Insider's Guide To Life, Health, and Disability

What’s the Simplest Way to Create, Share and Track a Video on the Web?

Duaine Owings — Tue, 31 Jan 2012 07:13:04 +0000

So, you may ask how when I’m so busy do I find the time to create, upload and track a video on the web? There is a simple tool for you to use named
“Brainshark”.

Could a Second Medical Opinion Save Your Life?

Duaine Owings — Wed, 04 Jan 2012 00:43:04 +0000

Could a 2nd Medical Opinion Save Your Life?

How Much Life Insurance Do I Need? Life Calculator

Duaine Owings — Thu, 22 Dec 2011 22:33:42 +0000

If you’ve ever wondered if the amount of life insurance you have is enough for your family or don’t know where to start here is a quick and easy Life Insurance Calculator to use online.

What are the different types of Health Plans available?

Duaine Owings — Wed, 21 Dec 2011 00:40:51 +0000

There are five main types of health insurance plans. Traditional indemnity plans are at one end of the spectrum, and health maintenance organizations (HMOs) are at the other. Preferred provider organizations (PPOs) and point-of-service plans (POS) combine features of both indemnity plans and HMOs, but are generally considered managed care plans. A new option, created by Congress in 2003, is a Health Savings Account (HSA). It combines a high-deductible health plan (HMO, PPO or Indemnity) with a tax-advantaged savings account.

It’s important to understand the differences among the types of plans, and we encourage you to read through this section to familiarize yourself with each. But you should bear in mind that distinctions among plans grow increasingly blurred everyday. Almost all indemnity plans (also called fee-for-service plans) apply managed care techniques to contain costs and guarantee appropriate care. Likewise, an increasing number of managed care plans contain fee-for-service elements. The most important thing to keep in mind is that there are more health insurance options available today than ever before, and that’s good news for consumers.

Indemnity plans With an indemnity plan, you can go to the doctor of your choice, and you, your doctor or your hospital submits a claim to your insurance company for reimbursement. Just note that you will only be reimbursed for “covered” medical expenses, a list of which can be found in your benefits summary. The good news is that the vast majority of procedures will be covered under an indemnity plan.

Indemnity plans pay a sizable percentage of what they consider the “usual and customary” charge for covered services in your area. The insurer generally pays 80 percent of the usual and customary costs and you pay the other 20 percent, which is known as the coinsurance. If the provider charges more than the usual and customary rates, you will have to pay both the coinsurance and the excess charges.

For example, if your insurer determines that the usual and customary fee for “X medical service” is $100, the insurer will pay $80 and you will be required to pay the remaining $20. However, if your doctor charges more than the usual and customary fee, $105 for example, you would be required to pay the additional $5, making your total expense $25. Many indemnity plans reimburse at the 80/20 level, but some reimburse at other levels, such as 70/30.

In addition to the coinsurance, most indemnity plans have deductibles. These are amounts of covered expenses you must pay before the insurer will start reimbursing you for your medical bills. These might range from $100 to $300 per year per individual, or $500, $1,000 or more per family. Generally, the higher the deductible, the lower the premiums, which are the monthly, quarterly, or annual payments for the insurance.

Indemnity policies typically have an out-of-pocket maximum. This means that once your covered expenses reach a certain amount in a given calendar year, the insurer will pay the usual and customary fee in full. However, if your doctor charges you more than the usual and customary fee, you still may have to pay a portion of the bill.

Some policies also have lifetime limits on benefits. Most experts recommend that you look for a policy that has a lifetime limit of at least $1 million.

With a health maintenance organization (HMO), instead of paying for each individual service that you receive, you pay a set premium. In return, HMOs offer you a range of health benefits, including preventive care.

With an HMO, you choose a primary care physician affiliated with your plan, usually a general practitioner, to coordinate your care. Generally, you must receive a referral from your primary care physician before visiting a specialist in your provider network. With rare exceptions, your HMO will require that you seek care within its network of providers doctors, hospitals, and labs – with whom your HMO has negotiated a fee schedule. Negotiating discounts from providers is one of the main ways HMOs keep healthcare costs in check. HMOs are generally the most affordable type of health insurance plan.

In addition to your premiums, most HMOs require a copayment for certain services, for example, $10 or $20 for an office visit. Some, but not all, HMOs will apply copayments to hospitalizations as well.

One of the interesting things about HMOs is that they deliver care directly to patients. Patients may go to an HMO’s medical facility to see the nurses and doctors. Another common model is a network of individual practitioners. In these individual practice associations (IPAs), you will get your care in the office of a physician who may accept patients from different health plans.

A preferred provider organization (PPO) is the form of managed care closest to an indemnity plan, which typically allows you to see any doctor, any time. A PPO negotiates discounts with doctors, hospitals and other providers, who then become part of the PPO network.

When you see a physician in the network, you typically make a copayment, a fixed fee for service, such as $25. When you see a physician out of the network, you’ll still receive coverage, but your insurance will only cover only a portion of the bill, usually 70, 80 or 90 percent. The remaining amount, known as coinsurance, is your responsibility. For example, the insurer may reimburse you for 80 percent of the cost of the doctor’s visit if you go to a provider outside the network. So after an office visit, you’ll owe 20 percent of the total bill, plus your copayment.

In addition to the coinsurance, PPOs may also have deductibles. These are amounts of covered expenses you must pay before the insurer will start reimbursing you for your medical bills. These might range from $100 to $300 per year per individual, or $500 or more per family. Generally, the higher the deductible, the lower the premiums, which are the monthly, quarterly, or annual payments for the insurance.

One of the things people like about PPOs is the ability to make self-referrals. That means you can see any doctor you want, including specialists inside and outside the PPO network, without a referral. Also, premiums are usually lower than indemnity plans because of the negotiated provider discounts.

POS plans A point-of-service plan (POS) combines elements of both a health maintenance organization (HMO) and a preferred provider organization (PPO). The plan allows you to use a primary care physician to coordinate your care, or you can self-direct your care at the “point of service.”

When medical care is needed, you generally have to two or three options, depending on the particular health plan:

Higher copays seen for Medicare drugs

Duaine Owings — Wed, 16 Nov 2011 22:23:38 +0000

With three weeks left for seniors to change their Medicare prescription plan for 2012, a study released Wednesday finds that copays for brand-name drugs are going up — sharply in some cases.

What is Life Insurance anyway?

Duaine Owings — Thu, 03 Nov 2011 04:53:12 +0000

Life insurance is a contract between the policy holder and the insurer, where the insurer promises to pay a designated beneficiary a sum of money (the “benefits”) upon the death of the insured person. Depending on the contract, other events such as terminal illness or critical illness may also trigger payment. In return, the policy holder agrees to pay a stipulated amount (the “premium”) at regular intervals or in lump sums. In some countries, death expenses such as funerals are included in the premium; however, in the United States the predominant form simply specifies a lump sum to be paid on the insured’s demise.

It’s Medicare Choice Time Again

Duaine Owings — Tue, 11 Oct 2011 18:23:07 +0000

Compare, Shop, and

Save When Looking

for a Medicare Plan

10/11/2011

Dear Clients and Friends:

We truly appreciate having you as our client, and hope you are doing well. We are here to satisfy your professional needs, but we also strive to make a difference in your life as a trusted resource and a valued consultant.

A Sad Story With A Happy Ending…

Duaine Owings — Tue, 20 Sep 2011 22:08:58 +0000

A Legacy of Love

Just how bad is the economy?

Duaine Owings — Thu, 07 Jul 2011 06:22:48 +0000

Here are a few statistics for you. There have been several economic recessions since the end of World War II. The Joint Economic Committee has studied recoveries from previous recessions and compared them to the current situation. We are now 38 months past the beginning of the recession. When past recessions are studied, the committee found that at the 38-month marker employment would be about 3.7% higher than it was at the beginning of the recession. Employment is now – at the 38-month mark – 5% below what it was at the start of the recession. In previous recessions our economy enjoyed an average growth of 9.9% over 13-quarter period since the beginning of the recession. Where are we now? Our GDP has grown by 0.8% over that same 13-quarter period since the beginning of the 2008 recession.

Members of the U.S. House outperform the average stock-market investor by 6.8%

Duaine Owings — Fri, 03 Jun 2011 18:13:37 +0000

According the journal Business and Politics,
members of the U.S. House outperform the average stock-market investor by 6.8%
per annum after compounding…better than hedge-fund superstars. The authors
say, “We find strong evidence that Members of the House have some type of
non-public information which they use for personal gain.” And, drum roll
please, U.S. Senators get 10.7% per year more than we peons! The Senators’ edge
over the House members in investment return is “due presumably to less
influence and power held by the individual members” of the House. In the
House, Democrats did four times as well as the Republicans, generating excess
returns of 73 basis points per month versus 18 basis points.