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Breaking news! Renewal of an individual plan from the old market is a qualifying event with Assurant Health.

I just received outstanding news from Assurant Health insurance company. In February I wrote this article that referred to a federal regulation which states that if you have an individual health insurance policy from the ‘old market’ – non grandfathered plans from 2013, 2012, 2011, 2010 and even grandfathered plans purchased prior to 3/23/2010. And, that policy renews in 2014 you can purchase a new 2014 ‘Medal’ plan on a guaranteed issue basis (no preexisting conditions) all year long, even outside of ‘open enrollment’ periods. The problem is other carriers are not considering the renewal of an old policy to be a ‘qualifying event’. So up until now, I was told that short term (temporary health Insurance) would be the only alternative for those who still have pre-2014 policies that are renewing this year.

Assurant Health announced yesterday that they are now honoring this regulation that states quite clearly that if you have an ‘old’ policy from the ‘old’ market and that plan renews you can purchase a 2014 ‘qualified’ Bronze, Silver, Gold or Platinum health insurance plan on or off the exchange on a guaranteed issue basis between open enrollment periods. This is VERY good news for anyone who has an ‘old policy’ that renews this year and is facing a large premium increase and/or has exclusion riders on their existing policy and wishes to purchase a new 2014 plan without exclusion riders. 

At this juncture, Assurant Health is the only carrier that I am aware of that is honoring the aforementioned regulation and as such they have a corner on the market until the next open enrollment period begins on November 15, 2014 for coverage effective dates beginning no sooner than January 1, 2014. As I stated in this recent article, many health insurance carriers like Aetna and Humana are not even offering short term (temporary) health insurance products until the next open enrollment period and the few carriers who are offer them with dangerously low lifetime maximum coverage amounts. It must also be reiterated that if you purchase short term coverage these policies do not cover preexisting conditions and you will be subject to a 1% of your MAGI ‘fine’ (TAX) from the IRS if you purchase short term coverage because those plans are not considered ‘qualified health plans’ under CMS and HHS regulations.

If your old health insurance plan is renewing in 2014 and you wish to get quotes from Assurant Health for a qualified replacement plan click their logo below. There is a now a new section on the application where you will need to either upload a copy of your existing health insurance ID card proving that you have a policy from the old market or you can fax a copy of your old ID card to the fax number provided on the application. This is necessary to prove that you qualify for a special enrollment period as an applicant with a qualifying event. 

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The next wave of Obamacare horror stories won’t be about cancellations.

The last quarter of 2013 was filled with horror stories of millions of Americans – many of them Cancer patients – losing their health insurance because of the PPACA “Obamacare”. Even though Barack Obama promised “if you like your plan you can keep your plan and no one will take it away from you, period.” At the very least, many of the 6.3 million policy holders who had their coverage canceled were able to obtain a QHP – ‘qualified health plan’ – on a guaranteed issue basis (no preexisting conditions) as a replacement shortly thereafter. Albeit those plans are often times more expensive and expose those consumers to higher premiums and out of pocket risk exposure, most especially if they do not qualify for taxpayer funded ‘advance premium tax credits’-  to artificially lower premiums and ‘cost sharing’ subsidies to lower deductibles.

That was then, this is now.

The new wave of Obamacare horror stories will begin being told all across America now that we are outside of the first national ‘open enrollment‘ period which ended on 3/31/2014. Only this time it won’t be about Americans losing their health insurance. It will instead be about the vast majority of Americans being unable to purchase individual, renewable health insurance from any carrier no matter how sick they are until January 1, 2015. That’s right, unlike before Obamacare when you could blame those “evil health insurance companies” for “denying you your right to health care.” Now, the blame will rest squarely on the shoulders of the greatest health insurance salesman in world history, Barack Obama.

Millions of Americans are about to be denied their ‘right‘ to health care.

It is Barack Obama’s health care law that will be directly responsible for denying millions of sick Americans their ‘right‘ to health insurance from now until January 1, 2015. From now until then Americans who wish to purchase their own individual, renewable health insurance are barred by federal law from doing so. In fact, the only way to do so now is you have a ‘qualifying life event’ and as such qualify for a ‘special enrollment‘ period.  The truth is under Obamacare your ‘right’ to health care refers to beseeching yet another group of nameless, faceless government bureaucrats who may or may not let you purchase health insurance that will cover your preexisting conditions. Yeah, this is going to be great! Forward!

Sarah

The rest of us in the individual market will be barred by federal law from obtaining our own health insurance that covers preexisting conditions until January 1st, 2015. It is from this pool of millions that the new horror stories will come from. Imagine you are a low information voter who doesn’t vote at the ballot box but votes for American Idol candidates every year.  Then, imagine you develop cancer or another life threatening illness in May and find out that you can’t get health insurance coverage that covers your preexisting condition for another 7 months. Yeah, 2014 is going to be a great year politically for Republicans. Not even they can screw this gift up.

       Examples of qualifying life events are:

  • You move to a new area that offers you different plans, or isn’t covered by your HMO network.
  • You get married.
  • You get pregnant or adopt a child.
  • You lose other health coverage due to job loss, a decrease in work hours, end of COBRA coverage or other reasons.
  • You become a U.S. citizen.
  • Your income changes, or some other event changes your income or household status.
  • You can prove that your health insurance company violated its contract with you.
  • You are no longer covered on a family member’s policy because you turned 26, you have legally separated from or divorced your spouse, or the policy holder has passed away.
  • You become a member of an Indian tribe. Other complicated cases that may qualify for a special enrollment period
  • You faced a serious medical condition or natural disaster that kept you from enrolling. For example:
    • An unexpected hospitalization or temporary cognitive disability
    • A natural disaster, such as an earthquake, massive flooding, or hurricane
    • A planned Marketplace system outage, such as Social Security Administration system outage

    Misinformation or misrepresentation Misconduct by a non-Marketplace enrollment assister (like an insurance company, navigator, certified application counselor, or agent or broker) resulted in you:

    • Not getting enrolled in a plan
    • Being enrolled in the wrong plan
    • Not getting the premium tax credit or cost-sharing reduction you were eligible for

    Enrollment error Your application may have been rejected by the insurance company’s system because of errors in reading the data, or some of the data was missing or inaccurate. System errors related to immigration status An error in the processing of applications or system caused you to get an incorrect immigration eligibility result when you tried to apply for coverage. Display errors on HealthCare.gov Incorrect plan data was displayed at the time that you selected your health plan, such as benefit or cost-sharing information. This includes issues where some consumers were allowed to enroll in plans offered in a different area, or enroll in plans that don’t allow certain categories of family relationships to enroll together. Medicaid/Marketplace transfers

    • If you applied for Medicaid through your state, or were sent to Medicaid from the Marketplace, but you weren’t eligible for Medicaid.
    • Your state transferred your information to the Marketplace but you didn’t get an answer about your eligibility and/or didn’t get enrolled before March 31.

    Error messages Your application was stopped due to specific error messages. For example, you received a “data sources down” error message or another error message that didn’t allow you to enroll. Unresolved casework You’re working with a caseworker on an enrollment issue that didn’t get resolved before March 31. Victims of domestic abuse You’re a victim of domestic abuse and weren’t previously allowed to enroll and receive advance payments of the premium tax credit separately from your spouse. You’ll be able to do so now. Other system errors Other system errors that kept you from enrolling, as determined by the Centers for Medicare & Medicaid Services

You can still buy health insurance in the individual market but it won’t cover your preexisting conditions

Nonrenewable ‘short term’ or ‘temporary’ individual health insurance policies are still available for sale but they will not cover your preexisting conditions. And, only a few health insurers are still offering them.  Some of the biggest players in the market such as Aetna and Humana are not offering temporary plans. Of the few carriers who still are, I recommend Assurant Health for unlike other carriers Assurant Health covers outpatient prescription drugs the same as any other illness. Other carriers do not. To get quotes for temporary health insurance coverage from Assurant Health click their banner below:
Assurant Short-Term Logo
You will owe a non compliance ‘fine’ (TAX) to the IRS for taking the short term route

You must also understand that you will be subject to a 1% of your MAGI ‘fine’ (TAX) for purchasing temporary health insurance since these plans do not include the “essential health benefits” under Obamacare such as Maternity for 62 year old women and single men, drug rehab coverage for those who do not own a crack pipe and pediatric dental for those without children. As such temporary policies are not considered ‘qualified health plans’. Rest assured though, if you are self employed and do not over pay your taxes you will never pay that ‘fine’ (TAX) for the only recourse the IRS has to collect that fine is to hold your tax refund. All criminal penalties for non compliance were removed from the health care law prior to passage.

The other kind of health insurance that covers preexisting conditions outside of open enrollment

The other option if you need coverage for preexisting conditions outside of open ‘enrollment’ is to purchase small group health insurance which is available to groups of two or more people.  However, you must be incorporated and take a Schedule K as an owner of the company. Also, if you are already sick the policy will be max rated and with most carriers if you are going to add employees they must be W2 employees not 1099 contractors.

If your pre-2014 individual health plan is renewing that is a ‘qualifying event’ with Assurant

Assurant Health announced yesterday that they are now honoring this regulation that states quite clearly that if you have an ‘old’ policy from the ‘old’ market and that plan renews you can purchase a 2014 ‘qualified’ Bronze, Silver, Gold or Platinum health insurance plan on or off the exchange on a guaranteed issue basis between open enrollment periods. This is VERY good news for anyone who has an ‘old policy’ that renews this year and is facing a large premium increase and/or has exclusion riders on their existing policy and wishes to purchase a new 2014 plan without exclusion riders.

At this juncture, Assurant Health is the only carrier that I am aware of that is honoring the aforementioned regulation and as such they have a corner on the market until the next open enrollment period begins on November 15, 2014 for coverage effective dates beginning no sooner than January 1, 2014. As I stated in this recent article, many health insurance carriers like Aetna and Humana are not even offering short term (temporary) health insurance products until the next open enrollment period and the few carriers who are offer them with dangerously low lifetime maximum coverage amounts. It must also be reiterated that if you purchase short term coverage these policies do not cover preexisting conditions and you will be subject to a 1% of your MAGI ‘fine (TAX) from the IRS if you purchase short term coverage because those plans are not considered ‘qualified health plans under CMS and HHS regulations.

If your old health insurance plan is renewing in 2014 and you wish to get quotes from Assurant Health for a qualified replacement plan click their logo below. There is a now a new section on the application where you will need to either upload a copy of your existing health insurance ID card proving that you have a policy from the old market or you can fax a copy of your old ID card to the fax number provided on the application. This is necessary to prove that you qualify for a special enrollment period as an applicant with a qualifying event.

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Obamacare Open Enrollment is ending soon. If you have preexisting conditions you need to understand the new rules.

The next available effective date for individual major medical health insurance policies purchased on or off the “Health Insurance Exchange” is May 1, 2014.  The last date to buy that coverage is March 31, 2014. After March 31, 2014 you will not be able to purchase individual major medical health insurance on or off the exchange until the next “open enrollment” period begins again on 11/15/2014 and lasts until 2/15/2015. So, if you have a preexisting condition you need to start familiarizing yourself with how open enrollment works now, not later nowAlso, due to a new rule issued by CMS on December 19th 2013 (which expanded the original hardship exemption) the 6.3 million American policy holders who have lost their health insurance because of Obamacare will not be subject to a fine (TAX) in the year 2014 for not buying health insurance.

The old rules are gone

The old rules pertaining to purchasing health insurance in the individual major medical market are now gone. You can no longer purchase individual major medical health insurance coverage whenever you want, all year long. There are now specific time periods where this kind of coverage will be available in 2014 and in subsequent years. Those periods are called open enrollment periods. Outside of those open enrollment periods individual major medical health insurance coverage will not be available for sale. This means that you will not be able to get coverage for preexisting conditions.

This is why it is essential that you understand the new rules for they will affect you and everyone you know who has a preexisting condition or has lost their health insurance because of Obamacare. This is especially true because our existing state run high risk health insurance pools which provided guaranteed issue coverage for those who were declined health insurance coverage for decades before Obamacare are now being dissolved.

Buying insurance on and off the Obamacare exchange

It is important to know that you do not have to purchase health insurance at Healthcare.gov. All products sold on and off the new Obamacare HIX – “Health Insurance Exchange Marketplace” will be guaranteed issue products during the two national Open Enrollment periods. They are:

Open Enrollment Period One: 1/1/14 – 3/31/14

Open Enrollment Period Two: 11/15/14 – 2/15/15

This means that you can not be denied coverage and no exclusion riders can be placed on your policy whether you buy the product on or off the Obamacare HIX but only during these two time periods. After these two open enrollment periods you can be denied coverage. In fact, individual major medical products will not be offered between these two national open enrollment periods. If insurance carriers continued to offer guaranteed issue coverage all year long it would lead to adverse selection, as it did in Massachusetts.

What you need to know right now

Since time is of the essence (and their is nothing timely about purchasing health insurance on the exchange). You need to know the only reason to purchase health insurance inside the HIX – Health Insurance Exchange Marketplace (Healthcare.gov) is if you qualify for an APTC – Advance Premium Tax Credit – (subsidy) to artificially lower the high cost of the Obamacare “Medal” plans – Bronze, Silver, Gold and Platinum. In order to qualify for an APTX your 2014 total household MAGI – Modified Adjusted Gross Income – income after taxes and retirement contributions must be less than:

$46,960 for an individual
$62,040 for a couple
$78,120 for a family of three
$94,200 for a family of four
$110,280 for a family of five
$126,360 for a family of six

If your income is more than the aforementioned amounts, you should purchase your health insurance outside of the HIX. The same plans are available off the exchange and the application process is much faster and far more secure. Again, all major medical health insurance products purchased inside and outside the HIX will be guarantee issue (no preexisting conditions) during the two national Open Enrollment periods in 2014.

If you live in Illinois, the best priced 2014 ‘Medal’ plans are insured and underwritten by Blue Cross Blue Shield of Illinois a Division of Health Care Services Corporation. Find the right health insurance plan for you by exploring all of the plan options, save plans that fit your needs in your Shopping Cart and return to apply for coverage when you are ready. Click their logo to begin.

 

To shop for all plans on and off the Obamacare HIX in all 50 states click the banner below:

http://www.smedleyinsurancegroup.com/images/health-care-reform-quick-quotes.jpg

A cheaper option for those without preexisting conditions

If you do not have any serious preexisting conditions, you can save a lot of money if you purchase a non-renewable Temporary health insurance policy for a period of one year. These health insurance policies do not cover preexisting conditions nor do they include all of the federally mandated “Essential Health Benefits” such as Maternity, Drug Rehab coverage and Pediatric Dental. This also means that they are not considered ‘Qualified Health Plans’ meaning that you will be subject to the 1% of your MAGI penalty in 2014 if you purchase one of these plans. That stated the premium difference between these plans and ‘Qualified Health Plans’ is significant. The price difference far outweighs the additional fine you would pay to the IRS in most cases.

To run quotes for a Temporary health insurance plan off the exchange click the banner below:

If that Temporary insurance quote engine does not work in your state click the banner below:

http://www.smedleyinsurancegroup.com/images/health-care-reform-quick-quotes.jpg

Very Important Note: Since the PPACA mandates that all health insurance policies cover preexisting conditions during the first national Open Enrollment period from 1/1/14 – 3/31/14 and the second national open enrollment period from 11/15/14 – 02/15/15. You can now safely purchase Temporary health insurance knowing that when your one year Temporary policy ends you will qualify by federal law for any ‘Qualified Health Plan’ regardless of preexisting conditions during the second annual open enrollment period in 2014. Outside of those two aforementioned open enrollment periods you will not be able to obtain coverage for a preexisting condition. For this reason you must not purchase the 6 month Temporary health insurance option.

Only the 12 month Temporary insurance option is acceptable at this juncture. If you purchase a 6 month Temporary policy your coverage will end in between the two aforementioned open enrollment periods and you will not be able to obtain another policy that will cover a preexisting condition that you may develop during the first 6 months of Temporary policy ownership. HHS may yet provide us with further guidance as to whether or not the loss of a Temporary health plan outside of open enrollment periods will qualify as a “Special Enrollment” period in 2014 so that one could obtain a “Qualified Health Plan” on a guaranteed issue basis outside of open enrollment periods. As of the date of this writing no such guidance has been received.

What if your plan renews and you lose it in 2014 outside of open enrollment?

If your individual health plan renews in 2014 or you lose that plan  in a month that is outside of the two national open enrollment periods (which would be between 4/1/14 and 11/15/14) that will also be considered a Special Enrollment period. So, you will be able to buy another individual major medical policy on a guaranteed issue basis (no preexisting conditions) from any carrier offering a QHP – Qualified Health Plan – even though you will be at that juncture outside of open enrollment. 

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This is your chance to legally challenge Obamacare at NO cost to you.

The Illinois Policy Institute has teamed up with the Liberty Justice Center to seek plaintiffs for a lawsuit against the PPACA – Patient Protection and Affordable Care Act – a.k.a. “Obamacare”. It will take every legal and legislative avenue at their disposal to stop Obamacare. Your information will be totally confidential, and there is no cost involved. They’re looking for people to join a lawsuit that will challenge an IRS rule that extends Obamacare health insurance subsidies and the Obamacare “employer mandate” to states like Illinois where they shouldn’t apply because the state government hasn’t established its own insurance exchange. The original deadline to participate in this suit was January 31, 2014. However, the attorneys at the Liberty Justice Center have now extended the deadline because they are looking for more plaintiffs.

As a result of the aforementioned unlawful IRS rule, many people who would otherwise be exempt from the Obamacare individual mandate will be forced to buy insurance they don’t want.  You may be eligible to participate in their lawsuit if you:

    • Are a resident of Illinois or any of the following states: AL, AK, AZ, AR, DE, FL, GA, ID, IN, IA, KS, LA, ME, MI, MS, MO, MT, NE, NH, NJ, NC, ND, OH, OK, PA, SC, SD, TN, TX, UT, VA, WV, WI, or WY;
    • Are ineligible for Medicaid;
    • Have not been offered Obamacare-compliant health benefits from an employer;
    • Are a nonsmoker;
    • Have a household income between 100% and 400% of the federal poverty level in 2014 ($11,490 to $45,960 for a single person — see this chart for other household sizes); and
    • Do not want to buy insurance for 2015 or, if you are 30 or over, either do not want to buy insurance or plan to purchase a catastrophic plan for 2015.
If you meet these criteria and are interested in helping us take our case to court — at no cost to you — please call Jacob Huebert at 312.263.7668, extension 219 or email him at jhuebert@libertyjusticecenter.org.

Fill out this short survey to get started. Please respond a.s.a.p.

State-based exchanges and federally facilitated exchanges

Section 1311 of the PPACA describes state-based health insurance exchanges. That section outlines the powers granted to the IRS to provide APTC – “Advance Premium Tax Credits” (a.k.a. ‘subsidies’) that will be used to artificially lower the high cost of health insurance offered in a state-based exchange. Tied to those APTC’s is also the power granted to the IRS to levy a $2,000 or $3,000 excise tax (non-tax deductible) on all employers with 50 or more full-time employees (first 30 employees waived) if they do not provide PPACA approved health insurance. This is a lot of new power granted to the IRS and this is the primary reason the IRS is hiring thousands of new agents.

Section 1321 of the PPACA describes federally-facilitated exchanges and state-federal partnership exchanges – like the exchange the state of Illinois has chosen to establish. In these types of exchanges, the IRS is granted no authority to provide APTC’s or to levy excise taxes on any employer in that state for not providing PPACA approved health insurance. Since the crafters of the PPACA assumed that every state would willingly establish a state-based exchange, there was no money appropriated for federally-facilitated exchanges. Thus far 34 states have chosen not to open a state-based health insurance exchange.

The illegal action taken by the IRS 

Here’s the kicker, in order to ‘fix’ this legal ‘opt out’ that section 1321 provides to states that choose not to open a state-based exchange. The Internal Revenue Service finalized a proposed rule on the 2 year anniversary of the passage of the PPACA that offers APTC’s -Advance Premium Tax Credits – through exchanges “established under section 1311 OR 1321 of the PPACA. Those six characters—”or 1321″—constitute an unconstitutional and as such illegal rewriting of the statute. By issuing tax credits where Congress did not authorize them, this rule also triggers APTC’s “subsidies” and imposes excise taxes on employers with 50 or more full-time employees in all 50 states with either a state-based, state-federal partnership or federally facilitated exchange. Since the IRS is not a Legislative branch, this action was an illegal action not authorized by Congress and it must not stand.

Worse yet President Obama is following that new proposed rule that was written by the IRS as if it was codified law. This illegal action and President Obama’s support of it has prompted Oklahoma Attorney General E. Scott Pruitt to amend his lawsuit to include a section that sues the IRS for illegally writing new law and granting itself power that it was not granted in the PPACA as originally written. Read more about Mr. Pruitt’s lawsuit here. Mr. Pruitt sat down with Fox News’ Sean Hannity to discuss the progress of his pending case against the IRS on December 6, 2013. Watch the interview below:

As of May 28, 2013 here’s where the numbers stand:

exchanges

  • Committed to a state-based exchange: 17 states and Washington, D.C. (described in section 1311)
  • Planning for a partnership exchange: 7 states (described in section 1321)
  • No to state-based exchange. Defaulting to Federal Exchange: 27 states (described in section 1321)

I recently commented about this illegal action taken by the IRS for Champion News talk radio on Chicago’s AM560TheAnswer radio:

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Parents can get subsidized coverage at HealthCare.gov but not their children.

Welcome to the latest ‘glitch’ at the $630,000,000 (and growing) HealthCare.gov web site!

Let’s say you’re a family of five and you have 3 children. To qualify for Medicaid in Illinois your total household MAGI – Modified Adjusted Gross Income – has to be less than $38,048. In Indiana it must be less than $27,910 annually for a family of five. So if you’re above that income level you won’t have any problems enrolling you AND your children on a subsidized plan through the Obamacare “Health Insurance Exchange Marketplace”.

However because Illinois has a program called “All Kids Covered” which was initially funded under the federal SCHIP bill and is part of Medicaid you will have a big problem enrolling your children at HealthCare.gov. Under All KidsCovered a family of five can make $82,710 a year and their kids will qualify for coverage under All Kids Covered which then makes their kids ineligible to receive a subsidy on the PPACA (Obamacare) “Health Insurance Exchange Marketplace“.

Indiana’s “Healthy Indiana” plan states that children from a family of five making less than $27,910 can qualify for Healthy Indiana coverage. Since your children can qualify for coverage under “Healthy Indiana”, Healthcare.gov is not allowing them to receive subsidized health insurance inside the Obamacare “Health Insurance Exchange Marketplace”. The “Marketplace” is instead kicking them to other programs established prior to Obamacare like Healthy Indiana or other offshoots of Medicaid.

So this is why HealthCare.gov is not allowing parents to enroll their kids on their health plans. Parents now are faced with three options, neither one ideal

1.) Pay full price for your children with no subsidy in the “Health Insurance Exchange Marketplace” and only get a subsidy for you and your spouse which means you will have to complete 2 separate applications, one application seeking a subsidy for you and your spouse and one application paying full price with no subsidy for your children. This of course would mean that you will have two separate policies and will receive two separate bills from the insurance company. It also means that both policies will have their own separate deductibles and other out of pocket costs which significantly increases the total out of pocket risk for the family.

2.) Decline the subsidy for the entire family (even though you qualify) and pay full price for coverage off the “Health Insurance Exchange Marketplace” for the entire family.

3.) Enroll your children on AllKidsCovered (Medicaid) and then enroll you and your spouse on the “Health Insurance Exchange Marketplace” and receive the subsidy for only you and your spouse.

Isn’t BIG government great? No worries though! Those helpful “Navigators” over at Healthcare.gov have provided a convenient “appeal request form” that you can download here.  Using this convenient “appeal request form” will allow you to state your problem and they will get right on it! You can expect a response as soon as you can ice skate on the river Styx.

Sadly, this ‘glitch’ is not isolated to Illinois. You will find that convenient ‘appeal request form’ embedded in this CNN article about another family going through the same “train wreck” in Pennsylvania. It’s also happening in Indiana, Alabama and all over the country. 

If you’re experiencing this problem you should not rely only on the ‘experts’ at HealthCare.gov You should contact your state’s department of insurance and your insurance carrier directly for help. They will both most likely be more helpful to you than the bloated bureaucracy that is Healthcare.gov.

Oh and if you have a newborn child don’t expect that child to be covered under Obamacare. The brilliant designers of the $630,000,000 HealthCare.gov web site forgot to include a tool to add newborns to your policy. Thankfully that ‘glitch’ has now been fixed via a new “Special Enrollment” period.

Maybe this is why the latest Gallup poll shows a record number of Americans who now believe BIG government is the greatest threat to our future. When I saw that poll I was encouraged ….. and then I watched the video below. Before you watch the video understand that the reason that 17% of the federal government was ‘shut down’ back in October was because the U.S. House of Representatives appropriated all funding necessary to keep the government running but excluded funding for Obamacare. They knew that many Americans had already lost their coverage because of Obamacare and that millions more would as well. So they attempted to stop this ‘train wreck’ before it began. The U.S. Senate - led by Senator Harry Reid and his Democrat majority - chose not to spend any of the money appropriated by the House because it didn’t include funding for Obamacare. So, it wasn’t the Republican party or the Tea Party that ‘shut down’ government. It was the Democrat party. Or… maybe it was Bush’s fault:

Yours Truly tried my level best to explain all of this to the low information voters in Chicago back in October on ABC‘s “Windy City Live” program. As you can tell from watching the video below, they did not want to hear the truth.

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TruthAboutObamacare.com 2013 in review

The WordPress.com stats helper monkeys prepared a 2013 annual report for this blog.

Here’s an excerpt:

The Louvre Museum has 8.5 million visitors per year. This blog was viewed about 120,000 times in 2013. If it were an exhibit at the Louvre Museum, it would take about 5 days for that many people to see it.

Click here to see the complete report.

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If your state high risk pool cancelled your policy you do have options.

If you have a preexisting condition such as Cancer, Heart Disease or Diabetes or your build falls outside what is considered acceptable underwriting guidelines and you have received a policy termination letter from your state High Risk Health Insurance Pool like this one from the Illinois ICHIP – Illinois Comprehensive Health Insurance Plan. Know that you should apply now for a guaranteed issue (you can not be denied coverage) replacement plan with an effective date of 1/1/2014.

Since State High Risk Health Insurance Pools are already ‘maximum rated’ due to the fact that our state risk pools cover those with severe preexisting conditions, your premium should be less than what you are paying now most especially if your household MAGI – Modified Adjusted Gross Income – (income after taxes and after retirement contributions) is less than:

$46,960 for an individual
$62,040 for a couple
$78,120 for a family of three
$94,200 for a family of four
$110,280 for a family of five
$126,360 for a family of six

Since Blue Cross Blue Shield of Illinois is the administrator for our ICHIP program you have been using Blue Cross Blue Shield of Illinois providers whilst insured with ICHIP. If you wish to stay with BCBSIL providers click the logo below and apply for coverage with Blue Cross Blue Shield of Illinois, a Division of Health Care Services Corporation. Find the right health insurance plan for you by exploring all of the options, save the plans that fit your needs in your Shopping Cart and return to apply for coverage when you are ready. Don’t forget, the last day for the Patient Protection and Affordable Care Act (PPACA) “Open Enrollment” is February 15, 2014.

 

If you have received a policy termination letter from another State High Risk Health Insurance Pool. Yes, that’s right we had state based High Risk Health Insurance Pools which provided guaranteed issue coverage to individuals with preexisting conditions in 34 other states long before Obamacare. You can shop for all plans on (subsidized) and off (unsubsidized) the “Health Insurance Exchange Marketplace” in all 50 states by clicking the banner below. Remember that all Qualified Health Plans (excluding Temporary plans) sold on and off  the exchange will be guaranteed issue between the two national “Open Enrollment” periods beginning 1/1/14 – 3/31/14 and again during the recently delayed new second “Open Enrollment” period of  11/15/14 – 01/15/15.

http://www.smedleyinsurancegroup.com/images/health-care-reform-quick-quotes.jpg

Please note: Outside of these two national “Open Enrollment” periods you will not be able to obtain guaranteed issue coverage for a preexisting condition as an individual or family applicant and you will be denied coverage unless your situation is deemed a “Special Enrollment”.

In addition to increasing your lifetime coverage to an unlimited coverage amount for each insured member and the addition of four more of these ten “Essential Health Benefits“. You already have 6 of them on your policy. However, now you get to pay for Maternity coverage, “Substance Abuse Disorder Services” and Pediatric Dental, whether you want that or not.

You will also have ‘first dollar’ coverage (no deductible or co pay required) for the following Preventative Care services and exams on all policies sold after 1/1/2014. You do not have any these benefits currently provided on your existing High Risk Health Insurance Pool coverage:

15 Covered Preventive Services for Adults:
  1. Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
  2. Alcohol Misuse screening and counseling
  3. Aspirin use for men and women of certain ages
  4. Blood Pressure screening for all adults
  5. Cholesterol screening for adults of certain ages or at higher risk
  6. Colorectal Cancer screening for adults over 50
  7. Depression screening for adults
  8. Type 2 Diabetes screening for adults with high blood pressure
  9. Diet counseling for adults at higher risk for chronic disease
  10. HIV screening for all adults at higher risk
  11. Immunization vaccines for adults–doses, recommended ages, and recommended populations vary:
  12. Obesity screening and counseling for all adults
  13. Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
  14. Tobacco Use screening for all adults and cessation interventions for tobacco users
  15. Syphilis screening for all adults at higher risk

22 Covered Preventive Services for Women, Including Pregnant Women

  1. Anemia screening on a routine basis for pregnant women
  2. Bacteriuria urinary tract or other infection screening for pregnant women
  3. BRCA counseling about genetic testing for women at higher risk
  4. Breast Cancer Mammography screenings every 1 to 2 years for women over 40
  5. Breast Cancer Chemoprevention counseling for women at higher risk
  6. Breastfeeding comprehensive support and counseling from trained providers, as well as access to breastfeeding supplies, for pregnant and nursing women*
  7. Cervical Cancer screening for sexually active women
  8. Chlamydia Infection screening for younger women and other women at higher risk
  9. Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, including abortifacient drugs – some religious organizations are now exempt from this mandate
  10. Domestic and interpersonal violence screening and counseling for all women*
  11. Folic Acid supplements for women who may become pregnant
  12. Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
  13. Gonorrhea screening for all women at higher risk
  14. Hepatitis B screening for pregnant women at their first prenatal visit
  15. Human Immunodeficiency Virus (HIV) screening and counseling for sexually active women*
  16. Human Papillomavirus (HPV) DNA Test: high risk HPV DNA testing every three years for women with normal cytology results who are 30 or older
  17. Osteoporosis screening for women over age 60 depending on risk factors
  18. Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  19. Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
  20. Sexually Transmitted Infections (STI) counseling for sexually active women
  21. Syphilis screening for all pregnant women or other women at increased risk
  22. Well-woman visits to obtain recommended preventive services

26 Covered Preventive Services for Children

  1. Alcohol and Drug Use assessments for adolescents
  2. Autism screening for children at 18 and 24 months
  3. Behavioral assessments for children of all ages
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  4. Blood Pressure screening for children
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  5. Cervical Dysplasia screening for sexually active females
  6. Congenital Hypothyroidism screening for newborns
  7. Depression screening for adolescents
  8. Developmental screening for children under age 3, and surveillance throughout childhood
  9. Dyslipidemia screening for children at higher risk of lipid disorders
    Ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  10. Fluoride Chemoprevention supplements for children without fluoride in their water source
  11. Gonorrhea preventive medication for the eyes of all newborns
  12. Hearing screening for all newborns
  13. Height, Weight and Body Mass Index measurements for children
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  14. Hematocrit or Hemoglobin screening for children
  15. Hemoglobinopathies or sickle cell screening for newborns
  16. HIV screening for adolescents at higher risk
  17. Immunization vaccines for children from birth to age 18 —doses, recommended ages, and recommended populations vary:
  18. Iron supplements for children ages 6 to 12 months at risk for anemia
  19. Lead screening for children at risk of exposure
  20. Medical History for all children throughout development
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  21. Obesity screening and counseling
  22. Oral Health risk assessment for young children
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years.
  23. Phenylketonuria (PKU) screening for this genetic disorder in newborns
  24. Sexually Transmitted Infection (STI) prevention counseling and screening for adolescents at higher risk
  25. Tuberculin testing for children at higher risk of tuberculosis
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  26. Vision screening for all children
    Source:
    https://www.healthcare.gov/what-are-my-preventive-care-benefits

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