Question: I moved my family from Virginia to Alaska last week. We have an individual family policy (not group) from Anthem BCBS Virginia. My intention was to keep the Virginia policy and apply for a new policy when we got here. Since arriving I have not been feeling well. It may be nothing but my concern is that if I visit a doctor and there is something wrong I may not be able to get a new policy. Is this a ligitimate concern and what if any recommendations do you have? Thank you!!

Answer: Your Anthem Blue Cross Blue Shield of Virginia policy covers you in Alaska. As long as you get medical services from a provider who is in the Premera Blue Cross of Alaska network, your coverage in Alaska will be the same as they would have been in Virginia. If you have something wrong, get treatment. It could be something that would become serious if not treated now. Go see a doctor!

Normally, your current policy will cover you in Alaska for months (six months is probably the limit). You should apply for coverage with Premera Blue Cross in Alaska if you live there on a more permanent basis. If you have developed a serious medical condition in the meantime and do not qualify for individual health insurance with a new carrier, there are other options like HIPAA and PCIP.

Question: Can you opt out of mandatory maternity coverage in California if dont want it?

Answer: Not if you are covered by a group health insurance plan. California law requires all employer sponsored group health plans to include maternity coverage. While it seems illogical for a single male or an older female to be required to pay the extra costs associated with insuring for maternity coverage when they will never use the benefit, it is one of the basics that makes insurance work, that is: those with no claims finance those with claims. It makes the maternity benefit affordable for all those who need it.

In the individual health insurance market, many plans are available without the maternity benefit. This makes those non-maternity plans more affordable, but also makes those plans with a maternity benefit very expensive for the few who require it.

Question: Does Obamacare provide maternity for married dependents?

Answer: The Affordable Care Act (ACA) includes several categories of essential benefits to set a benefits floor for all health insurance plans from 2014 going forward and maternity and newborn care is one of those categories.

But I think you may be asking another question. It sounds like your married son or daughter is covered under your health insurance policy and you have a grandchild on the way. We don’t know yet how that situation will be covered in 2014, but today, the maternity and delivery costs will not be covered by your health insurance.

Question: If you are treated for an illness in the last few days of December and have to have additional treatment in January of the following year for the same illness do you still have to meet your deductible again.

Answer: Generally, the annual deductible resets on January 1st. But you may want to contact your health insurance company to ask about “fourth-quarter roll over.” Some health insurers will allow dollars paid toward your deductible in the final months of 2011 to “roll over” or count toward your 2012 annual deductible. This can give you a head start toward meeting your deductible in the new year.

Question: Do you have to have a cafeteria plan for health premiums to be pre-tax?

Answer: Yes. A version of the Section 125 “cafeteria plan” can be designed for premiums only. This single purpose plan is referred to as a Premium Only Plan or POP plan. With a POP plan in place employers may deduct the employee’s portion of the company-sponsored group health insurance premium directly from said employee’s paycheck before taxes are deducted. While very simple in design, POP plans must be properly executed to meet IRS requirements. We provide POP plans for as little as $150 for a one-time set-up fee. Call my office at 800-557-5693.

Question: If a person is in the process of addressing a health problem at the end of the year and his insurance changes in January which is responsible for the health coverage?

Answer: It sounds like your employer-sponsored health insurance coverage has changed insurance carriers. It you have ongoing treatments that continue from 2011 into 2012, the old insurance is responsible for all medical services received in 2011 even though you may not be billed until 2012. Conversely, the new insurance plan will be responsible for all medical services with dates of service in 2012.

Question: I am very confused by the deductibles on my family’s health insurance. Does the whole family meet the deductible or just one person?

Answer: I don’t blame you for being confused. There are differences in how health plans work for families versus individuals. The main difference between individual and family coverage is how the annual deductible is computed.

Individual Deductible Family Plans: Some family insurance has separate deductibles for each individual and then a family deductible limit. For example. a plan might have a $5000 deductible for each family member and a $10,000 deductible limit for the whole family. What that means is that any given individual in the family must reach $5000 in covered medical expenses before the health plan begins to pay. Also, let’s say that this family has 3 individual members and that the total in family expenses exceeds $10,000, from this point on through the end of that calendar year all family members will have been deemed to have met their deductible. Statistically, only one family member usually has major medical expenses in a given year, so the individual deductible plan is generally recommended.

Aggregate Deductible Family Plans: Some family health plans have one deductible for the whole family. For instance, a plan might have a $10,000 deductible for the family and each family member’s covered medical expenses are combined to meet the $10,000 family deductible. Statistically, only one family member usually has major medical expenses in a given year, so the $10,000 family aggregate deductible is usually harder to reach. We generally recommend family health plans with this type of family deductible, but there are situations when an aggregate deductible is preferable, for instance a large family would have a greater chance of meeting the family deductible with no single individual accounting for $5,000.

Question: I read in the newspaper that the Preexisting Conditions Health Insurance Plan was a bust. What happened?

Answer: It's not a failure by any means, however enrollment is less than expected so far.

Several months ago, the special insurance pools became one of the earliest facets of the new health-care law to take effect. They are intended as a temporary coping mechanism for people with preexisting medical conditions that traditional insurance companies do not want to cover. The program is temporary, because, starting in 2014, the law will forbid insurers to reject customers based on whether they are healthy or sick.

One must be a resident of California, have a pre-existing condition as shown by a
Rejection letter from a health insurance company in the last 12 months, or coverage offered with premiums higher than those of the state risk pool, be a U.S. Citizen, U.S. National or lawfully present foreign national, and have been uninsured for 6 month prior to application for the plan.

A fundamental problem is that insurance for people with existing medical problems remains too expensive for many. Monthly premiums range from $350 to $600 for a middle-aged individual in California.

Another hurdle is the requirement that an applicant must have been uninsured for 6 months prior to applying for the special risk pools. The thinking behind this requirement is to prevent a wholesale migration of insureds from existing state major risk pools to the new pools where rates and coverage are better. HHS needs to take a look at removing that requirement.

Question: I have been diagnosed with breast cancer and I am covered under my husband's current COBRA coverage. What happens to me when the COBRA coverage ends in November?

Today, the six month anniversary of the enactment of the Affordable Care Act, some of the law's key provisions go into effect. Here's a look at how the law affects people who get their health insurance at work, people who buy their own individual health insurance or are enrolled in Medicare.

Q: I get my coverage through work and the "open enrollment" period for next year is approaching. I'd like to keep my current health plan. Will it be affected by the new law?

A: Your plan will feature some new consumer protections. For example, your plan won't be able to set a lifetime limit on coverage. And if you have an adult child up to age 26 who can't get health insurance at a job, you'll be able to keep him or her on your health plan. These changes kick in for plan years beginning on or after Sept. 23. If your employer makes significant changes - like cutting benefits or raising your out-of-pocket costs beyond a specific amount - the plan is considered a new plan (rather than an existing "grandfathered" one) and must include a wider set of consumer protections.

Q: Like what?

Patients will get, for example, certain preventive services such as breast cancer screenings and cholesterol tests without paying deductibles or co-payments. In addition, they'll be able to see obstetricians and pediatricians without getting prior authorizations. Recommended immunizations also must be provided at no cost.

Q: What if my employer offers a new plan and I want to switch to that?

A: In that case, your coverage would include the wider set of protections.

Q: Will my health insurance cost less?

A: Probably not. Health insurance premiums have been increasing steadily over the last decade and that trend is continuing. According to a new report from the Kaiser Family Foundation and the Health Research & Educational Trust, workers nationwide on average are paying 14 percent, or $482, more for family health insurance coverage in 2010 than in 2009. Employers, struggling with the recession, aren't increasing their share. Instead, they're shifting more costs onto employees, according to the survey. A recent study by the National Business Group on Health found almost two-thirds of employers planned to ask employees to contribute more toward their premiums.

Q: I'm a small business owner. Do I have to offer coverage to my workers this fall? And if I do, will the government help me pay for it?

A: No business owner - small or large -- is required to offer coverage. But small businesses with 25 or fewer full-time employees who earn an average yearly salary of $50,000 or less will qualify for a tax credit up to 35 percent of the cost of premiums. The credit increases to 50 percent in 2014 for most small employers. To qualify for the credits, businesses must cover at least 50 percent of the cost of workers' insurance. Starting in 2014, businesses with 50 or more employees that don't provide health care coverage and have at least one full-time worker who receives subsidized coverage in the health insurance exchanges will have to pay a fee of up to $2,000 per full-time employee. (The firm's first 30 workers would be excluded from the fee.) Businesses with 50 or fewer workers would be exempt from the requirement.

Q: I buy my own health insurance coverage. How will the health law affect my coverage?

A: For policy years starting after Sept. 23, all health insurance policies in the individual market will be barred from cancelling coverage once you get sick -- a practice known as "rescission" - unless you committed fraud when applying for coverage. Insurers will be prohibited from setting lifetime limits on your coverage. The plans must allow you to keep an adult child up to age 26 on your health plan. New policies can't deny coverage for children up to age 19 based on a pre-existing medical condition. But "grandfathered" plans can; they can also set annual dollar limits and require cost-sharing for some preventive services. Most people in the individual market are expected to move to a new plan by 2014. Other provisions of the law will kick in later. For example, as of 2014 insurers won't be able to refuse to cover adults with pre-existing medical conditions. That same year, individuals whose incomes are up to 400 percent of poverty -- $88,200 for a family of four at the current poverty level - will qualify for subsidies to help purchase health insurance on exchanges, marketplaces where consumers can shop for coverage. At that point, most people will have to have health insurance or pay a fine.

Q: I'm on Medicare. Will my benefits change?

A: Your basic package of Medicare benefits won't shrink and in fact will expand under the law. But if you're in a Medicare Advantage plan - a private plan that offers Medicare benefits - you might lose some extra benefits at some point. In terms of the overall Medicare program, let's start with prescription drugs. As of late August, one million Medicare beneficiaries received a $250 check to help cover prescription drug costs in what's known as the doughnut hole. That's the gap in coverage where beneficiaries must pay the full cost of their prescriptions until catastrophic coverage kicks in. Starting next year, beneficiaries will receive a 50 percent discount on brand name drugs and a 7 percent discount on generic drugs while they are in the coverage gap. The health law closes the gap entirely by 2020. In addition, beginning next year, Medicare beneficiaries won't have to pay co-payments or deductibles on many preventive health care services, including diabetes and cervical cancer screenings. Medicare will also pay for an annual wellness visit to the doctor. To help pay for the health overhaul, Congress is cutting payments to Medicare Advantage plans, beginning the year after next. Beneficiaries won't lose any of their basic Medicare benefits as a result of the reductions but some Medicare Advantage insurers could decide to stop offering additional benefits, such as coverage for eyeglasses or gym memberships.

Q: Many Republicans have criticized the health care law as too intrusive and too expensive. If they pick up seats in the November election, how could the law be affected?

A: Some Republicans have threatened to block funding for the implementation of the law; others have called for its outright repeal. But accomplishing either would be tough unless they win large majorities in both the House and Senate. President Barack Obama would likely veto any legislation to gut the law, so Republicans would need a veto-proof majority - two-thirds of both chambers - to override such an action. Also, some Republicans might be reluctant to repeal provisions of the bill that are popular with the public, such as keeping a child up to age 26 on their parents' health care plan or outlawing rescissions and lifetime and annual limits.

QUESTION: I am a juvenile type 1 diabetic, have a heart condition called Torsades de Pointes, and I have celiac sprue. I dont get Medicaid anymore and I have a child. I'm not able to afford my diabetes supplies nor my other supplies for the other problems. I need an affordable insurance company to get coverage through.

Question: My daughter will finish her MBA in Ohio, and plans to stay from October to December (3 months),in CALIFORNIA,and maybe extend the residence for a longer period. We would like us to suggest what health insurance she should take and the cost.

Question: What is the low income insurance program with pre-existing illness that the gov.has now besides medicaid or Medicare. Heard on the news and they said you must sign up on 7-1-2010.

I have a preexisting condition and recently lost my job -- and with it, my health benefits. What does this law do for me?

I have a great insurance policy through my employer, and I don't want it to change. But my friends at work say that the government will be taxing our plan. What's up with that?

Question: So what's to stop my insurer from raising my health insurance rates between now and 2014?

Question: I have a high deductible health insurance plan. I recently found out I am pregnant (We've been trying). I also found out that my insurance does not cover maternity--at all. Out-of-pocket payments do not go towards my deductible. I've looked into Medicaid. I make too much. What are my options?

Question: I hear that most of the Health Reform changes won't happen until 2014. What, if anything, changes right away?

Qustion: I can't get health insurance because of my pre-existing conditions. Will I be covered by the new healthcare plan next year?

Question: Hello. My maternity rider became effective March 1 but I found out I am pregnant and based on my last period and the ultrasound I got at the free clinic it looks like I might have conceived the third week in February (just a week shy). Since it is so close to my effective date and there is no way to be 100% sure, how will the insurance company determine my conception date? If they go by the due date then what if the baby ends up being late? How is all this determined? Please help!

Question: My son has bipolar and was in an auto accident a few months ago and hasn't been able to work. He was on his company insurance but lost his coverage. He is looking for a new job but needs health insurance for his monthly therapy and prescriptions. We were going to put him on an individual policy until he gets a job with employer insurance again. The companies we looked at will not cover the bipolar, what can we do? With so many people suffering from mental health issues , it is amazing to me that they don't consider it like any other physical condition.

Question: I have recently changed jobs where the health insurance is very cheap for me but very expensive to add my wife. I'd like to get a private plan for her, but she takes several medications that could make it prohibitive. Is there some obvious option for this situation? She's otherwise healthy and I would consider high deductibles.

QUESTION: I am required by court order to provide insurance for my child. Do I have to go on my group's policy or can I just enroll my child?

Question: I'm over 50 which means that I need a bone scan. My doctor says its not necessary but will give me an Rx if I really think I cant live without it. How do I know if its covered on my plan?

Question: When I ran a quote on the website it wasn't clear about bills that the insurance company would pay and what bills I pay . What happened the last time I had insurance was I went for some blood work and I ended up paying for the whole thing! The plan I was looking at was the Unicare performance 2000 in Texas. I can afford it ok. but does it cover the things I need?

Question: I live in Texas and my wife and children are currently in Oklahoma and will be there through the end of the year. I'd like to be covered when I visit them and vise versa. Is there such a thing as an insurance plan that will cover all of us?