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- ObamaCare Treats or Tricks: VOTE! 👻
ObamaCare Treats or Tricks: VOTE! 👻
Naama O. Pozniak
October 28, 2024
Should we say spooky healthcare, as it's time for a splash of knowledge before we hit the poll? To try and dive in, let's look into Obamacare. The pros are that it extends healthcare to millions, ends denial for pre-existing conditions, and keeps young adults on family plans till 26. But we've got some cons lurking: rising premiums and high deductibles add to out-of-pocket burdens, sparking debates on accessibility and affordability. Understanding both sides ensures an informed discussion on reform.
It is critical this year; let’s create a wave by heading to the polls because voting isn’t just our right—it’s our power. Don't think your voice doesn't count; we make a tidal wave of difference together. Grab your facts and masks and make a splash that echoes! 🌊🗳️
Here are some facts: Kamala Biden Administration Healthcare Policy vs. Trump Administration
Pros:
💀Expansion of ACA: The administration aims to build on the Affordable Care Act (ACA), increasing coverage and subsidies to make healthcare more affordable. We have to ask ourselves: who is paying for it?
💀Public Option: Introducing a public health insurance option to compete with private insurers, potentially lowering costs.
💀Medicaid Expansion: Encourages more states to expand Medicaid, covering more low-income individuals.
💀Focus on Drug Prices: Exerts pressure on pharmaceutical companies to lower prescription drug prices.
💀Comprehensive Coverage: Emphasizes comprehensive coverage, including mental health, reproductive health, and pre-existing conditions.
Cons:
💀Cost Concerns: The expansion could increase federal spending and taxes.
💀Regulations misaligned assets with subsidies, leading to 1/3 of the population benefiting wrongly.
💀For example, California only offers 1 PPO in the market, while some states only provide HMO options.
💀Complex Implementation: Implementing a public option and expanding services was and still is complicated.
💀 Employer offering coverage is shrinking.
💀Potential Resistance: Faces political resistance, particularly from states against Medicaid expansion or federal mandates.
Trump Administration Healthcare Policy:
Pros:
🎃Deregulation: Promoted deregulation, allowing for more insurance choices, such as short-term plans, which will be cheaper and more effective.
🎃State Flexibility: Granted waivers to states, enabling them to develop customized healthcare solutions.
🎃Tax Cuts: Removed individual mandate penalties, financially relieving uninsured individuals.
🎃Emphasis on HSAs: Encouraged the use of Health Savings Accounts, giving people more control over healthcare expenses.
Cons:
🎃Coverage Concerns: Attempts to repeal the ACA and weaken its provisions could reduce coverage accessibility, particularly for pre-existing conditions.
🎃Short-Term Plans Lack Coverage: The encouragement of short-term plans led to criticism due to their limited coverage, which often does not cover essential health benefits.
🎃Increased Uninsured Rates: Given reduced Medicaid expansion incentives, strategies were said to lead to higher uninsured rates.
🎃Prescription Focus: Less focus was placed on controlling prescription drug costs, leading to continued high medication prices.
Decision-Making Considerations
👻Coverage Needs: Consider if comprehensive coverage or flexible plans fit better with personal health needs.
👻Cost Priorities: Evaluate willingness to balance federal spending against out-of-pocket costs.
👻State vs Federal: Decide whether state-based solutions or federal oversight align with personal priorities.
👻Access to Providers: Consider the importance of network size and choice within insurance plans.
Support for healthcare policy involves evaluating which policies align with individual healthcare priorities, economic consequences, and ethical perspectives on healthcare access and equity. I find inspiration in Robert Kennedy's views. Although I don't identify as a Democrat or Republican, his vision and mission in the healthcare industry resonate with me. He addresses the issues that often go unacknowledged and emphasizes the importance of sharing authentic research to raise public awareness.
So, I hope that in a divisive time Filled with escalating challenges, we can choose our response paths—crafting refined healthcare approaches and advocating for innovative, compassionate solutions. Let us unite in promoting policies fostering healing and informed access, leveraging our collective strength to bridge divides.
Embrace a Halloween that sparks new beginnings and unveils magical moments!
Love, Naama & The RightPlan Team,
💀👻🎃🧡
Medicare
Prescription Drug- Part D and Medicare Advantage
If you have not yet sent your current prescriptions, we urge you to do so immediately. Your prompt action is crucial.
Key Coverage Changes Coming in 2025
It's your responsibility to review your Medicare coverage. This year, it’s more important than ever. Don't delay; take control of your healthcare.
Changes related to the Inflation Reduction Act could significantly impact your prescription drug coverage. If you received your Annual Notice of Change letter this September, it's crucial that you contact us. We help people daily, and you want to be ready for 2025.
Exciting Medicare Update: Coverage for AI in Coronary Plaque Assessment
Here's some good news: CMS has announced that Medicare will now cover the use of advanced artificial intelligence (AI) platforms, including the innovative Heart Flow system, to assess coronary plaque. These cutting-edge tools are not just for diagnostic studies in patients with chest pain; they're for improving the early detection and treatment of coronary artery disease, bringing hope for better health outcomes.
Covered California
Renewals are happening NOW! Please follow up with us to renew your current plan!
Please send us your updated income so you won’t have any surprises on a lump sum out of pocket. It is critical to review your current income at all times.
November 1st is when the market is officially opening if you want to look into a new plan. The effective date will be 01/01/2025, unless you are experiencing a unique special enrollment.
For 2025, Covered California and private health options maintain the same out-of-pocket maximums at $350 for pediatric benefits and $700 for families. Children's dental care is integrated into all plans, while adults may add family dental plans post-medical enrollment. It's important to note that only health plans, not dental plans, receive subsidies. Regulation created unrelated connections between assets and subsidies, resulting in 1/3 of the population receiving subsidies where they shouldn't.
DACA announcement –
This is an important message for November 1st. You will be able to obtain coverage and subsidies through Covered California if you have the following documents:
You came to the US before the age of 16.
Resided in the U.S. continuously since June 15, 2007.
Do not currently have legal immigration status.
Were present in the U.S. on June 15, 2012.
Were under 31 years of age as of June 15, 2012
Required documents:
I-797 - one-page letter - will have an end date
I766 - actual card
Employer
Governor Newsom has signed several Senate and Assembly Bills that expand California's coverage requirements for fully insured health plans. These bills focus on improving maternal healthcare, preventive care, and protections for artificial intelligence. These new requirements are contributing to the significant rate increases across ALL carriers.
Kaiser Permanente just announced that effective January 1, 2025, small group will no longer offer the Bronze 60 HMO 5400/60 + Child Dental plan Alt and INF plans, and these plans will not be available when you renew this year.
We want to assure you that we are carefully learning how you can continue being covered under Kaiser with a similar Bronze:
The closet plan will be 2025 Bronze 60 HMO 5800/60 PCP + Child Dental and INF plans. Initially, the 2024 Bronze 6300/60 plan was updated for 2025 to offer a reduced medical plan deductible.
Amazon Pharmacy Takes Over
Amazon Pharmacy is set to replace CVS Caremark Mail Service Pharmacy, offering a streamlined, digital-first experience for prescription home delivery.
New ID Cards for Blue Shield Members featuring updated pharmacy details for Individual, Family Plans (IFP), and Medicare members during January 2025 renewals. Members should use these cards for future pharmacy visits. Access to updated cards is available online via the member's myblueshield account and through the Blue Shield mobile app.
Naama in the spotlight!
London, October 2024 📍 Guided by her brother, Abhishek Singh, a global leader in crypto and Web3, Naama was honored with an invitation to the UK-India Leaders Conference at the UK Parliament’s House of Commons.
Naama found herself at the center of vital discussions about the importance of UK-India collaboration, with an added focus on expanding efforts for global good, especially in improving healthcare access and quality worldwide. For her, it was inspiring to see how these conversations tied into the broader global healthcare dialogue.
🎤 Naama at the NextGen Benefits Mastermind event at Phoenix. Each time Naama shares mindful moments with a team or during employee renewals, stress levels drop, connections strengthen, and positive energy flows, creating meaningful shared experiences. 💐
October is A Key Month for Breast Cancer Awareness
Take Charge!!!
October is a great reminder to keep Cancer Awareness Month - a crucial early detection and proactive health management. It's our responsibility as women to prioritize our annual exams, as catching breast cancer early is when it's most treatable.
It's a call to action: Schedule your Women Well Exam NOW ~
Exciting advancements in healthcare are revolutionizing cancer detection methods. The future holds the promise of diagnosing cancer without pain or invasive procedures. With advanced technologies in development, we're moving towards identifying tumors without the need for biopsies or blood draws. Let's take the lead in health advocacy. I encourage everyone to make use of the 0 Co-pay annual exam and prioritize regular check-ups. Staying informed about cutting-edge developments not only empowers us but also inspires change, leading to a longer and healthier life.
Further, October is ADHD Awareness Month, which reminds us that the health and well-being market offers some alternative or supplemental coverage for ADHD, as well as positive diagnostics and access to care—make sure to consult your provider.
Don’t wait to be sick to take care of your health - Red Light Therapy
Red light therapy (RLT) uses low-level red light to stimulate healing and rejuvenation in the body:
Key benefits:
Improved Skin Health: Helps with wrinkles, acne, and scars by stimulating collagen production.
Pain Relief: Reduces inflammation and promotes muscle recovery after injuries or workouts.
Enhanced Healing: Speeds up recovery from wounds and cuts by promoting cell regeneration.
Reduced Joint Pain: Helpful for those with arthritis or other joint conditions.
Before starting RLT, it's important to consult with a healthcare professional, especially if you have underlying health conditions. This ensures you're making an informed decision about your health. Enjoy -
What we are reading
The Capitalist Manifesto: Why the Global Free Market Will Save the World – This compelling book argues for the power of global capitalism to drive innovation, create economic opportunity, and solve global challenges. Perfect for readers curious about the future of free markets and global progress.
Fall Travel
The holidays are right around the corner! Please remember to make sure we travel right~
Keep in mind that most domestic health insurance plans don’t provide the coverage you need abroad. That’s where GeoBlue comes in, offering comprehensive protection for international travelers. Here are some key benefits:
24/7 Assistance: Help with setting up hospital stays and coordinating care worldwide.
COVID-19 Testing & Treatment: Covered abroad, ensuring peace of mind.
Global Provider Network: Access to top doctors and hospitals worldwide.
Evacuation & Repatriation: Extensive coverage in case of emergencies.
Cashless, Direct Pay: No upfront payments for medical care overseas.
Valuable Digital Tools: 24/7 telemedicine and security profiles at your fingertips.
Omar is here to help and follow up with any of you – Reach out to him on [email protected]
Keep it safe, stay positive and know that we are on this ride of life together,
From our hearts to yours,
Naama, and the RightPlan Team,
🤎