Health Care Reform Articles
We’ve compiled a host of articles regarding different topics related to your personal health and health care reform. Whether you want to learn more about the importance of monitoring your health through lab testing to Christian, member-based “insurance” alternatives, to candid insight from a physician, you’ll find a wealth of information here. Check back often, as we are continually adding new information from our guest contributors.
Using Flexible Spending Plans Wisely with Catastrophic Health Plans
This is a big year for healthcare changes. The Affordable Care Act requires individuals to purchase health insurance or pay an Individual Shared Responsibility Payment. While those who already have insurance aren’t affected by this mandate which is effective this year, there are quite a few who need to make plans to deal with this,
This is a big year for healthcare changes. The Affordable Care Act requires individuals to purchase health insurance or pay an Individual Shared Responsibility Payment. While those who already have insurance aren’t affected by this mandate which is effective this year, there are quite a few who need to make plans to deal with this, if they haven’t yet. Insurance is critical for protecting people from financial ruin due to major medical care, but may not be needed for planned or routine care.
The Obama administration is expecting that there are millions of people who will have the option of choosing a Catastrophic Health Plan. What is this and who is eligible? A Catastrophic Health Insurance Plan is intended to pay for healthcare needs after a very high deductible is met. The Catastrophic options found on the Healthcare Marketplace may carry deductibles as high as the maximum out of pocket limit of $6350 per person. Although the plan includes 3 doctor’s office visits per year and must cover the 10 essential benefits required by the Affordable Care Act, the majority of healthcare will be out-of-pocket. Only those who are 30 or under or have other extenuating circumstances (such as having their healthcare insurance plans cancelled) are eligible. For these people it will be important to plan out their expected medical expenses for the year and set a budget.
One way to manage a catastrophic insurance plan is through a Flexible Spending Account. If your company offers one of these and you fall under the category of those able to choose a high deductible plan, you will be able to set aside pre-tax dollars that can then be used for medical purposes that your plan doesn’t cover. Although you are still paying for the medical care, your money goes further because it is deducted from your paycheck before taxes are taken out, reducing the amount of taxes you pay. This puts the responsibility for planning out your healthcare for the year on you but will ensure that you become a smarter healthcare consumer.
So, if this is an option for you, what is the best way to use your Flexible Spending dollars? Start by planning your expected medical costs for the year.
- Calculate the costs for your plan including co-pays that you will need to pay.
- Determine how many doctor’s visits and services you expect to need during the year. Be sure to schedule them, or put scheduling them on your calendar, so you aren’t at the doctor the whole month of December to ensure that your funds get used.
- Combine the two above to get your planned medical expenses laid out, subtracting anything that your plan will cover, such as the three basic visits. Set a budget at the beginning of the year using the numbers above for check-ups, lab tests, vision and dental.
- Start saving for medical events that won’t be covered until you reach your deductible. Add this to the budget for expected medical care.
The total of what you will need to put into a Flexible Spending Account is your budget for expected medical care, less your insurance premium. These funds can be used throughout the year to pay for your non-covered medical expenses. Since FSA funds need to be used by the end of the year it is important to estimate as closely as possible what to save in the FSA. You will still need to save for unexpected large medical emergencies, but since you have a budget laid out, you can feel relatively comfortable that you won’t lose your money at the end of the year.
If you haven’t used all of your FSA dollars by year’s end, here are some ideas for making the most of your money:
- Stock up on medical supplies that you know you will need such as contact lenses, headache or cold medications, blood pressure monitors, first aid kids or wrist, joint or knee braces. Most of these items are identified in Publication 502, Medical and Dental Expenses and include everything from birth control and breast pumps to eye surgery and fertility enhancement.
- Consider using your funds for procedures or improvements you’ve been considering. These might include a new set of dentures, laser eye surgery, prescription sunglasses or anything you’ve been putting off.
- Birth control, orthodontia, stop smoking aids such as Nicorette or special foods for a diet are covered. FSA funds can be used for anything supported by a doctor’s recommendation.
- Consider proactive health and wellness care, such as getting lab tests to monitor your overall health, or to check out symptoms you may be having, but you haven’t wanted to go see your doctor about yet due to your budget and fear of the cost of care.
- Finally, go back through your receipts and look for qualified expenses from your grocery or pharmacy receipts and you may find a lot that you can be reimbursed for.
Most of us have gotten used to using healthcare insurance for any little thing that we think we need medically. The Affordable Care Act is going to get a lot of people rethinking what health insurance is really intended to do: Protect us from having to use our life savings for unexpected medical emergencies or illness.
Small Business Owners and the ACA
If you are a small business owner or self-employed, the Affordable Care Act (“ACA”) probably has you scratching your head. Am I suddenly going to have to shell out a lot of money for my employees’ health insurance? Will my premiums go up? Will I be able to afford it? How do I know whether
If you are a small business owner or self-employed, the Affordable Care Act (“ACA”) probably has you scratching your head. Am I suddenly going to have to shell out a lot of money for my employees’ health insurance? Will my premiums go up? Will I be able to afford it? How do I know whether I can use the healthcare marketplace and whether I’m eligible for subsidies? In addition, the regulations keep changing and deadlines for some phases of the employer mandates have been pushed out even farther. With constantly moving targets it’s no wonder we’re confused. It is complicated for entrepreneurs to know what to pay attention to, but you need to start watching closely, if you haven’t already.
If you are self-employed you will need to have a pretty clear estimate of how much you earn to determine whether you are eligible for tax subsidies. If you purchase health insurance on the health insurance exchange marketplace you will have to provide some estimate for your income. If you make more than 400% of the Federal Poverty Level (FPL) ($46,000 for an individual or $94,000 for a family of four) you will end up paying full price on the exchange. If your income and your business are stable this is simple enough even if it’s more than you want to pay.
But, what if your income fluctuates because some months you make more than others and you don’t know how much you will make? You will need to estimate what you think you might make and then use that to determine whether you are eligible for subsidies. If you make less than the FPL, under $11,000, you should apply for Medicaid. There is good news for those who think they will be eligible for subsidies: If you end up not making enough to qualify for health insurance through the marketplace and you should have been on Medicaid, you won’t be penalized for getting subsidies. Unfortunately, the reverse is that if you make more than 400% of the FPL during the year, you will be required to pay the subsidies back.
If you are a small business owner who has employees, the trigger isn’t how much you make but how many employees you have. If you employ less than 50 people, you are not required to offer health insurance to your employees. Small business owners with 50-99 employees will be required to provide affordable health care to cover essential services including many preventive care services. Affordability is key and you can be penalized if your plans aren’t affordable for your employees.
The date for this to go into effect has been moved to 2016, but you should begin tracking employees’ hours. These numbers will be used to categorize companies later so you need to know who is full time (working at least 30 hours per week) and be able to support your data. If the coverage doesn’t cover essential services or is too expensive (more than 9.5% of household income) and an employee purchases health insurance on the exchange and gets subsidies, the employer will be penalized.
Because health insurance providers are now required to provide essential care for many people who may have pre-existing conditions premiums are going up. While the Obama administration hopes that having employers providing healthcare coverage will help to keep these costs reasonable, many insurance companies have already raised their rates. This has caused some small businesses to rush out and renew their plans early to avoid higher prices down the road. According to a study conducted by the National Federation of Independent Businesses (NFIB) Research Foundation 66% of small businesses are cutting into their profit to pay for cost increases and 40% have deferred investments to cover the premiums. The projected increases may mean some small businesses will continue their employee plans only through 2014 and then drop them when it’s time to renew and the costs are too high.
The Affordable Care Act will make all of us reach deeper into our pockets to pay for our healthcare, both small businesses and individuals. It is time to get smart about how we spend our healthcare dollars and small businesses will be thinking long and hard about whether they will be footing the bill for their employees in coming years. If you have coverage through a small employer, enjoy it while you can, and start planning your healthcare budget for checkups and medical tests and be proactive with taking control of your and your family’s health in case you’re on your own.
Personalization and Health Care Reform: Can They Work Together?
Health care reform is many things to many people: better coverage for those who can’t afford healthcare; higher deductibles and prices for those who already had health insurance; complicated changes to existing healthcare plans; insurance coverage for those with pre-existing conditions; and the muddle of the Healthcare Marketplace to find a plan that works for
Health care reform is many things to many people: better coverage for those who can’t afford healthcare; higher deductibles and prices for those who already had health insurance; complicated changes to existing healthcare plans; insurance coverage for those with pre-existing conditions; and the muddle of the Healthcare Marketplace to find a plan that works for you and that you can afford. But it may also mean personalization of healthcare.
What does “personalization” mean and how will people get it when choosing medical services? When you go into a retail store to purchase something but you don’t know exactly where to look or what the right choice is, who do you ask? Generally people ask the retail sales associate.
The expectation is that they will know not only where the product is in the store, but the best purpose for it and how to use it. Unfortunately, according to a recent survey, the “Retail Buying Experience”, we are more often than not disappointed. 2 out of 5 consumers become frustrated because the sales associate doesn’t have the expertise to guide them toward the right product for their specific needs. The survey findings really point to one word: personalization.
The Affordable Care Act will push all of us to become smarter consumers of healthcare because more of us will be opting for High Deductible Health Plans (HDHP) and the use of Health Savings Accounts (HSAs) in order to cut costs on rising healthcare costs and insurance premiums. Health insurance companies are required to cover basic preventive care services and tests which weren’t previously covered. Many people, and their companies who provide the health insurance policies, have seen their premiums and costs rise due to these requirements. The requirement for everyone to purchase health insurance will push young, healthy individuals to seek out the least expensive options, frequently the HDHPs.
These changes will lead us all toward being more selective in the healthcare choices we make. You may want to be more proactive with your own individual wellness in an effort to stay healthier and keep your insurance premiums and health-related costs down. You may also choose to have lab tests whether they are covered by your insurance or not because you believe you need the information they will provide to measure and monitor your health. Independent labs like ANY LAB TEST NOW® have Medical Assistants who are knowledgeable about the tests that they provide and can guide consumers to the ones that may be the most appropriate for their circumstances. If the lab test results are “abnormal” or “out-of-range”, you will be encouraged to then see your physician.
A “one size fits all” approach is no longer the norm as we adapt to stricter healthcare budgets. Personalization is a major trend for 2014, not only at drug stores and big box stores, but at your doctor’s office and your chosen lab testing facility.
Children’s Health Insurance Program (CHIP) and Pregnant Women
If you’ve heard of the Children’s Health Insurance Program (CHIP) you may be aware that it provides medical care at little or no cost to children whose families cannot afford health insurance and medical care. Each state offers CHIP coverage and works closely with its state Medicaid program. If the family or guardian of a
If you’ve heard of the Children’s Health Insurance Program (CHIP) you may be aware that it provides medical care at little or no cost to children whose families cannot afford health insurance and medical care. Each state offers CHIP coverage and works closely with its state Medicaid program. If the family or guardian of a child makes too much to qualify for Medicare, they may be eligible for CHIP. The Affordable Care Act has helped to create a simple streamlined system of affordable coverage between Medicaid, CHIP and the Affordable Insurance Exchanges, making it easier for individuals to determine whether they qualify for Medicaid or CHIP.
The CHIP program provides vital care for low income children but what about the unborn children of pregnant women who cannot afford health care?
CHIP also offers a perinatal program that provides coverage to pregnant women with household incomes up to 200 percent of the FPL who are not eligible for Medicaid. This is equal to $22,980 for an individual and goes up by $12,060 for each additional person in the household.
While CHIP covers children from birth through the age of 18, the CHIP perinatal coverage provides health care to unborn children for a 12 month coverage period. It covers labor with delivery and prenatal care for the pregnant mother as well. The baby’s health and medical services are covered for the first months of life with no waiting period. This ensures that pregnant women, unborn children and newborns receive critical health care.
Do I qualify?
If you meet the financial qualifications you may be eligible to receive the CHIP perinatal coverage free or for very low cost ($50/year). For example, in Texas, if you are pregnant, a Texas resident (either a US citizen or a qualified immigrant), you don’t have insurance, and you cannot get Medicaid you may be eligible. Not all states offer this benefit so you will need to go to the CHIP website to determine whether you are eligible and if it is available in your state.
What does CHIP perinatal coverage include?
- Up to 20 prenatal visits.
- First 28 weeks of pregnancy ― one visit every four weeks.
- 28 to 36 weeks of pregnancy ― one visit every two to three weeks.
- 36 weeks to delivery ― one visit per week.
- Additional prenatal visits allowed if medically necessary.
- Some laboratory testing, assessments, planning services, education and counseling.
- Prescription drug coverage based on the current CHIP policies.
- Hospital facility charges and professional services charges related to the delivery. Preterm labor that does not result in a birth and false labor are not covered benefits. This will vary depending upon your income.
What are the benefits once the child is born?
- Two postpartum visits for the mother.
- Depending on the family’s income level, the newborn’s first hospital admission may or may not be covered by CHIP perinatal.
- Once a child is discharged from the initial hospital admission, the child receives the traditional CHIP benefit package.
CHIP perinatal does not cover services that are not related to labor or the health of the baby.
How do I find out more?
The Connecting Kids to Coverage National Campaign, begun in 2012 to provide information and encourage enrollment in Medicaid and CHIP for eligible families. The Campaign lets families know who is eligible, what benefits children can get and how to apply for coverage. To find out if your state participates go to InsureKidsNow.gov. This website will allow you to find out which programs your state offers and provides links for applying for Medicaid or CHIP programs.
If you think you may be eligible, reach out now to get the health care that you and your child needs!
- Up to 20 prenatal visits.
Healthcare Reform is Here: Do You Know What to Expect for 2014?
The march of the Affordable Care Act continues and there are more changes coming in 2014. We’ve already seen some changes including expanded coverage for some doc tor’s visits and prescriptions. The biggest change coming during 2014 is the requirement that individuals must purchase insurance and businesses with more than 50 employees must provide health
The march of the Affordable Care Act continues and there are more changes coming in 2014. We’ve already seen some changes including expanded coverage for some doc tor’s visits and prescriptions. The biggest change coming during 2014 is the requirement that individuals must purchase insurance and businesses with more than 50 employees must provide health insurance for their workforce. While this is great for those who have not been able to afford healthcare insurance before, some of us will feel the pinch of higher insurance premiums as health insurance companies expand their coverage to include required, essential health benefits. Others may not be able to qualify for subsidies to help pay for health insurance. The changes we’ll see in 2014 are:
- Continuation of Healthcare Marketplace enrollments through March 2014. Coverage will begin on January 1, 2014 for those who have enrolled during the fall of 2013. You won’t be able to enroll after March 31, 2014 unless you have a qualifying life event, such as moving to a new state, certain changes in your income or changing the size of your family by getting married, having a baby or getting a divorce. Open enrollment for 2015 will likely open on November 15, 2014.
- Individual Mandate and “individual responsibility payment” for those who do not purchase health insurance by April 1, 2014. Individuals who do not buy health insurance by this date will be required to pay a penalty called the individual responsibility payment. During this first year the payment will be 1% of your household income or $95 per person up to a maximum of $285 per family, whichever is higher. By 2016 the fee will increase to $695 per person.
- Households with income levels between at the Federal Poverty Level (FPL), $11,490 for 2014, up to 138% of the FPL, or $15,856, are eligible for subsidized healthcare. In some states Medicaid will expand in 2014 and raise the annual income for which more individuals and families will qualify to receive healthcare coverage. However, nearly 5 million Americans will fall into a gap between healthcare subsidies and Medicaid. This means that they make too much to qualify for Medicaid but not enough to qualify for healthcare subsidies. These people will need to explore low-cost health care at community health centers and direct access lab testing facilities.
- Businesses with 50 or more full-time employees must offer health insurance to employees but aren’t subject to penalties until 2015. These penalties are the Employer’s “Shared Responsibility Payments” that they will need to pay if they don’t provide health insurance to employees.
- Businesses with less than 25 employees may be eligible for a tax credit of 50 percent of the cost of insurance premiums they pay for their employees.
- Insurers may no longer deny coverage for pre-existing conditions, with exceptions for previous plans that are still in place. These grandfathered plans will be allowed to continue to exclude pre-existing conditions. Medicaid and the Children’s Health Insurance Program (CHIP) cannot refuse to cover you and can’t charge you more because of a health condition.
- Insurance companies may no longer set annuals or lifetime caps on essential health benefits which include:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (such as surgery)
- Maternity and newborn care (care before and after your baby is born)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services
Insurance companies will still be allowed to put annual and lifetime dollar amounts on services that do not fall under these essential health benefits. This specific 2014 change will be particularly helpful for those who have a catastrophic illness or accident and those with chronic illnesses that require expensive or long-term medications and treatments. On December 31, 2014 grandfathered plans that do not comply with the ACA will expire, but this may be reviewed and the plans extended.
If you haven’t looked into which healthcare plan you will purchase and how you will manage the upcoming changes to the healthcare landscape, you only have a few months left. It’s time to make some decisions and become an informed healthcare consumer. Are you ready?
Do You Know How to Prepare a Healthcare Budget?
If you’ve been reading the news about the Affordable Care Act (ACA) and the Healthcare Marketplace you may be starting to get worried. Are you prepared for the changes? Those who are employed and have medical insurance through their job or those who are already on Medicare or Medicaid may not have much to worry
If you’ve been reading the news about the Affordable Care Act (ACA) and the Healthcare Marketplace you may be starting to get worried. Are you prepared for the changes? Those who are employed and have medical insurance through their job or those who are already on Medicare or Medicaid may not have much to worry about. For most of these people, healthcare costs will stay relatively stable and there won’t be major changes to their plans. But, some health insurance companies are dropping policies and customers or raising their rates because their previous plans don’t meet the requirements of the ACA.
If you have to get new health insurance, either due to a change by your insurance company, or if you’ve been taking your chances without any healthcare coverage at all, you may be in for a big surprise. Do you know how much it will cost you? Are deductibles, premiums, maximum out-of-pockets amounts and co-pays clear to you? If not, you have some planning to do. You’re going to need to lay out a healthcare budget so that you know what you can afford and what that money will get you.
The first step is to determine what you can expect to pay and what you get in return. Add up all of the costs below and try to estimate what the insurance, deductible, co-pays and scheduled or necessary medical procedures will cost so that you are prepared. We have included a Healthcare Budget checklist at the end of this article to help you get started with the planning process.
- Monthly Insurance Premiums – This is the monthly cost that you pay for having health insurance whether you go to the doctor that month or not.
- Deductibles (Individual vs. Family) – This is the amount that you need to pay before your health insurance coverage kicks in. Not all services are subject to the deductible but will apply if you are seeing a doctor who is out of your network or you are getting a health service that isn’t fully covered under your plan. The deductible can range from $250 to over $6000. The higher your monthly premium, the lower your deductible and vice versa, the lower your monthly premium, the higher your deductible. If you expect to need a lot of medical care until you reach the deductible you may spend more if you try to go for a lower monthly payment. There are also different limits for individuals and families. An individual limit is lower than the family limit which can be reached by any combination of medical services.
The Healthcare Marketplace offers 5 levels of insurance coverage: Bronze, Silver, Gold, Platinum and Catastrophic. The Bronze plan offers a lower monthly payment but carries a high deductible and Catastrophic offers the lowest with very minimal healthcare coverage, but is only available to those under 30 or those with a hardship exemption. The Platinum plan has the highest monthly premium and a very low deductible which is perfect for those who know that they will use healthcare services frequently or may have a pre-existing condition that is expensive to treat. As an example, the Silver Plan, which falls about in the middle in terms of monthly premium and deductible will require you to pay 30% of your healthcare costs while meeting your deductible. On the Gold Plan you will need to pay 20% of your healthcare costs. For more detailed information, check out our “What Are Your Options” Infographic.
- Co-pays or co-insurance – Take a look at the co-pay, a set amount per doctor visit, you and/or your family might need to pay by reviewing the average number of doctor’s visits over the past 2 years. It used to be as low as $10 but now may be higher, especially if you go to a specialist or to the Emergency Room. These co-pays can be as high as $150!! Co-insurance is your share of the cost, so you would be responsible for 20% (or more) of the visit.
- Out-of-Pocket Maximum – These expenses are the amount that you could have to pay over the course of a year in deductibles and co-pays for covered visits and procedures before your insurance company pays 100% of your healthcare costs. Premiums are not included in this number and some policies do not include deductibles or co-pays. For any Marketplace plan in 2014 the maximum out-of-pocket for an individual is $6350 and $12,700 for a family.
- Unexpected Costs and Health Savings Accounts – Prepare for an emergency. Establish a savings account or if you qualify by having a high deductible insurance plan, Health Savings Account (HSA) that comes out of your paycheck automatically with direct deposit, if possible. Funds deposited in an HSA account are tax-free, so it makes sense to plan ahead and may monthly or bi-monthly deposits based on the budget you determine. And, unlike a Flexible Spending Account (FSA), these funds are yours and rollover year after year.
To determine the cost of your coverage you will need to get quotes from health insurance companies. Look into whether or not you are eligible for a Medicare or tax subsidy to help cover all or part of your health insurance premiums. The Kaiser Family Foundation provides a tax subsidy calculator to help you figure that out. Additional online resources that can help you determine which healthcare plan and subsidies you may qualify for include Healthcare.gov and Fair Health Consumer Cost Lookup.
It is important to know what a doctor’s visit or a procedure will cost before you go. Plan out the cost of those that you know you will need so that you can include the costs in your budget. Sites such as Clear Health Costs or Credit.com have tools that can help. Many consumers do not know that they can ask for the cash or self-pay price in advance. Some healthcare providers may be willing to negotiate a lower price for cash or self-pay.
When setting a doctor’s appointment, check to ensure that the doctor is in your health insurance network to avoid paying the out-of-network prices and be sure to get any required authorization before scheduling a visit with a specialist or planning a medical procedure. With the Affordable Care Act, some preventive care and prescriptions are covered before you have met your deductible so be aware of which services or prescriptions you shouldn’t pay for out-of-pocket. Let’s get started with your healthcare budget! (Insert Infographic Here)
You are empowered to make healthcare decisions for yourself and the options for medical care continue to grow. Medical consumers will have to become better informed and get used to price shopping for doctors and services, mixing and matching, to find the right combination for their health and budgets. Get to know service providers in your community that offer transparent, affordable prices that meet your needs, such as lab testing services required by doctors to best treat and diagnose, MRIs centers, and after-hours emergency services and clinics. Become an informed healthcare consumer and Take Control of Your Health® without emptying your wallet!
HEALTHCARE BUDGET CHECKLIST
Monthly Insurance Premium:
Average Monthly Cost of Prescriptions =
Average Number of Prescriptions per Month _____ x Co-Pay or Co-Insurance (%) per visit ______ x Cost per Prescription with Selected Healthcare Plan ______:
Total Estimated Monthly Healthcare Costs:
Total Estimated Annual Healthcare Costs (Monthly x 12):
ADDITIONAL MEDICAL COSTS
Think about any additional costs that you may incur over the year above the monthly costs needed. Plan to save for these in advance or over time so you are prepared.
Planned Medical Procedures:
Having a Baby, Knee Surgery you’ve needed for a while, necessary services based on a pre-existing condition. Consider the total cost of the procedure and whether you will have met your deductible and what percentage your plan will pay. Use an online tool to help figure out the expected cost (Clear Health Costs).
Health Savings Accounts:
These accounts allow you to save pre-tax dollars for co-insurance, medical tests, lab tests and procedures that you want/need before you’ve met your deductible or that your insurance doesn’t cover.
Unexpected Emergency Savings
Medical emergencies do happen so set aside some savings that will cover the deductible in case an unexpected accident sends you to the emergency room.
Proactive Health Monitoring
It makes sense to monitor your health periodically, and you have the ability to purchase lab tests to see where you stand. Consider annual lab tests to check your cholesterol, glucose, hormones and more.
Total Estimated Annual Savings Needed for 2014 Medical Care:
Christian Healthcare Ministries: An Eligible Option Under the U.S. Affordable Care Act
The Patient Protection and Affordable Care Act (PPACA)—more commonly known as Obamacare—is the new national health care law. The principle of sharing health costs among Christian believers, however, is as old as the New Testament—and contemporary enough to be included in America’s new health care law. “With great power the apostles continued to testify to
The Patient Protection and Affordable Care Act (PPACA)—more commonly known as Obamacare—is the new national health care law. The principle of sharing health costs among Christian believers, however, is as old as the New Testament—and contemporary enough to be included in America’s new health care law.
“With great power the apostles continued to testify to the resurrection of the Lord Jesus. And God’s grace was so powerfully at work in them all that there were no needy persons among them. For from time to time those who owned land or houses sold them, brought the money from the sales and put it at the apostles’ feet, and it was distributed to anyone who had need.” Acts 4:33-35
This New Testament passage is the biblical rationale for the existence of Christian Healthcare Ministries (CHM). CHM exists to glorify God and serve His people by enabling them to meet their health care costs affordably, compassionately and biblically. Our members are employing the same principle as the early Christians. They are meeting other’s needs, in this case exclusively in the area of medical bills.
This particular approach is not a new concept, as CHM today is more than 32 years old.
Our ministry works in a way that is familiar to every Christian. The membership – or congregation – makes financial gifts that are used to meet a need.
It’s the way Christians for more than 2,000 years have supported everything from church staffs and missionaries to building programs to benevolence efforts. A need exists, whether it’s to pay a pastor or help a church member who has lost a job. Money is collected and used to meet the need.
CHM works similarly. Our members each month send financial gifts to our ministry, which is then distributed to members who have medical conditions.
Our ministry is not insurance. There is no assignment of risk. There are no contracts. Our members agree to voluntarily share in meeting each other’s eligible medical bills.
Thus, CHM’s ability to serve God and our members isn’t based in legal compulsion or contractual obligation. The strength of our ministry is the faithfulness and Christian commitment of our members to each other, all of whom are meeting a critical life need as they support their fellow Christians.
CHM members are technically self-pay patients. Except they really aren’t. Each member has tens of thousands of fellow members supporting them with their financial gifts and prayers.
As technically self-pay patients, members are able to negotiate their own arrangements with health care providers. For example, one of our members who was experiencing significant chest pain spent seven hours in a hospital emergency room being tested for a possible heart attack or heart problems.
The diagnosis was pericarditis, a painful condition that was in this case treatable with high doses of ibuprofen. The bill was $8,900. As a self-pay patient our member received a 47 percent discount on his bill. CHM shared 100 percent of his remaining costs. When our member went to the cardiologist for a follow-up visit, he explained that he was a member of a health care sharing ministry and asked the cardiologist for a discount. The physician said that sounded good to him; he said his physicians’ group had six employees whose only job each day was to file insurance claims and talk to insurance companies. Instead of his normal $130 office visit, his charge to the member was $90.
This is only one example of CHM members saving on health care costs and having their needs met while they also help meet the needs of fellow Christians.
CHM meets the legal criteria under the Patient Protection and Affordable Care Act (more commonly known as Obamacare) for health care sharing ministries. CHM is an eligible option under the law through which members can meet the legal requirement to have health cost support. That means ministry members need not fear penalties for not having “health insurance.”
CHM has programs that provide for health cost support for members with pre-existing conditions and health cost support for medical bills that reach $1 million per condition. Additionally, our employees regularly pray in special prayer sessions, in our weekly chapel services, and over the phone.
Once again, CHM is not an insurance company and the services we offer are not insurance coverage. Members are responsible for more of their personal health care administration. There is not a central office handling all aspects of their care incident and simply sending them a bill or a statement.
The decision to join CHM should be made with full understanding that it is not a contractual legal relationship into which you’re entering: it’s joining hands with fellow Christians and depending on them with the same faith that the early Christians demonstrated when they put their gifts at the apostles’ feet.
It’s a way of life and faith that worked 2,000 years ago. And it works today.
Telemedicine: Feel Better About Your Doctor While Reducing Health Care Costs (and Saving Time)
Have you been feeling the pinch from rising healthcare costs? Have your insurance premiums been going up? If they haven’t yet, they may with the required services that health insurance companies now have to pay for due to the Affordable Care Act and the increase in those who are now covered. Going to see the
Have you been feeling the pinch from rising healthcare costs? Have your insurance premiums been going up? If they haven’t yet, they may with the required services that health insurance companies now have to pay for due to the Affordable Care Act and the increase in those who are now covered. Going to see the doctor takes time, as well. Do you hate spending time in a doctor’s waiting room, only to be told, “You have a sore throat. Take some aspirin and come back in a week if it still hurts.”? We are all busy and that time spent waiting is frustrating, while doctors are frazzled with the number of patients they see every day.
According to the Wellness Council of America, “Approximately 70% of all doctor visits are unnecessary, and over a third of all minor medical conditions can be treated without a trip to the doctor at all.” There are numerous common conditions that can be treated with simple home remedies. Preventive treatments can be implemented at home with guided medical advice for chronic conditions such as migraines, arthritis, diabetes that can improve daily life for sufferers. Wouldn’t it be nice to be able to make a quick phone call to speak with a doctor, at your convenience, to get the care you need for simple to manage, but painful or worrisome conditions?
Telemedicine could be the answer to the dilemma of long waits in the doctor’s office and high medical costs. The American Telemedicine Association defines telemedicine as “The use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status.” In short, telemedicine is the practice of getting medical consultations remotely. Over the past 40 years the practice of remote medicine has grown dramatically, starting out as a way to reach patients living in remote areas, to becoming an integrated piece of a medical practice. It can include multiple types of services using telecommunications technology such as two-way video, email and smart phones. Several studies have shown that telemedicine can reduce not only the cost of medical care, but can improve overall care and patient satisfaction.
Programs such as AmeriDoc provide access to network physicians 24 hours a day, 7 days a week who can provide detailed consultations and diagnose common conditions, even prescribing medications, if necessary. The physician then develops treatment plans for managing the illness or condition and instructs patients on the plan via telephone or live video. Doctors who are involved in telemedicine programs have found that with most technology there is no difference in their ability to collect accurate data and correctly diagnose conditions between remote and physical consultations. If necessary, doctors can direct patients to obtain lab tests to confirm a diagnosis or provide additional information. A combination of telemedicine and independent lab testing facilities can provide valuable data that doctors can use to develop treatment plans providing the same level of quality and effective healthcare results as a physical doctor’s office visit.
As healthcare in the United States continues to change, our options for accessing medical care will need to adjust. Whether you are trying to cut healthcare costs, don’t use healthcare services often enough for an expensive health insurance plan or are trying to find more convenient, effective medical care, telemedicine may be a perfect solution.
Which Healthcare Services Do You Really Need?
Watching your health and your budget is going to get a lot more complicated. With the Individual Health Insurance Mandate portion of the Affordable Care Act kicking in you will have to think through your options. Some preventive services will be covered with no copay. But what tests and services do you really need to
Watching your health and your budget is going to get a lot more complicated. With the Individual Health Insurance Mandate portion of the Affordable Care Act kicking in you will have to think through your options. Some preventive services will be covered with no copay. But what tests and services do you really need to watch your health and catch big health issues before they cause huge health problems?
Direct access lab testing facilities like ANY LAB TEST NOW® are a great option if you opt out of mandatory health insurance or are deciding to go for catastrophic, high-deductible or “consumer-driven” care which provides only minimal visits per year and carries high deductibles. Here are some tests you should try to squeeze into your healthcare budget:
- Blood pressure screening – Home blood pressure cuffs are readily available so you can track this yourself.
- C-reactive protein test – This protein can indicate the level of inflammation in the body and has been recognized as a useful adjunct to traditional cardiovascular tests like cholesterol and blood pressure.
- Colonoscopy – Colon cancer is the third most common cancer in men and women so screenings beginning at age 50 are critical.
- CYP450 test – This test can monitor the efficiency of your liver based on the availability of the right enzymes to process medications, allowing doctors to prescribe exactly the right dosage for your body.
- Diabetes risk tests – With type 2 diabetes on the rise, a simple blood glucose test can tell you whether you may be at higher risk for diabetes.
- Lipids panel – Still recognized as a key indicator of cardiovascular disease, newer lipid tests including the VAP (Vertical Auto Profile) test can provide more detailed information about the state of your cholesterol.
- Pap smear – This test is recommended for all women who are 21 or over and/or sexually active.
- Prostate specific antigen (PSA) – Establishing a baseline number for men is essential to long-term tracking of the health of their prostates and early warning for potential issues down the line.
- Skin cancer exam – Skin cancer rates have been rising and you should be checked every year for unusual growths or changes to your skin.
- Stress test – Used to determine the likelihood of coronary artery disease, this is especially recommended for those over age 50.
Of the tests listed above the ones that will be covered under the ACA include blood pressure screening, colonoscopies, diabetes screening (only if you have high blood pressure), cholesterol screening and pap smears (HPV DNA test). This means if you want dig deeper into your health, you’ll have to go shopping for the best price on your own. When you are on a budget, the last thing you need are price surprises. ANY LAB TEST NOW® provides transparent prices so you know how your proactive care will fit into your healthcare budget.
These tests are available at ANY LAB TEST NOW® locations and do not require a doctor’s order or prescription. With a Flexible Spending Account most of the costs can be covered using your pre-tax dollars. Do your research and make the most of your options!
Telemedicine Services – an Alternative Healthcare Option
Continuing on with the theme from my last article, patients across the country are considering alternative means for receiving their healthcare. Some patients have considered concierge medicine which allows them to have 24/7 contact with their physician for an annual fee. However, patients, physicians, and hospitals have turned to technology to help better address the
Continuing on with the theme from my last article, patients across the country are considering alternative means for receiving their healthcare. Some patients have considered concierge medicine which allows them to have 24/7 contact with their physician for an annual fee. However, patients, physicians, and hospitals have turned to technology to help better address the needs of patients from distant locations.
Telemedicine is the “use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status.” Telemedicine includes all kinds applications and services. I-pads, two-way video, email, Facebook, Skype, and smart phones all are means in which people use to communicate with their healthcare providers.
Historically, telemedicine started out over forty years ago when hospitals attempted to extend care to patients in the most remote of areas. With the evolution of technology, physicians have been able to increase their footprint to areas not easily reached throughout the country. The use of telemedicine has spread rapidly and is now becoming integrated into the ongoing operations of physician practices, hospitals, and home health agencies. It has become equally prevalent in consumer’s homes and workplaces when people want a more rapid evaluation to their problems.
In one model, telemedicne allows its consumers with minor illnesses to discuss their symptoms in real time with a professional provider for an upfront fee. They then are able to diagnose and treat a patient’s symptoms by your history and a virtual evaluation through video and audio. The practitioner can then order labs through outpatient testing and call or fax in your prescription and treat your illness without ever having to wait in an emergency department waiting room or a primary care doctors office.
Telemedicine is evolving so that physicians can monitor the status of their patients. Monitoring a patient at home using known devices like blood pressure monitors and weight monitoring for heart failure and subsequently transferring the information to a caregiver is a fast growing emerging service. These remote monitoring solutions have a focus on current high morbidity chronic diseases and can work to help keep people out of the hospital and emergency department.
One concern from both doctors and patients was whether insurance paid for those services. An increasing number of private insurers are paying for those services. As far as Medicare and Medicaid reimbursement, these are regulated by the state laws and will vary depending on the location of the patient.
Medical specialty services that use telemedicine often use a “tele-” as a prefix to describe their services. For example, telemedicine as applied by radiologists is called Teleradiology. This is commonly being used in emergency departments and radiology departments across the country to provide speedy results for patients. Similarly telemedicine as applied by cardiologists is termed as telecardiology, etc. Teleneurology is being used to help manage stroke patients when neurologists are not present in the ED.
As advancements in communications advance, be prepared to use telemedicine at an increased rate. It is not only the cost for delivering healthcare that can be addressed with improvement of technology, but also the level of service and accommodation for patients and their families.