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Friday, 23 December 2011 14:50 |
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House Republicans decided compromise was necessary and are extending the payroll tax cut for 2 months. But more importantly, Congress is extending the Medicare physician fee schedule reductions as well. I believe most agree extending the payroll tax cut leaving extra money our pockets is good for the economy and good for us all. I believe preventing the Medicare fee schedule has an even bigger impact. With our massive debt and generally bad economic times, many argue reducing government spending is a good idea. But cutting Medicare payments to physicians by 27% would have been disastrous for seniors and physicians alike. Taking care of seniors is time consuming. For many physicians, Medicare pays less than private commercial insurance. Simply put, many primary care doctors would not be able to keep their practices open if these cuts went through. This is not a scare tactic by some lobbying group. As someone who runs a large physician network I can assure you these cuts, had they gone through, would have been a disaster for everyone.
For whatever reason, and there are many, seniors, physicians, and hospitals go through this nightmare scenario each and every year. Sometimes, with short term extensions like we just received from Congress for two months, we go through it more than once a year. It needs to stop. Congress needs to address this flawed formula. I think most would agree there should be a way to tie the fee schedule to some form of modest growth but a reduction of the magnitude faced each and every year needs to end once and for all. |
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Monday, 31 October 2011 19:25 |
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What is an FSA?
- Used to pay for medical expenses not paid for by insurance for example this deductibles, copayments, and coinsurance
- Can also be used for qualified medical expense, such as dental and vision expenses and over the counter drugs
- "Use it or lose it" money must be spent by the end of the year or the money is lost
Healthcare Reform Impact on FSAs
- In 2011 over the counter drugs require a prescription in order to be FSA eligible such as Advil
- Beginning in January 2013 a new maximum dollars allowed into account beginning in 2013 of $2500
What is an HSA?
- Must also be enrolled in a high deductible health plan
- Unlike a FSA the funds roll over year to year if not spent.
- Account is owned by the individual
- may be used for any qualified medical expense.
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Last Updated on Friday, 23 December 2011 14:54 |
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Monday, 31 October 2011 17:45 |
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The Medicare donut hole is the coverage gap in Medicare Part D Drug Coverage, where you are not insured for the cost of drugs
• The gap amount, or dollar threshold where you lose coverage for 2012 is $2930.
This number is calculated on retail costs of the drugs, not what you personally spend, i.e. co-pay or co-insurance.
• You exit the Donut Hole when your total out of pocket expenses reaches $4,700.
This number was calculated in a new way beginning in 2011
• In 2011, and continuing in 2012 when you are in the Donut Hole you will receive discounts of 50% on Brand drugs and 7% on Generic drugs, this will keep you in the hole longer though.
For exiting the donut hole, calculations include not only what you have paid toward your prescriptions, but also what specific extra help programs have paid toward your medication costs.
• After you have spent $4,700 (left the donut hole) catastrophic coverage kicks in and you will have to spend $2.60 per month for generics / $6.50 per month for name brand medications or 5% of the medication's retail cost, whichever cost is higher.
• Healthcare reform plans on eliminating the Donut Hole in 2020 |
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Last Updated on Friday, 23 December 2011 14:55 |
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Why are insurance premiums going up? |
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Thursday, 29 September 2011 15:19 |
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I spoke to so many people today who were wondering why health insurance premiums were going up so much next year. Almost everyone thought it was because of healthcare reform. No one was being negative, they were merely trying to understand why it's going to cost so much more next year. It is important to make sure people understand healthcare premiums have been going up year after year -- long before healthcare reform was passed. While last year the increases were lower than this year, for a whole host of reasons, the harsh reality is our healthcare costs will continue to rise until we are all willing to truly tackle the many reasons behind the explosive growth. To name a few, an aging population, new drugs and technologies to treat an ever increasing number of diseases, and finally, if not most importantly, our insatiable demand for healthcare services when we want them, regardless of the costs.
I have written about this before but I feel it is important to remind everyone when insurance companies raise their rates year after year. It would be easy to blame healthcare reform, but it is also wrong. We need to give healthcare reform a chance to work. It really starts in 2014. Until then, we are going to have to deal with what we have and hope that as more and more reforms are implemented, we may finally see some relief. Even then, I am not optimistic that we will have done enough to control costs. Congress will need to make some hard decisions. We all will have to make some hard decisions about how to pay for healthcare in the future. In the interim, do not blame healthcare reform for the high costs. If you are really looking for someone to blame, call your congressman. |
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Last Updated on Saturday, 29 October 2011 03:21 |
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