University Of Utah Health System Now Out-Of-Network For Patients With Humana Insurance

Written by Continental on . Posted in Uncategorized

The Salt Lake (UT) Tribune (8/31, Stuckey) reports the University of Utah health system is now considered out-of-network by Humana, so patients with Humana insurance will likely have to pay more to receive healthcare from the University of Utah. Jason Stevenson, the education and communications director of the Utah Health Policy Project, says the change could be a “considerable disruption” for some individuals seeking healthcare.

ACA Exchanges Expected To See Big Rate Hikes

Written by Continental on . Posted in Uncategorized

USA Today (9/1, O’Donnell, Leys) reports, “Dramatic drops in insurance company participation on” some states’ Affordable Care Act exchanges and decreased competition are, in part, causing “often jarring rate hikes” for next year’s premiums that “threaten to surpass the” the pre-ACA individual market’s “high and wildly fluctuating rates,” according to insurance regulators and records. Health and Human Service Department Secretary Sylvia Burwell said that insurance premiums probably remained below the level they’d be under the Congressional Budget Office’s early high projections and that the ACA affected many Americans, not just the 11 million people enrolled in insurance through the exchanges. She also said her agency can take administrative actions to make the exchanges “sustainable in the long term,” although she added that congressional action could “speeds things up.” Meanwhile, National Association of Insurance Commissioners President John Huff said it is “past due” for “substantive corrections” to the ACA.

CMS Warns ACA Subsidies Will End For Those Who Do Not Verify Their Citizenship.

Written by Continental on . Posted in Affordable Care Act

The Washington Post Share to FacebookShare to Twitter (8/13, Goldstein) reports that the Centers for Medicare and Medicaid Services is “warning hundreds of thousands of people who have bought health plans through the federal insurance exchange that their coverage will be cut off at the end of next month unless they quickly provide proof that their citizenship or immigration status makes them eligible for the new marketplace.” According to the Post, “310,000 people around the country” have been told that they “have until Sept. 5 to send copies of green cards, proof of citizenship or other documents to show that they qualify for the coverage,” and “if they do not, their coverage will end on Sept. 30.” The Post says this is “the first step the Obama administration has taken to hold consumers accountable” regarding information they provided when seeking benefits via HealthCare.gov.

Two federal courts, two conflicted rulings. What does it all mean?

Written by Continental on . Posted in Affordable Care Act

On Tuesday, two federal courts issued rulings on President Obama’s healthcare law. Here’s what you need to know about how the rulings affect you:

What did the courts say?

A panel in the D.C. Circuit Court of Appeals ruled that the Affordable Care Act (ACA) does not allow the federal government to distribute insurance subsidies through a federal exchange being used in 36 states. Many states declined to set up their own insurance exchanges, forcing the federal government to set up its own central exchange where subsidized plans are sold. The D.C. court said that only people living in those states with their own exchanges are eligible for federal subsidies, due to ambiguities in the language of the ACA.

But in the Fourth Circuit Court of Appeals, judges reached the opposite conclusion. That panel ruled that the federal government doeshave the authority to hand out insurance subsidies through the federal exchange, and always intended subsidies to be available to any eligible individual in the U.S., regardless of who is running the exchange.

What happens next?

The federal government will appeal the D.C. court ruling and plaintiffs in the identical case in the Fourth Circuit will also likely appeal. The issue is likely to remain unsettled for many months.

What does this mean for Americans currently getting insurance through the ACA?

Nothing yet. With conflicting rulings on the same day and appeals certain, the status quo will remain in place — for now.

Medicare Preventive Coverage For Men

Written by Continental on . Posted in Medicare

Are you the type of guy who puts off doing a task and later wishes he’d just done it? If you’re a man with Medicare, now’s the time to talk with your doctor about whether you should get screened forprostate cancer, for colorectal cancer, or for both. Even if you’re feeling fine, screening tests can find cancer early, when treatment works best.

Don’t put off screenings if you’re worried about the cost: Medicare covers a digital rectal exam and Prostate Specific Antigen (PSA) test once every 12 months if you’re a man with Medicare who’s 50 or over. Also, Medicare also covers several types of colorectal cancer screenings, and you pay nothing for most tests.

Did you know prostate cancer is the most common cancer in men, second only to lung cancer in the number of total male cancer deaths? You’re at higher risk for getting prostate cancer if you’re a man 50 or older, are African-American, or have a father, brother, or son who has had prostate cancer.

Colorectal cancer is also common among men—in fact, it’s the third most commonly diagnosed cancer diagnosed in both men and women in the US and the third leading cause of cancer death. In most cases, colorectal cancer develops from precancerous polyps (abnormal growths) in the colon or rectum. Fortunately, screening tests can find these polyps, so you can get them removed before they turn into cancer.

Your risk of getting colorectal cancer goes up as you age. If everyone 50 or older got screened regularly, we could avoid as many as 60% of deaths from this cancer. Make sure you get screened regularly for colorectal cancer if you’re 50 or older, or have a personal or family history of colorectal issues.

June is Men’s Health Month, a perfect time for you (and the men in your life) to take the steps to live a safer, healthier life. Watch our videos on how Medicare has you covered on prostate cancer andcolorectal cancer screenings, and visit the Centers for Disease Control for more information on men’s health.

Health Insurance Federal Marketplace

Written by BooAdmin on . Posted in Affordable Care Act

Up to 300,000 Utahns may be eligible to receive an available tax credit if they buy health insurance on the Up to 300,000 Utahns may be eligible to receive an available tax credit if they buy health insurance on the federal marketplace.

The subsidy, meant to make health care more affordable for more Americans, is available to people with incomes between 100 percent and 400 percent of the federal poverty level, and it is applied to the premium cost of any plan purchased at healthcare.gov.

“When people hear that, they’re no longer complaining about having to buy health insurance, and they’re excited about what they can qualify for, typically,” said Randall Serr, director of Take Care Utah, a consumer health assistance program hosted by the Utah Health Policy Project that, with United Way, is receiving federal grant money to help Utahns enroll for coverage.

Serr said that despite a federal marketplace website that is not yet completely reliable, Utahns have been able to submit paper applications for health insurance and use helpful tools, such as a subsidy calculator, to get an estimate of how much of a tax credit they might qualify for.

The tax credit is then applied directly to premium costs and paid to the insurer.

A new report from the Kaiser Family Foundation estimates the number of eligible Utahns using an analysis of federally collected population and economic data. The report also suggests that by 2018, around 20 million people covered in marketplaces nationwide will receive premium tax credits to aid them with their premium costs.

Tax credits are expected to average $2,700 for individual coverage purchased on the marketplace, and about $5,500 per family, covering about 32 percent of premiums for a so-called “silver,” or midlevel plan, according to Kaiser.

“Tax subsidies are an essential part of the equation for many people who buy insurance through the new marketplaces next year,” Foundation President and CEO Drew Altman said in a prepared statement. “They will help make coverage more affordable for low- and middle-income people.”

People without insurance after March 31, 2014, will be assessed a fee with their taxes the following year.

“The subsidies make (health insurance) obtainable. They make it affordable. They make it a reality that people can work into their monthly budget and still have money left over for their car and food and housing and saving for their child’s education,” said Jason Stevenson, education and communications director for the Utah Health Policy Project, a nonprofit group that advocates for health care for all Utahns.

He said the group believes more Utahns than originally projected might become eligible for subsidies, as businesses adapt to the changes inflicted by the Affordable Care Act and perhaps send more people to the marketplace to purchase insurance.

The Kaiser report, which provides state-by-state data, suggests that 206,000 Utahns are eligible for premium assistance through a subsidy, but a previous Families USA-commissioned report states that nearly 270,000 Utahns could qualify for the help.

Tax credits are determined on a sliding scale, based on income, so that individuals and families with the lowest incomes will receive the largest tax credits, “ensuring that the assistance is targeted to the people who need it most,” according to the Families USA report. Tax credits are also only available to marketplace enrollees.

“People who have higher incomes are still getting help, but they’re getting a smaller amount of help,” Stevenson said.

The amount of people eligible in Utah puts the Beehive State about average, in the middle of all states.

Kaiser reports that three states, Texas, California and Florida, each have more than 1 million tax-credit-eligible residents, and another seven states have more than 500,000 tax-credit-eligible residents. At the lower end, seven states have fewer than 50,000 tax-credit-eligible residents, with the District of Columbia (9,500) and Vermont (27,000) having the fewest.

The five states with the most tax-credit-eligible individuals account for about 40 percent of all such individuals nationally, according to the report.

Both reports suggest that tax credits are a key part of the Affordable Care Act, helping to put health insurance in reach of working families and low-income residents.

Successful health care reform relies on the majority of individuals obtaining health insurance, including those who are generally healthy. Premiums, available benefits and risk adjustment are determined based on the insured population.

The Kaiser report states that individuals with pre-existing conditions and those in state-based high risk pools will likely join the marketplace earliest, indicating a disproportionately sick population. Higher enrollment levels may suggest a more balanced pool, indicating a more stable health insurance market, according to Kaiser.

Stevenson said the tax credits make marketplace enrollment more appealing to many Utahns. And while “many aren’t used to the idea of getting help to buy insurance,” he said the system mirrors one that many employers have been using for years to offer insurance coverage to employees..

The subsidy, meant to make health care more affordable for more Americans, is available to people with incomes between 100 percent and 400 percent of the federal poverty level, and it is applied to the premium cost of any plan purchased at healthcare.gov.

“When people hear that, they’re no longer complaining about having to buy health insurance, and they’re excited about what they can qualify for, typically,” said Randall Serr, director of Take Care Utah, a consumer health assistance program hosted by the Utah Health Policy Project that, with United Way, is receiving federal grant money to help Utahns enroll for coverage.

Serr said that despite a federal marketplace website that is not yet completely reliable, Utahns have been able to submit paper applications for health insurance and use helpful tools, such as a subsidy calculator, to get an estimate of how much of a tax credit they might qualify for.

The tax credit is then applied directly to premium costs and paid to the insurer.

A new report from the Kaiser Family Foundation estimates the number of eligible Utahns using an analysis of federally collected population and economic data. The report also suggests that by 2018, around 20 million people covered in marketplaces nationwide will receive premium tax credits to aid them with their premium costs.

Tax credits are expected to average $2,700 for individual coverage purchased on the marketplace, and about $5,500 per family, covering about 32 percent of premiums for a so-called “silver,” or midlevel plan, according to Kaiser.

“Tax subsidies are an essential part of the equation for many people who buy insurance through the new marketplaces next year,” Foundation President and CEO Drew Altman said in a prepared statement. “They will help make coverage more affordable for low- and middle-income people.”

People without insurance after March 31, 2014, will be assessed a fee with their taxes the following year.

“The subsidies make (health insurance) obtainable. They make it affordable. They make it a reality that people can work into their monthly budget and still have money left over for their car and food and housing and saving for their child’s education,” said Jason Stevenson, education and communications director for the Utah Health Policy Project, a nonprofit group that advocates for health care for all Utahns.

He said the group believes more Utahns than originally projected might become eligible for subsidies, as businesses adapt to the changes inflicted by the Affordable Care Act and perhaps send more people to the marketplace to purchase insurance.

The Kaiser report, which provides state-by-state data, suggests that 206,000 Utahns are eligible for premium assistance through a subsidy, but a previous Families USA-commissioned report states that nearly 270,000 Utahns could qualify for the help.

Tax credits are determined on a sliding scale, based on income, so that individuals and families with the lowest incomes will receive the largest tax credits, “ensuring that the assistance is targeted to the people who need it most,” according to the Families USA report. Tax credits are also only available to marketplace enrollees.

“People who have higher incomes are still getting help, but they’re getting a smaller amount of help,” Stevenson said.

The amount of people eligible in Utah puts the Beehive State about average, in the middle of all states.

Kaiser reports that three states, Texas, California and Florida, each have more than 1 million tax-credit-eligible residents, and another seven states have more than 500,000 tax-credit-eligible residents. At the lower end, seven states have fewer than 50,000 tax-credit-eligible residents, with the District of Columbia (9,500) and Vermont (27,000) having the fewest.

The five states with the most tax-credit-eligible individuals account for about 40 percent of all such individuals nationally, according to the report.

Both reports suggest that tax credits are a key part of the Affordable Care Act, helping to put health insurance in reach of working families and low-income residents.

Successful health care reform relies on the majority of individuals obtaining health insurance, including those who are generally healthy. Premiums, available benefits and risk adjustment are determined based on the insured population.

The Kaiser report states that individuals with pre-existing conditions and those in state-based high risk pools will likely join the marketplace earliest, indicating a disproportionately sick population. Higher enrollment levels may suggest a more balanced pool, indicating a more stable health insurance market, according to Kaiser.

Stevenson said the tax credits make marketplace enrollment more appealing to many Utahns. And while “many aren’t used to the idea of getting help to buy insurance,” he said the system mirrors one that many employers have been using for years to offer insurance coverage to employees.

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