Insurance quesitons

SCHIP

If you are a low income parent and your child does not have insurance coverage you should look at two options. the first and best option is SCHIP. (State Childrens Health Insurance Plan). Schip covers the children of many low income persons. the good news, is that SCHIP was recently expanded. It is possible that if you have been denied for SCHIP in the past you will now be eligible. With expanded funding it is likely most states will be taking new applications in the near future. In many states it is expected that as early as April the new funds will be available.

If you do not meet the guidelines for SCHIP, and you still need insurance for children in grades K-12, most schools offer a private 3rd party low cost insurance plan for students. Call you local school and ask for information on any low cost health plans for students. These plans are often offered at the beginning of the school year and most parents miss the offering in the blitz of information at the start of school.

Rick

Issue of no insurance:

First look at the alternatives. If you are in school, talk to your school about student health insurance, it may be worthwhile to enroll in order to get health insurance at a reasonable rate.

Here are some other options.

First be sure you are plugged into your local social services agencies. Medical supplies are often assisted by local programs. Call your providers. Many offer a free or low cost services and supplies.

Now, no one likes or can get all free stuff. So the best bet is to find health insurance. Lets remember some things. First if you are currently on a plan you will be COBRA eligible on your plan when it ends. You can pay the full cost of your current plan plus 2% for 18 months in order to keep your current insurance. I strongly suggest you get in touch with your current provider (that includes a parent insurance provider) to discuss COBRA coverage. This is a very big deal and do not let it pass without discussing it at least.

It will be expensive. But, and I want you to understand this, if you are gambling with a chronic disease, it may be something you have to afford. New this year is if you are less then 24 and not married, you may continue on your parents plan so long as you stay in school.

Now I know this does not answer your issues. Health insurance for a chronic disease person has to be the number one thing you consider when you make a life change. Please do so carefully. Do not jump, then think, oh I should have thought about health insurance first.

Rick

Why AIG is important.

Today the federal government will likely intervene in favor of AIG once again. No doubt many of us (including me) are angry and a little upset about these massive interventions. What many us do not know is why7 the AIG intervention is so important. Here is an explanation.

First we have to start with the nature of Insurance. When we buy insurance either at our employer or from the guy on the corner we prefer to think the name on the policy is our insurance provider. That is only partially true. In reality we are purchasing a house of insurance. It is termed spreading the risk. Lets take health insurance for instance.

Say we buy insurance form XYZ company, they will administer the claims process and pay some portion of each claim based on the premiums received. However XYZ company also uses a portion of our premium to purchaser what is called reinsurance. It specifies that after a certain level of claims, $100,000 is typical, the reinsurance carrier will pay all claims.

This reinsurance, makes all insurance possibile. In fact all insurance is backstopped by a system of reinsurance. All reinsurance carriers are in fact reinsured by other carriers. In fact the there only a few carriers in the world who hold the majority of risk. In the health insurance market there are perhaps ten to twenty reinsurance carriers. All of which are reinsured for some level of risk. Almost no company takes both the first dollar and the last dollar of risk for any policy.

Now this is where AIG comes in. AIG is one the largest reinsruser in the world. Along with Loyds of London , AIG is the backstop for millions of health, life and commercial transactions int eh world. In fact oif AIG went bankrupt tomorrow, almost all business int he world would come to screeching halt. AIG reinsures, property, liability, health, auto and transactional activities. In fact the insurance house of cards would collapse in a matter of hours if AIG were to fail.

Consider this, you might have an auto policy that is reinsured by AIG and not even know it. In fact you may have several policies that are reinsured by AIG, in most cases it is unlikely you know about this arrangement. Now suppose AIG fails. Almost immediately there will be a crisis in the reinsruance market. Insurance companies will be searching for new reinsurers and the price will escalate dramatically. Making current policies unprofitable. At the very least the price of insurance will escalate significantly.

Of more immediate importance is that many of the current policies will immediately no longer be “insured”. With the reinsurance carrier no longer in business, the basis of the individual policies would not be valid thus rendering them little more than paper promises without good back up for catastrophic claims. In short without insurance business stops.

One area of insurance is for decisions made by boards of directors, so that they can make decision about the company. Without this insurance, no sane person would serve on a board of directors for any company because every decision from the simple, should we shovel the walks to the complicated business decisions have potential for ligation. Without insurance, this litigation is personnel, Directors are personally liable for these decsions and as such no one would serve, it is simply to risky. AIG in its various forms and acting as a backstop for other companies can and does reinsure a great potion of the business climate.

Now lest say you drive a car, have life insurance, health insurance, property causality, liability, or homeowners insurance. It is a safe bet that at least some of these products are reinsured by AIG. In short if AIG fails, a vast portion of the US and World economy simply becomes uninsured. And if it is not insured, it will not operate. WOudl you drive a car without insurance? Well for one it is illegal, and second the risk would be astronomical.

In short, AIG is way to big to fail,.

Rick

I just changed employers, and of course insurance companies, and am fighting over copays. My previous carrier Anthem Blue Cross charged a singe copay for Byetta and the associated pen needles needed to inject the drug. My current carrier Aetna is saying that since these are 2 separate rx, then I need to pay a copay on each. And since they charge needles at the highest tier, the charges are extreme. I live and work in California and I’m aware that each state has peculiar requirements for coverage.

I’ve tried calling customer service and get conflicting replies depending on whom I speak with. I’ve filed a formal protest with them, to which I’ve gotten no reply.

Lee;

Most companies treat needles and drugs as two separate prescriptions with separate co-pays. I do have a suggestion, that might help, I am guessing that you are paying the higher deductible because generics are not available. Sometimes in a plan it is possible to appeal the non generic designation based on the lack of a generic substitute. I suggest you read the plan carefully and see if this forms a possible appeal. Even if not go ahead and appeal and call your personnel department and complain about the lack of a generic equivalent, many things PD’s can intervene and help this kind of issue along. I wish you the very best of good fortune.

Rick Phillips

Thanks for the ideas. I’m told that for some injectables that Aetna does consider them a single copay for a kit as they deem it. But I’ll try the generic v brand approach as well.