Health Insurance

The Supreme Court, Health Care, and You

On June 26, 2015, the Supreme Court made an important decision about the Health Insurance Marketplace keeping           quality, affordable coverage for millions of Americans.  The Supreme Court’s decision confirmed that if you qualify, you can receive financial assistance, including premium tax benefit to make coverage more affordable no matter where you live.

On average, consumers enrolled in the Marketplace are receiving $3,260 per year in tax credit, or $272 each month.

About 8 in 10 consumers could find coverage for $100 or less with tax credit through the Marketplace.

If you don’t have health insurance, see if you can get health coverage for 2015.  You may qualify for a Special Enrollment Period due to life change, such as marriage, having a baby, or losing other coverage.  Open enrollment for 2016 starts on November 1, 2015.

For more information, click here.

Teaching Suggestions

  • Ask students if anyone in their family is affected by the Supreme Court ruling, and if so, how?
  • Ask students to prepare a summary of the major provisions of the Affordable Care Act.

Discussion Questions

  1. Why is it important to inform the Marketplace about any changes to your household, income, and insurance status?
  2. If you have health insurance through your employer or purchased it on the individual market, does the Supreme Court ruling impact you?
Categories: Chapter 9, Health Insurance, insurance, Wise Shopping | Tags: , , | Leave a comment

CMS Proposes Rule to Strengthen Managed Care for Medicaid and CHIP enrollees

On May 26, 2015, the Centers for Medicare and Medicaid Services (CMS) proposed to modernize Medicaid and Children’s Health Insurance Program (CHIP) managed care regulations to update the programs’ rules and strengthen the delivery of quality care for beneficiaries.  This proposed rule is the major update to Medicaid and CHIP managed care regulations in more than a decade.  It would improve beneficiary communications and access, provide new program integrity tools, support state efforts to deliver higher quality care in a cost-effective way, and better align Medicaid and CHIP managed care rules and practices with other sources of health insurance coverage.  Overall, this proposed rule supports the agency’s mission of better care, smarter spending, and healthier people.

For more information, click here.

Teaching Suggestions

  • Ask students to visit the CMS.gov website to learn how the healthcare delivery landscape has changed and grown substantially since 2002.
  • Ask students how CMS might strengthen the quality of care provided to beneficiaries.

Discussion Questions

  1. Why is the CMS proposing new rules to strengthen managed care for Medicaid and CHIP enrollees?
  2. How does the CMS plan to modernize Medicaid and CHIP regulations?
Categories: Chapter 9, Health Insurance | Tags: , , | Leave a comment

5 Ways To Become An Informed Medicare Consumer

Each day, you make important choices about your finances, health, privacy, and more.  Medicare has 5 things you can do to help you become an informed Medicare consumer.

  1. Know your rights. As a person with Medicare, you have certain rights and protections designed to help protect you and make sure you get the health care services the law provides.
  2. Protect your identity. Identity theft happens when someone uses your personal information without your consent to commit fraud or other crimes.  Keep the following information safe:
    • Your name
    • Your Social Security Number (SSN)
    • Your Medicare Number (or your membership card if you’re in a Medicare Advantage or other Medicare health plan)
    • Your credit card and bank account numbers
  1. Help fight Medicare fraud. Medicare fraud takes money from the Medicare program each year, which means higher health care costs for you.  Learn how to report fraud.
  2. Get involved with other seniors with the Senior Medicare Patrol (SMP). The SMP educates and empowers people with Medicare to take an active role in detecting and preventing health care fraud and abuse.
  3. Make informed Medicare choices. Each year during the Fall Open Enrollment Period (October 25-December 7), review your plan to make sure it will meet your needs for the following year.  If you are not satisfied with your current plan, you can switch during the Open Enrollment Period.

For more information, click here.

Teaching Suggestions

  • Ask students to prepare a list of medical expenses that Medicare does not cover.
  • Ask students to check out the Centers for Medicare and Medicaid Services (CMS) videos for tips on preventing Medicare fraud and see how seniors are learning to stop, spot, and report fraud.

Discussion Questions

  1. Why is it vital to fight against Medicare fraud?
  2. Why is it important to review your health care plan during the Fall Enrollment Period?
Categories: Chapter 9, Frauds and Scams, Health Insurance | Tags: , , | Leave a comment

Emergency Department for Routine Care?

A new study, published in March 2015 in the Annals of Emergency Medicine, shows that the annual rate of emergency department visits by young adults age 19-25 decreased by 1.4 percent in 2011.  This represents 191,000 fewer emergency department visits by young people in this age group.

For this study, currently the most extensive analysis of its kind, researchers examined more than 17 million emergency department visits between 2007 and 2011 from the Nationwide Emergency Department Sample database of the Agency for Healthcare Research and Quality’s Hospital Cost and Utilization Project.

The Affordable Care Act requires health plans that offer coverage to allow young adults to stay on their parents’ plan until age 26.  This has allowed young adults to seek care in the most appropriate setting, reserving costly emergency department use for real emergencies.

For additional information, click here.

Teaching Suggestions

  • Ask students what else can be done to reduce the high cost of healthcare.
  • What can students do to reduce their own personal healthcare costs?

Discussion Questions

  1. What are several reasons for the rising healthcare expenditures?
  2. Has the Affordable Care Act reduced the costs of healthcare?
Categories: Chapter 9, Health Insurance | Tags: , | Leave a comment

Your 2015 Tax Return and the Health Care Law

Certain provisions of the Affordable Care Act will probably affect your federal income tax return when you file this year.  The law requires that you and each member of your family have qualifying health insurance coverage for each month of the year, qualify for an exemption from the coverage requirement, or make an individual shared responsibility payment when filing your federal income tax return.

Most taxpayers will simply check a box on the tax return to indicate that each member of their family had qualifying health coverage for the whole year.  Qualifying health insurance includes coverage for most, but not all, types of health care coverage plans.  If you bought coverage through the Health Insurance Marketplace, you should receive Form 1095A, Health Insurance Marketplace Statement from your Marketplace by early February.

For more information, Click Here.

Teaching Suggestions

  • Ask students to search the Internet to gather more information about the new IRS requirements and the Affordable Care Act.
  • What are provisions that might affect an individual and their families?

Discussion Questions

  1. What are the reporting requirements when you file your federal income tax return this year?
  2. How can you determine if you are eligible for an exemption?
  3. What should you do if you are expecting to receive 1095A and you don’t receive it by early February.
Categories: Chapter 3, Chapter 9, Health Insurance, insurance, Taxes | Tags: , , , | Leave a comment

Trick yourself into saving

Saving money can be automatic with some simple actions that would reduce your monthly spending.  Some actions, which can include lowering your monthly cash outflows by as much as $400, include:

 

  • Using a programmable thermostat which can be used to automatically raise and lower the temperature in your home, resulting in energy savings.
  • Increasing insurance deductibles for your home and auto insurance which will likely result in an annual savings of several hundred dollars.
  • Practicing less aggressive driving; using a constant speed can save money on fuel costs.
  • Seeking out ways to reduce your communication bills, such as using basic cable along with streaming video on your computer. Also, using a free texting app on your phone.
  • Using a refillable water bottle can save hundreds of dollars by not buying bottled water.

 

To ensure that you actually save this money, each month, have funds automatically moved into a savings account or investment program.
For additional information on saving, go to:

http://www.bankrate.com/finance/video/saving-money/trick-yourself-into-saving.aspx#ixzz3IKDG71pN

 Teaching Suggestions

  • Have students conduct online research to determine various actions to reduce spending and increase savings.
  • Have students interview several people to determine various actions that might be considered for reducing spending.

Discussion Questions 

  1. What actions have you taken to reduce spending and increase savings?
  2. Explain short-term and long-term benefits of reduced spending.
Categories: Car Insurance, Chapter 2, Chapter 6, Financial Planning, Health Insurance, insurance, Purchasing Strategies, Savings, Wise Shopping | Tags: , | Leave a comment

Medicaid and Children’s Health Insurance Program (CHIP)

Did you know that Medicaid and Children’s Health Insurance Program (CHIP) offer free or low cost health coverage for eligible children and other family members? Medicaid and CHIP cover:

  • Children and teens up to age 19
  • Young people up to 21 may be covered under Medicaid
  • Youth who have “aged out” of foster care can be covered under Medicaid until they reach age 26

Children may be eligible based on their family income.  Eligibility depends on your income, the number of people in your family and the rules in your state. In almost every state, children in families with income up to 200 percent of the federal poverty level ($47,700 per year for a family of four) are covered. In more than half the states, the income eligibility for children can be even higher.

Eligible children and teens can get regular check-ups, shots, doctor and dentist visits, vision care, hospital care, mental health services, needed medications and more.  All preventive services for children are available at no cost.

For more information, go to

http://www.insurekidsnow.gov/chip/index.html

Teaching suggestions

  • Ask students how can they find a health care provider (doctor, dentist or pharmacist) in their area who accepts Medicaid or CHIP?
  • Is there a special enrollment period for Medicaid or CHIP?
  • How can you apply for Medicaid and CHIP?

Discussion Questions

  1. Can working parents who may not have health coverage through their jobs cover their children under the CHIP program?
  2. Who can apply for Medicaid or CHIP for a child?

 

Categories: Chapter 9, Health Insurance, insurance | Tags: | Leave a comment

Discount Plans for Health Insurance?

Looking for health insurance? Make sure that’s what you’re buying, or you could find yourself on the hook for big medical bills with no way to pay them.

That’s because what sounds like affordable health insurance may be a medical discount plan instead.  Medical discount plans can help some people to save money on their health care costs, but discount plans aren’t health insurance.

Although some medical discount plans provide legitimate discounts, others take your money and offer very little in return.  The Federal Trade Commission (FTC) and its state law enforcement partners also have found that dishonest marketers selling these plans have tried to make people think they’re selling health insurance, or have lied about what their plans really offer.

If you buy a health insurance plan, it generally covers a broad range of services, and pays you or your health care provider for a portion of your medical bills. If you buy a medical discount plan, you generally are paying for a list of providers and sellers who may be willing to offer “discounts” on some of their services, products or procedures. Medical discount plans don’t pay your health care costs.

“Discounts of up to 70%”–but how often will you save that much? Savings with discount plans typically are a lot less. When you consider a discount plan’s monthly premiums and enrollment fees, there may be no “discount” at all.  What’s more, if you have major health problems or an emergency, you will have to cover most, or all, of the bills if you don’t have health insurance.

For additional information go

http://www.consumer.ftc.gov/articles/0165-discount-plan-or-health-insurance

Teaching Suggestions

  • Ask student how they should react if they are pressured to sign up quickly or miss out on a “special deal”.
  • Why is it important to check with your state insurance department, your state Attorney General, and your Better Business Bureau before signing up for such discount plans?

Discussion Questions

  1. Why medical discount plans are not health insurance plans?
  2. Do medical discount plans pay for your health care costs?
  3. Are medical discount plans a good substitute for comprehensive health insurance plans?
Categories: Chapter 9, Health Insurance | Tags: , | Leave a comment

Medicare & You 2015: What’s Important in 2015?

In September 2014, millions of Americans received a 152-page booklet from the Centers for Medicare and Medicaid Services, called Medicare & You 2015.  It doesn’t have much of a plot, but it might be the most important reading for seniors or their adult children.  Here is what’s important in 2015:

  • Stay healthy with Medicare-covered preventive services. Medicare pays for many services that can prevent or detect health problems early when they are easier to treat.  Ask your health care provider what services you need.
  • Keep track of your personal health information. Access your personal health information using Medicare’s Blue Button.  This information can help you make more informed decisions about your care and can give your healthcare providers a more complete view of your health history.
  • Continue to get help in the prescription drug coverage gap. If you reach the coverage gap in your Medicare prescription drug coverage, you’ll quality for some savings on generic and brand-name drugs.
  • Find out what you pay for Medicare (Part A and Part B). The 2015 Medicare premium and deductible amounts were not available at the time of printing.  To get most up-to-date cost information, call 1-800-Medicare.

For additional information go to

http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf

Teaching Suggestions

  • Ask students to choose a current issue of Money, Consumer Reports, Kiplinger’s Personal Finance, and summarize an article that updates Medicare’s programs for 2015.
  • Ask student where they can find other ways to get Medicare information and compare the quality of plans and health care providers.

Discussion Questions

  1. What factors should senior citizens consider in making the choice among various types of Medicare, medigap, or HMO health care insurance policies?
  2. What services are not covered by Medicare?
Categories: Chapter 9, Health Insurance, insurance | Tags: | Leave a comment

You Tube Videos: Healthcare and Taxes

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

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