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Being a specialized caregiver, you do not have to go it alone.

 

Caring for a special needs child or an elderly adult can be met with fear and uncertainty. After all, when a diagnosis is made or the aging process leaves a parent in need of continual help, an uncharted territory lies ahead for the caregiver.

No person needs to take on the role alone. Resources exist to connect caregivers with a community of other caregivers and organizations that can provide both financial and emotional support.

In fact, make that step number one.

 

  • Find a support system, build your tribe. That can be neighbors, friends, people from your congregation etc. People that understand [to the best of their ability] the situation and may even be a similar one. Take to the internet and seek out local organizations that deal with the same specific issue, talk and share with others.

 

  • Knowledge is power. Ask questions, find out everything you can about the diagnosis. Do your research and stay up to date on the latest treatments etc. for the condition. Being armed with the latest information is empowering.

 

  • Take care of you! The stresses of caring for others nonstop can be overwhelming. Take a break from time to time, ask for help from a trusted family member or friend. Often people around us wish to help, they just need to be told how. Local care agencies are another great resource to explore if you need it.

 

 

Preventive Health Service

Understanding Preventive Health Services

Preventive Health Service

 

 

Did you know that many preventive health services are covered by most health insurance policies at no cost to you? Waiting until you need to go to the doctor due to illness should be a thing of the past, practicing a healthy lifestyle and visiting the doctor for routine, preventive services is the key to a longer, healthier life.

When you become ill, you have no choice but to pay attention to your health. But, with free preventive services, like immunizations and yearly exams, you can get ahead of something that may have become catastrophic otherwise. Insurance companies want you to stay healthy, and in doing so, it keeps the cost of healthcare down.

Insurance carriers do have some age restrictions on some services, but overall, these preventive services are covered:

*Adult services:

• Laboratory tests

• Contraception

• Procedures; i.e., Pap Test, Lung Cancer Screening (between ages 55 and 80), Screening Mammogram

• Immunizations

• Examinations and Counseling; i.e., Physical Exam

*Obstetrical services:

• Laboratory tests; i.e., Iron Deficiency Anemia Screening, Diabetes Screening

• Breast feeding supplies and support; i.e., Breast Pump

*Pediatric services:

• Examinations and Counseling; i.e., Well-child Visit

• Immunizations

• Laboratory tests; i.e., Newborn Metabolic Screening (younger than age 1),

It may be beneficial to think of utilizing preventive services as a personal investment in your health future. In additional to practicing healthy living habits, like exercising and eating a well balanced diet, getting to the doctor on a regular basis will pay large dividends in your overall health as you age.

 

 

Source: Select Health 

Recent Study Looks At Health Care Pricing

According to a recently published healthcare economics paper, different insurers pay varied prices for the same services and procedures at the same hospital, indicating that bargaining leverage really does impact healthcare prices.

 

Authors took actual data from claims for three national insurers. Studies showed that dominate hospitals can dictate how much they are going to get paid for specific services and procedures. For hospitals that hold an monopoly in their area, that number was 12.5% higher than those who had nearby competitors. For more concentrated markets, providers can shift more risk to insurers, which affects the ability to keep prices at a set standard.

 

“The two main types of contracts use prospectively set prices that pay a fixed dollar amount based on the DRG classification code, or a model that sets payments as a percentage of hospital charges.
Hospitals are likely to prefer the latter because they get paid for every service they provide, and thus bear less risk. This drives prices up and also places less pressure on the hospital to reduce costs.”

 

In simply terms, it’s about negotiation. The hospital may charge $50,000 for a hip replacement, but the negotiated price may be more like $22,000, Medicare reimbursements would be even less.

 

“Researchers also found that prices increased by more than 6% when merging hospitals were less than 5 miles apart. They didn’t find significant price impact when the hospitals were separated by at least 25 miles.”

 

 

 

 

Sources: The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured Zack Cooper (Yale University) Stuart V. Craig (University of Pennsylvania) Martin Gaynor (Carnegie Mellon University and NBER) John Van Reenen (Massachusetts Institute of Technology, CEP, and NBER)

Modernhealthcare.com

Health Care Cost Institute

 

 

Open Enrollment Begins November 1–Five Factors to Consider.

Did you know there are five factors that can affect how much your health plan’s monthly premium under the health care law? However, individual states can limit how much these factors come into play.

These five factors are:

  • Age: Premiums can be up to 3 times higher for older people than for younger people.
  • Location: Where you live has a big effect on your premiums. Differences in competition, state and local rules, and cost of living are the reasons why.
  • Tobacco use: Insurers can charge tobacco users up to 50% more than those who don’t use tobacco.
  • Individual vs. family enrollment: Insurers can charge more for a plan that also covers a spouse and/or dependents.
  • Plan category: Bronze, Silver, Gold, Platinum, and Catastrophic. The categories are based on how you and the plan share costs. Bronze plans usually have lower monthly premiums and higher out-of-pocket costs when you get care. Platinum plans usually have the highest premiums and lowest out-of-pocket costs.

In addition, insurance companies may offer more benefits, which could also affect costs. Furthermore, insurance companies can not charge women and men different prices for the same plan, nor can they take your current medical history or health into account when, otherwise known as pre-existing conditions.

Small business owners are voicing their opinions on the President’s ideas to repeal and replace the Affordable Care Act.

When 1,000 small business owners were recently survived, 53.1 percent are against the health care bill passed by the House, while only 13 percent support it.

An impartial position of 34 percent was reported while a large majority of 60.4 percent do not think the bill would have a negative effect on their small business. Almost all agreed at 92.5 percent that insurance companies should provide coverage to people with pre-existing conditions.

At 72 percent, most small business owners agreed that expanding access to health care is most important over reducing taxes and decreasing the federal debt.

 

Sources: BenefitsPro.com, Fit Small Business

Understanding Mini-Medical Plans

Many industries or small sized employer groups utilize a mini-medical plan, such as restaurants, hotels, maid services, catering services, etc. These limited benefit plans pay for covered services at an affordable premium for both the employees and the employers. But keep in mind, they cost less, so they cover less, and most likely will not protect you from a bankruptcy situation for any catastrophic medical care.

Mini-medical plans provide a basic level of coverage for people who do not have access to a major medical plan or traditional coverage.

Some large employers have a class of employees who are ineligible for their companies traditional health insurance plan for a variety of reasons. For instance, they may be only seasonal or part-time employees. Being able to offer them a mini-medical plan helps to boast employee moral and increases retention.

Mini-medical plans are not meant to replace major medical plans, but to fill a specific niche and provide some medical coverage for those who may not qualify otherwise.