Category Archives: CoveredCA

Obesity Now Classified As a Disease

“The American Medical Association’s announcement last June that is was changing the designation of obesity from a disorder to a disease. This has and will continue have an effect on employers and insurance companies. The use and cost of weight loss drugs will continue to rise. in order for employers to minimize the increased risk, they will need to create wellness programs that focus on weight and healthy living.

Prescription Drugs

Businesses can establishing a corporate wellness program as an alternative to their employee’s relying on doctor-prescribed medication to deal with this newly classified disease.  In the U.S. physician-dispensed drugs have become a common occurrence in the medical care of injured workers and obesity.

Year-after-year the costs of prescription drugs in workers’ compensation are either on the rise, or are being battled tooth-and-nail by state governments and workers’ compensation stakeholders, adding to growing frustration and costs. 

Obesity

Despite AMA’s recent disease proclamation, obesity already had a sort of disease status in the eyes of many, including other large organizations, as well as branches of the government.

According to the Centers for Disease Control and Prevention, the health consequences of obesity include:

  • Coronary heart disease
  • Type 2 diabetes
  • Cancers (endometrial, breast, and colon)
  • Hypertension
  • Dyslipidemia
  • Gynecological problems (abnormal menses, infertility)

From a business perspective, obesity impacts not only the healthcare system, but health insurance, businesses and the economy as a whole.

The insurance industry, like most other systems and industries, will have to grapple with how to deal with the increasing costs in the best way it can. That could mean seeking rate hikes, reducing other services, or reducing risks.

No matter what the outcome of the decisons made based on the transition of the new classifications made we will always keep your well-being at the frontmost part of decision making.

http://www.mertensinsurance.com

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Do you have COBRA?

Covered California Creates Limited Special-Enrollment Period for Those Covered by COBRA

COBRA Enrollees Have 60 Days to Switch to an Exchange Plan; Move Is Expected to Save California Consumers Money on Health Insurance

SACRAMENTO, Calif. — Beginning Thursday, May 15, Covered California will launch a limited-time special-enrollment period for people who have COBRA health insurance and would like to switch to an exchange plan.

People who have health coverage through COBRA (the Consolidated Omnibus Budget Reconciliation Act) will be eligible to shop for and buy coverage through Covered California from May 15 through July 15, 2014. The two-month window mirrors a U.S. Department of Health and Human Services (HHS) ruling announced May 2 that allows COBRA enrollees to buy plans through the federal exchange until July 1st.

Covered California™ and the California Department of Health Care Services (DHCS) announced today that from Oct. 1, 2013, to March 31, 2014*, under the Patient Protection and Affordable Care Act, 122,971 consumers in two Inland Empire counties enrolled in subsidized and non-subsidized Covered California health insurance plans. The new total represents a 70 percent increase from the 72,340 enrollments recorded through Jan. 31.

A strong turnout in the closing weeks of open enrollment in Sacramento counties helped push county enrollment in Covered California health insurance plans to 400,889 consumers. The results announced today by Covered California™ and the California Department of Health Care Services (DHCS) represent a 66 percent increase during March* over the 241,312 enrollments that had been recorded .The new total represents a 59 percent increase from the 76,875 enrollments recorded through Feb. 28.

Health Care Where You Live

A recent study by the Commonwealth Fund found that where you live within the United affordable health insurance

States actually plays a bigger role in your overall health care than your income.  High-income people who live in states with poor healthcare are worse off than low-income people in states with good healthcare.

To determine each state’s health score, investigators looked at factors ranging from how many people in a state had health insurance and whether they had enough coverage, as well as how many people used the emergency room for care rather than a doctor’s office and how well a state’s health care system protected its citizens from dangerous medications.

The reason for the income-location discrepancy has to do with access and affordability, prevention and treatment, avoidable hospital use and living healthy lives.  In areas where there is less access to healthcare, it doesn’t matter what your income is; there is still less access.  With less access, prevention and treatment rates go down and avoidable hospital use goes up.

The good news is that California scored relatively high on the health score spectrum compared with other states.  Generally, northern and western states performed well, while states in the south, southeast and southwest maintained health care access “similar to developing countries in Southeast Asia.”  Across the board, scoring high in one factor did not seem to affect the scores in other factors.  For example, Colorado performed in the top quartile for avoiding the hospital and healthy lives, but in the lowest 25% for access and affordability.

Poor scores on any of the scoring factors can be a real danger to the people.  Many people are going without screenings and vaccinations, and in eight states, at least 40% of Medicare beneficiaries were prescribed medications considered dangerous for seniors.  “We see potential for real gains if we aim high,” said Cathy Schoen, senior vice president of The Commonwealth Fund. “This is putting everyone at risk, not just the low-income population.”

The best thing you can do, regardless of your income or location, is to make your healthcare a priority.  Living a healthy lifestyle and getting proper preventative care is critical to your long term health, and preventative care at a doctor’s office is far less expensive than costly hospital visits.  Educating yourself about your options and the appropriate time to visit a doctor can go a long way in ensuring that you and your family get the best health care possible.


For more information about health care, feel free to contact us at Mertens Insurance or 1-888-503-7180. You can also come into one of our three locations in Lincoln, CA, Grass Valley, CA or Yuma, AZ. Follow us on Google+!

Covered California Gearing Towards Meeting Goals

According to the latest information, approximately 728k have signed up through Covered health insuranceCalifornia so far. This is more than halfway toward meeting the original projection of 1.3 million for individual policies by the March 31st enrollment deadline, per federal data released last Wednesday.  Six weeks remain until the end of enrollment, and exchange director Peter Lee said last Monday that he expects March to be a very busy time as people try to enroll before the deadline.

Continue reading Covered California Gearing Towards Meeting Goals

Quality Insurance Ratings Discussed by Covered California

Health Exchange in California

Covered California is the board that oversees health exchange in California.  They are meeting for the first time since enrollment began to consider changes in the implementation of the Affordable Care Act.  Figures that were released by the board said there were more than 125,000 applications that they received, but the number of completed enrollments is thought to be somewhere around 16,000.  There is not reliable data available on all health plans, which is why Covered California executives say they have to prolong providing the public with ratings until October 2015.

covered ca Continue reading Quality Insurance Ratings Discussed by Covered California

Healthcare Where You Live

A recent study by the Commonwealth Fund found that where you live within the United affordable health insuranceStates actually plays a bigger role in your overall health care than your income.  High-income people who live in states with poor healthcare are worse off than low-income people in states with good healthcare.

To determine each state’s health score, investigators looked at factors ranging from how many people in a state had health insurance and whether they had enough coverage, as well as how many people used the emergency room for care rather than a doctor’s office and how well a state’s health care system protected its citizens from dangerous medications.

Continue reading Healthcare Where You Live

ObamaCare in California: What you need to know about Covered California

You’ve probably been hearing more buzz than usual about ObamaCare these past few weeks.  On October 1, 2013, California’s health care exchange, called “Covered California,” will open for business.  ObamaCare’s individual mandate will take effect on January 1, 2014, but people can only buy coverage in California between October 2013 and March 2014.  Miss that window and you’ll be out of luck until it reopens in 2015.health insurance

With the time ticking, many people are rushing to learn more about what is available, how much it will cost, and how to get coverage.  The health care exchanges vary from state to state, and in California, we will be dealing with Covered California.  There are currently 12 different companies authorized to provide benefits under Covered California for 2014.  They are: Alameda Alliance for Health, Anthem Blue Cross of California, Blue Shield of California, Chinese Community Health Plan, Contra Costa Health Plan, Health Net, Kaiser Permanente, L.A. Care Health Plan, Molina Healthcare, Sharp Health Plan, Valley Health Plan and Western Health Advantage.  Continue reading ObamaCare in California: What you need to know about Covered California