As a result of the passage of the Affordable Care Act on March 23, 2010, health insurance companies have removed any annual maximum on prescription drug coverage. This is good news for consumers who have to spend thousands of dollars per year on prescriptions. In the past it was possible to reach the prescription drug benefit maximum [...]
Archive for the ‘Health Insurance’ Category
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What Are Preventive Services?
Posted by admin on June 13th, 2011
As a result of the passage of the Affordable Care Act, insurance policies issued after 9-23-2010 include most preventative services as covered services. These covered preventative services must be provided at no out of pocket costs to the consumer and without a waiting period. Preventative services such as annual physicals, routine mammograms, PAP smears, and PSA tests are now [...]
Pre-Existing Condition Usage
Posted by larry on June 10th, 2011
Earlier this week Health and Human Services (HHS) secretary Kathleen Sebelius announced that enrollment in the government’s Pre-Existing Condition Insurance Plan (PCIP) had reached 18,000. Kathleen Sebelius had expected enrollment to be over 300,000. HHS missed by a factor of 16. They now believe that people with pre-existing conditions cannot afford to pay the PCIP [...]
Why is it hard to get health insurance when you are already pregnant?
Posted by admin on December 28th, 2008
Insurance is designed to protect you against the huge cost of an unexpected illness. The key word here is “unexpected.” Buying insurance after you are already pregnant is like waiting to buy insurance for your home as the fire trucks start pouring water on the the blaze. The insurance companies would go broke in less [...]
What is a “covered” service?
Posted by admin on May 8th, 2007
A “covered” service is one that is listed in the contract between the doctor or hospital and the insurance company. The contract specifies the agreed upon charge for each service covered by the contract. If the service is not listed on the contract, the doctor or hospital is free to charge any amount they wish. [...]
Generic Drug Popularity
Posted by admin on May 4th, 2007
The Pharmacy Benefit Management company Medco reported that 64.1% of all prescription drugs sold in 2008 were generic. Generic drugs represent a great savings over brand name drugs to consumers. Use of generic prescriptions when possible helps keep health insurance premiums low. It is important to use generics whenever possible because spending on prescription drugs is the fastest [...]
What is coinsurance?
Posted by admin on May 3rd, 2007
Hospital bills, X-rays, lab tests, major test such as Ultrasound imaging, MRI, CAT, MRA/MRS, and PET scans are subject to annual deductible and coinsurance. Assume you have a $1,000 annual deductible and 80% coinsurance with a $3,000 Out-of-Pocket (OOP) maximum. If you have a $1,500 MRI, you would pay $1,000 plus 20% of the balance [...]
