HIPPA (Health Insurance Portability and Accountability Act)

With the growing use of paperless forms, electronic information transfers and storage has become the norm. This is true about our medical information as well. So, how do we know that our sensitive medical records are being kept private? Thanks to a federal law entitled Health Insurance Portability and Accountability Act (HIPAA), health plans, health care providers, and health care clearinghouses are required to abide by a set of standards to protect your data. While this law does offer protection for certain things, there are some companies that are not required to follow these standards. Keep reading to find out where the loopholes are and how you are being protected by this law. 

What is the HIPAA Law and Privacy Rule?

Although HIPAA and Privacy and Security Rules have been around since 1996, there have been many revisions and changes over the years so to keep up with evolving health information technology. HIPAA and the HIPAA Privacy Rule set the bar for standards that protect sensitive patient information by making the rules for electronic exchange as well as the privacy and confidentiality of medical records and information by health care providers, health care clearing houses, and health plans. In accordance with HIPPA, Administrative Simplification Rules were created to safeguard patient privacy. This allows for information that is medically necessary to be shared while also maintaining the patient’s privacy rights. The majority of professionals in the health care industry are required to be compliant with the HIPAA regulations and rules. 

Why do we have the HIPAA Act and Privacy Rule?

The original goal of HIPAA was to make it easier for patients to keep up with their health insurance coverage. This is ultimately why the Administrative Simplification Rules were created to simplify administrative procedures and keep costs at a decent rate. Because of all the exchanges of medical information between insurance companies and health care providers, the HIPAA Act aims to keep things simple when it comes to the healthcare industry’s handling of patient records and documents and places a high importance on maintain patients’ protected health information. 

HIPAA Titles

The Health Insurance Portability and Accountability Act, a federal law which was designed to safeguard healthcare data from data breaches, has five titles. Here is a description of each title:

  • Title I: HIPAA Health Insurance Reform: The objective of Title I is to help individuals maintain health insurance coverage in the event that they lose or change jobs. It also prevents group health plans from rejecting applicants from being covered for having specific chronic illnesses or pre-existing conditions. 
  • Title II: HIPAA Administrative Simplification: Title II holds the U.S. Department of Health and Human Services (HHS) responsible for setting national standards for processing electronic healthcare transactions. In accordance with this title, healthcare organizations must implement data security for health data transactions and maintain HIPPA compliance with the rules set by HHS. 
  • Title III: HIPPA Tax-Related Health Provisions: This title is all about the national standards regarding tax-related provisions as well as the general rules and principles in relation to medical care.  
  • Title IV: Application and Enforcement of Group Health Plan Requirements: Title IV elaborates further on issues related to health insurance coverage and reform, one key point being for patients with pre-existing conditions. 
  • Title V: Revenue Offsets:  This title has provisions regarding company-owned life insurance policies as well as how to handle situations in which individuals lose their citizenship due to issues with income taxes. 

In day to day conversations, when you hear someone bring up HIPAA compliance, they are most likely referring to Title II. To become compliant with HIPAA Title II, the health care industry must follow these provisions:

  • National Provider Identifier Standard: Every healthcare entity is required to have a 10-digit national provider identifier number that is unique to them, otherwise known as, an NPI. 
  • Transactions and Code Sets Standard: Healthcare organizations are required to follow a set of standards pertaining to electronic data interchange (EDI) to be able to submit and process insurance claims.  
  • HIPAA Privacy Rule: This rule sets national standards that help to protect patient health information.
  • HIPAA Security Rule: This rule establishes the standards for patient data security. 

What information is protected by HIPAA?

The HIPAA Privacy Rule safeguards all individually identifiable health information obtained or transferred by a covered entity or business associate. Sometimes this information is stored or transmitted electronically, digitally, on paper or orally. Individually identifiable health information can also be referred to under the Privacy Rule as PHI. 

Examples of PHI are:

  • Personal identifying information such as the name, address, birth date and Social Security number of the patient. 
  • The mental or physical health condition of a person.
  • Certain Information regarding the payment for treatments.

HIPAA penalties

Health industries and professionals should take extra caution to prevent HIPAA violations. If a data breach occurs or if there is a failure to give patients access to their PHI, it could result in a fine. 

There are several types of HIPAA violations and penalties including:

  • Accidental HIPAA violations could result in $100 for an isolated incident and an upward of $25,000 for repeat offenses.
  • Situations in which there is reasonable cause for the HIPAA violation could result in a $1,000 fine and an upward of $100,000 annually for repeat violations.
  • Willfully neglecting HIPAA can cost anywhere between $10,000-$50,000 and $250,000-$1.5 million depending on whether or not it was an isolated occurrence, If it was corrected within a specific timeframe. 

The largest penalty one could receive for a HIPAA violation is $50,000 per violation and $1.5 million per year for repeated offenses.

HIPPA (Health Insurance Portability and Accountability Act) is a post from Pocket Your Dollars.

Source: pocketyourdollars.com

How Does Coronavirus Affect Life Insurance?

Coronavirus hasn’t entirely ended life as we knew it, but it’s certainly caused changes, some of which are likely to be with us for a very long time.

For some the coronavirus is literally a matter of life and death, and it raises an important question: how does coronavirus affect life insurance?

No one likes to think about the possibility of losing their life, or that of a loved one to this virus, but for over 150,000 families here in the US, it has turned out to be a reality.

Let’s examine the impact it may have on your existing policies, and perhaps more importantly, how it may affect applications for new life insurance coverage.

How Does Coronavirus Affect Life Insurance You Already Have?

There’s good news if you already have a life insurance policy in place. Generally speaking, the insurance company will pay a death benefit even if you die from the coronavirus. With few exceptions, life insurance policies will pay for any cause of death once the policy is in force. There are very few exceptions to this rule, such as acts of war or terrorism. Pandemics are not a known exception.

If you’re feeling at all uncomfortable about how the coronavirus might impact your existing life insurance policies, contact the company for clarification. Alternatively, review your life insurance policy paying particular attention to the exclusions. If there’s nothing that looks like death due to a pandemic, you should be good to go.

But once the policy is in place, there are only a few reasons why the insurance company can deny a claim:

  • Non-payment of premiums – if you exceed the grace period for the payment, which is generally 30 or 31 days, your policy will lapse. But even if it does, you may still be able to apply for reinstatement. However, after a lapse, you won’t be covered until payment is made.
  • Providing false information on an application – if you fail to disclose certain health conditions that result in your death, the company can deny payment for insurance fraud. For example, if you’re a smoker, but check non-smoker on the application, payment of the death benefit can be denied if smoking is determined to be a contributing cause of death.
  • Death within the first two years the policy is in force – often referred to as the period of contestability, the insurance company can investigate the specific causes of death for any reason within the first two years. If it’s determined that death was caused by a pre-existing condition, the claim can be denied.

None of these are a serious factor when it comes to the coronavirus, unless you tested positive for the virus prior to application, and didn’t disclose it. But since the coronavirus can strike suddenly, it shouldn’t interfere with your death benefits if it occurs once your policy is already in force.

How Does Coronavirus Affect Life Insurance You’re Applying For?

This is just a guess on my part, but I think people may be giving more thought to buying life insurance now they may have at any time in the past. The coronavirus has turned out to be a real threat to both life and health, which makes it natural to consider the worst.

But whatever you do, don’t let your fear of the unknown keep you from applying for coverage. Though you may be wishing you bought a policy, or taken additional coverage, before the virus hit, now is still the very best time to apply. And that’s not a sales pitch!

No matter what’s going on in the world, the best time to apply for life insurance is always now. That’s because you’re younger and likely healthier right now than you’ll ever be again. Both conditions are major advantages when it comes to buying life insurance. If you delay applying, you’ll pay a higher premium by applying later when you’re a little bit older. But if you develop a serious health condition between now and then, not only will your premium be higher, but you may even be denied for coverage completely.

Don’t let fears of the coronavirus get in your way. If you believe you need life insurance, or more of it, apply now.

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That said, the impact of the coronavirus on new applications for life insurance is more significant than it is for existing policies.

The deaths of more than 100,000 people in the US is naturally having an effect on claims being paid by life insurance companies. While there’s been no significant across-the-board change in how most life insurance companies evaluate new applications, the situation is evolving rapidly. Exactly how that will play out going forward is anyone’s guess at the moment.

What to Expect When Applying for Life Insurance in the Age of the Coronavirus

If you’re under 60 and in good or excellent health, and not currently showing signs of the virus, the likelihood of being approved for life insurance is as good as it’s ever been. You can make an application, and not concern yourself with the virus.

That said, it may be more difficult to get life insurance if you have any conditions determined to put you at risk for the coronavirus, as determined by the Centers for Disease Control (CDC).

These include:

  • Ages 65 and older.
  • Obesity, defined as a body mass index of 40 or greater.
  • Certain health conditions, including asthma, chronic kidney disease and being treated by dialysis, lung disease, diabetes, hemoglobin disorders, immunocompromised, liver disease, and serious heart conditions.
  • People in nursing homes or long-term care facilities.

Now to be fair, each of the above conditions would require special consideration even apart from the coronavirus. But since they’re known coronavirus risk factors, the impact of each has become more important in the life insurance application process.

If any of these conditions apply to you, the best strategy is to work with insurance companies that already specialize in those categories.

There are insurance companies that take a more favorable view of people with any of the following conditions:

  • Over 65
  • Kidney disease
  • Certain lung diseases, including Asthma
  • Liver disease
  • Certain heart conditions

More Specific Application Factors

But even with insurance companies that specialize in providing coverage for people with certain health conditions, some have introduced new restrictions in light of the coronavirus.

For example, if you have a significant health condition and you’re over 65, you may find fewer companies willing to provide coverage.

The insurance company may also check your records for previous coronavirus episodes or exposures. Expect additional testing to determine if you’re currently infected. Most likely, the application process will be delayed until the condition clears, unless it has resulted in long-term complications.

Travel is another factor being closely examined. The CDC maintains an updated list of travel recommendations by country. If you’ve recently traveled to a high-risk country, or you plan to do so in the near future, you may be considered at higher risk for the coronavirus. How each insurance company handles this situation will vary. But your application may be delayed until you’ve completed a recommended quarantine period.

Other Financial Areas to Consider that May be Affected

Since the coronavirus is still very much active in the US and around the world, financial considerations are in a constant state of flux. If you’re concerned at all about the impact of the virus on other insurance types, you should contact your providers for more information.

Other insurance policies that my warrant special consideration are:

  • Employer-sponsored life insurance. There’s not much to worry about here, since these are group plans. Your acceptance is guaranteed upon employment. The policy will almost certainly pay the death benefit, even if your cause of death is related to the virus.
  • Health insurance. There’s been no media coverage of health insurance companies refusing to pay medical claims resulting from the coronavirus. But if you’re concerned, contact your health insurance company for clarification.

Action Steps to Take in the Age of the Coronavirus

Many have been gripped by fear in the face of the coronavirus, which is mostly a fear of the unknown. But the best way to overcome fear is through positive action.

I recommend the following:

1. Be proactive about your health.

Since there is a connection between poor health and the virus, commit to improving your health. Maintain a proper diet, get regular exercise, and follow the CDC coronavirus guidelines on how to protect yourself.

2. If you need life insurance, buy it now.

Don’t wait for a bout with the virus to take this step. It’s important for a number of reasons and the consequences of not having it can be severe. Compare the best life insurance companies to get started.

3. Consider no medical exam life insurance.

If you don’t have the virus, and you want to do a policy as quickly as possible, no medical exam life insurance will be a way to get coverage almost immediately.

4. Look for the lowest cost life insurance providers.

Low cost means you can buy a larger policy. With the uncertainty caused by the coronavirus, having enough life insurance is almost as important as having a policy at all. Look into cheap term life insurance to learn more about what you can afford.

5. Keep a healthy credit score.

Did you know that your credit score is a factor in setting the premium on your life insurance policy? If so, you have one more reason to maintain a healthy credit score. One of the best ways to do it is by regularly monitoring your credit and credit score. There are plenty of services available to help you monitor your credit.

6. Make paying your life insurance premiums a priority

This action step rates a special discussion. When times get tough, and money is in short supply, people often cancel or reduce their insurance coverage. That includes life insurance. But that can be a major mistake in the middle of a pandemic. The coronavirus means that maintaining your current life insurance policies must be a high priority.

The virus and the uncertainty it’s generating in the economy and the job market are making finances less stable than they’ve been in years. You’ll need to be intentional about maintaining financial buffers.

7. Start an emergency fund.

If you don’t already have one place, start building one today. If you already have one up and running, make a plan to increase it regularly.

You should also do what you can to maximize the interest you’re earning on your emergency fund. You should park your fund in a high-interest savings account, some of which are paying interest that’s more than 20 times the national bank average.

8. Get Better Control of Your Debts

In another direction, be purposeful about paying down your debt. Lower debt levels translate into lower monthly payments, and that improves your cash flow.

If you don’t have the funds to pay down your debts, there are ways you can make them more manageable.

For example, if you have high-interest credit card debt, there are balance transfer credit cards that provide a 0% introductory APR for up to 21 months. By eliminating the interest for that length of time, you’ll be able to dedicate more of each payment toward principal reduction.

Still another strategy for lowering your debts is to do a debt consolidation using a low interest personal loan. Personal loans are unsecured loans that have a fixed interest rate and monthly payment, as well as a specific loan term. You can consolidate several loans and credit cards into a single personal loan for up to $40,000, with interest rates starting as low as 5.99%.

Final Thoughts

We’ve covered a lot of ground in this article. But that’s because the coronavirus comes close to being an all-encompassing crisis. It’s been said the coronavirus is both a health crisis and an economic crisis at the same time. It requires strategies on multiple fronts, including protecting your health, your finances, and your family’s finances when you’re no longer around to provide for them.

That’s where life insurance comes into the picture. The basic process hasn’t changed much from the coronavirus, at least not up to this point. But that’s why it’s so important to apply for coverage now, before major changes are put into effect.

The post How Does Coronavirus Affect Life Insurance? appeared first on Good Financial Cents®.

Source: goodfinancialcents.com

Choosing a Health Plan

In a lot of cases, our health insurance coverage comes from a group plan that is offered to you by your employer or by your spouse’s employer. For individuals who do not have insurance through their employer, individual policies exist as an option as well. 

Of course, you can also opt for having no coverage at all, but in the case of an emergency, this could be detrimental to your financial health. No matter your age or marital status, it’s worth looking into your options for a good health care plan to protect yourself from a medically-induced financial struggle. 

No matter what kind of plan you choose, there will always be some out-of-pocket expenses, which means you’ll have some decisions to make. Deciding what type of healthcare plan to choose can be stressful, but it doesn’t have to be overwhelming. In the sections below, we will discuss the key factors that play into choosing the right health insurance plan. 

Types of health plans available 

There are a lot of different terms to learn when sorting through health insurance plans, and each of them come with their own set of distinctions. Before we discuss the difference between HMOs, PPOs, POS Plans and Indemnity plans, it’s important to start with the most common types of health insurance categories: 

  • Indemnity of Fee-for-Service Plans: Health insurance plans that enable you to go to any doctor or specialist that you want without a referral are called indemnity, fee-for-service, or point of service (POS) plans. The insurance company will cover a predetermined amount of your medical expenses, and you will be responsible for the remaining balance. These plans tend to be the most flexible since there are no set restrictions on the medical providers you’re allowed to use, and you are usually not required to choose a primary care physician. 
  • Health Maintenance Organizations (HMOs): A Health Maintenance Organization (HMO) is a band of healthcare professionals and medical facilities that offer a set package of medical services at a fixed rate. This plan does require that you have a primary care physician (PCP), who would serve as the middle-man when it comes to health care. Your primary care physician would then decide whether or not seeking out a specialist is necessary. If your PCP finds it necessary for you to see a specialist, they will then issue you an in-network referral. 
  • Preferred Provider Organizations (PPOs): A Preferred Provider Organization (PPO) has the same organized care characteristic that you will get from an HMO, but with the benefit of more flexible options. A PPO allows you to seek healthcare outside of your network if you feel the need to. Keep in mind that doing so will usually cost you more in out-of-pocket expenses, but a PPO would still cover some of the cost, unlike an HMO. If having a wider variety of options is important to you, then a PPO might be a good option for you. 

Pros and cons of each health plan

Each type of plan comes with their own implications. Ultimately, you’ll have to figure out what is most important to you in order to make your decision. Let’s compare the pros and cons of each plan.

Indemnity Plans

Pros: The major advantage of this type of plan is that you are able to choose where you get your medical care from and which doctor to go to, without the need for a referral or a pre-approval. 

Cons: Indemnity plans will usually come with much higher premiums and deductibles, making them more expensive than perhaps an HMO or PPO. Another area where these plans fall short is the route you may have to take to get coverage. You may have to pay for your medical services out of your own pocket, and subsequently submit a claim to get reimbursed by your insurance company. There’s no telling how long this could take, and you also face the risk of not getting reimbursed at all. 

Health Maintenance Organizations (HMOs) 

Pros: The best thing about getting an HMO insurance plan is that your out-of-pocket medical expenses are usually pretty affordable, and you can expect to pay the same amount for each visit, depending on whether it’s a primary care physician or a specialist.

Cons: In most cases, any services that you receive from a medical professional outside of your healthcare network will not be covered with an HMO plan. Another drawback is that you have to get referred by your primary care physician in order to see a specialist. This may not be seen as a disadvantage to some, but for others it could be seen as an unnecessary extra step in the process if you already know what you need. 

Preferred Provider Organizations (PPO)

Pros: This type of plan offers customers much more flexibility than they would have with an HMO with a lot lower rates than one might experience through an indemnity plan. 

Cons: The main drawback with a PPO is that the out-of-pocket costs are generally less predictable.

Choosing a Health Plan is a post from Pocket Your Dollars.

Source: pocketyourdollars.com