Alexa Kasdan had a cold and a sore throat.

The 40-year-old public policy consultant from Brooklyn, N.Y., didn't want her upcoming vacation trip ruined by strep throat. So after it had lingered for more than a week, she decided to get it checked out.

Kasdan visited her primary care physician, Roya Fathollahi, at Manhattan Specialty Care, just off Park Avenue South and not far from tony Gramercy Park.

The visit was quick. Kasdan got her throat swabbed, gave a tube of blood and was sent out the door with a prescription for antibiotics.

She soon felt better, and the trip went off without a hitch.

Then the bill came.

Patient: Alexa Kasdan, 40, a public policy consultant in New York City, insured by Blue Cross and Blue Shield of Minnesota through her partner's employer.

Total bill: $28,395.50 for an out-of-network throat swab. Her insurer cut a check for $25,865.24.

Read more at NPR....

One concern raised by critics of a government-run, single-payer healthcare system like Medicare for All is that the government will start rationing health care to keep costs down.

But some healthcare industry players are already trying to ration health care by using the QALY system.

Quality-adjusted life years, or QALYs, were “originally developed as a measure of health effectiveness for cost-effectiveness analysis, a method intended to aid decision-makers charged with allocating scarce resources across competing health-care programs,” according to the medical journal Value in Health. They are used by firms like the U.K.’s National Institute for Health and Care Excellence (NICE) and the U.S.’s Institute for Clinical and Economic Review (ICER) to guide drug price decision-making.
Sometimes NICE and ICER use QALY analysis to pressure drug companies to lower their prices. However, they also are used to prevent drugs from going to market or discourage health insurance companies from covering costly drugs, which can prevent patients from receiving life-saving or life-improving treatments.

Here’s how QALYs work: if a person suffering from depression or multiple sclerosis has a QALY value of 0.5, that means they have 50 percent of the value of one year of life of a healthy person. The underlying principle is to mathematically quantify the quality of life for people with certain health conditions.
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If, say, the price for an antidepressant is too high relative to how much it would improve the quality of life of a depressed individual — who already has a shorter life expectancy than an average healthy person — then a firm like ICER will recommend that antidepressant not go to market.

Read more at Inside Sources....

On the last Tuesday of July, Tres Biggs stepped into the courthouse in Coffeyville, Kansas, for medical debt collection day, a monthly ritual in this quiet city of 9,000, just over the Oklahoma border. He was one of 90 people who had been summoned, sued by the local hospital, or doctors, or an ambulance service over unpaid bills. Some wore eye patches and bandages; others limped to their seats by the wood-paneled walls. Biggs, who is 41, had to take a day off from work to be there. He knew from experience that if he didn’t show up, he could be put in jail.

Before the morning’s hearing, he listened as defendants traded stories. One woman recalled how, at four months pregnant, she had reported a money order scam to her local sheriff’s office only to discover that she had a warrant; she was arrested on the spot. A radiologist had sued her over a $230 bill, and she’d missed one hearing too many. Another woman said she watched, a decade ago, as a deputy came to the door for her diabetic aunt and took her to jail in her final years of life. Now here she was, dealing with her own debt, trying to head off the same fate.
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Biggs, who is tall and broad-shouldered, with sun-scorched skin and bright hazel eyes, looked up as defendants talked, but he was embarrassed to say much. His court dates had begun after his son developed lymphoma, and they’d picked up when his wife started having seizures. He, too, had been arrested because of medical debt. It had happened more than once.

Read more at ProPublica....

UnitedHealth Group said it will expand its Medicare Advantage health plan offerings to seniors in 100 new counties next year in what has become the most competitive business for health insurance giants.

UnitedHealth said its UnitedHealthcare insurance business will “offer more than 100 new plans as it expands its offerings to reach an additional 1.2 million people in 100
new counties.” The insurer currently sells individual Medicare Advantage plans in more than 1,700 counties but that will grow to more than 1,800, the insurer said.

“In 2020, 90% of people eligible for Medicare will have a choice of UnitedHealthcare Medicare Advantage plans, nationwide,” the company, which is the nation’s largest health insurer, disclosed in an announcement Tuesday morning.
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Read more at Forbes....

Medicare's Open Enrollment Period (OEP) is almost upon us. October 15 until December 7 is that time of year when those already on Medicare can change to, or change between, Medicare Advantage plans.
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Those who are turning 65 can choose to join a Medicare Advantage plan during the three months before their birth month, the month of their birthday, and for three months past their birth month. This is called the Initial Coverage Election Period (ICEP). If you miss this time frame, you cannot join an MA plan until the next OEP.

Questions? Call or message me at 678-654-9500.

Medicare covers the majority of older Americans’ health needs -- from hospital care to doctor visits to lab tests and prescription drugs. Here are some needs that aren't a part of the program — and how you might pay for them.    

Opticians and eye exams
While Original Medicare does cover ophthalmological expenses such as cataract surgery, it doesn’t cover routine eye exams, glasses or contact lenses. Nor do any Medigap plans, the supplemental insurance that is available from private insurers to augment Medicare coverage. Some Medicare Advantage plans cover routine vision care and glasses.

Solution: For some people, it makes sense to buy a vision insurance policy for a few hundred dollars a year to defray the costs of glasses or contact lenses.

Hearing aids
Medicare covers ear-related medical conditions, but Original Medicare and Medigap plans don’t pay for routine hearing tests or aids. 

Solution: If you are in a Medicare Advantage plan, check your policy to see if it covers hearing-related needs. If it doesn’t, or if you have Original Medicare, consider buying insurance or a membership in a discount plan that helps cover the cost of such devices. Also, some programs help people with lower incomes get needed hearing support. Or you can pay as you go. Congress has passed legislation allowing some hearing aids to be sold without a prescription. The devices could be available in a few years. 

Dental workOriginal Medicare and Medigap policies do not cover dental care such as routine checkups or big-ticket items, including dentures and root canals.
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Solution: Some Medicare Advantage plans offer dental coverage. If yours does not, or if you opt for Original Medicare, consider buying an individual dental insurance plan or a dental discount plan.

Read more at AARP....

Every year, millions of American consumers — nearly 7% of the population — are victims of scams and fraud. In 2017, the number of fraud victims in the US reached 16.7 million, with $16.8 billion lost.
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For more than 45 years, I’ve worked with, advised and consulted with the FBI and hundreds of financial institutions, corporations and government agencies around the world to help them in their fight against fraud.

But my expertise began more than 50 years ago, in an unusual way: I was one of the world’s most famous con artists. While I’m ashamed of what I did as a young man — cheating, stealing and, along the way, deceiving and hurting people — I was grateful for the opportunity to turn myself around.

My story, which is depicted in my 1980 memoir, “Catch Me If You Can,” gave me a wider audience to talk about fraud prevention.

Protect your identity

Identity theft is the deliberate use of someone else’s identity (e.g., name, address, Social Security number, bank accounts) to get money and credit, obtain employment, steal property, falsify educational and other credentials, access healthcare and more.

Continue reading at CNBC....

"I don’t need to worry about drug prices. I have insurance!”
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At GoodRx, we hear people say this all the time. After all, isn’t that what health insurance is for? You pay your premium and then insurance pays for your medical bills. Right?

If you use GoodRx, you probably already know that prescription drug insurance isn’t what it used to be. Not long ago, most Americans had generous prescription benefits as part of their insurance. You probably remember $10 copays and never being shocked at the pharmacy counter.

So, what’s changed? In general, health insurance is simply paying for less than it used to. The cost of healthcare has gone up, payors (whether the insurance company, your employer, or even the government) need to control their costs and they shuffle that cost to you, the patient, in different ways. As a consumer, you need to watch out for these “features” of your insurance policy, all of which could cost you at the pharmacy counter:
​

• Deductibles. Most plans these days have deductibles, where you’re responsible for your own costs up to a certain limit. In fact, deductibles are increasing faster than wages in the US. Some common plans now have up to a $5,000 deductible! Many Americans now have high-deductible health plans (HDHPs), which means we’re on the hook for most of our healthcare costs throughout the year.
• Formularies. Formularies are the list of drugs that insurers cover—and they’re shrinking. Fewer drugs are being covered and more drugs are being excluded. If your drug is not on the list, you might be hit with the full cash price of the drug unless you find other ways to save.
• Tiers. Formularies often price drugs by tier; each tier indicates how much you’ll pay for a covered drug. Recently, more and more tiers have been added to increase your copay. A Tier 1 drug might be a $10 co-pay, a Tier 2 might be $30, etc. There are now some plans that have up to six tiers.
• Copay vs. co-insurance. Sound confusing? It’s not. A copay is a set amount your insurance requires you to pay for a drug, regardless of its retail price. Co-insurance means you’re responsible for a percentage of the drug’s full price. More and more, plans are moving to co-insurance, which could mean significant increases for you.
• Prior authorization. Just because a drug is on formulary doesn’t mean your prescription is covered. Even when a drug is on formulary, some insurers require patients to also get approval for the drug before they’re allowed to fill their prescription. It often means getting a doctor to send in a prior authorization form—and there’s no guarantee they will approve it.
• Step therapy. To contain costs, insurers prefer that you use cheaper drugs before trying more expensive ones—and they often insist on it with step therapy. If a drug you prefer requires step therapy, you have to try another (typically cheaper) drug first and provide evidence that it didn’t work before your insurer will approve your preferred (typically more expensive) drug.
• Quantity limits: To ensure patient safety and keep costs low, most insurers will limit the amount of certain drugs you can purchase in a given time period. Quantity limits may be day-to-day, week-to-week or month-to-month and will differ between drugs. Drugs typically under quantity limit restrictions are those that are intended for short-term use, have serious side effects when overused or have high potential for abuse.

​Continue reading at GoodRx.com....

Medicare Part D is the federal government health insurance plan that covers prescription medications. Maybe you just enrolled, or you’ve been on a plan for a while and were recently prescribed an expensive brand name drug. Whatever the case, you might be surprised by your out-of-pocket costs. Even with Medicare, medication expenses can pile up, costing some patients several thousand dollars a year. 

Unfortunately, drug manufacturer discounts and copay coupons can’t help since they’re not available to people who have health coverage through the government. But there are still many resources available if you’re looking to save on your medications.

State resources

Depending on where you live, your state may offer programs to help. A good place to start is your local Department of Aging. This office of the United States Department of Health & Human Services can help you find the best Medicare plan for the coverage you need.
Some states even have their own cost-savings programs for older adults. For example, Pennsylvania runs PACE and PACENET. These programs offer low-cost prescription medications if you meet certain qualifications.

Read more at GoodRx.com...

Don't rely on the "kindness of strangers" as a substitute for life and health insurance.

Rising support for socialism in the United States comes at a time when politicians like Sen. Bernie Sanders, I-Vt., promise a great many “free” services, to be provided or guaranteed by the government.

Supporters often point to nations with large social programs, such as Canada, the United Kingdom, and the Scandinavian states, particularly when it comes to health care.

Never mind that these are not true socialist countries, but highly taxed market economies with large welfare states. That aside, they do offer a government-guaranteed health service that many in America wish to emulate.

The problem for their argument is that, despite these extremely generous programs, some of these countries are seeing steady a growth of private health insurance.

“Medicare for All,” the prominent socialized medicine proposal in the United States, is most similar to the Canadian system in which providers bill the regional office administering the program.
In Medicare for All, there would be no cost-sharing schemes and all coverage would be comprehensive, including prescription drugs, dental, vision, and other services deemed necessary by the secretary of health and human services.

Tens of thousands of consumers still making monthly payments for "practically worthless" health insurance plans purchased from a shuttered Hollywood-based agency will be allowed to cancel those plans, a federal judge has ordered.

Thursday's ruling by U.S. District Judge Darrin P. Gayles marks the latest courtroom defeat in Steven J. Dorfman's fight to prevent the Federal Trade Commission from permanently closing his company, Simple Health Plans LLC, and distributing its remaining assets to victims of what the FTC calls a sophisticated scam.

Dorfman's customers will be contacted within days by the distributor of their plans, Health Insurance Innovations, and given the option to cancel and cease incurring monthly charges. They will not be given refunds for payments made prior to Thursday's ruling.

Simple Health Plans and numerous affiliated companies have been shut down since Oct. 31, when the FTC secured a temporary restraining order and froze its assets.

The FTC is accusing Dorfman of masterminding a scheme to fool uninsured consumers into thinking they were buying comprehensive health insurance that covered preexisting conditions and complied with the Affordable Care Act.

Keep reading at Insurance News Net....

President Trump’s attempt to transform American health insurance is almost complete.Twenty months ago, frustrated after attempts to repeal Obamacare fell apart in the Republican-controlled Senate, Trump pledged to use executive power to do what Congress failed to legislate. An executive order set in motion regulations to promote “health care choice and competition across the United States.”

On Thursday, the administration finished the last of three rules to do just that — advancing conservative policies without undoing the central framework established by the ACA.

Together, the changes have loosened Obama-era restrictions on short-term health plans that don’t meet the Affordable Care Act’s standards. They’ve permitted small employers to join together to buy lightly regulated coverage called association health plans. And the rule published this week gives employers, particularly small businesses, more flexibility to steer tax-exempt dollars to employees for health care.

The administrative actions are far short of repealing or replacing the Affordable Care Act, the law that expanded coverage to about 20 million people. Many of the ACA’s elements remain largely intact, including billions of dollars in subsidies, strict standards for insurance plan design, and rules that protect people with pre-existing medical conditions.

Continue reading at The Trib....

Health plans that require consumers to spend thousands of dollars before insurance kicks in are more common than ever before.

About 40 percent of Americans have health plans with $1,200 or more in deductibles.

The plans are meant to push consumers to make smarter health care choices, but a new study from USC has found they put some people at greater financial risk. 

The research, in the April edition of the American Journal of Managed Care, shows people with chronic health conditions, and those with lower incomes, are the most likely to be impacted by a high medical bill stemming from the deductible.

"When they face this bill, it has a serious consequence for them. Not every family can absorb a $2,000 bill without changing their lifestyle," said Neeraj Sood, Director of Research at the USC Schaeffer Center for Health Policy & Economics.

"The most vulnerable populations are the ones who are going to face the highest risk."
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To see how a high deductible plan might affect you, here's a breakdown of how they work - and what to look out for:

WHAT DOES HIGH DEDUCTIBLE MEAN, EXACTLY?

The premium is your monthly payment that keeps your name on the health insurance rolls. The deductible is the amount you have to pay before the health insurance kicks in. It could be anywhere from $1200 to $2000 or $3000 -- even up to $10,000.

Keep reading at 89.3 KPCC....

A top executive at the trade group representing health insurers on Monday warned of premium increases for ObamaCare plans next year, saying the situation is “not a pretty picture right now.”
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Matt Eyles, senior executive vice president of America’s Health Insurance Plans (AHIP), said that insurers “want to make sure people have access to coverage at the most affordable price, but that also has to reflect what the reality is right now and it’s not a pretty picture right now.”

Eyles, who will become CEO of AHIP on June 1, blamed several policies advanced by Republicans in Congress or the administration for the problems.Speaking at an event hosted by The Atlantic, he noted the repeal of the individual mandate in the tax bill in December, which is expected to lead to less healthy people signing up, as well as initiatives from the Trump administration to expand access to cheaper, skimpier plans known as short-term plans, which have also raised fears of siphoning away healthy people and causing an increase in premiums.

Continue reading at The Hill....

Between a third and a half of people age 45 to 59 and a quarter of those 60+ went without needed health care in the past year due to its cost, according to a troubling new survey from the West Health Institute and NORC at the University of Chicago.

“We were surprised by the magnitude of the findings,” said Dr. Zia Agha, chief medical officer at the West Health Institute, a nonprofit applied medical research organization based in San Diego. “And 80% of the people we surveyed had health insurance, so just having insurance does not make you immune to health care costs.”

The researchers at West Health Institute and NORC at the University of Chicago (a nonpartisan research institution) interviewed 1,302 adults. Their findings were released at the American Society on Aging’s 2018 Aging in America conference in San Francisco.

​Age 45 to 59 skipping health care

Specifically, the survey found these results for people age 45 to 59 (members of Generation X and boomers) as a result of health care costs:

• 49% didn’t go to the doctor last year when they were sick or injured
• 45% skipped a recommended medical test or treatment
• 43% didn’t go to a dentist when they needed treatment
• 40% went without a routine physical or other preventive health care
• 30% didn’t fill a prescription or took less than the prescribed dose of medicine

Age 60+ skipping health care

​The percentages were less dramatic for people 60 + (boomers aged 60 to 72 and Americans older than 72) — perhaps partly because those 65 and older have Medicare. But they are still concerning:

• 30% didn’t go to a dentist last year when they needed treatment
• 27% went without a routine physical or other preventive health care
• 25% didn’t fill a prescription or took less than the prescribed dose of medicine
• 25% skipped a recommended medical test or treatment
• 24% didn’t go to the doctor when they were sick or injured

Younger Americans were even more likely to go without health care due to costs last year, the survey found.

Continue reading at MarketWatch....

Under Armour, Inc. (NYSE: UA, UAA) today announced that it is notifying users of MyFitnessPal -- the company's food and nutrition application and website -- about a data security issue. On March 25, the MyFitnessPal team became aware that an unauthorized party acquired data associated with MyFitnessPal user accounts in late February 2018. The company quickly took steps to determine the nature and scope of the issue and to alert the MyFitnessPal community of the incident.

Read the press release here....

Health insurance – here's the big picture in 131 words.

If you're not covered by health insurance through your employer or your spouse's employer, then you really care about just one thing, and that's being able to get good health insurance coverage without spending an arm and a leg and without having an astronomically high deductible, so high that basically, you can't even afford to use your insurance.

If you need in your mind an example, consider the average Obamacare health policy. The monthly premium for a family of four – mom, dad, and two kids – is over $1,400.00 a month, with a deductible for the first two people who become sick or injured of around $6,800.00 each. That's basically a yearly cost of 12 x $1,400.00 = $16,800.00 PLUS the deductible of $6,800.00 for a total of $23,600.00 a year BEFORE you can actually use your insurance – and that's if your doctor will accept it.

This article is dedicated to those of us who want and need truly affordable health insurance that we can actually use.

So I’ll ask you something. Have you used Obamacare health insurance? If so then, you’re the last of your kind. Fewer than 10 million Americans even have it. Doctors don't want to accept it, and many insurance companies don't even want to sell it; they've left the Marketplace in droves over the past few years.

Even at the high prices they're charging, they aren't making a profit, because Obamacare changed the game. Most of those 10 million Americans who DO have Obamacare aren't paying for it themselves – taxpayers are footing the bill. And most of those 10 million Americans who do have Obamacare are already sick, running up medical bills. That's hardly a sustainable business plan for insurers, many of whom have simply gotten out of the health insurance business rather than continuing to bleed money.

Rather than sell on the Obamacare Marketplace, many insurance companies have decided to focus their efforts in other areas, like life insurance, disability insurance, and annuities, basically abandoning the individual health insurance market and those of us who need good, affordable health insurance. There was a time not so long ago when there were dozens – maybe hundreds – of companies selling traditional health insurance. Not any longer – the government took over traditional health insurance business. And killed it.

If you walk into an insurance agent's office today, you will find a ton of brochures offering life insurance policies, auto policies, homeowners policies, disability polices. What you won't find very often are health insurance policies. I often drop by the offices of other agents – and find that most of them are either uninsured themselves, or that they are covered under a spouse's employer's group policy. I've found a few agents covered under an Obamacare policy, but they hate it – and before I leave their office, they've learned about my solution and not only do they switch their own coverage, but sign up to sell our plan, too.

Our solution is modern health insurance – a low-cost plan with a zero deductible that you can use at every medical office and every hospital in the country. It's called the Expected Benefits Plan. We call it that because you know what to expect. You know that you can afford it. You know how much will be paid for a particular event or procedure or doctor visit or medication. You know that it will be accepted by any doctor or hospital. You know that you can concentrate on healing and recovering from your accident or illness instead of stressing over medical bills.

Look. For people who are uninsured and for people who make too much money for Obamacare subsidies and for people who just want affordable, usable health insurance, our Expected Benefits Plan is exactly what you've been searching for.

Expected Benefits is a new kind of health insurance. It's what other companies may soon be offering – but we have led the way. It will save you money, it will reduce or eliminate your medical bills, and it will give you peace of mind.

Unlike traditional health insurance, it is easy on your budget, it eliminates deductibles, and it is accepted everywhere. It pays for or helps pay for doctor and dentist visits, lab work, prescriptions, surgeries, broken arms, broken legs, physicals, mammograms, and pretty much whatever else is medically necessary, It lets you talk with a doctor on the phone through the Teladoc service, at no additional cost. If you are diagnosed with a critical illness – heart attack, internal cancer, stroke, kidney failure, major organ transplant – you'll find a $50,000 check in your mailbox to help you while you're recovering. If you're advised to have a surgery, we'll even find the best doctor and the best price and schedule it for you.

And once accepted, you can keep the Expected Benefits coverage until you're age 65, no matter what may happen to your health status.

Let me tell you a little bit about our team. I'm David Ross. I'm a licensed life and health agent based in Atlanta. Our Expected Benefits Plan is currently available in 22 states, and we expect to be adding four more to that list soon. We have dozens of people at our agency in Nashville backing me up, and over 200 people working for you and me at the home office of New Era / Philadelphia American in Houston, the 100-plus year old insurance company behind our Expected Benefits Plan.

And then there are the people who will be working directly for you, as an Expected Benefits policy owner. You'll have the team at LabCorp, providing you with discounts of up to 80% on your medical labwork. You'll have the entire team at Teladoc, a full staff of licensed medical doctors to take your calls 24/7/365 to discuss any minor health issue you may have, who will call in prescriptions for you if necessary. And you'll have over 900,000 medical doctors and medical facilities and over 4,500 hospitals across the country available to take care of you if you are sick or injured.

Right now, if history holds true, someone reading this is pulling their hair out trying to figure out the health insurance maze, and wondering if they can afford quality health insurance. We have figured out the maze for you. And yes, you can afford our quality health insurance.

Let's pause for a minute. We're pretty choosy about who we cover. Unlike Obamacare, which is required to accept everyone, we don't accept people who already have a serious illness. That's how we keep our premiums so low. However, once you're accepted, you're covered until you're age 65 and you're eligible for Medicare – no matter what happens to your health.

Why don’t you tell me about your health insurance needs? Just a few simple questions about your age, who in your family you want to cover, whether you use tobacco, and your zip code – and I can show you how inexpensive your premium will be. You'll be pleasantly surprised at how little our Plan costs compared to a non-subsidized Obamacare policy or to your current group health policy.

Call or email me for your quote. If you like what you hear – and you will – I'll ask you a few questions about your health, and if you qualify, we'll have you and your family covered with awesome, amazing, and affordable health insurance in just a few days.


David Ross
678-654-9500
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Healthcare matters can involve a whole host of medical and legal complications. At best, these issues may affect you financially; at worst, they could mean the difference between life and death. Whether you go to the hospital for a routine procedure or an emergency, there are steps you can take to help avoid complications. 

1. Have an up-to-date Medical Power of Attorney or Advanced Medical Directive (“Living Will”). In the event you cannot make medical decisions yourself, these documents entrust decisions about your care to a person you designate. Advise your family of your designation so that person is notified when decisions must be made.

2. Make sure your name, identifying information and all other information is completely accurate at each doctor’s appointment, outpatient surgery and hospitalization. Serious problems involving medical care sometimes begin as simple clerical errors. A small error can create a major treatment crisis. Reduce the chance of error by carefully reviewing all your doctor’s office or hospital admissions paperwork. During hospitalization check your hospital wristband for errors. 

Continue reading at LegalShield.com....

By David Ross

You may think health insurance is too expensive for you.

And it is true that health insurance policies offered in the Obamacare Marketplace ("Affordable Care Act" policies) are astronomically expensive, have ridiculously high deductibles, and are only available from a dwindling number of companies. This recent article reports rates for ACA coverage are expected to jump another 90% in the near future.

What the mainstream news doesn't tell you is this: LOW-COST HEALTH INSURANCE IS AVAILABLE!

You cannot afford to NOT have health insurance.

Just because you consider yourself “healthy” doesn't mean you can afford to go uninsured.

I recall a man who told me just that a few years ago. He was hesitant to buy insurance, being a 40-something who never went to the doctor. He finally decided to get coverage for himself and his new wife, mostly out of concern over the then-existent tax penalty for not having coverage.

He went the next year-and-a-half paying his premiums, but never even going to the doctor.

And then – he was shot. A totally random event put him in the hospital with serious injuries and serious medical bills.

Another client, a sixty-year old man, the owner of an auto body shop, didn't have coverage when I met him. His reason for not having health insurance? He said his insurance had gotten too expensive so he had dropped it for himself and his employees. When I told him about our low-cost policy, he jumped at the chance to sign up.

Seven months later he had a heart attack, and almost immediately had over $75,000 in medical expenses. His new insurance plan, the new one I helped him get, covered his expenses, and all he had to worry about was getting well.

Not all stories end as well.

Recently a friend on Facebook posted a link to a GoFundMe page, asking for donations to help pay medical bills for her uninsured daughter-in-law who had been severely injured in an automobie accident. The post said the hospital had dismissed her after only four days because she didn't have insurance, though she still needs additional care and therapy. Why didn't a young mother have health insurance? Did she think she couldn't afford to be covered, or did she think she would never need health insurance?

She could have had a great health insurance plan for about $120 a month.

The man who got shot had coverage – including dental insurance plus an extra critical illness rider that would pay him $50,000 should he be diagnosed with a critical illness – for about $220 a month. That includes both him and his wife.

The 60-year old's coverage cost him about $400 a month, and saved him over $75,000.

These are incredibly low rates, and are certainly affordable for most people. Of course, no one likes paying for something they aren't “using.” Heck, I don't like paying for things I do use, like cell phone service and gasoline.

But like cell phones and gasoline, in today's world, health insurance is a necessity.


For details about our Expected Benefits health insurance plan, visit our site.

by Dr. Sharon Orrange 

After practicing medicine for 20 years, I’ve become adept at “clarifying” to insurance companies why patients are taking certain medications. The same medications appear to trigger red flags for both long-term care and life insurance companies.   
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Their “concern” makes sense for some medications because they are used for serious chronic illnesses, but for others, the insurance companies are worried about your lifestyle. Most on this list are important medications so do not stop taking them because you’re concerned about rejection and do not omit them from your forms. Instead, along with your physician, you can clarify and appeal their decision.   

Here are the ten worst medications to be taking that will trigger a “no” or a further review if applying for life insurance or long-term care insurance.

1. Namenda (memantine) or Aricept (donepezil). One of the more obvious red flags, dementia is expensive for Long-term care insurance plans because folks with dementia are often physically healthy and their care is expensive. Pro tip: be careful here because Namenda is also prescribed for migraine prevention and may trigger an unnecessary alarm.
2. Hydrocodone, oxycodone, morphine aka “Opioids.” Long-term use of pain medication raises red flags for insurance companies and almost always results in a closer review. Why? Because costs associated with chronic pain patients taking opioids are substantial and range from 560 to 635 billion per year in the U.S. in 2010. Insurance companies run for the hills because of that.
3. Xanax (alprazolam), Ativan (lorazepam) and Valium (diazepam) are benzodiazepines that will lead to a closer review of your application. Why? Several studies have shown an association between benzodiazepines and risk of death.  In folks 65 years or older benzodiazepines increase the risk of falls and fracture-related mortality. Some studies have found a threefold or higher increase in the risk of all-cause mortality among adult populations using benzodiazepines even for durations shorter than one month.