Tag Archives: Affordable Care Act

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Is Your Health Insurance Cancelled?

Unfortunately, the future of health insurance is very uncertain right now.

Did you know that a group of 13 male, Republican Senators is currently working on a draft bill of the repeal/replace Obamacare behind closed doors?

The group of Senators claimed they are close to having a proposal to take to the floor.

The bill has been drafted behind closed doors, with many senators unaware of any details. Some Democrat Senators have expressed outrage at the closed-door approach to the drafting.

Sen. Lindsey Graham, R – S.C. stated that the bill is being drafted from a one-party perspective because no Democrat is willing to help with the draft. He said that although this is not the ideal approach, it’s the only way they are able to draft the bill.

In 2017, approximately 12.2 million people were enrolled or automatically re-enrolled in a Affordable Care Act Marketplace plan (“Obamacare Exchange.”)

The changes to the healthcare bill will affect millions of people, yet we know very little about the potential changes.

The Senate Committee has stated that they will submit the draft bill to the Congressional Budget Office prior to releasing to the public, for nonpartisan analysis of things such as the cost, and how many people will gain or lose coverage, if enacted.

Once the bill is drafted, there are still many uncertainties.

Many experts have stated that the chances of it passing is very unlikely. No Democrats are expected to vote to repeal Obamacare. Republicans can’t lose more than two votes to pass the bill, and several Republicans have already expressed concerns.

What are your thoughts on the replacement bill for the Affordable Care Act? Would you like there to be more transparency?

Get involved by contacting your representatives to let them know your opinions!

To learn more about health and women’s health check out the Women’s Mind Body Wellness Summit. It contains 6 interviews by top female health professionals plus two workout videos and 3 bonus videos on mind-body wellness with MyHealthSpin Founder Lori-Ann Rickard.

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Jimmy Kimmel’s Healthcare Scare: What You Should Know

As you may know, on May 1, 2017, Jimmy Kimmel spoke about the birth of his baby boy, Billy.

If you haven’t seen the clip, click here to watch.

Unfortunately, several hours after the birth of his baby, Jimmy and his wife Molly learned that Billy had a heart defect and needed surgery to save his life.

Jimmy thanked Cedars-Sinai Hospital and Children’s Hospital Los Angeles for providing Billy with amazing care. Because of the attentive staff and great care, his newborn son is home and doing well.

Jimmy’s message was extremely important and shows how far we have come in healthcare, and how far we have to go.

Friends, family, and readers have asked me some questions about what Jimmy had to say. Here’s my take:

Jimmy spoke about “pre-existing conditions.”

Question: What are pre-existing conditions and how do they affect healthcare coverage?

Answer: Pre-existing conditions are health problems that occur prior to the date new health coverage starts.

Jimmy is correct that prior to the passage of the Affordable Care Act (“ACA”), pre-existing conditions, such as birth defects, could prevent someone like baby Billy from getting coverage. They also enabled insurance companies to charge individuals more. The ACA now prevents health insurance companies from refusing coverage or charging more for pre-existing conditions.

Question: What is the National Institutes of Health (“NIH”)?

Answer: NIH is part of the U.S. Department of Health and Human Services and is the nation’s medical research agency. Jimmy is correct that, despite initial plans to cut the budget for NIH, Congress increased its funding by $2 billion.

As a mother of two and a parent of a daughter born with a serious disease, I was touched by Jimmy’s message. It’s important to stay in the know about healthcare and healthcare policies, in case you or a loved one is impacted.

Congratulations to Jimmy Kimmel and his family on their baby boy!

To learn more about health care for your family, check out the Women’s Mind Body Wellness Summit. It contains 6 interviews by top female health professionals plus two workout videos and 3 bonus videos on mind-body wellness with MyHealthSpin founder Lori-Ann Rickard.

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Healthcare Benefits for Mental Health Services

psychiatrist examining a male patientIn terms of well-being, mental health is just as important as physical health. However, it has not always seemed that way in the eyes of the insurance companies. Previously, little emphasis was placed on the importance of mental health as a component of overall well-being. And a lot of insurance plans simply did not provide care for those with mental health issues.

Now, with the Affordable Care Act (ACA), mental health benefits have become more widely available to those in need. When the ACA was signed in to law in 2010 there were strict guidelines as to what each plan must cover. All plans were to include benefits such as maternity care, preventative services, and mental health care.

In terms of mental health benefits, all plans must cover three things: behavioral health treatment, such as psychotherapy and counseling, mental and behavioral health inpatient services, and abuse treatment. Also, you will not be penalized for a preexisting condition, such as depression. And thanks to the ACA, a majority of plans cover preventative mental health services, such as behavioral assessments and depression screenings.

This is all great news, but some people do not even know that their health insurance plans provide mental health care. Therefore, I have put together a list of things you should know about your coverage.

First, mental health issues must be covered equal than or greater than the coverage provided for medical or surgical treatments. This means that all copays must be equal across the board. Your charge for a visit with your psychiatrist is the same as an appointment with your orthopedic surgeon.

Also, there is no annual maximum in terms of treatment visits. Insurance companies are prohibited from putting a financial cap on treatments. However, they can limit the number of visits based off of medical necessity. Once you see a psychiatrist they set up a treatment plan, at the end of that treatment plan there is a reevaluation. If they feel your care still is medically necessary, your insurance is required to continue to pay for your treatment.

Second, all mental health diagnoses are covered under the federal parity law, whether it is a disease, such as schizophrenia, or a substance abuse problem. However, specific health plans are allowed to exclude certain diagnoses in any area of mental or physical health.

Third, it is important to remember that not all doctors take your insurance, even if you have mental health coverage. A lot of mental health providers are “not in network” with many insurance companies because their reimbursement rates are so low. Therefore, it is important to check if a provider is within your network before scheduling your first appointment

It is extremely important to know and to understand what your insurance company covers. Also, before you schedule your appointment you should call and find out what your deductible is, what your copay is and any other pertinent information. This will help you to save money and to save time.

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