레이블이 Aetna Members인 게시물을 표시합니다. 모든 게시물 표시
레이블이 Aetna Members인 게시물을 표시합니다. 모든 게시물 표시

2013년 12월 1일 일요일

About 'aetna'|Backed By New Partnerships With Humana, Aetna & Verizon, Blueprint Health Debuts Its Third Class Of Healthcare Disruptors







About 'aetna'|Backed By New Partnerships With Humana, Aetna & Verizon, Blueprint Health Debuts Its Third Class Of Healthcare Disruptors








Whether               you               are               self-employed               or               simply               unfortunate               enough               to               work               for               an               exploitatively               capitalist               company               that               does               not               offer               benefits,               you               may               need               to               purchase               your               own               health               insurance               plan.

If               you               are               like               me               (fairly               young               and               in               good               health),               you               may               be               looking               for               cheap               health               insurance               for               single               people               -               basic               coverage               with               low               premiums               and               adequate               benefits               in               case               of               an               emergency               or               other               onerous               health               expense.

For               those               of               us               without               pre-existing               conditions,               children,               or               other               complicating               factors,               a               simple               health               insurance               plan               with               a               high               deductible               may               be               appropriate.

If               you               can               afford               to               pay               for               most               low-cost               medical               expenses               out-of-pocket               and               just               want               to               cover               yourself               in               case               of               hospitalization,               surgery,               or               a               hefty               unforeseen               medical               expense,               there               are               several               providers               that               offer               cheap               health               insurance               with               low               premiums               for               single               people.

Availability               of               basic               coverage               does               vary               by               your               geographic               area,               your               state's               regulations,               and               other               details               beyond               your               control.

Since               no               company               offers               this               type               of               insurance               in               every               single               state,               I               have               focused               on               providers               who               sell               relatively               cheap               health               insurance               for               single               people               in               a               large               number               of               states               (14               or               more).

Here               are               four               companies               offering               plans               with               basic               coverage               from               whom               you               can               request               quotes.
               Celtic               -               basic               coverage               available               in               33               states               
               http://www.celtic-net.com/
               Using               my               own               profile               as               a               non-smoking               27               year-old               Wisconsin               resident,               I               found               cheap               health               insurance               plans               with               Celtic               that               touted               low               premiums,               like               $66               a               month               for               a               $1500               premium               and               20%               coinsurance.

That               particular               PPO               plan               stood               out               as               a               good               deal               for               single               people               -               a               very               reasonable               premium               in               exchange               for               a               relatively               low               deductible.

This               means               that,               once               my               annual               costs               crest               above               $1500,               the               insurance               kicks               in               such               that               (in               most               situations)               I               would               only               pay               20%               of               future               bills.

For               basic               coverage               at               under               $70               a               month,               this               is               a               well-balanced               plan.

Celtic               offers               a               wide               variety               of               plans,               but               as               the               deductibles               go               up               (to               as               high               as               $5000),               the               monthly               premiums               don't               decrease               significantly               to               accommodate.

Celtic               claims               that               it               has               earned               an               A.M.

Best               "Excellent"               rating               of               A-               since               1986.

For               payment               options,               they               also               offer               both               monthly               EFT               and               quarterly               bills.
               Golden               Rule               -               basic               coverage               available               in               26               states               
               http://www.goldenrule.com/
               At               least               in               my               state,               Golden               Rule               had               a               plethora               of               options.

They               offered               me               23               different               plans,               all               with               slightly               different               features.

The               most               expensive               was               a               $500               deductible               plan               (that's               very               low!)               with               a               monthly               premium               of               about               $150.

For               this               higher               monthly               payment,               I'd               have               the               security               of               knowing               that               my               benefits               kicked               in               rather               quickly               (less               worry               about               having               lots               of               cash               to               cover               expenses               in               an               emergency).

Leading               up               to               the               end               of               the               spectrum,               with               premiums               half               as               high,               Golden               Rule               offers               plans               with               deductibles               of               $1000,               $1500,               $2000,               $5000,               and               numerous               amounts               in               between.

Once               the               deductible               is               met,               some               plans               cover               office               visits               and               some               don't,               so               be               sure               to               investigate               all               the               details.

But               there's               bound               to               be               a               cheap               health               insurance               plan               through               Golden               Rule               that               is               perfect               for               single               people               in               your               situation,               provided               you               live               in               one               of               their               26               states.

Golden               Rule               is               also               rated               "Excellent"               by               A.M.

Best.
               Aetna               -               basic               coverage               available               14               states               
               http://www.aetna.com
               Although               Aetna's               basic               coverage               plans               are               not               available               in               Wisconsin,               for               the               purposes               of               quotes,               I               pretended               to               be               a               single               person               living               in               other               states.

They               offered               me               a               limited               selection               of               plans               -               usually               just               four               or               five.

The               one               low-deductible               plan               was               comparatively               expensive               at               nearly               $200.

For               someone               seeking               cheap               health               insurance,               that               might               go               over               budget.

There               were               a               few               other               plans               with               more               reasonable               rates,               but               I               noticed               that               coinsurance               was               sometimes               at               30%,               higher               than               most               plans               by               competitors.

Depending               on               your               state               of               residence,               you               may               get               more               variety               in               Aetna's               offerings,               so               it's               worth               trying               in               the               name               of               low               premiums.

And               I               must               note               that               some               cheap               health               insurance               seekers               might               feel               more               comfortable               with               Aetna,               as               it               is               more               of               a               household               name               than               the               other               companies               profiled               here               for               single               people.
               Time               Insurance               -               basic               coverage               available               in               18               states               
               http://www.timeinsurance.com/
               After               searching               in               several               states,               I               found               very               little               flexibility               or               choice               in               Time               Insurance               plans.

Premiums               were               very               high               compared               to               similar               plans               by               other               companies               in               the               same               states.

Time's               A.M.

Best               rating               is               solid               at               A-,               and               they               are               an               Assurant               Health               Company,               meaning               that               they               are               part               of               a               much               larger,               well-known               organization.

But               as               far               as               I               can               detect,               there               is               no               clear               advantage               to               Time               Insurance,               at               least               for               single               people               who               want               basic               coverage               Low               premiums               and               good               benefits               are               available               from               too               many               other               providers.
               Final               Note:               Some               aggregate               sites               like               www.ehealthinsurance.com               provide               quotes               from               multiple               companies               at               once,               so               you               may               want               to               use               such               a               site               to               identify               other               cheap               health               insurance               providers               who               sell               basic               coverage               to               single               people               in               your               area.






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    2013년 11월 28일 목요일

    About 'aetna insurance'|Antique Advertising Mirror - Aetna Insurance







    About 'aetna insurance'|Antique Advertising Mirror - Aetna Insurance








    Insurance.

    It's               a               part               of               modern-day               working               life               for               most               of               us,               and               I               know               we               should               all               feel               fortunate               if               we               have               it.

    But               that               doesn't               mean               it               isn't               frustrating               sometimes.

    The               details               of               your               prescription               benefits               might               be               buried               somewhere               in               the               insurance               packet               your               employer               has               given               you.

    However,               how               it               works               when               you               are               at               the               pharmacy               can               be               mysterious.

    Even               as               a               pharmacist               who               bills               prescription               claims               all               day               long,               I               still               don't               always               understand               all               the               details,               but               I'll               try               to               cover               the               basics               for               you.

    Online               Billing               using               BINs
                   Almost               all               insurance               plans,               including               state               Medicaid               plans,               are               billed               online.

    At               the               pharmacy               we               enter               the               numbers               on               your               card               into               the               computer,               and               the               computer               does               the               rest.

    The               information               on               your               card               is               absolutely               necessary.

    Sometimes               I               look               back               on               the               good               old               days               when               we               only               dealt               with               a               handful               of               plans,               and               they               all               used               Social               Security               Numbers               as               ID               numbers.

    Now               we               deal               with               so               many               different               plans               every               day,               I               don't               think               I               could               list               them               all,               and               few               use               SSNs               anymore.
                   The               magic               number               on               your               card               is               the               BIN.

    BIN               stands               for               Bank               Identification               Number;               a               confusing               term               because               there               are               no               banks               involved               at               this               point               in               the               billing.

    Apparently               the               term               is               a               holdover               from               early               electronic               banking               lingo.

    This               5               digit               number               tells               our               computer               where               to               send               the               claim,               and               if               we               have               trouble               we               can               usually               find               a               help-desk               phone               number               for               that               BIN.
                   Pharmacy               Benefit               Managers
                   The               claim               is               not               transmitted               directly               to               your               insurance               company.

    It               is               sent               off               to               what               is               known               as               a               Pharmacy               Benefit               Manager               (PBM),               a               for-profit               company               that               only               handles               prescription               billing.

    It               may               be               a               separate               branch               of               your               insurance               company,               like               Aetna,               or               it               can               be               a               completely               different               entity               like               Medco               or               Express               Scripts.

    Each               PBM               has               a               different               BIN.

    It               can               get               even               more               confusing               if               your               employer               decides               to               switch               PBMs.

    They               may               have               signed               a               new               contract               with               the               new               PBM               that               has               promised               to               give               the               same               benefits,               but               that               doesn't               mean               everything               is               the               same               for               online               billing               of               the               claim.

    Without               the               new               card               (or               at               least               the               new               BIN               and               ID               numbers),               you               may               have               a               hard               time               at               the               pharmacy.

    Here               in               Washington               State,               state               employees               have               had               PBM               changes               twice               in               the               last               several               years.

    If               you               are               in               a               large               group               like               state               employees               or               a               major               employer               in               your               area,               the               pharmacy               can               probably               figure               it               out               for               you,               but               to               be               safe               you               should               always               have               a               copy               of               your               newest               card               on               you.
                   Formularies,               Prior               Authorizations,               and               other               Restrictions
                   There               are               many               people               who               think               PBMs               are               evil               companies,               denying               your               prescription               claims               just               for               the               fun               of               it.

    The               truth,               in               my               humble               opinion,               is               they               are               only               one               part               of               our               messed-up               for-profit               insurance               system               in               this               country.

    The               PBMs               offer               employers               different               coverage               plans               at               different               prices.

    The               lower               priced               plans               that               many               employers               choose               to               try               to               keep               overhead               down               will               have               higher               co-pays               and               more               restrictions.
                   The               major               restriction               you               should               know               about               is               the               formulary.

    This               is               a               list               of               preferred               medications               that               the               PBMs               don't               make               readily               available               to               pharmacies               or               doctors,               or               if               they               do,               it               is               incredibly               complicated               because               different               plans               offered               by               that               PBM               have               different               formularies.

    My               advice               to               you               is               to               get               a               copy               of               your               plan's               formulary               for               yourself.

    It               may               be               available               on               PBMs               website               for               patients               to               download,               or               you               should               be               able               to               call               customer               service               and               have               a               copy               mailed               to               you.
                   This               will               hopefully               save               you               from               the               dreaded               Prior               Authorization               (PA)               situation.

    Many               expensive               medications               will               not               be               on               the               formulary,               and               the               PBM               will               only               cover               them               after               getting               more               information               from               the               prescriber.

    If               the               prescriber               gives               them               the               answers               they               want               about               your               diagnosis               and               other,               cheaper               medications               you               may               have               tried,               then               a               PA               will               be               given.

    I               might               agree               that               this               is               a               reasonable               cost-saving               measure,               except               that               it               usually               takes               anywhere               from               a               few               days               to               a               few               weeks               to               get               a               reply               to               a               PA               request.

    When               one               plan               wanted               to               get               PAs               on               an               expensive               antibiotic               (as               if               the               patient               could               wait               several               days               to               start               it!),               I               was               thoroughly               disgusted               with               them.
                   All               plans               will               have               a               maximum               quantity               per               fill.

    This               is               usually               30               to               34               days               at               a               retail               pharmacy.

    More               and               more               PBMs               are               offering               the               option               of               a               larger               supply               if               go               with               their               mail-order               pharmacy.

    Or               you               may               only               be               able               to               fill               only               a               few               times               at               your               neighborhood               pharmacy               and               then               be               forced               into               mail-order.

    There               can               also               be               limits               on               the               quantities               of               certain               medications               that               are               lower               than               your               usual               maximum               quantity.

    This               usually               applies               to               "as               needed"               medications               like               those               for               sleep,               migraines,               and               erectile               dysfunction.
                   With               state-run               programs               there               is               usually               a               middle               man               who               handles               billing,               but               doesn't               call               the               shots               as               much               as               the               PBMs.

    There               are               still               restrictions               and               medications               that               require               PAs,               but               these               are               determined               by               the               state,               not               the               company               processing               the               claim.
                   What               to               do               if               you               are               unhappy               with               your               coverage
                   The               whole               medical               insurance               system               needs               a               major               overhaul               if               you               ask               me.

    Contact               your               congressperson               if               you               want               to               see               healthcare               reform.

    In               the               meantime,               you               will               have               to               work               within               the               system.
                   Let               your               employer               know               if               you               don't               like               your               coverage.

    You               and               your               co-workers               might               be               able               to               negotiate               with               your               employer               for               a               better               pharmacy               benefit               package               the               next               time               around.

    Also,               remember               your               employer               may               have               signed               the               contract,               but               you               are               paying               the               premium               (benefits               are               part               of               your               compensation               for               working               hard).

    The               insurance               company               works               for               you;               not               the               other               way               around,               so               don't               hesitate               to               call               the               customer               service               phone               number               on               your               card               if               you               have               any               questions.

    If               you               do               run               into               a               situation               where               the               plan               is               giving               you               a               hard               time               over               a               PA,               don't               give               up.

    Have               the               pharmacy               call,               have               your               doctor               call,               and               call               yourself               until               you               get               a               satisfactory               response               from               the               PBM.Always               have               your               current               prescription               insurance               card               on               you.Have               your               doctor               check               your               plan's               formulary.Don't               forget               the               insurance               company               works               for               you;               not               the               other               way               around.






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