Category: Living Written by Real Times Media
1. Is my doctor or hospital in the plan?
For many consumers, this is one of the most important considerations, although it is not always easy to find out. It’s especially important to check for those shopping for coverage in the new marketplaces because some insurers have created smaller networks of doctors and hospitals to keep premiums lower.
A first glance at the websites may not tell consumers the breadth of a particular plan’s network of doctors and hospitals. But most of the sites will include links to insurers’ provider directories. Massachusetts’ website, for instance, describes insurers as either having a broad network or a more limited one. And in Nevada, the website allows shoppers to type in a doctor’s name to find all the plans in which that physician participates, says Robert Krughoff, president of Consumers’ Checkbook, a nonprofit organization that rates health care providers.
Because provider directories have not always been up to date or accurate, advocates suggest that shoppers double-check by calling their providers to make sure they are participating in that particular plan. “If you are making a choice based on that, then you should certainly check” with your provider, Krughoff stressed.
2. What drugs will the plan cover and how much might I pay for them?
Unlike the Medicare prescription drug program website, consumers shopping for health insurance through the new markets generally cannot enter the drugs they take to find out which plans cover them. But the websites are expected to include links to insurers’ sites, where that information should be available.
In addition, the health law requires insurers to provide consumers with a “summary of benefits and coverage” which includes detailed information about the policy’s annual deductible as well as how much it charges consumers for doctor visits, hospital care and prescription drugs, including co-payments for generic, brand-name and specialty drugs. The health law limits overall out-of-pocket costs to no more than $6,350 for an individual, or $12,700 for a family per year. Those benefit summaries will be available when people are “shopping for coverage, enrolling in coverage, at each new plan year, and within seven business days of requesting a copy from their health insurance issuer or group health plan,” according to the Obama administration. That information is important because policies may vary widely in how much consumers are on the hook for similar services, such as hospitalization, emergency room use, maternity care or drug costs, said policy analyst Lynn Quincy at Consumers Union, publisher of Consumer Reports. The open enrollment period under the health law extends until the end of March, although consumers who want coverage to begin Jan. 1, 2014 need to enroll and pay no later than mid-December.
3. How do the insurers compare on quality and customer satisfaction?
In most states, consumers will see little or no data on quality or satisfaction this fall. That’s partly because the federal health law does not require the marketplaces to post quality information about participating plans for two years. But it’s also because the policies are all new, so regulators don’t have a track record to measure. Still, a few states will include some measures of quality for this enrollment year. Massachusetts notes how many “stars” each plan gets from the National Committee for Quality Assurance (NCQA), a rating agency. States that choose to include quality ratings on their websites this fall will rely on overall data about an insurance carrier, such as what percentage of its policyholders get recommended cancer screenings, rather than narrower data from a specific type of policy the insurer offers.
Consumers looking for more information about specific insurers can check Consumer Reports, which links to data from the NCQA. They can also look at U.S. News & World Report, which has developed its own ranking of health plans
- ^some insurers have created smaller networks of doctors and hospitals to keep premiums (www.kaiserhealthnews.org)
- ^Those benefit summaries will be available (www.cms.gov)
- ^the federal health law does not require the marketplaces to post quality information (www.kaiserhealthnews.org)
- ^Consumer Reports (www.consumerreports.org)
- ^its own ranking of health plans (health.usnews.com)
Last Updated on Sunday, 01 December 2013 21:47
This Thanksgiving, Have a Family Health History Discussion Michigan Residents Encouraged to Discuss Cancer Risks Within Families
Category: Living Written by AJ Williams, Chronicle Web Editor
LANSING – Each year, Thanksgiving marks Family Health History Day when families are encouraged to discuss their health history with one another. Learning about your families’ health history is important for certain cancer screenings, such as colorectal cancer. Screening helps detect issues before there are symptoms and can save lives, but only if people know their risks and get tested.
Colorectal cancer is the second leading cancer killer among men and women, but only one out of three adults who should have a screening test for colorectal cancer is getting tested. Though colorectal cancer screening rates in Michigan are higher than the national average, there is still much work to be done to reduce preventable deaths. As with many cancers, the earlier colorectal cancer is detected, the better the outcomes. About 90 percent of people live five or more years when their colorectal cancer is found early through screening. Additionally, some screening tests can find and remove growths called polyps before they become cancer.
Experts recommend colorectal cancer screening for adults between 50 and 75 years of age and earlier for people with a family history of colorectal cancer or polyps. Families should talk about their family history of colorectal cancer, in addition to other cancers, and share the information with their physician. Michigan physicians can help residents make a decision about what colorectal cancer screening test is best for them.
There are several different ways to do colorectal cancer testing and it is important to talk with your doctor about the test that is best for you. Studies show that people who are able to pick the test they prefer are more likely to actually complete the test. In addition, many insurance plans provide coverage for colorectal cancer screenings.
The U.S. Preventive Services Task Force (USPSTF) recommends any of three colorectal cancer screening tests, including colonoscopy, stool tests, and sigmoidoscopy. Increasing the use of recommended colorectal cancer tests can save more lives and is cost-effective. The three tests vary in cost and frequency of testing, providing options for personal preference. Typically, the stool test should be done annually, whereas sigmoidoscopy should be done every five years along with a stool test and a colonoscopy should be done once every 10 years.
The best thing that residents can do is to speak with their family members about their risks and then talk with their doctor about screening options. For more information, visit www.michigan.gov/cancer or the Centers for Disease Control and Prevention’s colorectal cancer screening website at www.cdc.gov/cancer/colorectal/basic_info/screening/index.htm.
Last Updated on Tuesday, 26 November 2013 13:52
Category: Living Written by Roz Edward, National Content Director
(Photo by Getty)
There's only one woman in this world who can upstage an entire week — an entire Fashion Week — of gorgeous gowns, and that lady, our friends, would be Beyonce.
The singer shined in a heavily-embellished, sheer-paneled Elie Saab gown last night — thanks in part to her killer curves, fearless choice of bright pink lips, and, oh yeah, all those beads — at the premiere for her upcoming HBO documentary, Life is But a Dream.
Take a look at the gown (and Bey!) in all their glistening glory.
It's safe to say Queen B completely blew her black-and-white Grammys look away — just like our minds after that Destiny's Child Super Bowl reunion! (Yes, we're still thinking about it.)
Last Updated on Thursday, 14 February 2013 07:33
Category: Living Written by Cornelius Fortune
Myspace recently announced a new brand website and a suite of products that together redefine the company as a social entertainment destination for Gen Y . Myspace is creating a rich, highly-personalized experience for people to discover content and connect with other fans who share similar interests. The entertainment experience will span music, celebrities, movies, television and games and will be available through multiple platforms, including online, mobile devices and offline events.
Last Updated on Wednesday, 17 August 2011 13:07
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