Health Insurance: How Ya Doin'?

I recently had a conversation with my favorite Aunt who is in her mid-sixties, and she updated me on the "health insurance hell" she has recently been enduring. 

Her existing insurance provider, which she purchased on her own, out of pocket, decided to drop her.

She doesn't qualify for Medicaid.

She isn't ready to accept Social Security retirement yet, so she doesn't qualify for Medicare. 

So, her only option appears to be utilizing the state health insurance exchange.  Or, go without health insurance and face a penalty, which would be a risky move.

In the process she is required to get herself NOT qualified, so she has had to divulge all of her intimate financial information and prove she is in fact a citizen of the United States (with more copies of intimate information).  She has spent hours on the telephone, had several face to face meetings, not to mention making a mess of her important files (which adds more stress).  This has literally become a part time job for her because, of course, there are deadlines.

And she isn't even done yet. 

Her frustration oozes through to me and I don't know what to say, except to email her a link for a little bit of comic relief: 
http://www.theblaze.com/stories/2013/10/27/you-will-probably-want-to-see-this-saturday-night-live-skit-mocking-the-obamacare-website/

Health Care - Whatsamatta?

I was going through the different articles I have written for our newsletter and came across "Ways to Cut Your Health Care Costs NOW!" from our January 2010 issue. It got me to thinking about the new health care bill signed by the President last week.

Will we really have to care about our health and health-related expenses anymore?

Everyone will have insurance, and every disease, disorder, or condition should be covered with the sky as the limit on how much can be spent on individual health. Do we no longer have an incentive to live a healthier lifestyle?

Will we more readily go to the doctor for something we previously tried treating at home first?

Will we no longer check our hospital and insurance bills carefully, or shop for and ask for generic prescriptions?

What exactly will the new bill cover? If you are diagnosed with cancer, what tests, procedures and treatments will the new policy cover? Will this policy be aggressive enough to help you beat a deadly disease?

What about the privacy of our health records? How will that change now that there will be a shift from the private sector to the public sector?

What if employers cut jobs again or make their positions part time trying to keep their businesses afloat after the last economic downturn?

Will people really go to jail if they fail to sign up or pay for health insurance?

We all want this new policy to work, but what if it doesnt?

Genetic Testing - Is It Right for YOU? (Part II)

In part one, Sandy talked about her position on genetic testing and why she would not consider it at this time. But lets assume you have decided that you need to know if you are predisposed to a disease. Lets say that for example, you have been told you carry a high potential of developing breast cancer. Now what?

If you go through your doctor, this information is now in your medical records. But who has access to it? Obviously, you now know that you need to be very diligent about getting tested. But will your insurance provider cover these tests? Do you need to disclose your genetic results to your insurance for the tests to be covered? What about life insurance? Are you now less likely to get a medical or life insurance policy? If you don’t actually have the disease, should you have to disclose this information?

We are still in murky waters as far as regulation of genetic information. As of March 2008, the National Conference of State Legislatures shows that only 27 states require consent to disclose genetic information. Seven states require consent to obtain/access genetic information and only 5 states define genetic information as personal property. If there is an information violation, only 19 states have specific penalties for genetic privacy violations.

In May of 2008, The Genetic Information Nondiscrimation Act of 2008 (GINA) was enacted, which prohibits the improper use of genetic information in health insurance and employment. It prohibits health plans and insurers from denying a healthy person coverage, or charging higher premiums. Employers are prohibited from using genetic information when making employment or employee decisions.

One option to keep your results private is Direct-to-Consumer (DTC) Genetic Testing. Doctors acquire the permission of the patient and order the desired test, but you don’t technically go through a health care professional. The risk involved with DTC testing is the possibility of misreading test results. Also, critics argue DTC has unregulated advertising and marketing claims and overall lack of governmental oversight. There are hundreds of tests available but the FDA has not yet officially substantiated the claimed accuracy of the majority of DTC genetic tests.

What do you do if your health insurer drops you? First, appeal the decision. Every insurer has an appeals process. Second, call the state regulator. Each state insurance department has a consumer complaint hotline or help line. To find your state’s office, go to naic.org. Last, consider hiring help. Ask your doctor’s office for a referral to a health care advocate. Be sure to ask for fees and referrals up front.

* Names have been changed for privacy
Source: wikipedia.org/wiki/genetic_testing & Genetic_Information_Nondiscrimination_Act
Ncsl.org/IssuesResearch/Health/GeneticPrivacyLaws; usaweekend.com