Comprehensive Insurance

Monday, 12 June 2017

Uber-Medicare

Need a lift to your medical appointment? Do you have your red, white and blue Medicare card?

No problem.

Don't call Uber. Call for an Ambulance. Let Medicare foot the bill.

According to FOX 5, non-emergency ambulance service is supposed to be restricted to people who cannot get to dialysis any other way without putting their health in danger. However three times a week, a Caring Hands ambulance pulled up to the homes of Georgians who say they didn’t need it. And those patients say Medicare is footing the bill.

This means, if the patient is on Medicare, it’s an average $500 taxpayer-funded payment to Caring Hands for every round trip. - Fox News via Firefighting News

Bear in mind that Medicare does indeed pay for medically necessary ambulance transport. The problem here is, many of these patients could have traveled by car or bus.

At $500 per trip times 3 that's $1500 per week, about $75,000 per year in "free" rides for the patient.

If Medicare denies your claim you may have to rob a bank to pay for your trip.

But not for the taxpayers who actually fund the trips.

#MedicareFraud #MedicareAmbulance

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Friday, 9 June 2017

Friday LinkFest

1 - First up, the newest from the MIB (Medical Information Bureau, no aliens invloved)(that we know of):

"U.S. individual life insurance application activity was 2% lower in May than it was in May 2016 ... activity dropped 2.8% for consumers ages 60 and older, and 5.2% for consumers ages 45 to 59."

Keep in mind that these things tend to run in cycles, and there's really no way to know why these numbers have declined. Interestingly, "[a]ctivity for consumers younger than 45 held steady."

Hunh.

2 - From FoIB Holly R, news that Evergreen State's insurance market's shrinking (again). This time, though, the implications are more dramatic: next year, two of the state's counties will have no health insurance carriers to choose from at all. It appears that Premera Blue Cross has seen the writing on the wall.

3 - Finally, Aetna's bailing on Connecticut. No, not (necessarily) the insurance market, but the actual state itself:

"Aetna, one of Connecticut’s largest employers, confirmed this week that it is leaving the state ... has been in Hartford for over 150 years."

And pays some big dollars into both Hartford's and the Nutmeg State's coffers. Enough dollars, in fact, that this may be a tipping point for Hartford's very future:

"[E]normous fiscal challenges at the state and city level, which, in Hartford’s case, have prompted open discussion of bankruptcy."

Gulp.

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Much ado about not much (Twitter-style)

Several months ago, we posted about a misleadingly-named plan that purported to cover potentially business-hurting Tweets:

"[T]hese plans aren't really what one would call a traditional insurance product; rather than indemnifying via dollars, they "instead offer 24-7 public relations assistance should Trump’s ire befall them."

But with more and more folks (famous or not) baring their souls (among other things) on social media, there's a very real danger that one could end up on the wrong side of a defamation (libel) suit for dissing a company or another person. Our friend Allison Bell (ironically) tweeted a link to a recent story about an actual insurance plan now available to thee and me, not just professional journos:

"A longtime necessity for journalists, such policies are now being sold to the average American, bundled with more traditional policies covering homes and cars."

Which is nice, and true, but hardly "breaking news." I turned to our longtime guru of all things P&C, Bill M, who confirmed that homeowner's plans (and umbrellas) already include coverage for libel and slander, and specifically the "duty to defend;" that is, the insurer is on the hook for one's attorney fees (with some caveats). So, more a new way to look at already common (and important) coverage.

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Wednesday, 7 June 2017

Wednesday Linkage

In no particular order:

■ Back in Aught Nine, we reported on a real life version of a classic sci-fi widget:

"Robert A Heinlein, wrote a haunting short story about a scientist, Pinero, who discovered a means to literally and accurately determine one's date of death."

That post was about an online, virtual lifespan calculator. But now co-blogger Bob V tips us to a company that claims to have a real-life version:

"GWG Life ... started requiring those people to turn over a saliva sample. Its quarry: patterns of DNA methylation. In layman’s terms, it analyzes the samples to see whether certain genes are switched on or off at hundreds of specific spots."

Why?

"In theory, that could help the company predict your life span"

It's not a slam-dunk, but along with the burgeoning market for genetic testing, we may be entering a very interesting (kinda scary) era.

■ Our friend The Political Hat picks up on a theme familiar to IB regulars, assisted suicide as healthcare cost container:

"Increasingly, suicide is being accepted as a legitimate medical treatment."

And he provides video from a Silver State doc to back this up.

Oy.

■ From the Turnabout Is Fair Play Files we have this item, Jay Hancock tells us that former drug reps are now working for insurance companies, touting lower cost alternatives:

"As a drug salesman, Mike Courtney worked hard to make health care expensive ... He’s on a different mission now: When he calls on doctors, he champions generic drugs."

How he got there is pretty darned interesting.

Bonus: FoIB Kim D provided us with this link to a neat slideshow about 15 common mistakes folks make when they're buyng insurance.

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Tuesday, 6 June 2017

The Cobbler's Insurance

Everyone's heard the old saw about how the cobbler's kids go shoeless. Well, here's a cautionary insurance tale along those lines.

Two years ago, we lost our beloved 13 year old puppy to a virulent form of canine leukemia. As with many human cases, the last few days saw some rather hefty health care provider bills (which, all told, included a comma).

This past December, we decided that we were ready to welcome a new puppy into our home, and were adopted by a very cute, lovable, high energy rescue mix. Unlike our previous two, we had this one "chipped." Part of that process involved getting a quote for pet insurance, which we did. It wasn't really a major expense ($30/month? Something like that), but we kept putting it off. After all, she's only a puppy, what could possibly generate a big enough vet bill to justify it?

Yeah, I know.

This weekend, the poor thing let out a major yelp running down the hall, and hobbled back in on 3 legs, the fourth one just ... danging. We were getting ready to take her to the emergency vet when she "shrugged it off" and resumed 4-legged mode. Okay, just a one-off, no biggie.

Except that this continued every few hours. I was able to get a vet appointment for this morning (we've used this vet through 3 dogs, well over 20 years, and they're wonderful). Take the poor little one in, and turns out she has a congenital knee ligament issue (not uncommon in small breeds like hers). Thankfully, it's not life-threatening, but it does need to be addressed, soon, and surgically.

And yes, there will be a comma involved.

And yes, that $30 a month seems much less of a burden now.

But unlike ACA plans, pet insurance doesn't cover pre-existing conditions. So, (expensive) lesson learned.

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Anthem Exiting Ohio Exchanges!

In a producer news release Anthem has announced it will pull out of Ohio for on exchange business in 2018. They will be reducing their off exchange options too. From the release:

"As the Individual marketplace continues to evolve, we look forward to seeing important changes made to the health care law. We hope these changes will stabilize the market and allow us to have a more robust presence in the future."

This is huge news as Anthem was the only insurer available in 19 counties in Ohio last year. For another 28 counties they were one of two insurers in the market. We will update IB as more details are shared.

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Carrots and Sticks: Empire State-style

As more and more carriers exit more and more states, New York Governor Andrew Cuomo thinks he's hit on a useful solution: leave the health insurance market, kiss other opportunities goodbye, as well:

"Insurers that leave the individual market would be cut off from participating in other government health programs, including Medicaid, the Children’s Health Insurance Program and the Essential Plan"

Two thoughts here:

First, good for him. While I generally dislike the heavy the hand of government forcing a company into a specific behavior, it seems to me that it's not only within that entity's purview to make the choice to leave a painful one. After all, he';s not forcing carriers to stay, just incenting them to consider such a move in terms of the bigger picture.

After all, I've always been a fan of the 58-state laboratory model.

Second, what the heck is an "Essential Plan?"

Well, it turns out that it's one of the "Basic Health Plans" the previous administration greenlit targeted at low- and moderate-income folks. It's not quite "bare bones," since it still includes a number of "freebies." On the other hand, it costs $20 a month per person (in some cases, not even that), and includes "free" preventive care.

Your tax dollars at work.

[Hat Tip: FoIB Allison B]

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