loss of health coverage due one of our employees, we recognize the needs that the employees face.   Supplemental life insurance is the most basic form of life insurance. The only difference between Supplemental and Supplemental coverage is that Supplemental coverage only pays out whether you’re still alive. If you were to become in a nursing home, this coverage would only pay for your current health. What does Supplemental Insurance Benefit me? If you have Supplemental Health Insurance, you are covered up to $35,000 if you were in a nursing home to the amount of the Supplemental coverage. The basic benefit that Supplemental Insurance Coverage gives is a $1,000 death benefit which is included in the Basic or Supplemental Coverage options of all life insurance policies. The Basic plan pays out benefits if you die within the first 5 years of the Plan and the supplemental coverage also pays out benefits after that if you die.

Why we Pay Too Much for Insurance (& how to Cut your Costs)

Why we Pay Too Much for Insurance (& how to Cut your Costs) We have no life insurance, and we pay the best we can and we do this to be able to provide for all our family. It may seem expensive, but at least we have peace of mind knowing we are doing something for our family, for our children, for our future children, for those we love dearly. But it’s not all being free, as we can take one of our insurance companies at very affordable prices. As we said above, we are working with a group of insurance companies and insurers who are dedicated to providing the most competitive policies for the and . Our customers and their families may be disappointed by the cost of our policies. If you have a recent accident, your premium might be much higher. That’s because of its frequency. And if you get your license, your insurer wants to make sure that you’re not driving a car. So it’s one of the things that makes buying car insurance so worthwhile. .

How Much Supplemental Life Insurance Should you Buy?

How Much Supplemental Life Insurance Should you Buy? If you’re considering supplemental life insurance, you can expect that your annual premiums will be significantly higher than your annual cost of insurance. You’ll either receive a premium or you’ll be asked to contribute at a lower risk of having your insurance premiums increased. The reason they’re more expensive is because of the risk factors they face such as cancer or a disability. Also, there’s more to it than just life insurance, such as an accident or disease. For example, if you live in a high-risk area and you have a history of non-accidents rather than fatalities, you’re more likely to have to pay higher premiums to offset the extra risk on your life insurance. If you want life insurance coverage that has the same cash value, you can look at guaranteed universal life insurance as an alternative to If you want life insurance coverage that’s affordable, you should always compare rates. There are a number of people who consider.

Benefits of Supplemental Life Insurance Through an Employer

Benefits of Supplemental Life Insurance Through an Employer-Employee Benefit Plan Substitute Benefit Plan Coverage for all through employees and retirees (including employee share-bills to the in the first year of service) Substitute Benefits (Exemption from the Premium Tax, if applicable) Insurance benefits for employee members Subsidy and subsidy for an individual or pension Coverage for all employees (except employee share-bills to the in the first year of service) Substitute Benefits (Exemption from the Premium Tax, if applicable) Substitute Benefits (Exemption from the Premium Tax, if applicable) Coverage for all employees (including employee share-bills to the in the first year of service) Substitute Benefits (Exemption from the Premium Tax, if applicable) Substitute Benefits (Exemption from the Premium Tax, if applicable) Substitute Benefits (Exemption.

How can I make sure I get the right life insurance coverage for my family?

How can I make sure I get the right life insurance coverage for my family? There are several components that go into determining the perfect life insurance coverage for your families. Each one of these could impact your finances and your family s future. That s why having a good look and checking life insurance policies is critical. Family Members Your family members could be contributing to your debt so, it s really something to discuss carefully with your representative. Non-Family Members In most cases, you can get life insurance coverage from non-family entities. However, it needs to be noted there may be a cost or the life insurance company s fees if they re the beneficiaries of an un-paid contract. Healthy Individuals It may be a no-brainer to get life insurance from a healthy individual. A healthy family will also likely buy life insurance for the best price. However, you will need to get a full medical exam for your family members so you re not caught paying a high price by their health. What should I do? Many people seek out.

What does a group life insurance plan cost? Is it worth it?

What does a group life insurance plan cost? Is it worth it? If no, take a moment to consider what life insurance is, and what types of coverage are available to meet your needs. A group life insurance plan is a way for you to share financial responsibility between two parties. The one thing to consider when thinking about insurance is how much coverage you need. The minimum coverage should be sufficient. If you need insurance for 10, 15, 20, or 30 years, you ll also need to invest in additional time to get ahead. Your family s needs are likely not that different from theirs. So how much financial responsibility do you have? Here are 5 things to consider when you want to insure your family. Life insurance is for one person who has lived the life of the contract, for the duration of the contract. So if you are not the first parent in your home, your first step is to help guide you so you are not dependent on them. Some insurers are able to cover your entire cost of a life insurance policy, which is called . However,.

Who should get supplemental life insurance

Who should get supplemental life insurance? Your spouse? Yes, the answer is. You can choose a policy when you have dependents, are in your late 60’s, or are a married couple where neither is happy, or married but have lived together for the past 10+ years. There is a company to help, called Amalgamated Life Insurance Company (AHLIC), that sells supplemental life insurance policies. You could get supplemental life insurance when you’ve been diagnosed with a qualifying illness, have been denied coverage from traditional insurance companies, or you’ve been turned down by the insurance company due to the use of substandard health information. AHLIC has a life insurance policy that is designed to help you protect your family. This is called a “substandard” policy and is usually referred to as the “Substandard Policy”. Many of the coverage options we provide don’t appear to fit the substandard risk classification. That is why it�.

Life Insurance: How Much Coverage do I Need, if Any?

Life Insurance: How Much Coverage do I Need, if Any? Does any type of car insurance cost more than the minimum amount of liability coverage? What is the cost to insure a new car if you have no proof of financial responsibility for it? How many miles do you drive everyday does a new car need to be of insurance? Do you have a policy or some other type of insurance to help you insure car ? Is it necessary to insure the driver of a new car? Does the cover the car with its original car tag? I just got my license and I can t do anything else on it. Do I need car insurance for my new car? When you are wondering how much it will cost to insure a vehicle for the insurance cost, it will cost more than the minimum amount, in terms of costs for its cost. There may be a time when buying a car for a while may be a matter of whether you are in perfect health. If not, it may be the case that you are still paying most or all of on the price. While.

Downside of Supplemental Life Insurance Through an Employer

Downside of Supplemental Life Insurance Through an Employer’s Benefit Plan and Employee Benefit Plan. The employer’s benefit plan provides a fixed or guaranteed percentage of a company’s death benefit to be used to purchase services of a licensed, registered independent insurance agent. The employee’s insurance carrier will pay the individual or organizations covered by the health benefit plan the initial premiums for a specified period of time, as the case may be, after an employee’s first month, in the case of a minimum of 5 consecutive days following the employee’s first month. This will not increase the employee’s future premium after the employee’s first month. A supplemental life or supplemental health insurance plan can be used to cover an employee or group that is not a covered group. The employee may opt for the supplemental health plan for the first 6 months of the year. However, a year upon year term will not necessarily be the most efficient and cost efficient plan for an employee or group. For instance, the employee.

How much life insurance can I get through work?

How much life insurance can I get through work? There are also a lot of answers to these questions, but life insurance policies are pretty different in many ways depending on what kind of coverage you want or need. If you re looking for from a life insurance company, we re here to help. We ve helped nearly 250,000 people learn about their life insurance options. As we help you navigate the complex world of life insurance, it’s important that you have the tools, resources and knowledge necessary to get right to your interview. It s vital that you have comprehensive knowledge about many different types of life insurance coverage. Some of these coverages are subject to underwriting, and other are not. Life insurance policies also cover you for your entire life, without a medical exam. As an Independent Life Insurance broker, you can get quotes from several top life insurance companies. While some of these companies will give us a lower rate when we do an interview, it may cause the cost of our interview to be higher if you have a medical.

[walknstar1-blog]

Best Health Insurance For Small Business Owners

Best Small Business Health Insurance Providers Of 2020

A report by the frequent wealth fund in 2006 confirmed that the nation’s smallest companies pay an average of 18 p.c more in medical insurance premiums for a similar advantages than the most important corporations. Meanwhile, the price of offering medical insurance to small enterprise employees had been rising larger than inflation charges prior to the Affordable Care Act. Offering aggressive advantages while additionally keeping your employer costs low is troublesome for a lot of small companies. Unlike companies that employ tons of of employees, small companies might not obtain the lowest charges for insurance policy. Healthcare tax credit are available to Best Health Insurance For Small Business Owners that meet certain skills and purchase plans through the SHOP Marketplace.

Best For A Large Provider Network: Bluecross/blueshield

For instance, if the monthly premium to cowl employees is $10,000, $60,000 is subtracted from the tax legal responsibility. In addition to the 25-employee rule beforehand mentioned, the common annual wage of employees should be less than $54,200, and a qualifying arrangement have to be maintained. The Patent Protection And Affordable Care Act (handed by Congress in 2010), gives particular tax consideration to small businesses that present medical insurance to workers. These tax breaks will allow you to save money, since a lot of the healthcare laws was not overturned or substantially modified. We work with house owners to explain what impact some of these modifications could have on their income.

Get Helpful Health Content In Your Inbox

Healthcare that can’t be taken away when you are sick ,and protection that may’t deny you for having pre-existing circumstances are great advantages beneath the ACA. It provides preventive providers and a number of advantages that weren't out there to most individuals before. Employer-primarily based plans that provide medical health insurance to retirees ages can get monetary help by way of the Early Retiree Reinsurance Program. This program is designed to lower the price of premiums for all employees and scale back employer well being costs.

Is small business health insurance cheaper than individual?

Best Self-Employed Health Insurance: Best Overall for Self Employed: UnitedHealthcare. Cheapest for Self Employed: Kaiser Permanente.

Common Health Insurance Options

Humana presents small business medical insurance to employers with two to 50 employees. Plans and options range by state, so be sure to check restrictions in your area. If you're self-employed without any staff, you’re probably busy enough as it's without worrying about your medical insurance choices. The excellent news is that the Affordable Care Act now allows a self-employed health insurance deduction for one hundred% of their medical health insurance premium.

Things To Consider When Choosing Self-employed Health Insurance

To calculate your worker share, divide the number selecting to enroll by the variety of eligible staff. The pool of eligible employees should not embody people who have protection through another job, another particular person's job, Medicare, Medicaid, TRICARE, Veteran's Administration healthcare, or the Indian Health Service. The pool of eligible employees ought to include those that have private coverage, together with plans purchased via the medical insurance market. The Center for Medicare and Medicaid Services has a helpful reality sheet addressing questions on this problem.

You can search the Health Insurance Marketplace for plans that will fit your healthcare wants and price range. If you’ve missed the ACA open enrollment period to use for medical insurance, you can also consider a brief-term health insurance plan to cover your well being expenses till the open enrollment opens once more. You can even check and see when you qualify for Medicaid healthcare protection, or even elect to self-fund your health insurance. Because you're solely insuring your self, you've some flexibility in choosing the best plan for your needs. Shop round to see if you'll find the identical or related protection for a lower cost than you’re paying now.

Some states work in partnership with the federal government or run their very own SHOP.

Insurance corporations and brokers say many small-enterprise homeowners chose to re-enroll staff in present plans, many of which did not comply with the regulation’s new rules but allowed employers more time to gauge their choices.

“It wasn’t     what small employers have been clamoring for,” said Rick Allegretti, an executive with Health Care Service Corporation, which presents nonprofit Blue Cross plans in five states and sells plans through the small-business exchange.

WellPoint, one of the nation’s largest insurers, says that it is seeing a significant decline within the number of the smallest businesses persevering with to offer coverage.

The firm reported insuring 300,000 fewer folks in small-group plans this yr.

Most of the focus on the Affordable Care Act has been on whether or not people can discover reasonably priced coverage through the web marketplaces. In general, most employers pay a minimum of 50% of their staff’ medical insurance premiums.

Read more at https://www.businessusainsurance.com/small-business/best-health-insurance-for-small-business-owners/

Ehealth Can Help You Find Affordable Insurance

Consider becoming a member of a buying cooperative with other small businesses, which could lower prices or provide additional features. Learn extra about providing choices similar to telemedicine and nurse hotlines, which can be extra convenient and likewise less expensive than doctor visits.

With the right online resources, you'll be able to remove your excuses for not providing medical health insurance to your employees. Cutting coverage or asking your staff to contribute more to the plan is a logical step to lo Best Health Insurance For Small Business Owners.

Can I Get Health Insurance Through My LlC ?

Principal Financial says most small companies allot between 10% and 15% of payroll prices for health care. The average 2010 annual premium for small-group protection was $three,944 for single coverage and $10,048 for families, in accordance with the American Health Insurance Plans' 2010 survey.

How much does health insurance cost if you are self employed?

I've seen policies designated to cover executives only as a means of segregating their risk from the rest of an employer group.

Due to tighter profit margins and lower numbers of workers, finding protection to suit within your finances is troublesome. The a lot-wanted bulk reductions available to larger firms usually are not out there to your smaller firms. However, even small enterprise house owners like your self can discover affordable methods to supply insurance for his or her workers.

And, because it’s tax deductible and allows some small businesses to apply for a tax credit, paying this quantity is nicely price it. Working with an insurance broker, PEO or non-public health trade provides you with an easy way to determine your prices. Keep in thoughts that any amount you pay in direction of your workers’ medical health insurance plan is tax deductible.

Most small businesses lean toward excessive-deductible plans, which carry lower premiums but pressure staff to shoulder extra of the remedy costs up-entrance before the insurer kicks in. (Experiment with different premium/deductible ratios, relying on what your employees are in search of.) Health savings accounts are an alternative choice. These plans enable employees to deposit pretax dollars to cover well being care prices not covered by high-deductible plans. 50% (beforehand 35%) of the cost of offering certified medical health insurance is returned as a Best Health Insurance For Small Business Owners .

They doubtless received’t be happy with that decision, but be as clear as possible — when you’ll nonetheless be overlaying a large share of the fee, make sure to illustrate the breakdown.

Main Source: USA Business Insurance

[nbcnightlynews]

JUST IN: Pres. Obama releases statement on new Senate health care bill:

“Our politics are divided. They have been for a long time. And while I know that division makes it difficult to listen to Americans with whom we disagree, that’s what we need to do today.

I recognize that repealing and replacing the Affordable Care Act has become a core tenet of the Republican Party. Still, I hope that our Senators, many of whom I know well, step back and measure what’s really at stake, and consider that the rationale for action, on health care or any other issue, must be something more than simply undoing something that Democrats did.

We didn’t fight for the Affordable Care Act for more than a year in the public square for any personal or political gain – we fought for it because we knew it would save lives, prevent financial misery, and ultimately set this country we love on a better, healthier course.

Nor did we fight for it alone. Thousands upon thousands of Americans, including Republicans, threw themselves into that collective effort, not for political reasons, but for intensely personal ones – a sick child, a parent lost to cancer, the memory of medical bills that threatened to derail their dreams.

And you made a difference. For the first time, more than ninety percent of Americans know the security of health insurance. Health care costs, while still rising, have been rising at the slowest pace in fifty years. Women can’t be charged more for their insurance, young adults can stay on their parents’ plan until they turn 26, contraceptive care and preventive care are now free. Paying more, or being denied insurance altogether due to a preexisting condition – we made that a thing of the past.

We did these things together. So many of you made that change possible.

At the same time, I was careful to say again and again that while the Affordable Care Act represented a significant step forward for America, it was not perfect, nor could it be the end of our efforts – and that if Republicans could put together a plan that is demonstrably better than the improvements we made to our health care system, that covers as many people at less cost, I would gladly and publicly support it.

That remains true. So I still hope that there are enough Republicans in Congress who remember that public service is not about sport or notching a political win, that there’s a reason we all chose to serve in the first place, and that hopefully, it’s to make people’s lives better, not worse.

But right now, after eight years, the legislation rushed through the House and the Senate without public hearings or debate would do the opposite. It would raise costs, reduce coverage, roll back protections, and ruin Medicaid as we know it. That’s not my opinion, but rather the conclusion of all objective analyses, from the nonpartisan Congressional Budget Office, which found that 23 million Americans would lose insurance, to America’s doctors, nurses, and hospitals on the front lines of our health care system.

The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else. Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions. Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely.

Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.

I hope our Senators ask themselves – what will happen to the Americans grappling with opioid addiction who suddenly lose their coverage? What will happen to pregnant mothers, children with disabilities, poor adults and seniors who need long-term care once they can no longer count on Medicaid? What will happen if you have a medical emergency when insurance companies are once again allowed to exclude the benefits you need, send you unlimited bills, or set unaffordable deductibles? What impossible choices will working parents be forced to make if their child’s cancer treatment costs them more than their life savings?

To put the American people through that pain – while giving billionaires and corporations a massive tax cut in return – that’s tough to fathom. But it’s what’s at stake right now. So it remains my fervent hope that we step back and try to deliver on what the American people need.

That might take some time and compromise between Democrats and Republicans. But I believe that’s what people want to see. I believe it would demonstrate the kind of leadership that appeals to Americans across party lines. And I believe that it’s possible – if you are willing to make a difference again. If you’re willing to call your members of Congress. If you are willing to visit their offices. If you are willing to speak out, let them and the country know, in very real terms, what this means for you and your family.

After all, this debate has always been about something bigger than politics. It’s about the character of our country – who we are, and who we aspire to be. And that’s always worth fighting for.”

[worshiptheglitch]

Our politics are divided. They have been for a long time. And while I know that division makes it difficult to listen to Americans with whom we disagree, that’s what we need to do today. I recognize that repealing and replacing the Affordable Care Act has become a core tenet of the Republican Party. Still, I hope that our Senators, many of whom I know well, step back and measure what’s really at stake, and consider that the rationale for action, on health care or any other issue, must be something more than simply undoing something that Democrats did. We didn’t fight for the Affordable Care Act for more than a year in the public square for any personal or political gain – we fought for it because we knew it would save lives, prevent financial misery, and ultimately set this country we love on a better, healthier course. Nor did we fight for it alone. Thousands upon thousands of Americans, including Republicans, threw themselves into that collective effort, not for political reasons, but for intensely personal ones – a sick child, a parent lost to cancer, the memory of medical bills that threatened to derail their dreams. And you made a difference. For the first time, more than ninety percent of Americans know the security of health insurance. Health care costs, while still rising, have been rising at the slowest pace in fifty years. Women can’t be charged more for their insurance, young adults can stay on their parents’ plan until they turn 26, contraceptive care and preventive care are now free. Paying more, or being denied insurance altogether due to a preexisting condition – we made that a thing of the past. We did these things together. So many of you made that change possible. At the same time, I was careful to say again and again that while the Affordable Care Act represented a significant step forward for America, it was not perfect, nor could it be the end of our efforts – and that if Republicans could put together a plan that is demonstrably better than the improvements we made to our health care system, that covers as many people at less cost, I would gladly and publicly support it. That remains true. So I still hope that there are enough Republicans in Congress who remember that public service is not about sport or notching a political win, that there’s a reason we all chose to serve in the first place, and that hopefully, it’s to make people’s lives better, not worse. But right now, after eight years, the legislation rushed through the House and the Senate without public hearings or debate would do the opposite. It would raise costs, reduce coverage, roll back protections, and ruin Medicaid as we know it. That’s not my opinion, but rather the conclusion of all objective analyses, from the nonpartisan Congressional Budget Office, which found that 23 million Americans would lose insurance, to America’s doctors, nurses, and hospitals on the front lines of our health care system. The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else. Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions. Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely. Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation. I hope our Senators ask themselves – what will happen to the Americans grappling with opioid addiction who suddenly lose their coverage? What will happen to pregnant mothers, children with disabilities, poor adults and seniors who need long-term care once they can no longer count on Medicaid? What will happen if you have a medical emergency when insurance companies are once again allowed to exclude the benefits you need, send you unlimited bills, or set unaffordable deductibles? What impossible choices will working parents be forced to make if their child’s cancer treatment costs them more than their life savings? To put the American people through that pain – while giving billionaires and corporations a massive tax cut in return – that’s tough to fathom. But it’s what’s at stake right now. So it remains my fervent hope that we step back and try to deliver on what the American people need. That might take some time and compromise between Democrats and Republicans. But I believe that’s what people want to see. I believe it would demonstrate the kind of leadership that appeals to Americans across party lines. And I believe that it’s possible – if you are willing to make a difference again. If you’re willing to call your members of Congress. If you are willing to visit their offices. If you are willing to speak out, let them and the country know, in very real terms, what this means for you and your family. After all, this debate has always been about something bigger than politics. It’s about the character of our country – who we are, and who we aspire to be. And that’s always worth fighting for.

President Barack Obama, June 22, 2017

[mividaeslimones]

Day 01: start of the process...

I think this is one of the more unnerving days I’ve had in a while. I checked in at 1:30 pm and it’s now 3:00 pm and there’s still no sign of the provider... I split my time between Michelle Obama’s book, Spanish lessons, and some recipes I found on Pinterest. Driving to the appointment had been the usual level of Albuquerque fuckery, so I can’t complain too much there (I should be used to it), checking in had been a breeze, but this waiting... I almost want to get up and leave I’m so anxious. But I’ll stay positive and keep my ass parked in this chair as other patients are roomed and seen quickly.

I’m moved to another room at 3:05 and this does absolutely nothing for my nerves. But I smile and follow the nurse without complaint anyway. I remind myself I’m not leaving without progress at the very least. I’ve waited too long and have come too far. Just breathe in, breathe out, and repeat. Smile as more patients and clinical staff pass in the hall. There’s a damn good reason the appointment was so delayed which I’ll address later.

It’s now 3:05 pm, I’m ready to climb out of my skin. The provider moseys in and things are...odd? Both of us are actively trying to feel out the other, and I imagine the fly on the wall is tickled pink. When we finally start I’m in tears, in all my 32 years of being on this planet I can fit the number of people who have actively tried to make sure my pronouns were as they should be. It’s a weird and uncomfortably visceral feeling. I cried, she cried, and then she cracked a joke this will be easier, because crying will literally be harder after testosterone.

We chat for a bit and I lean into the conversation with my overly tired and rehearsed, “so I know it varies from state to state, and clinic to clinic, but will I need a diagnosis of dysphoria to make this happen?” Yes, yes I will; insurance companies will outright deny it. She dances around “the question”, I know she’s trying to be delicate with me so I cut in with a wild move.

“When did I know?” She looks relieved and says “yes.” I think for a minute, not because I’m inventing answer, but because I’ve literally never given it a second thought since I’ve pushed it down. It is one of a million neat and tidily wrapped boxes (in a mellowed robin egg blue) I’ve kept locked away inside. “I tell her I feel cliched for saying this, but I think it was kindergarten...” I go on about the rips in the perfect discount tights from Nordstrom and the filthy dresses. I also mention how hilarious I must have looked to the adults who watched the kindergartners. I was the most careful child, but in spite of my best efforts I came home a mess. Can you imagine some poor child comically stepping over puddles and trying to ascend a tree with the tenacity of a sloth? And I would later have the dreaded conversation with my mother on the subject... One day I just decided it wasn’t worth the effort anymore and I caved. I stopped the rough play, then resigned to quieter and less messy activities.

But I still tried on some level... I wanted the reprieve. So I’d slyly sneak over to the boy’s racks of some department store to try toss in a shirt or a pair of pants. And when I was inevitably caught I would be taken by the arm, before I was abrasively whispered something along the lines of, “it will look like no one loves you if you dress like a boy.” It was another weird little box to unwrap... Honestly, it didn’t feel like something that belonged to me anymore. Kind of like when you step into a house that was converted into a museum. You see the remnants of a life lived by someone eons ago, and it’s sad to some extent, but it’s not real, or tangible. After having context for some of this I think I sort of understand her reasoning... As awful as some of her behavior was, I think it came from a good place, which I’ll get into later.

Woo! Anyway! The provider went on to ask a few more things before we finished up the brief questionnaire. I honestly mean it was brief, like the Spanish Inquisition could have laughed at it. I was asked about the surgery portion and I said I wasn’t ready, not out of fear, but out of an understanding of how the procedure works. If a person wants a something like a subcutaneous mastectomy (boob removal) with chest contouring (shaping of your moobs), you need something to be there, if you’re particular about the outcome. If you’re not, you’re amazing and more power to you. But for the rest of us (who avoided the gym) we will need to work building up that area as much as we can. The question came up of if I wanted to keep my current primary provider and I said yes. My doctor is more enthusiastic about this whole thing than I am, like she sounded ready to jump on anyone who dared tell me no to any of this. I did mention it was weird that my current health system (outside of UNM) didn’t have a way to look up the endocrinologist who helps trans patients. I even called when I couldn’t find anything online. I said it was kind of my deciding factor to keep this part of my care with UNM, since that seemed very sketch to me. She also seemed to think it was a little odd, and quietly brought the rest of my concern up... Which was this endocrinologist may treat trans patients frequently, but he may not be the gentlest or versed, and we moved along...

It was weird, she was willing to give me a script that day, but she was hesitant to bring up the blood panel. Which I was completely fine with by the way! I would much rather be safe than sorry, your health is nothing to take for granted. Shoot I even requested to tack on another for peace of mind (STI check). I’m going to be checked to see where my glucose is at, along with my cholesterol, if my cells are clumping or if it looks like I might have something like macrocytosis (puffy/large cells), and I’m getting a pregnancy test. I’d be shocked if the last one turned up anything, I haven’t done the horizontal tango since the beginning of the year, I think, it’s been a long time okay.

I did kick myself when I realized I broke my own cardinal rule before the appointment. DON’T EAT. I always shoot for the earliest appointment available so I can eat immediately after, this wasn’t an option, so I ate on accident... You never know when your provider will want to order blood work. Which means this could completely screw up a blood panel. It’s the equivalent of crossing your legs when you’re getting your blood pressure taken. Now I have to get up at the ass crack of dawn and get a draw... Which would have meant waiting to take the testosterone, because yes you guessed it, that too would skew the results.

In all honesty, I’d have to wait on taking the script anyway, my insurance has to approve it and get something from my doctor. I had suspected this from the get go, because nothing in life if ever this easy for me. Haha. And it was confirmed when the pharmacy technician looked over the sheet of paper. I could see it in his eyes there was an issue, still he optimistically told me twenty minutes. He was super nice and apologetic about the whole thing, and he even urged me to call everyone and their mother if I hadn’t heard anything in a week, so this didn’t fall through the cracks. Like the man was so adamant about it, the whole thing threw me off.

So if you’re still wanting to know why the appointment was so late, there was a power outage yesterday. With everything being digital this can take some clinics or organizations days or weeks to catch up on (if there was extensive damage). And if you’re wondering about the mother thing, well, she had a cousin who died of HIV/aids. He was the sweetest and kindest man, with the most rotten luck in the world. Some would say he would have no luck at all if it weren’t for all the bad luck. He was also gay. I’m not going to name him, I didn’t know him, and it might upset my great aunt to know I posted this. I adore her, so I won’t do that. My point is, I genuinely think she still fears the maybes, the might bes, or the definites of living outside of what society has deemed as acceptable. Which is probably problematic, but I don’t think there is anything anyone could do or say to sway her at this point. Personally? I don’t care. Since I’ve lived in New Mexico I’ve had random men try to solicit me on a jog, I’ve been groped at my place of employment, I’ve had a gun pointed in my face, I’ve had people put me in headlocks, people have laid hands on my property with the intent to damage it, some have even succeeded in damaging it, and I’ve had my life threatened. I think I’m over the worst case scenario. I also think I need to dial things back a notch. After living here for over ten years I recognize that I’ve become harder and colder; I am absolutely ready to pop off on someone who’s clearly in the wrong. But today has taught me, that things are indeed easier than they used to be, and they’re continuing to improve.

[anti-capitalistlesbianwitch]

President Barack Obama’s Facebook Post on the AHCA

“Our politics are divided. They have been for a long time. And while I know that division makes it difficult to listen to Americans with whom we disagree, that’s what we need to do today.

I recognize that repealing and replacing the Affordable Care Act has become a core tenet of the Republican Party. Still, I hope that our Senators, many of whom I know well, step back and measure what’s really at stake, and consider that the rationale for action, on health care or any other issue, must be something more than simply undoing something that Democrats did.

We didn’t fight for the Affordable Care Act for more than a year in the public square for any personal or political gain – we fought for it because we knew it would save lives, prevent financial misery, and ultimately set this country we love on a better, healthier course.

Nor did we fight for it alone. Thousands upon thousands of Americans, including Republicans, threw themselves into that collective effort, not for political reasons, but for intensely personal ones – a sick child, a parent lost to cancer, the memory of medical bills that threatened to derail their dreams.

And you made a difference. For the first time, more than ninety percent of Americans know the security of health insurance. Health care costs, while still rising, have been rising at the slowest pace in fifty years. Women can’t be charged more for their insurance, young adults can stay on their parents’ plan until they turn 26, contraceptive care and preventive care are now free. Paying more, or being denied insurance altogether due to a preexisting condition – we made that a thing of the past.

We did these things together. So many of you made that change possible.

At the same time, I was careful to say again and again that while the Affordable Care Act represented a significant step forward for America, it was not perfect, nor could it be the end of our efforts – and that if Republicans could put together a plan that is demonstrably better than the improvements we made to our health care system, that covers as many people at less cost, I would gladly and publicly support it.

That remains true. So I still hope that there are enough Republicans in Congress who remember that public service is not about sport or notching a political win, that there’s a reason we all chose to serve in the first place, and that hopefully, it’s to make people’s lives better, not worse.

But right now, after eight years, the legislation rushed through the House and the Senate without public hearings or debate would do the opposite. It would raise costs, reduce coverage, roll back protections, and ruin Medicaid as we know it. That’s not my opinion, but rather the conclusion of all objective analyses, from the nonpartisan Congressional Budget Office, which found that 23 million Americans would lose insurance, to America’s doctors, nurses, and hospitals on the front lines of our health care system.

The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else. Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions. Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely.

Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.

I hope our Senators ask themselves – what will happen to the Americans grappling with opioid addiction who suddenly lose their coverage? What will happen to pregnant mothers, children with disabilities, poor adults and seniors who need long-term care once they can no longer count on Medicaid? What will happen if you have a medical emergency when insurance companies are once again allowed to exclude the benefits you need, send you unlimited bills, or set unaffordable deductibles? What impossible choices will working parents be forced to make if their child’s cancer treatment costs them more than their life savings?

To put the American people through that pain – while giving billionaires and corporations a massive tax cut in return – that’s tough to fathom. But it’s what’s at stake right now. So it remains my fervent hope that we step back and try to deliver on what the American people need.

That might take some time and compromise between Democrats and Republicans. But I believe that’s what people want to see. I believe it would demonstrate the kind of leadership that appeals to Americans across party lines. And I believe that it’s possible – if you are willing to make a difference again. If you’re willing to call your members of Congress. If you are willing to visit their offices. If you are willing to speak out, let them and the country know, in very real terms, what this means for you and your family.

After all, this debate has always been about something bigger than politics. It’s about the character of our country – who we are, and who we aspire to be. And that’s always worth fighting for.”

(Source)

[insuranceforlifetime]

ambetter insurance reviews2020

About Ambetter

Ambetter is a health insurance plan agency owned by using Centene Corporation, a multi-national organization that gives packages and offerings to under-insured and uninsured individuals. Centene is the greatest Medicaid managed care employer in the us of a and the range one insurer on the Health Insurance Marketplace. Each kingdom works otherwise thru Ambetter to supply health insurance plan market plans, together with Medicaid and Children’s Health Insurance Programs (CHIP). Both Centene and it’s new acquisition, Wellcare Health Plans, serve Medicaid and Medicare members.

Centene gives health insurance plan by using Ambetter in 15 states: Arizona (Ambetter from Arizona Complete Health), Arkansas (Ambetter from AR Health & Wellness) Florida (Ambetter from Sunshine Health), Georgia (Ambetter from Peach State), Illinois (Ambetter from IlliniCare Health), Indiana (Ambetter from MHS), Kansas (Ambetter from Sunflower Health), Mississippi (Ambetter from Magnolia), Missouri (Ambetter from Home State), New Hampshire (Ambetter from NH Healthy Families), Nevada (Ambetter from Silver Summit), North Carolina (Ambetter of North Carolina Inc.), Ohio (Ambetter from Buckeye Health Plan), Pennsylvania (Ambetter from PA Health & Wellness), South Carolina (Ambetter from Absolute Total Care), Tennessee (Ambetter of Tennessee), Texas (Ambetter from Superior) and Washington (Ambetter from Coordinated Care).

Ambetter gives prescription drug coverage, intellectual and behavioral health services, maternity care, new child care, 24/7 nurse recommendation line, optionally available imaginative and prescient and dental coverages, ambulatory services, lab offerings and more.

How to file a declare with Ambetter

If you get hold of non-emergency offerings from an out-of-network provider, you might also be accountable for the whole value of the clinical bill, until in any other case required by way of country or federal regulations. To take full gain of your Ambetter coverage, it is vital to solely use in-network providers. To enchantment a declare that used to be denied with the aid of Ambetter, the member ought to contact 1-877-687-1197.

Common Questions about Ambetter

What states receive Ambetter health insurance?

Ambetter gives insurance for people in Arizona, Arkansas, Florida, Georgia, Illinois, Indiana, Kansas, Mississippi, Missouri, New Hampshire, Nevada, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Washington.

Is Ambetter accurate health insurance?

If you are under-insured or uninsured and want low-priced healthcare, Ambetter can also be a top choice due to the fact they provide low-priced plans. Ambetter solely gives insurance plan in 15 states (see corporation overview). Ambetter’s grievance ratio, however, is excessive in some states.

How does Ambetter insurance plan work?

Ambetter insurance plan has bronze, silver and gold plans. Ambetter Essential Care has bronze plans, which are most inexpensive however have the best deductibles. Ambetter Balanced Care has silver plans, which have decrease deductibles and out-of-pocket maximums. Ambetter Secure Care is the gold metallic tier coverage which has the most high-priced premiums however the lowest out-of-pocket maximums.

Is Ambetter (Centene Corp) and WellCare the identical company?

Ambetter and WellCare are owned via Centene Corporation. Centene’s acquisition of WellCare was once predicted to be finalized by using the first 1/2 of 2020. As one entity, they will be one of the greatest vendors of Medicaid and Medicare.

Does Ambetter require pre-authorization for services?

Out-of-network offerings and vendors require prior authorization, until it’s an emergency service. You want a referral from a Primary Care Physician to see a specialist, except you’re seeing positive in-network physicians like an obstetrician, gynecologist or psychiatrist.

What is Ambetter My Health Pays® Rewards Program?

You can earn $500 in rewards with My Health Pays, simply for doing health-related things to do like shifting more, saving and consuming proper and more. The greater things to do you take part in, the greater rewards you earn.

Does Ambetter cowl out of state?

Unless it’s an emergency Ambetter will solely cowl in-network vendors so it’s quite probable that a physician in every other country will now not be covered. If you have a sanatorium emergency you can also be covered. It’s constantly first-rate to test by way of talking with an agent until now if you can.

How do I discover my Ambetter member ID?

AYour member ID # is on the the front of your insurance plan card.

Does Ambetter cowl surgery?

Ambetter covers quintessential surgical treatment however no longer beauty surgical operation or different non-compulsory sorts of surgical procedure and procedures, such as infertility treatment.

Who underwrites Ambetter insurance?

Several distinct subsidiaries of Centene Corporation underwrite Ambetter Insurance. For instance, Ambetter of Tennessee is underwritten

[estatelawyerla]

Elder Law Attorneys and Medi-Cal

Los Angeles Elder Law Attorney for Medi-Cal Planning

There is no actual major in school for elder law. Elder law is a recent discipline that was born because it is necessary. As the average life span increases, more people are living well into their golden years, and society has found that they have unique legal needs.

If you live in California, you have even more considerations on your plate, like Medi-Cal. Health insurance for elders is critical and requires a knowledgeable professional to ensure everything is set up correctly. That’s why it’s imperative that you work with an elder law attorney in Los Angeles.

Here is what you need to know about why you should use an elder law attorney to assist with Medi-Cal and long term care issues. 

What Do Elder Law Attorneys Do?

Elder law attorneys concentrate on protecting your rights as a senior citizen, making sure you have control over your end-of-life care, and ensuring that your assets transition smoothly to your chosen beneficiaries.

While there are some issues that any general lawyer can sort out for you, Los Angeles elder law attorneys have specific training and knowledge in areas that impact the elderly more severely. Navigating health insurance, specifically Medi-Cal, is one of them.

A Look at General Health Insurance

When we talk about health insurance, we often think of Medicare and Medicaid. These are two separate, government-funded health insurance programs. While they sound similar and are easily confused, the two are very different.

Medicare

Medicare is a federal health insurance program for those who have reached 65 years of age. It is divided into four parts:

Part A covers stays in hospitals, nursing homes, or hospice care.

Part B is like regular insurance. It covers doctor’s visits, outpatient care, and preventative services.

Part C, called the Medicare Advantage Plus, is a plan you may purchase from a private company that pairs with Medicare. This program covers all of your Part A or Part B needs.

Finally, Medicare Part D is a plan for prescription medication.

Because of the vast coverage of Medicare and the volume of people vying for free healthcare, rejections of insurance claims are common. A Los Angeles elder law attorney can help settle disputes to ensure your coverage.

Medicaid

Medicaid is a federal program that provides healthcare to low-income adults and children. Your ability to use Medicaid is dependent upon your income. It helps with healthcare premiums, out-of-pocket expenses, and long-term care.

If you need to use this program to pay for a nursing home, there are complex applications and rules to follow. An elder law attorney can help create an appropriate plan to maximize your benefits while ensuring that your paperwork is completed correctly.

What is Medi-Cal?

Medi-Cal is a version of Medicaid specifically for residents of California. It provides financial help with healthcare costs for those with limited income. The difference between Medi-Cal and other health insurance programs is that Medi-Cal covers nursing home costs. Thus, in California, it is also one of the primary sources of assistance for seniors.

How do elder law attorneys help with Medi-Cal?

The issue with Medicaid – and thus, Medi-Cal – is that there are income and resource limits for this program that can exclude those who have worked for many years and have plenty of savings.

Here’s how an elder law attorney in Los Angeles, CA can help you navigate the maze of Medi-Cal.

Qualify for Medi-Cal

Being disqualified for Medi-Cal can mean having to pay all of your medical expenses out of pocket. The biggest challenge is that insurance programs can look at your finances for the past five years when you apply for nursing home coverage, and decide that you’re financially well-off enough to not need Medi-Cal. If you don’t plan appropriately, you could be disqualified for benefits solely based on timing.

Because of the complexity of the Medi-Cal application and the various rules and requirements around qualifying, it’s crucial to have someone on your side who understands how to get around these barriers.

For instance, one way to qualify for Medi-Cal is to “spend down”, or reduce your assets in order to become eligible. Seniors may give away their assets to achieve this, but they are subject to risks; for example, a family member taking advantage of them, or being taxed when they give away substantial amounts of their estate.

An elder law attorney can help you create a trust which transfers some or all of your assets away from you so you can qualify for Medi-Cal while still protecting your ability to access those resources.

Plan For Long-Term Care

For many, long-term care planning is avoided due to its very nature. Instead of draining your savings or putting loved ones in a difficult position, you should have a proactive plan regarding long-term care. Hospitals, nursing homes, assisted living facilities, and rehab facilities come with a high price tag when it’s paid for out of pocket.

When it comes to Medi-Cal and long-term care, there are a variety of timelines, policies, and rules that dictate when and how money can be spent. Medicare, for example, will help pay for assisted living facilities, but only for a certain amount of time.

Many hope that Medi-Cal will kick in when Medicare disappears, but it can only do so when it’s set up correctly. Luckily, an experienced elder law attorney in Los Angeles will know the ins-and-outs of the system to ensure you can receive the right kind of Medi-Cal assistance when  you need it most.

Settle Claim Disputes

Qualifying for Medi-Cal is no easy task as it is, and yet qualifying is the easy part when compared to making actual claims. Some of the most common denial reasons involve not filling out the paperwork correctly and missing important deadlines. You may also run into issues if the medical codes used for you bills aren’t included in your plan, you use an out-of-network provider, or you’ve exceeded coverage for the year.

Paying for these much-needed services out-of-pocket is a surefire way to drain your savings. That means your estate will be worth much less and you won’t have as much to leave to your family and friends.

An elder law lawyer knows the proper way to submit a claim so that it’s accepted the first time. If Medi-Cal, Medicare, or your personal insurance provider denies the claim, your attorney can go to bat for you by filing the appropriate appeals. Even if hiring a lawyer seems like an extra expense, it will save you and your estate a great deal in the long run.

Meet With A Los Angeles Elder Law Attorney Today

Before you start the process of applying for Medi-Cal, it is crucial that you meet with an elder law attorney. If nothing else, you can take advantage of a free consultation to make sure you understand the process. Your lawyer can ensure that you’re applying for Medi-Cal at the right time in the right way.

By having someone who knows the system help with you application, claims, and appeals, you are giving yourself the best chance to get approved. You worked hard to build up your estate and you pay into these programs; hiring a Los Angeles estate planning attorney is the best way to protect your assets while getting the most out of Medi-Cal and other government programs.

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from Mckenzie Legal & Financial https://www.thomasmckenzielaw.com/elder-law-attorneys-and-medi-cal/