• Your Guide to Health Insurance

     
     
     
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    4/21/2014

    Back in the early 1900s it didn’t cost much to see a doctor and your doctor would even make house calls! But as good as that sounds, in many cases, the doctor couldn’t do very much to help. Since then, advances in science and technology have dramatically improved health care. Unfortunately, the downside is that health care costs much more now than it did then.

    In fact, today in the United States, quality health care often costs so much that it is too expensive for most of us to afford it on our own, so we need insurance. Read on to learn more about health insurance coverage in the United States and how you can keep or find the best and most affordable health insurance for you and your family.

    Finding Affordable Health Insurance

    The word affordable is tricky. Who decides what’s affordable? Many people feel that they have been paying more than they should have to for a long time. And the cost of coverage continues to rise with no real end in sight. Even if you’ve always had insurance through your employer, over time you’ve probably had more and more withheld from your paycheck to cover rising premium and healthcare costs.

    Ongoing attempts to reform the healthcare system in the United States have brought about some change. One of the most recent, the Affordable Care Act (ACA), attempts not only to control costs but also to improve the quality and access to care. To understand these changes, and how they affect you and your health insurance coverage, it helps to start with the basics.

    Health Insurance Basics and FAQs

    The concept behind health insurance is fairly simple. You agree to pay an insurance company a certain amount of money on a regular basis (your premium) and the company pays some or all of your medical expenses. It’s when you apply the concept to the real world that it often becomes more complicated.

    A big company such as Blue Cross and Blue Shield, for example, insures nearly 100 million people, each with his or her own unique circumstances. Consequently, to protect the rights of both the insurance companies and the people they insure, policies are written to account for all possible scenarios, often making them full of jargon and difficult to understand.

    Click here for help with wading through the paperwork to find what you really need to know.

    Your Options for Coverage

    Most people in the United States get their health insurance through their employers. Others have insurance they purchased directly from an insurance company or from the health insurance marketplaces created as a result of the Affordable Care Act (ACA). Still other people don’t have health insurance at all. But, with few exceptions, as of March 31, 2014, the Affordable Care Act (ACA) requires that all Americans either have healthcare insurance or pay a penalty.

    Click here to learn more about reviewing the coverage you already have, changing your coverage, or getting coverage for the first time.

    Shopping for Health Insurance

    Whether you are thinking about changing your health insurance coverage or you are getting coverage for the first time, it’s a good idea to take some time to understand what’s available and what you can afford given your circumstances. As a consumer, it is up to you to protect yourself by knowing exactly what you are getting for your money. Click here to for help with determining what is and isn’t covered by your plan, what to look for in new plans, and how to compare one plan to another.

    How to Afford Your Medications

    Medications can be the biggest chunk of your healthcare costs. Plans vary in terms of how much they cover, but you may be able to reduce these costs. Click here to learn more.

    Your Guide to the Affordable Care Act (ACA or “Obamacare”)

    The Affordable Care Act (ACA or “Obamacare”), passed in 2010, brought about changes in the U.S. healthcare system that have probably affected your life in one way or another. Perhaps you have compared and bought health insurance in the health insurance marketplace, qualified for Medicaid for the first time, or have a son or daughter who is covered by your plan a little longer.

    Click here to learn more about the ACA and how it may affect your health insurance coverage and quality of care.

    Getting Help

    Understanding health insurance and how it works is not easy, especially with all the changes brought about by the ACA. Don’t be embarrassed if you need some help figuring it out. It’s a lot like preparing your taxes. You don’t have to tackle it alone. Click here to find helpful resources both online and by telephone. For specific questions, see Health Insurance Basics and FAQs on this website.

  • More About Health Insurance

     
     
     
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    Expansion of Coverage Under the Affordable Care Act

    Access to quality health care for you and your family is influenced by a number of factors that include your insurance status, income, race, gender, age, and where you live. The Affordable Care Act (ACA) attempts to address inequities or special considerations in these areas to make comprehensive and affordable health insurance coverage available to more people.

    Financial and Health Insurance Information for Patients with Congenital Heart Disease

    If you or your child was born with a heart defect (congenital heart disease), paying for treatment will usually involve using different types of resources - whether those resources are private insurance, government programs, or out-of-pocket payments. Complicated medical tests or procedures can be expensive, so it is particularly important that patients who will need treatment and follow-up throughout their lives maintain some form of active medical coverage. It is crucial to avoid gaps in medical coverage during the transition from childhood to adult care. Once insurance coverage is lost, it can lead to long delays in coverage and can be very difficult to get back. Talk to your healthcare providers specifically about how to prevent gaps in coverage.

    Grandfathered Health Insurance Plans

    If you were enrolled in an individual plan from a private insurance companies before March 23, 2010, or if you participate in an employer-sponsored health insurance plan that has been in place since before the Affordable Care Act (ACA) became law on March 23, 2010 (even if you enrolled after that date), and it has not changed substantially in terms of costs and benefits provided, it is possible that your plan is grandfathered. Grandfathered plans may not be subject to some of the ACA’s requirements for health insurance plans.

    Health Insurance Basics and FAQs

    We all complain about the rising cost of health care and health insurance, and yet many of us don’t really know what we’re paying for or if we’re paying the right amount. According to a study by George Loewenstein and his colleagues, only 14 percent of a group of people with employer-sponsored health insurance could define basic health insurance terms such as deductible, copay, and coinsurance. Can you? You might be surprised.

    Health Insurance Resources

    Don’t be embarrassed if you need help understanding your health insurance coverage. It is complicated, and for most of us, just as difficult as preparing our taxes. But you don’t have to tackle it alone. Ask a friend or relative to help. Or, if you have the resources, hire a consultant.

    Health Insurance Shopping List

    Consider asking these questions before buying health insurance coverage.

    How Does the Affordable Care Act Affect My Quality of Care

    We would like to think that we’re getting quality care every time we see a doctor or go to the hospital for an emergency. But that may not always be the case. The United States spent $2.5 trillion on health care in 2009 - more than any other country - and yet the outcomes of our care weren’t as good as those in other countries, according to the Institute of Medicine (IOM), a branch of the National Academy of Sciences that provides nonpartisan advice on health issues.

    How to Afford Your Medications

    The high cost of medications for cardiovascular disease is one of the most common reasons patients give for not taking their medicine. But when you consider what is at stake—your health and possibly your life—you must find a way to afford them. Don’t wait to fill your prescriptions until you can afford them. You need them now. If you are already taking medication but are thinking about stopping, skipping, or dividing up your doses to make your medication more affordable, don’t do it until you talk with your doctor. Your doctor and others can help you get the medication you need.

    Important Health Insurance Terms to Know

    Insurance policies are legally binding documents, written to protect the rights of both you and the insurance provider. Unfortunately, the language they used to do that can also make policies and benefit information difficult to understand.

    Medicare and the Affordable Care Act

    Medicare provides health care for over 48 million Americans. So it’s not surprising that strengthening and improving that program is a major goal of healthcare reform in the Affordable Care Act (ACA) passed in March 2010. According to Kathleen Sebelius, then-Secretary of Health & Human Services, rather than change or diminish your current Medicare benefits, the ACA is designed to improve Medicare by introducing new benefits and savings with an emphasis on delivering quality care.

    Questions to Ask before Participating in a Clinical Trial

    Before choosing to participate in a clinical trial, it is often helpful to talk to a physician, family members, or friends. Here are some questions you may have about joining a clinical trial.

    SecondsCount Guide to the Affordable Care Act
    (ACA or “ObamaCare")

    If you are confused and overwhelmed by everything you’ve heard about healthcare reform and the Affordable Care Act (ACA or “Obamacare”) https://www.healthcare.gov/where-can-i-read-the-affordable-care-act/ and how it might affect you and your family, you are not alone. Good health care is critical to living a quality life and it doesn’t come cheap, so it’s not surprising that it inspires lively discussion and strong opinions.

    SecondsCount Healthcare Guide

    Managing your healthcare needs and those of your family can be a daunting task. It can require a good deal of time, money, and specialized knowledge, and it involves making decisions that can affect the quality and length of your life and of those you love. The SecondsCount Healthcare Guide is designed to make your job easier and give you the information and tools you need to protect your most valuable asset - your health.

    Tips on Getting the Most from Your Health Insurance

    These tips address common issues and concerns of people trying to understand and use their health insurance. By following these suggestions now you may save money and get more services from your plan.

    Your Guide to New Treatments and Technologies

    Now more than ever, people with cardiovascular disease can be assured there are effective medications, procedures, and other treatments available to treat their conditions. As knowledge of cardiovascular disease has expanded, so has the ability to treat the disease. Yet the medical community is always working toward new innovations to improve patient care, especially considering cardiovascular disease is the leading cause of death in the United States, with nearly 80 million Americans estimated to have a form of the disease.

    Your Rights and Protections Under the
    Affordable Care Act

    The Affordable Care Act (ACA) has provisions designed to protect you from abuses by insurance companies. The insurance industry was regulated by the government before the ACA, but the intent of the law is to take those protections even further by...