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AXA’s first international health insurance products launch in Egypt

AXA Egypt announced, the launch of its international health insurance products, “Global Protect Health Plans”. The new product is available in 4 plans; Standard, Comprehensive, Prestige, and Prestige Plus, offering extensive protection and care for people living a global life and expecting exceptional healthcare standards wherever they go around the world.

As the global number 1 brand, AXA Egypt’s Global Protect Health Plans can leverage 14,000 healthcare providers in over 60 countries in a global network and more than 2,000 hospitals, clinics and pharmacies locally.

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CVS Health to acquire Aetna for $69 billion in year’s largest acquisition

U.S. drugstore chain operator CVS Health Corp (CVS.N) said on Sunday it had agreed to acquire U.S. health insurer Aetna Inc (AET.N) for $69 billion, seeking to tackle soaring healthcare spending through lower-cost medical services in pharmacies.

 

This year’s largest corporate acquisition will combine one of the nation’s largest pharmacy benefits managers (PBMs) and pharmacy operators with one of its oldest health insurers, whose national business ranges from employer healthcare to government plans.

The deal comes after Aetna’s $37 billion plan to acquire smaller U.S. health insurance peer Humana Inc (HUM.N) was blocked in January by a U.S. federal judge over antitrust concerns. A proposed combination of peers Anthem Inc (ANTM.N) and Cigna Corp (CI.N) was also shot down.

Aetna shareholders stand to receive $207 per share in the deal with CVS, the companies said. The consideration comprises $145 per share in cash and 0.8378 CVS shares for each Aetna share. Reuters first reported the terms of the deal earlier on Sunday.

Aetna shareholders will own about 22 percent of the combined company, while CVS shareholders will own the remainder.

The companies said that cost synergies in the second full year after the transaction closes — 2020 if the deal closes in the second half of 2018 as they expect — would amount to $750 million. They foresee it adding to adjusted earnings per share by the low- to mid-single digit percentage points.

Their vision expands beyond capitalizing on CVS’ existing MinuteClinic structure, which largely offers preventative services like flu shots, the companies’ chief executives said in an interview.

“When you walk into CVS there’s the pharmacy. What if there’s a vision and audiology center, and perhaps a nutritionist, and some sort of care manager?” CVS CEO Larry Merlo said.

Aetna will be operated as a separate unit and Aetna’s existing leadership is expected to run the Aetna businesses, Merlo said. Aetna will have two of its directors, in addition to Aetna CEO Mark Bertolini join the board of CVS.

The deal comes as healthcare payers and pharmacies are responding to a shifting landscape, including changes in the Affordable Care Act, rising drug prices and the threat of competition from online retailers such as Amazon.com Inc (AMZN.O).

CVS plans to use its low-cost clinics to provide medical services to Aetna’s roughly 23 million medical members. In addition to health clinics and medical equipment, CVS could provide assistance with vision, hearing and nutrition.

A combined insurer and PBM will also likely be better placed to negotiate lower drug prices, and the arrangement could boost sales for CVS’s front-of-store retail business.

The company expects to invest billions of dollars in the coming years to add clinics and services, largely financed by diverting funds away from other planned investments.

That could eventually cut costs substantially, with the clinics serving as an alternative to more expensive hospital emergency room visits.

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Invest your way into health-care security

Health care has become one of the biggest — and most costly — unknowns during retirement. Financial advisors say ignore what you don’t know and prepare for the worst.

The health-care debate in the United States has turned into a jumble of ideas. Some want to go back to a system similar to the one we had prior to the Affordable Care Act, others want to fix the issues in the current system, while still others want single-payer. While compromise feels unlikely at this point, it leaves a huge question for savers: What will health care look like when I retire? For that, there’s no clear answer.

And it’s a problem. As Washington debates, the cost of health care continues its precipitous climb. According to an estimate developed by the brokerage firm Fidelity, a couple retiring at age 65 can expect to spend $275,000 during retirement on medical expenses. It’s a 6 percent increase from 2016 estimates, and that doesn’t include covering certain health-related expenses, such as the cost of a nursing home.

There seems to be no end to this health-care rise, and it only fuels more speculation of how the system could change when you’re ready to actually tap the funds. All these unknowns make it difficult to plan, apart from saving as much as possible.

“Health coverage is going to look different in 20 or 30 years,” said Eric Dostal, a certified financial planner and advisor at Sontag Advisory. But Dostal added that, for planning purposes, it doesn’t matter what Washington is discussing as potential options for changing health care. Instead, he suggests you “plan for what you know today.”

Take advantage of an HSA

When clients ask advisor Phillip Christenson about health-care planning, he admits he has no idea how health care will look when they’re ready to tap funds. Therefore, he runs a few different scenarios, analyzing how much they will need if health-care costs inflate by 10 percent or 15 percent or more. “There’s no real answer, since we don’t know what’s going to happen in the future,” said Christenson, who co-founded Phillip James Financial.

If the clients need more savings, he will see if they qualify for a health savings account.

“The HSA is not only a huge benefit for medical costs, but it’s also like a secret IRA,” Christenson added.

According to the American Health Insurance Plans, the rate of HSA use has risen to 20.2 million last year, up from 3.2 million in 2006. It has become a popular tactic to earmark some retirement savings specifically for health care, since you can carry over the balance if you don’t use the funds for health-related costs.

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The Only Guide To Buying Health Insurance You’ll Need This Year

It’s open enrollment season for health insurance. And this year there’s much more confusion than in past years, given the events in Washington. Don’t worry: I’ll break it all down for you in this, the only guide to buying health insurance you’ll need this year, with links to in-depth, trustworthy resources.

Your choices will be quite different this year, partly because state regulators and individual insurers are reacting differently to the events in Washington. Also, in many cases, the government tax credit subsidy to people who buy insurance on the exchanges has changed – so even if you didn’t qualify last year, you might this year.

The tips here are most useful for people who are getting health insurance under the Affordable Care Act, outside of employer-sponsored offerings – those who use either healthcare.gov or the insurance exchange in their home state (California and New York, for example). If you have an employer-sponsored plan, you too will be required to know more than in past years, but your questions are likely to be different from those of A.C.A. customers.

For Affordable Care Act purchasers, the administration has cut the advertising budget that was intended to encourage  enrollment as well as cutting funding for navigators, the people paid to advise enrollees about the subtleties, making it harder to know what to do.

The administration also cut the enrollment period to Nov. 1-Dec. 15 , for coverage beginning Jan. 1, 2018, in the states where healthcare.gov, the federal site, runs enrollment; in states that have their own exchanges, enrollment deadlines can be as early as Dec. 15 or as late as Jan. 31 for 2018 coverage. Know your deadline.

Another big hurdle for all of us: Information is fragmentary and seems to be changing constantly. This brings anxiety, and it also threatens your ability to be calm and do your best research. Stay calm. Do your homework.

In preparation, you’ll want to do all the normal things – think ahead. If you’re planning to have a baby or major surgery, for example, you’ll choose to go one way. If you don’t expect to have big spending, you’ll go another way. Check that your providers are indeed in the network of the plan you’re contemplating. If you have big medication expenses, you’ll factor those into your decision, just as in previous years.

But this year is different on several levels. Here are our five smart tips.

  1. Do your research carefully. Decisions will vary greatly state by state, and family by family. For example, you may qualify for tax credits this year, even if you did not last year. About 80 percent of people who buy insurance on the exchanges qualify for a the tax-credit subsidy – so don’t be scared by a sticker price on a plan, but rather go through the entire process of inputting your income, number of children etc. Resist the impulse to take the “silver is always better” advice from people who don’t know your situation and your state’s regulatory decisions. Resist the impulse to renew what you had last year, because there have been big changes. This is all mind-numbingly complicated, and we will all of us hate our insurers forever. But we must plow ahead, and research carefully.
  2. Look at this site, and this state-by-state breakdown for insights. Charles Gaba is a web developer in Michigan who has become a national expert on the arcane ways of the A.C.A. He and some colleagues did amazing research on the effects of the administration’s last-minute decision to throw into doubt the payments made to insurers to ease out-of-pocket costs for some insured people (the Cost Sharing Reductions), and other factors. He credits fellow A.C.A. nerds Dave Anderson (Balloon Juice), Louise Norris (healthinsurance.org) and Andrew Sprung (Xpostfactoid) for assistance. Their work fills an important gap with the cut in navigators. Without going into deep detail, I strongly suggest that you read this post and then keep an eye on Gaba’s site and this spreadsheet for updates and this explainer for details if you want. In some states, for example, a silver plan can cost more than a gold plan this year, depending on your income. In some states, a bronze plan will be free, depending on your income. Last-minute changes are still turning up. (Disclosure: Gaba and I talk from time to time, though we have never done business together.)
  3. Look outside the exchanges. You might think you are better off on the exchange in your state, or that you don’t qualify for a tax credit subsidy. If you don’t qualify for a subsidy, you might well be better off outside of the exchange. In New York State, where I live, some insurance companies are selling individual plans both on the exchange and off the exchange — and some are selling little or no individual business directly, off the exchange. Gaba’s advice: “The main point is that EVERYONE should shop around REGARDLESS of which state they live in since there are so many other variables. If someone is 100% certain that they don’t qualify for subsidies, they should make sure to compare on- and off-exchange options.”
  4. Ask friends and neighbors. Many of us do this already, but this year it makes even more sense. You may find official assistance,  though even if you can, real people may know more than a navigator or an off-exchange broker (a broker, too, is probably making money by selling you something). In my village, for example, there’s a Facebook group of people researching this topic with information like “Susie at Medical Group A says they won’t be taking Insurance X this year” or “I found this broker through a friend – he sells off-exchange policies and may be a resource. Please report back.” Or “This broker says he’s the only one, but I found this one too.” Or “I searched my GP and the insurer’s website says she isn’t a participating provider — but another doctor in her practice is. Then I called the doctors’ billing department and they told me if one doctor in the group participates they all do.”
  5. See if you have any non-obvious opportunities, like a union or trade group. We hear that many people find USAA to be a good choice, but it requires a military affiliation in your family. Others may have access to a Chamber of Commerce insurance plan. Here’s a list of organizations compiled by PEN America, the writers group, listing options that you may not have thought of as membership organizations. One example: A friend’s wife is a lighting designer, and she’s insuring him through her union membership.
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How Digital Pills Could Change The Health Insurance Game

hopping, social networking, finance, and education have all gone digital. Why shouldn’t your healthcare go digital too?

On Nov. 13, the FDA approved its first ever digital pill, a landmark decision for the future of U.S. health care.

Dosage Goes Digital

The first ever digital pill will be a version of Bristol-Myers Squibb Co BMY 0.01%’s antipsychotic drug Abilify. But it could open a floodgate that may change the way insurance companies assess a customer’s coverage eligibility.

Digital pills monitor and report drug dosages to family members and physicians to help ensure patents are taking medications as prescribed. Patients must consent to the data sharing beforehand, but insurance companies may see an opening to potentially deny coverage to patients who do not follow their prescribed regimen.

Cost Savings?

At the same time, insurers could incentivize customers to choose digital pills by providing them with coverage discounts. If digital pills pave the way to more adherence on behalf of patients, they could help lower the overall cost of healthcare in the U.S.

“When patients don’t adhere to lifestyle or medications that are prescribed for them, there are really substantive consequences that are bad for the patient and very costly,” said William Shrank, CMO of the health plan division at the University of Pittsburgh Medical Center.

In fact, the New York Times estimates that patients who do not take drugs as prescribed add an extra $100 billion annually to the total cost of U.S. health care. When patients don’t take their medications as prescribed, their health can deteriorate, leading to more costly treatments down the line.

Unanswered Questions

For now, the biggest question surrounding digital pills will be whether or not insurance companies will cover them at all. The digital version of Abilify is expected to be more expensive than the standard version, and insurance companies will likely need to see evidence that the drug is helping reduce total cost before they will voluntarily cover the digital version.

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New health insurance law in the House of Representatives

CAIRO – 28 November 2017 – Minister of Health and Population, Ahmed Emad Eddin Rady, attended the joint committee of the Health, Legislative, and Constitutional Affairs, as well as the House of Representatives’ Planning and Budget Committee, to discuss the new comprehensive health insurance draft submitted by the government, which was preliminary approved by the previous committees last week. The committee also included Ali Hegazi, assistant to Ministry of Health and Population for Health Insurance Affairs, and Mohamed Moaet, Deputy to the Minister of Finance.

The Minister explained that 14 articles out of 67 of the law were discussed; each article was talked about separately. The discussed articles were approved after undergoing the necessary amendments on them. The suggestions of the health committee were modified, including those regarding the committee from the Central Agency for Mobilization and Statistics (CAPMAS) with finance and solidarity committees. Article (9) of the draft was also modified in order to redefine the number of members of the permanent pricing committee for medical services to range from nine to 15 members.

Rady revealed that Article (4) is concerned with the establishment of the General Authority for Comprehensive Social Health Insurance (GACSHI) to be an independent legal entity with an independent and separate budget. The authority will be under the primary supervision of the Prime Minister with a special administration.

Rady also pointed out that Article (5) is concerned with the formation of the Board of Directors of the Authority, and that it states that the term of the Council is four years, to be renewed once. Article (6) stipulates that the Board of Directors of the Authority is the supreme authority of its affairs as well as setting the necessary policies required to accomplish its goal. Article (7) provides for the appointment of an executive director for the authority to administer it, where his term of office will be four years, to be renewed once.

The Health Minister explained that Article (8) stipulates that all administrative and financial assets – except medical assets – of the General Authority for Health Insurance along with its branches and entities associated to health ministry shall be affiliated to the GACSHI. It was stipulated in the draft that there will be a special committee in the GACSHI to be responsible for pricing the presented medical service, Article (10) states that GACSHI shall be responsible for following up the medical treatment of the insured patients in case they received a medical treatment at one of the medical entities which are not registered in the GACSHI.

Insured patients shall have the right to choose the treatment entities in case of emergency at one of the non-contracting medical entities, in such cases the GACSHI shall have the right to regulate the refund expenses in accordance with the applicable price regulations of the Authority.

The health minister added that Article (11) stipulates that the Authority shall have the right to exclude any service providers in cases where service providers are less focused towards the citizens. Whereas, Article (12) states that in the case of injury of the insured during work or because of work, the employer shall inform the GACSHI as soon as the injury takes place.

Rady noted that Article (13) is concerned with the issuance of disability certificates resulting from the incidence of any disease and its percentage. As for Article (14), the GACSHI is obliged to submit performance reports regarding its financial position and semi-annual financial statements to the Cabinet and House of Representatives at least once a year.

According to the new health insurance law, the government will fully cover health expenses for those who are unable to pay for their medical treatment. They are about 30 percent of Egypt’s population. “The system will be applied gradually between 2018 and 2032,” said Ali Hegazy, head of the General Authority for Health Insurance. He added that around 42 million citizens do not benefit from any health insurance services.

The current budget for this insurance reaches LE 8 billion annually, according to Hegazy; however, covering the appropriate services in accordance with international standards would require an additional LE 90 million annually.

Employees will be obliged to subscribe to the new health insurance system. It will cost between LE 1,300- 4,000 per year, depending on the income. However, citizens who cannot afford the fees will be exempted from paying any subscription fees.

The current insurance system only covers about 60 percent of the citizens, where each one used to pay only LE 112. However, due to its bad quality only six percent of citizens used its services.

Hegazy stated, the new program will be funded through the taxes imposed on cigarettes and tobacco, along with other items and other funding sources. “The new program will be introduced with high efficiency. It will also end the high cost of medical services provided by the private sector,” said Hegazy.

According to Hegazy, all private hospitals will have to adhere to the prices set by the government. The bill, which has been developed over the past six years, was drafted by 22 health insurance officials, bankers, and academic physicians.