Chapter 9

You Tube Videos: Healthcare and Taxes

Posted on September 20, 2014 by Melissa Hart

In September 2014, the Internal Revenue Service announced the availability of new You Tube Videos to help taxpayers get important information about the Affordable Care Act and tax return filing.  These videos on IRS You Tube channel discuss the premium tax credit and the individual shared responsibility provision.  These provisions of the Affordable Care Act will affect tax returns beginning with the 2014 filing year.

In the premium tax credit video, the IRS Commissioner explains how it can help make purchasing health care through the Health Insurance Marketplace more affordable for people with moderate incomes.

For additional information on the tax provisions of the Affordable Care Act go to
http://www.irs.gov/uac/Newsroom/New-YouTube-Videos-Provide-Tips-on-Health-Care-Tax-Returns

Teaching Suggestions

You may want to use the original article to discuss

  • What are the criteria used to be exempt from the Individual Shared Responsibility provision?
  • How and where can you obtain an exemption?
  • Who is subject to the individual shared responsibility provision?
  • What you need to do if you want to be sure you have minimum essential coverage or an exemption for 2014?

Discussion Questions

  1. What will you have to do if you don’t have or don’t maintain your health insurance coverage?
  2. If you don’t have health insurance coverage or qualify for an exemption, how and when must you make an Individual Shared Responsibility payment?
Categories: Chapter 9, Disability Insurance, Health Insurance, insurance | Tags: , , | Leave a comment

Health Scams: Don’t Take Risks With Your Health and Your Money

Posted on August 6, 2014 by Melissa Hart

Lots of people are fooled with buying health products that sound great, but are really fakes.  These products may cause serious health problems, such as pain, suffering, or even death.

Watch out for the following fraudulent claims:

  • It’s Natural. Just because a product is “natural” does not mean it is safe.
  • It’s So Easy. Don’t believe the promises of “lose weight while you sleep.”  If it sounds too easy, it might be a scam.
  • Miracle Cure. Generally, one pill will not treat or cure many different illnesses such as cancer, diabetes, AIDS, or arthritis.
  • It Worked for Me. Personal success stories by “real people” or doctors are easy to make up.
  • They Don’t Want You to Know. Always ask your health care providers what is best for your health.

 

For additional information on health fraud and scams go to http://www.fda.gov/healthfraud, http://www.fda.gov/medwatch, and http://www.ftc.gov

Teaching Suggestions

  • Ask students if they have fallen prey to health care scammers.
  • Have students make a short presentation with a summary of actions that might be taken to avoid health scams.

Discussion Questions

  1. Why do health scammers continue to prey on unsuspecting consumers?
  2. What can consumers do to avoid being victimized by health scammers?
Categories: Chapter 9, Frauds and Scams | Tags: , , , | Leave a comment

Increased Oversight Needed For Growing Managed Care Expenditures

Posted on August 2, 2014 by Melissa Hart

In fiscal year 2013, the Medicaid program covered about 71.7 million people at a cost of $431.1 billion, of which Centers for Medicare and Medical Services (CMS) estimated that $14.4 billion (5.8 percent) were improper  payments.  In 2014, the Government Accountability Office (GAO) examined how state and federal agencies ensure comprehensive integrity efforts, such as payment review, auditing, and investigating fraud.  To improve the efficiency and effectiveness of Medicaid program, the GAO recommends that the Administrator of CMS should:

  • update its Medicaid managed care guidance on program integrity practices,
  • provide the states with additional support in overseeing Medicaid managed care program integrity, and
  • require states to audit payments to and by managed care organizations.

For additional information and complete GAO report go to http://www.gao.gov/products/GAO-13-34.

Teaching Suggestions

  • Ask students what are typical benefits that Medicaid provides.
  • Ask students to prepare a summary report on how to prevent or reduce the Medicaid fraud.

Discussion Questions

  1. What is Medicaid and how it assists low-income individuals and families?
  2. How is Medicaid financed?
  3. Do people with Medicaid need to buy supplemental medical insurance?
Categories: Chapter 9, Health Insurance | Tags: | Leave a comment

How Healthy is Your Insurance Company?

Posted on June 11, 2014 by Melissa Hart

When buying home, health, auto or rental insurance, you should find out if your state insurance department offers any information about insurance companies and rates.  Check several sources for the best rate and get quotes online.  Consult an independent insurance agent who represents several insurers in your area to get a better deal.

 Before purchasing insurance, be sure the insurance company is licensed and covered by the state’s guaranty fund.  The fund pays claims if the company defaults.  Your state insurance department can provide this information.

Research the complaint record of the company.  Contact your state insurance department, or visit the website of the National Association of Insurance Commissioners (www.naic.org), which maintains a database of complaints filed with state regulators.  Finally check the financial stability of the insurance company.

For additional information and guidance visit the following websites:

http://www.ambest.com, http://www.standardandpoors.com, and http://www.moodys.com

Discussion Questions

  1. Why is it important to contact state insurance department before purchasing insurance?
  2. How can an independent insurance agent provide a better insurance rate?
  3. Why is an insurance company’s financial stability important?

Teaching Suggestions

You may want to use the information in this blog post and the websites to

*  Have students visit the various websites in this blog and then prepare a short summary of their findings.

*  explore a few advantages of purchasing insurance from an independent insurance agent?

Categories: Chapter 8, Chapter 9, Chapter_10, Home Insurance, insurance | Tags: , , | Leave a comment

What is the Health Insurance Marketplace?

Posted on April 9, 2014 by Melissa Hart

Health Insurance and the Patient Protection and Affordability Care Act of 2010 created state-based health insurance marketplace (also called insurance exchange) through which individuals can purchase health insurance coverage.

Open enrollment in the Health Insurance Marketplace ends on March 31, 2014.  The next open enrollment period for 2015 coverage starts from November 15, 2014 and ends on February 15, 2015.  There are several ways to sign up for Marketplace plans, but applying online is the quickest method to  get coverage.  You can buy a marketplace plan directly from an insurance company, with the help of a broker or an agent, or using an online service.  If you can’t afford a health plan or can’t wait until coverage begins, you can get low-cost care at a Community Health Center near you.

For additional information about the Health Insurance Marketplaces go to https://www.healthcare.gov/what-is-the-health-insurance-marketplace.

Discussion Questions

  1. What are several methods of getting health insurance coverage through the Health Insurance Marketplaces?
  2. Can a Marketplace refuse the coverage or charge you more because you have an illness or a medical condition?
  3. How do you choose a health insurance plan that is  right for you?

Teaching Suggestions

You may want to use the information in this blog post and the original source to discuss

  • The 5 categories of Marketplace plans: Bronze, Silver, Gold, Platinum, and Catastrophic.
  • How you may be able to get lower costs on deductibles, copayments, and coinsurance?
  • How to apply and enroll in health coverage in the Marketplace?
Categories: Chapter 9, Health Insurance | Tags: , | Leave a comment

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