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"Is 'Obamacare' like Canada's health-care system? 'Not even close,' according to critics The first major U.S. health-care reform passed in nearly 50 years is the Obamacare but regardless of critics passing judgment on "Obamacare" as "Canadian-style" health insurance, critics note that major differences between the two systems persist. The U.S. Patient Protection and Affordable Care Act, which went into effect earlier this week, is "not even close" to the Canadian system says McGill University Professor of Political Science Antonia Maioni. "Obamacare keeps in place the basic principle of health care in the United States which is: if you want to get access to care you need to buy insurance coverage," she told CTV News Channel on Friday. "Obamacare is trying to make it easier for people to be able to buy that insurance coverage and, if you are very poor, to be able to qualify for a government program. But it doesn't have the same principle as in Canada, where if you are a legal resident, you are automatically enrolled in a provincial or territorial health plan." In an op-ed published in the Globe and Mail, Maioni said the major differences between "Obamacare" and Canada's health-care system include: "Obamacare" is not a single-payer system (where one entity, usually the government, pays all costs) Care depends on the type of insurance coverage you buy Insurance coverage varies by state Wait times are based on the level of insurance coverage Obamacare" faces challenges in cost control Maioni said that while "Obamacare" was passed, in part, to address American spending on health care - the highest in the world at nearly 18 per cent of GDP, or $3 trillion - the act remains "problematic." "There's nothing in it that speaks to really serious cost control," she said. She furthermore said that while Canada also spends a lot on health care, there are mechanisms that the provinces can use to contain spen

February 25, 2014 - The Internal Revenue Service is offering educational Health Care Tax Tips to help individuals understand how the Affordable Care Act may affect their taxes. The IRS has designed the Health Care Tax Tips to help people understand what they need to know for the federal individual income tax returns they are filing this year, as well as for future tax returns. This includes information on the Premium Tax Credit and making health care coverage choices. Although many of the tax provisions included in the law went into effect on Jan. 1, 2014, most do not affect the 2013 tax returns. The Health Care Tax Tips, which are now available at IRS.gov/aca, include: * IRS Reminds Individuals of Health Care Choices for 2014? Find out what you need to know about how health care choices you make for 2014 may affect your taxes. * The Health Insurance Marketplace - Learn about Your Health Insurance Coverage Options - Find out about getting health care coverage through the Health Insurance Marketplace. * The Premium Tax Credit? Learn the basics of the Premium Tax Credit, including who might be eligible and how to get the credit. * The Individual Shared Responsibility Payment - An Overview? Provides information about types of qualifying coverage, exemptions from having coverage, and making a payment if you do not have qualifying coverage or an exemption. * Three Timely Tips about Taxes and the Health Care Law? Provides tips that help with filing the 2013 tax return, including information about employment status, tax favored health plans and itemized deductions. * Four Tax Facts about the Health Care Law for Individuals? Offers basic tips to help people determine if the Affordable Care Act affects them and their families, and where to find more information. * Changes in Circumstances can Affect your Premium Tax Credit? Learn the importance of reporting any changes in circumstances that inv

Consumer Alert: The Impact of Health Care Fraud on You! In 2011, $2.27 trillion was spent on health care and more than four billion health insurance claims were processed in the United States. It is an undisputed reality that some of these health insurance claims are fraudulent. Although they constitute only a small fraction, those fraudulent claims carry a very high price tag. The National Health Care Anti-Fraud Association (NHCAA) estimates that the financial losses due to health care fraud are in the tens of billions of dollars each year. Whether you have employer-sponsored health insurance or you purchase your own insurance policy, health care fraud inevitably translates into higher premiums and out-of-pocket expenses for consumers, as well as reduced benefits or coverage. For employers-private and government alike-health care fraud increases the cost of providing insurance benefits to employees and, in turn, increases the overall cost of doing business. For many Americans, the increased expense resulting from fraud could mean the difference between making health insurance a reality or not. However, financial losses caused by health care fraud are only part of the story. Health care fraud has a human face too. Individual victims of health care fraud are sadly easy to find. These are people who are exploited and subjected to unnecessary or unsafe medical procedures. Or whose medical records are compromised or whose legitimate insurance information is used to submit falsified claims. Don't be fooled into thinking that health care fraud is a victimless crime. There is no doubt that health care fraud can have devastating effects. What Does Health Care Fraud Look Like? The majority of health care fraud is committed by a very small minority of dishonest health care providers. Sadly, the actions of these deceitful few ultimately serve to sully the reputation of perhaps the most trusted and respected members of our society-

http://www.westhillinsuranceconsulting.com/blog/westhill-consulting-retire-overseas-8-top-spots-for-quality-health-care/

Retiring overseas may seem like a fabulous idea, but the quality of health care often has post 50s thinking twice before making a move abroad. But they needn't worry.Live and Invest Overseas, an online publication devoted to helping those interested in living abroad, has a list of the eight best places to retire for quality health care. (They also published a list of the 21 best places to retire in 2013 earlier this year.)

A nonprofit organization the three work with known as Health Care Cost Institute, a nonpartisan research organization, said the insurance companies will develop and provide consumers "free access to an online tool that will offer consumers the most comprehensive information about the price and quality of health care services." Additional health plans could soon join Aetna, Humana and UnitedHealth in the effort. The move by the insurance companies comes as more Americans gain health care coverage under the Affordable Care Act. Meanwhile, these newly insured Americans and those already with coverage are demanding more information about the cost of care as deductibles and co-payments rise and they pay more out of their own pockets for medical services and treatments. "This unprecedented initiative is testament to our belief that educated consumers benefit the entire health care system," UnitedHealth Group said in a statement to Forbes. The information on prices will also include information about quality and other information in an effort to help health care become more transparent. "Consumers, employers and regulatory agencies will now have a single source of consistent, transparent health care information based on the most reliable data available, including actual costs, which only insurers currently have," David Newman, the Health Care Cost Institute's executive director said in a statement issued this morning. There will be three tiers of information provided. In one tier, any consumer will get average price information for an "episode of care" such as a knee replacement or heart surgery based on complex coding and claims data submitted to and analyzed by the Institute. In another tier, consumers with coverage from Aetna, Humana or UnitedHealth Group will get more detailed price information given the health plan subscribers in their plans already have a relationship with the companies and therefore more specific information on their networ

Westhill Consulting Insurance - How to Avoid Health Care Fraud Mail-order medications Patients who buy drugs through mail-order companies could be rolling the dice with their health says Dr. Deborah C. Peel, a physician and founder of the nonprofit Patient Privacy Rights. There's a high probability in many cases that these drugs are counterfeit Peel added. "And you don't ever know because the fraudulent tablets look just like the real ones," says Peel. She says ordering from companies that specialize in mail-order sales that are not affiliated with a legitimate insurance company, especially from foreign countries, can be very risky. Not only could the quality be questionable, it could also be illegal. "But people are desperate because we're being so grossly overcharged for medication," she says. Peel says you can lessen costs by buying generic. You can spot it by: the best thing to do is to keep away from buying drugs from foreign or obscure pharmacies. And if you decide to go with the mail-order route, just stay with U.S.-based companies because if it's a U.S. company, you can report the health care fraud to the Food and Drug Administration while if it's a foreign company, there's little that can or will be done. False product claims According to the Federal Trade Commission, millions fall victim each year to false miracle cures. Especially vulnerable are victims of debilitating and potentially deadly illnesses such as cancer, multiple sclerosis, HIV and AIDS. The FTC website says scammers take advantage of people with a grim diagnosis such as cancer and "promote unproven - and potentially dangerous - substances like black salve, essiac tea, or laetrile with claims that the products are both 'natural' and effective." But, say physicians and other experts, simply because something is advertised as "natural" doesn't mean it works. And while a patient is experimenting with bogus treatments, he or she can squander the opportu

Health care fraud is a type of white-collar crime that involves the filing of dishonest health care claims in order to turn a profit. Fraudulent health care schemes come in many forms. Practitioner schemes include: individuals obtaining subsidized or fully-covered prescription pills that are actually unneeded and then selling them on the black market for a profit; billing by practitioners for care that they never rendered; filing duplicate claims for the same service rendered; altering the dates, description of services, or identities of members or providers; billing for a non-covered service as a covered service; modifying medical records; intentional incorrect reporting of diagnoses or procedures to maximize payment; use of unlicensed staff; accepting or giving kickbacks for member referrals; waiving member co-pays; and prescribing additional or unnecessary treatment. Members can commit health care fraud by providing false information when applying for programs or services, forging or selling prescription drugs, using transportation benefits for non-medical related purposes, and loaning or using another's insurance card. When a health care fraud is perpetrated, the health care provider passes the costs along to its customers. Because of the pervasiveness of health care fraud, statistics now show that 10 cents of every dollar spent on health care goes toward paying for fraudulent health care claims. Congressional legislation requires that health care insurance pay a legitimate claim within 30 days. The Federal Bureau of Investigation, the U.S. Postal Service, and the Office of the Inspector General all are charged with the responsibility of investigating healthcare fraud. However, because of the 30-day rule, these agencies rarely have enough time to perform an adequate investigation before an insurer has to pay.

The needs of elderly parents can surprise even those who are prepared, but you don't have to support your family alone Adult children of older parents should prepare financially for the costs of care and travel. Photograph: Alamy We all want to age like the late Pete Seeger, who celebrated his 90th birthday performing onstage in front of thousands of adoring fans of all ages at Madison Square Garden, and went on to entertain the Newport Jazz Festival audiences a few months later. In our pragmatic moments, we know that the odds of living that long and in such good health aren't in our favor. We know we need to plan not only to live longer but perhaps to spend more time in costly nursing homes or care facilities. It's not just ourselves we have to worry about. Failing to develop a plan to help our parents in their final years could deliver a similar kind of blow to our emotional and financial wellbeing. In the last few months, I've watched three friends, ranging in age from their 40s to the early 60s, scramble to resolve non-medical problems for their parents. In all cases, that meant forking out on costly airfares to be there in person; in one case, it required money to hire a new accountant. "I've always been aware that at some point, there would be an emergency, but I had assumed it would be a stroke or something, not this," one told me, ruefully. A recent US Trust survey revealed that while about half of all Americans have planned for their own long-term care needs, on

All the news about the Affordable Care Act has got me thinking about my health. I've been looking to download some health and fitness apps, but I notice many ask for a lot of personal information. Just how safe are these to use? The Affordable Care Act is bringing health care to a lot people's attention. It is also proving to be a field day for scammers. The Affordable Care Act has finally gone into effect. It brings sweeping changes to America's health care system. As usual, I am not going to comment on any of the politics involved. But I think everyone will agree that navigating the new system is very confusing. As with any moment of confusion, scammers are jumping in. They have got some new scams cooked up to scare and trick you. Let us start with insurance scams. One widely publicized requirement of the Affordable Care Act is that everyone needs insurance. I know some people are just going to grab whatever plan is cheapest. You might be tempted to fire up Google and search for insurance companies, but that is a bad idea. Scammers are setting up tons of fake insurance websites. You think you are signing up for insurance but you are really giving away your information. The place to start your search is the Health Insurance Marketplace at healthcare.gov. This is the official federal source for insurance providers. Of course, nothing is that simple. Sixteen states and the District of Columbia have their own marketplaces.

The clock on insurance deductibles reset on Jan. 1, and that means big medical bills are in store for some. Patients may be required to pay thousands of dollars before their health care coverage kicks in. Insurers typically begin or renew policies in January, and that means customers could face some daunting cost-sharing requirements in the first few months of the year. That's especially true if they need surgery or have a particularly expensive prescription. Deductibles topping $3,000 are common among plans sold on the health care overhaul's public insurance exchanges, which provide coverage for millions. Companies also have been raising deductibles for years on employer-sponsored health plans, the most common form of coverage in the United States. Plus cost-sharing requirements for Medicare prescription drug coverage renew every year. All this adds up to a business boon for organizations like the Patient Access Network Foundation, which offers grants to help cover prescription costs for dozens of life-threatening, chronic or rare diseases. The nonprofit had to hire about 80 temporary employees to help handle the heavy workload it receives at the start of the year. It fielded 4,000 calls a day last month, double its normal total. "Everybody who works doing what we do has the same challenge," CEO Daniel Klein said. Klein's foundation is one option patients can turn to if too many expenses hit at the start of the year. Here are some other tips. Understand your coverage: You can't prepare for medical expenses until you know how big the bills might be. Your insurance should come with a plan summary that lays out important numbers. Start by understanding your plan's deductibles, which can differ significantly depending on whether care is received inside or outside the insurer's network of providers. If you take prescriptions, double check how much they will cost. Drug coverage is commonly divided in

Here's some cheerful news: States and the federal government are doing little to stop a costly form of Medicaid fraud, according to a government report released last week. Medicaid, the federal-state health insurance program for poor Americans, now covers more than half its members through what's known as Medicaid managed care. States pay private companies a fixed rate to insure Medicaid patients. It has become more popular in recent years than the traditional "fee for service" arrangement, in which Medicaid programs reimburse doctors and hospitals directly for each service they provide. Despite the growth of managed care in recent decades, officials responsible for policing Medicaid "did not closely examine Medicaid managed-care payments, but instead primarily focused their program integrity efforts on [fee-for-service] claims," according to the Government Accountability Office, the investigative arm of Congress. The managed-care programs made up about 27 percent of federal spending on Medicaid, according to the GAO. The nonpartisan investigators interviewed authorities in California, Florida, Maryland, New Jersey, New York, Ohio, and Texas over the past 12 months. STORY: No Background Checks Needed for Home Health Workers in 10 States Funded jointly by the federal government and the states, Medicaid provided health insurance to about 72 million low-income Americans at a cost of $431 billion last year, according to the report. By the Medicaid agency's own reckoning, $14.4 billion of federal spending on Medicaid constituted "improper payments," which include both overpayments and underpayments. That's 5.8 percent of what the federal government spends on the program. The $14 billion figure doesn't tally what states lose to bad payments. The fraud risk for managed care is twofold. Doctors or other health-care providers could be bilking the managed-care companies, which pass on those fraudulent costs to the government.

Not long after she signed up for health insurance under the Affordable Care Act, Judy Shoemaker received a phone call that puzzled her. The caller said she was welcoming new members to the insurance network and then asked Ms. Shoemaker to take a survey about health care issues, so information could be provided to her physician. Ms. Shoemaker declined, saying she didn't understand why her insurer would be seeking medical information to give to her doctor. "I thought it was strange," said Ms. Shoemaker, a consultant to nonprofits in Indiana. "I can talk to my doctor myself." James Tuck, who runs a dog care business in Chicago, got a similar call after signing up for insurance through the Affordable Care Act in March. The caller said he was contacting Mr. Tuck on behalf of his new insurer, Blue Cross Blue Shield of Illinois, to go over his benefits and ask him some questions. Mr. Tuck hadn't yet received his insurance card and was hesitant to answer questions, especially after he consulted a private health advocate, who had helped him evaluate insurance options. She advised him not to answer the queries. "She said their goal is to find a reason to get you booted off your insurance." Insurers say they are doing nothing of the sort. Lauren Perlstein, a spokeswoman for the Health Care Service Corporation, parent of Blue Cross Blue Shield of Illinois and plans in four other states, said in an email that the company contacted new policy holders to help "new members get the proper coverage and medical assistance they need, by helping guide them through the health care system." The company's "experts" contact new members to explain benefits and answer any questions, she said, as well as to "identify members who can benefit from our personalized medical management program so they can best manage their health."

With the widespread of insurance nowadays, people are confused which one is legit and which one is a fraud; which can offer better and which one cost less. Choosing the right health coverage has never been easy, and the health reform law has made things more complicated. Besides sorting through differences in premiums, deductibles, and copayments, you need to consider new provisions in the law that have recently kicked in and could impact your coverage for the coming year. Westhill Insurance Consulting can help you clear away any confusion, doubts and complaints. Health insurance should cover any medical need you may have, now or in the future. Buying insurance on your own used to be riskier because many plans didn't cover important things such as prescription drugs or mental health care. Every kind of health insurance must now cover preventive care, with no deductibles, co-pays, or other types of out-of-pocket expenses. That includes Pap and cholesterol tests, mammograms, immunizations, and colonoscopies when age- and condition-appropriate. But even though you no longer have to worry about your basic health care needs being covered, you'll still have to navigate lots of other confusing choices. That's true even if you get coverage through a job, because more than half of workers have a choice of two or more types of health plans. 1. Do you want to pay for care now or later? All health plans have to come up with enough money to pay for the medical expenses of their members. You can choose to collect most of the money up front in the form of premiums. If you have a high premium, you'll pay a smaller share out of your own pocket, in the form of deductibles, co-insurance, and co-pays. Or plans can go the other way, charging smaller premiums but asking you to pay a bigger share on your own. 2. Are you OK with a small network of docs? Doctors and hospitals accept lower fees from insurers if they know they'll be part of a small, o