Your Insurance Matters Archive Page

march 30, 2008

Topic
Health Care
Proposed Health Care Legislation, - Bill HB2041 "Patient and Nursing Staff Ratios"
Hear why the Arizona Nurses Association and the American Nurses Association want this bill defeated.

The Conclusion
Part 2 of Larry's Tip
A way to use complimentary and alternative medicine along with western medicine in your overall health care plan
and save money on the insurance premium all at the same time.
Click here to read Part 1 from
last Sundays show in the archive section.

Guest
Arizona Nurses Association
www.aznurse.org

WHO?
The Arizona Nurses Association (AzNA) is the only statewide professional association of registered nurses, and is a constituent member of the American Nurses Association (ANA).

Since 1919, the Arizona Nurses Association has been helping nurses navigate an increasingly complex healthcare environment. AzNA is the largest and most widely recognized professional nursing organization in Arizona with members from all practice roles and settings. While many organizations talk about what they will do for their members, AzNA has been delivering results benefiting nurses for over 85 years.

WHAT?
AzNA is led by an eleven member Board of Directors elected by the association members. Unique to professional nursing organizations in the state of Arizona has a full-time Executive Director, a registered nurse, with other full-time and part-time office staff. In addition, AzNA has a paid lobbyist who works under the direction of the Executive Director, guided by the board of directors' approved legislative agenda, and in collaboration with the Legislative Committee. AzNA utilizes a host of expert consultants to support its mission and strategic direction.

OUR MISSION:"To advance, promote and protect the value, contributions and development of Arizona's professional nurses."

WHERE? Arizona Nurses Association 1850 E. Southern Avenue, Suite 1 Tempe, AZ 85282
480-831-0404 www.aznurse.org

The Insurance Term of the Week:
Pre-Admission Certification
Sometimes called Pre-Certification Review or Pre-Admission Review, most health insurance policies have this provision.
This is approval by a case manager or insurance company representative (usually a nurse) for a person to be admitted to a hospital or in -patient facility, granted prior to the admittance.
Pre-Admission Certification must be obtained by the individual. Sometimes, however, the physician will contact the appropriate individual. The goal of Pre-Admission Certification is to insure the individual is not exposed to services that are not medically necessary.

Larry's Tip of the Week:
Solutions Part 2
"Providing a health insurance plan for my family that incorporates the use of complimentary and alternative therapies along with Western medicine and saving money on the insurance premium.”

Steps to take:

1. Sign up for a high deductible health insurance plan.
2. Create a 2nd health account.
3. Create a health savings account.
4. Sign up for health a health discount cared covering: dental, vision, vitamins and herbs and alternative medicine practice.
5. Add a medical expense rider to your auto insurance premium.

Let's start with the health insurance policy.
What is health insurance? What is it's purpose?
"The nature of insurance is to cover the costs for an individual when those costs are so great that the individual would suffer great hardship if he had to pay them himself."

Example: When a house burns down, the cost of replacing the entire house is probably out of reach for the individual. So we buy house insurance and pay a small premium each month to insure that if the house burns down money will be there to replace it quickly. We don't, however, expect the insurance to pay every bit of maintenance from window cleaning to installing a new phone line or repairing a wall in the bedroom.

We seem to take a different approach with health insurance. We expect the health insurance to be there for the big stuff, but we also expect that it should coverall medical services no matter how small. When we visit the doctor with the sniffles, we want the insurance to pay. If we us one $50.00 bottle of prescription medicine, we want the insurance company to pay.

We need to change our current mind set with health insurance. What we have now is unworkable. We have created a monster with:

1. Sky high costs
2. Idiotic bureaucracy
3. Unhappiness in doctors and patients

We must rethink our approach to health care.

The way to opt out of this madness is to buy a high deductible policy. Insurance companies make these premiums lower because you are saving them overhead. Buy a high deductible qualified HSA plan of $2500.00 family deductible with a co insurance of 100% the 2500 is an optimal deductible because even if you had a bad year and had to pay the entire deductible, you will still be ahead because you've been paying lower premiums.

Lets compare some hard numbers

Low Deductible Plan	High Deductible Plan
$250 Deductible Physician Co-Pay - $25 Prescription Drug Card Monthly premium - $800	$2500 Deductible/100% not included not included Monthly premium - $330
The monthly difference in premiums between the low and the high deductible is $470 ($800 - $330) Multiply that by twelve months in the year, and you've saved $5640.

Year One Scenario - No Big Illnesses
$900 Spent - $750 for doctor, $150 RX

Low Deductible Plan	High Deductible Plan
$0 Deductible Physician Co-Pay X3 - $75 Prescription Costs (30%) - $45 Premium Paid- $9600 Total Paid - $9720	$750 Deductible Physician Co-Pay X3 - $0 Prescription Costs (30%) - $150 Monthly premium - $3960 Total Paid - $4860
Overall the the savings from the high deductible to the low deductible plan is $4860.

Year Two Scenario - Family Member Expenses
$67,000 spent in hospital, $5,000 in prescriptions

Low Deductible Plan	High Deductible Plan
$250 Deductible Physician Co-Pay - $2000 Prescr. Costs (30%) - $1500 Premium Paid- $9600 Total Paid - $13,350	$2500 Deductible Physician Co-Pay - $0 Prescr. Costs (30%) - $0 Monthly premium - $4860 Total Paid - $7360
Overall the the savings from the high deductible to the low deductible plan is $5990.

Year Three Scenario - Incorporate Holistic Health
$6,500 spent on Holistic Health, $2,000 on Western Medicine (expenses outside Dr. Office)

Low Deductible Plan	High Deductible Plan
$250 Deductible Physician Co-Pay - $1300 Prescription Costs (30%) - $0 Premium Paid- $9600 Total Paid - $17,650	$2500 Deductible Physician Co-Pay - $0 Prescription Costs (30%) - $0 Monthly premium - $4860 Total Paid - $13,860
Overall the the savings from the high deductible to the low deductible plan is $3790.

Step #2

Take the $5640 you save in premiums and put it into a savings plan every year and it will grow to $113, 557 in fifteen years (4% return).

What could you do with $113, 557?

If you like using holistic, complimentary and alternative care you can incorporate this into your family's health care plan. Use this money to pay for holistic health services and products , such as:

Traditional Chinese Medicine	Fitness Trainer	Naturopathy	Psychology
Yoga Classes	Herbs and Vitamins	Homeopathy	Energy Work
Martial Arts Classes	Massage Therapy	ETC.

Step #3

Open up a Health Savings Account as a way to cover the small expenses and save on taxes.

The HSA is a special type of account that works like an individual retirement account. Except that in an HSA in addition to writing off the amount deposited from your taxes, you can also withdraw the money tax free as long as it is used to pay for valid medical expenses.

A partial list of valid expenses:		Dental Treatment	Lab Fees
Insurance Premiums	Co Pay from Dr. Visits	Eye Glasses, Contact Lenses	Pharmaceuticals
Acupuncture	Chiropractor	Medical Equipment and Supplies	Weight Loss Programs

For a complete list, http://www.irs.gov/pub/irs-pdf/p502.pdf

Take control of your family's health care plan. Essentially, be your own insurance company for the small expenses that fall under your deductible.

HSA accounts can be rolled over from year to year. There is no "use it or loose it" with HSA's. Whatever you don't use is rolled over to the next year (with interest). You can put more money in each year. Or just sit on the money you do have without additional deposits.

The HSA is only available if you have the high deductible qualified health plan. For an HSA established by an employee of a company, the employee, the company or both may contribute to the HSA. Employer paid contributions to an HSA are treated as employer-provided coverage for medical expenses.

Step #4

You may want to look at purchasing a Dental and Vision card that provides discounts on dental and vision services and products, for further savings.

Step #5

Purchase the health insurance rider on your automobile insurance. If you or a family member should need health coverage from a car accident, you will not have to pay the $2500 in deductible on your health insurance. Your car insurance company will pay it for you.

Reference: "Health Insurance off The Grid", by Daryl Kulak


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