One of the first things to mention about the Alliance health plan is that this company really has a much extended network of pharmacies, clinics and doctor offices it co-works with and allows its clients to benefit discounts from. And, no doubt it is one of the major advantages over its market competitors. Having thousands of clients all over USA as their members that provider has the weight and power to negotiate the best prices with its network service partners. So, unlike it is with some smaller benefit plans sellers, with Alliance there is no need to worry about the limited number of places you can get serviced with its discount card. Now, to understand better what an Alliance is, it has to be stated that this plan is not any kind of health insurance. But, it certainly can be used along with your personal and group insurance. If your insurance, for instance, is not covering some drugs you need, you may get discounts from your that health plan.
Another benefit of using a health Alliance card is that you may include your close relations, living under your roof in your discount card, stating them as your dependents. So, your Alliance health plan may work as some sort of your family medical plans’ option. There are two different types of option: gold and platinum. Both of them provide discounts on such essential medical things, as prescription drugs, dental or vision care, chiropractic help, but platinum Alliance health plan also provides discounts on hospital and physicians services, while gold one doesn’t. It is great to know that an Alliance health plan does not have any restrictions as to the number of times you use it or as to any kind of medical condition you may have. In any case, your health plan provides you with up to 60 percents discounts on your prescription drugs and up to 30 percents discounts on your doctor visits. So, there is no limitation as to how frequently you may use it.
There are two payment options an Alliance offers to its clients: monthly fees and annual fees. Besides, there is a 24/7 support service working to help along its clients and to answer any questions. Signing up is not difficult. It can be done right online by filling out one simple application. So, no paper work is required. As you may see, using an Alliance health plan really can save you much money and cut down your health care bill by the half.
The Medical economics, managed care, governmental cut-backs, each a catalyst for downsizing has created a climate of unprecedented financial pressures. Consequently, new alliances and strategies for growth are at the forefront. Emerging as a viable affordable health care alternative, adult day care is such an alliance.
Adult day care, a community-based program designed to meet the needs of functionally impaired adults through an individual plan of care, is composed of 5-8 hours of care/ programing including door-to-door transportation and lunch for adults 18 and over. It is a program designed to serve adults who may be physically impaired, who may have some form of dementia, and who may need special supervision, increased social opportunities, assistance with personal care or other activities of daily living.
Senior citizens, wheelchair bound or ambulatory, may not as yet require the services provided by a nursing home; a center very likely, will be all the support necessary for these individuals. Thus, adult day care meets the needs of the frail elderly and provides a cost efficient alternative to institutionalization.
Professional nurses can have a tremendous impact on society in adult medical day care. By daily evaluation of the frail elderly, nurses can recognize and interpret the signs of a potential medical problem and often prevent a medical emergency. Professional nursing is the basic premise upon which the cost saving centers are based; without which centers cannot function efficiently.
The financial incentive to start one’s own facility is excellent. States now provide a Medicaid Waiver which allows people to stay in their own homes; grant money and Veterans benefits are also available. Moreover, these programs can be enhanced by providing revenue producing ancillary services such as nursing services, geriatric nurse practitioners, medical care, rehabilitation, occupational, physical and speech therapies, family support, nutritional counseling, mental health services, medication reviews and case management for those senior citizens coping with multiple health problems. These services may be billed to Medicare. These programs reduce geriatric hospital stays and re-admissions by providing an additional discharge option.
This type of facility requires the least amount of “start-up” capital when compared to other health related facilities. Some adult day care centers were started in churches. This enabled these centers to have an initial client-base from the congregation. Thus, because of their low rent involvement their start-up capital was minimal.
The demand for these centers continues to grow. By the year 2020, it is estimated that our nation’s elderly population will increase to over 53 million.
In this complex world, where our technologies may sometimes compromise our ideologies, there are some justifiable concerns over the quality and quantity of care being received by our frail elderly. Whereas, with adult medical day care, the frail elderly can obtain the medical and social assistance they require, and the cost savings pressures of managed care and downsizing may be satisfied.
Recently there has been a proliferation of advertisements for health cards. These cards claim to offer access to high quality and affordable medical care, dental care, prescription drugs, vision and other health care services. The rates vary but may be as little as $20 a month to as high of $125 a month for a family. The two big selling points of these plans are that they are affordable and that you cannot be turned down.
Exactly what are you buying? Health cards can also be called discount medical programs or plans. This industry has grown so large that they even have their own trade association, the Consumer Health Alliance. Here is the definition of a health card given by the Consumer Health Alliance. “Our member companies make health care products and services, including prescription drugs, dental, chiropractic, eye care, physician, hospital and laboratory services, available to millions of Americans by providing opportunities for consumers to directly purchase health care services and products at discounted rates.” According to the Consumer Health Alliance more then 28 million consumers have purchased these plans for various companies.
The problem lies not in the concept of the programs but in the sale and execution. The most important fact you must know about these health cards is that they are NOT health insurance. Many consumers have failed to understand what they are buying and as a result have been saddled with hundreds and even thousands of dollars in medical bills they assumed would be covered by their health card.
These plans advertise that they are affiliated with networks of medical providers. That is generally true. Their affiliation may even be with some of the national networks that insurance companies use themselves. The plan representative tells you that if you use the services of a network provider, you will get a discount on the service similar to the discounts that insurance companies negotiate when providers join their networks.
One company, for instance, gives you an example. If you see a network provider, that doctor’s normal charge for an office visit may be $120. But with your discount health card, you will only be charged $90 thus saving you $30 each time you visit the doctor, On the surface that may sound good, but remember, the consumer and only the consumer, has to pay the provider $90 every time he visits that doctor.
What happens if we discuss a hospitalization rather than a doctor’s visit. You find you need a hip replacement. According the the American Academy of Orthopedic Surgeons, the average cost of a hip replacement in 2006 was $42,000. You see a doctor who is in the network used by your $29.95 a month health card. You expect to get a significant discount for the procedure because you used a network provider. Remember your doctor visit. You got a $25% discount and only had to pay the doctor $90 of the $120 bill.
But now you have a bill from the hospital for your hip replacement for $42,000. It is also discounted at 25%. That means you owe the hospital $31,500. And you have to pay it. It’s better than owing $42,000 of course, but $31,500 is still a pretty significant amount of money that the consumer has to pay out. Unfortunately, the companies that sell these cards focus your attention on the small services. But, if consumers are smart, they will focus on the big items, which is the real risk of not having health insurance.
For some people who don’t qualify for medical insurance, discount cards may be the only option. Individual health insurance generally is medically underwritten which means if a person has a medical condition that the insurance company does not want to insure, they will be unable to get health insurance. Most states have what are called pool plans, which will insure persons with medical conditions, but as you can imagine, these plans are extremely expensive.
The real danger of these cards is the aggressive methods used to sell them. Many of these plans are actually sold as Multi Level Marketing plans. The sales representatives do not have to be licensed insurance agents, because the plans are not insurance. There interest is in adding people to their downline as that is how they make money. Learning the programs and carefully advising consumers as to what they are buying may not be the most important thing to these sales representatives.
If you are considering buying a health plan, be careful and ask questions. Understand first and foremost, that you are NOT buying insurance. Be wary of extravagant promises of discounts up to 60%. In our hip replacement example, for instance, a 60% discount would mean the service would only cost you $16,800. It is unlikely that a provider hospital would give you that kind of discount. Ask for specifics about hospitals, doctors and procedures. Ask if all the providers honor the advertised discounts. Sometimes doctors and other providers are not even aware they are listed as participants in these plans.
Ask about hidden fees. Often there are administrative fees hidden in the fine print. Be especially careful if there are fees charged for each use of your card. These fees may eat up almost all of your discount.
Discount health cards are never a substitute for health insurance. Before you consider buying one, think about how you will use it. If your need is for less expensive services, such as routine doctor’s visits, dental or vision discounts, they may be worth it. Remember, if you need an expensive procedure such as a hospitalization or surgery, you will be paying most of the bill yourself. No matter what the representative tells you or the advertisements imply, your card will never pay one single cent to any provider. The consumer will always be responsible for the amount of the charge less any discount that might be applied.
Consider your needs and the needs of your family. If you can afford it, buy health insurance. Even a plan with a high deductible such as an HSA will be a better option because at some point after the deductible is met, the insurance will pay the balance of the bill. If you can’t afford insurance or you cannot qualify because of medical problems, a health card may be useful. But before your buy, understand what it is and what it can really do for you.
In Pennsylvania alone, over 1.4 million people lack health insurance. My family was part of this statistic less than two years ago when my husband unexpectedly lost his job. To make matters worse, just five days earlier, we learned we were pregnant with our second child. The financial position we found ourselves in was terrifying. We dropped a full-time income and lost medical insurance in only one week’s time. Cobra was offered to us, but with the loss of income, we didn’t have the $400 it would cost for the monthly premium. Thousands of individuals and families find themselves in similar situations everyday. There are several reasons for the lack of insurance. But whatever the reason, it is important to know that you have options.
According to the Consumer Health Alliance more than 45 million Americans are without health benefits and that number is steadily growing. In most cases, for the households with no benefits, at least one person in the household is working a full-time job. The number of households that have insurance are dealing with rising premiums, rising co-pays, and a loss of benefits. In fact, health insurance costs are rising by 10% to 15% or more annually! The middle class is the hardest hit by these rising costs. They make too little to cover insurance premiums on a monthly basis, but they make too much to qualify for Medicaid. The Health Care Situation is distressing. But it’s NOT hopeless.
Consumer Driven Health Care is a relatively new concept but it should by no means be overlooked. The Consumer Health Alliance was launched in 1992 to regulate this new industry. The companies affiliated with the Consumer Health Alliance offer discount medical cards to their members. According to the Consumer Health Alliance, these discount cards are gaining popularity because they allow consumers to gain access to the healthcare they need without the exclusions, limitations, and paperwork typically associated with insurance. If you are suffering from a medical condition and can’t get insurance, a discount plan won’t exclude you! In fact, your medical history is of no concern to them. You can enroll in the plan and get affordable care immediately! And even better, the monthly membership fee is nominal.
The other benefit to these plans is that many offer supplemental packages that include dental, vision, prescription, and chiropractic benefits that are an affordable complement to insurance plans. Too many companies are having to scale back the benefits packages for their employees just to keep insurance affordable. Although a good dental plan is the 2nd most requested benefit, it’s also one of the first things to go when a company is forced to cut back.
The plans work this way. For a low monthly fee, members of discount plans gain access to wholesale rates similar to what large insurance companies pay. When care is received at a participating provider, the member pays the discounted fee at the time of service. It’s a benefit not only to the member, but also to the provider who is able to get payment up front with no paperwork to file. The services offered by the benefits companies will vary. For example, AmeriPlan Health® offers a comprehensive package for the uninsured that includes Doctors, Specialists, Ancillary care (labs, scans, hearing, etc.), Dental, Vision, Prescription, Chiropractic, and Hospitalization. They also offer a Dental Plan that includes FREE Vision, Prescription, and Chiropractic Benefits.
Should you look into a fee-for-service plan? That depends, every insurance plan is different. Some are very comprehensive and include a good dental and vision plan. Others don’t. If you’ve got kids that need orthodontic work, a discount plan could save you thousands. If you are looking into bridgework, cosmetic dentistry, or dentures, it would be worth your while to check out a discount plan. I can’t say enough about how great these plans are.
It’s my mission to get benefits to those who need them. I will never forget the stress our family faced when we didn’t have any medical benefits. If you are undinsured or underinsured, look into your options. You can get affordable care. And if you are uninsurable, there is help for you as well!