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CONSUMER DRIVEN HEALTH CARE Are You Up to Speed? Presented By: John V. Stewart, MSM, CDHC Stewart’s Insurance Depot S.E. Georgia 912.434.2090 N.E. Florida 904.729.4025 Metro Indianapolis, IN 317.570.1271

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Page 1: Consumer Driven Health Care

CONSUMER DRIVEN HEALTH CARE

Are You Up to Speed?

Presented By:John V. Stewart, MSM, CDHC

Stewart’s Insurance DepotS.E. Georgia 912.434.2090N.E. Florida 904.729.4025

Metro Indianapolis, IN 317.570.1271Metro Cincinnati, OH 513.868.0040

Nationwide 866.203.5097

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CONSUMER AWARENESS

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Consumer Awareness

Some myths and facts:

Health insurance companies make lots of money on us!

Fact: Health Insurance Companies make 3 cents on every dollar.

Fact: The insurance industry is the only industry required by law to make a profit.

So where does our insurance dollars go?

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So where does our insurance dollars go?

If 87 cents of every major medical insurance dollar goes to covering us, what can I do to help control my costs and keep my insurance premiums as low as possible?

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Your personal Survey on Major Medical InsuranceCost savings start with what kind of major medical plan I am looking to purchase.

The plan will cover with ages of:

I would like a ( local, regional or national ) insurance carrier

What amount do I want to pay as a deductible?

Do I want a coinsurance amount (what % 90/10, 80/20,70/30, 50/50)?

How many times a year do I go to the doctor?

Do I want a plan that has doctor copays?

How many prescriptions do I purchase a year?

Do I want a plan that has prescription drug coverage?

Do I want a tax advantage plan with qualifying highdeductible insurance? Y or N

How much am I willing to put into an HSA account/year?

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How much do you want to spend on Major Medical Insurance?George Ready (Age 30) 32034 Single

Plan Type Deductible Coinsurance Total Out of Pocket Copay Premium % Cost Difference Cost of Copay/yearSaver $2,500.00 $3,000.00 $5,500.00 N/A $70.80 Base of % Base No Copay80% Plan $2,500.00 $3,000.00 $5,500.00 N/A $106.68 33.63%Copay Plan $2,500.00 $3,000.00 $5,500.00 $35.00 $110.57 35.97% $477.24100% Plan $2,500.00 $0.00 $2,500.00 N/A $127.09 44.29%Single HSA * $2,500.00 $0.00 $2,500.00 N/A $128.02 44.70%

Nancy Ready (Age 30) 32034 Single

Plan Type Deductible Coinsurance Total Out of Pocket Copay Premium % Cost Difference Cost of Copay/yearSaver $2,500.00 $3,000.00 $5,500.00 N/A $91.94 Base of % Base No Copay80% Plan $2,500.00 $3,000.00 $5,500.00 N/A $140.08 34.37%Copay Plan $2,500.00 $3,000.00 $5,500.00 $35.00 $166.98 44.94% $900.48100% Plan $2,500.00 $0.00 $2,500.00 N/A $165.13 44.32%Single HSA * $2,500.00 $0.00 $2,500.00 N/A $167.91 45.24%

George Ready & Family (Parents Age 30) 32034

Plan Type Deductible Coinsurance Total Out of Pocket Copay Premium % Cost Difference Cost of Copay/yearSaver (2) $5,000.00 $6,000.00 $11,000.00 N/A $268.83 Base of % Base No Copay80% Plan (2) $5,000.00 $6,000.00 $11,000.00 N/A $270.68 0.68%Copay Plan (2) $5,000.00 $6,000.00 $11,000.00 $35.00 $506.15 46.89% $2,847.84Plan 100 (2) $5,000.00 $0.00 $5,000.00 N/A $481.89 44.21%Family HSA (1)* $5,000.00 $0.00 $5,000.00 N/A $451.67 40.48%

Gearge Ready & Wife (Age 60) 32034

Plan Type Deductible Coinsurance Total Out of Pocket Copay Premium % Cost Difference Cost of Copay/yearSaver (2) $10,000.00 $6,000.00 $26,000.00 N/A $285.72 Base of % Base No Copay80% Plan (2) (2) $10,000.00 $6,000.00 $26,000.00 N/A $374.78 23.76%Copay Plan (2) $10,000.00 $6,000.00 $26,000.00 $35.00 $445.28 35.83% $1,914.72Plan 100 (2) $10,000.00 $0.00 $20,000.00 N/A $443.43 35.57%Family HSA (1)* $10,000.00 $0.00 $10,000.00 N/A $521.38 45.20%

() Indicates number of persons needed to meet deductible requirement* HSAs have benefit of a health savings account and tax deduction of income and 0 tax when used for IRS acceptable major medical procedures and RxsNote: the plans outside the HSAs and 0 coinsurance plans have larger out-of-pocketsLook what it costs to have an office visit copay and other bells and whistles. Note: rich benefit plan

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WHY HSA QUALIFIED PLANS?

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Why HSA Qualified Plans?• You are in control of how you use your health care dollars.

• Become more involved in managing your cost of care.

• Learn how to shop for the best prices for your care.

• Your tax-advantage contributions to your HSA account grow over time.

• It is your money to use tax-free for qualified medical expenses.

• There is no “use it or lose it” philosophy. If you don’t use it, save it for next year. Or better yet, for retirement.

• After age 65, HSA funds can be used for non-qualified expenses and only income tax is assessed.

From HSABank website

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An HSA Growth IllustrationIncome tax reduction anyone?

Contribution 2011 Limits Single Family

Minimum Deductible $1,200 $2,400

Maximum Out-of-Pocket $5,950 $11,900

Contribution Limit $3,050 $6,150

Catch-up Contribution (55 or older) $1,000 $1,000

The Happy family with George age 30 and Susan age 30 have changed from a conventional major medical plan to a High deductible HSA qualified family plan. No kids yet, but who knows…. Remember HSA/HDHP family plans; all insured members have access to these funds for medical expenses as allowable by the IRS. When George and Susan convert to Medicare at age 65, here is what they have.

Estimates Below for this illustration:Enter your average contribution per year: $ 4,000.00Enter your average medical expenses per year: $ 850.00How many years will your account accumulate? 35Enter your federal tax bracket: 28% Enter your state tax: Florida no state income taxEnter your bank interest rate: 3%

Results of the Happy family having a HDHP/HSA:

Future Value CalculatorNet Contributions: $110,250.00 Net Contributions Per Year: $3,150.00 Tax Savings on Contributions: $30,870.00 Tax Savings on tax-deferred growth: $22,457.56 Future Value: $190,455.56 From HSABank website

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Ask Questions

Investigate Cost of

Care

Make InformedDecisions

ALL RIGHT: I’M READY TO TAKE CONTROL!

How do I do it?

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Are we shopping for major medical care services like we shop for other things?

Are we a savvy shopper for major medical care services?

Do we just wave our major medical insurance card and say ….. “just fix me?”

OR

• Do we ask what the costs will be?

• Do we check to find the least costs for the services needed?

• Do we use our network provider directory?

• Do we check out where we are going to buyour medications?

• Do we investigate second opinions and alternate treatment regimens?

• Do we investigate the treatment we need to be informed?

Check if you do:

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OUR VISITS TO OUR DOCTORS

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What to do at the doctor visit:• Inform your doctor of any changes you are experiencing.• Be honest about how you are feeling.• If you are taking medication(s) prescribed by another

doctor(s), inform your doctor of these and why you are taking them.

• Give your doctor your family medical history regarding major illness issues and cause of death. Go back to at least your grandparents.

Also be sure to:

Take your notebook and pen….

Take notes on what to do.

Ask questions……

Write down answers.

Dr Jones Visit 6/2/2011

Been having a sharp pain in

my back

Get an MRI

New RX

Take two pills every four hours

Xembonitin 5 mg

1 refill

Call Dr Smith if get dizzy and

stop taking medication

Is there a generic for this? Yes

Remember the 6th highest cause of death in the US is from taking

the wrong prescription!

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Some Helpful Resources:

Your doctor says you need to have a Carpal Tunnel condition evaluated and you need to have it verified by an MRA and then possible surgery.

You are now a savvy health care shopper what do you do?Here are some suggested internet resources:

The HSA Insider hsafinder.com

CDHC Solutions CDHC Solutions “Ask the Experts”

Consumer Driven Patient2Patient”Market Report

MCOL’s Consumer Driven Care

Or any other resource you choose. Here is what we found…

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MRI- MusculoskeletalAlways check our your provider directory and the cost first

Source: http://www.pearldiverinc.com/cct/content/index.jsp

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Carpal Tunnel SurgeryHow much do you want to spend?

Source: http://www.pearldiverinc.com/cct/content/index.jsp

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Are you receiving the best value for your dollar?Have you ever thought about paying cash instead of using your insurance? If you have a health savings account/ high deductible major medical plan, you have the best of both worlds.

or ?

Next time you visit your doctor and have to have an out-patient surgery and you have an HSA Account ask what it would cost if you paid using your plan or cash for it all?

Using my insurance plan. $

Not using a hospital. $

Using a stand alone facility. $

From the above ask the Big Question…What if I pay cash for the whole procedure using this facility?

$

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WHAT IS IN YOUR EYE?

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What is in your eye?Your eyes can tell you many things about the condition of your body. Examination of your eyes can forewarn you of subtle changes taking place in various parts of your body such as:

GlaucomaCataractsDiabetes

High Blood PressureNight BlindnessDetached Retina

Macro DegenerationDepth Perception

Wear good quality sunglass, avoid glares and use eye protection when working. Never ever look directly at the sun or other high intense light!!!!!

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ANYONE FOR HEARING?

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Anyone for Hearing?

Hearing is very important and subtle changes in hearing can cause long-term results:

• Get your hearing checked by competent professionals

• Early detection results in less chances of major loss.

• Never listen to very loud music or expose yourself to loud noises.

• Wear ear protection.

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SOME FINAL THOUGHTS ON OTHER CARE

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Get Your Dental Check-Up & CleaningWHY?• Prevents tooth decay• Check for oral cancers• Detection of Periodontal Diseases• Helps keep you healthy from other diseases.

Periodontitis (http://www.nlm.nih.gov/medlineplus/ency/art)

Periodontitis occurs when inflammation or infection of the gums gingivitis is untreated or treatment is delayed. Infection and inflammation spreads from the gums (gingiva) to the ligaments and bone that support the teeth. Loss of support causes the teeth to become loose and eventually fall out. Periodontitis is the primary cause of tooth loss in adults. This disorder is uncommon in childhood but increases during adolescence.CausesPeriodontitis occurs when inflammation or infection of the gums gingivitis is untreated or treatment is delayed. Infection and inflammation spreads plaque and tartar accumulate at the base of the teeth. Inflammation causes a pocket to develop between the gums and the teeth, which fills with plaque and tartar. Soft tissue swelling traps the plaque in the pocket. Continued inflammation eventually causes destruction of the tissues and bone surrounding the tooth. Because plaque contains bacteria, infection is likely and a tooth abscesses may also develop, which increases the rate of bone destruction.

Updated by: Jack D. Rosenberg, DDS, Advanced Dental Care, Palm Beach Gardens, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, M.D., MHA, Medical Director, A.D.A.M., Inc.

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Where do you keep a copy of your Health Care Power of Attorney?

Bank File Drawer Shoe Box Attached tosomething

Oh, it is somewhere around

One of the most important places to keep a copy of your POA Health Care is in:

The glove box

I never thought of that…..Mary Stewart912.434.2090

And carry a card like this in your wallet.

You never know what may happen.

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It’s all about how we take care of ourselves.Remember, take time out of your life for you

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QUESTIONS? COMMENTS?Contact Us:

Stewart’s Insurance Depot, John Stewart

S.E. Georgia 912.434.2090

N.E. Florida 904.729.4025

Metro Indianapolis, IN 317.570.1271

Metro Cincinnati, OH 513.868.0040

Nationwide 866.203.5097

Email: [email protected]

Website: www.stewartsinsuredepot.com