Health Insurance

Congress and the President are at Logger Heads over the issue of financing health care to children. However, a recent study looks at the type of care we are currently giving to children, and the results are shocking.

• 46% of the children received indicated care
• 67.6% of the indicated care was given in acute medical situations
• 53.4% of the indicated care was given for chronic conditions

Do you remember, Mychelle ? I do. She was the little girl, who was taken to the emergency room, diagnosed, and the correct treatment ordered. She died. What happened? She had insurance, she arrived at the emergency room in a timely fashion, the physician was competent. The shocking reason Mychelle died was that her insurance carrier, or more pointedly, the insurance clerk, would not approve the treatment, as the emergency room was not covered in her insurance plan.

Approximately 5 billion dollars a year are spent on Cancer Research via the National Cancer Institute. Slowly but surely, dents are being made in the monster clad armor called “Cancer”.

Despite this progress, cancer is anticipated to more than double by the year 2050, and close to 3 million people a year will hear the dreaded words: “you have cancer”. A blue ribbon panel, composed of Lance Armstrong and a distinguished physician from MD Anderson in Texas among others, blasted the Federal Government for not doing more.

Childhood obesity is becoming an epidemic. It is estimated that 80% of obese children will be obese when they become 25.

Along with an increase risk of cardiovascular disease, diabetes, hypertension; children can have strokes (yes, Virginia, children can have strokes too, and are at increased risk if overweight). These children are also more likely to complain of bone and joint pain due to the increased weight placed on their skeletal structure. Osteoarthritis is likely.

CDC recommends 3 additional vaccines for Pre-Teens. For some, it's because immunity has worn off, and for others, its because their risk of getting the disease is higher. Because they are recommended and not mandated a lot of insurance plans will not pay for them.

1. Whooping cough: The CDC recommends that a booster be given before the child enters high school. The initial whooping cough shot was given prior to grade school, but immunity has gradually worn off. There have been several cases of whooping cough reported in the Chicago area, and other big cities. Whooping cough can last for weeks or months, and may lead to pneumonia. Deaths may occur. The cost is approximately $40.

This week, the House of Representatives may vote on the Children’s Health and Medicare Protection, or CHAMP, Act.

The CHAMP Act will address the “asset test” by raising the test limits and thus giving more low–income Medicare beneficiaries extra help with prescription drug costs.

Currently, if anyone has prepared for retirement and has a meager $12,000 in savings accounts or IRA's; they fail the means test.

Consider Switching to Generics, Over-The-Counter (OTC), or Other Lower-Cost Drugs

You may wish to talk to your doctor about the drugs you are currently taking to find out if there are generic, over-the-counter (OTC), or less-expensive brand-name drugs that would work just as well as the ones you're taking now.

Cost savings information through the use of mail-order pharmacies, generic or less-expensive brand-name drugs is also available in the Prescription Drug Plan Finder section of www.medicare.gov

There is extra help for people with limited income and resources. Almost 1 in 3 people with Medicare will qualify for extra help. If you qualify for extra help, Medicare will pay for almost all of your prescription drug costs. You can apply or get more information about the extra help by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or visiting www.socialsecurity.gov.

Your decision about Medicare prescription drug coverage depends on the kind of health care coverage you have now. There are two ways to get Medicare prescription drug coverage. You can join a Medicare prescription drug plan or you can join a Medicare Advantage Plan or other Medicare Health Plan that offers drug coverage.

Whatever plan you choose, Medicare drug coverage will help you by covering brand-name and generic drugs at pharmacies that are convenient for you.

You may sign up when you first become eligible for Medicare (three months before the month you turn age 65 until three months after you turn age 65). If you get Medicare due to a disability, you can join from three months before to three months after your 25th month of cash disability payments. If you don't sign up when you are first eligible, you may pay a penalty. If you didn't join when you were first eligible, your next opportunity to enroll will be from November 15, 2007 to December 31, 2007.