Health Insurance Blog

Geisinger Health Plan has announced that they will no longer screen visitors or restrict people from entering Geisinger Medical Center in Danville.  This is great news in terms of the virus and the threat it now poses.  The cases of H1N1 in the area is very low right now and an emergence of the regular seasonal flu has yet to be seen.

Entrances at GMC and GWV will reopen to the public and kids under 12 will be allowed to visit again.  Similar restrictions have been placed in hospitals and health systems throughout the country during the peaks of the H1N1 flu season.  The Cleveland Clinic restricted children from entering unnecessarily even if they did not have the flu.  All of this was done to limit the spread of the flu virus as much as reasonably possible.

Geisinger Health Insurance still encourages all visitors of their health system hospitals to screen themselves for flu like symptoms and stay home if they are under the weather.  Some symptoms to look for according to their website are fever, cough, headache, aching joints, and sore muscles.

Humana Insurance announced in February that they will be cutting their workforce throughout the course of 2010 according to their website.  They will be dropping about 1400 positions, which is about 5%, throughout 2010.  They will be balancing 2500 job reductions with the addition of 1100 jobs in areas that are experiencing growth.  The job cuts will come from attrition, outsourcing, process efficiencies, and the elimination of positions.

Some of the areas experiencing growth right now are medicare cost containment capabilities, pharmacy management, and specialty products.  By growing these lucrative areas Humana can focus on saving money for their members and offering lower Humana insurance quotes.  Humana’s President and CEO Michael B. McCallister regrets the loss of jobs, but says it’s necessary for Humana growth.

All employees affected by this plan will have a 60-day notice period at Humana.  Human Resources plans on working closely with the affected employees to help them find internal positions or outplacement assistance.  Severance packages and continuation of health benefits will be offered.  It seems that no industry is safe from job cuts.

Congress has announced a 21.2% cut in Medicare pay for physicians according to the article “Reduction in Medicare Pay Worries Physicians and Patients” by Amit Pathania on TopNews.com.  This is a concern for many and will affect both Medicare patients and doctors.

With less money allocated towards Medicare doctors, the doctors are forced to see less Medicare patients which may mean many will have to look for a different doctor.  According to one survey of neurosurgeons from 2010, about 60% of doctors are lessening their Medicare patients in their practice, and 40% will be cutting back on consultations by new Medicare patients.  Neurosurgeons have made the decision to not treat new patients.

The Congressional Budget Office states an estimate of a savings of $7.3 Billion in the deficit by pushing the Medicare pay cuts to October 1st.  It’s critical that those on Medicare and using Medicare supplement insurance understand what their doctor’s intentions are with their Medicare patients so that they have ample time to find a new, quality doctor if need be.

President Obama called for a rare meeting with lawmakers as part of a last effort to revive his health care priority.  The debate lasted all day and there wasn’t a resolution but voices were heard.  Obama gave his personal experiences with individual health insurance, including his mother’s battle with cancer.  He appealed to the fact that the health care system is not getting better, but only worse.

The Republicans main argument was that the existing reform bills didn’t do anything to lower costs.  The bills are estimated to cost 1 trillion dollars over the next decade.  The Democrats pointed out that it is going to be costly initially to extend coverage to nearly 30 million uninsured Americans.  Republicans fear a government system taking over a mostly private sector.

There was agreement that there are fundamental differences between the two parties that are causing the major rift.  The Democrats are still hoping to revive the comprehensive bills that have passed the House and Senate but Republicans are clear that they do not do comprehensive very well.  The debate continues even longer.  This information was obtained from the article “Obama and Republicans Haggle in Last-Gasp Health Summit” found on earthtimes.org.

Mega Health Insurance has named Keith Gleason on Maine as their National Personal Producer of the Year for 2009.  He was presented with the award at the annual convention for insurance agents held in December in Dallas, Texas.  Gleason is the first to win both the National Personal Producer of the Year and the National First Year Achiever.

Gleason finished 2009 with about $1.6 million in personal production which has brought his career production to over $6 million in only 3 and a half years with Mega Insurance.  In addition to being the top personal producer recognition, Gleason received awards in 10 other categories including top Value Seller Award and the President’s Award for personal and team production.

Senior Vice President Jack Heller says that Gleason works with integrity and a strong commitment to Mega Insurance.  They want other agents to follow in his footsteps and strive for his goals.  He continuously shows quality business with his client relations.

KPS Health Insurance describes in detail what is involved in the serious crime of health care fraud on their website.  Health care fraud is committed when a provider or customer submits false information to a health insurer for use of obtaining a payout of some sort.

There are many different forms of health care abuse.  One of the most common is filing a claim for services or medications not really performed.  Billing for non-covered items using codes for items that are covered in a health insurance plan.  There is also altering billings or medical records or accepting gifts for patient referrals.

KPS Health Plan is working hard to ensure they protect their policy holders.  They have a dedicated special investigation unit who works to review all cases of fraud and health care abuse.  They verify all providers’ credentials to ensure consumer safety.  They encourage all of their members to protect their KPS Health Plan Identification cards as if it were one of their credit cards.  Identity theft through health insurance can be just as serious, if not more.

Both the House and Senate have passed their versions of health care reform according to the article “Understanding Key Provisions in Federal Health Care Reform” found on Business Journal’s website.  Congressional negotiators are currently working on an agreement between the two bills.  The full House and Senate must approve the package then it’s presented to the President to sign it into law.

It’s predicted to take until at least mid-February before an agreement is reached and it wouldn’t start until 2013 and possibly longer for certain plans.  In 2014 and years after, the health care reform plan budget would increase to match the Consumer Price Index, plus 1%.  Insurance companies and plan administrators would pay this extra tax.  Under the House bill there would be a penalty for each employee not covered by health insurance of 8%, and under the Senate bill the penalty would be $750 per employee not protected.

The article points out that about 30 million of the country’s 46 million uninsured would get health insurance, mostly through federal health insurance subsidies under the new plan.  Health insurance companies would have to redo their criteria for approving policies such as stopping exclusions for pre-existing medical conditions.  This is an important point for those shopping for individual health insurance who have been turned down previously because of an chronic illness they may have.

Health exchanges are included in Congress’s recent health care reform bill.  The article “Health Exchanges: What are They” on healthcentral.com defines a health exchange as a government sponsored market for buying health insurance.  It would be available to people not working for large companies and not on Medicaid, Medicare or any other public program.  Health care reform would result in approximately 30 million Americans using health exchanges to receive their health insurance.

This type of program has pros and cons.  It’s based on the philosophy of managed competition.  Only pre-approved health plans which meet government standards may compete in the health exchanges.  There is much debate over who would control these exchanges.  It can be controlled at state level or national level or a mixture of both.  There would need to be a consistent and fair way to get consumers affordable health insurance quotes.

The article “Collaborate on Health Exchanges” by Gary Lauer on USA Today’s site points out that America is so diverse, and no single approach is going to meet every consumer need.  In order for such a system to work, it will require a collaborative effort to get eligible Americans enrolled into exchanges quickly and smoothly and have significantly more people insured, which is Congress’ ultimate goal.

Residents living in Chicago suburbs pay on average 14.6% less on their health insurance rates according to the article “Health-care Insurance Cheaper in the Suburbs” by Sandra Guy on suntimes.com.  This may surprise many carrying Chicago health insurance.

Those living 15 to 25 miles from downtown Chicago pay 12-15% less on their health insurance premium and those living 25-40 miles outside the city pay 20-30% less.  This is according to data gathered by Norvax Inc.  They also found that people who live in the southern and western suburbs, which are generally considered blue collar, pay 24.5% less for Chicago health insurance.  Those who live in the northern areas pay 14.6% less.  The findings highlight the cost of health care in these various regions.

Health insurance quotes are definitely being affected by location, but the question is, is this fair?  Health insurance companies claim it’s a matter of risk-based pricing.  Astonishingly, 26.5% of Chiacgo residents do not carry health insurance according to the latest US Census Bureau report.  This may be a direct result of the insurance companies and the way they price their customers as well as regulations created by the state.

A prediction has been made by the president of the American Hospital Association in San Antonio last Wednesday according to the article “Hospital Leader Sees Health Care Bill Passing” by Don Finley on mysanantonio.com.  The president, Richard Umbdenstock, believes some sort of health reform bill will pass before Congress leaves for the December holiday. 

This could mean big changes for San Antonio health insurance.  The bill that passes will not be perfect but it will bring some value.  Umbdenstock noted that half of US hospitals are losing money and 25% are breaking even.  These groups are concerned about a government run plan taking over as they may lose even more money.  Back in June, hospitals agreed to give up about $155 billion in federal payments over the next ten years.  In return for this loss, a plan would be put in place to ensure 94% of US residents would have health insurance.  This would reduce their losses from the uninsured by about $171 billion.

A few weeks ago the health insurance industry released a report stating that the Senate bill would increase premiums for people with private insurance.  They did agree to change the ways in which they conduct business such as covering people with pre-existing conditions in return for the requirement that everyone must purchase health insurance.