Single Payer Healthcare

Single Payer Healthcare is a system in which all medical treatments and health care coverage are paid for by a single organization. In most cases, this single organization is a federal government. A single payer healthcare system does not, however, speak to who receives this treatment. Universal healthcare is a system in which every individual receives health care coverage. These two systems go hand in hand as Universal healthcare is not possible without a single payer health care system in place. Under a single payer healthcare, most services rendered come from private facilities rather than government-led facilities.

What is Single Payer Healthcare?

The idea behind single-payer health care is that every citizen would receive all medical services such as hospital care, doctor visits, preventative care, mental health services, dental, vision, prescription drug, reproductive health care and medical supply costs without the expense of these services coming directly from their pocket. That they would be paid for by a single payer or for lack of better words, the federal government. The idea is that patients would have a free choice who their doctor would be as well as doctors having autonomy of their patient’s care.

Of course, in an ideal world, this seems like an excellent program. In fact, you’ll find many people who can only speak of how great this program would be. They claim that this type of system costs less because there is no competition in this not for profit structure and an enormous amount of money is not wasted on administrative expenses. There is minimal paperwork for health care workers to do allowing them to focus more on the patient. And this system cuts out insurance companies which allow people to deal directly with their doctors instead of a third party to help pay for the services rendered. The also say that similar to the VA; we would see a decrease in prescription drug costs because the government would be a single buyer allowing them to purchase in bulk, getting a reduced price. Many would disagree with these statements as well. To find out more about their stance, see our next blog post.

April 27, 2017June 15, 2017

Medicare Advantage Insurance

One of the options you will be considering when looking at Medicare is if you will want to receive original Medicare Insurance (Parts A and B) and Medicare Advantage (part C). So what is the advantage to Medicare Advantage, if there is an advantage at all? Both of these options will cover many of the same services; it is a matter of deciding what will be the best for you and your health.

What is the Advantage of Medicare Advantage?

Medicare Advantage is an insurance option that is run through private organizations. These are organizations that you would recognize like Blue Shield, United Health Care, and Kaiser Permanente. Medicare Advantage includes what you would find in Original Medicare with the doctor and hospital care. But it also may include things that you would not find. These additional offerings will depend upon which plan and organization that you go through. But you can expect these offerings to include things like prescription drug coverage, vision, dental, and gym memberships. Medicare Advantage Insurance is also considered a less expensive option. The premiums that you pay in Medicare Advantage can be less expensive that the premiums in Plan B especially if it is combined with the premiums for a Medigap policy which many do include if they go with Original Medicare. Also, Medicare Advantage includes a Maximum Out-of-Pocket Expense which is a limit to the amount you pay out of pocket. The cap varies between plans, but after you reach the limit, all of your services are covered.

Of course, with every plan, there are also drawbacks. Because the program is run through private companies, there may be stricter rules and more limited options for care available. If you are not satisfied with Medicare Advantage Insurance, you can switch to Original Medicare, but it will be difficult to add Medigap at that time. Your Medigap options may be limited or even nonexistent. So it is important when looking at your options that you know exactly what you are signing up for. If you need information or have any questions, please call us. We have extensive knowledge and have helped countless others before you make the best decision for them.

April 18, 2017June 15, 2017

Medicare Health Insurance

What is Medicare? Medicare is a federal government funded program aimed to help adults over the age of 65 to receive Medicare Health Insurance. It also provides health insurance for disabled adults under 65 and anyone who has been diagnosed with End-Stage Renal Disease (permanent kidney failure).

Medicare has four different parts:

Part A is hospital insurance which includes help paying for inpatient hospital care, a skilled nursing facility, limited home health and hospice care.

Part B is medical insurance which contributes toward doctor services and outpatient care such as diagnostic tests, ambulance rides, and preventative care. Preventative care includes things like pap tests and mammograms as well as medical equipment and supplies. You will pay a premium each month for Part B. The cost will either be taken out of your social security if you are getting those benefits or you will receive a bill.

These two offerings make up what is called original Medicare. And where this can cover a significant portion of your medical insurance needs, this will not cover all of your medical costs. With the extra cost, some people want to consider how to get those additional costs covered through Medicare Parts C and D

Part C which can also be called Medicare Advantage plans. Part C includes what is covered in Medicare A and B and may help lower your costs and get additional benefits.

Part D helps you manage the costs of your prescription drugs because original Medicare did not include any coverage for this need.

While parts A and B coverage is the same across the United States, there is a large difference in the cost and coverage of parts A and B throughout America. Many healthcare providers actively work to keep those costs down by offering preventative services, provider partnerships, and wellness programs.

April 13, 2017June 15, 2017

History of Medicare in America

Every day we hear more and more about America’s health care system. But this is not new. You may be tempted to think that in the wake of Obamacare and Trumpcare that this wave of health talks is the first time America has been swept up. But that is just not the case with the History of Medicare in America. Did you know that when Teddy Roosevelt ran for president in 1912, his platform included a national health insurance system? But that message never really got much steam until the presidency of Harry S. Truman.

Truman wanted to address many issues in the healthcare industry. He had concerns about the lack of availability of health professionals in rural areas, he wanted to bring more attention to public health services to help curb the spread of infectious diseases, he wanted to invest in medical research, and finally, he wanted to provide a national health insurance plan. What?! Sounds familiar doesn’t it? There was a strong attack against the bill, and with the start of the Korean War, Truman was forced to drop the bill.

America’s health care system

However, that was not the end of it. In 1965, President Lyndon Johnson signed a health insurance bill for the elderly and needy. This bill is what we know today as MediCare. In an unusual twist, former President Harry Truman and his wife Bess were the first recipients of MediCare. But Medicare was to go through many more changes. The next few decades brought the change past Medicare Parts A and B. We saw the additions of Medigap and the addition of hospice care were included in the benefits. In the nineties, Medicare C was added, and in 2003 President George W. Bush signed Medicare D into law. And we have continued to see changes as the Affordable Care Act was enacted. It seems there are no easy answers when it comes to healthcare but we can expect to see more changes coming our way. We will have to wait and see what changes are around the bend for Medicare in the next few years.

April 3, 2017April 3, 2017

What Happens to AHCA Now?

Shortly after the American Health Care Act vote was pulled from the House Floor, Speaker Paul Ryan said that the American public would be “living with Obamacare for the foreseeable future.” Then, just three days later, he makes the statement that “If Obamacare just stays as is, that’s not acceptable to the American people.” So what does that mean for us today? It’s a little hard to say. It appears that this issue of health care reform is not closed, but at this current time, we do not hear any definitive timelines on when we can expect to see a new bill being formulated. At this period, President Trump is calling on the American public to be on the watch as he predicts that Obamacare will implode. But while we are watching and while there are no timelines, what do we do?

Where is may seem as though America is between the proverbial rock and hard place, however, we will most likely see very little change during 2017? Most insurance companies are currently reviewing their options about what plans they will offer and what they will charge for premiums in 2018. With large companies like Aetna giving themselves a deadline of April 1st to make decisions about what they will offer in 2018, most insurance companies will make their decisions closer to June. There is still a trend of insurance companies pulling out of areas where they have found financial hardships. Aetna is now only offering their services in 4 states where they previously were offered in 15 states.

One this is for certain, that at Bernardini & Donovan we will continue to offer you the best customer service and we will always work to find the best health insurance options available for you, your family or your business during this time of transition.

Keep up with our blog for the latest news on the American Health Care System!

March 29, 2017April 3, 2017

The ACHA is Pulled (For Now)

One of the biggest news stories recently has been the pull the healthcare reform bill on March 24th. If you’ve had your head in the sand here is a timeline of what went down:

-On Thursday afternoon the House vote was delayed. Members of the House Freedom Caucus met with President Trump but left feeling that their compromised could not be reached.

-Thursday evening the vote is back on. The White House communicated to the Republican party that no further negotiations were to be held and the vote was scheduled for the next day.

-Friday Morning comes, and the House proceeded with morning roll call. Where the vote was still planning on being held it was unclear if it would pass.

-On Friday Afternoon Speaker Paul Ryan urges the President to cancel the vote because they did not have the votes to pass the bill and at 3:30 pm the President agrees. At 4 pm, it is announced to the press that they vote has been canceled.

President Trump placed the blame of the bill not being able to be passed squarely at the feet of the Democrats saying that because they had not one Democrat vote, there was just a wide enough margin to ensure that the bill couldn’t pass and therefore did not go to vote. He also said that he is hopeful for the next version of the bill.

So what does that mean for us now? Speaker Paul Ryan says that he is not giving up on healthcare reform and that he believes that the American Health Care Act could still end up being passed. “About 90 percent of our members are for this bill, and we’re not going to give up after seven years of dealing with this, after running on a plan all of last year and translating that plan into legislation,” he said.

At this time we will just have to wait and see what the future holds for our health care reforms.

March 21, 2017April 3, 2017

The American Health Care Act: Part 2

In our last post, we started to discuss the American Health Care Act as it was presented to us by Speaker of the House Paul Ryan. If you have not read that yet, please find it here. After going over some of the failures of ObamaCare, Speaker Ryan started to explain what we will find in the legislation that is going up for a vote on March 24th.

Within the American Health Care Act, you will find the lowering costs of insurance premiums, creating more choices for citizens on their insurance options, giving patients control over their health care coverage and creating universal access to care. But how will they do that? First, they would repeal the taxes in ObamaCare. They would, secondly, stop the massive spending that is going on. They would end the federal mandates that are telling private citizens what to do. They will be protecting citizens with preexisting conditions by encouraging states to set up risk pools so that people with PEC could still get insurance. These state-based and federally contributed risk pools directly support any people with PEC so that the rest of the population has cheaper and more predictably priced health insurance. They also want to create more transparency within the health care systems so that patients know what they are paying for up front. Currently, you receive care and are then sent a bill. What you are billed for can come as a complete surprise. Instead, they would like to create a free market system that allows hospitals, insurance companies, and health providers to compete against each other for the business of the American citizens. This makes our health care system like every other market that we have in our country and gives the citizens the control they need to make good decisions. They want to move Medicaid to be state run systems. The states know better what the needs of their residents are and how to better care for them than a federally based system. They would allow young adults up to the age of 26 to stay on their parent’s insurance and would transition in their changes so that people’s current health care is not being immediate disrupted or not available to them.

What do we think of these changes? If the law passes, we could see rates drop by 20-30% with more plan choices and power to negotiate better contracts with doctors. But we want to wait and see how things play out. There are a lot of favorable items in the law that will favor lower premiums, but we will be taking a wait and see approach to see what ends up in the new law. Follow Bernardini & Donovan to stay up on the latest changes regarding your health care and how the new incoming legislation may affect you.

March 11, 2017April 3, 2017

The American Health Care Act: Part 1

Information about the American Health Care Act

On March 9th, Speaker of the House Paul Ryan did a powerpoint presentation about what was in the American Health Care Act. What he laid out was that this piece of law is essential the first piece of a three-pronged attack. The three-pronged attack being:

Reconciliation – this is the American Health Care Act. They are not able to put in every piece of legislation that they would like in this legislation due to certain Senate floor rules. They don’t want the whole thing to be thrown out before it can be voted on. But that is why this is a three-pronged attack.

Administration Action – Much of the current law has legislation written into it that gives the Secretary of Health and Human Services the right to deregulate the market and create more choices in the marketplace.

Additional Legislation – These would be all of the other laws that they are not able to pass in the American Health Care Act because if they did the Senate floor would throw it out. However, if they take these on a case by case basis, he believes that we will see a truly competitive market which could include interstate shopping as well we association health plans.

Speaker Paul Ryan also spent a good portion of his talk exposing the flaws of the ObamaCare. Since the passing of ObamaCare, he pointed out that citizens are seeing their health care options and choices of coverage disappearing. As many as 2,000 counties within the US that initially had 3 or more insurance options in 2016. In 2017 that number has plummeted. In 2016, 200 counties only had only one insurer choice. That is 1 in 3 counties in the US with only one insurance option. Humana has stated that it is planning on pulling out some of those counties which will leave those counties with zero options. While options for insurance coverage are going down, premiums are going up. People are receiving fewer choices, and the price they pay on their premiums continues to rise. In Minnesota, they saw a 59% increase in their premiums. In Tennessee, they saw a 63% increase. And in Arizona, they saw a 116% increase in their premiums. According to Aetna’s CEO, “Obamacare is in a death spiral. It is not getting any better, it’s getting worse”

Look for our next post to cover what is in the American Health Care Act and how we are viewing it.

January 5, 2017September 15, 2016

What to consider prior to buying health insurance for you and your family

As the time comes for open enrollment or to renew your health insurance, here are some helpful hints to look at before your purchase a plan.

Look before you renew
As the landscape for health insurance continues to change it is important that you make sure that your fully check out your options before opting to renew. Not only do the options available in your plan change from year to year but your personal circumstances change. You may have moved, found a new job, or had a child and all of these can change what you need from your provider. Also, if your plan is being replaced make sure you fully look over what it is being replaced with so you are not surprised later down the road and find that what you need is not covered.

Doctors and prescriptions, oh my…
You will want to make sure that your preferred doctor accepts that coverage before you enroll. And going to a doctor outside of your coverage can cost you substantially more that going in your plan. Also, you will want to know what your prescription medication is going to cost you. Most companies will assign medications to a different level or tier so that between different companies the medication you need may be covered but it may be on a different tier and therefore would cost you much more.

Consult an insurance broker
When the Affordable Care Act come into effect its purpose was to let people comparison shop relatively easily for different health care options. However, the health care market is wide and varied and you can very easily not see a special savings or find out that what you need is not covered when it is too late. Health Insurance brokers are working hard to stay ahead of the changes in the law, know all the different nuances of plans being offered and want to help you find your best fit. Contact us at Bernardini & Donovan and let us help you look beyond the bare essentials to finding a package that fits you and your family perfectly.

December 30, 2016September 15, 2016

Medicare Open Enrollment

That time of the year is coming up again! The Medicare Annual Enrollment Period is just around the corner. Each year from October 15 to December 7th you have the ability to enroll for Medicare. But as you prepare to enroll, now is an excellent time to go over what plans there are and more importantly than that, to look over what is important to you so that as you look through plans you can find the one that will meet your needs. You won’t want a plan that will keep you in a compromising position all year long. Make sure that you are well informed and take the time to know what you really want. For example, If you know that you are going to be on a fixed income you will want to make sure that you are looking at plans that will have low out of pocket costs. Or if you want to ensure that you are maintaining the best health possible then you may want a plan that is very proactive in prevention care.

When you are looking at you coverage make sure that you read the fine print to see what is covered in your care. You may be surprised at what you find there. Many health plans offer extras that are included in their plans such as wellness check ups, 24 hour hotlines to speak to nurses and discounts on fitness and nutrition plans. There is also often preventative care available to you. And the easiest way to prevent expensive out of pocket costs is to make sure that you are catching things before they really blow out of control. In fact, the Center for Disease Control has made an estimation of about 100,000 lives could be saved each year if they received the recommended preventative care. You will also want to know not only what doctors and hospitals are covered but what specialists and specialized medical facilities will be available to you.

We hope that these tips will help you prepare for open enrollment, but if you have any questions about Medicare, please let us at Bernardini & Donovan help you.

Blog

Single Payer Healthcare

Single Payer Healthcare

What is Single Payer Healthcare?

Medicare Advantage Insurance

Medicare Advantage Insurance

What is the Advantage of Medicare Advantage?

Medicare Health Insurance

Medicare Health Insurance

Medicare has four different parts:

History of Medicare in America

History of Medicare in America

America’s health care system

What Happens to AHCA Now?

The ACHA is Pulled (For Now)

The American Health Care Act: Part 2

The American Health Care Act: Part 1

What to consider prior to buying health insurance for you and your family

Medicare Open Enrollment

let Bernardini & Donovan find the right plan for you

Single Payer Healthcare

What is Single Payer Healthcare?

Medicare Advantage Insurance

What is the Advantage of Medicare Advantage?

Medicare Health Insurance

Medicare has four different parts:

History of Medicare in America

America’s health care system

let Bernardini & Donovan find the right plan for you

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