6 Ways to Cash in on the Health Law

[Guest guest]

6 Ways to Cash in on the Health Law

After a tumultuous infancy, the health-care reform law celebrates its first

birthday March 23. Despite ongoing legal challenges, several provisions of the

law have taken effect and are making changes in the way people pay for medical

care. Over the past year, I've received many questions from readers about how

the new law affects them. Here's what you need to know to make the most of the

new rules.

1. Health coverage for adult children. One of the highest-profile changes was

the rule permitting adult children to stay on their parents' health-insurance

policies until age 26, rather than kicking them off when they turn 21 or

graduate from college. You usually need to add your kids to your policy during

open enrollment in the fall for coverage to start at the beginning of the next

plan year. But parents may add adult children in the middle of the year under

certain circumstances, such as if the kids lose their own health-care coverage.

Contact your insurer or employer for specific sign-up rules.

If you already have family coverage for younger siblings, then you may not have

to pay more to add your grown kids. But if you have to switch from an individual

plan to a higher-cost family plan, it pays to compare the extra premiums with

the cost of buying the young adult his or her own policy. In many states, a

healthy twentysomething can buy an individual health insurance policy for about

$100 per month. See Keeping Adult Children Insured for more information about

the new rules and alternatives.

2. Coverage for preventive care. Many insurance plans must now provide certain

preventive-care screenings without charging deductibles or co-payments.

Depending on your age, this rule may apply to blood-pressure, diabetes and

cholesterol tests, mammograms and colonoscopies, flu shots, routine vaccines,

well-baby and well-child visits and other services.

If your health-insurance plan has not made major changes to its costs and

benefits since health-care reform was enacted (technically called a

" grandfathered " plan), the preventive-care requirements may not apply. Ask your

insurer or your employer's benefits office whether your plan qualifies. See the

preventive-care page at Healthcare.gov for a detailed list of the eligible

services.

Medicare beneficiaries also get some new preventive benefits, including an

annual wellness visit and a personalized prevention plan. Also, Medicare no

longer charges co-pays or deductibles for mammograms, cervical-cancer and

colorectal-cancer screenings, cholesterol tests, flu and pneumonia shots,

hepatitis B vaccinations, and certain kinds of prostate-cancer screenings. See

the Manage Your Health section of Medicare.gov for a list of who qualifies for

these services and how often you can take advantage of them.

3. Restrictions on using flexible spending money for nonprescription drugs.

Starting this year, you may no longer use tax-free money in your flexible

spending account or health savings account to stock up on over-the-counter

drugs, such as pain relievers and allergy medications, with the exception of

insulin. But there is a loophole: You can use the money if you get a

prescription. Don't schedule a special appointment, but the next time you're at

the doctor's office, ask for prescriptions for any pain relievers, allergy

medications, anti-fungals or cough-and-cold medicines you use regularly. See

Make the Most of the New Flex-Account Rules for more about this and other

changes to FSAs.

4. Stiffer penalty for nonmedical withdrawals from a health savings account.

Although HSAs have always provided attractive tax benefits, the downside was

that you paid a 10% penalty if you used the money for nonmedical expenses before

age 65. That penalty has now doubled, to 20%, starting in 2011.

But there are still plenty of medical bills you can spend the money on

penalty-free at any age, including insurance deductibles and co-payments,

prescription drugs, uninsured vision and dental care, and a portion of

long-term-care premiums (based on age).

You may open a health savings account if you have a health-insurance policy with

at least a $1,200 deductible for individual coverage or $2,400 for family

coverage in 2011. See What to Know About Health Savings Accounts and Health

Savings Account Answers for more information about how these plans work and

which expenses qualify.

5. The shrinking Medicare Part D doughnut hole. The worst thing about the

Medicare prescription-drug program has always been the doughnut hole -- the

coverage gap after your total drug costs reach $2,840 for the year, in which you

have to pay all of your bills yourself until your out-of-pocket drug costs reach

$4,550 for the year. But the doughnut hole is starting to close in 2011, and it

will disappear entirely by 2020.

This year, after your total drug costs reach $2,850, your pharmacist will

automatically apply a 50% discount on brand-name drugs. The pharmacy will

continue to apply the discount when you purchase the medications until your

out-of-pocket costs reach $4,550; the entire cost of the drug (before the 50%

discount is applied) counts toward the amount needed to fill the coverage gap.

Also starting this year, you'll pay only 93% of the cost of generic drugs in the

doughnut hole, with the government picking up the remaining 7%. See Help With

High Drug Costs for more information about the new rules and how these discounts

are applied.

6. New coverage for people with preexisting conditions. The health-reform law

will eventually prohibit insurers from rejecting people because of their health.

But that rule doesn't take effect until 2014, so the law also created high-risk

insurance pools to help cover people with health problems until then.

The Pre-Existing Condition Insurance Plan sounds good on paper, but it has been

less popular than expected because of a big catch: You may only qualify for

coverage if you have been uninsured for at least six months. The new pools --

some are run by states, some by the federal government -- can be a good solution

for people who have been uninsured for an extended period of time. But there are

better options for people with health problems who are about to lose coverage:

You may have other federal and state protections, including coverage-extension

requirements or access to state high-risk pools that existed before health-care

reform and may not have a six-month waiting period. See FAQs on the New

High-Risk Pool for more information about the new pools and your alternatives.

[Guest guest]

I am in total disagreement. I mean no offense to you, but based on what we

have seen with socialized health care around the world, I do not believe

this health care law is going to do our children any good.

Besides the unconstitutionalness of the whole thing, but I am not interested

in any kind of debate here.

I hope this is not a forum where this kind of politically divisive thing is

pushed because that is not why I joined.

Peacefully yours,

PJ

Prayer changes things.

" ONE MAN WITH COURAGE IS A MAJORITY "

~ Jefferson

From:

[mailto: ] On Behalf Of jeannne buesser

Sent: Thursday, March 24, 2011 3:04 PM

ApraxiaNetworkOfBergenCountyegroups;

Subject: 6 Ways to Cash in on the Health Law

6 Ways to Cash in on the Health Law

After a tumultuous infancy, the health-care reform law celebrates its first

birthday March 23. Despite ongoing legal challenges, several provisions of

the law have taken effect and are making changes in the way people pay for

medical care. Over the past year, I've received many questions from readers

about how the new law affects them. Here's what you need to know to make the

most of the new rules.

1. Health coverage for adult children. One of the highest-profile changes

was the rule permitting adult children to stay on their parents'

health-insurance policies until age 26, rather than kicking them off when

they turn 21 or graduate from college. You usually need to add your kids to

your policy during open enrollment in the fall for coverage to start at the

beginning of the next plan year. But parents may add adult children in the

middle of the year under certain circumstances, such as if the kids lose

their own health-care coverage. Contact your insurer or employer for

specific sign-up rules.

If you already have family coverage for younger siblings, then you may not

have to pay more to add your grown kids. But if you have to switch from an

individual plan to a higher-cost family plan, it pays to compare the extra

premiums with the cost of buying the young adult his or her own policy. In

many states, a healthy twentysomething can buy an individual health

insurance policy for about $100 per month. See Keeping Adult Children

Insured for more information about the new rules and alternatives.

2. Coverage for preventive care. Many insurance plans must now provide

certain preventive-care screenings without charging deductibles or

co-payments. Depending on your age, this rule may apply to blood-pressure,

diabetes and cholesterol tests, mammograms and colonoscopies, flu shots,

routine vaccines, well-baby and well-child visits and other services.

If your health-insurance plan has not made major changes to its costs and

benefits since health-care reform was enacted (technically called a

" grandfathered " plan), the preventive-care requirements may not apply. Ask

your insurer or your employer's benefits office whether your plan qualifies.

See the preventive-care page at Healthcare.gov for a detailed list of the

eligible services.

Medicare beneficiaries also get some new preventive benefits, including an

annual wellness visit and a personalized prevention plan. Also, Medicare no

longer charges co-pays or deductibles for mammograms, cervical-cancer and

colorectal-cancer screenings, cholesterol tests, flu and pneumonia shots,

hepatitis B vaccinations, and certain kinds of prostate-cancer screenings.

See the Manage Your Health section of Medicare.gov for a list of who

qualifies for these services and how often you can take advantage of them.

3. Restrictions on using flexible spending money for nonprescription drugs.

Starting this year, you may no longer use tax-free money in your flexible

spending account or health savings account to stock up on over-the-counter

drugs, such as pain relievers and allergy medications, with the exception of

insulin. But there is a loophole: You can use the money if you get a

prescription. Don't schedule a special appointment, but the next time you're

at the doctor's office, ask for prescriptions for any pain relievers,

allergy medications, anti-fungals or cough-and-cold medicines you use

regularly. See Make the Most of the New Flex-Account Rules for more about

this and other changes to FSAs.

4. Stiffer penalty for nonmedical withdrawals from a health savings account.

Although HSAs have always provided attractive tax benefits, the downside was

that you paid a 10% penalty if you used the money for nonmedical expenses

before age 65. That penalty has now doubled, to 20%, starting in 2011.

But there are still plenty of medical bills you can spend the money on

penalty-free at any age, including insurance deductibles and co-payments,

prescription drugs, uninsured vision and dental care, and a portion of

long-term-care premiums (based on age).

You may open a health savings account if you have a health-insurance policy

with at least a $1,200 deductible for individual coverage or $2,400 for

family coverage in 2011. See What to Know About Health Savings Accounts and

Health Savings Account Answers for more information about how these plans

work and which expenses qualify.

5. The shrinking Medicare Part D doughnut hole. The worst thing about the

Medicare prescription-drug program has always been the doughnut hole -- the

coverage gap after your total drug costs reach $2,840 for the year, in which

you have to pay all of your bills yourself until your out-of-pocket drug

costs reach $4,550 for the year. But the doughnut hole is starting to close

in 2011, and it will disappear entirely by 2020.

This year, after your total drug costs reach $2,850, your pharmacist will

automatically apply a 50% discount on brand-name drugs. The pharmacy will

continue to apply the discount when you purchase the medications until your

out-of-pocket costs reach $4,550; the entire cost of the drug (before the

50% discount is applied) counts toward the amount needed to fill the

coverage gap. Also starting this year, you'll pay only 93% of the cost of

generic drugs in the doughnut hole, with the government picking up the

remaining 7%. See Help With High Drug Costs for more information about the

new rules and how these discounts are applied.

6. New coverage for people with preexisting conditions. The health-reform

law will eventually prohibit insurers from rejecting people because of their

health. But that rule doesn't take effect until 2014, so the law also

created high-risk insurance pools to help cover people with health problems

until then.

The Pre-Existing Condition Insurance Plan sounds good on paper, but it has

been less popular than expected because of a big catch: You may only qualify

for coverage if you have been uninsured for at least six months. The new

pools -- some are run by states, some by the federal government -- can be a

good solution for people who have been uninsured for an extended period of

time. But there are better options for people with health problems who are

about to lose coverage: You may have other federal and state protections,

including coverage-extension requirements or access to state high-risk pools

that existed before health-care reform and may not have a six-month waiting

period. See FAQs on the New High-Risk Pool for more information about the

new pools and your alternatives.

[Guest guest]

Hi PJ -the message below is not written by the poster, it's an article that was

just published yesterday by NASDAQ in regards to helping families navigate

healthcare today which from what I read is of relevance for those with special

needs children

http://community.nasdaq.com/News/2011-03/6-ways-to-cash-in-on-the-health-law.asp\

x?storyid=66619 and

http://www.medicare-health.com/6-ways-to-cash-in-on-the-health-law-nasdaq-2/

If you disagree with this article you can share your views at NASDAQ

http://community.nasdaq.com/News/2011-03/6-ways-to-cash-in-on-the-health-law.asp\

x?storyid=66619 - just checked and there are so far zero comments on the article

-they do show some of the tweets people sent out about it on Twitter.

I however am not quite sure what advice exactly in the article you feel brings

in a debate to a political spin. I just read the same article from NASDAQ and I

read it as to how to best navigate and make the best of healthcare today in the

US regarding preexisting conditions, age a special needs child can remain on

their parent's insurance etc.

If you check the archives here this isn't a group specifically for political

views -but we do not limit views in any area as all are welcome to share what's

on their mind. Political views only rarely in the past decade have come up

-yours is the first in awhile.

All views (outside of flames) are allowed even though each are only the view of

the poster and not this group.

=====