Health Insurance News – Flu and H1N1 Vaccines: Safe? Free? Available?
October 21, 2009
The hype around flu vaccines has certainly grown exponentially this year given the scarier strains of influenza on the loose and the H1N1 virus. There is so much information floating around the internet and being reported on the news that our heads are spinning!!! What to believe and more importantly, what to do?
Doctor’s offices have even begun to email patients keeping them posted of the latest information and availability of the vaccines. But of course, we are already concerned given the reported H1N1 deaths we are hearing about as well as the rare, debilitating side effects of the vaccine itself. YIKES! These days, there seems to be nothing more scary than making the decision to get a flu shot, except maybe the scarier choice – not to get one! But…at least the vaccines will be FREE for everyone with current medical insurance plans. It has been noted that insurance companies and those administering vaccines are in agreement that the vaccines will be given at no cost to insured people.
Though reports have gone on and on about a shortage of the vaccines, current reports say that there will be plenty of the vaccine and enough for everyone. However, for starters, the vaccine will be given to people based on priority that looks similar to the following:
- ALL PEOPLE who live with/care for babies UNDER 6 months of age.
- CHILDREN 6 months through 4 years of age.
- CHILDREN age 5 to 18 years who have CHRONIC HEALTH CONDITIONS
There is also much talk about the injectable H1N1 vaccine and the safety of some of it’s elements. The injectable H1N1 vaccine DOES contain the preservative Thimerosal. While flu vaccine containing Thimerosal is typically restricted to patients 3 years and older, California has granted an exemption allowing this H1N1 vaccine to be given to patients 6 months and older. Thimerosal-free vaccines are expected to be available at some point but nobody knows when or how much will be available.
Bottom line, we are probably best to rely on information directly from our trusted doctors and his/her team of staff. This year is not the year to skip your flu shot, but it definitely doesn’t hurt to be informed, ask questions and stay home when you are sick. Oh yea, and WASH YOUR HANDS!
If we can be of assistance to you or someone you know, give us a call at (925) 627-1800 or visits up online at www.safeguardfinancial.com
Health Insurance FAQ #2 – My rates just went up, why again?
October 14, 2009
I get hundreds of calls asking questions about rate increases. The truth is, rate increases happen. And, unfortunately, they happen OFTEN! Each carrier seems to publish new rates at different times of the year and some of them, more than once a year. Some ask for more of our money in the spring, others change things up in the summer, fall, and most reevaluate rates at the beginning of each calendar year.
For the most part, you are looking at a minimum of 1 rate change per year, but don’t be surprised if there is a second change, and sometimes even a 3rd. Yes, I really did say “three.” Above and beyond the new plan rates that each carrier settles on for the year or a couple times per year, you could face an increase in your rate because of a birthday you will be celebrating. Typically the “bigger” birthdays come every 5 years after age 30. 30, 35, 40, 45, 50… If it wasn’t tough enough to achieve these age milestones, the insurance carriers stick you with a higher medical premium because you are “old” and might start costing them more money. Now, this is not always the case — you may not pay more at each of these birthdays, but you often will.
In the case of individual and/or family plans (outside of an employer sponsored group plan) these rate increases have nothing to do with how much or how little you use your medical plan. You are still subject to the rate increases even if you have not been to the doctor at all that year or at all in 5 years. Many people think that their rate increases when they use their plan more frequently — this is NOT true.
There are options! When you get the notice that your premium is increasing 29%, you have every right to choose a new plan that suits your budget better. Often you can make these changes with no repercussions and will not even have to be subjected to underwriting — just an easy request, and your plan and premium can be changed in no time!
If we can be of assistance to you, please feel free to contact us at (925) 627-1800 or visit us online www.safeguardfinancial.com
Health Insurance Explained – Deductibles: When will I have to pay?
October 7, 2009
Deductibles here…deductibles there — It seems deductibles are everywhere! How do we know when we will have to pay?
Well, it is true, more and more medical plans (dental and vision too) have a deductible associated with most, if not, all services. Nowadays, people are more conscientious than ever about budgeting and oftentimes, big medical bills are not something we have planned for. I may be generalizing a bit to try to keep things as simple as possible, but what I am about to say is pretty standard across most medical plans that have a deductible.
First, however, and maybe most importantly, let’s make sure we are all on the same page about what we mean by “deductible.” A deductible is the amount YOU have to pay before your insurance company (medical plan) pays what they have promised to pay. Correcting a common mistake: deductibles are NOT the same as copays!!!!!
Taking a look at a medical plan summary of benefits, you will see information on the amount of the deductible and when it is, or is not going to come into play. For instance, a plan may state “deductible waived” for certain services (most commonly deductibles might be waived for preventive care and/or doctor office visits.) Other services may state a percent that the plan will pay AFTER the deductible is met. In this case, YOU are responsible to pay the amount of the deductible OR the entire amount of the bill, whichever is less. Once you have met the deductible, say it is $500, then the insurance company will pick up the percent they have promised to pay and will send you a bill for the remainder.
It gets very complicated right about here! Some deducible plans will pay 100% of covered medical expenses afer you have met the deductible. These plans are usually those with the higher deductibles, $5,000-$10,000. The alternate are those which do exactly what we described above, YOU pay the deductible AND smaller % of additional bills after the deductible is met. When will the bills stop, you ask? Medical plans will also list an “Annual Out of Pocket Maximum” for each plan. Once you reach this total in out of pocket expenses (your portion) — This is when the bills will stop! But…these deductibles and out of pocket expenses start over every year! Most, if not all health plans operate on a calendar year system, so every January, dollars start back at $0.
For help on finding the right health plan and more about deductibles and how health plans work, please call us at (925) 627-1800 or visit our website: www.safeguardfinancial.com
Health Insurance Tip #4 – HSA Eligible Expenses…Keep Your Receipts!
September 30, 2009
As discussed previously, Health Savings Accounts (HSA) are accounts intended for saving money to pay for medical expenses. There are some tax benefits that could come from maintaining one of these accounts (please seek tax advice from a tax professional) but the funds must be used appropriately. There are some “no-no’s” when it comes to spending your HSA money so be sure you know what expenses are eligible expenses and which are not. There is a long list of eligible medical expenses and even several over the counter (OTC) medications on the “eligible” list.
Unfortunately, your lip balm, gym membership, and elective plastic surgery do not qualify as eligible expenses under you HSA account. But, cough drops, antacids and your teenager’s braces ARE eligible expenses, as well as the typical medical expenses: doctor’s visits, inpatient/outpatient surgery, eye glasses, contact lenses, dental checkups, and more.
It is best and strongly recommended to maintain receipts for all expenses paid for with HSA funds so you have record for tax time and in case there are any questions later on down the road. Keeping these receipts also helps to ensure you are being reimbursed by your HSA account for all eligible expense.
Since HSA plans and HSA accounts have become more and more popular, some stores have even made things easier by noting HSA eligible purchases in store and on your sales receipt. Safeway and their affiliate stores as well as Costco Wholesale stores were some of the first to do this and many more stores have followed in their footsteps.
Who determines these eligible expenses, you ask?
Generally, medical expenses allowed as deductions are determined by Section 213 (d) of the Internal Revenue Code.
For more information, please refer to IRS Publication 502 titled, “Medical and Dental Expenses,” Catalog Number 15002Q. You can order the publication by calling (800) TAX FORM or see it online at www.irs.gov/pub/irs-pdf/p502.pdf.
Health Insurance FAQ #1 – What is a HSA?
September 24, 2009
The “HSA” topic can get quite confusing with all the acronyms that are thrown at us from the health insurance sector. HSA, HRA, HIA, FSA, HDHP, OTC, OOPM… these all have their place in the system but what do we really need to know?
Though I do plan to define/explain each of these (stay tuned for future posts) I think we will start with “HSA” since this seems to be the most popular and most prominent player on the scene presently. HSA compatible plans are simply heath plans that can be linked to a Health Savings Account (HSA). Many banks offer these type of accounts, but not all. A traditional checking or savings account may NOT work the same as a HSA so it is important to know what you have in place to understand the benefits you are or are not getting.
The original intention of an HSA account was to put money away for medical expenses that would not be paid by your health insurance company/plan. Since HSA compatible health plans are typically high deductible PPO plans (HDHP), there is an amount each member must meet (+/- $1500-$5000) before anything will be paid by the insurance company. There are a few exceptions, but for the most part — this is what we are looking at.
Funds put into an HSA are not taxable up to a maximum amount per year, though these account holders must abide by certain rules when it comes to using the money. (For tax advice, please seek the services of professional in the field.) HSA funds are intended for use towards medical expenses. This includes the typical: office visits, hospitalization, medical procedures, etc. but may also include certain over the counter medications, dental care, medical devices, and more. Just because an HSA account is open does not mean these funds must be used. Some people choose not to use these funds and instead, let the money “grow.” Unlike the “vintage” HSA plans and some other similar concepts, what isn’t used at the end of the year is NOT lost! There are lots of ”fancy” ways to allocate/invest HSA funds now days that were not available just a short time ago. (of course, you will want to talk with your CPA and/or financial advisor to discuss details that may benefit you.)
Now, the other side of this…just because you have a HSA compatible health plan does NOT require you to have an HSA account with a bank. HSA plans are popular and preferred by some, outside of any benefit they may get from having a health savings account at a bank.
The “vintage” HSA compatible plans that were first on the scene a few years back did not impress me. In my opinion, they really didn’t offer a whole lot of incentive for people to take the “risk” on a new concept and a new type of plan. Now, the plans are better, and many consumers have been educated on how the HSA compatible plans work and people now know how they can maximize their benefits when using their health savings accounts. These plans are HOT!
If you have questions or would like to learn more about HSA’s and how you can benefit, please feel free to contact one of our Benefits Consultants, (925) 627-1800 or visit www.safeguardfinancial.com
Health Insurance Tip #3 – Should I be scared of “Underwriting”?
September 17, 2009
“Underwriting” has become a bit of a “bad” word in the health insurance industry. Even the healthiest of people shudder when told that their application will have to be sent for underwriting review. President Obama spoke about the overwhelming health care issue in his speech on health care reform just last week. Obama touched on a part of his plan that would make underwriting a thing of the past: not allowing for exclusion of pre-existing conditions and disallowing health insurance companies to decline coverage to any person, regardless of their health history.
Do I think this is a great idea? YES! Would I love for this to become a reality? YES! Do I think this can happen the way it has been explained to us? Unfortunately, NO.
The truth the way I see it, underwriting is here to stay, at least for a little while. And, underwriting will indeed be the determining factor for whether many of us are granted the coverage we apply for, or not. However, there are ways to make “underwriting” a little less intimidating and the answers lay with your trusted benefits broker. Brokers, like myself, are given information that is not always distributed to the general public. These guides give us an inside look into how underwriters think and what may determine their decisions. The fear of underwriting can be overcome and the key is: educate yourself! Know when to be “scared” of underwriting and when it won’t affect you. Know what options you have and the pros and cons of all. Know who can get you the answers you need and call him or her! Often, the best, easiest, and least time consuming way you can educate yourself on issues that may affect you is by working with a broker whom you trust.
If our benefits consultants can assist you, please contact us at (925) 627-1800 or visit our website www.safeguardfinancial.com
Health Insurance Tip #2 – “In-Network” vs. “Out of Network”
September 9, 2009
Understanding your health plan’s benefits is the first step to saving money!
For most of you enrolled in PPO plans, you have the ability to see any doctor, for any reason, at any time – one of the main reasons you chose a PPO plan, right? But…some doctor visits will cost you more money. Which ones? Because there are “In Network” and “Out of Network” benefits associated with these PPO plans, it is imperative that we understand what this means and who’s who.
There are 2 main categories of doctors when speaking of PPO plans;
“In Network” = Doctors/Providers who are contracted providers of your health insurance plan/carrier and
“Out of Network” = Doctors/Providers who are not contracted providers of your health insurance plan/carrier.
Though most PPO plans will pay some of the fee charged by “out of network” providers (commonly 50% after deductible), the amount they pay for these “out of network” services is typically significantly less than what is paid towards visits to an “in network” doctor (commonly 70-80% or more.)
Keep in mind, these percentages take into consideration other factors such as “negotiated rates” and/or “usual and customary” fees for service, so determining certain costs may not be as easy as multiplying numbers.
Who’s “In Network?” Just ask! Ask the receptionist or billing contact at your doctor’s office whether they are “In Network” providers of your health plan. But, beware…the doctor’s office may say that they are a provider on your PPO plan when they are NOT an “in network” doctor - this is not uncommon because of the “out of network” benefits paid by most PPO plans. Be specific in what information you are looking for and ask your health insurance agent or broker if you still are not sure. You can do your own provider search of ”in network” providers or to get a list of doctors by calling your health carrier or by visiting their website.
If we can be of assistance, please call (925) 627-1800 or visit our website www.safeguardfinancial.com
Health Insurance Tip #1 – Lower premiums courtesy of a younger spouse
September 3, 2009
Do you have a spouse that is younger than you? You could be saving money!
Health insurance premiums, in most cases, are determined by 2 main factors: location (county/zip code) and age. If you are enrolling in a health insurance plan along with your spouse, you could save money just by listing the younger spouse as the “primary applicant.”
Each circumstance is different and all carriers have different rates and rules so be sure you are getting the best deal!
Click Here to shop health plans and rates or visits our website at www.safeguardfinancial.com
If you have specific questions about how Safeguard can help you, feel free to call us: (925) 627-1800
Hello world! Announcing Safeguard Benefits and Insurance Services Company on CityScoop!
March 25, 2009
Welcome to Safeguard Benfits and Insurance Services company’s CityScoop website. We offer free information and tips here at our CityScoop website. We servce the entire San Francisco Bay Area including Oakland, Walnut Creek and San Jose, CA. If you need health insurance or life insurance or anything else that we offer please visit our site for more info.
You can visit our main website at www.safeguardfinancial.com.
