The Obama administration’s creation of the Affordable Care Act sparked a major battle. One particular mandate that is being challenged by Florida Republicans is the health care reputation mandate. Gov. Rick Scott is seeking a waiver that would potentially cost nearly $60 million in refunds alone. Who can lose? Health insurance consumers may be out of luck.
What is the health insurance reimbursement mandate?
It is known as the minimum loss rate (MLR) mandate. It states that insurance companies that do not spend at least 80 percent of the premiums they charge on individual and small business health insurance plans must provide refunds to policyholders. According to the Florida Office of Insurance Regulation, nearly 340,000 Floridians would be eligible for those Florida health insurance reimbursements. Under health care reform, insurers can keep 20 percent of premiums for administrative expenses and profits, but insurers are fighting for a bigger share even as some insurers have reported record profits. .
While people who really don’t have a problem paying for health insurance decide whether those who do will get help, you can regain some control over the cost of health care. Instead of waiting for reimbursement, see what other strategies can help you spend less on health care.
It is well known that Florida health insurance plans that do not cover major medical expenses until you have paid a fair number of medical bills on your own have some of the lowest monthly premiums available. If you think that’s not for you because you need a doctor to help you manage your diabetes or because you’re taking a lot of prescriptions, the 2011 changes may make those plans more appealing.
Even a plan with a $10,000 deductible purchased now begins to cover health care immediately, as long as the service is coded with the correct preventive health care codes. Everything from checkups and tests to detect illnesses to counseling to help you lose weight or improve the nutrition level of your meals is covered without having to pay a deductible. However, there is a caveat. You will need to work with doctors in the plan’s network to avoid out-of-pocket costs.
These covered preventive health care services may not provide everything you need, but you can save so much on premiums with a high-deductible plan that the amount you save will pay for any extra. Seriously, people are shifting to reduce their annual health insurance bill by millions and thousands of dollars.
For any health care you pay for yourself, look for ways to lower those costs, too. Prescription prices are notoriously high, more and more pharmacies offer discount programs. Also, insurance agents are handing out discount cards for prescription drugs. You can also buy your medicine in a stronger dose for the same price you are paying now. Pharmacies sell real pill splitters so you can simply cut pills in half to continue taking the same dose, only at half the cost.
You can also check out PPO plans. This is a form of managed care that gives you substantial discounts for using a network provider. PPO networks are known for including a substantial number of providers, so they rarely narrow down your choice of doctors much. However, always check a plan’s provider network before submitting a request.