Posts Tagged ‘Health Insurance’
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In today’s tough economic times, a lot of people find the cost of prescription drugs unaffordable. What makes this situation even worse is the fact that many are also not covered by any type of health insurance nor are they covered by a prescription drug insurance.
Unfortunately, many of these people have illnesses that require medications. But there is a glimmer of hope: several pharmaceutical companies, organizations and large retailers offer free or low cost medication access programs. The web, as always, is an excellent resource towards finding and applying to these programs.
For example, one such pharmaceutical company is Xubex. Their patient assistance program is partnered with some of the leading providers of pharmaceutical care. This program offers all generic medications at a low cost. Moreover, certain people who qualify for their program receive a three month supply of medication for as little as $20. Note that certain companies enable getting free samples of brand name pharmaceutical products as well as discounts and coupons.
How does one apply to such programs?
Almost all pharmaceutical companies that offer medication assistance to people who cannot afford them are bound by their own specific policies. In order to get more specific information regarding these assistance programs, it is advised to go to company’s website, and if the information cannot be found there, directly contact the company.
Once the details of the program are obtained, certain forms must be filled by the patient (either online or downloadable PDFs) and mailed along with supporting documents. Every application must also be signed by the doctor who has prescribed the medication who is also required to fill in a section of the application form. It is worth nothing that certain companies require the complete application forms to be directly faxed from the doctor’s office.
These supporting documents include prescriptions and payment requirements. A necessary – and understandable – component of the application is the details regarding the patient’s income sources (or lack of). Clearly this aspect is one of the major variables that are used to determine a candidate’s eligibility for the no cost or low cost medication access programs.
Some companies also allow applying on behalf of other patients; this can be very helpful if one has a sick mother that is simply too ill to apply on her own.
After receiving the application, if approved, patients usually receive the medication within the next 24 hours.
Note that this type of application has to be redone every year along with up-to-date supporting financial documents. After all, it is possible that a patient’s financial situation has changed for the better and he may no longer be eligible for the program, allowing another, less fortunate patient to take his place.
We are privileged to live in a world where many companies offer such programs to those less fortunate. The fact that companies continue offering such programs to those less fortunate even in these tough times is truly a testament to the generosity of the human spirit.
Accidents are one of the major causes of death in the United States. Therefore, it should come as no surprise that a lot of accidents take place throughout the year, every year. Unfortunately, many people get injured, some quite seriously, and are left handicapped for life. Even if they survive and are released from the hospital, these people still require medical equipment to help them with their daily lives.
This type of medical equipment falls under the definition of “durable medical equipment” and includes oxygen tents, iron lungs, catheters, CPAP, wheelchairs, hospital beds and nebulizers. Most of this equipments is covered by health insurance plans.
In addition to those disabled by accidents, this type of equipment is also used by those disabled since birth and by senior citizens suffering from certain ailments or diseases. There are various companies supplying good quality and durable medical equipment with the commendable goal of assisting patients who have certain disabilities lead an independent life. Equipment such as electric scooters, rollators, grabbers and magnifiers also come fall under the “durable medical equipment” term.
As one seeks durable medical equipment to provide for those injured in an accident to help them with their daily activities, it is vital to ensure quality and durability. The reason is obvious: since a person’s life may depend on this equipment - or at the very least, a large portion of his life would be affected by it - it has to be be hundred percent safe and comfortable.
There are various companies providing durable medical equipment of high quality for patients. These include the Total e-Medical, Durable Medical Equipment, to name a few. Most of these companies operate with customer satisfaction being a primary goal and provide excellent quality equipment as well as fantastic service after the sale has been complete.
It is important to emphasize that particularly after an accident, it is essential to ensure the patients’ get their durable medical equipments delivered on time. Almost all companies supplying this equipment train their staff to be courteous and offer the most dedicated service. Something quite unusual in these times.
What happens if you need durable medical equipment?
In the unfortunate event you have been in an accident and have become disabled, you should look for a reliable supplier of durable medical equipment. One of the primary resources for finding the best suppliers in your area is the Internet. There are various companies that can be located online (and this website aims to provide links to many of them). Furthermore, you can compare prices and features of the equipment you are looking for, and order the most appropriate one for you. Finally, if you have a specific query or issue that needs to be addressed, you should always attempt to contact companies online - most will respond and may even get their sales executive to come and meet you in person.
Once they arrive, these sales people will be able to provide useful advice regarding the best equipment that is most suitable for your requirements. Note that your doctor should be involved in this decision making as well. Once you have made a decision on which equipment you are interested in obtaining, they will deliver it to your home. Finally, if there is ever a problem or a malfunction in the equipment, these companies will also provide you with excellent backup service.
There are other alternatives. There are numerous support groups online, such as Yahoo Groups, Google Groups, and forums dedicated to certain subjects. These provide excellent resources for asking questions and getting extremely useful information with regards to medical equipment and its suppliers. In fact, many times this information can be more useful than what the doctor suggests, as the people who give answers are the people who are actually use these machine in their day-to-day lives.
One final source of information with regards to durable medical equipment suppliers is - perhaps surprisingly - the local yellow pages. You can just contact a few of these companies over the phone and get a quote and features of the desired equipment. After comparing the brand, quality and price you can settle on the company that offers the best deal. Choose your durable medical equipment with care as, sadly, this might be a lifelong companion.
My Online Medical Supplies offers a wide range of medical equipment and supplies, including:
- Quality Medical Equipment, free shipping on orders over $100
- Mobility aids for you or your loved one - Walkers, rollators, wheelchairs, canes and more.
To see the full list, visit our medical equipment and supplies section.
Modern medical science is continuously devising new ways to keep us healthier and live longer, but this comes at a cost - health care has now become more expensive. Here are some proven and useful tips which will help you in cut your health insurance costs:
First, Health insurance can be purchased individually or as a part of group policy. Group Policies are arranged and purchased by employers and associations for their employees. If purchased in bulk they come at a cheaper price. The administration costs involved are reduced and employees have to pay only a part of the premium thus cutting their huge health insurance bills. Consequently, if you have a choice, go with a group policy offered by your employer.
Second, Through group health insurance policies employees can also cover their families’ health care facilities as well. This is signicifantly cheaper than purchasing health insurance individually for each family member.
Third, Shop around: compare the various Health Insurance Plans. Different health insurance plans may offer different premiums. The quote you will get are likely to be different, and assuming all are equivalent, you could simply go with the cheapest. When doing this assessment, examine in detail coverage and the features of the plan, including limitations and exclusions if any. For example, if you had to make frequent visits to a specific type of doctor (i.e. a psychiatrist), verify whether they are covered in the health insurance plan, and whether there is a certain quota to these treatment. You can compare rates of 100 providers using this link. As for comparison of medicare rates, use this link.
Fourth, This continues the previous item, when assessing the various health plans, make sure you take a plan that suits you. For example, if you are generally a healthy person and rarely need to see a doctor, you may opt to go with a plan that is less flexible, offers a higher co-payment but significantly lower premiums. Similarly, if you don’t wear glasses, and have good eyesight, you probably don’t need a vision insurance plan.
Fifth, Order prescriptions through mail: it is possible to order several months’ worth of supply by ordering prescriptions through a prescription drug plan (covered in one’s health insurance). This will definitely save you money. Likewise, most of the pharmacies offer discounts on bulk purchases as well.
Sixth, Use Generic Brands: Discuss your financial needs with your doctor and ask him whether he could prescribe generic drugs rather than brand names. Generic drugs are claimed to be as effective, only much cheaper, than their brand name counterparts. Note that certain companies enable getting free samples of pharmaceutical products as well as discounts and coupons.
Seventh, Check the accuracy of the Bills: although this may seem like common sense, most health insurance bills are overly complicated. Therefore, check each item in the bill, verify its correctness, and whether this should have been fully covered by your plan or not. It is very possible the insurance company has accidentally overcharged you due to a mistake, and a simple phone call can rectify this error.
Eighth, Plan ahead: according to current IRS rules it is necessary to itemize the deductions. Your total medical expenses must go beyond 7.5% of your adjusted gross income. Once you reach this threshold, you can deduct various medical expenses when filing taxes. When filing taxes, it is possible to include medical expenses which cover a wide variety of treatments: from basic health care services to hearing aids as well eyeglasses. Make sure you keep track of these expenses so you could later claim them in your annual tax return.
Ninth, Consider preventative care: some insurance plans offer workshops that aim to improve your health in general, such as Tai Chi. Participating in these may not only increase your health, but also reduce your future health care bills.
Tenth, Use free health screenings: often, local hospitals offer health screenings for free such as for cholesterol and blood pressure. By participating in these you could save money.
An individual can guarantee that funds will be available to pay for his or health care benefits, if necessary, by routinely paying a premium (which can be on a monthly or an annual basis).
Until the 1970s, the majority of individuals received standard insurance coverage. Nowadays these plans are known as “fee-for-service” plans. Similar to auto insurance, indemnity plans require you to pay a deductible to cover a portion of your medical expenses. The insurance company then will pay the remaining, albeit sometimes not all, of the balance. Modern medical science is continuously devising new ways to keep us healthier and live longer, but this comes at a cost - health care has now become more expensive.
Fee-For-Service
Indemnity or fee-for-service coverages have been the industry’s standard for decades. The benefit of this type of health plan is that a person may choose his own doctor or hospital. Furthermore, he can refer himself to a specialist without getting approval and, as long as it’s an in-network provider, enjoy the same co-pay. No referral or approval is required to make such an appointment with a physician. That being said, there are limits: for example, a person may require approval to visit the emergency room, unless some circumstances, such as being incapacitated, prevent him from doing so.
The negative aspect of fee-for-service plans is that they normally require higher out-of-pocket expenses. Frequently a deductible exists, typically around several hundred dollars, only after which the insurance provider begins paying. After this threshold has been reached , the insurance provider usually pays most (%75-80) of the doctor’s fees. It may also be necessary for a person to pay immediately and send in a bill in order to receive reimbursement. Alternatively, the physician himself could bill the insurance company directly.
Generally, insurers will pay solely for medical expenses that are considered to be “reasonable and customary” when under fee-for-service plans, take into consideration the average fee that similar practitioners charge for equivalent services. If an individual happens to be billed by a physician that charges more than what the insurance company has defined to be acceptable, he will likely need to pay the difference in costs on his own.
Interestingly, fee-for-service plans have tended in the past to not cover preventative care services, such as annual physicals, but an increasing number of insurance providers are now beginning to include preventative care services, as growing evidence suggests that in the long run, this will actually save them money (i.e. prevent a man from smoking, and he may not need expensive cancer treatments 20 years from now).
Fee-for-service plans often have a maximum limit for out-of-pocket expenses; once that maximum amount has been reached they cover the rest of the bill themselves. It goes without saying that the maximum amount is normally high.
In summary, fee-for-service plans provide more options in exchange for increased out-of-pocket costs, higher premiums and more bureaucracy.
Managed Care
As popular as managed care has become in the past decade, it actually originated in the 1930s, and has been with us in various forms since then. As the health care insurance industry evolved, we were presented with three varieties of managed care plans. Nowadays, most individuals with private health insurance also participate in some variation of managed care.
While there are some key differences among the various forms of managed care plans, they share common elements. Specifically:
- An arrangement exists between the insurance company and a network of health care providers.
- The insured individual gets significant financial incentives to use the providers within this network.
- There typically are specific guidelines for choosing medical professionals and a formal procedure to assure high quality of care.
Health Maintenance Organizations (HMOs)
Most discussion about HMOs are about closed-panel HMOs, which are the cheapest but most rigid health plans available. These plans are structured for group plans as opposed to individual plans. This comes in exchange for a lower - or no - co-payment due at the time of the doctor’s visit.
Although HMOs plans have lower premiums and require less paperwork, members are limited to the health care providers in their network, and their primary care physician must refer them to specialists if they want to see one. Furthermore, as long as one is physically capable of doing so, he is also likely to require approval in order to go to the emergency room (an inconvenience to say the least!).
HMO plans may offer central medical clinics; alternatively, they may comprise a network of participating individual health care providers. Normally, a member is required to use HMO-approved doctors, otherwise he will pay all fees himself. As far as consumer impressions, HMOs beat out the competition in programs for preventative care and health improvement, but this comes at a great reduction in flexibility.
Preferred Provider Organizations (PPOs)
PPOs offer more flexible plans than ’standard’ managed care. PPO plans have a network of health care providers with which they have agreement that the latter will charge lower fees. As is the case with managed care, PPOs also give their insured individuals a financial incentive to use health care providers within their network. To illustrate, going to an in-network health care provider may require a $15 co-pay. However, in order to see an out-of-network health care provider, insured individuals would have to pay all medical expenses on their own and then submit a claim for typically an 75-80% reimbursement. In some cases there will also be a deductible payment required for service outside of the network or at the very least, the insured individual would have to pay for the differences in the costs between an in-network and an out-of-network treatment.
That being said, one advantage of a PPO is that the insured individual can see a specialist in-network doctor without getting prior approval and pay the standard co-pay. In other words, using in-network doctors means cheaper treatments and less bureaucracy. On the down side, PPO plans typically do not cover preventive care programs.
Point-of-Service (POS)
POS plans are like a PPO plans, but they uses a Primary Care Physician (a PCP) as a ‘gatekeeper’ for services. The plan will provide each member a list of doctors to choose a PCP from. Similar to PPO plans, going to an out-of-network doctor is still possible, and the insured individual will be partially reimbursed for the costs. However, this comes at a price; if one wishes to see a specialist, he typically must be referred by his PCP (and that is why he is called the ‘gatekeeper’). One can ‘bypass’ the gatekeeper, but it will result in higher out-of-pocket costs and far more bureaucracy.
If a participating physician agrees to refer an individual to an out-of-network health care provider, the insurance plan normally pays most of that cost. however, if he or she goes to an out-of-network health care provider without a referral, then most likely they’ll receive a smaller reimbursement and have to deal with far more paperwork. The insurance provider may also charge a deductible if one sees a provider outside of their network.
One additional advantage of POS plans is that they often cover more preventative care services, at times even programs such as workshops on nutrition, Tai Chi classes, and smoking cessation.
Exclusive Provider Organizations (EPO)
EPOs are PPO Plans that ‘feel’ like HMO plans. EPOs make it even more attractive for insured individuals to seek medical treatment within their network. For example, even though going to an out-of-network health care provider is possible, the insurance plan will not cover anything: the insured individual will have to pay entire cost of the treatment on his own.