Tag Archives: Health insurance

Straight, No Chaser: Sign Up For the Affordable Care Act – Today's the Deadline


Over 6 million of the previously 50 million American medically uninsured have already signed up for the Affordable Care Act (ACA aka Obamacare). Have you? Let’s consider this an open forum. Today is the deadline for signing up without penalty. It’s important that you realize what that means. I’m willing to answer any questions you have on signing up, penalties for not signing up and what it means to be enrolled.  In the meantime, refer to these past Straight, No Chaser blogs and refer to the governmental site at www.healthcare.gov.

I welcome any questions or comments. To get you started, here’s five quick points you should know.

  • In order to sign up, go to www.healthcare/gov or call 1-800-318-2596.
  • You can also buy policies directly from insurers. However, you won’t be eligible for premium tax credits that can reduce your costs. Those who purchase on the exchange and have an income between 100% and 400% of the poverty level may get tax credits to reduce their costs.
  • If you fail to sign up, the fine is $95 or 1% of your income after $10,150 — whichever is higher — for a single person this year. However, that penalty increases over time and with the size of your family.
  • To be eligible for health coverage through the ACA Marketplaces, you must live in the U.S. and be a U.S. citizen or national. You also can’t be in prison.
  • The cost of insurance vary dramatically, based on your income and family size. Check www.healthcare.gov for details.

Good luck, and good healthy!
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Straight, No Chaser: A Solution to the Upcoming Healthcare Crisis and the Affordable Care Act

Many of you have heard or seen me discuss various aspects of the Patient Protection and Affordable Care Act.  This ambitious effort seeks to maintain the current level of quality that exists (via maintaining the same insurance coverage for those individuals that already have it), while adding approximately 30 million individuals to the insurance rolls while not increasing overall system costs.
Have you noticed that one part of the conversation that doesn’t seem to occur is “Who’s going to take care of these 30 million new individuals? Also, what about the other 20 million that still won’t have insurance?” The twin deterrents of co-pays and deductibles will eventually be stiffened to curtail over- and inappropriate utilization of the emergency room for both the newly insured and the uninsured voucher recipients (Besides, who wants to deal with the long wait times both in your physician’s office and the ER, soon to be even worse with all the newly insured?). Similarly, you would presume that armies of new physicians are being trained to meet this growth in the newly insured, but that simply isn’t the case. Additional options to address this influx will be necessary. Prominent among these options will be those providing better education and greater empowerment of patients to direct their own care.
Sterling Medical Advice (SMA) is a national public health initiative that provides a solution to these issues by the introduction of 24/7 online personal healthcare consulting, featuring physicians and other care professionals covering the entire spectrum of medicine and healthcare. Consultations will be personalized and immediately available to those in need around the clock.
“What’s that, and when might you use it?” Here are a few examples.

  • You need advice regarding an immediate medical concern
  • You need general information about your medical condition
  • You need immediate information about your prescription
  • You are experiencing symptoms and want to know why
  • You want to learn more information about a medical condition that is part of your family history
  • You want additional details on your upcoming medical procedure
  • You need advice regarding the best care option for addressing a medical concern (e.g., emergency room vs. urgent care vs. scheduling an appointment with your primary care physician)
  • You want a second opinion on your new diagnosis
  • You want a second opinion on your new treatment plan
  • You need additional information about what to expect from a newly diagnosed condition

Sterling Medical Advice will improve public health outcomes while reducing healthcare costs for individuals, families and businesses and the healthcare system at large. Personal healthcare consulting will create a better-educated and empowered population and will become an additional component to the American health care system without compromising quality.
To find out more about Sterling Medical Advice, visit www.sterlingmedicaladvice.com, and thanks for following Straight, No Chaser.

Straight, No Chaser: Revisiting the Affordable Care Act – How You or Your Employer Can Save Up to 50% of HealthCare Costs


Politics aside, I’m not so sure why business owners are focusing on the angst of implementation of the Affordable Care Act instead of the opportunities to save.
Consider the following from the Small Business Association website: “The Affordable Care Act (ACA) creates new incentives for employers to promote wellness among employees by creating supportive, healthier work environments and encouraging employees to take advantage of workplace wellness programs. Health-contingent wellness programs generally require employees to meet a specific standard related to their health, e.g., decreased tobacco use or lowered cholesterol levels. Under the ACA rules that take effect on January 1, 2014, employer rewards will increase from a 20–30% refund of their healthcare coverage costs for employing health-contingent programs, up to 50% for programs designed to prevent or reduce tobacco use.”
Subscribing to www.sterlingmedicaladvice.com as an employee benefit will save companies up to half of the insurance costs they are already paying for their employees.  These savings can occur at a cost of less than 10% of current costs of insurance! For more information about the final rules’ flexibility in eligible wellness programs, visit www.dol.gov/ebsa.  Have your employee assistance program administrator contact us at 1-866-ADVICE3 (238-4233) or email us at sales@sterlingmedicaladvice.com.

Looking to cut your ACA tax in half? Sign up with SMA, reduce absenteeism, win the appreciation of your employees, and save a bundle.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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Straight, No Chaser: It's October 1st – Do You Know Where Your Affordable Care Act Health Insurance Exchanges Are? Your Top Ten Questions


No politics here folks, just facts. The bottom line is the Affordable Care Act (ACA) isn’t going anywhere prior to implementation, so let’s look at where things are. You can go here for previous comments on the ACA.
1. What changes today? The exchanges as scheduled to open for administrative business and to begin signing up customers. This is expected to affect approximately 30 million Americans who previously had not been covered by insurance plans. However, online enrollment has been delayed until November. It is still thought this won’t delay the onset of benefits.
2. Do I qualify for an exchange? You do if you are an employee of a business with less than 50 employees and have to buy your own insurance, and if you currently can’t get insurance because of a preexisting medical condition, or you can’t afford the cost.
3. So do I have insurance today if I enroll? No. Benefits begin on January 1st.
4. What about the individual mandate? It’s still in effect. Starting January 1st, most Americans must either be insured or face a fine.
5. What about the employer mandate? It’s actually been delayed until 2015. This mandate requires any company with over 50 employees to offer benefits to anyone working more than 30 hours a week.
6. Is any of this affected by the governmental shutdown? No. In short, funding for the ACA is not under the control of Congress.
7. How do I know what’s happening in my state? 16 states plus the District of Columbia are setting up their own exchanges. The other 34 states  are being run either totally or partially by the federal government. Refer to the lead picture to see what your state is doing, then go to www.healthcare.gov for details.
8. How does the insurance provided by the exchanges compare with that of traditional insurance? Different exchange plans will have different levels of coverage (eg.bronze, silver, gold and platinum). You’ll get to select a plan based on your needs.
9. What about the costs? This is tricky. Obviously, the plans differ based on the one selected. Additionally, if you’re below 400% of the poverty level (which equals $45,960 for an individual and $92,200 for a family of four), you’ll be eligible for tax credits to bring down the costs of the respective plans. In general, the costs of individual insurance within the exchanges will be dramatically lower than private insurance for those who qualify.
10. Where do I sign up and/or get more information? Try www.healthcare.gov.