Don't have health insurance? Here's how the Affordable Care Act (aka Obamacare) will change that. October 01, 2013 at 02:13AM
How Much Will My Health Insurance Cost? | Health and Burn Weight
Finding health insurance that doesn't crush your household budget may soon get a little easier thanks to the new health insurance marketplaces, or exchanges, operating in every state.
But how much will a good health plan set you back? And do you qualify for a federal tax credit to lower your monthly premiums?
You can find out what your costs and potential savings might be when you submit an application for health insurance through your state marketplace. (Open enrollment in the health insurance exchanges, a centerpiece of the health reform law known as the Patient Protection and Affordable Care Act, runs from October 1 through March 31, 2014.)
But if you just want a rough estimate before diving into the exchange, you can try one of the online calculators that have popped up on the web, including some state marketplace websites.
“I think its a first good place to get started,” said Regan Hunt, executive director of Kentucky Voices for Health, a Louisville-based nonprofit coalition working to ensure access to affordable health care. “Some people really like to do their due diligence and their research before getting online to go shopping,” she said.
However, the calculators are limited in what they can tell you, she added. How you define your household size, for example, or your estimated earnings after a job loss could affect the numbers.
“Your final premiums and costs may differ from the estimates, perhaps significantly, depending on where you live and the coverage you select,” cautions HealthCare.gov, the federal governments website for health reform information.
Hunts advice? Try several calculators to see if theres much difference in the answers you get. “Dont just stick with one.”
Four Calculators to Try
The Henry J. Kaiser Family Foundations Subsidy Calculator
HealthCare.gov directs consumers to The Henry J. Kaiser Family Foundations subsidy calculator . Enter your state, an estimate of your 2014 annual income, whether you have access to employer coverage, the number of people in your family, including the number of adults and children, and whether anyone is a smoker.
The calculator can tell where your household income ranks as a percentage of the federal poverty level, whether you would qualify for Medicaid and, if you qualify for coverage through the marketplace, what your annual premium might be and the size of the federal tax credit you may receive to offset your costs. Itll tell you the premium and cost-sharing amounts for a “silver” plan and compare those estimates to what you might pay in a “bronze” plan. It also tells you the most you would pay out of pocket.
If you have kids, the calculator will advise you about other coverage options, such as the Childrens Health Insurance Program.
eHealth Inc.
At eHealth Inc. , the parent company of online health insurance site eHealthInsurance, you can find out whether you may be eligible for the premium tax credit based on your household size and income level.
Just plug in a few pieces of data and the calculator spits out the amount of the tax credit you may receive based on a typical plan in your state. It also tells you the penalty you would pay in 2014 if you chose not to remain uninsured.
GoHealth
Or you can try GoHealth , another online portal for health insurance, which calculates your premium and tax credit using your zip code, income, age and family size.
SHOUTAmerica
The nonprofit group SHOUTAmerica, through its educational initiative Young Americans for Affordable Healthcare offers a tool for figuring out how health reform will affect young adults insurance costs in 2014.
Use it to ballpark your cost after any applicable premium tax credit. You can also learn about other health insurance options. For example, young adults under 26 may be eligible to stay on their parents health plan, and adults under 30 can buy a “catastrophic” health plan with a lower premium but higher out-of-pocket costs. October 01, 2013 at 02:13AM
But how much will a good health plan set you back? And do you qualify for a federal tax credit to lower your monthly premiums?
You can find out what your costs and potential savings might be when you submit an application for health insurance through your state marketplace. (Open enrollment in the health insurance exchanges, a centerpiece of the health reform law known as the Patient Protection and Affordable Care Act, runs from October 1 through March 31, 2014.)
But if you just want a rough estimate before diving into the exchange, you can try one of the online calculators that have popped up on the web, including some state marketplace websites.
“I think its a first good place to get started,” said Regan Hunt, executive director of Kentucky Voices for Health, a Louisville-based nonprofit coalition working to ensure access to affordable health care. “Some people really like to do their due diligence and their research before getting online to go shopping,” she said.
However, the calculators are limited in what they can tell you, she added. How you define your household size, for example, or your estimated earnings after a job loss could affect the numbers.
“Your final premiums and costs may differ from the estimates, perhaps significantly, depending on where you live and the coverage you select,” cautions HealthCare.gov, the federal governments website for health reform information.
Hunts advice? Try several calculators to see if theres much difference in the answers you get. “Dont just stick with one.”
Four Calculators to Try
The Henry J. Kaiser Family Foundations Subsidy Calculator
HealthCare.gov directs consumers to The Henry J. Kaiser Family Foundations subsidy calculator . Enter your state, an estimate of your 2014 annual income, whether you have access to employer coverage, the number of people in your family, including the number of adults and children, and whether anyone is a smoker.
The calculator can tell where your household income ranks as a percentage of the federal poverty level, whether you would qualify for Medicaid and, if you qualify for coverage through the marketplace, what your annual premium might be and the size of the federal tax credit you may receive to offset your costs. Itll tell you the premium and cost-sharing amounts for a “silver” plan and compare those estimates to what you might pay in a “bronze” plan. It also tells you the most you would pay out of pocket.
If you have kids, the calculator will advise you about other coverage options, such as the Childrens Health Insurance Program.
eHealth Inc.
At eHealth Inc. , the parent company of online health insurance site eHealthInsurance, you can find out whether you may be eligible for the premium tax credit based on your household size and income level.
Just plug in a few pieces of data and the calculator spits out the amount of the tax credit you may receive based on a typical plan in your state. It also tells you the penalty you would pay in 2014 if you chose not to remain uninsured.
GoHealth
Or you can try GoHealth , another online portal for health insurance, which calculates your premium and tax credit using your zip code, income, age and family size.
SHOUTAmerica
The nonprofit group SHOUTAmerica, through its educational initiative Young Americans for Affordable Healthcare offers a tool for figuring out how health reform will affect young adults insurance costs in 2014.
Use it to ballpark your cost after any applicable premium tax credit. You can also learn about other health insurance options. For example, young adults under 26 may be eligible to stay on their parents health plan, and adults under 30 can buy a “catastrophic” health plan with a lower premium but higher out-of-pocket costs. October 01, 2013 at 02:13AM
5 Proven Ways to Reduce Your Medical Bills | Health and Burn Weight
Few people realize that in the murky world of medical billing, there is often room for negotiation. If youre paying providers from your own pocket—because you have no insurance, have maxed out your insurance, or are seeking treatment out-of-network—its worth asking for a discount on services. Hospitals and doctors will sometimes consider accepting less than the full list price—after all, they routinely give substantial discounts when the payer is Medicare, Medicaid, or an insurance company. Even with an overdue bill, the provider may be persuaded to be flexible. Here are some bargaining strategies you can try.
1. Pay today. Go to the billing office and offer to pay with cash or by credit card on the spot. “I would try for a 20% discount,” says Larry Gelb, CEO of CareCounsel LLC, a health-care advocacy firm. “Often they will be obliging because they have a big incentive to get it settled rather than to go through a long, drawn-out collection. If you tie it to a little bit of a hardship story, you will increase your chances.”
2. Disclose your family income. You may be uncomfortable volunteering information about how much money you make, but if youre facing, for example, a $10,000 bill from a specialist, it might help to explain that your family of four lives on an income of $50,000. “Compared to the person with a net family income of $250,000, the health-care provider will look at those two people very differently,” says Marty Rosen, a former Aetna U.S. Healthcare executive and a cofounder of Health Advocate, a provider of health-care advocacy services to businesses and individuals. This is not a good strategy, Rosen notes, for families in an upper-income bracket.
3. Pile on the compliments. “A lot of doctors really respond to schmoozing,” says Laura Valentine, director of client services at CareCounsel. When she approaches billers on behalf of a patient, she appeals to doctors egos with a bit of flattery. She suggests saying something like, “I really wanted to have my cancer treatment here because my friends and colleagues all say youre the best and the brightest. But I have limitations on my pocketbook. Is there any type of discount or anything that you can do?”
4. Use Medicare rates to your advantage. Finding out what Medicare pays doctors and hospitals to perform a specific medical procedure will take a bit of research, but it is a gambit professional patient advocates frequently use. To do it, read carefully, because these steps are complicated: First ask your doctors office for the procedures CPT code, which stands for “Current Procedural Terminology” and is a code set developed and maintained by the American Medical Association (AMA) to ensure uniformity in describing medical, surgical, and diagnostic services. Next, go to the AMA websites CPT search engine to look up the Medicare payment for that procedure in your geographical area. (For example, the CPT code for one type of breast reconstruction surgery is 19361. Searching for the state of New York and the city of Manhattan, with the five-digit CPT code 19361, turns up a Medicare payment of $1808.76 for the procedure.) You can use that information in negotiating your non-Medicare rate, which you should do before the procedure. “Whatever you can do up-front is the best,” advises Valentine.
Not only will you have more bargaining leverage pre-procedure, but then, should anything change during or after the procedure, the hospital will also have a record that they cooperated with you before and will more likely be willing to cooperate again. For both hospital and doctors bills, a reasonable offer would be 25% above the Medicare rate, suggests Nora Johnson, the vice president and director of education and compliance for Medical Billing Advocates of America. If you are thinking about negotiating a hospital bill, however, consider hiring a professional advocate, since hospital bills are considerably more complex, Johnson adds.
5. Use your emotional state to your advantage. You may be feeling a lot of stress, but calling an administrator from the hospital an idiot is not going to get you very far. Instead, say something like, “I am just so frustrated right now. My spouse is ill, and Ive been trying to deal with my health plan, but I really want to make sure you get paid too.” Chances are, “because of human nature, they will try to help you, unless you get someone who is very hard,” says Valentine. September 27, 2013 at 02:13AM
1. Pay today. Go to the billing office and offer to pay with cash or by credit card on the spot. “I would try for a 20% discount,” says Larry Gelb, CEO of CareCounsel LLC, a health-care advocacy firm. “Often they will be obliging because they have a big incentive to get it settled rather than to go through a long, drawn-out collection. If you tie it to a little bit of a hardship story, you will increase your chances.”
2. Disclose your family income. You may be uncomfortable volunteering information about how much money you make, but if youre facing, for example, a $10,000 bill from a specialist, it might help to explain that your family of four lives on an income of $50,000. “Compared to the person with a net family income of $250,000, the health-care provider will look at those two people very differently,” says Marty Rosen, a former Aetna U.S. Healthcare executive and a cofounder of Health Advocate, a provider of health-care advocacy services to businesses and individuals. This is not a good strategy, Rosen notes, for families in an upper-income bracket.
3. Pile on the compliments. “A lot of doctors really respond to schmoozing,” says Laura Valentine, director of client services at CareCounsel. When she approaches billers on behalf of a patient, she appeals to doctors egos with a bit of flattery. She suggests saying something like, “I really wanted to have my cancer treatment here because my friends and colleagues all say youre the best and the brightest. But I have limitations on my pocketbook. Is there any type of discount or anything that you can do?”
4. Use Medicare rates to your advantage. Finding out what Medicare pays doctors and hospitals to perform a specific medical procedure will take a bit of research, but it is a gambit professional patient advocates frequently use. To do it, read carefully, because these steps are complicated: First ask your doctors office for the procedures CPT code, which stands for “Current Procedural Terminology” and is a code set developed and maintained by the American Medical Association (AMA) to ensure uniformity in describing medical, surgical, and diagnostic services. Next, go to the AMA websites CPT search engine to look up the Medicare payment for that procedure in your geographical area. (For example, the CPT code for one type of breast reconstruction surgery is 19361. Searching for the state of New York and the city of Manhattan, with the five-digit CPT code 19361, turns up a Medicare payment of $1808.76 for the procedure.) You can use that information in negotiating your non-Medicare rate, which you should do before the procedure. “Whatever you can do up-front is the best,” advises Valentine.
Not only will you have more bargaining leverage pre-procedure, but then, should anything change during or after the procedure, the hospital will also have a record that they cooperated with you before and will more likely be willing to cooperate again. For both hospital and doctors bills, a reasonable offer would be 25% above the Medicare rate, suggests Nora Johnson, the vice president and director of education and compliance for Medical Billing Advocates of America. If you are thinking about negotiating a hospital bill, however, consider hiring a professional advocate, since hospital bills are considerably more complex, Johnson adds.
5. Use your emotional state to your advantage. You may be feeling a lot of stress, but calling an administrator from the hospital an idiot is not going to get you very far. Instead, say something like, “I am just so frustrated right now. My spouse is ill, and Ive been trying to deal with my health plan, but I really want to make sure you get paid too.” Chances are, “because of human nature, they will try to help you, unless you get someone who is very hard,” says Valentine. September 27, 2013 at 02:13AM
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