Private Health Insurance in 2015- What to Expect and How to Position Yourself NOW!

Many sources including Kiplinger News is predicting some hefty increases in 2015 for private insurance.  It's expected to see rates rise between 7 to 12%. 

If you are employed; you too will face increases and with more employers expected to redesign plans and shift more of the cost of the premium to employees.  You can also expect to see higher co pays, deductibles and caps for out of pocket maximums.  

Under the ACA (Obamacare) rules in 2015 the maximum out of pocket for individuals can be $6,600 and $13,200 for a family.  

Other things to expect include smaller provider networks, less hospital choice and more managed care of chronic diseases such as diabetes, asthma and heart disease.  

Expect more programs geared to reduce smoking, weight reduction and providing a reward for compliance with a program.  

All of this is not new news; the cost of healthcare is increasing even more due to the administrative burden of healthcare reform; so now more than ever it is prudent to review your current lifestyle and implement your own changes to reduce the risk of needing healthcare thus avoiding the whole expense.  

So what are some things you can do?  

Simple daily changes; I like to call these "trades": 

stop drinking soda, drink water

stop eating fast food, cut up veggies and pack and snack

stop skipping meals, start using a healthy protein shake such as from Arbonne

stop parking close; park far away and walk and take steps not the elevator when possible

To learn more tips and ways to "make trades" contact me for a web presentation on trades to incorporate over 30 days that result in big improvements!  

Obamacare numbers- truth or fiction?

The recent celebration associated with the number of Americans who enrolled thru the federal exchange program (Obamacare) is in part a victory right?  Well, let's look at the numbers.

About 5 million of the 7.1 million were individuals who had a individual health plan and simply were forced to secure a new one thru the exchange.  So while about 2.1 million new sign up's occurred that is less than 20% of who could have enrolled.  Plus some folks are mixing apples and oranges by saying we also have 3 million new sign up's for Medicaid so the victory lap is now based on 10.1 million.

First, Medicaid isn't individual health insurance so let's keep the two distinct for celebrations.

We need to get more signed up; it's going to boil down to economics.  The insurance industry developed rates based on a boatload of assumptions and the bottom line is if we don't get more signed up and paying a premium we all lose!

Second, I seriously wonder if the current framework that existed to enroll folks (professional insurance agents with training and skin in the game) didn't provide the best vehicle to achieve the numbers we wanted to see.  Who better than a agent who relies upon commission to help sign up those without insurance.  OK, I'll stop my bitter rant.

The point is we may have built a stairway to nowhere and we may find the system produces more expense to run, manage and doesn't produce better results.  So should we keep subsidizing a losing battle?  If we look at it as any business person should; the answer is NO.

Ok, you are asking yourself- "which side is she on"??   Well, I personally believe every American deserves the right of access to healthcare and we should eliminate pre ex/plan maximums that hurt innocent people who simply get sick but I also personally believe we created a nightmare and we should look at the goal and fix the system to still reach the goal.

What do you think?

Medicare in 2015?

What's in store for those on a Medicare Advantage Plan in 2015?

Dollars are expected to dwindle from CMS to these plans.  In fact $716 Billion is part of the cuts to Medicare because of ACA (Obamacare).  Medicare Advantage (MA) plans will not be the only thing facing the reduced funding over the 10 year period.  Expect to see funding reduced to hospitals, home healthcare, skilled nursing and hospice.

What will carriers who offer MA plans do?  Those enrolled will likely see more expensive MA plans.  It may show up as higher co pays, higher deductibles, higher out of pocket maximums, more coinsurance, higher premiums and the dreaded smaller provider network.  Sounds a lot like what employers have to do every 2-3 years to afford to offer healthcare to their workforce right?

So what are some strategies you can use if you are in an MA plan today?

Stay turned to the next blog

Gut Health?

We are hearing Dr Oz and others talk about "gut health" yet if you are like the average person you scratch your head and wonder what do they mean?

Both good and bad bacteria reside in our gut.  The idea is to maintain more healthy bacteria and help it flourish.  What causes our gut to get out of balance?  Simple put: poor nutritional choices.  Sugar, processed food, food with little or no nutritional value.  When the balance gets out of whack it shows up in various ways such as sluggishness, lack of energy, wild cravings for carbs and sugar,  weight gain in the middle....You get the point!

So what are some things we can do to bring it back into balance?  Eat better, whole food; plant based and green and organic is a great start but it's so stinkin hard to switch so if you want to take the path of good nutrition and need some help; you aren't alone.  Contact me and you can view a web presentation with tips and techniques that yup even the weakest link can follow and succeed.  It takes about an hour to view the presentation but it's well worth it. 

Why is this important?  Well that gut that's out of balance will eventually affect the organs in your body and if it gets much much worse you may develop disease and then frankly it's pretty hard to reverse the damage done.

You are the strongest person you know so take the plunge, learn and make small changes that over time can product major results.  To your health!!

Hormonal Health

Are you worried about your libido? 

I am astounded as to the ads for men and women who are apparently suffering from hormonal imbalance. 

What used to be a "female" disorder is now an even bigger business for RX companies to promote even more solutions to women and men.

In the US we like to address the issue but not necessarily solve the problem.  Did you ever wonder why the imbalance occurs and are there any steps you can take to being balance back into your life or is having hormonal imbalance a process of aging? 

If you wonder about this and do some research you will find out there are some preventative steps you can take and should take.  It's not too late.  Always seek the advice of your doc but your health is your responsibility and an ounce of prevention is worth a pound of cure!

I am hosting a webinar on this topic Saturday 2/22 at 9am EST.  Simple message me for an invite. 

Let's call Wellness Programs thru Employers What They Truly Are- Control

The latest greatest salvation for employer health care costs is supposed to be wellness. What is it really?

Control- by providing incentives or disincentives to complete health risk assessments; it allows the employee to be segmented into a "category" for additional "wellness management".

Wellness management is better know as diabetes programs, asthma programs, obesity programs and such.  They are designed to monitor, manage a Disease.

Why not call these programs what they are: Disease Management Programs?

What is true wellness is a total review of the policy and procedures in which a company operates.  What are the work hours, quality of work  environment, access to nutritional food, access to fitness, access to high quality non toxic products and programs around wellness topics.  If you treat the workforce and promote a "wellness" philosophy from the top down; you'll have better adoption of "disease programs" since employees won't feel like it's simply another invasive control program.  Check out this recent article on this topic and see a poor example of control by Aetna in handling obesity; quite disgusting!

http://www.healthcarepayernews.com/content/wellness-skeptics-cite-employee-coercion-over-empowerment

What's an Out of Pocket?

What the heck is an "out of pocket"?

Had a client call just yesterday and wondering if a recent hospital stay for her husband was going to result in them paying their "out of pocket" amount in their Medicare plan.  This plan had a per day co pay and her husband was hospitalized for 2 days so in this case the co pay amount they are responsible to pay does go towards the out of pocket but nope they don't "pay the out of pocket".

Think of it like a maximum liability; it's the most you'd have to pay in a cal year before the plan picks up the full tab for covered expenses.  Kind of like a safety net- always great to have.

 Did you know traditional Medicare part B has no such out of pocket max?  Yikes you can get into a world of financial trouble with this option!