Thursday, April 30, 2009

Oxendine: Can Your Health Insurance Cope with Swine Flu?

Insurance Commissioner John W. Oxendine wants Georgians to be prepared for a possible swine flu outbreak by reviewing whether their health insurance policies will cover possible contingencies like hospitalization and prescription medications.

The Commissioner suggested that you take a few minutes and consider these questions:

* Does your policy have a preauthorization requirement for hospital admission or other services?

* What is your co-payment for the most common H1N1 treatments? The two drugs doctors can prescribe to treat H1N1 flu are Tamiflu and Relenza. Also find out if there are any coverage limitations that apply to the distribution of the medication. Some policies will restrict coverage on the number of doses per prescription or per year.

* What is your out-of-network co-payment? If your area is heavily affected by the spread of the H1N1 flu outbreak, your regular physician may not be able to see you in a timely manner. If you have to go out-of-network, be aware you will have to pay a higher co-payment for your office visit and possibly any tests run during the visit. Get prepared for any eventuality with the following checklist:

-- Have your health insurance I.D. card handy.
-- Review your health insurance policy provisions. Know which doctors and hospitals are in your network.
-- Make note of your co-payments. Know how much a doctor's office visit will cost. Check to see if your co-payments go up if you go out-of-network.
-- Find the list of pharmacies covered by your health insurance policy.
-- If you have plans to travel, make sure you check to see if there are any doctors or medical facilities in-network where you will be visiting.
-- Make sure you have contact details for your health insurance company available in case you have questions. Your employer may gather all pertinent health insurance information together for you in one simple-to-reference form. If they do, post the information where it can easily be accessed by you and your family.
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Wednesday, April 29, 2009

30 Days to Hurricane Season: FEMA Advises to Prepare Now With Flood Insurance

/PRNewswire/ -- June 1, 2009 marks the beginning of Atlantic hurricane season. In addition to knowing appropriate safety precautions, FEMA recommends protecting your property now with a flood insurance policy. It typically takes 30 days from the time of purchase for a policy to become effective.

"Past hurricane seasons have shown that storms can form as early as the beginning of June, so property owners can't afford to wait to buy flood insurance," said Ed Connor, Acting Federal Insurance Administrator and Acting Assistant Administrator, FEMA Mitigation Directorate. "Homeowners insurance doesn't cover flood damage and, without flood insurance, property owners may have to absorb the financial losses on their own. Just a few inches of water can cost thousands of dollars in repairs and, in this economy, few can afford that potential drain on their savings."

Flood insurance is affordable and available through about 85 insurance companies in approximately 20,600 participating communities nationwide. National flood insurance is available to renters, business owners and homeowners, even if it is not required by the terms of a mortgage. While the average flood insurance policy is around $540 a year, homeowners can protect their properties in moderate-to low-risk areas with lower cost Preferred Risk Policies (PRPs) that start at just $119 a year.

Individuals can learn how to prepare for floods, how to purchase a flood insurance policy and the benefits of protecting their properties against flooding by visiting or calling 1-800-427-2419.

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Tuesday, April 21, 2009

On-Line Petition Launched in Support of a National Health Insurer Code of Conduct

(BUSINESS WIRE)--In an effort to ensure and protect patient access to approved medical treatments, a petition in support of a Health Insurer Code of Conduct was launched today by the Alliance for Patient Access (AfPA). The petition calls for the adoption of a Code of Conduct, currently being drafted by the American Medical Association, which will address restrictive practices of the managed care industry which undermine the integrity of doctor-patient relationships.

The AMA House of Delegates passed a resolution in November of 2008 to draft and adopt a National Health Insurer Code of Conduct. According to the resolution, the AMA code will set forth clear and concise principles addressing both medical policies and payment issues, as well as create a mechanism to monitor compliance by managed care companies.

Currently, while many managed care organizations maintain appropriate focus on quality measures, some managed care plans and pharmacy benefit managers employ aggressive tactics to cut costs, while at the same time shifting blame for consequences of actions such as premium increases and cost-sharing strategies onto other parties in the healthcare industry.

“In Georgia, the cost-control efforts implemented by managed care health plans have created the widespread perception that such plans are more interested in saving money than providing quality health care,” said Dr. Christina Mayville, a neurologist in Macon, GA. “Unlike many other stakeholders in the health care industry, however, there is no overarching standard of conduct for health plans. The Alliance for Patient Access is taking the lead to collect support for a Code of Conduct to empower health plans to voluntarily agree to abide by principled guidelines and specific protocols regarding certain issues that are particularly prone to abuse.”

AfPA’s petition calls for autonomy between doctors and managed care companies, as well as full transparency regarding a patient’s prescribed course of care. This includes any relationships with outside parties that might influence doctors’ decisions. AfPA also calls for upholding business integrity, with fees reflecting acceptable rates and prescribed courses of treatment resulting from medically-based, not fiscally-driven, decisions. Finally, AfPA’s first priority remains patients’ access to quality medical care that ensures their safety and welfare.

“A Code of Conduct for the managed care industry is highly overdue,” said Dr. David Charles, AfPA Chairman. “The petition is a way for us to show managed care companies that we will not stand by as they attempt to interfere with the course of treatment prescribed to patients by their doctors. A Health Insurer Code of Conduct will help protect patients by regulating the practices of managed care companies and holding them accountable to the same standards to which the rest of the healthcare industry already adheres.”

The American Medical Association (AMA) passed a resolution in November 2008 to adopt a Health Insurer Code of Conduct, which it is currently drafting. The AMA will vote to adopt the code in June.

The AfPA petition for a Health Insurer Code of Conduct can be found at

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