No Magic Wand With Obamacare

This year many people think Christmas came early with the health insurance marketplace, AKA "Obamacare". All across America, we have preconceived notion about what the "Obamacare" plans do. Most of them are false. What is the truth? Let's pull the rabbit out of the hat and see.

I have heard statements that are made similar to the following:

"Isn't Obamacare cheaper"

"I should be able to get it for free through Obamacare"

"Aren't the Obamcare plans better coverage"

I can go on and on.

The truth is, there is no magic with this. None...

What is it then? All math and taxes.

What! Let me explain, so listen up...

"Obamacare" plans are about plan changes to meet the requirements of a "Qualifying Health Plan" and tax credits/government subsidy. When comparing plans both on the Marketplace (Obamacare) and off the marketplace, and when comparing the same plan, they are exactly the same. No difference except 3 things:

    If you qualify for a tax credit and exactly how much of a government subsidy. Then your "Retail Premium" will be reduced by the exact amount of the tax credit qualified for.
    If you do qualify for a tax credit, you may also qualify for a tax credit to reduce your out-of-pocket expenses on the Silver Plans. This will vary depending on the household income and filing status.
    There are a few plans off the Marketplace (Obamacare) that are not tax credit eligible and will not be available on the Marketplace, only outside of the Marketplace. The opposite is true as well. There are a few plans that are only available through the marketplace and are not available outside of the Marketplace.

It is important to keep in mind that the "Retail Premiums" for comparable plans on and off the marketplace are the exact same (when comparing all the same particulars). There are two reasons this is important:

    Once you get your official tax credit, the government subsidy reduces it from the retail premium. If you do not qualify for a tax credit, now or in the future, you have to pay the full retail premium to have the health insurance.
    One day you may not qualify for the health insurance tax credit and you will need to pay the full retail premium to maintain coverage.

The reality is there is no "magic" in Obamacare. It is simply math and taxes. There are no lower premiums available on the Marketplace unless you pick a lower level plan (more exposure to you) or receive any tax credit. There is the false hope that a magic wand is available on the Marketplace (Obamacare) and your premiums will instantly lower. This is simply not the case.

The Marketplace is nothing more than the controller for premium tax credit and cost sharing credits. The "Hub", if you will, for getting dollars from the government to lower your cost for health insurance, assuming you qualify. Otherwise, they are no advantage to you, your family, or your business to go to the Marketplace for health insurance.

Arthur "Butch" Zemar is a 2014 Broker of the Year Finalist, an insurance specialist, author and President at Elite Benefits of America. Butch Zemar is actively developing informative resources, such as articles and videos that deliver vital information on healthcare reform and employer options. Elite Benefits of America has consultative packages for employers, as well as insurance solutions, to keep employers compliant with healthcare reform and keep skyrocketing premiums under control.

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The EHIC Card and Private Medicine in Europe

EHIC Card

Some people head off overseas on holiday or business trips clutching their EHIC card confident in the belief that it will cover them for any medical costs they might incur.

In fact, it's a little more complicated than that.

Keep in mind

At the outset, there are three critically important points to keep in mind when reading this article:

1. The EHIC card (European Health Insurance Card) is only valid for European Union countries plus one or two others associated with it. Nothing in what follows applies to medical treatment outside of the EU.

2. The position with the use of this card may vary considerably depending upon which of the EU member states you are in. That's because their health systems are different and therefore just what the card will do for you will vary.

3. The subject area of this article has been subject to inter-governmental squabbling for some years and that looks likely to continue. So, what is accurate today might not be totally accurate tomorrow.

Public versus private health

In general terms, the system is intended to give European Union citizens travelling in another EU country the right to access any freely-provided emergency medical services made available by the country concerned to their own citizens. That access should be free if it is also free to local citizens.

Now although it isn't entirely explicitly stated, there is an inbuilt assumption that such services are provided by the state. For example, in the United Kingdom, accident and emergency services are almost exclusively provided by the NHS, as opposed to private hospitals. Private hospitals in the UK tend to be aimed exclusively at non-critical treatment or that which is elective in nature.

So, in the UK a visitor from another EU country who was in urgent need of medical attention would almost certainly obtain it from a public health service GP or perhaps an accident and emergency unit. As publicly provided services, these are largely entirely free of charge to a UK citizen, so they would also be covered by the visiting EU citizen's EHIC card.

Things aren't the same everywhere

Unfortunately, in some other European countries, the distinction between public and private treatment can be rather more blurred. In some countries, private hospitals may provide certain components of treatment that might normally be offered by the NHS in the UK. The citizens may be able to choose between going to a public hospital or GP, and therefore pay nothing all, or going to a private hospital or GP and paying for their treatment or making a substantial contribution to it.

What this means for you

The position is exceptionally complicated but broadly speaking, if you accidentally choose to use a private hospital or private doctor when travelling in the European Union, you may find that they won't accept your EHIC card. You also typically will not be able to reclaim your expenditure upon your return to the UK.

There is no universal answer to this potential problem other than to be aware of it and to make sure that you take advice abroad when seeking urgent treatment. Make sure you ask the doctor or institution concerned (in advance where practical and safe) whether they are a public or private operation and whether they will take an EHIC card.

P.K. Chong is the Managing Director of All About EHIC. As a major insurance authority, we provide information and top up insurance for those travellers with an EHIC card, (European Health Insurance Card). Our excellent top up insurance covers issues not covered by the EHIC card.

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Watch Out for Fraud on the EHIC Card

The EHIC Card

It's incredible just how scammers can spot an opportunity; one such area they've recently moved into is that of the EHIC card.

A quick refresher
Just in case you didn't know it, if you are a citizen of the United Kingdom and are travelling to another European Union country, then any emergency treatment medical costs you incur will typically be paid for free of charge under the European Health Insurance Card system.

If really is as simple as that! The only caveat to keep in mind is that this assumes that similar urgent treatment would be free to the local citizens of the country you are visiting. So, if they would get it free of charge under their state scheme, then so would you.

Where the scams operate
The EHIC card is available entirely free of charge from the NHS and can be applied for through their website. You have nothing at all to pay. Unfortunately, some opportunists consistently offer services relating to 'obtaining' this card for you and they will typically charge you a fee for doing so.

Although this article should not be seen as qualified legal advice, there does not appear to be anything obviously illegal about this. What you should be questioning though is why you are paying someone to do something for you that you could do yourself for free at the click of a few buttons on the NHS website?

What makes some of these services objectionable is that they may imply that somehow this process of getting an EHIC card is difficult, complicated or bureaucratic and that they will be doing something to help you cut through all that and obtain a card quicker than you could get it yourself. That is misleading.

A few complications
The process is simple and straightforward for the vast majority of applicants. There are however a few potential complications that can arise.

Those might include circumstances, such as if you are not a citizen of the European Union; you are a citizen of another EU country who has not yet had time to become registered on the various UK social security systems; or you are not a UK citizen but your children are.

In all these cases, there are procedures and processes to follow which are comprehensively dealt with on the web site of the NHS. You should not need to pay any third party to intervene on your behalf or to act as an intermediary between you and the National Health Service. In some cases, your citizens' advice bureau may be able to offer you specific advice on some of the above scenarios.

The EHIC card is essentially a very simple system and it is a great shame these scams are being perpetrated. If you are in any doubt whatsoever, try contacting the NHS through their above-mentioned website.

P.K. Chong is the Managing Director of All About EHIC. As a major insurance authority, we provide information and top up insurance for those travellers with an EHIC card, (European Health Insurance Card). Our excellent top up insurance covers issues not covered by the EHIC card.

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Finding Health Insurance That Covers Medication Assisted Treatment

Covers Medication Assisted Treatment

If you're on MAT or have family in treatment, you know the high cost of care and the dangers of skipping doses. But unfortunately, there are many times that patients come up short on paying their daily treatment cost. With the passage of the Affordable Care Act (ACA), the problem of paying for treatment may no longer be an issue for some.

Whitehuouse.gov states that "The ACA includes substance use disorders as one of the ten elements of essential health benefits. This means that all health insurance sold on Health Insurance Exchanges or provided by Medicaid to certain newly eligible adults starting in 2014 must include services for substance use disorders." Although not all health insurance providers cover the same treatment options, it is expected that they now cover some medications for opiate treatment and programs to treat substance abuse.

Depending on the insurance company, either a combination of Suboxone, Subutex or Methadone or all three will typically be covered under a health insurance plan in a post ACA world. Not only are the medications covered by the plans, but many of the consumers purchasing the plans will qualify for tax credits to help pay the plans monthly premiums and co-insurance deductions to help pay plan deductibles and prescription copays. The tax credits are available to those whose incomes are below 400 percent of the federal poverty line and the co-insurance deductions are available to consumers who have incomes under 250 percent of the federal poverty line. So as an example, an individual with an income in 2015 of less than $46,680 would qualify for a tax credit and an income of less than $29,175 would qualify for a co-insurance deduction.

Customers can apply for these plans at healthcare.gov, by working with a health insurance agent or by calling insurance companies directly that participate in the federal exchange. One source for those looking to work with an agent to find insurance that covers their MAT is saveonmethadone.com. The site (and sites like it) look to match consumers with insurers that cover their medications and treatment providers. No matter what channel you use to obtain your ACA insurance coverage the monthly premium cost should be the same. This is because each plan that a carrier offers must have the plan cost approved by the individual states Department Of Insurance. This allows consumers that would like to use the services of a licenced health insurance agent to have peace of mind in knowing that they will not be charged any additional fees for seeking the advice of an agent.

Larry Medcalf is a licensed insurance agent. His main focus is on serving the life, health, medicare and long-term care insurance needs of small businesses and middle-income families and individuals.

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Controlling Health Insurance Costs for Employees

Health Insurance Costs for Employees

Health insurance costs have gone through the roof in recent years, especially since the Affordable Care Act has been signed into law. Many are looking for ways to control the costs. Some are left empty-handed. You almost need an insider to give you the best tips. However, many do not know where to look. In the meantime, they are forced to pay higher premiums and out-of-pocket costs. Where does the bleeding stop?

The bleeding stops with the employer strategies. Employers need to have good expert consultant or advisor to make sure their moves are not only in the favor of themselves, the employer, but also the employees. At times there is a disconnect from the employers to the employees because the employer is more concerned about their pocketbook. Rightly so. However, there just has to be a good mix between benefits and the cost for everyone.

Employers should start off with finding a team of experts. These are the specialist in the trenches everyday making things work. They may have published their own material on the subject, have a team of advisors and are willing to take the time with you.

Employers should also offer multiple options for employees to choose from. You may have high standards based on your current standard of living, but your employees do not. There definitely has to be a low-cost, high deductible option as well as the rich, low deductible option. Let the employee take control on their health care by starting out with making their own plan selection.

Employers should also offer a series of voluntary benefits. This does a few things.

Retention of great talent is hard, but can be done. This is one way to hook those key employees.

Some employees just love little things such as dental and vision. So give it to them. The good news, the employer does not have to pay for these benefits. They can to add value by contributing, but not required to do so. This will increase employee production in the workplace.

Offering voluntary benefits, such as dental and vision, will increase the enrollment percentages in the group health plan. Some employers maybe opposed to this. However, in some situations, this can help lower the over all cost for some small to mid-sized employers. This could be the key to making or breaking a benefits program.

For smaller employers, 49 employees and fewer, have different strategies to work with since they are exempt from the employer mandate requirements. Small employers have the option listed above to help control costs and provide value to their employees. Since the market with 49 employees and fewer are on the community rating platform for premiums, the premiums will not necessarily decrease as a result of increasing the membership.

Another option for smaller employers is dissolving the traditional group plans and allowing the employees to be guided with an insurance professional on the exchange/marketplace for options and the possibility of receiving a tax credit to reduce premiums.

Employers will lose the pre-tax benefit of group health insurance by allowing employees to purchase their own health insurance. So we need to do the math to see which side has a greater advantage.

Employers also have to be careful when allowing their employees to purchase an individual plan. Depending on how you do it, there could be some tax consequences to worry about.

The best thing an employer needs to do is bring in their health insurance expert or consultant. I encourage to at least bring in one other person in addition to your current benefits insurance agent/consultant. This will allow you to see a couple different ideas as well as making sure your current consultant is acting in your best interests. You would be surprised how many insurance agents get complacent in what they do and use their own interests for the strategies they use.

Arthur "Butch" Zemar is a 2014 Broker of the Year Finalist, an insurance specialist, author and President at Elite Benefits of America. Butch Zemar is actively developing informative resources, such as articles and videos that deliver vital information on healthcare reform and employer options. Elite Benefits of America has consultative packages for employers, as well as insurance solutions, to keep employers compliant with healthcare reform and keep skyrocketing premiums under control.

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Choosing the Right Health Insurance for Your Needs

Making sure your body is in the best shape possible is important to your longevity. However, preventative care can also have a big impact on your wallet. Yearly exams for your teeth, eyes, and body can be expensive when you pay out of pocket, which is why health insurance can be very beneficial. The right plan can offset your costs with deductibles that are lower than paying for everything yourself. Having this kind of coverage can also help you choose a doctor based on skill rather than how cheap they are. Learn how to pick the best plan for your needs, so you can get the care you deserve.

What Are Your Needs?

The first thing you should think about is what kind of coverage you want. For example, if you wear glasses, you should probably choose health insurance that has a vision care package. If you are worried about dental costs, consider adding dental to your premium.

Many people choose to pay a small monthly premium that covers major medical expenses but doesn't cover everyday prescription costs or doctors visits. This is often referred to as hazard coverage. Having this type of coverage is not true protection; instead, it provides peace of mind in case you are faced with a large medical expense unexpectedly.

If you have medical needs that require you to visit a doctor frequently, a plan with a cheap deductible (the portion you pay when you use your coverage) may be the best choice for you. The cheaper your deductible, the more expensive your premium will be. However, over the course of a year, you may end up paying less out of pocket with this type of plan.

How Much Have You Already Paid Out of Pocket?

Gather your receipts from the past year and add up how much it has cost you to pay for your dental work, annual exams, and glasses out of pocket. Without health insurance, these dollars add up. Try to find a plan that fits within the budget you have already spent over the last year that also meets the medical requirements you have. This will help you save money and get a decent idea of what you can realistically afford.

Getting health insurance lets you rest easy knowing that you can get quality care whenever you require dental, vision, or general doctor visits. Before choosing just any plan, you need to determine your needs and how much you can afford.

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Products To Consider In Your 4 Pillars of Protection Insurance Portfolio

With a wide range of insurance products available today it is important to understand the differences and benefits to you and your specific situation. A basic portfolio for any person but more specifically for a self-employed person should encompass the 4 following aspects.

Disability

By far one of the most important products for anyone, specifically self-employed people is disability insurance. We all work to handle our weekly and monthly expenses in addition to providing the "little extras" if we have anything left over. Employees of a company for the most part will have benefits provided to them however, being self-employed our livelihood depends on our ability to go to work and earn an income. In the event your ability to work is suddenly removed, disability insurance could be the key to your survival. Your income is the fuel for everything. Remove that and over time all else will fall apart.

Life Insurance

Life insurance has so many uses that it could essentially apply to everyone. However, the general consensus of life insurance is that it is suitable only for people with a family. This couldn't be further from the truth. Life insurance can be used to protect a debt over a period of time, provide for your survivors after final expenses, or give to a charity upon your death. For people who would like the idea of having a benefit as well as a savings or investment vehicle, life insurance could also be an option for you. Life insurance must be carefully evaluated to ensure that it is structured properly based on your specific situation.

Critical Illness

In my experience I have seen this product misunderstood the most. The important thing to understand about CI is that it will pay a lump sum benefit in the event you're diagnosed with a "specific" covered illness. Most CI products will protect against heart attack, cancer, and stroke however, each policy will differ between companies for other covered illnesses beyond these. Do not make the mistake like most do in thinking that this operates like disability insurance. Yes, they are both living benefits but they provide protection in varying ways.

Investments

Within financial circles it is encouraged to have a minimum of 6 months of disposable "liquid" income saved. For most people this is a tremendous feat and some people often throw their hands up in the air and forfeit the idea that they too can have investments. Life insurance can be designed in such a way that not only do you have protection but also an accumulating asset. Outside of life insurance there are many ways to protect and grow your money. The concern for most people is having a large sum of money lying around to be able to invest.
If having a large starting capital is a concern of yours like it was for me, then I welcome you to consider an alternative to the "traditional investments and savings plan".

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