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Featured Article:
The federal Health Care Reform law was passed on March 26, 2010. Individuals interested in Florida health plans and Blue Cross Blue Shield of Florida, BCBSF, are very eager to learn how Florida health insurance will be affected.
Whether one has coverage or is seeking a quote for affordable health insurance, and whether or not one resides in Tampa, Sarasota, Fort Myers, or in Lakeland near our four Bay Marketing offices, Floridians ask what the rest of the country wants to know: "How will my future, and my family's future, be impacted this year, and later, when the federal changes are fully underway?"
With a greater and greater percentage of the population being in the "senior citizen" demographic as years pass, we will surely all be affected by issues that elder Americans face.
Many rules are being written now, but one clear change health care reform brings is that Medicare will begin paying $250 in annual rebate to those in the coverage gap of the "donut hole" of Medicare Part D. Historically, this "donut hole" has affected no less than 300,000 Floridians. The $250 rebate check will be sent within a few months after a senior's lapse in Medicare D coverage starts in a given year. Once a person is in the "donut hole", and receives the check, no other Medicare funds are available. Well over 10 times this amount may be spent out of pocket before catastrophic coverage from Medicare takes over till year-end. The cycle begins again the next year and is a serious concern for millions of Americans.
Beginning in January 2011, a more significant change for seniors is coming around the bend. Name-brand drugs will be at a 50% discount during one's lapse in Medicare D coverage.
Since rising drug costs are a big concern, it's difficult to predict overall outcome. Many have noted that name-brand drug costs rise at levels exceeding that of overall inflation.
If the donut hole closes as the new law promises will take place by 2020, seniors will still pay 25% of their total drug costs under Medicare D, unless they have insurance to supplement or replace Medicare.
Long-term value and security are provided through a number of different plans through Bay Marketing and BCBC of Florida. With the financial burdens the future will surely bring, people of all ages can benefit by having the right coverage at the right time.
Advantage65 offered by BCBSF includes a variety of network-based Medicare supplement plans that can be customized to fit one's needs. CompCoverage offers five supplemental insurance plans. Blue Medicare PPO - features no referrals plus prescription drug coverage. Blue Medicare HMO (offered by Health Options, Inc.) includes prescription drug coverage and preventive health care. Blue Medicare Rx (Medicare Part D) has improved, low cost options - some with no deductibles. BCBSF also offers dental, disability, life, and long-term care insurance policies, and flexible Spending Accounts, (FSA) and Health Reimbursement Accounts (HRA) and Health Savings Accounts (HSA). See http://www.floridahealthplansonline.com/products.html for our great line of products for all ages and stages of life. Bay Marketing has a plan to fit your every need.
With many questions still unanswered, there is one thing we can be certain about:
The overall security available through having insurance coverage that's right for us (and those we love) now is an essential element in building the health care and financial picture we all wish to see in the years to come.
Serving central and west coast Florida, Bay Marketing, a licensed independent contractor with Blue Cross Blue Shield of Florida, has been providing insurance plan information for individuals and employers during the last twenty years. Many of their professional agents specialize in commercial health insurance for the Florida business owner. Contact Bay Marketing for an online individual and group insurance quote at Florida Health Plans Online, http://www.floridahealthplansonline.com
Federal Health Insurance Reform Future Tasks
The federal health care reform legislation, known as the Patient Protection and Affordable Care Act, signed by the President on March 23, 2010, and the Health Care and Education Reconciliation Act approved by Congress, signed by the President today, will expand the availability of health care coverage to millions of Americans. While some of the measures will be implemented this year, many do not take effect until 2014 and some extend out to 2020.
Below is a high-level overview of the timeline. It is important to note that many of these reforms and their effective dates are subject to the rules and regulations process both at the state and federal levels – which could alter the intended timing of implementation.
2010
New Programs:
* Temporary retiree reinsurance program is established
* National risk pool is created, small business tax credit is established
* $250 rebate for Medicare members who reach the "doughnut hole"
Insurance Reforms:
* Prohibits lifetime benefit limits – based on dollar amounts
* Allows restricted annual limits on the dollar value of certain benefits
* Coverage rescissions/cancellations are prohibited (except for fraud or intentional misrepresentation)
* Cost-sharing obligations for preventive services are prohibited
* Dependent coverage up to age 26 is mandated
* Internal and external appeal processes must be established
* Pre-existing condition exclusions for dependent children (under 19 years of age) are prohibited
* New health plan disclosure and transparency requirements are created
2011
Insurance Reforms:
* Uniform coverage documents and standard definitions are developed
* Minimum medical loss ratios are mandated
Medicare Reforms:
* Medicare Advantage cost sharing limits effective
* Medicare beneficiaries who reach the doughnut hole will receive a 50% discount on brand name drugs
* A 10% Medicare bonus will be provided to primary care physicians and general surgeons practicing in underserved areas, such as inner cities and rural communities.
* Medicare Advantage plans would begin to have their payments frozen.
Other:
* Employers are required to report the value of health care benefits on employees' W2 tax statements.
* Annual industry fee for pharmaceutical manufacturers of brand name drugs.
* Voluntary long term care insurance program would be made available to provide cash benefit for assisting disabled individuals to stay in their homes or cover nursing home costs. Benefits would start five years after people begin paying a fee for coverage.
* Funding for community health centers would be increased to provide care for many low income and uninsured people.
2012
* Hospitals, physicians, and payers would be encouraged to band together in "accountable care organizations."
* Hospitals with high rates of preventable readmissions would face reduced Medicare payments.
2013
* Individuals making $200,000 a year or couples making $250,000 would have a higher Medicare payroll tax of 2.35% on earned income —up from the current 1.45%. A new tax of 3.8% on unearned income, such as dividends and interest, is also added.
* Medical expense contributions to flexible spending accounts (FSAs) limited to $2,500 a year—indexed for inflation. In addition, the thresholds for claiming itemized tax deduction for medical expenses rise from 7.5% to 10% of income.
* Medical device manufacturers would have a 2.9% sales tax on medical devices; devices such as eyeglasses, contact lenses, and hearing aids would be exempt.
* Eliminates deduction for expenses allocable to Medicare Part D subsidy for employers who maintain prescription drug plans for their Medicare Part D eligible retirees.
2014
Coverage Mandates & Subsidies:
* Individual and employer coverage responsibilities are effective.
* Individual affordability tax credits are created and small business tax credits are expanded.
Health Insurance Exchange & Insurance Reforms:
* State individual and small group health insurance exchanges operational.
* Guaranteed issue, guaranteed renewability, modified community rating and minimum benefit standards ("essential benefits" plan) effective.
* Lifetime and annual dollar limits are prohibited for essential benefits.
* Pre-existing condition exclusions are prohibited.
Taxes & Fees:
* Addition of new taxes on health insurers
Medicaid and Medicare Reform:
* Medicaid expanded to cover low income individuals under age 65 up to 133% of the federal poverty level—about $28,300 for a family of four.
* Minimum medical loss ratio of 85% required for Medicare Advantage plans
2018
Taxes & Fees:
* Tax ("Cadillac tax") imposed on employer sponsored health insurance plans that offer policies with generous levels of coverage.
2020
Medicare Reform:
* Doughnut hole coverage gap in Medicare prescription benefit is fully phased out. Seniors continue to pay the standard 25% of their drug costs until they reach the threshold for Medicare catastrophic coverage.
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