Children's insurance program may need wait list

SACRAMENTO—The state's budget woes could leave thousands of California children on a waiting list for health care.

State officials who oversee the Healthy Families Program are scrambling to find ways around a $17.2 million budget shortage.

The program provides low-cost health, dental and vision coverage to uninsured children of working families.

Currently, 883,589 children rely on the low-cost health insurance state program, and about 27,125 new applicants enroll each month.

The Managed Risk Medical Insurance Board warns a long waiting list could amass quickly, with an estimated 160,000 children waitlisted in the first six months.

The board is slated to meet in Sacramento on Wednesday. If approved, the stoppage could be implemented as soon as Dec. 18.

Source: http://www.mercurynews.com/news/ci_10977114

If you lose your job, keep your health insurance

The latest unemployment numbers are awful.

U.S. job losses accelerated in the last two months, pushing the nation's unemployment rate to a 14-year high in October.

As workers lose their jobs, a crucial benefit they must keep is their health insurance. Don't go without this.

It may be tough to pay the premium while you search for a new job, but you'll really be in a world of hurt if a major illness or accident wipes out what funds you have.

"If you think losing your job is a possibility in the next year, start reviewing your employer health care plans now," said Sam Gibbs, a senior vice president and consumer expert with eHealth Insurance.com, a health insurance information Web site.

"During open enrollment [when you select benefits for the coming year], you may be able to choose a plan that would cost less if you were later required to pay all of the premium through COBRA," he said. "Always make sure that the plan you choose will cover the health care benefits you need for the coming year."

It's important to understand what COBRA is because it plays a major role in your health insurance if you're laid off.

COBRA stands for the Consolidated Omnibus Budget Reconciliation Act of 1986. The federal law requires employers that lay off workers to offer them a chance to continue with the employer's health insurance policy for 18 months after leaving their job.

However, you will have to pay the monthly premium – and it's expensive because you're paying both the employee and employer contributions.

The average monthly COBRA premium is $400 for an individual and $1,078 for a family, according to eHealthInsurance.com.

It may be tempting to go without health insurance and save the expense, but that would be a mistake. Instead, take the COBRA coverage and shop around for less expensive coverage that still meets your needs.

"If you are considering switching your health insurance plans, never switch from an employer-based plan or COBRA continuation coverage until you are approved for another plan," Mr. Gibbs said. "It is important to have no interruption in your health insurance coverage."

If you're healthy, you may qualify for an individual and family health policy.

If your health isn't so good, you may still qualify for an individual or family plan – but you may have to pay a higher premium. Talk to at least two insurance agents to find out whether you qualify for an individual and family plan.

You might also consider raising your deductible to save on the premium.

"If you're healthy and don't need to see your doctor a lot, go with a higher deductible unless you are anticipating expensive procedures like a surgery or child birth, or other medical expenses within the year," Mr. Gibbs said.

If you've already been laid off, see if you can get on your spouse's health insurance plan.

If not, and you're healthy, find an individual and family plan that has the same benefits and the same doctors that you like.

An uncertain employment situation calls for cutting out unnecessary expenditures, but health insurance isn't one of them.

Source:

S&P changes US health insurance outlook to negative

NEW YORK, Nov 3 (Reuters) - Standard & Poor's on Monday said it expects the number of downgrades of companies in the U.S. health insurance sector to pick up, reflecting weaker operating results and a worsening economy.

S&P changed its outlook on the sector to negative, from stable, indicating companies in the sector are more likely to be downgraded over the next one to two years.

"Aggressive pricing, unforeseen medical trend development, and slowing top-line growth that have driven performance shortfalls beyond our downside expectations," S&P said in a statement.

"Overall, we believe the sector is feeling the strain of a slumping U.S. economy and more intense competitive pressure, which we expect to persist meaningfully into 2009," the rating agency added.

Shares of health insurance companies were hurt last week after Aetna Inc (AET.N: Quote, Profile, Research, Stock Buzz) said third quarter net income dropped to $277.3 million from $496.7 million a year earlier, and Cigna Corp (CI.N: Quote, Profile, Research, Stock Buzz) said net income dropped to $171 million from $365 million for the same period.

"In the past few months, health-insurer-related rating activity has quickly taken a negative turn as pressure on earnings and cash-flow levels raised concerns about goodwill valuation (for some companies) and quality of capital in general," S&P added.

In spite of the negative outlook, S&P said it expects downgrades to be limited to only a subset of companies with negative outlooks, the negative sector outlook also indicates that upgrades will also be less common. (Reporting by Karen Brettell; Editing by James Dalgleish)

Source: http://www.reuters.com/article/marketsNews/idUSN0332254520081103

Many uninsured kids have parents with insurance

WASHINGTON (Reuters) - More than 2 million children in the United States who have no health insurance of any kind have at least one parent who gets employer-provided medical coverage, researchers said on Tuesday.

These parents typically get insurance through work that covers them but cannot afford the extra thousands of dollars that may be needed for a plan that also covers their children, the researchers wrote in the Journal of the American Medical Association.

"I think there's been a myth that all uninsured children have uninsured parents, and so if we cover the parents we can cover the kids," Dr. Jennifer DeVoe of Oregon Health & Science University, who led the study, said in an interview.

"In most cases the parents have insurance through work at reduced rate or no cost, but adding their family is unaffordable," DeVoe added.

The Census Bureau said in August 8.1 million, or 11 percent, of children under 18 had no health insurance in 2007.

The researchers calculated that about 28 percent of these uninsured children -- or about 2.3 million -- had at least one parent with health insurance. Most are from low- or middle-income families, DeVoe said.

The high cost of health care and medical insurance and the large numbers of Americans who remain uninsured have been key issues in the U.S. presidential campaign this year.

The study found that children of single parents and children in Hispanic families were more likely than others to lack health insurance even if a parent is covered. It was also more likely in the South and West.

The study was based on data from 2002 to 2005 released by the Agency for Health Care Research and Quality, part of the U.S. Department of Health and Human Services.

Dr. Carolyn Clancy, who heads the agency, said some of these uninsured children likely qualify for public coverage, but their parents may not be aware of their eligibility.

DeVoe said a short-term approach to address the problem would be to expand the State Children's Health Insurance Program that provides public coverage for certain children in low- and moderate-income families.

President George W. Bush twice has vetoed bills that would have expanded the program.

The Census Bureau said 15.3 percent of Americans overall had no health insurance in 2007, meaning 45.7 million were uninsured in a country of about 300 million people.

Source:http://uk.reuters.com/article/healthNews

Insurance firm won't cover deaths

A medical malpractice insurance company claims it does not have to pay any damages that may be awarded to the families of deceased former patients of a Murray doctor charged in their deaths.
In court documents filed Tuesday, the Utah Medical Insurance Association argues its insurance policy issued to Dr. Warren R. Stack does not cover the deaths of patients Brandon Scott or Thaison Roark.
Stack, 61, is accused of illegally prescribing painkillers to as many as 80 people a day, leading to the deaths of at least five. He was indicted last year on 18 criminal counts, including conspiracy, dispensing drugs outside the bounds of medical practice resulting in death, unlawful distribution of a controlled substance and health care fraud.
One of Stack's employees has pleaded guilty to conspiracy in the case and agreed to testify against Stack in federal court, the association stated.
Stack's insurance policy excludes coverage for acts that violate the law, the association wrote. That means it does not cover the deaths of Scott or Roark, whose families have sued Stack.
Scott was 34 when he died in 2005. Roark died in 2006 at age 20. Court documents state that drugs prescribed by Stack also led to the deaths of Tyler Lugo, 24; Kaydie Winters, 25; and Michael W. Barker, 50.


Source:http://www.sltrib.com/news/ci_10674569

In Sickness and in Health (Insurance)

Re “Health Benefits Inspire a Rush to the Altar, or to Divorce Court” (front page, Aug. 13): The grotesque reality of my life has been constant constraint by the need for health insurance. With a congenital heart condition and a degenerative eye condition, I married my wife while in graduate school because I was no longer eligible for my parents’ group plan, and at the time few graduate programs offered grouphealth.

My career choices were dictated by the knowledge that I needed group health: the tenuous life of an academic in a tough job market seemed too risky, so I switched to law school. I avoided private-sector legal jobs upon discovering that many firms do not provide group insurance but expect individual lawyers to find individualhealth plans, so I ended up working for the state.

Fortunately, things have worked out for me so far. It was not desperate need, such as you described, but a sense of obligation and responsibility that drove me to make major life decisions based onhealth insurance needs (I do not have family who could foot the bill for open-heart surgery). But only in America are people with pre-existing medical conditions forced to plan every aspect of their lives around the need for grouphealth insurance. I have often toyed with the thought of emigrating to Canada or Britain simply to escape the constant, gnawing, lifelong fear of what might happen should my grouphealth for any reason ever lapse.

news source : http://www.nytimes.com/

Is Low-Cost Health Insurance Worth It?

Infomercial king Billy Mays, known for screaming about the wonders of cleaning solutions Kaboom!, OxiClean, and other household products, is now starring in a commercial for what he calls "the most important product I've ever endorsed:" health insurance. The bearded salesman started pitching iCan Benefit Group's "health insurance that you can actually afford" in May 2008, pointing to the need for its health plans given that 47 million Americans are uninsured. In the commercial, Mays says iCan's plans include guaranteed acceptance, starting as low as $160 per month for individuals and $260 for families, and can allow you to lower your monthly premium, increase coverage, or both. Concludes Mays: "You can't afford not to make this call."

His pitch shows how difficult it has become for many hard-pressed Americans to afford basic necessities, such as health care, as the cost of food, gasoline, and many adjustable-rate mortgage payments climb, while wages barely budge and employers cut jobs. To protect your assets, it's important that yourinsurance policies give you enough coverage in case something horrible happens to you or a loved one. Mays is understandably "passionate about health care." We all need health insurance, yet many Americans can't afford it, while the cost of the plans and of medical care keeps rising. Mays is pitching iCan's Mini Medical, a type of limited healthinsurance for those who can't afford major medical insurance or have been turned down because of preexisting health conditions.

Low Premiums Mean High Risk

These limited plans are not for everyone, and they could end up costing more if you need expensive care. "The problem is they're advertising these unbelievably low premium healthinsurance plans," says Mark Kenison, a financial adviser who specializes in insurance at Turning Point Benefits Group in Charlotte, N.C. "All you're doing its transferring risk to yourself so your monthly premiums are lower."

Consumers might focus on the low monthly price and not examine the cost and coverage of each health service, Kenison says. Beware of policies that don't set a maximum amount that you'd be responsible for paying for a health service, he advises. For example, iCan's mini-medical plan will probably not provide enough coverage if you get badly injured or need surgery. Looking at an example of the company's lowest-cost offering, iCan's mini-medical plan costs an individual $160 per month in North Carolina—plus an additional, $100 one-time enrollment fee—and covers a maximum of just $1,000 for surgery per year, with anesthesia limited to $250 per surgery. If you're hospitalized, the plan would cover only $200 for the first day and $100 each additional day, with a maximum of $1,100 for up to 10 days. On average, hospital care is estimated to cost $1,931 a person per year, according to the latest figures (2004) from the U.S. government's Centers for Medicare & Medicaid Services.

The low maximum benefits—and the prospect of huge additional out-of-pocket expenditures—bothers some financial pros. "It just feels wrong," says Kenison, adding that most people would be better off getting a major medical plan that limits their risk to a certain dollar amount. If you end up with a large medical bill, members of iCan's health plans have a health advocate to negotiate pricing and hospital charges, says Harold Shatz, managing member of iCan Benefit Group in Boca Raton, Fla. A $40,000 to $50,000 medical bill can be reduced to $10,000 to $12,000 through network pricing and use of a health advocate to examine the bills and find errors, he says.

news source : http://www.businessweek.com/