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In our current health insurance environment, gap or voluntary insurance has become increasingly prevalent and popular and rightly so.  

Gap insurance can be defined as any policy designed to fill in the gaps that major medical does not cover, especially deductibles and coinsurance.  These policies are increasingly popular as companies continue to raise deductibles and decrease benefits on their group policies.  They are also an effective way to enhance benefits of individual policies while keeping premiums reasonable

The most popular gap and voluntary policies are mainly for accident, critical illness, and disability.  Accident policies are especially popular for people that are highly involved in sports and recreation or families with small children.  Many of these policies cover all costs for anything accident or injury related with a $100 or $0 deductible!  Critical illness is also popular because it can provide a lump sum benefit of up to $100,000 upon first diagnosis of a critical illness.  This will not only pay all expenses that the health plan will not cover, but also provides additional funds to cover for other non-medical expenses such as lost work time, etc.  The need for this is illustrated by the fact that a large percentage of medical bankruptcies throughout the country are filed by people that had major medical health insurance!


 
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Most people don't realize that there are ways out there to save you money on your prescriptions without having to pay a ton for coverage. Here are 5 Ways in which you can save money.




1. Ask about Generic options

In most cases there is a Generic medication to go with the Name brand. This can save you lots on your prescriptions. Over 80% of drugs have cheaper Generic form.  If it is a new drug you may have to wait at least 6 months for a Generic to come out, But do ask after you have been on it for awhile.

2. Look into Splitting Higher-Dose Pills

Pill splitting is based on the fact that many pills cost about the same even if they contain twice as much medication. Make sure to ask your physician if it is safe to split your medication and save.

3. Talk Openly with your Physician

Your Physician doesn't always know the costs and/or your healthcare plan. Make sure that you share the costs (if you know them...) and your healthcare plan with him/her so they can help prescribe which prescription is going to be best for you and your wallet.

4. Shop Around

Pharmacies don't all charge the same for prescriptions. Ask a few pharmacies and talk to your local one about  the best price that you have found. Negotiate your price. Pharmacies want your business and want to keep you as a patient.

5. Look into Assistance Programs

Many if not all pharmaceutical companies provide their drugs at discounted prices and sometimes free. Check their websites or contact them directly.  We have included one to help!  It is Prescriptions United.  Use the code on the flier below and receive 10% off your already discounted order!!!  (30-60%)

Discount Code: PPU-1048-1000

I know that we all want and need to save money where we can. I hope that this helps us all out.

Prescriptions United
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Many of Today's Health Insurance Policies contain deductibles, and it is likely that the trend towards higher deductibles will continue. So how do you know what is the right deductible for you?

The Basics

Health insurance policies with deductibles require the customer to pay the entire cost of treatment up to a specific dollar amount before the carrier will begin contributing.

Why?

By requiring customers to pay for the first portion of their treatment costs, the likelihood of unnecessary procedures will be reduced, and the cost of care for each individual customer will be lower. The result is a reduction in premiums for customers and lower claims payments for carriers.

Choosing a Deductible

Larger deductibles mean smaller monthly premium payments for Health insurance coverage. It is essential to prevent financial difficulty in the future you must pick a plan that fits in your budget. If you are looking into a plan with a high deductible be aware that your out of pocket cost in an emergency may be higher. Plan and save for such Emergencies. If you are still wary of which plan will best fit for you make sure to contact Marc and Ed. (855-876-5252)


 
I have worked with hundreds of people in assisting them in choosing health insurance benefits.  Here are some of the most common mistakes and misconceptions that I have witnessed:

1-Many simply choose the plan with the highest deductible because of the lower premium because of a tight budget.  Don't get me wrong.  I am a big fan of high deductible plans.  However, in most cases they should be coupled with supplemental benefits such as accident, hospital, and critical illness insurance to curb the costs that would be incurred in any of these situations.  Remember that most medical bankruptcies happen to people WITH major medical health insurance.  Just ask yourself if you could easily handle the costs if something happened and you had to pay out your deductible and coinsurance.  How would it affect your family?  You may be surprised how inexpensive it can be to couple a high deductible plan with supplemental benefits as opposed to purchasing a lower deductible plan.  The other great thing is that most supplemental plans begin covering with DOLLAR ONE with NO deductible!

2-Another common misconception, and this goes right along with the first one, is that it is easier and better to buy all of your coverage from one company.  For example, some companies I work with offer health insurance with supplemental riders such as accident, dental, disability, and life insurance.  However, my clients can get much better coverage by purchasing those policies from other companies that SPECIALIZE in that type of coverage!  They get much better value for their dollar by having a few separate policies for each type of coverage and the total premium is usually about the same.  In many cases I have been able to lower client's premiums and cut their out-of-pocket risk in half at the same time!

For a free consultation on how to customize a policy specifically for you and your family's needs, please contact us at info@prospersbs.com.

 
Here’s a bold prediction for the new year. By 2020, the American health insurance industry will be extinct. Insurance companies will be replaced by accountable care organizations — groups of doctors, hospitals and other health care providers who come together to provide the full range of medical care for patients.

Already, most insurance companies barely function as insurers. Most non-elderly Americans — or 60 percent of Americans with employer-provided health insurance — work for companies that are self-insured. In these cases it is the employer, not the insurance company, that assumes most of the risk of paying for the medical care of employees and their families. All that insurance companies do is process billing claims.

For individuals and small businesses, health insurance companies usually do provide insurance; they take a premium and assume financial responsibility for paying the bills. But the amount of risk sharing that is accomplished is limited because the insurers charge premiums that vary, depending on the health of an individual or a group of employees, and use their data and market power to identify healthy people to cover and unhealthy people to exclude from coverage. (The health care law’s total ban on exclusions for pre-existing conditions will begin in 2014.)
Many health insurance companies also impose barriers — like requiring prior authorization for tests and treatments and denying payment for covered services, which forces patients to appeal — to discourage patients from using the medical services for which they are insured and to attempt to avoid paying for those services. While these barriers can reduce waste by preventing unnecessary care, they can also discourage patients from receiving care they need, as well as impose administrative burdens on doctors and patients.

But thanks to the accountable care organizations provided for by the health care reform act, a new system is on its way, one that will make insurance companies unnecessary. Accountable care organizations will increase coordination of patient’s care and shift the focus of medicine away from treating sickness and toward keeping people healthy.

Because most physicians and hospitals today are paid on a fee-for-service basis, medical care is organized around treating a specific episode of illness rather than the whole patient. This system encourages overtreatment and leads to mistakes and miscommunication when patients are sent between their primary care doctors, specialists and hospitals. Indeed, under today’s payment system, investments in providing better care are doubly penalized. If a hospital hires a nurse to follow up with patients after they are discharged in order to reduce readmissions — for example, to help patients with diabetes improve blood sugar control — it must pay for the nurse, which is typically not reimbursed by insurance companies or Medicare, and it loses revenue by preventing the readmission.

In contrast, accountable care organizations will typically be paid a fixed amount per patient, along with bonuses for achieving quality targets. The organizations will make money by keeping their patients healthy and out of the hospital and by avoiding unnecessary tests, drugs and procedures. Thus, they will actually have a financial incentive to hire that nurse for follow-ups.

In addition to providing better and more efficient care, A.C.O.’s will also make health insurers superfluous. Because they will each be responsible for a large group of patients (typically more than 15,000), they will pool the risk of patients who have higher-than-average costs with those with lower costs. And with the end of fee-for-service payments, insurance companies will no longer be needed to handle complicated billing and claims processing, nor will they need to be paid a fee for doing so. Payments can flow directly from an employer, Medicare or Medicaid to the accountable care organizations. A.C.O.’s will require enhanced information systems to track patients and figure out how to deliver more effective care, but this analytic capacity will be directed at improving health outcomes, not at imposing barriers to those seeking treatment.

A.C.O.’s are not simply a return to the health maintenance organizations of the 1990s. Although in both models patients are members of a provider network with a specific group of doctors and hospitals, and both are paid primarily per member rather than per procedure or test, there are big differences between them. H.M.O.’s were often large national corporations far removed from their members. In contrast, A.C.O.’s will consist of local health care providers working as a team to take care of patients who are likely to be members for years at a time. H.M.O.’s often cut costs not by keeping people healthy but by denying patients services and by forcing doctors and hospitals to take lower payments. In the 1990s, we lacked the information technology and proven models of integrated care delivery that we have now. These advances will allow A.C.O.’s to simultaneously improve health outcomes and reduce costs.

A final bonus of A.C.O.’s is that they will lead to a better form of competition in health care markets. Today, consumers have to choose among insurance plans with a bewildering array of copayments, deductibles and annual out of pocket maximums — choices that few of us are any good at making. In the A.C.O. model, consumers will choose a primary care physician and the team of doctors and hospitals that are in the same group. Choosing a doctor and provider group is a responsibility that consumers want to have and are likely to be much better at.

A few health insurers see this asteroid coming. Wellpoint, for example, bought the clinic operator CareMore for $800 million last summer to make the transition into the A.C.O. business. Others, like the Optum unit of UnitedHealth Group, are developing data analysis services to provide to future A.C.O.’s. If they don’t want to go the way of the dinosaurs, insurance companies will have to find a new business to be in, one that is useful in the new world of coordinated care.

By EZEKIEL J. EMANUEL and JEFFREY B. LIEBMAN 
http://opinionator.blogs.nytimes.com/2012/01/30/the-end-of-health-insurance-companies/