Healthcare.gov Open for Consumers and Health Insurance Companies

The U.S. Department of Health and Human Services, under the authority of President Barack Obama, unveiled an innovative new online tool to help consumers take control of their health care by connecting them to new information and resources that will help them access quality, affordable health care coverage.  As stipulated by the Affordable Care Act, HealthCare.gov is the first website to provide consumers with both public and private health coverage options tailored specifically for their needs in a single, easy-to-use tool.

HealthCare.gov helps consumers take control of their health care and make the choices that are right for them, by putting the power of information at their fingertips,” said HHS Secretary Kathleen Sebelius.  “For too long, the insurance market has been confusing and hard to navigate.  HealthCare.gov makes it easy for consumers and small businesses to compare health insurance plans in both the public and the private sector and find other important health care information.”

HealthCare.gov is the first central database of health coverage options, combining information about public programs, from Medicare to the new Pre-Existing Conditions Insurance Plan, with information from more than 1,000 private insurance plans. Consumers can receive information about options specific to their life situation and local community. In addition, the website will be a one-stop-shop for information about the implementation of the Affordable Care Act as well as other health care resources. The website will connect consumers to quality rankings for local health care providers as well as preventive services. (more…)

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Do a Total Background Check on Yourself – Annual Consumer Reporting Agencies

The Federal laws FCRA and FACTA, which govern the credit bureaus Experian, Equifax, and TransUnion, also regulate a whole universe of other corporations known as “nationwide specialty consumer reporting agencies” and include such companies as: ChoicePoint, Acxiom, CBC Innovis, PayChex, the Insurance Services Office (ISO), Tenant Data Services, LexisNexis, Retail Equation, Central Credit, TeleTrack, the Medical Information Bureau Inc. (MIB), Ingenix Inc., and Milliman Inc.  In fact, just as financial companies rely on “credit reports” to establish credit for customers, insurance, real estate, banking, and retail companies also utilize credit report files to assess consumers and charge higher prices.

For example, health and life insurance corporations rely on some of these nationwide consumer specialty reporting agencies to provide powerful technologies for evaluating and pricing individual insurance applicants: personal “medical report” files.  The Washington Post says that these medical reports, which are “like credit reports for your health records,” have been created for more than 200 million Americans.

Here is a comprehensive list of websites, telephone numbers, and mailing addresses for the top 25 most frequently requested annual consumer reports available to you from the nationwide consumer reporting agencies under the Fair Credit Reporting Act (FCRA).  Through these reports, these consumer reporting agencies extensively monitor your personal medical, insurance, employment, rental, and banking history.  Federal law entitles all consumers to check and verify each report, once every year because they significantly impact your options and costs of credit.

As The Consumerist advises, “Be sure to check them out and correct any errors, before a crisis hits.” (more…)

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Text of Health Care Bill – Patient Protection and Affordable Care Act (HR 3590) – Text of Bill

President Barack Obama Signs Historic Health Insurance Reform Law Overhaul. Health Insurance Reform Overhaul for Health Care Signed after Congress passes Health Care Vote.

On March 23, 2010 in Washington, D.C. at The White House, President Barack Obama signed into law a nearly $1 trillion health care overhaul that ranks among the biggest changes ever devised by Washington and will reshape the way virtually every American receives and pays for treatment. It will rework fully one-sixth of the U.S. economy and for the first time cement insurance coverage as the right of every U.S. citizen.

However, until the regulations take effect in 2014, if you have a pre-existing medical condition, you’re going to have a hard time buying individual insurance, in all but a handful of states. You might get turned down completely, or be charged very high premiums and probably also have to wait as long as a year (paying those very high premiums the whole time) before the health plan covers your condition’s treatment.

Health and life insurance corporations have powerful technologies for evaluating and pricing individual insurance applicants: personal “medical report” files.  The Washington Post says that these medical reports, which are “like credit reports for your health records,” have been created for more than 200 million Americans.

Alarmingly, your medical report files may include both medical and non-medical information about you.  For instance, personal data collected by the Medical Information Bureau (MIB) may include medical conditions, credit report history, driving records, criminal activity, drug use, sexual orientation, participation in hazardous sports, and personal or family genetic history.  Using information from your medical report files, insurance companies can charge higher premiums or terminate coverage.

No consumer should pay for health or life insurance without first reviewing their annual medical report files.  Under Federal law, all consumers are entitled to an annual copy of their medical report files from the nationwide specialty consumer reporting agencies, including the Medical Information Bureau Inc., Milliman Inc., and Ingenix Inc.

Read the full text of the Protection and Affordable Care Act – Bill Number H.R. 3590 below.

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Organizations that Protect Consumer Privacy in Health and Medical Records

Health information technology (“Health IT” or “Electronic Medical Records” or “Personal Health Records (PHR)”) has tremendous potential to improve health care quality and reduce costs while empowering patients to play a greater role in the management of their own care. At the same time, however, electronic storage and exchange of personal health information poses risks to privacy.  Unaddressed, privacy concerns can stand in the way of realizing the benefits of health IT, for neither patients nor providers will make full use of a system they do not trust.

As corporations such as Google (Google Health), Microsoft (Microsoft HealthVault), IBM (IBM Healthcare and IBM Health Integration Framework for Healthcare Providers), and UnitedHealth Group (MyOptumHealth.com) develop personal health systems (PHS) to exchange private medical records and health information, consumers must demand fully transparency in the use of their data and require access to check and verify their own personal records.

Federal laws give you the right to see, get a copy of and amend (correct) your medical record by adding information to it.  Additionally, most states have laws that give you rights to your medical records.  The following organizations help consumers and patients navigate the complex relationships between privacy, security, confidentiality, and the management of personal electronic health records.

The Prescription Project (The Pew Charitable Trusts)
Created with the Pew Charitable Trusts, the Prescription Project seeks to eliminate conflicts of interest created by pharmaceutical marketing by promoting policy change within academic medical centers, professional medical societies and public and private payers. In addition, the Prescription Project will advance state and national level policy solutions. New prescription drugs and medical devices are revolutionizing the practice of health care, enhancing disease management and improving quality of life. However, aggressive pharmaceutical marketing to physicians is creating real and perceived conflicts of interest in the medical profession and raising questions about the appropriateness of treatment choices. These practices can compromise patient care and increase health care costs. It is essential that physicians base their prescribing decisions on accurate and unbiased information, not on misleading marketing materials.
www.PrescriptionProject.org

Georgetown University’s Center on Medical Records Rights and Privacy
Georgetown University’s Center on Medical Records Rights and Privacy provides state-specific guides to help consumers access their medical records and electronic medical records. The Center on Medical Record Rights and Privacy is based at Georgetown University’s Health Policy Institute, a non-partisan multi-disciplinary group of faculty and staff dedicated to conducting research on key issues in health policy and health services research. The Center is dedicated to raising public awareness of the rights and responsibilities associated with medical records and other health information. The Center focuses on a range of topics related to consumers’ rights to their own medical records and privacy protections afforded to this information. The Center has expertise in the Health Privacy Rule issued under the Health Insurance Portability and Accountability Act (HIPAA), the Fair and Accurate Credit Transactions Act as well as state laws that address medical record rights and privacy. The Center provides information on these topics to a broad range of stakeholders such as policy makers, health care professionals, consumers, and the media through research studies, policy analyses, testimony, and consumer guides.
http://hpi.georgetown.edu/privacy/records.html

The Health Privacy Project
The Center for Democracy and Technology’s Health Privacy Project addresses policy questions, including: the proper role of notice and consent, the right of patients to access their own health records, identification and authentication, secondary uses, and enforcement mechanisms. The Center for Democracy and Technology’s Health Privacy Project also tackles the traditional exchange of records among health plans and providers, as well as new consumer access services and personal health records. The Health Privacy Project is a resource for information on medical records confidentiality. Its web site includes information on federal HIPAA regulations as well as state laws of all 50 states.
www.healthprivacy.org
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Disqualified for Health Insurance by Pre-Existing Conditions

In all but a handful of states, if you have a pre-existing medical condition, you’re going to have a hard time buying individual insurance. You might get turned down completely, or be charged very high premiums and probably also have to wait as long as a year (paying those very high premiums the whole time) before the health plan covers your condition’s treatment.  On the Consumer Reports Health Blog, Michael Miano shares how his insurance company disqualified him from coverage,

“When Michael Miano, 61, of Abingdon, Va., first sought to buy individual insurance in 2003 after leaving a federal regulatory position and exhausting his COBRA benefits, he was distressed to learn that he was uninsurable.” I’ve been diagnosed with diabetes but I’m perfectly healthy,” he says. “I follow a strict diet. I’m not overweight and I walk 20 miles a week. I check my glucose levels regularly. I take oral medication, and my diabetes is completely under control.”

His problems result from the practice called medical underwriting. It’s illegal nationwide for insurers to discriminate against people in group plans on the basis of their health. But in all but a handful of states, medical underwriting for individual plans is allowed.”

Whether you can get an individual health insurance policy, and how much you’ll have to pay for it, depends largely on your state’s laws and regulations. Some states allow medical underwriting, a practice in which insurers can reject people with illnesses, exclude specific conditions from coverage, and charge people with health issues much higher premiums. Other states outlaw medical underwriting. You can research your state’s rules at www.healthinsuranceinfo.net, maintained by the Georgetown University Health Policy Institute.
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Denied Insurance Because of A Medical Coding Error in Her MIB Report – Video

Consumer Reports Health’s Cover America Tour realized the impact of the Medical Information Bureau (MIB) when they visited Sheila (above) in Gulfport, Miss., the day after her 50th birthday.

When she attempted to apply for health insurance, Sheila was surprised when she was rejected for an individual health insurance policy by three different companies. She was even more shocked when she learned why: Her record with MIB listed her as having a history of Chronic Obstructive Pulmonary Disease (COPD). Sheila does suffer from asthma, but COPD is supposed to be used to indicate more severe diseases of the lungs, such as emphysema or severe bronchitis. No company would insure her with this damaging mark on her record.

Sheila eventually traced the problem to a coding disparity at her doctor’s office. She says letters and phone calls to both her doctor and MIB have been to no avail, and the problem remains uncorrected on her record, effectively blocking her from obtaining individual health coverage. Unable to obtain health insurance coverage because of this medical coding error on her MIB report, Sheila has been forced to exhaust her 401(k) savings to pay out of pocket for healthcare costs.

Watch Sheila’s story and, before you apply for insurance or pay another monthly premium, make sure you request a copy of your medical report file from the Medical Information Bureau (MIB).

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12 Tips for Choosing and Purchasing Affordable Life Insurance

Insurance is an important part of financial planning — but understanding insurance and buying the right product can be tricky. From whole to term life, riders to convertibility clauses, how do you make sense of all the choices? Most people rely on the expertise of their insurance advisor, broker, or sales representative to help them make the right decision.

Yet, for some people, insurance representatives have developed a bad reputation, and many people do not trust the “recommendations” they receive.

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Finding Affordable Health Insurance Policies for Individuals, Families, and Children

In America’s healthcare system, in most cases, you’re better off with the crowd. Usually, that crowd is your employer or a government pool like Medicare or Medicaid. But sometimes, due to choices you make, or circumstances you can’t control, you end up on your own, with full responsibility for your healthcare expenses.

Here are some circumstances under which you might end up needing to seek affordable individual health insurance:

  • You lose (or quit) your job.
  • You have insurance through your spouse or partner, and they lose or quit their job.
  • Your employer or your spouse’s stops offering insurance for you or your family.
  • You change jobs, and your new employer has a waiting period before you become eligible for coverage.
  • You take early retirement.

In some other circumstances, you may have the option to participate in group medical insurance, but it’s not in your financial interest to do so.

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