3 Questions For Your Doctor

Health insurance is a vital aspect of our health and well-being. And the exponentially rising cost of healthcare is insurmountable without some level of insurance. So, it is crucial that we are covered in the case of an unforeseeable ailment or injury. However, health insurance is a complicated web of pure confusion. It takes an expert, someone who has devoted their entire career to the subject, to fully understand its ins and outs. And while you do not need to comprehend every aspect of insurance or even your own coverage completely, there are some things you’ll want to be sure are made clear.
If you’ve recently moved or required specialized medical attention, you may be seeking a new primary physician. And in this process, you’ll need to consider a few questions. To help you better understand your insurance, your doctor, and choose the best avenue of care for your needs, know what questions to ask your physician’s office. These will help you know what is covered by your insurance plan and what to expect in costs before you even book an appointment. Take out the guesswork and surprises, and take hold of your health care!

Three questions to ask your doctor: 

1. Is this office covered by my current health insurance plan?

You can answer this inquiry in more than one way. You can simply call the office directly and ask. However, this might turn into quite a few phone calls to random doctors’ offices. Or you can check your health plan’s website for a provider directory. This may be a more direct and easily navigable solution. Also, check if your plan requires prior authorization before your visit. This will avoid charges that could otherwise be applied to your plan.

2. Does my health plan cover my healthcare requirements?

There are several essential health benefits covered by all private health care plans. These include prescription drugs, emergency visits, pregnancy, maternity, and newborn services. However, beyond these, each plan is a bit unique in its coverage. If you have questions about what particular services are covered, you can reach out to your plan for answers.

3. What will I be charged?

While you are free to visit an out-of-network provider, you’ll save the most money with someone who is in-network. This indicates that their office accepts your insurance, resulting in a smaller out-of-pocket fee. As discussed above, each plan is a bit different from the next. So avoid any unwelcome surprises and learn which services aren’t subject to your plan.
Insurance and finding a healthcare provider who is both in-network and compatible with your preferences and needs, can be a headache. That’s why we at Bernardini and Donovan are here for your insurance inquiries and navigation. Don’t go it alone- this is a complicated topic! So leave it to the experts. We’ll assist you in this process, finding the best options for your exact criteria.

Know Before You Go: Quick Tips to Take Before You Travel

As you plan your summer vacation, the last thing that you plan for is to get sick. However, studies have shown that around 15% of travelers experience some medical need during their travels. It can range from accidents or injuries surrounding their exciting plans or could be that they fall sick from some foreign bug. Either way, travelers that experience these type of medical needs often have some questions about how their medical needs will be paid for. So before you go on vacation, here are a few tips to make sure that your health has a priority.

  • Call Your Health Provider

    One of the easiest ways to find out if your health provider will pay for out of the country health benefits is to ask them! Some health policies will provide a certain amount of health coverage, but many will make you pay out of pocket and then submit for reimbursement. And if you have original Medicare, there is not international coverage. You will want to make sure that you are asking the following questions:

    • Will my policy cover me while I travel abroad?
    • Will I have to submit for a reimbursement
    • Will my coverage include preexisting conditions
    • Ask about injuries that are due to circumstances outside of your control, such as acts of war, natural disaster, or acts of terror?
    • Will preauthorization be needed for treatment in a hospital?
  • Get a Quote for Travel Medical Insurance

    This type of insurance is different than travel insurance because it focuses on your medical care or you need for evacuation instead of trip cancellation. If you should get injured or sick while on a trip, it helps to pay for your medical needs, and if you were to get injured in a remote area where you could not receive proper medical care, it would cover the cost of the evacuation to get to an appropriate hospital. Many types of travel insurance also include this aspect, so make sure that you are looking at precisely what is covered when you purchase it. It will usually cost you to 4-8% of what you have paid to go on your trip.

  • Don’t take unnecessary risks

    While we understand that for some, going on an adventure is part of their vacation, it is important that you are not signing up for an unsafe situation. Many times accidents that happen while on vacation are simply that, accidents. A person trips while walking on cobblestones or one may be involved in a car accident. These are all very normal if not unfortunate circumstances. But if you are signing up for an experience, make sure you are working with a reputable company that complies with basic safety standards.

    We hope that your summer vacations are full of fun and excitement and that sickness and injury stay far away. But if you should get ill, we hope that you’ve taken these tips to heart and covered yourself for any travel mishaps that you may encounter.

Out and About First-Aid

B-&-D-04-19-OUT-and-About-First-AID-02

Out and About First-Aid

Spring is in the air! Which means that we are coming to an end of a very wet winter for us in Southern California. But one of the many benefits to all of the rain is the Rolling Green Hills and Mountains. There is never a better time to go for a hike, a long walk or backpacking for a few days. But while you are out communing with nature, you will want to make sure that you are prepared for any possible injuries that could happen. Bring along some basic first aid that is set up for your type of excursion as well as for how many people will be going with you and you will be on the right track. Here are a few common problems that come up while taking part in outdoor activities.

Dehydration

This is a tricky one because most people do not realize they are dehydrated until its too late. But the best way to combat dehydration is to take small sips of water throughout your outdoor activity. Make sure to carry enough water for the whole of your trip or know where you can refill your water bottle. If safe water is not available, sterilization tablets will be a must-have.

Cuts and bites

If you get a cut, you will want to ensure that you clean the area off with a disinfectant and make sure there is no debris in the wound. Then you need to stop the bleeding. Use a sterile piece of gauze to apply pressure and to stop the bleeding. Then use a bandaid to protect the wound. If you get stung by an insect make sure to remove the stinger as soon as possible and use pain relievers, a cold pack, and/or anti-itch creams to help.

Hopefully, these few tips will help you next time you go for a hike. And we have one final suggestion. Always be sure to carry a first aid kit with you. A basic first aid kit will include:

  • One elastic-roll bandage
  • Aspirin or ibuprofen
  • Adhesive tape
  • Alcohol Swabs
  • Antacid
  • Antihistamine
  • Antiseptic ointment
  • Adhesive bandages, assorted sizes
  • Bulb irrigating syringe
  • Butterfly bandages
  • Chemical heat and cold packs
  • Dry-wash pads or wipes
  • Diarrhea medicine
  • Gauze pads
  • Hydrocortisone cream (soothes allergic skin)
  • Insect repellent
  • Mirror, small and unbreakable
  • Moleskin, 1 or 2 packets
  • Cotton swab, sterile, packaged in pairs
  • Safety pins
  • Scissors (Swiss Army Pen Knife has scissors, small blade and nail file)
  • Sunscreen
  • Triangular bandage
  • Tweezers
First Aid box - bdhealthinsurance.

Value of Health Insurance

Value of Health Insurance

Value of Health Insurance

Having health insurance provides real tangible benefits. It also provides more abstract benefits. With any insurance that you are purchasing you are essentially investing in your peace of mind. There are always What-if’s that run through our minds. But insurance promises to be something that will help you if any of those scary what if’s come to pass. You get in a car accident – you have insurance for that. Your loved one passes away – you have insurance for that. You get sick – you have insurance for that.

 

Health insurance comes with mandated benefits as well. Every insurance plan that you can purchase will include:
Outpatient care
Emergency services
Hospitalization
Mental Healthcare
Prescription drugs
Rehabilitative services
Laboratory Services
Preventive Care
Pediatric Services.
Some plans that you purchase can have more services. But under the Affordable Care Act, which is still the law, though that may change soon, these benefits are all mandatory.

 

Without health insurance, there is a higher possibility of suffering from debilitating debt due to high medical costs. No one plans on breaking a bone or needing to stay in the hospital. If it were up to us, we would all be healthy at all times. But these things do happen, and the cost of fixing a broken leg can be up to $7,500.  A three-day stay in the hospital can be upwards of $30,000. These are astronomical numbers in comparison to what you pay in premiums and co-pays.

 

Another important aspect to look at with health care is the preventative care. Most of these services have no cost to you. Receiving shots or getting specific screening tests allows you to catch anything early or prevent illness from ever getting a foothold. Our health is one of our most valuable assets. And keeping our health as a priority through proper preventative care will save you in the long run. Speak to us today about which health insurance will be the best for you, your family or your business.

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.

What you need to know about Medicare Deadlines.

There are some people in the world that just know things. They are the mavens that can rattle off facts, dates and details that the rest of the population just never grasped. This blog post is not for them. This post is for those of us who don’t know the first thing about Medicare and the deadlines needed to sign up.

So first things first. You become eligible for Medicare when you turn 65. But the deadlines for signing up extend to the months that surround you birthday. However, there is an exception if you already are receiving Social Security benefits you are automatically enrolled in Medicare A and B. But if that is not the case then you need to sign up yourself. You have a window of enrollment that last seven months. The seven month window begins three months before your birthday month, goes through your birthday month and continues on for the next three months after your birthday. So if your birthday was in June you could sign up for Medicare starting March 1st and it would end September 30th. If you miss this deadline you can join during open enrollment from January 1 to March 31 each year.

The reason that you will want to make sure that you sign up during these seven months is so you will avoid any fees that come with signing up late. The monthly Part B premiums will be raised by 10% for each 12 month period you wait to sign up for Medicare. “The idea behind the penalty is to give people a financial incentive to enroll in insurance from the get-go as opposed to waiting until they have some kind of negative health event,” says Mark Duggan, an economics professor at Stanford University.

It is important to note that if you or your spouse are still working for an insurance providing company when you or your spouse turn 65 it is not mandatory to enroll at that time, you can stay with your current provider. However, once the household member that they insurance is provided through retires then you will need to enroll. You will have an 8 month period enrollment time. The 8 month time period starts the month after the employment ends or when your insurance coverage from that job ends.

We hope this information helps, but if you have more questions please feel free to contact us at Bernardini & Donovan

Taxpayers Covering Majority of California’s Health Care.

Most people assume that our healthcare systems are paid for through private funds. Those private funds coming from health insurance premiums or from employer based coverage. However, a recent study shows that in California, that is just not the case. In fact about 71% of all funds paying for California’s healthcare comes from public funds, meaning California’s taxpayers are paying for a majority of the state’s health coverage. In 2016 it is estimated that $367 billion will be spent on health care. With these numbers that means that roughly around $260 billion will come from taxpayer money.

But California seems to be a unique case. When looking at the country as a whole, it was estimated that only 45% of the $3 trillion spent on health care comes from public funds. So what has made California stand out so much from the national average? Well there are a few factors to look at. One is that the national average is estimated to be much lower than what is actually being used. The American Journal of Public Health estimates that a more accurate picture of national spending is around 65% of public funds are put towards health care. The second aspect is that California does have some unique cases. UCLA’s study on California’s expenditures states that “health spending through county public health expenditures, new Affordable Care Act subsidies and tax subsidies for employer-based health insurance drives the proportion of care paid for by the public well beyond the CMS estimate” California also has had a larger expansion of Medi-Cal coverage showing around ⅓ of the state’s population is covered through this low income program.

What does this mean for you? Researchers are now beginning to question what it would look like to have a single payer health care system because we are already leaning towards that end of the spectrum as it stands. But we will have to wait and see how things continue to change with our aging generations and shifting political systems.

Affordable Care Act – Here to Stay?

When the Affordable Care Act was signed into law in 2010 there were so many predictions going on. This will never last…. How can we possibly sustain this… This will change everything… Whether you were for the Affordable Care Act or against it we have seen some drastic changes in our country because of it. We have seen people who were not insured be penalized on their federal income taxes for not signing up. We have seen families adjusting to different expenditures on their health care. We have seen many who never had health insurance now be covered. But one of the questions that you may be asking (along with many other Americans) is the Affordable Care Act here to stay?

This is an excellent question and depending on who you ask you may receive two drastically different answers. The Los Angeles time recently reported on a study done by the Urban Institute which gathers and studies information about economics and social policy. Their recent study about the Patient Protection and Affordable Care Act started in 2011. Their studies show “a widespread slowdown in spending growth expenditure projections and the cost of the ACA” Meaning that the projection of spending for the years 2014 – 2019 is $2.6 trillion lower than what was originally thought to be needed. Which leads many people to speculate that the Affordable Care Act is working and therefore here to stay.

However, in June of this year we saw House Speaker Paul Ryan calling for and presenting his plan for healthcare reform. His plan detailed that they would like to “repeal Obamacare, Provide Americans with more choices, lower cost and greater flexibility as well as protect our nation’s most vulnerable and spur innovation in healthcare.” Paul Ryan also said that he wants to shift from Obamacare’s focus on quantity and how many people are covered to quality and ensuring that people receive the care they want. However, this plan has come under attack because the plan lacked specifics on how they would make these changes.

It seems that this debate will be continuing for some time. But know that we at Bernardini & Donovan plan on staying ahead of the curve so that with each change we can equip you with all the information that you need and the help design health coverage plans for you and your family.

Mergers and Withdrawals

Last summer we saw a huge announcement within our health providers when the Big Five national health providers announced that they would become the Big Three with a merger between Anthem and Cigna and a merger between Aetna and Humana. However, as soon as the announcement was made there were outcries against these mergers. There has been concern that if these five large companies which provide much of the innovation within the health industry are not working to stand out or outperform their competitors then the innovations such as new programs for consumers, seniors, and formerly uninsured will stop as well as the possibility of insurance premiums going up. And just recently the US Attorney General Loretta E. Lynch, announced that they had filed lawsuits against these mergers with the purpose of blocking these deals. Their main concern is that these mergers “would leave much of the multitrillion-dollar health insurance industry in the hands of three mammoth insurance companies… If these mergers were to take place, the competition among insurers that has pushed them to provide lower premiums, higher-quality care and better benefits would be eliminated,” said Lynch.

This last month we have also watched at Aetna has started to withdraw their services from certain markets in the United States. This is allow many Americans more limited options for their health care providers and in some cases leaving them with only one option if they are to receive health insurance. These changes will mean that many people will need to change their doctors or their prefered treatment facility to what will be covered under their new plans.

What does this mean for us? It’s hard to say at this time what these changes mean for us. While there are concerns of loss of innovation and rising premium costs, the insurance companies have continue to insist that that will not be the case. But at the very least this is one of the most politicized antitrust cases to be seen in some time.

Health and Wellness Benefits

There are so many benefits to having health insurance. From the simple fact that when you are feeling not at your best you have a place to go to get some care. Even having the peace of mind of knowing that when your baby won’t stop coughing you have an expert at hand who will give you everything you need to take care of your little one. But did you know that there are many additional benefits to your health insurance besides your basic doctor visits, prescription drugs and hospital care.

  • Online access – How many times have you lost your ID card and need to call to get a new one mailed to you. With online access you can print out a new ID card immediately. You can also see your claims, changed doctors, and never be on hold for over an hour again. You can do all of these and more online.
  • Gym Membership – Many insurance companies are now offering gym memberships, discounts on gym membership or even reimbursement on a gym membership if you check in a certain number of times at the gym per month. They may also offer discounts on gym equipment. So if you are looking to invest in an elliptical or a treadmill check to see if you get a discount.

  • Diet plans – You may find a discount on certain weight loss and diet plans such as Weight Watchers, Jenny Craig or Nutrisystem.

  • Homeopathic Medicine – more insurance programs are covering homeopathic remedies such as acupuncture or chiropractic care. If they don’t completely cover it they may also offer to add it on for a small fee.
  • 24 hours nurse care – small children always seem to get every cold that is out there. And with this service you can call a nurse hotline and get advice if it is enough of an emergency situation to go to urgent care or emergency room.

  • Employee Assistance Program – get financial advice for today or for your future financial planning.

  • Mental Health – Talk to someone via telephone as well as in person visits if needed.

Health insurance costs are continuing to go up but there are other benefits available to you that adds to the value to your health insurance plans.