| Workshop Minutes: Insurance Discussion |
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Minutes Started Mon Jun 25 2007 22:58:36 GMT+0000 (UTC)
matt: click on an open sguare to have a seat
TwistedStitches: Thanks mom!
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TwistedStitches: lol
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anda: Welcome, everyone!
TwistedStitches: Hi everyone!
TwistedStitches: Thanks for coming to our workshop
matt: hi
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Vanessa: hello!
Messaging enabled.
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TwistedStitches: As soon as everyone is in and seated we can get things rolling
TwistedStitches: Absolutely!
Vanessa: Hi mickey!
meetyourmaker: whats good, yall
matt: sup
TwistedStitches: Gosh it seems so long since I have seen all the avatars gathered around like this
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anda: move me
anda: hahaha
anda: thanks
matt: np
reconstructionist: dance, rummies!
TwistedStitches: I suddenly feel dizzy
anda: i'm going to remindthe forums and chat rooms that this is happening real fast
anda: brb
TwistedStitches: Thanks Anda
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pitterpattern: Hello!
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TwistedStitches: Bare with the cave women Lunadesigns as she attempts to work a computer Ha!
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TwistedStitches: just kidding mom!
reconstructionist: heh cave women
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LucysPostcardQuilts: Hello!
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sojourncuriosities: I am here!
TwistedStitches: Hey Lucy
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LucysPostcardQuilts: Hi TS. :)
LaneesCrochet: Hello!
TwistedStitches: How goes it
LucysPostcardQuilts: Good Good. :)
sojourncuriosities: is the theory that once all the seats are full it begins?
LucysPostcardQuilts: Loving this fancy format. :)
orbitpie: Hello!
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LaneesCrochet: looks kinda odd, lol
matt: ssa can you move me top the left
sojourncuriosities: TS i think i'm supposed to contact you but now i can't remember why
matt: vanessa
Vanessa: I don't think we need to wait for all the seats to be full to start
sojourncuriosities: i think saltrivergallery sent me
matt: that is
LunaDesigns: Hi Arizonadreams. Are you from Tucson by chance?
TwistedStitches: Really? hmmmm, I cannot remember
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jamric: Hello!
matt: thanks
arizonadreams: Phoenix
Vanessa: hahah
anda: don't thorw bombs
LucysPostcardQuilts: oops
LunaDesigns: Oh - well welcome
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matt: should we get started?
LucysPostcardQuilts: i pushed a button, sorry
LucysPostcardQuilts: i didnt know what it would do.
TwistedStitches: My unlce Tony owns the Teepee restaurant there
Vanessa: yes let's take a poll to see who is uninsured
anda: I'm going to turn off gifts
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anda: to avoid food fights
Do you have Health Insurance
TwistedStitches: I think we can start soon if you want matt
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14 yay, 12 nay, 4 abstain
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TwistedStitches: Well if everyone is ready, we can start if you'd like admin.
Vanessa: Let's get started!
anda: Yeah!
Vanessa: Thanks so much to everyone for coming
curbsidetreasure: Hello!
TwistedStitches: I am going to turn chat off right now so we can begin
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Vanessa: ok
LunaDesigns: Hello everyone. I am Carmen (lunadesigns) with Pam (Twisted Stitches)
LunaDesigns: Thank you for joining us and if everyone could take a seat, that would be great.
Vanessa: everyone, you will get a prompt that will explain to you how to ask questions
Vanessa: if you try to type
anda: (just type /ask before your question and it will go into the queue)
Vanessa: the questions will go into a queue for Luna and Twisted to see
TwistedStitches: Thank you vanessa and Anda for reminding us of that
Vanessa: and answer
LunaDesigns: This workshop is on a subject of great importance and frustration to all of us.
LunaDesigns: Tonight we are going to give you some basic insurance education on what plans are avail and differences.
LunaDesigns: I also have some specific websites you can go to later and check out prescription assistance.
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LunaDesigns: I will keep talking and then take your general questions at the end.
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LunaDesigns: Understand, due to the Privacy Act, I can't answer specific personal questions.
LunaDesigns: I will do that if you email them to me at luna_c@bellsouth.net
LunaDesigns: So let's get started.
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LunaDesigns: First let's talk HMOs. These plans offer full coverages with yearly deductibles ranging from $250-$5000.
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LunaDesigns: We pay co-insurance $0-20% with max out of pocket expenses -usually $2000 for indiv. $4000-family
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Vanessa: that's per year $2000-4?
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LunaDesigns: We pay co-pays of $15-$25 for doctor visits. Yes per year
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LunaDesigns: ER co-pays are usually $150 waived if you are admitted to hospital.
LunaDesigns: The companies pay 100% after your co-pays. Hospitalizations require deductible and co-insurance from you.
LunaDesigns: We must use network of providers. This is the most commonly used plan but not the best. HMOs have come under fire for denying claims.
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LunaDesigns: Doctors feel they place too many restrictions on healthcare.
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TwistedStitches: If anyone has questions about HMO's we will ike to go ahead and take some now
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intothefire asks, so the co-insurance is for procedure or dr's visits or both?
LunaDesigns: Both
intothefire asks, how are out-patient procedures treated?
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LunaDesigns: Outpatient is usually $100-$150 co-pay.
avion asks, if you have a 4000 per year deductible what is the point of insurance?
LunaDesigns: That is not a deductible. It is the maximum out of pocket expense you will incur in one year.
Vanessa: Can you get acces to an HMO plan as an individual?
meredithdillman: if you like to gamble
reiynscape: max allowed then?
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LunaDesigns: As an individual you can get an HMO.
meredithdillman: was that for a family? what about how much for a single person?
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LunaDesigns: Maximum out of pocket means that is the most you will spend. The company will pay the rest. Most of us, unless hospitalized for major problem, will not meet that max.
LunaDesigns: An individual is usually $2000 a year
meredithdillman: eek
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LunaDesigns: Again, remember - most of us are not hospitalized every year.
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LunaDesigns: The deductible goes into effect for in hospital. The rest of the time we pay co-pays.
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TwistedStitches: Now on to PPO's. We will take more questions at the end if you missed anything
Vanessa: Where do you go to get a list of HMOs that will accept individuals?
LunaDesigns: All HMOS accept individuals.
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LunaDesigns: Back to PPOs. Work like HMOs except you can go out of network for 70% coverage
LunaDesigns: They give us choices of what providers we want to use.
LunaDesigns: Personally, I prefer choices.
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TwistedStitches: I am going to open the floor for questions. Please type /ask then your question it will go into my queue
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spindlecatstudio asks, what does hmo and ppo stand for?
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LunaDesigns: HMO-Health Maintenance Organization PPO- Preferred Provider Organizations.
matt asks, what is the typical monthly cost for an individual seeking a PPO or HMO?
LunaDesigns: Can't tell you - rates depend on ages and medical conditions. Email me with your particulars and I will give you rates.
LunaDesigns: luna_c@bellsouth.net
matt: say for a healthy 230 year old
matt: who is self employed
TwistedStitches: LOL!
matt: whoops
matt: I mean 30
thechocolatelab: ha
LunaDesigns: Well if you have made it that far - you don't need health insurance.
LaneesCrochet: ha!
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intothefire: I've got quotes now for $80 - $150
matt: that seems very low
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intothefire: Not including maternity coverage
matt: the lowest I had in NYC was about 300 or 400
Vanessa: do rates vary state to state?
LunaDesigns: That sounds good. Yes rates vary state to state as do the coverages.
Zahour asks, are you sure all HMO's accept individuals? I had an issue with Oxford only accepting companies and not individuals for insurance plans.
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deuxoiseaux: if i move to another state, do i have to start over with pre-existing conditions if i stay with the same company? like, say, blue cross/blue shield?
LunaDesigns: Ok - group insurance companies will not offer individual but all individual insuring companies will take you pending medical eligibilty.
LunaDesigns: If you move out of state - some companies will require you to change to that state plan and rates will be different and , yes, pre-x will start again.
matt: if they type /ask
matt: whoops
LunaDesigns: Blue Cross has plans in every state but they are not the same company. You have to apply in each state.
spindlecatstudio asks, what would be a sample procedure for applying for insurance? Do you get interviewed? Need references??
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LunaDesigns: No references. Application and medical underwriting. You can go direct to the company or use an agent.
thechocolatelab asks, how extensive are the medical questions for health insurance? It's not like life insurance where there's a Guaranteed Issue is it?
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intothefire: is pre-existing only for diagnosed issues?
LunaDesigns: For regular medical underwriting, very extensive and restrictive. Guaranteed issue does not use medical underwriting.
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TwistedStitches: Please type /ask and then your question so it goes into our queue. Other wise it may get missed
LunaDesigns: You just need to qualify by having had 18 mo. continuous coverage.
LunaDesigns: Or coming off Cobra or group insurance and not eligible for any other plan.
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LunaDesigns: Pre-x means any condition you were treated for in the last twelve months.
LunaDesigns: Some policies have a 12 month waiting period on pre-x.
hobbledehoy asks, do they need to know your family's medical history?
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LunaDesigns: Yes.
Zahour asks, so if we dropped our insurance last year and cancelled cobra a year ago to, we cannot qualify... so how do we get insured?
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LunaDesigns: You must have had coverage in the last 63 days. If not - we need to talk. Email me.
TwistedStitches: We are going to move on to major medicals now. I will open floor for questions after she get through
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LunaDesigns: Major medicals cover major expenses. We are expected to cover the small stuff. Usually deductibles are high (up to $10,000). They pay 80%. So if you have $10,000 burning a hole in your pocket. This one's for you
LunaDesigns: Not the best choice for most of us, you'll agree.
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TwistedStitches: We will take questions now
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thechocolatelab asks, By Major Medical, do you mean Catastrophic type policies?
LunaDesigns: Yes.
matt: st of my friends have it, because it is the most affordable
matt: is there another option
matt: that is better
matt: but not as costly as an hmo
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LunaDesigns: Catastrophic means some major event that costs a lot. Yes they are cheaper. The less risk the company takes, the cheaper the premiums. But there are better options. Email me.
thechocolatelab asks, And aren't those deductibles (10,000) not out of pocket deductibles, but deductibles that are paid out by your regular insurance first??
LunaDesigns: Yes. those high deductibles do get paid first.
thechocolatelab: ahhh ok.
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TwistedStitches: Moving on to group plans now.
LunaDesigns: Those of us who work for an employer can get covered under a group plan for low premiums. However, when you leave your job, you also leave your insurance.
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LunaDesigns: While the employee pays cheap premiums, dependant coverages are usuallly really high. When you leave your job, if your employer has 20+ full time
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LunaDesigns: employees, theymust offer you COBRA coverages
Vanessa: how long does cobra last?
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LunaDesigns: This keeps the same plan you had with the group, with slightly higher premiums, usually 2-5% more. It lasts for 18 mo. and then you have to find individual plan
LunaDesigns: or find another employer.
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LunaDesigns: One good thing - if you are uninsurable - you now qualify for guaranteed issue with a small number of companies.
LunaDesigns: You exericise your HIPPA provision which not all policies have.
Vanessa: I've heard about the Freelancer's Union offering group plans. Are there other organizations like this?
LunaDesigns: HIPPA provision means - you had 18 mo, continuous coverage, were on a group plan, aren't on Medicare or Medicaid.
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LunaDesigns: There are some. They used to be called Associations. Co-ops. But they have been done away with.
TwistedStitches: COBRA stands for the Consolidated Omnibus Budget Reconstruction Act
TwistedStitches: We will take questions now
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Vanessa: why were the coops done away with?
LunaDesigns: FYI - Female 55 - diabetic, high BP, cholesterol - guaranteed issue plan with premium of $685 mo.
LunaDesigns: Co-ops were considered not employer related and not really legal.
spindlecatstudio asks, what happens if a self-employed spouse, covered under a partner's insurance, gets divorced? What are insurance options for the self-employed ex?
thechocolatelab: so expensive.
LunaDesigns: You will have to get your own policy. Children can remain on the parent's policy till age 19 unless still student then until age 25.
LunaDesigns: My premium is very high. But my choice is pay 685 or thousands if I don't have coverage. I'll pay the 685.
spindlecatstudio asks, No COBRA for the ex?
LunaDesigns: That depends on your negotiations. Usually, upon the employee's death, his dependents can continue COBRA for 36 months. But divorce is different. Check with your attorney.
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TwistedStitches: We are moving ont to insurance for seniors.
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LunaDesigns: Seniors 65+ have Medicare Advantage plans available to them with premiums ranging from $0 - 175 roughly. The 0 premium plans are HMOs the other PPOs. Part D of Medicare now provides RX coverages.
LunaDesigns: Lately, these plans have been under fire because they haven't been sold properly.
LunaDesigns: Agents must explain them thoroughly including exclusions. That hasn't been happening.
LunaDesigns: And many senior s are now stuck in plans they can't afford with prescriptions costs they can't meet until next Nov.
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TwistedStitches: Open for questions
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LunaDesigns: This is not to say that no Medicare Advantage plans are good. You just have to know what you are buying.
Vanessa: poll/ are any of you seniors or live with seniors?
thechocolatelab: That's the same for any insurance.
are any of you seniors or live with seniors?
LunaDesigns: These plans are also available to people under 65 on disability. And yes the same rule applys to any insurance you buy. KNOW WHAT YOU ARE GETTING.
spindlecatstudio asks, Are there any common mistakes to avoid?
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LunaDesigns: When buying any insurance, know what you need, make sure what you're buying gives you that
LunaDesigns: And ask lots of questions. Don't just sign away.
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Vanessa: yes are there scams to watch out for?
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LunaDesigns: Yes. lots of scams out there. Make sure the company providing the coverage actually exists and is licensed in your state.
spindlecatstudio asks, Is there a checklist or questionaire somewhere that can help an individual or family determine what they need?
LunaDesigns: Your department of insurance can verify that for you.
intothefire: ask/ should you stick with a major company?
LunaDesigns: Yes I have questionaires I can send you. email me.
LunaDesigns: luna_c@bellsouth.net
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spindlecatstudio: thank you.
LunaDesigns: Major companies are best but there are many good small companies out there. Just check with your department of insurance. They all list the companies licensed in their states.
LunaDesigns: And they don't give those licenses out to everyone.
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TwistedStitches: Moving on to HSA now
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LunaDesigns: HSAs are health savings accounts. With HSAs you can still receive the same great care as with traditional plans.
LunaDesigns: While building equity through tax-advantaged savings account. You must ahve a high deductible health plan.
LunaDesigns: Deductibles range from $1100+
LunaDesigns: You save part of the money that would have gone to insurance premiums.
LunaDesigns: You or your employer paylower premiums on a high ded plan
LunaDesigns: You pay providers directly from your account. When you have met your ded, the company pays the rest.
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LunaDesigns: And what you don't spend by the end of the year, you keep.
LunaDesigns: HSAs don't work for everyone.
Messaging enabled.
TwistedStitches: Open for questions
spindlecatstudio asks, If you get insurance with a company licensed in your state, what happens if your doctor is out of state?
takeiteasy: Hello!
LunaDesigns: If you have an HMO, you only have emergency coverage out of state.
LunaDesigns: With a PPO, you will have at least 70% coverage.
intothefire asks, why don't HSAs work for everyone?
LunaDesigns: Well, for me. I can barely afford the premium and have nothing left over every month to put into the account.
intothefire asks, do the ratings mean anything?
LunaDesigns: Do you mean the A-best ratings on companies?
intothefire: yes
LunaDesigns: Definitely. Don't work with a company that has less than an A- rating. The others may not be around too long.
LunaDesigns: Pacificare in NC has a B- rating because they have been denying so many claims.
Vanessa: who rates them?
LunaDesigns: A-Best is the best known one. There are others.
LunaDesigns: These are companies that work with the states in keeping tabs on insurance companies.
avion asks, how do you find out a company's rating?
LunaDesigns: The dept. of insurance has a rating listed for each company. Also you can go online to the company website and find it there.
LunaDesigns: or email me.
TwistedStitches: That's her answer for everything! LOL!
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TwistedStitches: moving on to other issues
LunaDesigns: OK - although I am only licensed in AZ and NC, I have contacted all the states and have their info to send to you.
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LunaDesigns: All states have programs for uninsured, self-employed and kids. You have to qualify usually by income. I have the info. Email me. lol
TwistedStitches: ha
TwistedStitches: Now moving onto prescription information
LunaDesigns: the following are websites for you to check on assistance with prescription costs.
LunaDesigns: GenericMedicineProgram.com
LunaDesigns: FreeMedicine.com
LunaDesigns: GlobalPrescriptionAssistance.com
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LunaDesigns: These will all save you money. I save $200 monthly with Generic rx.
TwistedStitches: Open for questions about anything we have discussed tonight
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Vanessa: if someone has the emergency only health insurace, what counts as an emergency?
TeenAngster: Are there any pre-existing qualifications for the prescription websites?
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LunaDesigns: If you email me, I will research your needs and get back to you. I will not sell you policies but will direct you to the appropriate agent or site.
JayesLittleJoys: Hello!
LunaDesigns: The insurance company has the last word on emergency. However, if you are having chest pains and go to ER and find out it was heartburn only.- they usually still pay. Use the prudent man rule. Err on the side of caution.
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ShopClementine: pre-existing conditions: can a new company deny coverage, or must your coverage have lapsed to be denied on a pre-existing condition?
TeenAngster: Prudent man rule?
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LunaDesigns: Income eligible. Basically, for an individual if you make less than $20,000 you qualify.
TwistedStitches: please type /ask and then your question so they go into our queue. we don't want to miss naything
LunaDesigns: The income qualifications differ from state to state.
LunaDesigns: Prudent man rule. If you think you're having a heart attack, go to ER. Use common sense.
Vanessa asks, What if how much money you make fluctuates?
LunaDesigns: They will use an average.
LunaDesigns: For most of us trying to make a living on arts and crafts, we really do qualify.
matt asks, can people under 60 qualify for medicare, if no, is their an alternative for those under say 40?
LunaDesigns: If you are under 65 and on disabililty, you qualify for Medicare. For the rest, there is Medicaid if your income in roughly under $25,000 annually.
LunaDesigns: One more thing. I want to give you a heads up on a life insurance potential scam.
LunaDesigns: Agents are trying to sell zero premium life plans to seniors. No premiums to pay and they won't tell you who the insurer is.
LunaDesigns: A policy is written on an senior for $50,000 with no premiums to pay. At death, the beneficiary gets $15,000 and the company keeps the rest.
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LunaDesigns: So far all states are saying this does not comply with state compliance regulations.
LunaDesigns: If you're not an family memeber or employer, you can't take out a policy on someone else. Must have insurable interest.
LunaDesigns: IF IT SOUNDS TOO GOOD TO BE TRUE, it is!
LunaDesigns: We will be ending soon but if you have more questions, we will be using June 30 to help answer more questions in workshop. I'll take more now.
intothefire asks, what's the better? Plan 1 $35/$50 copay, $5000 ded. 100/80 with $200 rx ded @$115 or Plan2 $35/$50 copay, 80/5000with rx copay @ $80
intothefire: i don't know what any of that means :-(
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LunaDesigns: Plan one is more to my liking. I prefer 100% coverage. The 35/50 is doctor/specialist co-pays, then your deductible, and then a separate rx deductible of $200.
LunaDesigns: It all depends on your comfort zone. What can you afford?
intothefire: plan 1 the out of pocket limit is the deductible
TwistedStitches: We are going to have to end this at 8:30. So if we did not answer all your questions tonight, we will try to on the next round
intothefire: plan 2 makes me wonder if I could lose my shirt
TwistedStitches: June 30th at 12noon
matt: bravo!
LunaDesigns: you are right on both counts. But you definitely can't afford to go without.
intothefire: thank you!
matt: thanks so much
Vanessa: THank you!
TwistedStitches: Thanks Carmen!
spindlecatstudio: thank you!!
TwistedStitches: also known as mom!
autumnomatopoeia: thanks much!
LunaDesigns: Please email me with particulars. I am willing to research all I can for anyone. Let me help you.
Vanessa: You are so generous with your time!
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TwistedStitches: Thanks everyone for letting us have this workshop. I hope we were able to help as many as we could
Vanessa: We'll do a follow up post on the blog with further details about the 30th
matt: danke
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KnitKnit: thanks a lot, this was much appreciated!
hobbledehoy: thanks!!!
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spindlecatstudio: gracias!
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jared: thank you!
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TwistedStitches: Tips can be dropped off at the door...I love anything with skulls... JUST KIDDING!
ShopClementine: Luna, could you give your email address one more time, please? ;)
AshleyJacobsen: thank you!
LunaDesigns: luna_c@bellsouth.net
ShopClementine: you're a doll!!!!!!!!
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TeenAngster: Thanks!
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ShopClementine: THANK YOU SO MUCH
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LunaDesigns: Thanks for joining us. Please remember - we want to be of service to the community. Use us!
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takeiteasy: Thank you so much! I missed the first part of this workshop and that was the part I needed to hear...am about to lose my health insurance in the coming months and was thrilled to see this workshop...thank you!
LunaDesigns: email me
arizonadreams: Thanks for all the info.!
takeiteasy: thank you so much...
TwistedStitches: Make sure you check the minutes on the workshop for any info you may have missed or email uus
LunaDesigns: Thanks to Etsy for allowing us to do this.
TwistedStitches: Take care everyone. See you around the forums!
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takeiteasy: how does one check the minutes...I was going to ask but did not wan to sound like a complete idiot...this is my 1st Etsy workshop.
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TwistedStitches: They post them in the blog
takeiteasy: gotcha! might save me from bothering you! :-)
TwistedStitches: Any further info about our next meeting will be posted there. No one bothers us. We love to help
TwistedStitches: Have a good evening everyone. We are off to bed!
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takeiteasy: What goes around comes around, I say and yall have some good coming to ya!
TwistedStitches: Aw!
takeiteasy: sleep tight...
LunaDesigns: thanks
TwistedStitches: bye everyone!
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munieca: Hello!
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munieca: no one here?
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munieca: hi
munieca: hibcyrjewelry
bcyrjewelry: Hello!
munieca: what is this??
bcyrjewelry: is it all over? i forgot at 7:00...
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bcyrjewelry: it was supposed to be about health insurance, but i can see its all done!
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bcyrjewelry: oh well, i'll read the minutes I guess! have a good night :)
munieca: I dont know
munieca: :(
munieca: bye
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dbdesignsit: Hello!
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Minutes Stopped Tue Jun 26 2007 00:50:05 GMT+0000 (UTC)
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