Monthly Archives

February 2018

Don’t pay retail price at the Doctor’s office for Lab Tests. Use a direct to consumer lab and save hundreds of dollars.

By | Save on Medical Costs

Did you know that you can choose the lab that will conduct the tests you need – and by choosing them through this site: Any Lab Test Now you can save Hundreds of Dollars!

LabTestsLab test fees work the same way for a group plan or Obamacare.  They are part of the deductible.  Said another way – Doctor copay is for the Doctor visit  (“Labor” in car repair talk) and Labs are considered “parts” – which always go toward the deductible.

Lab Tests can include items with VERY high mark-ups.  To protect your pocketbook always ask for a cash discount.  In many cases you can ask – and receive – substantial discounts on tests that your doctor already ordered just by asking before paying your bill!

Be Sure To Protect Your Pocketbook

In the future use a direct to consumer lab.   Any Lab Test Now has an instant quote available online.  All you do is take a picture of the doctors order and they price it for you: http://go.anylabtestnow.com/san-antonio-boerne-quote-request/.

Many labs can be purchased at 75% off using a direct to consumer lab like Healthcheckusa 

Lab Discounts

How do I take the test? A blood sample will be taken by a qualified technician and analyzed by an accredited medical laboratory. You can view test results on the HealthCheckUSA website within four (4) business days after testing.

 

New Ruling makes Short Term Medical into “Trump Care”

By | Health Reform

Highlights of Proposed Ruling:Update

  • The preliminary final ruling vindicates Short Term Medical as a viable alternative to ACA ( Obamacare). The ruling cites lower cost and more access to providers via PPOs and changes the penalty for not having an ACA Plan to Zero Starting January 1, 2019.
  • The New Ruling resets the duration of Short Term Medical Plans to 12 months (as it was for the last 20 years).
  • In addition, they are considering processes for expedited or streamlined reapplication for short-term limited-duration insurance that would simplify the reapplication process and minimize the burden on consumers.

The result will be to make Short Term Medical Plans easy to reapply for after the initial 12 month period.

Other comments touting the benefits of Short Term Medical are:

  • Individuals who purchase short-term, limited-duration insurance (as opposed to being uninsured would) potentially experience improved health outcomes and have greater protection from catastrophic health care expenses.
  • Individuals purchasing short-term, limited-duration policies could obtain broader access to health care providers compared to those ACA-compliant plans that have narrow provider networks.
  • Short-term, limited-duration insurance policies can be priced in an actuarially fair manner, subject to State law saving consumers over 70% off cost of ACA plan.

To see the actual proposal click here for PDF (make sure you download it).

Contact Mark Deschenes 800-257-1723 at Health-Life-Dental-Insurance.com to get your quote and see how much you can save.

Baby Boomer Rescue

By | Life Insurance, Living Benefits, Supplemental Coverage

A study showed that boomers turning 65 in 2011 are expected to retiredlive until they are 85.2 years old.

If you were born between 1946-1964 you are a baby boomer.

You are probably living pretty well, but in the back of your mind, you know you have not saved enough for your retirement…and specifically you have not saved enough to take care of the biggest expense: high medical bills-

Now I’m NOT talking about medical bills like doctor or hospital bills – those will be taken care of by Medicare & your supplement.

I’m talking about the medical bills you will have for your home care and eventually nursing home care that are NOT covered by Medicare. These are costs you will incur once you’re no longer able to take care of yourself. Either from becoming mentally disabled, physically disabled, or suffering from a critical illness.

In these cases, family members will mean well and help with things like cooking and cleaning or taking you to a doctor’s visit. But when it comes to being able to take time off work, moving you into their home, or providing around the clock care that’s something else. Our children have their own lives and simply cannot afford that level of commitment.

Have you thought about how YOU want to live? How you will provide for yourself if YOU can’t take care of yourself?

Well some of you may consider 10 Countries where that social security check will let you retire: Cambodia, Malaysia, Nicaragua, Indonesia, Columbia, Thailand, Costa Rica, Mexico, or Panama.

But for the rest of us who don’t want to retire in a foreign country (away from our family!) we better have a plan to help stretch what savings…and make sure we don’t become a burden to our children and grandchildren.

In the 90’s planners offered Long Term Care Policies. They were great until they stopped being sold due to the unlimited benefits most of them offered.

This has left a coverage gap that, until recently, went unfilled. Now I’m happy to present what I believe to be the “poor man’s retirement plan”, The Living Benefit Life Insurance Policy.

A Living Benefit plan is like Neapolitan ice cream – remember that? You got 3 flavors Chocolate, Vanilla, and Strawberry all in one scoop. A Living Benefit plan is just like that, you get a Term Life Policy that provides a death benefit, Critical Illness coverage that provides a lump sum of cash if you suffer from any of 15 major illnesses that affect your life expectancy, and a Chronic Illness benefit that is triggered just like a long term care plan was.  The Chronic Illness plan covers cognitive loss or inability to preform 2 of 6 activities of daily living (eating, bathing, dressing, toileting, transferring-walking and continence).

In these cases your Living Benefits plan comes to the rescue – providing a large lump sum of cash exactly when you need it most.

More importantly the benefits are based upon a guaranteed level premium for a pre-determined number of years, this means you can transfer some of this risk for an affordable predetermined cost.

I highly recommend the purchase for anyone who can qualify. Trade in your old style life insurance that pays only upon death – to the new style of coverage that provides cash for YOUR life.

Failure to do so may hasten the depletion of your retirement nest egg – or worse, put you in poverty at the mercy of the welfare system. Take it from me – both of my parents had dementia and ended up bouncing around welfare nursing homes. This experience has branded me for life and made me determined to help as many people as I can.

Now’s the Time to Get the Help You Need.

Provide me a little information and let’s start a conversation about your needs, your budget, and what you qualify for – this way I can prepare a plan to enhance YOU and YOUR family’s future security…and help you retire with confidence and style.

Call right now! 1-800-257-1723 Or click here to schedule an appointment.

 

Learn How Your Health Plan Saves You Money While Never Being Out of Network – How to File Claims for Healthcare Providers that Are Behind the Learning Curve

By | Health Insurance

Your Pivot Health – Companion Life Plan is an Any Provider Reference Based Pricing Plan (RBP) and NOT a PPO.  Learn about the difference between a PPO and RBP plan: image

Reference-Based Pricing (RBP) programs are gaining in popularity due to their significant cost savings to both the employer and their employee/members. These savings often exceed 30 percent compared to the PPOs.

PPO plans are at the heart of the overpayment problem.

The Accountable Care Act turned a spotlight on the employer pays health care system, and a variety of companies started to publish data outing the PPO industry and the ridiculous “discount” reimbursement model. In reality, hospitals readily accept 130% to 150% of what Medicare would pay (sometimes less) for those willing to make cash-based payments. Intelligent employers started asking about ways to close the gap between the 300% of Medicare most are paying via the PPO models and what hospitals except from cash-based payers.

PPO plans cost more because there is typically no transparency in fees for services charged by providers.  As a result patients simply seek health care with no regard for cost whatsoever. The provider industry (hospitals and doctors) is aware of this flaw in the purchasing system and takes full advantage through what many would suggest are egregious overcharges for services.

Reference-Based Pricing (RBP) – What’s fair?

RBP offers remedies to this inflated, unfair system by using a defined-contribution model of health care benefit financing. First, an employer or sponsor of a group health plan determines a fair and just reimbursement for a medical service and defines such in its agreement with its membership.

Pivot Health – How It Works

Pivot Health – Companion Life uses 150% of Medicare for Facilities and 125% of Medicare for Physicians.  This is offered as payment first on an ANY PROVIDER basis.

If the provider does not want to accept that as payment in full, Allied (Pivot Plans are exclusively administered by an independent third party administrator- in this case Allied National) has a “balance billing” that uses a negotiations model requiring that all claims be negotiated to mutual satisfaction.

How to file your own claim- Pivot Health- Companion Life

In the event your medical provider will not willingly process your claim, access the Pivot concierge service through the numbers on the back or your ID card.

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If you need additional assistance follow these instructions:image3

IF you paid the claim yourself make sure to put PLEASE PAY PATIENT on your ITEMIZED BILL so reimbursement is made payable to YOU.

WHY USE THIS TYPE OF REIMBURSEMENT?

You get a much lower rate.  That is why! Since RBP plans are exclusively administered by independent third-party administrators (TPAs), there are typically additional savings in administrative fees and the elimination of PPO access costs as well. Typically these savings often exceed 30 percent compared to the PPOs.

This adds up to saving potentially thousands of dollars a year of premium put back in YOUR pocket.

Secondly but important – Many other Short Term Medical Plans have gone from a true PPO to a NETWORK ONLY OPTION.  This is very risky. If your provider is deemed out of network, then ZERO payment is payable.  Here’s an excerpt from ONE plan that uses this type of limited network arrangement:

Please Note: There are no non-network benefits. You must use a network doctor or hospital. These plans pay no benefits for out-of-network expenses except for emergencies. Emergency treatment from a non-network provider will be treated as a network eligible service. 

This could make you responsible for the entire out of network claim. With RBP from Companion this can NEVER Happen!

Yes, sometimes it can be a bit inconvenient, but you have an agent for support and to direct you to the concierge service included with your plan at no extra charge.

Here is how it works in detail:

Usual and Customary Billing Process. The Pivot Health short term medical claims reimbursement system is set up to guarantee that no member will be responsible for a balance bill due to the discount taken for charges above the Medicare Reference Pricing amount, subject to the terms outlined in the certificate of insurance. This insurance plan reimburses medical providers based on a percentage above Medicare allowable amounts, paying: • 150% of Medicare allowable amount for medical facilities • 125% of Medicare allowable amount for physician claims.

When bills are received, they are repriced according to these percentages of the Medicare allowed amounts, based on the Medicare fee schedule. Payment is made to the provider based on this amount and the reduction shown as a discount by the provider. If a provider wishes to review and discuss the allowed amount or initially objects to the reimbursement amount, the provider is connected with the repricing vendor. The repricing vendor is authorized to negotiate a settlement. In addition, providers are contacted proactively, to confirm that they are accepting the reimbursements and not shifting costs to members. If the provider bills the member for any portion of the discount, the member may refer that bill to Allied who will initiate the negotiation process. • The member needs to send a copy of the bill to Allied to validate the provider is billing for the discount. • The member is responsible for their out of pocket amounts (deductible and coinsurance). However, some members may not be clear on exactly what is being billed by the provider.

Allied National will research and advise the insured if the discount has been applied or initiate contact with the provider by the repricing vendor. When insured members have questions or concerns, they should submit the bill to Allied by email to balancebilling@alliednational.com.

The bottom line:  It’s your money – why pay twice the price if you don’t have too!

For more information call us – 1-800-257-1723 – or click here to set an appointment