Finance and Business

CHIP stands for Children’s Health Insurance Program and was proposed by the Congress in 1997. It is a special program connecting federal and state government with the aim to provide additional health coverage to uninsured children and future mothers who don’t have the financial abilities to purchase a separate individual policy but still don’t qualify for Medicaid.

On February 4, 2009, CHIP was expanded by President Obama’s passing of law on Children’s Health Insurance Program Reauthorization Act (CHIPRA). This expansion raises the number of children within CHIP from 7 million to 11 million and extends its payment through 2013. Read the rest of this entry »

Having an Exclusive Provider Organization (EPO) means that the medical service providers you will receive care from should have signed up an agreement with the insurance company to allow offering you these services. This way EPO plans are somewhat similar to PPO (Preferred Provider Organization) plans, meaning that the person having such a plan can obtain inexpensive medical services at a facility that makes part of the EPO network. Still, if you choose to receive your medical care at a facility outside the network, a PPO plan will still cover your costs, only to a smaller extent. With most EPO plans, you won’t receive any insurance coverage when visiting a specialist outside the network.

When you choose an EPO plan, you will instantly notice that the fees you are charged with by the medical service providers that have accepted to join your insurance company’s network are significantly lower than those normally charged. So when you receive your health benefits within the EPO network, you can rest assured that the rates you will be charged for the services will be very advantageous and your insurance provider will pay for all the services you receive.

However, if you have a condition that none of the specialists making part of the EPO network can help you with and you are forced to seek medical attention outside of the network, make sure you have enough money because you will pay for the service to the full extent. This is because EPO plans do not include any services provided outside the selection of facilities and specialists that have an agreement with the insurance carrier. Moreover, in contrast with PPO and HMO plans that have fairly large networks of health service providers, EPO plans usually have a much smaller number of specialists and facilities being part of their network. This means that you have fewer professionals to choose from when you need medical attention. Read the rest of this entry »

Washington likes acronyms when it comes to lawmaking and this new law is no exception. This is the Genetic Information Nondiscrimination Act (GINA) and this November sees it finally come into force. Because it affects both employers and the insurance industry, this has been a hard-fought change and was only signed into law last year. Now it should prevent you from obvious discrimination. Sadly, it does not rule out discrimination by backdoor means. If an employer overhears you talking at the water cooler or routinely surveys local news including the obituaries, it is legal to use this information. But, overall, you should find some improvement. It covers two different situations with the same type of result. Firstly, it prohibits employers from asking you to go through a genetic test or making genetic information the basis of deciding whether to hire, promote or fire you. Secondly, it prohibits insurers from testing or demanding genetic information about you or your family in deciding whether to offer you coverage, in setting the premium rate and level of the deductible, or continue the cover.

Let’s be completely clear. The law does not care who is asking for the information If it is going to be used for either purpose, the asking is unlawful. If this happens to you in an interview, it may pose a dilemma. If you cite the law and refuse to answer, the interviewer may think you a troublemaker with something to hide and not hire you. That you can complain to the local Department of Labor and take satisfaction in seeing a civil penalty imposed, this does not replace the offer of employment in these difficult economic times. The temptation to answer will be strong. But when it comes to insurance companies, you must stand up and assert your rights. If the insurer persists, report to your state’s Department of Insurance. This will put the insurers at risk of losing their license to sell policies in your state. This is a big stick to wave in defense of your rights. More importantly, the Department can order the insurers to offer you insurance on regular terms which protects you. Once employed, it’s just as important to stay alert. The operators of group health plans are known to offer incentives like lower premiums to employees who answer a questionnaire including questions about their family medical history. Obviously, insurers want to know if there is a risk of serious diseases like cancer. You might be more at risk if there is a history of cancer in your family. Everyone should refuse to answer. Read the rest of this entry »