Health Cards and Health Insurance Are Very Different

Recently there has been a proliferation of advertisements for health cards. These cards claim to offer access to high quality and affordable medical care, dental care, prescription drugs, vision and other health care services. The rates vary but may be as little as $20 a month to as high of $125 a month for a family. The two big selling points of these plans are that they are affordable and that you cannot be turned down.

Exactly what are you buying? Health cards can also be called discount medical programs or plans. This industry has grown so large that they even have their own trade association, the Consumer Health Alliance. Here is the definition of a health card given by the Consumer Health Alliance. “Our member companies make health care products and services, including prescription drugs, dental, chiropractic, eye care, physician, hospital and laboratory services, available to millions of Americans by providing opportunities for consumers to directly purchase health care services and products at discounted rates.” According to the Consumer Health Alliance more then 28 million consumers have purchased these plans for various companies.

The problem lies not in the concept of the programs but in the sale and execution. The most important fact you must know about these health cards is that they are NOT health insurance. Many consumers have failed to understand what they are buying and as a result have been saddled with hundreds and even thousands of dollars in medical bills they assumed would be covered by their health card.

These plans advertise that they are affiliated with networks of medical providers. That is generally true. Their affiliation may even be with some of the national networks that insurance companies use themselves. The plan representative tells you that if you use the services of a network provider, you will get a discount on the service similar to the discounts that insurance companies negotiate when providers join their networks.

One company, for instance, gives you an example. If you see a network provider, that doctor’s normal charge for an office visit may be $120. But with your discount health card, you will only be charged $90 thus saving you $30 each time you visit the doctor, On the surface that may sound good, but remember, the consumer and only the consumer, has to pay the provider $90 every time he visits that doctor.

What happens if we discuss a hospitalization rather than a doctor’s visit. You find you need a hip replacement. According the the American Academy of Orthopedic Surgeons, the average cost of a hip replacement in 2006 was $42,000. You see a doctor who is in the network used by your $29.95 a month health card. You expect to get a significant discount for the procedure because you used a network provider. Remember your doctor visit. You got a $25% discount and only had to pay the doctor $90 of the $120 bill.

But now you have a bill from the hospital for your hip replacement for $42,000. It is also discounted at 25%. That means you owe the hospital $31,500. And you have to pay it. It’s better than owing $42,000 of course, but $31,500 is still a pretty significant amount of money that the consumer has to pay out. Unfortunately, the companies that sell these cards focus your attention on the small services. But, if consumers are smart, they will focus on the big items, which is the real risk of not having health insurance.

For some people who don’t qualify for medical insurance, discount cards may be the only option. Individual health insurance generally is medically underwritten which means if a person has a medical condition that the insurance company does not want to insure, they will be unable to get health insurance. Most states have what are called pool plans, which will insure persons with medical conditions, but as you can imagine, these plans are extremely expensive.

The real danger of these cards is the aggressive methods used to sell them. Many of these plans are actually sold as Multi Level Marketing plans. The sales representatives do not have to be licensed insurance agents, because the plans are not insurance. There interest is in adding people to their downline as that is how they make money. Learning the programs and carefully advising consumers as to what they are buying may not be the most important thing to these sales representatives.

If you are considering buying a health plan, be careful and ask questions. Understand first and foremost, that you are NOT buying insurance. Be wary of extravagant promises of discounts up to 60%. In our hip replacement example, for instance, a 60% discount would mean the service would only cost you $16,800. It is unlikely that a provider hospital would give you that kind of discount. Ask for specifics about hospitals, doctors and procedures. Ask if all the providers honor the advertised discounts. Sometimes doctors and other providers are not even aware they are listed as participants in these plans.

Ask about hidden fees. Often there are administrative fees hidden in the fine print. Be especially careful if there are fees charged for each use of your card. These fees may eat up almost all of your discount.

Discount health cards are never a substitute for health insurance. Before you consider buying one, think about how you will use it. If your need is for less expensive services, such as routine doctor’s visits, dental or vision discounts, they may be worth it. Remember, if you need an expensive procedure such as a hospitalization or surgery, you will be paying most of the bill yourself. No matter what the representative tells you or the advertisements imply, your card will never pay one single cent to any provider. The consumer will always be responsible for the amount of the charge less any discount that might be applied.

Consider your needs and the needs of your family. If you can afford it, buy health insurance. Even a plan with a high deductible such as an HSA will be a better option because at some point after the deductible is met, the insurance will pay the balance of the bill. If you can’t afford insurance or you cannot qualify because of medical problems, a health card may be useful. But before your buy, understand what it is and what it can really do for you.

What are Discount Health Plans?

As anyone who has had to pay for health insurance recently can tell you, the cost of providing health insurance for a family of 4 has risen tremendously over the past few decades. Many small and medium size industries can no longer continue to provide their workers with expensive health insurance benefits. In recent years, employees have had to pay a larger percentage of their health insurance costs, and many businesses have terminated their health insurance benefits, altogether. Other companies have cut down on the number of full time workers hired, so that they can save the cost of providing health insurance for their employees.

Should you find yourself in the unfortunate position of working for a company that does not provide health insurance benefits, most likely you will either have to purchase an expensive major medical policy on your own or do without. Because the high cost of major medical insurance can be out of reach for many, some families will choose to go without these important benefits entirely. The cost of health insurance can take a big bite out of a middle income family’s budget. These families are truly caught between. They earn too much to qualify for Medicaid and other government assistance programs, but do not earn enough to afford the high cost of health insurance. Even if an individual can afford the high price of health insurance, if a patient suffers from a chronic illness like diabetes, high blood pressure, asthma, high cholesterol, or heart disease, he or she can be denied coverage. People have even been turned down for excess weight and prescription drug use. It seems like the big insurance companies are looking for reasons not to insure people, so those individuals who need it most may find themselves without any benefits.

Fortunately, discount health plans offer families a way to save money on their health care costs. But what are discount health plans, and how can they be used to help families and businesses?

Discount health plans can be used in several different ways. For those individuals or families that lack dental or health insurance, discount medical plans can be used as stand alone health programs. These discount plans provide needed savings on all medical and dental services. Consumers can even save money on medical costs not normally covered by traditional insurance such as cosmetic surgery, cosmetic dentistry, dental implants, orthodontia, Lasik eye surgery, and even alternative medicine. Unlike traditional insurance there are no limits on visits or services, no waiting periods, no age limits, and ongoing conditions are accepted.

Businesses can save money by purchasing a high deductible health savings account or hospital only plan. A discount medical plan is purchased along with the high deductible plan. These supplemental benefits provide savings on routine health expenditures while the catastrophic insurance provides a safety net for lengthy hospitalizations and complex care. By combining a high deductible plan with a discount health plan, companies can save money on their health insurance benefits while providing their valued employees with needed financial security.

The discount dental plan is probably the most popular discount health program. Statistics show that seven out of ten Americans do not have a dental plan. Among the 30% that do have dental insurance, most are underinsured. Many dental plans do not provide treatment for ongoing conditions, have expenditure limits, waiting periods, and often don’t provide for even necessary procedures such as orthodontic treatment. Cosmetic dentistry and implants are usually not covered.

Discount dental plans provide the consumer with an excellent choice for saving money on dental care. These affordable dental plans are reasonably priced alternatives to expensive dental insurance plans. Savings can range from 25% for specialist treatment to 80% for exams. Most major dental procedures such as fillings, root canals, dentures, crowns and bridges, and orthodontic treatment are available through plan dentists at a 50% to 60% discount–literally cutting a family’s dental bill in half. In addition, patients with pre-existing conditions can qualify for these plans, and there are no limits on visits or services. Often these affordable dental plans offer value added services such as a prescription card, discounts on eyeglasses and contact lenses, and savings on chiropractic treatment.

Many discount health programs also offer a basic health plan which provides savings on medical examinations and physician visits. Ancillary services such as laboratory tests, imaging studies (MRIs, CAT scans, mammograms), physical therapy, diabetic supplies, hearing aids, and mental health services are also provided at significant discounts. A 24/7 nurse line and wellness programs may also be included in a good discount health program. Should hospitalization become necessary, the patient will be assigned an advocate who will negotiate the hospital bill and work out a payment plan based on the patient’s ability to pay. Hospital bills have been drastically reduced through these advocacy programs. One company, AmeriPlan┬« USA, has even added a prescription advocacy program. This program takes advantage of patient assistance programs available through major pharmaceutical companies. Individuals with over $90 per month of prescription expenses, who meet income eligibility requirements, may be able to receive all or most of their medications for just the cost of a small monthly service fee.

Most discount health plan companies also offer a combined medical and dental discount plan. This program combines dental, vision, prescription, and chiropractic benefits with discounts on physician visits, lab tests, ancillary services, and hospital advocacy.

When looking for a discount health plan, here are some things to consider. Look for a company that is a member of both the Consumer Health Alliance and the National Association of Dental Plans. These two organizations set strict standards for discount dental and medical programs and are your assurance of the company’s integrity and reputation. Also look for a plan that offers a good choice of dentists, doctors, and other healthcare providers in your area. The company should also provide an 800 customer service number, a schedule of provider fees and services, and informational booklets and websites.

Illinois Health Insurance – Thinking iChips is the Only Answer? Maybe Not!

Many people feel that to get Illinois health insurance with a pre-existing health condition is virtually impossible without going to the Illinois CHIP program. In some cases this might be true. But is it true in all cases? Maybe not! It will depend on the pre-existing health condition that you have.

Each health insurance carrier that solicits sales in Illinois, whether it is Blue Cross Blue Shield, Humana, Health Alliance or United Health Care, underwrites a little differently for each health condition based on their own actuarial tables and claims experience. A lot of times what it boils down too, is what that condition cost them in the past? That is why many different health insurance carriers only approve the application with a rider or exclusion attached to it. When a health insurance carrier does this it simply means they are not willing to take the risk for the amount of premium they receive in return.

If a carrier approves your application but is putting a rider on your health condition that doesn’t mean you have to accept it, you can refuse to take it. In choosing not to though the carrier will simply withdraw their offer for coverage. That’s a decision that you would need to decide for yourself. Considering whether the risk of taking that rider is worth the benefit of the having a lower premium.

What if you had a complete hip replacement 3 years ago and you have never seen a doctor for it since.

Would having coverage for your hip be important to you?

I would certainly think so, who wouldn’t want to have it covered. Almost every carrier in this state would refuse to offer you coverage without a rider or exclusion on your hip. So one would think the only way to have your hip covered would be to go onto the state run CHIP program. Not true! If you were to fill out an application with Health Alliance, which is only available to Illinois residents your hip would be covered without a rider or exclusion.

That is why it is critical to go with an agent or agency that specializes in health insurance. They will be the ones that can give you advice as to what you’re best options are.

About the Alliance Health Plan

One of the first things to mention about the Alliance health plan is that this company really has a much extended network of pharmacies, clinics and doctor offices it co-works with and allows its clients to benefit discounts from. And, no doubt it is one of the major advantages over its market competitors. Having thousands of clients all over USA as their members that provider has the weight and power to negotiate the best prices with its network service partners. So, unlike it is with some smaller benefit plans sellers, with Alliance there is no need to worry about the limited number of places you can get serviced with its discount card. Now, to understand better what an Alliance is, it has to be stated that this plan is not any kind of health insurance. But, it certainly can be used along with your personal and group insurance. If your insurance, for instance, is not covering some drugs you need, you may get discounts from your that health plan.

Another benefit of using a health Alliance card is that you may include your close relations, living under your roof in your discount card, stating them as your dependents. So, your Alliance health plan may work as some sort of your family medical plans’ option. There are two different types of option: gold and platinum. Both of them provide discounts on such essential medical things, as prescription drugs, dental or vision care, chiropractic help, but platinum Alliance health plan also provides discounts on hospital and physicians services, while gold one doesn’t. It is great to know that an Alliance health plan does not have any restrictions as to the number of times you use it or as to any kind of medical condition you may have. In any case, your health plan provides you with up to 60 percents discounts on your prescription drugs and up to 30 percents discounts on your doctor visits. So, there is no limitation as to how frequently you may use it.

There are two payment options an Alliance offers to its clients: monthly fees and annual fees. Besides, there is a 24/7 support service working to help along its clients and to answer any questions. Signing up is not difficult. It can be done right online by filling out one simple application. So, no paper work is required. As you may see, using an Alliance health plan really can save you much money and cut down your health care bill by the half.

Health Insurance for Musicians? – An Innovative Austin Program

Austin enjoys the self-promoted but well-deserved reputation as live music capital of the world. In recent years, the city has decided to put its money where its mouth is to ensure that it stays that way. One of the most innovative and socially progressive ways it is doing that is by providing an insurance program for working musicians through HAAM, or Health Alliance for Austin Musicians.

It’s a unique concept. Besides New Orleans, Austin is the only city in the US to provide such comprehensive health care to its local musicians.

“This city loves those who make music for us all,” according to Betty Dunkerley, Austin Mayor Pro Tem and HAAM board member. “What better way than Health Alliance for Austin Musicians is there to show our appreciation? HAAM makes members’ lives better.”

HAAM was created in 2005 as a result of a partnership between local hospitals and the SIMS foundation with support from the city and various Austin businesses. They recognized the tremendous need that existed in the community of musicians in the city for affordable health care. More than 8,000 working musicians live in Austin and most of them are uninsured. Rather than wait for the federal or state government to come up with a plan to help the millions of Americans who do not have health insurance, this community of musicians and their supporters decided to provide that help themselves.

Funding for the organization is provided by business and private donations and various grants. The HAAM benefit day every October mobilizes musicians, local businesses and city officials to raise money for the organization. In 2006 they raised more than $107,000, and more than $180,000 in 2007. Other events throughout the year, such as Austin music backer Nancy Coplin’s BIG SIX-O birthday party recently, donate their proceeds to HAAM as well. Of course, interested supporters may also donate money at any time through the HAAM.

HAAM’s 2007 annual report reveals nearly 4,900 medical, dental and mental health visits which earned a 94 percent approval rating from member-musicians. This success results from a one-of-a-kind collaboration among the Seton Family of Hospitals (clinic visits, prescriptions, hospital services and specialist referrals), St. David’s Community Health Foundation Leadership (dental visits) and The SIMS Foundation (counseling, psychiatric and addiction-recovery sessions).

Membership in 2007 grew to 929 of which 65 percent were age 40 and younger, with 67 percent earning less than $15,000 a year. To receive the benefits from the program, members must live in Travis County and be able to prove that they earn money playing music. For many services, members must pay a small co-pay; some other services are provided for free.

The SIMS foundation was named after Austin musician Sims Ellison who lost a long battle with depression and committed suicide in 1995. His death shocked the Austin community and a group of family and friends decided to create the SIMS foundation to provide low-cost counseling, psychiatric and addiction recovery service to musicians who needed it. The foundation provided more than 2,300 such sessions in 2007.

In addition, through HAAM, more than 573 members made more than 1,300 clinic visits that same year and benefitted from more than 500 hospital services of various kinds as well. Many members also took advantage of the free dental services provided by the organization.

Almost all members are very positive about the work HAAM is doing and the services it provides. Guy Forsyth is an Austin musician who has built up quite a reputation throughout Texas.

“It makes me really happy for younger musicians who are coming up and for parents who may have a child who’s very talented and it’s scary to think of them becoming an artist. Because we see all these examples around us of people, who aren’t part of a corporate structure are left behind in terms of health care and public support,” Forsyth said.