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Monthly Archives: May 2012

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    For Many, Affordable Care Act Won’t Cover Bariatric Surgery

For Many, Affordable Care Act Won’t Cover Bariatric Surgery

Uninsured Americans who are hoping the new health insurance law will give them access to weight loss treatments are likely to be disappointed.

That’s especially the case in the Deep South, where obesity rates are among the highest in the nation, and states will not require health plans sold on the new online insurance marketplaces to cover medical weight loss treatments like prescription drugs and bariatric surgery.

Dr. Erin Cummins directs the bariatric surgery department at in the state capital of Jackson. She grew up in the Delta, her husband is a cotton farmer, and although she’s petite and fit, she understands well enough how Mississippians end up on her operating table.

“You have to realize in the South, everything revolves around food. Reunions, funerals, parties — everything revolves around food,” Cummins says.

That long-standing food culture, as well as other factors like inactivity and poverty, have saddled Mississippi with the highest obesity rate in the nation.

Tips to pick the right health cover to suit your needs

It takes an agent several days, even weeks, to convince a customer to buy health insurance. Yet, 10 minutes at the billing counter of a hospital were enough to persuade Avinash Sharma (see picture).

When the Delhi-based professional visited a friend, who had undergone a minor surgery in a private hospital last month, he was shocked to see the bill at the time of discharge.

“A simple operation and one night’s hospitalisation cost him Rs 1.4 lakh. The cover from his employer covered only Rs 50,000 of the cost,” he says.

We are not surprised. Healthcare costs are rising at a fast clip. According to a survey by insurance consultancy firm, Towers Watson India, healthcare costs in India increased by 13.25% in 2011.

Health Insurance Reform: Steps to Take Now to Prepare

The Affordable Care Act doesn’t go into full force until January 2014, so you have plenty of time to get your company’s health insurance plans in order, right? Wrong, say health-care experts. Regardless of whether you already offer health insurance, or you plan to do so starting in 2014, there are several steps you need to take now to prepare for life under the Affordable Care Act, which is commonly called Obamacare.

Open enrollment, both for private health plans and for the new insurance marketplaces established by the law, starts Oct. 1. That’s sooner than you may think, given the complexities of the law, says Meredith Olafson, senior policy advisor in the Small Business Administration’s office of entrepreneurial development. “Every business owner is going to be impacted differently,” Olafson says. “They need to know the facts and information to plan for what’s ahead.”

Here are five important ways to ready yourself for health reform:

1. Brace for rising costs. Several major insurance carriers have warned that premiums will rise by more than 20 percent next year, and Aetna CEO Mark Bertolini told Wall Street analysts that premiums may even double for some small businesses.

In addition to preparing for that price boost, you need to understand what your company’s requirements will be for contributing to your plan. For example, the law says that to be deemed “affordable,” an employee’s out-of-pocket costs cannot total more than 9.5 percent of his or her income. Some companies used to be able to hold down healthcare costs by offering high-deductible plans, which shifted more of the out-of-pocket burden to employees. But under the law, “high” will likely be capped at deductibles of $2,000 a year for individuals and $4,000 for families.