Tuesday, April 30, 2013

Health Insurance Importance


Health Insurance Importance, health, good health, insurance
Our health is really important, take it for granted to save a few dollars, and the repercussions will hunt you in the future. It will cost you a lot and will surely drill holes in your pocket. Furthermore, if you cannot work due to your health, how will you earn for yourself and your family?

Just like money, we never really have a true idea of its value until we lose it.


Life is unpredictable. That's why health insurance is important, it's designed to protect us in case of emergency. It guarantees medical treatment based on your coverage.

Insurance can be expensive but it's worth it. A report by the New York-based Commonwealth Fund estimated that 84 million adults in the US have inadequate health care coverage. Families are foregoing care because they cannot afford it, even with the implementation of the AffordableCare Act in January 2014. The under-insured and uninsured will just be transferred to an inferior plan with huge out-of-pocket costs.

Investing in insurance now is like investing in your quality of life. Having good health and preventive care plan may help but there's really nothing better than knowing that you and your family are protected.

Monday, April 15, 2013

ACE USA Expands Coverage to Address Growing Trend of Hospital and Physician Integration

ACE USA Medical Risk Group introduce a wide range of physician professional liability insurance products and coverage solutions in support of hospitals and healthcare facilities for their employed physicians, and their owned or affiliated medical groups. Product offerings include companion primary physician professional liability policies, fronting capabilities for primary physician professional liability policies, reinsurance of physician professional liability policies issued by healthcare facility captives, and uniquely structured integrated hospital and physician insurance program designs that may include separate or shared retentions and policy limits.

The physician professional liability insurance coverages are available for hospitals, healthcare facilities and Accountable Care Organizations (ACO) providing insurance or alternative risk financing solutions to their employed physicians, or owned or affiliated medical groups.

Product Highlights of the companion Primary Physicians Professional Liability policy* include:

  • Separate limits of liability each physician and corporate entity
  • Defense expense in addition to policy limits
  • First dollar coverage (no deductible) or deductible options
  • Individual tail coverage or group rolling tail coverage for departed physicians
  • Consent to settle provision
  • Professional Legal & Audit Defense Coverage
  • Full claims capabilities to support companion primary physician primary policies

Benefits of an integrated or coordinated hospital / physician insurance program include:

  • Common insurance or reinsurance partner for both the healthcare system and their employed, owned or affiliated physician groups
  • Joint or coordinated defense provides greater control and cost containment of joint claims
  • Coordinated risk management support services
  • Integrating physician insurance into an integrated self-insurance or alternative risk financing mechanism may offer lower cost compared to traditional insurance
  • Backed by the ACE Group’s financial strength and excellent reputation

*This coverage is currently not available for stand-alone medical groups that are not owned by or affiliated with an ACE insured hospital or healthcare system.

Baby Stuck in Hospital Because of Insurance Company


A 3-month old baby boy in Nebraska was separated from his parents for 100 days because their insurance company refuses to pay for their baby to be moved.

The baby is in Presbyterian St. Luke’s Hospital in Denver, while his parents live in Lincoln, Nebraska, and have been forced to commute to see their son every other weekend.

Julius James Frack was born on December 30, 2012 weighing one pound, six ounces and was only 12 inches long.

Jennifer and David Frack weren't expecting the baby to arrive soon but had complication with her pregnancy while visiting family in Sydney, Nebraska, after Christmas.

Doctocs in Sydney said that the mom needed needed specialized care and arranged for her to be flown to Presbyterian St. Luke’s Hospital in Denver. Because Julius was so small, he was rushed to the hospital’s NICU.   

The mom healed in a few weeks and was allowed to go home but the baby was too fragile for long drive. Howerver, the parents need to go back to work. And since December, the parents has been spending too much money to drive back and forth from Lincoln to Denver every other weekend.

Fracks asked to have Julius moved since the commute is too much. Doctors told the parents that the baby needs to be transferred by helicopter and doctors at Presbyterian St. Luke’s Hospital helped them fill out paperwork but their insurance company denied the request.

The Fracks’ insurance company, Blue Cross and Blue Shield of Nebraska, released a statement that said, “In general, when our nurses and physician reviewers look at cases such as this, the decision to cover a service is based on whether a ‘medical necessity’ exists,” said Dr. David Filipi, Chief Medical Director, Blue Cross and Blue Shield of Nebrask

source: http://kdvr.com/2013/04/14/parents-separated-from-baby-for-100-days-over-insurance-decision/#ooid=9kOHB5YTqKX8XQn55UgtnqXYpYBIbLXu

Monday, April 1, 2013

Using Medicaid Dollars for Private Insurance

The Obama administration and Republican officials in several states are exploring ways to redirect federal money intended to expand Medicaid, the main public insurance program for the poor, and use it instead to buy private health insurance for Medicaid recipients. The approach could have important benefits for beneficiaries and for the future of health care reform. But the idea also carries big risks. Federal officials will need to enforce strict conditions before agreeing to any redirection of Medicaid dollars that were originally intended to enlarge the Medicaid rolls.

The Supreme Court ruled last year that the states could decide whether they want to expand their Medicaid programs to cover more of the uninsured; they can’t be required to do so, as the health reform law intended.

The law provides hugely attractive financial incentives for states to add more people. The federal government will pay 100 percent of the cost of caring for newly eligible enrollees for the first three years, tapering to 90 percent in later years. Even so, some state officials, mostly Republicans, are proposing that the very generous federal financing for expansion be used instead to pay the premiums of poor people on new electronic health care exchanges, created by the reform law, where people can shop for subsidized private insurance.

Private insurance obtained on the exchanges could help poor beneficiaries in several ways. They would be less vulnerable to disruptions every time their incomes fluctuated above or below the boundary line that determines whether they are poor enough to qualify for Medicaid, where they would see one array of doctors, or slightly better off and eligible for subsidized insurance on the exchanges, where they might see a completely different group of doctors. Providers would be paid the same amount whether treating a Medicaid recipient or a privately insured patient, potentially creating a wider network of doctors for Medicaid patients. And some poor residents of states resistant to expansion, who would otherwise be frozen out by a glitch in the reform law, could gain coverage through the exchanges.

But the main benefit would be political in that it could engage Republicans in the whole health reform effort, make it easier to carry out the law and reduce the appetite among Congressional Republicans to gut the law.

There are at least two big caveats. The switch would be likely to increase costs for the federal government, and ultimately state governments, because private insurance is almost always more costly than Medicaid. That could force a cutback in the number of people covered because the money won’t go as far. There is also a risk that poor people will end up with fewer benefits and higher cost-sharing on the exchanges despite regulations that should prohibit that.

Federal officials must be vigilant in ensuring that recipients on the exchanges receive the same services and same cost-sharing limits that they would under an expanded Medicaid program. State officials who don’t want to play by those rules would be better off using the generous federal dollars as originally intended — to expand their Medicaid programs to cover many more of their uninsured residents.

nytimes.com