Monthly Archives: August 2016

The Benefits Of Home Health Care

It can be extremely overwhelming to have a family member that requires constant care. A lot of us simply don’t have the time or the facilities to be on-hand at all times even though we might want to. You may experience feelings of guilt that you can’t do all that your family member needs and can’t be with them all the time. However, you are not alone. Today, millions of adults across the word are finding themselves in a position where they are juggling taking care of older relatives or parents and their own lives and career. Many people struggle so you shouldn’t feel ashamed or guilty about your inability to do everything.

It can be hard to get the balance right between doing all you can for your elderly relative and looking after your own needs and this is why many people turn to home health care to help lighten the load. Home health care is a great way to ensure that you get the respite you need while making sure that your relative or parent is still looked after. In many cases, home health care is a necessity for families as it allows the career to get enough rest to ensure that they will be able to look after the elderly relative properly in the future.

There are many benefits involved in hiring home health care. The main advantage is that the person in question will be receiving the very best care possible. These people are trained medical staff and now how to look after your relative or parent properly. They will have years of experience and a wealth of expertise in dealing with emergency health situations so you really can trust them.

As well as providing essential medical care, home health care professionals will give the social interaction that your loved one really craves. No-one likes to be left on their own for long periods of time, and as much as they will love talking to you, they will also really enjoy interacting with other people. For some, home health care is their only connection to the world and without they feel lost.

The chances are you won’t always be available to help your loved one with their meals. If you worry that they aren’t eating nutritiously, that they aren’t eating at all or that they are skipping their medication then home health care could help. A member of staff can help your loved one with meal times and ensure that take their medication at the right times throughout the day.

Home health care workers can also help with any transport issues you may be having with your loved one. If you can’t get to them to take them to the doctors or any other appointment then they can do this for you and make sure that they get their safely.

There are so many more benefits to hiring home health care but the main one being that some of the pressure is taken off you and you can get back on track with your own life and responsibilities. Home health care really is a practical alternative to attempting to take on everything yourself. Home health care really can be a godsend for those people who don’t need continuous nursing help but who want to be cared for in the comfort of their own home. Most people feel most comfortable at home as it is the place where their family and friends can come and visit them and sometimes familiar surroundings can help aid recovery time. Home health care services vary depending on the personal needs of the person needing the care. For some, they just need some companion care whilst other suffer from more serious illnesses and require more complex medical monitoring.

Ways To Reduce Your Health Care

Adjust Your Deductible

The two main component of a health insurance plan are the premium and costs you pay for health care via your co-pay, co-insurance and deductible. The more you agree to pay for your health care, the less your monthly premium will be. Insurance companies know that when people have a financial stake in their own health care bills they tend to be more judicious in their use of medical services. Agreeing to pay a higher deductible, or rate of co-insurance, will result in lower monthly premiums. Sometimes these reductions can be quite significant and if saved will cover most if not all of the cost of the higher deductible.

This approach is less effective for people who use a lot of health care services every year, racking up large bills. However, for people who are generally health and don’t use a lot of health care, they can realize dramatic savings using a high deductible health plan. Plans with high premiums are guaranteed to cost you a lot of money even if you don’t go to the doctor. Plans with high deductibles will only cost you a lot if you actually use medical services.

Use Tax Advantages

There are a few ways to reduce your health insurance costs using the income tax system. The first and most common way is to use a health savings account otherwise known as an HSA. An HSA is a special banking account you are allowed to put pretax money in to spend on health care costs. The money you put into your health savings account does not get taxed as regular income. Depending on the tax bracket you are in, this can be a significant discount on health care costs. Many health care plans do not cover things like maternity, dental services and eye care. However, these services can be paid for out of an HSA.

To be eligible for an HSA, you must have a high deductible health insurance plan that meets the IRS requirements for health savings accounts. Generally you have to carry a high deductible and the plan has to have limits on total out of pocket cots.

If you are facing large health care bills, you may be able to deduct them from your income tax. You are allowed to deduct any medical expenses above 7.5% of your adjusted gross income. There are a wide variety of services that can be included in this amount, even a mileage deduction for transportation to and from the hospital. Make sure to consult a tax advisor if you choose to go this route.

Use your free Preventive Care

All health insurance plans are now required to provide free preventive care, so make sure you use it. Routine checkups and some testing is free for adults. Well baby visits and immunizations are free for children. These are significant benefits so make sure you are taking full advantage of them.

Shop Around

One of the reasons health care has become so expensive is there is little price competition. Don’t be afraid to ask what a doctor charges, especially for planned or expected health care. Some hospitals can be very competitive on price for services like labor and delivery, while others can be quite expensive. Don’t assume health care costs the same everywhere, it certainly does not.

Emergency rooms are especially to be avoided if you are looking to reduce your health care costs. They should only be used for true emergencies. For non life threatening medical issues like ear infections or even a cut requiring stitches, consider using an urgent care or local clinic. The costs of services at these locations can be a tenth of what an emergency room will charge.

Stay Healthy

This may sound like tired advice, but staying out of the hospital is the best way to reduce your costs. Try putting everyday activities in terms of what they may cost you in the long run. Sitting on the couch with a big bowl of ice cream is much more expensive than a nice walk outside. If living a long life isn’t enough motivation to be healthy now, consider that your unhealthy lifestyle will cost you a lot of money in health care costs.

The Importance of Your Health Care

Health insurance plans are complicated. This used to be the problem of the Human Resources department. However, today more Americans then ever are sharing the responsibility of making decisions for their employer based health care coverage. Millions more are on their own, purchasing health insurance in the private market. While many decisions are centered on the monthly premium, the level of your health insurance deductible can greatly impact the overall cost of your plan and even your level of care.

What Is A Deductible?

A deductible is the amount of health care that the insured must pay before the health plan provider begins to make payments. The deductible applies only to medical care that has been billed directly through the insurance provider. It does not apply to any medical care paid for outside of the health plan.

Deductibles can vary widely from just a few hundred dollars to over $10,000 a year. Some will vary based on in-network versus out-of-network medical care. The deductible is wiped clear once a year, usually on January 1st.

Growing Influence

Most people have typically received health care coverage through their employer. Under such plans, the worker generally paid very little for actual medical care used. There might be a co-pay for a visit to the doctor and perhaps a small yearly deductible, but for the most part, benefits meant you did not pay much, if at all, for the health care you used.

But that’s often no longer the case. The reality is that health care costs have been on a steady, high growth rate over the past two decades. The cost for an employer to provide health benefits has reached a critically high level, in many cases well over five figures. In response, many employers have pushed some of the costs back on the employee. This is often seen directly in an increased share of the monthly premium paid by the employee, but also an increase in plans with high deductibles, most or all of which will be the responsibility of the employee.

High or Low?

When selecting a health care plan, many people focus on the monthly premium. When it comes to budgeting, many people think in month-to-month terms. Low premium, high deductible plans can look attractive. However, with such plans, the insured will have to spend a lot of money out of pocket, in addition to the premium, in the event that they use medical care. Plans such as these are best paired with a health savings account, so that money can be saved tax-free towards the deductible. Otherwise you may be stuck with a very large medical bill you are unprepared to pay.

Many people are used to low-deductible plans, and often prefer them. Its nice to know your medical care has been largely taken care of in a standard monthly payment. Part of why people have insurance is to have predictable costs. However, the cost of high premium plans has risen dramatically over the years, often beyond what a car payment is and in some cases rivaling a house payment. This has made high premium plans less attractive.

What Is Best For You?

In general, a high deductible plan will have a lower total yearly cost then a high premium plan. This is because many people do not use as much medical care as they think over the course of a year. What they have to pay towards a deductible is often offset by their monthly savings with the lower premium.

If you are someone who uses a lot of health care year in and year out, a high premium plan may be a better solution. High premium plans can also be a good decision for people who have a hard time saving. A high deductible plan can be a major hardship for people who do not have much in savings and who typically do not save a lot of money. A high premium plan is somewhat like a forced savings plan.

Health Care Reform

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To stir emotions the health care reform debate doesn’t have to peel the onion back very far. There are those who could always afford health insurance and are worried that their costs will significantly rise in the attempt to cover the cost of care for those who have gone without. There are those with numerous and expensive to treat medical problems, who have no health insurance or inadequate health insurance coverage and they need relief, now! And there are those who are healthy, have chosen not to have health insurance, and resent a mandate requiring them to “buy-in” or face monetary penalties.

How to provide health care.

The Health Care Affordability Act of 2010 is wide in its scope and goals. First, it moves us to a place where most Americans will be covered by health insurance. This will remove “the” key impediment to “routine” health care services for millions of Americans. Subsidies will insure health care insurance regardless of an ability to pay and just because you have pre-existing medical conditions you will still be eligible for “reasonably priced” coverage. Stated another way, insurers will not be able to reject you or drastically increase your premiums if you suffer from chronic illnesses that generate a high level of claims, nor will they be allowed to set dollar limits on health insurance coverage.

To fund these objectives the Health Care Affordability Act requires all Americans to purchase health insurance. There will be subsidies if you are in a low income category and if you have no ability to pay anything you will be eligible for Medicaid as these state level programs will be more accommodating and act as the ultimate safety net. Through its mandates, the law requires millions of healthy individuals to pay into the system. The idea here is that those of us who are not in need of health care will fund those who draw from it. Since any of us can succumb to a health emergency at any time and thus become in need of potentially costly health care interventions those who support the mandate feel that this is fair – we are simply looking out for each other. Next, there are numerous plans in testing phases that are designed to make the delivery of health care more efficient and more cost effective. These pilot programs are being managed by the Center for Medicare and Medicaid Services (CMS) and include the cooperation of health systems throughout the country. These are complex to say the least and in early development stages and until proven, which is years from now, it is not known what their effect will be.

I support the attempt by the Obama administration and others to get something done on this pressing national issue. But there is a lack of candor about the cost, where the funds will come from, what treatments and medical technologies will be restricted due to very high costs and how the demand of millions of newly insured patients will be managed in terms of timely access to care and treatments. I have spent forty-one years of my life in a medical technology career that focused on global health economics and reimbursement issues and believe me, something will have to give. In every country outside of America, health care budgets are limited and capped. Fees to hospitals and physicians are set, annually reviewed and kept in check and new medical technology prices and access to them are restricted in subtle and not so subtle ways. And if you think that these policies won’t happen in America – think again, as spending limits are being set and will be set and we will have to live within them!

Having said that, let’s continue on with the reforms, some government mandated, some driven by the market place as conservative health policies propose. Just know that we will be dealing with health care reform for a very long time and there are going to be a lot of disillusioned folks along the way, newly enfranchised and otherwise. The emerging health care system will be “more just” but it will require real and noticeable sacrifice from the majority of Americans who heretofore never much worried about the fairness of it all.

Australian Health Care Benefits

Moving to Australia is an exciting prospect. However inevitably the question of health care is raised. No one wants to become ill or injured while living in Australia and then be left with an enormous bill to pay.

Does Australia have free health care?

Medicare is Australia’s publicly funded health care system however it does not provide 100% coverage. Medicare provides eligible individuals access to free or subsidised medical, optometrical (eye care) and public hospital care. Medicare does not pay towards ambulance costs, physiotherapy, spectacles, podiatry, chiropractic services, or private hospital accommodation.

Medicare also does not cover dental costs, with some exceptions for low-income earners. A nationwide Denticare Australia program may be extended in the next government budget, however the specific details are yet to be announced. Some dental organisations provide interest free payment plans, member discounted services that attract an annual fee, or discounts for regular patients to help manage costs.

Individuals can also choose to access private health services that charge for their services, and may choose to take out private health insurance to cover these types of costs.

Will I be eligible for a Reciprocal Health Care Agreement?

The Australian Government also has Reciprocal Health Care Agreements with some countries that provide ‘restricted access’ to public health care while in Australia. Restricted access usually limits care to ‘medically necessary’ treatments eg. Ill health or injury which occurs while you are in Australia and which requires treatment through a public hospital before you return home.

Individuals from New Zealand and Ireland do not get issued with a Medicare card and instead present their passport at public hospitals or pharmacies. Non-hospital care, such as attending a local GP doctor, is not covered. Other reciprocal agreements will pay Medicare benefits for out-of-pocket medical treatment provided by doctors through private surgeries and community health centres. All agreements cover subsidised medicines under the Pharmaceutical Benefits Scheme (PBS).

Note: Reciprocal agreements technically only cover individuals if they have come directly from the reciprocal country eg. If you were previously living in another foreign country prior to coming to Australia you may not be eligible, as you have not been recently been part of the health system for your country of nationality. However application of this requirement varies between Medicare staff.

Medicare Information Kits for migrants are available in 19 different languages.

What amount is subsidised by the government?

The benefit (or refund) that you receive back from Medicare is based on the Medicare Benefits Schedule (MBS) for that specific service which is set by the government. Doctors and other health service professionals can choose to charge over the schedule fee or bulk bill. Bulk billing is when doctors bill Medicare directly, accepting the Medicare benefits as full payment for the service. If doctors charge a higher amount the patient wears the extra costs.

Many doctors now offer to process Medicare claims electronically at the end of the appointment. Alternatively you can lodge most claims online, visit a Medicare office or post in your claims. Refer also to How does Medicare work?

Patients may also be required to pay for additional tests or vaccinations that their doctor requests as part of their treatment.

Some benefit examples based on the current schedule (1 Nov 2011) are below:

Standard doctor Level B consultation for less than 20 minutes with a GP (General Practitioner) in their consulting rooms: Fee = $35.60 and Benefit = 100% so you receive a $35.60 rebate. Therefore if the doctor charges $65.00 for an appointment you will be out of pocket by $29.40. If the doctor bulk bills they would charge the $35.60 fee direct to Medicare resulting in no out of pocket costs for the bulk billed patient.

Specialist doctor consultation initial appointment in a hospital or their consulting rooms: Fee = $83.95 and Benefit = 75% (hospital in-patient) or 85% (out-of-hospital) so you would receive either a $63.00 or $71.40 rebate. Therefore if the doctor charges $130.00 for an appointment you will be out of pocket by $67.00 or $58.60. You will need a referral letter from a GP to see a specialist so will need to budget for both out of pocket costs. Specialist fees can also vary considerably with some charging several hundreds of dollars if they are highly specialised and sought after. It is worth checking fees prior to making appointments so you are prepared for any out of pocket costs.

Comprehensive dental oral examination, limited to 1 per provider every 2 years: Note: Any preventive services like removal of plaque and/or stains, or any fillings etc are billed separately and can quickly add up to a sizeable bill even with the rebates: Benefit = $40.50 so if the dentist charges $95 for this item you will be out of pocket by $54.50

Medicare concession card holders will usually be charged a lesser rate or receive some services for free.

Note: If you are not eligible for Medicare you will have to pay the full appointment fees. However you are also exempt from paying the Medicare Levy and any surcharges (see below for more information on these).

The Pharmaceutical Benefits Scheme (PBS) details the medicines subsidised by the government, which must be purchased through a pharmacy. Non-PBS medications will be charged at full price.

The government also protects high users of medical services from big out-of-pocket costs through the Medicare Safety Net, and provides pension and health care concessions for pensioners and low income earners. The PBS Safety Net is available for individuals who need a lot of medicines in any year.

Individuals may also be able to claim a tax offset of 20% for net medical expenses over the threshold, currently $1,500 for the tax year for eligible expenses.

Note: The above protections may only apply to individuals on full Medicare so check further with Medicare before applying.

Are there any costs when I use an ambulance?

Ambulance cover varies between the different Australian States & Territories.

In Queensland and Tasmania, ambulance services are provided free for local residents.

In all other States & Territories, fees may be charged. The fees can vary depending on: how far individuals travel by ambulance, the type of transport eg. helicopter, the nature of the illness, whether an emergency or not, and any concession eligibilities.

Residents living outside Queensland or Tasmania can insure against ambulance costs, either through membership schemes provided by the relevant ambulance service (in the Northern Territory, South Australia, Victoria and country areas of Western Australia) or through a private health insurance fund (in the Australian Capital Territory, New South Wales and metropolitan Western Australia).

Note: Check the details of any ambulance cover provided by private health insurers carefully as it may only be limited to ’emergency’ transportation eg. not covering trips between hospitals or non-critical call outs. Membership with ambulance services may be more comprehensive.

In most cases, local holiday or business visitors to other States & Territories will be covered if they were covered in their home State or Territory due to reciprocal arrangements. However it is worth checking this before travelling to other States or Territories.

Do I have to pay anything towards Medicare?

Medicare is funded by a Medicare Levy tax deduction taken from your income with the contribution level based on how much you earn. The Medicare Levy is currently 1.5% of taxable income.

In addition, the Medicare Levy Surcharge of 1% is levied on high-income earners who do not have private hospital cover. The income threshold for 2011-12 year is $80,000 for singles and 160,000 for couples / families increasing by $1,500 for second and subsequent dependents. The surcharge is designed to encourage individuals to take out private cover and therefore reduce the demand on the public Medicare system.

If you are not eligible for Medicare then you may qualify for a Medicare Levy exemption and will not have to pay the Medicare Levy or Medicare Levy Surcharge. You must however complete a Medicare Levy Exemption Form in order to be exempt from the tax.