Archive for August, 2017

Share of Cost, Stress hormone in hair could predict IVF outcomes

Thursday, Aug. 31st 2017 6:00 AM

A woman’s chances of pregnancy success with in vitro fertilization might be predicted through hormone levels in her hair. This is the finding of a new study published in the journal Psychoneuroendocrinology.

Conducted by researchers from the University of Nottingham in the United Kingdom, the study reveals that women with higher levels of the “stress hormone” cortisol in their hair were significantly less likely to conceive through in vitro fertilization (IVF) than women with lower levels.

Posted on Thursday, Aug. 31st 2017 6:00 AM | by Share of Cost | in Share of Cost | No Comments »

Gum Disease and Insurance Benefits.

Tuesday, Aug. 29th 2017 6:51 AM

Most all dental insurance plans will provide some coverage’s/benefits for the treatment of gum disease. When reviewing insurance plans you will find gum disease treatment either listed under Periodontics category in an HMO dental insurance plan or under majors services under most PPO and Indemnity insurance plans. Note: It is important to beware when buying a PPO and or an Indemnity dental insurance, that they will typically have waiting periods for majors dental care services. Waiting periods can very depending on the plan but in general terms, they can run around a year to 18 months.

Posted on Tuesday, Aug. 29th 2017 6:51 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Medicare Card, If You Are Looking to Enroll in a Medicare Plan

Sunday, Aug. 27th 2017 6:49 AM

Tips If You Are Looking to Enroll in a Medicare Plan

*  Be suspicious of anyone who contacts you about Medicare plans unless you gave them permission.

* There are no “early bird discounts” or “limited time offers.”

* Don’t let anyone rush you to enroll by claiming you need to “act now for the best deal.”

* Be skeptical of free gifts, free medical services, discount packages or any offer that sounds “too good to be true” – especially if you need to hand over your Medicare number in order to receive these items or deals. Decline politely but firmly.

* By law, any promotional items you’re offered to enroll in a plan must be worth no more than $15, and these items can’t be given on the condition that you enroll in a plan.

Call the California Senior Medicare Patrol (SMP) at 1-855-613-7080 to report suspected fraud.

Posted on Sunday, Aug. 27th 2017 6:49 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Medicare Card, Follow These Important Steps to Protect Yourself From Fraud

Friday, Aug. 25th 2017 5:46 AM

Follow These Important Steps to Protect Yourself From Fraud

* Don’t share your Medicare number or other personal information with anyone who contacts you by telephone, email, or by approaching you in person, unless you’ve given them permission in advance.  Medicare will NEVER contact you for your Medicare number or other personal information.

* Tell your friends and neighbors to guard their Medicare number.

* Don’t ever let anyone borrow or pay to use your Medicare number.

* Review your Medicare Summary Notice to be sure you and Medicare are only being charged for actual services.

* Be wary of salespeople who knock on your door or call you uninvited and try to sell you a product or service.

* Don’t accept items received through the mail that you didn’t order.  You should refuse the delivery and/or return it to the sender.  Keep a record of the sender’s name and the date you returned the items.

Posted on Friday, Aug. 25th 2017 5:46 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Guard Your Medicare Card

Wednesday, Aug. 23rd 2017 6:24 AM

Health care fraud drives up costs for everyone in the health care system. One way to protect against such fraud is to guard your Medicare number. Fraud schemes often depend on identity thieves getting hold of people’s Medicare numbers, so treat your number as you would a credit card.

 

 

Posted on Wednesday, Aug. 23rd 2017 6:24 AM | by Share of Cost | in Social Security | No Comments »

Share of Cost, ‘Marijuana receptor’ uncovered in new study

Monday, Aug. 21st 2017 6:00 AM

THC is the main psychoactive component of marijuana that is responsible for the mind-altering effects of the drug, but the exact mechanisms by which it produces such effects have been unclear. Now, researchers have pieced together the clearest picture to date of how THC binds to a specific cannabinoid receptor in the brain to produce the “high” associated with marijuana use.

In a study published in the journal Cell, researchers reveal how they have uncovered the structure of cannabinoid receptor 1 (CB1) – a receptor that is present on the surface of many nerve cells in the brain.

Posted on Monday, Aug. 21st 2017 6:00 AM | by Share of Cost | in Share of Cost | No Comments »

Treatment of Gum Disease

Saturday, Aug. 19th 2017 5:38 AM

To treat gum disease condition, your dentists scrape off the tartar on the surface of your teeth and under your gums. This type of dental service it normally call a deep cleaning. After having a deep cleaning done they may also have to use conventional antibiotics.

Posted on Saturday, Aug. 19th 2017 5:38 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, CHA Comments on Proposed Short Term Care Insurance Regulations

Thursday, Aug. 17th 2017 5:29 AM

October 20, 2016

 

Commissioner Katharine L. Wade
State of Connecticut Insurance Department
Attention: Kristin M. Campanelli
P.O. Box 816
Hartford, CT 06142-0816

 

Re: Proposed Short Term Care Insurance Regulations

 

Dear Commissioner Weddle:

We write to comment on your department’s proposed regulatory changes to short term care insurance policies. As you know, I am a funded consumer representative to the National Association of Insurance Commissioners (NAIC). I am a Policy Specialist for California Health Advocates (CHA), a not-for- profit organization that among many other Medicare related topics provides information, training, and education on long-term care and long term care insurance. We promote high legislative and regulatory standards for long-term care insurance in our state legislature, at the NAIC, and in Congressional testimony.

At the national Summer meeting of the NAIC, a new subgroup was appointed at our request to explore the issue of how these short term care policies are regulated. My request was backed up by a letter to the SITF signed by 20 consumer group representatives requesting that these products be regulated as long term care insurance. It seems illogical to many people that a product offering nursing home and home care benefits for 360 days or less is regulated differently, and under very general minimum standards, than one that provides those same benefits for 364 days or more. We have not heard a reasonable argument about why consumers should not be protected under the same standard simply because they buy a benefit that covers them for a fewer number of days.

As I review your proposed regulation I note that you have incorporated some of the standards from the long term care insurance models. I would encourage you to go beyond HR 5521 and bring these products under the umbrella of the long term care insurance standards with any exceptions for those elements you think shouldn’t apply to these products.

All of the definitions of benefit triggers, benefits, services, and places of care should be the same in a short term policy as they are in the NAIC Model

All of the disclosures in the NAIC Models should be required in a short term care policy, plus one additional disclosure.

A disclosure should be developed to clearly describe the limitations of a short term care policy with very limited benefits. Purchasers of a short term care policy should also be advised about the availability of a Partnership policy to cover one year of care that can potentially provide them with additional protection of their assets.

In any replacement situation agents should be required to identify in writing the reason for replacement, and explain why the replacement policy is to the advantage of the consumer. If coverage is being added to existing coverage agent should be required to explain in writing the advantage of the additional coverage to the applicant. These explanations should be part of the application or separately attached to the policy.

There is no justifiable reason that companies selling short term coverage ranging from a few months of benefit to just under one year be allowed a 55% loss ratio. The profit margin on these limited benefits is unreasonable, and short term policies should at a minimum comply with a 65% loss ratio for individual coverage and 75% for group coverage.

The actuarial evaluation of premiums for these policies should include an assessment of the limited risk a short term care policy is assuming, and require premiums to reflect that limited risk. In addition, an actuarial evaluation should take into account the difference in underwriting for a short term policy and for a traditional policy. Even with limited benefits it’s possible a company selling one of these short term care policies could underestimate their ultimate claims assumptions and fall into a spiral of rate increases. In another instance a policyholder could ultimately pay more in premiums over their lifetime than the small amount of benefit promised by a few months of coverage.

A consumer buying a short term care product providing benefits for a few months of coverage instead of years should not be less secure or less protected than someone buying more of the same benefits. In fact, consumers buying these limited benefits may require even more protection. They are more likely to be lower income or have a health condition than those who can afford or qualify for a greater amount of coverage. Consumers who buy short term care policies need all of the regulatory protections provided to those who buy a traditional long term care insurance product.

I’ve identified a few issues for your consideration with portions of the proposed regulation:

People buying these products think they are buying long term care insurance or benefits, but for a shorter period of time. Terminology throughout the regulation reinforces the ability of short term care policies to restrict benefits to needs and services that are primarily medical in nature, provided by or under the direction of medical personnel, and in facilities primarily or secondarily providing medical care services. This medical connection has little application to the need for nursing home and home care and community based care. It simply allows companies to restrict or limit benefits by connecting them in some way to medical care.

The use of the term “home health care” instead of home care allows medical criteria and personnel to be applied to care that is primarily a need for personal care services (formerly custodial care).
The use of “own home” and home “health” care throughout the regulation reinforces the ability of companies to restrict benefits and care.

Definitions throughout the regulation of “own home” would allow companies to deny benefits to someone living in the home of a family member, living in an independent living situation from receiving home care services in that setting.

Cognitive impairment represents about half the claims for long term care services today, along with functional impairments, but that broader term is missing throughout the regulation. Nowhere in the regulation are benefit triggers required or spelled out. Dementias other than Alzheimer’s are not recognized in exceptions or exclusions, or elsewhere in the regulation where all causes of dementias should be included. A short term policy would not be required under the proposed regulation to cover cognitive impairment at all.

It is possible, as this regulation is currently written, to write a short term policy with benefit triggers of 5 out of 6 (or even less) ADLs, for care in a nursing home that must be medically necessary at the beginning, and that is not at first custodial in nature.

Here are specific comments on a few provisions of the proposed regulation.

(New) Sec, 38a-xxx-2. Definitions

Definitions in this section reinforce the ability of companies to apply medical standards to benefit triggers, services, providers, and places of care. …..for necessary care or treatment of an injury, illness or loss of functional capacity provided by a certified or licensed health care provider…… and for…confinement in the insured’s own home….

(New) Sec. 38a-xxx-3 Policy definitions and terms

This section lists but does not contain definitions related to activities of daily living or of cognitive impairment thereby allowing companies to define these in very restrictive terms.

There is no requirement that ADLs or cognitive impairment be a benefit trigger, leaving companies free to exclude them completely or require a simultaneous number of ADLs, or require an unrealistic number of ADLs before benefits would be available. The definitions of “accidental injury” or an “acute condition” or medically necessary care” allows these terms to be applied to a benefit trigger or to the policy benefits. These terms and definitions in the regulation have little applicability to the need for the services in short term policies and give companies unrestricted ability to deny benefits.

Under (e) (3) of this section “a home or facility primarily used for the care and treatment of a mental disease or disorders, or custodial care” could exclude care in facilities that provide psychiatric care, or facilities that provide care to people with dementias. Many of those facilities are referred to as memory care facilities, and under these definitions could be excluded. (Some of the definitions of places of care should of course accurately correspond to where care is provided in your state, and how each place of care is regulated in Connecticut.)

Under (h) of this section “Home health care services” includes “medical and non-medical services, provided to ill, disabled or infirm persons who reside at home.”

This is very restrictive when applied to people who need long term care services. Terms like these would allow companies to sell very restrictive benefits that policyholders would be unlikely to discover until they filed a claim.

There is no definition in the regulation of assisted living which could allow companies to refuse to pay for home care in such a facility under the definitions in this regulation.

In (m) of this section: Alzheimer’s disease is excluded from the definition of mental and nervous disorders, but other dementias are not, leaving companies free to demand that benefits are only payable for Alzheimer’s disease.

In (n) of this section: Necessary care for confinement in the insured’s own home is predicated on home “health” care, again linking care to health and not ADLs or conditions of functional or cognitive impairments.

In (o) of this section: Necessary care for confinement in a nursing home is predicated on medically necessary care… that is not at first custodial care.” That is a Medicare standard for payment of nursing home benefits and completely out of place in policies that purport to provide care in a nursing home.

In (s) of this section: the standard of sickness or illness by disease has no place in any insurance policy providing benefits for nursing home and home care, and reinforces the connection to medical services.

Under Other Exclusions (2) (B) there is no exception from mental disease or disorder for Alzheimer’s or other dementias.

Under Limitations and Exclusions (d)(3) A policy is prevented from duplicating Medicare benefits, deductible, or copayment despite the fact that these are not tax qualified policies. There is no justification for carving out these benefits given the short term nature of these benefits and the high cost of care in a nursing home. This requirement is very detrimental to consumers and only benefits companies that write these policies.

Under Renewability (n) companies are able to use words and terms, “usual and customary,” “reasonable and customary,” that have caused claims problems in the past and are all medical in nature. Typically policies providing benefits for institutional and home care use a daily benefit dollar amount and there should be no reason to use those medically related terms. This is another option for companies to limit the amount of benefit they will pay at the time of a claim.

In short, many of the minimum requirements in the proposed regulation could lead to very restrictive policy benefits being sold in a short term care policy to the disadvantage of consumers. I urge you to consider bringing these products under the umbrella of long term care insurance standards with specific exceptions for those elements you think shouldn’t apply to these products.

Sincerely,
Bonnie Burns, Policy Specialist

 

Posted on Thursday, Aug. 17th 2017 5:29 AM | by Share of Cost | in Social Security | No Comments »

Gum Disease

Tuesday, Aug. 15th 2017 6:36 AM

Gum disease is a common condition among adults that occurs when bacteria form biofilms or plaques on teeth, and consequently the gums become inflamed. Some severe cases, called periodontitis, call for antibiotics. Many people have had some degree of gum inflammation, or gingivitis, caused by dental plaque. The gums get red and swollen, and they bleed easily. If left unchecked, the condition can progress to periodontitis. The plaque hardens into tartar, and the infection can spread below the gum line and destroy the tissue supporting the teeth.

Posted on Tuesday, Aug. 15th 2017 6:36 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Schizophrenia risk increased with alcohol, drug abuse

Sunday, Aug. 13th 2017 6:00 AM

The question of whether drug abuse increases the risk of developing schizophrenia and other mental illnesses has been a hotly debated topic for decades. New research from Denmark that includes data from more than 3 million individuals takes an in-depth look at the conundrum.

Posted on Sunday, Aug. 13th 2017 6:00 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, What is Red Eye

Friday, Aug. 11th 2017 6:00 AM

Red eye means other people see redness in the eye. It does not mean the person’s vision is turning red. Red eye without pain has many common causes that are not too serious. It can often be prevented or eased with home care.

Posted on Friday, Aug. 11th 2017 6:00 AM | by Share of Cost | in Share of Cost | No Comments »

Buying an Affordable Dental Insurance

Wednesday, Aug. 9th 2017 6:50 AM

Question: I live in New Jersey I would like to be able to compare dental insurance plans to make sure I am getting the best coverage’s for the best price. I see many dental plans that are costly but the coverage’s do not look all that good to me.

Answer: Depending on your dental care needs and what you are wanting in a dental insurance plan higher price dose not always mean better coverage’s. There are many personal factors that need to be taken into account when buying a dental insurance plan that best fits your needs. There are also two factors to take into account with regards to affordability. First the cost of the dental insurance plan, and second the plan benefits. You may find a really low cost dental insurance plan but the plan benefits may be not as good as buying a plan that may cost a little more. I suggest reviewing the dental insurance and plan options we provide and calling our member services at 310-534-3444 if you should have any questions about our plans cost and benefits.

Posted on Wednesday, Aug. 9th 2017 6:50 AM | by Share of Cost | in Share of Cost | No Comments »

Looking for Free Dental Care

Monday, Aug. 7th 2017 6:48 AM

 Question: I looking for free to very low cost dental care help for my 2 year old son. I do not need to take him to a dentist right now, however I currently do not have any benefits for dental care and since I am a low income I get some state aid but not for dental.  Where can I take my son for free to really low cost dental care?

Answer: For free dental care you would need to see when they are running the programs for free dental care. You can find that on the American Dental Association web site they will normally have dates listed. You may also want to look into going to any local dental schools they will normally charge you based on what you can afford to pay. In addition I also suggest reviewing our HMO insurance plans or our dental discount plans as these are low cost dental plans that will help to greatly reduce your dental care cost.

Posted on Monday, Aug. 7th 2017 6:48 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, NIH study determines key differences between allergic and non-allergic dust mite proteins

Saturday, Aug. 5th 2017 6:00 AM

Scientists from the National Institutes of Health have determined what differentiates dust mite allergens from the non-allergen proteins dust mites produce. According to the researchers, dust mite allergens are more chemically stable and produced in larger quantities than other dust mite proteins.

This study is the first to provide specific information about the characteristics of dust mite proteins, and may help researchers uncover factors that lead to the development of dust mite allergy and assist in the design of better allergy therapies.

Posted on Saturday, Aug. 5th 2017 6:00 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Elderly may face increased dementia risk after a disaster

Thursday, Aug. 3rd 2017 6:00 AM

Boston, MA – Elderly people who were uprooted from damaged or destroyed homes and who lost touch with their neighbors after the 2011 tsunami in Japan were more likely to experience increased symptoms of dementia than those who were able to stay in their homes, according to a new study from Harvard T.H. Chan School of Public Health. The study was the first to look at dementia as a potential health risk in the aftermath of a disaster.

The study was published online October 24, 2016 in an Early Edition of the Proceedings of the National Academy of Sciences journal (PNAS).

Posted on Thursday, Aug. 3rd 2017 6:00 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, New target identified to combat deadly allergic reactions

Tuesday, Aug. 1st 2017 6:00 AM

A molecular motor that controls the release of inflammatory factors that cause severe and fatal allergic reactions has now been identified by researchers. The study suggests that targeting this motor may be a new way to treat patients undergoing anaphylactic shock.

Researchers in France have identified a molecular motor that controls the release of inflammatory factors that cause severe and fatal allergic reactions. The study, “Kinesin-1 controls mast cell degranulation and anaphylaxis through PI3K-dependent recruitment to the granular Slp3/Rab27b complex,” which will be published online October 24 ahead of issue in The Journal of Cell Biology, suggests that targeting this motor may be a new way to treat patients undergoing anaphylactic shock.

Posted on Tuesday, Aug. 1st 2017 6:00 AM | by Share of Cost | in Share of Cost | No Comments »