Tag Archives: health insurance

Time for Change

Long View: Is It Time for a Change?

“Everyone appreciates the long, light evenings. Everyone laments their shortage as Autumn approaches; and nearly everyone has given utterance to regret that the clear, bright light of an early morning during Spring and Summer months is so seldom seen or used.”

This was written by a London builder named William Willett, who proposed daylight saving time from an idea conceived by Benjamin Franklin.

“Spring forward. Fall back,” was how I learned it! I remember daylight saving time when I was a child was a big deal. The Saturday night before the official time change would take place, my entire family worked together to make sure that all the clocks and watches in our household were set, not to mention the clocks in my parents’ cars. It never failed. There was always that tiny clock on the top of our stove that we would miss. My mom always caught it when she went to set the oven timer!

Then, once the clocks were all set, my sister and I pondered whether we lost or gained an hour of sleep. We always had to sit there for a minute or 2 and do the math before coming up with the answer.

For most of us today, time changes are not nearly as complicated as they used to be. Our world is much more hurried, and automation is everywhere. It’s accepted that almost every clock, watch, appliance, iPhone, and computer is programmed for daylight saving time. We really don’t have to worry about making sure all of our timepieces make the change. With our schedules so full, we don’t even realize we’ve gained an hour or lost an hour of sleep.

Just like the time change happens each November, Medicare’s Annual Enrollment Period (AEP) happens each October. Medicare beneficiaries can review their current plan and make any changes they feel are needed from October 15 through December 7.

Every year, the AEP is a good time to check your drugs and review upcoming services with your doctor, then make sure the plan you’re on is still the best fit. You might even want to get your family together to make sure you didn’t miss anything.

Some resources available to help you this AEP include Medicare.gov, which is easy to navigate and packed with information, and Illinois’ very own Senior Health Insurance Program (SHIP). The Illinois Department of Insurance offers this free, impartial counseling service for people who are Medicare-eligible. Visit Insurance.Illinois.gov or call them at 1-800-548-9034. You can also find the nearest SHIP office in this directory, or, in Iowa.

And don’t forget to check out your current insurance info at HealthAllianceMedicare.org. If you need to research plan options, you can “fall back” on us! We’re ready to help with any questions you may have for the upcoming plan year.

Mervet Adams is a community liaison with Health Alliance. She loves her grandson, family, nature, and fashion.

Answers to Your Health Insurance Questions

Vantage Point: Time to Answer Important Health Insurance Questions

It’s that time of year again. My husband comes home with a huge packet of healthcare information. Yep, it’s open enrollment for his employer health plan. It’s time for us to look at the options and choices that best suit our family in the coming year.

Every year, Medicare beneficiaries get this kind of event too. It’s called the Annual Enrollment Period (AEP). Each year from October 15 to December 7, they have the opportunity to look at the options available in their service area and choose which plan is the best for them and their health.

This is an important time for everyone. As we age, our health may change too. Understanding and knowing what coverage is best for you can be a daunting task, so you should ask yourself some very important questions each and every year.

Am I happy with my current plan? What’s changing for the new year? Is the premium going up on the plan I currently have? Do I need more coverage?

I understand that as Medicare members, you’re sent an enormous amount of marketing material during this time of year. All the Medicare Advantage, Medicare Supplement, and prescription drug plan companies are trying to get your attention and your business.

How do you weed through all the material? And even more important questions come up for you each year. Do I know the difference between Medicare Advantage and Medicare Supplement? Is the prescription drug plan I’m currently on the best value for the prescription drugs I’m taking? Finding the answers can be confusing and frustrating.

The answers you seek can be found quickly and easily. Visit our website or call us directly for answers to your health insurance questions. There are also independent brokers available to you, like GHB Insurance located right in Olympia, to help you with all the plan information you receive. In the Thurston County area, there are also SHIBA (Statewide Health Insurance Benefit Advisors) representatives who volunteer their time to help you understand Medicare and all the parts associated with it. They can be found at both the Lacey and Olympia senior centers.

So never fear, your Medicare questions can be answered here. Or at least, we can assist you in getting the answers you need. Remember, you have resources available to you. All you have to do is use them.

Joy Stanford is a community liaison with Health Alliance, serving Thurston County. She’s been involved with Medicare for 20+ years and truly enjoys it. She enjoys gospel, R&B, and country music, and she owns over 100 pairs of shoes.

Insurance Awareness

Insurance Awareness

Wednesday was National Insurance Awareness Day, so we helped raise insurance awareness this week with education and info about your plan.

Insurance may seem like a luxury, but without it, the cost of a broken arm is typically more than $2,500 dollars. If you have to stay in the hospital, it’s around another $7,400.

Broken Arm Costs

 

Under the ACA, you have certain benefits that are always covered, like yearly checkups and more.

Essential Health Benefits

 

If you’re on an HMO, you have to see doctors in your plan’s network, and if you’re on a PPO, you’ll save when staying in-network.

Choosing a primary care provider (PCP) gives you personal care, and your yearly visit keeps your preventive care up to date.

Your Yearly Preventive Care and Physical

 

The average ER visit costs more than the average American’s monthly rent. Know where to go when you’re sick and save.

Know Where To Go

 

Not sure what your insurance does after you get care? See a claim’s journey and make sense of what you get in the mail later, the EOB.

A Claim's Journey

 

Are you getting ready for Medicare? Learn about the parts, your eligibility, and enrolling.

Prepare for Medicare

SaveSave
Legal Advice: The Right Time for a Professional

Long View: Leaving Some Things to the Professionals

I have to admit the health insurance business is complicated and often difficult to understand. So many regulations are involved, and then there are the exceptions, annual plan changes, and the wide variety of policies that are available.

We help our Health Alliance members navigate the wonderful world of health insurance every day. Another arena that seems especially complicated to me is the law.

In central Illinois, there are resources for people who need legal advice for civil cases (not criminal), which are provided at no cost to those who qualify. One of these is called Prairie State Legal Services. Its mission is “to ensure equal access to justice and fair treatment under the law by providing legal advice and representation, advocacy, education, and outreach that serve to protect basic human needs and enforce or uphold rights.”

Adrian Barr is the Managing Attorney for Prairie State. He told me, “The legal system is a very difficult place to navigate for people who do not have attorneys. It is almost as if we in the legal community speak and write in a different language.”

“Having the opportunity to consult with an attorney about one’s legal situation can be an invaluable resource,” he said. “Prairie State will discuss a person’s legal situation with them and provide legal advice. Prairie State will also provide representation for important legal issues, including those that affect a person’s finances, safety, housing, or their health.”

Lora Felger is my co-worker in Iowa. She is very sharp, but knows legal questions are best left to the professionals. Lora suggests Iowans start with their local Area Agency on Aging. Iowa’s 6 regional Area Agencies on Aging partner with Iowa Legal Aid to offer free legal services to eligible seniors with the Legal Assistance Program. This program “serves persons 60 years of age and older by providing legal advice and representation, information and education, and referrals in civil legal matters throughout the state.”

I think I will have to be satisfied with my expertise in the field of health insurance. I feel justified in my decision to let the professionals handle any legal question that might come up. My personal experience also tells me it would be prudent to use a professional electrician whenever the need arises. I accidentally created an arc welder one time, but that’s a subject for another column.

Patrick Harness is a community liaison with a long history of experience in health insurance. If you ask him to pick a color, he always chooses orange, and he is known for his inability to parallel park.

In Case of Emergency: FAST

Vantage Point: Act FAST

Due to its beauty, 4 distinct seasons, diverse recreation opportunities, and 300-plus days a year of sunshine, North Central Washington is a paradise to many. Living here helps to promote a healthy lifestyle and positive attitude.

For several years, North Central Washington has also been known for the inevitability of summer wildfires. And last year, with the towns of Carlton and Pateros burning, and this year, with the town of Wenatchee on fire, it’s put a whole new meaning on how devastating, scarring, and unpredictable wildfires can be and how important it is to act fast when one occurs. The same can be said for a stroke.

A stroke is an often unrecognized, true emergency, cutting off vital blood flow and oxygen to the brain. Strokes are the second-leading cause of death for people 60 years or older worldwide, the fifth-leading cause of death in the United States, and a leading cause of serious long-term adult disability.

Strokes can happen to anyone, at any time, regardless of race, sex, or age. Risk factors include high blood pressure, high cholesterol, atrial fibrillation, smoking, diabetes, poor circulation, inactivity, obesity, and family history. You can learn more by visiting the National Stroke Association’s Stroke Awareness website, but the best action you can take is to get regular checkups with your primary care doctor, so together you can formulate your own prevention plan.

There are two types of strokes, ischemic and hemorrhagic, and during a stroke, 2 million brain cells die every minute, increasing risk of permanent brain damage and disability. Therefore, recognizing symptoms and acting fast to get medical attention can save a life and limit disabilities. The sooner you call 911, the better chance there is of recovery. So remember, “FAST” stands for:

  • Face, look for an uneven smile.
  • Arms, check to see if one arm is weak or unable to move.
  • Speech, listen for slurred speech or inability to speak.
  • Time, call 911 at the first sign.

Like natural disasters, many times, health concerns such as strokes come with no warning or time to prepare, so it’s important to have adequate health insurance coverage. Our expert and local customer service representatives are always here to help our members understand all their health insurance benefits, especially in the case of an emergency, so they can worry less and focus on what is most important, enjoying the North Central Washington good life.

Shannon Sims is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant, and Okanogan counties in Washington. She has four adult sons and two grandsons. During her time off, she performs as part of a rodeo drill team on her horse, Skeeter.

Planning for a Happy Retirement

Long View: How Much Money Do You Need for Retirement?

Benjamin Franklin’s saying, “a penny saved is a penny earned,” is still true today, especially when thinking about retirement. I think about the possibilities once in a while, but it seems too far in the future to worry about it right now.

I know in my grandparents’ day, retirement didn’t require much planning. Most folks didn’t live long enough for it to be a problem. These days with modern medicine, longevity is a much more attainable goal. It’s the actions we take to prepare for it that have the most impact on our quality of life.

The United States Census Bureau says people age 90 and older make up 4.7 percent of the population 65 and older. That’s expected to be as high as 10 percent by 2050.

I used an online retirement calculator to find out how much I should have saved at this point in my career. The results indicated I was well under my goal. The predictions were based on a life expectancy of 92 years, a daunting prospect at this stage of the game.

I have been meaning to increase the amount I put aside for retirement, but it seems I just don’t get around to it. Benjamin would advise me to “never leave that till tomorrow which you can do today.” Having looked into the future, I will definitely take some action. Even a slight increase now will make a difference in the long run.

“Obviously the earlier you start to save for retirement the better,” says Bob Ballsrud, executive vice president of Busey Wealth Management. “Our younger clients often invest in more growth assets because they have the time to recover from any temporary downturn. More mature clients often are encouraged to lower their risk because they will need to access the funds sooner. Either way, it’s the consistency of action and the appropriate planning that help you meet your goals.”

I know there are a number of factors to consider before retirement. It seems advance planning is the best course, or as Ben tells us, “Employ thy time well if thou meanest to gain leisure.”

Plan Ahead with Health Insurance

Part of planning for your future is making sure you can cover medical and hospital costs when you need to. Learn more about Medicare, wellness, and health insurance in general at HealthAlliance.org.

Medicare Basics Without an App

Vantage Point: There’s Not an App for That – But We Can Help!

Personal fitness trackers—like the Fitbit® or Jawbone®—are popular devices to help you keep your New Year’s resolutions and stay fit all year long. The fitness tracker collects data and sends it to a phone app that tracks physical activity, calorie intake, and sleep quality. Wouldn’t it be cool if the device included an insurance tab to help people navigate their Medicare benefits, too?

Could you imagine how you’d feel slipping on the device if it said,
• “You have adequate coverage for your current health.”
• “Your doctor is in-network, and the out-of-pocket cost for your upcoming appointment is $10.”
• “Warning, you are nearing the prescription coverage gap.”

Until that technology comes along, Health Alliance Medicare can help explain Medicare basics. Most people paid for Medicare Part A through their payroll taxes while they were working, so they don’t pay a premium now. Part A covers inpatient hospital procedures, but not the doctor who does the procedure.

Medicare Part B covers the doctor and requires a monthly premium. Both A and B have deductibles (what you pay before your coverage kicks in) and coinsurance (a percentage of total cost that you pay). Figuring out coinsurance is tricky because it’s hard to plan what the overall doctor visit or hospital cost will be.

Medicare Part D is for prescription drug coverage. If you don’t choose Part D when you become eligible for Medicare, you could pay a penalty, called the Late Enrollment Penalty, if you add it later. If you pay a lot for your medicine, it’s important to read your monthly Explanation of Benefits to see if and when you’ll fall into the coverage gap.

Medicare Advantage plans, like Health Alliance Medicare, are called Part C and cover every benefit of Original Medicare and more, plus you can add prescription drug coverage. Medicare Advantage plans can be an easy transition for those turning 65 because they look a lot like employer insurance plans.

Until someone invents a Medicare app, consider Health Alliance Medicare your source for information. Helping people get started with the right information to avoid common and costly pitfalls later is the best part of our jobs.