Car Accident Injury: Which Insurance Pays the Bill?

The answer is: The car insurance pays first. Most states require motorists to have personal injury protection. The amount of coverage can vary depending on the premium you decided to pay. So, the medical bills will be charged up to the limits of your auto policy, and your responsibility will be to pay up to the deductible. Once that limit is crossed, your health insurance policy steps in to cover the rest of the cost for the car accident injury.

However, note that -- depending on what kind of health coverage you have -- your insurance company will determine what is covered and what is not. So, be prepared to pay, for example, the deductible amount under the health insurance policy, any co-payments that are required, any charges from hospital/clinic that are not typically covered by the policy.

If you are the at-fault driver, be prepared for increases in your future policy premium. If, on the other hand, you are not the at-fault driver, the insurance companies involved may work behind the scenes to get the at-fault party’s policies to bear some of the costs. Victims of car crashes can also sometimes recover some of their out-of-pocket expenses by making that part of any car accident settlement agreement with the at-fault driver and/or their insurance carrier.

E-visits : Health Care Goes Online

In many cases of illness, the best care still calls for actual human touch. Still, in some special situation, if you're sick, you may not feel like wasting time in a doctor's office waiting room. And here comes a solution for such cases.

With the penetration of internet into all aspects of our daily life, health care couldn't remain aloof from all those advancements. It started with educational programs for degrees in healthcare management and nursing. Nowadays, more and more physicians are conducting online exams, and a growing number of insurance companies are supporting the concept. It's projected that one in five office visits could be eliminated through online communication. Recently, some of the biggest insurance companies, including Aetna and Cigna, started reimbursing doctors for E-exams.

The visits utilize questionnaires to help the doctor properly diagnose any problems in the patient. All of it is documented in the patient chart to refer to for future visits and care. The American Academy of Family Physicians also supports the idea, but stresses that only non-urgent medical issues can be handled this way. E-visits are best suited for people with easy to diagnose aches and pains, or for established patients who have previously received care from the physician's practice and now need follow-up visits.

E-visits should be a payable physician service. Usually, the patient initiates the process and agrees to e-visit service terms, privacy policy, and charge for receiving asynchronous care from a physician or other qualified health professional. Thereafter, electronic communication occurs over a HIPAA-compliant online connection, which includes the total interchange of online inquiries and other communications associated with this single patient encounter.

The physician appropriately documents the E-visits, including all pertinent communication related to the encounter. The physician or other qualified health professional has a defined period of time within which responses to an e-visit request are completed.

So, next time you are sick, may be putting your hand on the mouse would be a more convenient idea ....

2008 Medicare Drug Plans : Deadline 31st Dec

If you are a Medicare beneficiary, you have exactly 4 more weeks -- until Dec. 31 -- to select a new "Part D" prescription drug plan for 2008. Many of you may find rising costs and coverage changes for specific drugs that you use.

About 24 million people are already enrolled in Medicare, the federal health insurance program for those 65 and older and the disabled. The prescription-drug plans are administered by private companies, with United Healthcare and Humana two of the largest providers. There are about 1,800 individual drug plans for next year, 17 of which are national in scope.

It is wise not to blindly default to your current plans without checking alternative offerings. Also, even though low premium is a desirable factor, do not make that your priority -- It may turn out to be the costliest plan if you do not carefully consider your requirements. So, please compare plans based on your pharmaceutical needs and total costs.

First, prepare a list of the drugs you currently take and their dosages and then find out (i) if the plan covers your drugs and offers you a cheaper alternative than what you currently pay, (ii) if the pharmacies you regularly use are in the plan's network, (iii) if the plan puts any kind of restrictions on the purchase of your drug.

Starting this year, Medicare is offering an online feature drawn from multiple data sources for the quality of services offered, that compares local drug plans for pricing, ease of prescription fulfillment and customer service. It appears on the plan finder tool on its Web site, http://www.medicare.gov/ . You can put your ZIP codes and scrutinize a plan's performance before deciding to go for it.

Medicare also offers help via the toll-free phone 1-800-Medicare. The Medicare Rights Center also staffs a toll-free number with counselors ready to help at 1-800-333-4114.

Free Mammograms

Last week, Elizabeth Edwards, wife of presidential aspirant John Edwards and the mother of two young children, appeared with her husband on the campaign trail and confessed to having failed to get a mammogram. She was diagnosed with breast cancer nearly four years ago. The cancer went into remission after chemotherapy and radiation, but resurfaced and has spread to her ribs. It is incurable.

"I do not have to be in this situation," she told an audience in Davenport, Iowa. "I am responsible for putting myself, this man, my family and frankly, putting you all at risk, too, because I think you deserve the chance to vote for this man."

Currently, "Images of Health: Mammograms for a Million Moms," a public education campaign, is helping to save lives by encouraging women to visit www.imagesofhealth.com and pledge to get a mammogram. The site allows visitors to share their breast cancer stories, search for mammography centers and view video of the mammography process

If your insurance company does not cover mammogram and/or you cannot afford to pay for this important test, here is some advice. Not all insurance companies pay for mammograms, and not every woman is eligible for the government's program intended for low income families. The following organizations can help you identify free and low cost mammograms in your area:

1) The American Cancer Society www.cancer.org 800-ACS-2345. Contact their local office.
2) YWCA's Encore Plus program: Contact local office. The National office at 800-95-EPLUS .
3) National Cancer Institute: 800-4-CANCER www.nci.nih.gov .
4) State Office of Breast and Cervical Cancer: Contact your state Dept of Health.
5) October is National Breast Cancer Awareness month: Many mammogram facilities offer their services at special fees during this period. So, In September, you may call and see what kind of deal you can get or check online at www.nbcam.org .
6) Medicare coverage of mammograms: 800-MEDICARE.

Medicare Drug Plan Enrollment

It's decision time again for those aged 65 and older — and any friends or family members who help them with financial decisions. Between Nov. 15 and Dec. 31, seniors can enroll in a Medicare prescription drug plan — a benefit program launched in 2006 to help older adults and disabled people lower their prescription drug costs. Benefits will begin Jan. 1. Seniors who signed up for a plan during the initial enrollment period that began in November 2005 can also change plans beginning Wednesday.

People who are satisfied with their plan don't have to do anything to keep it; renewal for 2007 is automatic. But most stand-alone plans raised monthly premiums by an average of $4.50, changed other costs and generally expanded the list of drugs they will cover in 2007. So, the plan you signed up for in 2006 may not be the best plan for you in 2007, so you should compare your current plan with new ones available this year.

You don't have to enroll in a Medicare prescription drug plan if you have a drug benefit through a retirement plan, employer, veterans plan or other plan that is at least as good as standard Medicare coverage. That's called "creditable" coverage. If that plan or coverage level ends after Dec. 31, you may enroll in a Medicare plan without a financial penalty. Seniors who turn 65 after Dec. 31 have the normal Medicare open enrollment period with no penalty.

Because of the confusion, jammed medicare phone lines and computer glitches experienced in last year's enrollment, Medicare officials are encouraging seniors to enroll or make plan changes by Dec. 8, even though enrollment ends Dec. 31. There are a few other exceptions to enrollment deadlines and other restrictions. Also, while the benefit is offered nationwide, the number and kinds of plans vary by state. For more information, MEDICARE'S Web site, www.medicare.gov , and its 24-hour toll-free number, (800) MED-ICARE (633-4227).

Warning to Diabetics: Fake Test Strips

A public alert issued by the Food and Drug Administration today warned diabetics to watch for counterfeit versions of test strips commonly used to monitor blood sugar levels. The test strips, for use in glucose monitors made by a Johnson & Johnson company, were distributed nationwide.

The phony test strips are for use with various models of LifeScan Inc.'s OneTouch brand of blood glucose monitors. LifeScan is part of New Brunswick, N.J.-based Johnson & Johnson. The counterfeit test strips could give incorrect blood glucose values, leading patients to take too little or too much insulin and suffer injury or death, the FDA said. Diabetics who purchased the counterfeit test strips should stop using them, replace them immediately and call a doctor. The counterfeits are:

-OneTouch Basic/Profile, lot numbers 272894A, 2619932 and 2606340. The 50-count packages are labeled in English and French.
-OneTouch Ultra, lot number 2691191. The 50-count packages are labeled in English, Greek and Portuguese.

Samples of the stripes tested by LifeScan do produce blood-glucose results, but they do not meet company specifications. The fakes were distributed nationwide but primarily in Ohio, New York, Florida, Maryland and Missouri by Medical Plastic Devices Inc., of Quebec, Canada, and Champion Sales Inc., of Brooklyn, N.Y., the FDA said.

Consumers with questions can call LifeScan at (866) 621-4855.

Prescription Drug: Walmart's $4 Plan

Today Walmart announced an attractive '$4 per prescription for a 30-day supply' scheme for people with insurance and also those without coverage. The orders have to be made online and then picked up in-store. Walmart's idea for $4 prescriptions came from an earlier in-house program to provide $3 co-pays for Wal-Mart workers.

For the time being, the retailer is starting the program tomorrow in its Tampa, FL area stores, but will expand to more states in 2007. The announcement even rattled the Wall street and roiled the stock prices of generic drug wholesalers and pharmacy chains.

If Walmart can lure people to their stores with such a good deal on generics, the customers may as well buy other things from the retailer while coming to collect the drug. It would thus be good for the retailer giant as well as average consumers.

Medicare Premium Rises

Seniors' 'Part B' premiums for doctors' visits and lab tests paid by Medicare are set to go up by $5 per month in 2007. Most beneficiaries will now pay $93.50 per month, a 5.6% rise over 2006 premiums. But the costs could go even higher if doctors' groups succeed in their bid to prevent Medicare fee cuts.

Part B deductibles are also scheduled to go up by $5 to $131. Seniors pay an average of $27 per month in premiums for the Medicare prescription drug benefit, and usually pay the first $992 in hospital costs unless they are low-income.

At the same time, wealthy seniors will for the first time be asked to shoulder higher premium costs. Under Medicare's new premium schedule, seniors with incomes between $80,000 and $100,000 per year and married couples with annual incomes between $160,000 and $200,000 pay additional $12.50 per month over the $93.50 paid by most seniors. Individuals with annual incomes between $100,000 and $150,000 and married couples with annual incomes between $200,000 and $300,000 in 2007 will pay a monthly premium of $124.70. Individuals with annual incomes between $150,000 and $200,000 and married couples with annual incomes between $300,000 and $400,000 in 2007 will pay a monthly premium of $143.40. Individuals with annual incomes of $200,000 or more and married couples with annual incomes of $400,000 or more in 2007 will pay a monthly premium of $162.10.

Rising Healthcare Costs

According to a Kaiser Family Foundation survey, premiums for employer -provided health insurance in the U.S. rose 9.2% in 2005. This is after 4 successive years of double-digit increases but this slower rate is certainly not a good news. Even this slower rate of increase still has health insurance premiums rising more than twice as fast as overall inflation (3.5%), and more than three times faster than workers' wages (2.7%). Since 2000, premiums for coverage for a family have increased by 73%, compared with inflation growth of 14% and wage growth of 15%.

In dollar terms, average annual premiums for employer-sponsored coverage rose to $4,024 for single coverage and $10,880 for family coverage, according to the report. The family coverage of about $11000 is about equal to the full-time earnings of a minimum-wage worker. That is why more companies that offer health benefits are offering high- deductible plans (defined as $1,000 deductible for single coverage, $2,000 for family coverage).

In 2005, 20% of firms offered such plans, up from 10% last year and 5% the year before. About 56% of workers with coverage are in a health plan that requires that a deductible be met. In PPOs (preferred provider organizations), the average deductible for in-network services is $323 for single coverage and $679 for family coverage. Enrollment in PPOs grew over the last year while HMO (health maintenance organization) enrollment declined. PPOS enrolled 61% of employees with health coverage, up from 55% in 2004 and remain the most common type of plan. In 2005, one-third of firms with 200 or more workers are offering retiree coverage, about the same as last year but down from 66% in 1988.