Breast Cancer Awareness Month – The Need to Prepare for Medical Costs

October 18, 2014

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Cancer is a very devastating disease which can change many people’s lives because of the astronomical costs in treating it. Unfortunately, many women do not have adequate health coverage to cover their expenses. As a result, many resort to fundraising to accumulate the funds necessary to undergo treatment.

The average costs for breast cancer treatment total $128,556 over approximately a one and one half year treatment period, which includes doctors’ visits, outpatient visits, hospital visits, and inpatient stays, for women who received chemotherapy as their primary source of treatment. For women who have health insurance, especially now with the high deductibles which employees must pay under the current Health Care Reform, many will have substantial out of pocket costs which are not covered under their health care plans. As a result, many will have to resort to fundraising, borrowing money from family, friends, and employers, or paying with credit cards. If the patient happens to be a business owner, their businesses may suffer, causing bankruptcies because of the high medical costs.

One alternative to seeking funding for the balances which are not covered, is to purchase voluntary or supplemental coverage through an employer. Cancer policies are available which would cover most, if not all of the out of pocket costs not covered under health insurance policies. The out-of-pocket costs would be deductibles and co-payments.

Additionally, a short term and/or a long term disability policy would replace a portion of income lost during treatment. In some cases, the cost of premiums for these policies would be waived during the period of disability enabling the patient to keep the policy in force.

In order to ensure that there is adequate funding in the event that an employee or family member develops cancer, the employee must plan to have the coverage before the diagnosis is made. The employees would not be able to secure coverage for cancer after receiving the diagnosis from the doctor. It is impossible for us to know whether or not we will develop cancer during our lifetimes. Purchasing the coverage and ensuring that we have adequate disability insurance in addition to a cancer indemnity policy while we are healthy, would greatly reduce the stress in determining how we will pay for the cost of medical care.

Once employees purchase a supplemental or voluntary benefits plan to cover out-of-pocket costs or a portion of income, it is important to keep the policies in force. Once they lapse, it may be impossible to reinstate coverage. Most policies have a waiting period during which coverage would not be affordable if the employee is diagnosed, receives medical care or advice before the policy’s effective date. Proper planning is necessary to keep the policies in force.

In conclusion, taking surefire steps to protect one’s income and business through disability policies and cancer policies will enable employees to receive and pay for proper medical care, as well as to continue supporting the family.

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Catching the Wave – Adjusting to the Health Care Reform

October 14, 2013

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Business owners are facing tough decisions on whether they should offer health care benefits to their employees.  Business owners with under 50 employees are not obligated to offer health care benefits to their employees under the new Health care reform.  However, there is an incentive if they do. 

Any business owner with under twenty-five employees is now eligible for a thirty-five percent tax credit for 2013 and fifty percent for 2014.  It would be advisable for business owners to contact their accountants for the tax consequences.

This would be a good incentive for business owners to offer the health care benefits to their employees, however, most say they cannot afford it.  In that case, the employee would be able to shop for health insurance on the exchange.  If the employee cannot afford it, they would be eligible for a subsidy from the federal government if their income falls within four times the poverty level or $44,000.

If the employee still cannot afford the insurance premium after the subsidy, they can apply for Medicaid.  However, they must fall within the income guidelines in order to qualify for Medicaid.

Studies have shown that employees become more loyal, productive, and experience job satisfaction when they receive a comprehensive benefits package from their employer.  In return, they offer better customer service, take fewer days off, work more efficiently, tend not to complain as much, discover ways of being more effective, and are more enthusiastic about their work.

Since Massachusetts implemented the health care reform seven years ago, economic growth has increased and unemployment is still low.  Additionally, 90% of the people have health care and more are practicing preventive measures in their health.   Small business owners can now acquire health insurance for their families while they are building their businesses.  Because much of the overhead costs of selling insurance, premiums are lower.

In conclusion, the health care reform will help to improve employee morale and health and will help business owners to grow their businesses.


Health Care Reform Affects Women

October 6, 2013

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With the October 1 deadline behind us, it seems the word has spread about the new health care reform as many people are already flocking to the exchanges on-line to shop around or purchase the health coverage.

Now, employees who previously did not have health care coverage will be able to purchase the coverage on-line from one of the exchanges. There are several plans to choose from and it will take careful examination in order to choose a plan which is right for the employee. This would include a choice in the amount of co-payments and deductibles to be applied to the medical services.

Many of the services for medical care will include a deductible or co-payment, with the exception of some services for women. These services include preventive services such as, mammograms, screenings for cervical cancer, prenatal care, diabetes, obesity, breast cancer, and heart disease, and other services which pertain to the care of women. In these cases, co-payments and deductibles would not apply.

Additionally, women will not be charged higher rates than men for health care. To accommodate the people who will be visiting community health care centers, there will be an increase of $11 billion for funding of these centers.

 


The Future of Health Care Plans

September 21, 2013

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We are in the midst of transitioning to a new Health Care Reform where employees are going to have to choose a health care provider, if they currently do not have one.  As with any new procedure, there are going to be new decisions that have to be made about their health care.

By October 1, employers are now responsible for education their current employees about their health care choices and the availability of health coverage on the exchanges, if the employer opts not to provide health benefits to the employees.  Then they must post legal notices on the premises for new employees.

The employees must then visit the exchanges on-line and shop around for an insurance plan.  Each state has their own website.  For most employees this task could be overwhelming, as there are sixteen different plans available in the state of Rhode Island.  Some will not understand the different insurance terms and some may not have the patience to shop for coverage themselves.

The state has a staff available to answer questions and the site is very user friendly.  Employees have three months to choose a plan which would be effective on January 1, 2013.  Employees are expected to choose a lower priced plan with high deductibles and co-payments, rather than a plan with a low deductible and co-payments. 

This may put a strain on the budge when utilizing the services.  However, there are other plans available outside of the exchanges, at affordable prices, which would enable the employees to pay most if not all of their medical bills.

For anyone who wants more of an explanation on the details of the health care reform and the responsibilities of the employees and the employers, there will be workshop sponsored by the Chambers of Commerce and other organizations.  For a complete schedule of the locations, go to the Health Source RI website.


Health Care Reform & The Responsibilities of the States

August 12, 2013

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As we all now, one of the issues of the Obama administration has been health care reform. October 1st is a very important date for all business owners and their employees. This is the date that employers must meet their requirements under the new Health Care Reform. Although the health care mandate has been passed by Congress, there is still some uncertainty as far as how it will be enforced.

Approximately twenty-four states have passed legislation to enforce the changes in the laws and to regulate the insurers in their states, while the remaining states have not yet made decisions to enforce the laws. Some of the states may not be ready by the October 1st deadline to comply with the new health care reform.

This would be unfortunate for the consumers residing in states which have not enacted the enforcement of the reforms. These consumers could face not being able to take advantage of the benefits they may be entitled to receive. However, if the states do not act n the October 1st deadline, they risk the federal government moving in to regulate the insurers and to enforce the health care reform laws.