Health Insurance Rates and Premiums Demystified

No matter what you call them, health care premiums, rates, “bills,” are made up of the same things. Like many other critical services, health care costs are based primarily on how much the service costs and how much people use it. But, like anything as complicated as health care, there’s more to the story.

Rates submitted by health plans, and how those rates impact the premiums people pay, will receive significant attention. To fully understand why premiums may go up or down in 2017, consider the following factors:

Rates reflect medical costs: Medical costs make up most of the costs that go into the premiums people pay. By law, health plans must spend at least 80 cents out of every $1 of premiums on medical costs. Medical costs are higher in some places than others. Costs are higher when doctors and hospitals charge more, or when people go to the doctor more often, have more tests or fill more prescriptions. Medical costs also go up when drug prices go up (prescription drugprices jumped by more than 10 percent in 2015 alone) and often when new treatments are found.

On average, the people in plans on the public health insurance Marketplace or Exchange have been older, sicker and use more health care than people in other plans. This has been especially true for people who don’t join a plan at the start of the year, but wait and join later. This is one reason Exchange plans can cost more than plans offered through employers.

For all plans, medical costs continue to increase faster than the general rate of inflation and wage growth, and continue to be the driving force behind rate increases.

Risk pool and changes to government programs: The Affordable Care Act (ACA) included financial protections to maintain a stable marketplace and affordable premiums. However, two of the three programs that provided this financial protection now are set to end in 2016. When these programs go away, premiums need to rise even more.

So how do we make premiums more affordable? At Aetna, we’re working in many ways to help hold down our members’ costs. We’re working in new ways with many doctors, hospitals and health care systems so they get paid for the quality of care, not the quantity of services. We’rereaching out to members earlier to address potential health issues, so they can enjoy more healthy days. We’re emphasizing preventive care and cost-effective treatment locations in our benefit plans. And we’re giving members better online tools to understand their plans, find doctors and hospitals and estimate how much care will cost them. We’re even creating new kinds of health plans, such as our Leap plans that help remove barrier to care for people with chronic conditions. All of these things help hold down costs for people.

That’s not all. You can start by reading what Aetna is doing to build a better health system.

Brought to you by AETNA. Read More @: https://news.aetna.com/2016/06/health-insurance-rates-and-premiums-demystified/

Tags: affordable care act, consumers, health care costs, health plan rates, insurance rates, medical costs, personal health, quality care

Why do the Wealthy Need Life Insurance?

THE BLOG

3 Powerful Secrets the Wealthy Know About Life Insurance

 06/03/2015 03:55 pm ET | Updated Jun 02, 2016

Wm. Scott Page CEO, Published Author and Celebrity

At my company, we regularly work with high-net-worth individuals and some of these folks have tremendous wealth. Earlier in my career, I would be somewhat intimidated by them because they had amazing stories of success, and they could hop on their private jets and travel anywhere in the world with the same level of ease that the rest of us go to the grocery store.

Yet as time wore on, I started to learn that even the wealthiest people in America are generally down-to-earth folks who have worked very hard to earn their money, build their fortunes and retain their wealth. And just as Sam Walton, the founder of Walmart, drove a pickup truck until the day he died, many extremely wealthy people wear jeans, shop for bargains and don’t like to overpay - for anything.

Aside from learning about wealth creation, high-net-worth people can also teach us a great deal about many financial tools, including life insurance.

Lesson One: They have it, even though you may think they don’t need it.Though they may not be living from paycheck to paycheck, high-net-worth individuals still have life insurance. Here’s why:

1. Liquidity. When someone passes away, their assets may not be easily transferred into cash. The principle holds true for a mansion in the Hamptons or a ranch house in the suburbs. Life insurance enables surviving families to cover costs associated with the death of a loved one — as it may take time to sell the family home or turn other assets into cash that is more easily divided among heirs.
2. Income replacement. Wealthy folks worry about money too but maybe just on a different scale. How families will continue if a primary bread winner passes away is a relevant concern across all income groups.
3. Wealth transfer. While the average person may not be considering trust funds for their grandchildren, we all work hard for our money and we hope we can pass down the money we don’t need to our loved ones.

Lesson Two: Financial plans for the future should include life insurance
High-net-worth people consider life insurance a powerful tool that helps them hedge against the knowns and unknowns in life.

It’s true that many wealthy people buy life insurance to help pay future estate taxes: something most of us don’t worry about. The important lesson is that we should all be looking down the road at the future costs that will impact our heirs when we pass away. If you have accumulated a certain amount of wealth, a portion of your estate may be taxable and you may not want your heirs to have to pay extra taxes. If you own a business with a partner, you may want to use insurance to fund a buy/sell arrangement if you pass away unexpectedly. If your family business is reliant upon you in order to survive, perhaps a key-man policy is in order. Life insurance is a tremendous tool that has value far beyond the traditional reasons.

Wealth individuals also recognize that their goals and needs change, so life insurance should be regularly evaluated. Needs change and sometimes better insurance products come along or circumstances change so that coverage should be modified.

Lesson Three: Life insurance is an asset
Savvy and wealthy individuals recognize that life insurance is not just a tool but also an asset. In some instances, it has a precise cash value but always carries an intrinsic value. When a life insurance policy is no longer needed, it can often be sold through a transaction known as a life settlement. This is not an option solely for the super rich but one that any senior or baby boomer with an insurance policy can explore. Holders of whole or term insurance may be eligible to sell a policy on the open market for an immediate cash payout.

While we can’t all expect to join the ranks of high-net-worth Americans, we can employ the same financial tools to protect our personal fortunes and pay for retirement.

Follow Wm. Scott Page on Twitter: www.twitter.com/ScottPageCEO

Source: The Huffington Post 

http://www.huffingtonpost.com/wm-scott-page/3-powerful-secrets-the-we_b_7494292.html

Heat Stress in Older Adults

It's June! Time for fun in the sun, but also time to be extra cautious about too much time in the heat... 

Heat Stress in Older Adults

Older adults (that is, people aged 65 years and older) are more prone to heat stress than younger people for several reasons:

• Older adults do not adjust as well as young people to sudden changes in temperature.
• They are more likely to have a chronic medical condition that changes normal body responses to heat.
• They are more likely to take prescription medicines that impair the body's ability to regulate its temperature or that inhibit perspiration.

Heat Stroke

Heat stroke is the most serious heat-related illness. It occurs when the body becomes unable to control its temperature: the body's temperature rises rapidly, the body loses its ability to sweat, and it is unable to cool down. Body temperatures rise to 106°F or higher within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not provided.

Signs and Symptoms of Heat Stroke

Warning signs vary but may include the following:

• An extremely high body temperature (above 103°F)
• Red, hot, and dry skin (no sweating)
• Rapid, strong pulse
• Throbbing headache
• Dizziness
• Nausea

Heat Exhaustion

Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids.

Signs and Symptoms of Heat Exhaustion

Warning signs vary but may include the following:

• Heavy sweating
• Paleness
• Muscle Cramps
• Tiredness
• Weakness
• Dizziness
• Headache
• Nausea or vomiting
• Fainting
• Skin: may be cool and moist
• Pulse rate: fast and weak
• Breathing: fast and shallow

What You Can Do to Protect Yourself

You can follow these prevention tips to protect yourself from heat-related stress:

• Drink cool, nonalcoholic beverages. (If your doctor generally limits the amount of fluid you drink or has you on water pills, ask him how much you should drink when the weather is hot. Also, avoid extremely cold liquids because they can cause cramps.)
• Rest.
• Take a cool shower, bath, or sponge bath.
• If possible, seek an air-conditioned environment. (If you don't have air conditioning, consider visiting an air-conditioned shopping mall or public library to cool off.)
• Wear lightweight clothing.
• If possible, remain indoors in the heat of the day.
• Do not engage in strenuous activities.

What You Can Do to Help Protect Older Adult Relatives and Neighbors

If you have older adult relatives or neighbors, you can help them protect themselves from heat-related stress:

• Visit older adults at risk at least twice a day and watch them for signs of heat exhaustion or heat stroke.
• Encourage them to increase their fluid intake by drinking cool, nonalcoholic beverages regardless of their activity level.
  
  Warning: If their doctor generally limits the amount of fluid they drink or they are on water pills, they will need to ask their doctor how much they should drink while the weather is hot.
• Take them to air-conditioned locations if they have transportation problems.

What You Can Do for Someone With Heat Stress

If you see any signs of severe heat stress, you may be dealing with a life-threatening emergency. Have someone call for immediate medical assistance while you begin cooling the affected person. Do the following:

• Get the person to a shady area.
• Cool the person rapidly, using whatever methods you can. For example, immerse the person in a tub of cool water; place the person in a cool shower; spray the person with cool water from a garden hose; sponge the person with cool water; or if the humidity is low, wrap the person in a cool, wet sheet and fan him or her vigorously.
• Monitor body temperature and continue cooling efforts until the body temperature drops to 101°–102°F
• If emergency medical personnel are delayed, call the hospital emergency room for further instructions.
• Do not give the person alcohol to drink.
• Get medical assistance as soon as possible.

Source: Centers for Disease Control & Prevention

http://emergency.cdc.gov/disasters/extremeheat/older-adults-heat.asp

Benefits of Being Happy:

Happier people more likely to live longer...

"We can train ourselves to have more positive emotional qualities like happiness, kindness and mindfulness."

Happier people have an unusual amount of activity in one area of their brains – the left prefrontal cortex, scientists have found. Happier people are more likely to live longer and tend to be healthier, more successful and more socially engaged than people who describe themselves as less happy.

In the field of psychology, there’s been a lot of emphasis on figuring out people’s problems – what causes depression, anxiety or stress. It wasn’t until the 1990s when Dr. Martin Seligman, a psychologist at the University of Pennsylvania, realized we were missing a big piece of the puzzle. He asked the important question we’d all been missing, “What makes people happy?” It’s because of his question, that Dr. Seligman is considered the founding father of positive psychology.

“If we exercise that part of our brains, just like exercising a muscle, we can train ourselves to have more positive emotional qualities like happiness, kindness and mindfulness,” says Hyong Un, M.D,of Aetna Behavioral Health.

Want to be happier? 

To see for yourself try practicing one, or even all four, of these proven methods suggested by Dr. Un. You might be happy that you did.

1. Savor

Notice the good stuff. Good things happen to all of us, but so often we’re busy rushing through our day that these moments aren’t appreciated. Dr. Fred Bryant, a researcher at Loyola University in Chicago, coined the term “savor.”  He found that people who regularly pause to savor positive moments are more satisfied with life and are happier. You can savor the past, present or the future.

2. Gratitude

According to one study, simply having an attitude of gratitude can increase happiness by 25 percent. Being gracious can lead to optimism and self-confidence, while also deepening our relationships with one another.

3. Optimism

Optimism is linked to increased happiness. People who are optimistic are more likely to tackle their problems and persevere until they meet their goals. This results in increased feelings of success, improved self-esteem and productivity.

4. Generosity

Being generous leads to all kinds of great results. In one study, Dr. Sonja Lyubomirsky divided participants into two groups. She asked one group to commit five random acts of kindness per week for six weeks. The control group went about their lives as usual. The control group reported back feeling more stressed and less happy. But the random act of kindness group reported a 42 percent increase in their happiness levels.

“Life can throw a lot of curveballs,” Un says. “Positive thinking can’t prevent bad things from happening. But if we are essentially a happy person inside, it can help us make it through the rough spots.”

Brought to you by: Aetna

Read more: https://news.aetna.com/2016/05/happier-people-more-likely-to-live-longer/#.V1cDaI2OklE.facebook

2016 || Part D Donut Hole

Medicare Coverage & Costs | Tue, Apr 26, 2016 @ 09:00 AM

The Medicare Part D Donut Hole: Going…Going…Not Quite Gone

Posted by Medicare Made Clear

The prescription drug donut hole is a gap in Medicare Part D’s prescription drug coverage.

Once you and your Medicare Part D plan have spent a certain amount on covered prescription drugs during a calendar year ($3,310 in 2016), you reach the coverage gap. You are now in the Part D donut hole.

You pay a larger percentage of your prescription drug costs while you’re in the donut hole until another dollar limit ($7,062.50 in 2016) is reached. Then Medicare Part D coverage kicks in again.

Closing the Part D Donut Hole

The good news is the donut hole isn’t as big as it used to be. When Medicare Part D launched in 2006, Medicare beneficiaries had to pay 100% of their prescription drug costs during this gap in coverage. With the passage of the Affordable Care Act, that percentage started to drop.

In 2016, you pay 45% of the cost of brand-name prescription drugs and 58% for generics while in the donut hole. These percentages are scheduled to decrease every year, bottoming out at 25% for both brand-name and generic drugs in 2020.

This will effectively close the donut hole, putting costs on par with what you pay between the time you meet your deductible (if you have one) and when you hit your out-of-pocket spending limit.

Getting Into and Out Of the Donut Hole

It’s important to note that it’s not just your share of your prescription drug costs that get you into and out of the donut hole. The amount your plan pays also counts towards the first milestone that puts you into the donut hole.

Drug companies may help pay your way, too. They provide a 50% discount on brand-name drugs purchased while in the donut hole.

The drug company discount counts toward the second dollar limit, the one that marks the end of your passage through the coverage gap. For generic drugs, only the amount you pay out-of-pocket applies to your spending limit.

Conclusion

This will all get simpler in 2020 when the donut hole closes. Until then, following these tips may help you climb out of it more quickly – or keep you from falling into it in the first place:

• Stick with your plan’s formulary whenever possible. Only medications on the formulary, or for which you get an approved exception from the plan, count toward your spending limit.
• Make sure to get your drugs from a network pharmacy. Prescriptions you fill outside your network pharmacy don’t apply to your spending limit.
• Opt for generics if your doctor thinks they’re appropriate. The lower costs for generics may be enough to keep you from slipping into the donut hole.

Medicare Made Clear

10 Key Medicare Facts

Your Medicare journey may be smoother when you understand the rules of the road.

Medicare is a complex subject. Watch this video to get the main ideas behind it. Then you can dig deeper into what’s most important to you

10 Key Medicare Facts Summary

1. There are two main ways to get Medicare.

   • Original Medicare (Parts A and B) which is provided by the federal government
   • A Medicare Advantage plan (Part C) offered by a private insurance company

2. With Original Medicare, you may pay a share of the cost.

   • You contributed to Medicare by paying taxes. That’s why you’re eligible for Medicare when you turn 65.
   • Original Medicare may not pay for everything. You may pay a share of the cost in monthly premiums and copays.

3. Medicare supplement insurance helps with some out-of-pocket costs.

   • Medicare supplement insurance plans help with some of the expenses Medicare Parts A and B don't pay.
   • Medicare supplement insurance plans are offered by private insurance companies

4. Prescription drug coverage may help limit drug costs.

   • Original Medicare does not include prescription drug coverage. However as a Medicare member you can get Medicare Part D prescription drug coverage.
   • Prescription drug plans, also known as PDP, and Medicare Advantage plans are offered by private insurance companies.
   • You can enroll in a stand-alone Part D plan to go with your Original Medicare coverage.
   • You can enroll in a Medicare Advantage plan that includes prescription drug coverage.

5. Coverage choices vary by plan type and state.

   • Original Medicare (Parts A and B) is the same across the United States.
   • Medicare Advantage (Part C) and prescription drug (Part D) plans are offered by private insurance companies and may be available only in certain counties, states or regions.
   • Medicare supplement plans travel with you nationwide. The plans are standardized, but the availability may vary by state.

6. Your initial enrollment in Medicare is time sensitive.

   • The Initial Enrollment Period (IEP) is your first chance to enroll in Medicare. It’s the three months before your 65th birthday month, the month of your birthday, and the three months after your birthday month.
   • If you are eligible for Medicare due to disability, your IEP is based on your disability date.
   • Late enrollment penalties may be incurred for missing certain enrollment periods for Part B and prescription drug coverage.

7. Your health care needs may change over time.

   • After you choose your Medicare coverage, you can make changes once a year during Medicare Open Enrollment, October 15 through December 7.
   • You may change your coverage at certain other times if you qualify for a Special Enrollment Period.
   • Review your coverage each year to see if it still fits your needs.
   • These enrollment period restrictions do not apply to Medicare supplement insurance.

8. Special Enrollment Period (SEP).

   • In some cases you may be able to enroll in or switch plans at times besides your IEP or Medicare Open Enrollment.
   • You may qualify for an SEP if you retire and leave a health care plan sponsored by your employer or union.
   • You can usually use an SEP to change your coverage if you move out of your current plan’s service area.

9. Medicare can work with other health insurance.

   • Group or retiree health insurance sponsored by an employer or union can work with Medicare.
   • Your plan administrator can help you figure out how Medicare could work with your current coverage.
   • Medicare supplement plans work with Original Medicare, but not with Medicare Advantage plans.

10. Help is available.

    • Medicare can be complicated, but help is available.
    • You may qualify for financial help.

Medicare Made Clear: Brought to you by UnitedHealthCare

https://www.medicaremadeclear.com/about/medicare-facts?mrcid=display_fed&utm_source=YouTube&utm_medium=display&utm_content=Top10_3&utm_campaign=MMC+YouTube_TrueViewVID

2016 Best List Of Senior Discounts

FEBRUARY 28, 2016 BY THE SENIOR LIST 27 COMMENTS

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The Best List of Senior Discounts on the web.  Feel free to share it with friends and family!

© The Senior List, 2016. If you plan on recommending any of our discount lists, please do so with appropriate attribution to The Senior List® and a link back to our website. Thanks!  If you’re looking for a printable version of our list you’ll find it in our community library (members only area) located —> HERE.

*Please note: Many of the discounts you’ll see below are offered by franchise owners in local markets.  This means that discounts will vary from location to location.

We had an incredible response to our 2015 senior discount lists published last year.  Many of the service providers on our 2016 senior discounts list have been verified and those that have with be noted with a “verified” flag.  We reached out to all the businesses on our list, but some were unresponsive.  As usual, we’ll  rely on our community (you) to provide updates as you uncover them.  Use the comments section to help verify discount policies and/or note the specific senior discounts in your local area.Be the first to hear about new Discount Lists by joining us on Facebook.  We’re building an online community where people can engage with each other, provide advice, discuss products, and more.

Please understand that discount policies do change.  They change at the national level, and they change at the local level.  Sometimes these changes are published, and sometimes they’re not.  Our best advice for discount shoppers is to ask ahead of time so there are no surprises.

2016 Best List Of Senior Discounts

This master list of senior discounts is meant to be a guide, and with your help we’ll keep it updated throughout the year.  If you’re looking for short versions or printable versions of the individual categories, just navigate to the category “header”, and it will link you to that specific discount list.  You can also click the printer icon below for a printable list.

Senior Discounts at Grocery Stores

ALSO READ: Senior Discounts to Add to Your Repertoire in 2016

Albertsons: 10% off first Wednesday of each month ( 55 +)
American Discount Stores: 10% off every Monday (50 +)
Compare Foods Supermarket: 10% off every Wednesday (60+)
DeCicco Family Markets: 5% off every Wednesday (60+) verified
Fred Meyer senior discount: 10% first Tuesday of each month (55+) verified
Fry’s Food Stores: 10% off on the first Wednesday of every month (55 +) verified
Get free printable coupons now from Coupons.com
Great Valu Food Store: 5% off every Tuesday (60+)

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Gristedes Supermarket: 10% off every Tuesday (60+)
Harris Teeter: 5% off every Thursday (60+) verified
Hy-Vee: Says “Yes” (but discount policy varies by locale) verified
Kroger: 10% off (date varies by location) verified
Morton Williams Supermarket: 5% off every Tuesday (60+)
New Seasons: 10% off every Wednesday most items (65+), 10% off every Tuesday for militaryverified
Publix: 5% off every Wednesday ONLY in Tennessee, North Carolina and the northern portions of Alabama, South Carolina and Georgia (60 +) verified
Rogers Marketplace: 5% off every Thursday (60+)
Uncle Guiseppe’s Marketplace: 5% off (62+ on Wednesdays)

ALSO READ: Senior Discounts And Customer Loyalty

Senior Discounts On Prescriptions

AARP:  With the AARP Prescription Discount Card (provided by Catamaran an OptumRx company), AARP members and their families can access an average savings of 38% off prescription drugs (regardless of age or health status).  Must be a member of AARP to access benefits.  AARP boasts acceptance by 64,000 pharmacies nationwide. verified

Rite Aid:  Sign up for the Rite Aid Rx Savings Program.  Save 15% or more on thousands of brand name and generic prescription drugs by signing up for the Rite Aid Rx Savings Program. When you sign up, you’ll receive Rx Savings Card that gives you access to special discounts at Rite Aid pharmacy. verified

Costco Member Prescription Program:  The Costco Member Prescription Program is a prescription savings program for you and your family. It allows Members who have no prescription drug insurance or whose insurance does not cover all of their prescription medications. Save 2% – 40% at time of sale. verified

CVS Pharmacy:  Enroll in the CVS ExtraCare Savings and Rewards program.  You’ll receive “ExtraSavings” through personalized coupons delivered on receipts, and online via theExtraCare Coupon Center. ExtraBucks Rewards are earned by shopping and filling prescriptions.  You can earn up to 2% back in ExtraBucks Rewards from your everyday purchases.  Also, if you fill 10 prescriptions, your can earn $5 ExtraBucks Rewards through the ExtraCare Pharmacy & Health Rewards program.  verified

RELATED READ: PRESCRIPTION DRUG PRICES ON THE RISE

Kmart:  The Prescription Savings Club at Kmart (Pharmacy Savings Plus) is annually $15 per household or $10 per person.  You and the family are then covered  for certain generic drugs (starting at $5 for a 30-day supply and starting at $10 for a 90-day supply). The Drug Price lookup tool is an easy way to see if and how much you can save.   You can even get discounts on pet medications with a prescription from your vet. verified

Target: Target pharmacies are being rebranded to CVS Pharmacy brand.  This change is underway now.  Your Target (CVS) Pharmacy will already have your prescription records on file. You’ll be able to access your records and refill your prescriptions at CVS.com/Target or by visiting CVS Pharmacy inside Target stores.  Target says “As of December 16, 2015, Target Pharmacy guests have automatically moved to CVS Health’s network. Guests are encouraged to call their health-plan provider with any questions. For general pharmacy questions, you can contact your local pharmacy or CVS Customer Relations: 1-800-SHOP-CVS (1-800-746-7287).  The Target Prescription Savings Plan is no longer being offered.  It will be replaced with the CVS pharmacy and CVS rewards plan (which you can review above). verified

Walgreens Prescription Savings Club:  Membership fee required ($20 individual or $35 family per year). Walgreens Prescription Savings Club members get special discounts off the cash price of thousands of brand-name and generic medications as well as other benefits when they use their Prescription Savings Club Card. Additionally, if you don’t save at least the cost of your membership fee in one year, Walgreens will give you the difference. verified

Walmart Pharmacy Services: Walmart pharmacies offer low-cost generic prescription medications that can save you money. Walmart carries both generics (where they boast $4 refills) and branded drugs.  Check out the Walmart drug list to see if you can save on your medications. verified

Narcup.com: Start saving money today with Narcup.com’s prescription discount card for credit union members age 50 plus. However, it is also open to the general public. The program is for families, children and grand children who have no prescription drug insurance or whose insurance does not cover all their medications.

By using their prescription discount card, a person can save up to 50% on FDA approved drugs. In addition to 18,000 independent pharmacies, large chains including Walgreens, Kmart, Target, CVS, Rite Aid, Publix, Winn-Dixie and Safeway also participate in the network.Narcup.com does not charge any membership dues or fees. You can print off a prescription card and use it immediately. You can request a durable card by mail. A nice feature of the program is that you can look up your medication price based on your zip code. You can also compare prices at other pharmacies. verified

Click to read more: https://www.theseniorlist.com/2016/02/2016-best-list-senior-discounts/