The Difference Between Health Insurance And Dental Insurance Policies

Understanding the difference between dental insurance and health insurance policies is important for any individual who wants to take good care of his overall health condition. Although many people believe that medical and dental coverage are similar, it is essential to understand that each type of insurance has different features. In order to get a clear picture of the difference between health coverage and dental insurance, you need to consider their particular characteristics.

Dental care includes molar removal and tooth replacement, basic cavity care, teeth whitening, enamel cleaning, and cavity drilling, as well as complex procedures. A reliable dental insurance policy will cover the costs of regular checkups, dental treatments, and common procedures. When you go shopping for dental insurance, you will be able to choose from traditional insurance, discount dental plans, managed care plans, dental preferred provider organizations (DPPOs), and more. If you buy this type of insurance, you will not have to worry about the high costs of maintaining a good dental health. Although dental care falls under the general health care category, there is a clear distinction between these two terms.

Many health insurance plans cover only routine checkups, simple procedures, medical emergencies, and prescription drugs. However, you can get as much coverage as you need for a higher price. The more coverage that you buy, the more you will have to pay for insurance. You can opt for an individual or a group health insurance plan. It is advisable to search for health insurance policies that cover as much as possible, including previous health issues. Prescriptions, X-ray sessions, and emergency care should also be covered by the health insurance plan that you choose. Keep in mind that a number of factors such as your age, medical history, lifestyle, smoking habits, pre-existing conditions and income determines the cost of health insurance. Like dental insurance, most health insurance policies do not cover cosmetic procedures or any other interventions that are not medically necessary.

Although dental insurance and health insurance policies refer to different things, they work in basically the same way. Regardless of the type of insurance that you are interested in, it is essential to compare multiple quotes side by side before making a decision. You should always look for policies that offer enough coverage at a fair price. Both dental care and health insurance policies are priced very high, so it is up to you to find a plan that suits all of your needs. Remember to ask if there are any bonuses and discounts provided and stick to a policy that offers maximum benefits. In case you need help, do not hesitate to contact an insurance company featuring health and dental insurance plans.

Health Care Reform Implementation Update

Sept. 23, 2010, marked the six-month anniversary of the enactment of the Affordable Care Act. There has been a lot of news coverage on this milestone during the past few days and it is likely that more will follow.

Certain provisions of the Affordable Care Act are effective starting with plan years (in the individual market, policy years) beginning on or after Sept. 23, 2010. We believe that some of our members or groups may not recognize or understand the plan/policy year concepts and mistakenly assume that certain Affordable Care Act provisions will immediately apply to their coverage on Sept. 23, 2010.

We ask that you call us with any questions regarding certain provisions of the Affordable Care Act that may not immediately apply to your coverage, but will apply starting with plan/policy years beginning on or after Sept. 23, 2010.

New EOBs and Language Notifications

Beginning Sept. 23, 2010, members and providers will see a new section in Explanation of Benefits (EOBs) and denial letters that is referred to as “Important Updates (not applicable to all policies or plans)”. The new section informs members that if their plan/policy is non-grandfathered, as defined in the Affordable Care Act, and if their plan/policy has renewed after Sept. 23, 2010, then the information in the new section may apply to them. This would also apply to new plans that are effective on or after Sept. 23, 2010.

These requirements do not apply to grandfathered plans. However, you should note that the new notification language will be included on all EOBs and denial letters, including those to members of grandfathered plans. Our call center Customer Advocates will be prepared to help members determine whether or not their plan is grandfathered or non-grandfathered.

Appeals and External Review

Concerning external review of denials, all non-grandfathered plans that are not required to follow an existing state external review law – for example, most self-insured plans – the option to choose to follow either the existing state external review process (when permitted by the state’s Department of Insurance) or to follow the new federal external review process, as of their effective date.

Non-grandfathered ASO self-funded plans to submit an External Review Election Form for their medical benefit plan(s) to their account representative at least 30 calendar days prior to their renewal date. If they do not make their own selection by completing the form at least 30 calendar days prior to renewal, the states external review process will review it. At this time there will be no additional charge for this new service.

Essential Health Benefits

Starting with plan years beginning on or after Sept. 23, 2010, the Affordable Care Act generally prohibits group health insurance coverage from having annual limits on the dollar amount of essential health benefits.

However, for plan years beginning prior to Jan. 1, 2014, group health insurance coverage may have certain restricted annual limits on the dollar amount of essential health benefits in accordance with federal regulations.

Federal regulations and guidance also provide for the waiver of the restricted annual limit requirements under certain circumstances.

Pre-existing Under 19

Starting with plan years beginning on or after Sept. 23, 2010, the Affordable Care Act prohibits group health insurance coverage from imposing pre-existing condition exclusions on enrollees under age 19. If you missed this announcement earlier, you should note that we have now aligned our benefits with the Affordable Care Act by not allowing pre-existing exclusion only for enrollees up to age 19. This is for our fully insured and individual business – ASO/custom accounts may still vary their coverage to provide richer benefits.

Child-only Policies

We are awaiting state Department of Insurance approvals for our new child-only policy. Our target date to begin enrolling members is May 2011.

Special Open Enrollments

Some groups may be having their open enrollment now for plans starting Oct. 1, 2010. Included in open enrollment for these groups is a special open enrollment for adding dependents under the provision of the Affordable Care Act that extends adult child dependent coverage up to age 26. Those individuals who also reached a plan’s lifetime limit are also eligible for the special open enrollment.

Tags: health care overhaul, health care reform, obama care

This entry was posted on Thursday, September 30th, 2010 at 12:30 pm and is filed under health care overhaul, health care reform, obama care. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

View the original article here

Miami Health Insurance Outlook

Office of Community Health and Planning

The role of the Miami-Dade County Health Department Office of Community Health and Planning is to provide education in the community. The focus is on prevention through living a healthy lifestyle that includes eating a well-balanced healthy diet, exercise and no tobacco use.

The staff participates in community activities, including health fairs and health education workshops. At these events, the Office of Chronic Disease Prevention staff provides blood pressure screenings, nutrition education and body fat percent measurements while promoting a healthy lifestyle. They also work closely with other community partners including public schools, universities, community organizations, healthcare facilities and the Consortium for a Healthier Miami-Dade

MIAMI-DADE Hospital District Plan from Jackson Health System

Miami has a wonderful health system for those that know how to navigate it.  ECHealthInsurance.com has made this page for Miami residents who are uninsurable due to either health, wealth, or status issues.  We have listed every county health plan number, every contact for Medicaid, every primary care clinic, every free health center in Miami Dade for the poor, needy, and uninsured.

Patients who qualify for Jackson’s charity care program, which is supported by a half-cent sales tax and property-tax dollars, pay on a sliding scale.

Opened in 1918, Jackson is the main hospital in the county for the uninsured and the only to receive local tax dollars.

The hospital gave away about $471 million in medical care last year to uninsured patients. Jackson received $277 million from local taxes. The shortfall was partly offset by money Jackson makes caring for insured patients. As a result, Jackson lost about $120 million in 2004.

With 1,567 beds, Jackson Memorial Hospital is one of the largest hospitals in the country. But on any given day, patients are still stacked up in the downtown Miami hospital’s large emergency room. To help improve patients’ access to primary care, Jackson has 13 primary-care clinics across Miami-Dade County that treated an estimated 170,000 patients last year. Half the patients are uninsured.

Jackson Health System offers free or discounted care to people with incomes below 200 percent of the federal poverty level, or $37,000 for a family of four. Those with incomes under the poverty level pay $5 per drug, nothing for a clinic visit and nothing for routine lab tests and X-rays. Those making twice the poverty level pay $15 per drug and up to $55 for an office visit or medical tests.

But Jackson Memorial is a magnet for criticism from other hospitals who say it’s unfair that all local tax dollars go to one hospital to treat the uninsured although the uninsured go to all the hospitals in the county — albeit mostly to Jackson.

“The tax dollars should follow the patient, but in Miami-Dade there’s just not enough dollars to go around,”

But that hasn’t been enough. Jackson Health System expects to lose $25 million this year.

Borinquen Health Care Center, Inc.
3601 N. Federal Hwy.
Miami, FL 33137
305-576-6611

Camillus Health Concern, Inc.
336 NW 5th St.
Miami, FL 33128
305-577-4840 ext. 106
Health care for homeless

Citrus Health Network, Inc.
4125 West 20 Ave.
Hialeah, FL 33012-5875
Phone: 305-825-0300
Fax: 305-825-1645

Community Health of South Dade, Inc.
Doris Ison South Dade Health Center
10300 S.W. 216th St.
Miami, FL 33190
305-253-5100

Community Health of South Dade, Inc.
Everglades Health Center
19300 S.W. 376th St.
Florida City, FL Miami 33030
305-246-4607

Community Health of South Dade, Inc.
Martin Luther King Jr.
Clinica Campesina
810 W. Mowry St.
Homestead, FL 33030
305-248-4334

Community Health of South Dade, Inc.
Naranja Health Center
13805 SW 264th St.
Naranja, FL Miami 33032
305-258-6813

Community Health of South Dade, Inc.
South Dade Health Center
13600 SW 312th St.
Homestead, FL 33033
305-242-6069

Community Health of South Dade, Inc.
West Perrine Health Center
18255 Homestead Ave.
Perrine, FL 33157

Dr. Rafael A. Peñalver Clinic
971 NW 2nd St.
Miami, FL 33128
305-545-5180, ext. 184 or 185

Economic Opportunity Family Health Center
Flamingo Medical Center
901 East 10th Ave., Bay 39
Hialeah, FL 33010
305-887-0004

Economic Opportunity Family Health Center
James E. Scott Center
7200 NW 22nd Ave.
Miami, FL 33142
305-835-8122

Economic Opportunity Family Health Center
Jesse Trice Center for Community Health
5361 NW 22nd Ave.
Miami, FL 33142
305-637-6400

Economic Opportunity Family Health Center
Norland Family Health Center
18360 NW 7th Ave.
Miami Gardens, FL 33169
305-694-6270

Economic Opportunity Family Health Center
North Center
1220 NW 95th St.
Miami, FL 33147
305-694-6900

Helen B. Bentley Family Health Center
3090 SW 37th Ave.
Coconut Grove, FL 33133
305-447-4950

Miami Beach Community Health Center
Beverly Press Building
1221 71 Street
Miami Beach, FL 33141
305-538-8835

Miami Beach Community Health Center
Stanley C. Myers Building
710 Alton Road
Miami Beach, FL 33139
305-538-8835

Miami-Dade County Health Department
Main Complex
1350 NW 14th St.
Miami, FL 33125
Phones:
TB – 305-324-2462
Adult Immunizations - 305-324-2438
Family Planning - 305-325-2758
Laboratory - 305-324-2449
Sexually Transmitted Diseases (STD) – 305-325-3242
Vital Records -305-324-2489

Environmental South
Neighborhood Improvement
Contact: Trevor Coke
1725 NW 167 St.
Miami, FL 33056
Phone: 305-623-3574
Fax: 305-623-3623

North Miami Center
Women, Infants & Children (WIC)
Contact: Jessica Fitzgerald
14101 NW 8th Ave.
Miami, FL 33168
Phone: 305-688-4821
Fax: 305-953-3139

Dr. Rafael A. Peñalver Clinic
971 NW 2nd St.
Miami, FL 33128
305-545-5180, press 3 for administration

Rosie Lee Wesley (South Miami)
Contact: Marilyn Perez
6601 SW 62nd Ave.
Miami, FL 33143
Phone: 305-662-4932
Fax: 305-669-6907

PET Center
Contact: Hazel Ruffin, RN
615 Collins Avenue
Miami Beach, FL 33139
Phone: 305-535-5548
Fax: 305-535-5543

Juanita Mann Center
Northside Shopping Center
Contact: Yvonne Edwards (305-835-2200)
7900 NW 27 Ave.
Miami, FL 33147
Phone: 786-466-2100
Fax: 305-694-2913

View the original article here

Auto Insurance Rates Affected Positively by Auto Theft Rates

Posted on Fri, August 28, 2009

In one of our more recent news posts we see that the Insurance Information Institute notes the falling auto theft rates trend over the past 5 years.  13% less stolen autos in 2008 could be a result of many things, but one thing for sure is that the GPS systems which track stolen cars and easily find chop shops that are stripping and selling parts are helping.  Another thing is the fact that more vehicles are coming with factory alarms and vehicle electronics are getting more sophisticated making it harder for the average Joe to use a slimjim and 3 wires to have their prize driving down the road. 

This is a perfect example of how the market and the consumers naturally affect and fix their own problems though spending their dollars and developing products.

Considering auto theft and auto insurance fraud are major negative factors that affect your rates, it's no wonder that the decline shows some drops in rates across the board.  For example, it dropped 3.3% from 2005 to 2006.  If only something so simple could be applied to health insurance we would see rates dropp across the board!  Maybe there can?!  Educating people on making choices that lead to healthier lifestyles could be a start.  But that's a whole other issue right now and nobody knows what direction health insurance will be going with the proposed changes in our government

NPR Fires Juan Williams For What?

Posted October 21st, 2010 at 3:28pm in Ongoing Priorities  Print This Post

This morning, the media world was shocked to learn that Juan Williams was fired from National Public Radio (NPR) as a result of opinions he expressed last night on Fox News’ The O’Reilly Factor. Williams has been a long-time contributor to Fox News, where he offers unabashed center-left commentary.

The controversy is hard to figure out. During the segment in question, Williams defended Muslims from being painted with broad strokes, even though he had also felt the personal twangs of fear when on an airline with a religiously-garbed Muslim post-9/11. Many Americans may identify with this honest introspective position. Juan Williams, author of numerous civil rights books, was preaching tolerance in the face of his own self-doubts.

This whitewashing of news is typical of liberal media professionals who fear that the mere reporting of facts or a debate of views may incite some sort of American violence against a particular group. Of course, this ignores that such movements rarely exist. If anything, America was a model of tolerance following 9/11 as the nation stood together denouncing stereotypes even as they shared Juan Williams’ personal twangs of fear while boarding airlines.

If you wanted to add politics to the equation, our nation seemed to be much more tolerant in the seven post-9/11 years under President Bush, than under the following two under President Obama. Why is that?

Under President Bush, we were often and repeatedly told that this was not a war against a religion but against those that corrupted their religion. Americans understood this, accepted it, and supported the war’s prosecution. Under President Obama, we are told that religion had nothing to do with the terrorism to begin with, there is no “Global War on Terror” and we should bend over backwards to appeal to those who use religion as vehicle for hate against us. Americans do not understand this, do not accept it, and still want terrorism to be prosecuted in an honest environment.

But back to NPR. Do they have the right to fire Juan Williams? Of course. Juan has a first amendment right to say what he feels, and NPR has a business right to fire any of their employees for actions they deem harmful to their reputation. But American taxpayers also have a right to demand better business practices from an organization they help fund through tax dollars. NPR receives 16 percent of its funding from tax dollars and has a responsibility to justify that expenditure to us.

NPR has built a reputation for espousing a liberal view that goes largely unchecked. While liberals bash Fox News for having a conservative bent, they are defensive of organizations such as the New York Times or NPR who provide the “mainstream” liberal dogma on a daily basis. NPR will defend itself by pointing out that its staff register as “independents” and that political affiliation is not a factor in their news reporting, but it is impossible to ignore the reality of their liberal point of view. If NPR wants to be a liberally bent news organization, that is their prerogative, but should taxpayers support this endeavor? No.

The push for political correctness over the past two years has reached a point that is threatening our civil discourse. This is especially noted when conservatives are called racist for opposing the president’s economic and domestic policies. It’s also seen in what isn’t reported, as much as what is.

This was demonstrated a few weeks ago when ABC’s This Week host Christiane Amanpour hosted a “town hall” on American’s fears of Islam. Amanpour responded to guest Anjem Choudary’s statement that “We do believe as Muslims the East and the West will one day be governed by the Sharia, indeed we believe that one day the flag of Islam will fly over the White House…the day of judgment will not come until a group of my oma [sic] conquer the White House” with an “OK.”

The obvious purpose of the town hall was to paint ”fears” of Islam as irrational, spending a great deal of the hour chastising the Reverend Franklin Graham as intolerant. But when Amanpour’s guest, Mr. Choudary, threatened America and supported terrorism, the topic was changed and his comments went unchallenged, and unreported. Certainly, ABC would fire Amanpour for dismal ratings before her casual exchange with this man who glorified radical jihad and terrorism, but there wasn’t even a mainstream debate over this banter. But even without a national debate, Americans watching that program were smart enough to see Choudary as a man corrupting a religion rather than someone representing it.

It goes without question that Juan Williams is an honest analyst and reporter. We certainly don’t agree with him on many issues, but his discourse is civil and even handed. When he sees an opportunity to reach across the ideological spectrum to support an issue, he will, as he did with The Heritage Foundation when he narrated our documentary “Let Me Rise” on the topic of school choice and the D.C. Opportunity Scholarships the Obama administration ripped out of the hands of inner-city students trying to get a better education. NPR should have embraced the ability for Juan Williams to reach across the aisle and hold these conversations, rather than once again prove that its desire is to promote a liberal narrative rather than a truthful debate.

Juan Williams is not the first and will not be the last journalist fired under the guise of political opportunity (will Mara Liasson be next?). But Williams’ firing will highlight the hypocrisy of a media outlet that tolerates hateful speech directed at conservatives (“Teab#*gers” anyone?) but shows no such tolerance for honest and thoughtful introspection, even when it comes from the left as in the case of Juan Williams. His firing will also highlight the funding that NPR receives, and hopefully cause legislators in the next Congress to consider whether that is a necessary use of our tax dollars. Are we truly without enough television and radio choices in America today that we must continue to prop up an entity such as NPR? Maybe we should thank NPR for opening this debate.

Click here to watch Juan Williams in ‘Let Me Rise’

View the original article here

Morning Bell: Renewable Electricity Standards Kill Jobs Too

Posted October 21st, 2010 at 9:28am in Energy and Environment  Print This Post

Cap and trade legislation is dead. The left abandoned the policy this summer when it became clear it was a liability. Sen. George Voinovich (R-OH) told Politico: “You can’t use cap and trade anymore because it is like manure on the trough. It’s defined, and people are opposed to it.” But that doesn’t mean the left has abandoned plans to hike up our nation’s energy costs in a vain attempt to save the world. All they did was pick a new a set of government mandates and repackage it as Renewable Electricity Standards (RES). Don’t be fooled. The goal (reducing emissions) and mechanism (raising energy prices) are still the same. As is the result: millions of lost jobs at a time when unemployment already is hovering around 10%.

According to a Financial Times/Harris survey conducted this month, most Americans favor an expansion of renewable energy. But that support is very weak. When asked if they would be willing to pay as little as 5% more for electricity, only 32% of Americans answered yes. On the other hand, a full 57% of Americans said they would be opposed to paying for more than a 5% increase in electricity prices for renewable energy. And that is where the left’s RES dreams hit cold hard economic reality. Here are the prices that President Barack Obama’s  Energy Information Administration (EIA) projects for various sources of electricity per megawatt hour in 2016 (in 2008 dollars):

• Conventional coal power: $78.10
• Onshore wind power: $149.30
• Offshore wind power: $191.10
• Thermal solar power: $256.60
• Photo-voltaic solar power: $396.10

As you can see, the prices for alternative energy are at a minimum almost double the cost of conventional coal power. So what would happen if Congress mandated that utilities obtain growing percentages of their power from renewable sources of energy? A Heritage Foundation analysis of 22.5 % RES by 2025 found: 1) household electricity prices would jump 36%; 2) industry prices would rise by 60%; 3) national income (GDP) would be cut by $5.2 trillion between 2012 and 2035; and most importantly 4) RES would kill more than 1,000,000 jobs.

Renewables like hydro, wind, solar energy and biomass account for only 6% of our nation’s electricity generation. But when was the last time you saw a dam built? Take hydro-power out and renewables account for only 3% of our nation’s power. And this is after decades of existing generous renewable subsidies. If electricity created by wind and other renewables was cost competitive, consumers would use more of it without a federal law to force consumption. But renewable energy is not cost competitive, hence the need for government coercion to force the American people to buy it.

There simply is no upside to a RES. In fact, in some ways it is even worse than cap and trade. Heritage analyst David Kreutzer explains: “Electric power is one of the most critical inputs to a modern economy. Thus, it is no surprise that forcing the cost of electricity to rise dampens economic activity. The cost increase for electricity can be viewed as a particularly damaging energy tax, because a renewable mandate, unlike the case of a normal tax, provides no revenue to at least partially offset the higher cost. By way of comparison, the highway use tax on gasoline raises the price of gasoline, but it also generates revenues for building and maintaining roads and bridges. On the other hand, a renewable energy standard raises costs in the form of less efficient production, which provides no economic benefit.”

Quick Hits:

View the original article here

ObamaCare Unrealistic Cost Estimates Exposed by Dem Governor

   « Majority of Indies see Dems as more liberal than they are | Blog Home Page | Fannie, Freddie bailout could double in cost »
October 21, 2010 Richard BaehrThe single most compelling argument against the Patient Protection And Affordable Care Act, otherwise known as ObamaCare, was made today in the Wall Street Journal by the Democratic Governor of Tennessee Philip Bredesen. In essence, the subsidies offered to buy health insurance in the newly created exchanges beginning in 2014, are very attractive, and the penalties for companies who do not provide health insurance are quite modest (about $2,000 per employee). As a result, many employers, a lot more than estimated by the Congressional Budget Office or by Democrats in Congress who shilled for the bill, will simply be much better off  dropping their health insurance coverage, paying the penalty, and transferring the health insurance burden to the federal government. Bredesen makes the argument  that his own state of Tennessee with 40,000 direct employees, would significantly reduce its health care costs in 2014 by doing the same thing private companies will be incentivized to do -- drop health insurance coverage for its employees, and transfer the burden to the federal government through the newly created exchanges in each state.
Rather than 30 million people newly insured through an expansion of the Medicaid program income limits and the creation of the exchanges, there will be tens of millions of additional people, formerly covered by companies or governments, who may now be shifted onto the exchanges at additional cost to the federal government. This cost has not been included in any CBO estimate, and is the ultimate budget buster (as if $1.4 trillion annual deficits were not enough).
Of course, the identical scenario will play out in the market for individual health insurance coverage. Assuming the individual mandate is judged to be constitutionally acceptable, no thinking person would buy coverage in an exchange until he or she expected to have significant  bills. At that point, this person would purchase coverage immediately, since the penalty for not buying insurance is only $750 a year, in almost all cases less than the unsubsidized portion of the insurance premium that could be purchased in an exchange.
Bredesen makes the case that the drafters of the health reform bill, all Democrats, clearly had no conception of game theory. They knew, or the lobbyists working, with them knew, what they wanted to happen -- insure lots of people, and have the federal government pay for the new coverage. The cost of the bill was "scored" by the CBO, and determined to be a net deficit reduction bill, based on new taxes, and "savings" from the Medicare program (a big part from hammering the Medicare Advantage program). The Democrats wrote 2,000 plus pages of rules and regulations to presumably make sure everything worked out as they hoped. But there are other actors in the drama, who can compare two prices: say X and 2 X, and choose the strategy that costs them only X.
There is no believable federal budget for any year beginning in 2014 that is based on the numbers in the CBO estimate. The legislation and the system it created will be an enormous budget buster. We now have this honest assessment of how the bill will work, and what that will mean for the behavior of employers from an elected Democratic official with a lot of experience in health care reform efforts in his own state.
The urgency of the repeal effort should get a boost from Governor Bredesen's common sense article. That will require Republican control of both Houses of Congress in 2013, and the defeat of Barack Obama in 2012. It is that simple.

Ed Lasky adds:
There are signals being sent that the GOP, should it assume control of the House, may refuse to fund the exchanges. Then what happens? Will employers who moved employees off plans be leaving the employees in no man's land?
Will this then become the bludgeon to be wielded against Republicans -- that they are denying medical care insurance to millions of Americans by refusing to fund the exchanges?

Richard Baehr responds:

That threat assumed Obama was stil lin office in 2013, or GOP only controlled the House.  The cutoffs next year are pretty minor stuff, in terms of what is budgeted.  But defunding some of the 159 commissions would be helpful interim step.

View the original article here