Exam Title :
ISC2 Certified Authorization Professional (CAP)
Exam ID :
CAP
Exam Duration :
180 mins
Questions in exam :
125
Passing Score :
700/1000
Exam Center :
Pearson VUE
Real Questions :
ISC2 CAP Real Questions
VCE practice test :
ISC2 CAP Certification VCE Practice Test
Information Security Risk Management Program (15%)
Understand the Foundation of an Organization-Wide Information Security Risk Management Program
- Principles of information security
- National Institute of Standards and Technology (NIST) Risk Management Framework (RMF)
- RMF and System Development Life Cycle (SDLC) integration
- Information System (IS) boundary requirements
- Approaches to security control allocation
- Roles and responsibilities in the authorization process
Understand Risk Management Program Processes
- Enterprise program management controls
- Privacy requirements
- Third-party hosted Information Systems (IS)
Understand Regulatory and Legal Requirements
- Federal information security requirements
- Relevant privacy legislation
- Other applicable security-related mandates
Categorization of Information Systems (IS) (13%)
Define the Information System (IS)
- Identify the boundary of the Information System (IS)
- Describe the architecture
- Describe Information System (IS) purpose and functionality
Determine Categorization of the Information System (IS)
- Identify the information types processed, stored, or transmitted by the Information System (IS)
- Determine the impact level on confidentiality, integrity, and availability for each information type
- Determine Information System (IS) categorization and document results
Selection of Security Controls (13%)
Identify and Document Baseline and Inherited Controls
Select and Tailor Security Controls
- Determine applicability of recommended baseline
- Determine appropriate use of overlays
- Document applicability of security controls
Develop Security Control Monitoring Strategy
Review and Approve Security Plan (SP)
Implementation of Security Controls (15%)
Implement Selected Security Controls
- Confirm that security controls are consistent with enterprise architecture
- Coordinate inherited controls implementation with common control providers
- Determine mandatory configuration settings and verify implementation (e.g., United States Government Configuration Baseline (USGCB), National Institute of Standards and Technology (NIST) checklists, Defense Information Systems Agency (DISA), Security Technical Implementation Guides (STIGs), Center for Internet Security (CIS) benchmarks)
- Determine compensating security controls
Document Security Control Implementation
- Capture planned inputs, expected behavior, and expected outputs of security controls
- Verify documented details are in line with the purpose, scope, and impact of the Information System (IS)
- Obtain implementation information from appropriate organization entities (e.g., physical security, personnel security
Assessment of Security Controls (14%)
Prepare for Security Control Assessment (SCA)
- Determine Security Control Assessor (SCA) requirements
- Establish objectives and scope
- Determine methods and level of effort
- Determine necessary resources and logistics
- Collect and review artifacts (e.g., previous assessments, system documentation, policies)
- Finalize Security Control Assessment (SCA) plan
Conduct Security Control Assessment (SCA)
- Assess security control using standard assessment methods
- Collect and inventory assessment evidence
Prepare Initial Security Assessment Report (SAR)
- Analyze assessment results and identify weaknesses
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ISA
CAP
Certified Authorization Professional
https://killexams.com/pass4sure/exam-detail/CAP Question: 384
An authentication method uses smart cards as well as usernames and passwords for
authentication. Which of the following authentication methods is being referred to?
A. Anonymous
B. Multi-factor
C. Biometrics
D. Mutual Answer: B Question: 385
In 2003, NIST developed a new Certification & Accreditation (C&A) guideline known as FIPS
199. What levels of potential impact are defined by FIPS 199? Each correct answer represents a
complete solution. Choose all that apply.
A. Low
B. Moderate
C. High
D. Medium Answer: A, C, D Question: 386
Which of the following is NOT an objective of the security program?
A. Security organization
B. Security plan
C. Security education
D. Information classification Answer: B Question: 387
Walter is the project manager of a large construction project. He'll be working with several
vendors on the project. Vendors will be providing materials and labor for several parts of the
project. Some of the works in the project are very dangerous so Walter has implemented safety
requirements for all of the vendors and his own project team. Stakeholders for the project have
added new requirements, which have caused new risks in the project. A vendor has identified a
new risk that could affect the project if it comes into fruition. Walter agrees with the vendor and
has updated the risk register and created potential risk responses to mitigate the risk. What
should Walter also update in this scenario considering the risk event?
A. Project contractual relationship with the vendor
B. Project communications plan
C. Project management plan
D. Project scope statement Answer: C Question: 388
During which of the following processes, probability and impact matrix is prepared?
A. Plan Risk Responses
B. Perform Quantitative Risk Analysis
C. Perform Qualitative Risk Analysis
D. Monitoring and Control Risks Answer: C Question: 389
During qualitative risk analysis you want to define the risk urgency assessment. All of the
following are indicators of risk priority except for which one?
A. Symptoms
B. Cost of the project
C. Warning signs
D. Risk rating Answer: B Question: 390
Which of the following statements about Discretionary Access Control List (DACL) is true?
A. It is a rule list containing access control entries.
B. It specifies whether an audit activity should be performed when an object attempts to access a
resource.
C. It is a list containing user accounts, groups, and computers that are allowed (or denied) access
to the object.
D. It is a unique number that identifies a user, group, and computer account Answer: C Question: 391
Which of the following is used to indicate that the software has met a defined quality level and is
ready for mass distribution either by electronic means or by physical media?
A. DAA
B. RTM
C. ATM
D. CRO Answer: B Question: 392
Which of the following processes is a structured approach to transitioning individuals, teams,
and organizations from a current state to a desired future state?
A. Configuration management
B. Procurement management
C. Change management
D. Risk management Answer: C Question: 393
A security policy is an overall general statement produced by senior management that dictates
what role security plays within the organization. What are the different types of policies? Each
correct answer represents a complete solution. Choose all that apply.
A. Systematic
B. Regulatory
C. Advisory
D. Informative Answer: B, C, D Question: 394
Which of the following is a standard that sets basic requirements for assessing the effectiveness
of computer security controls built into a computer system?
A. TCSEC
B. FIPS
C. SSAA
D. FITSAF Answer: A Question: 395
Which of the following statements correctly describes DIACAP residual risk?
A. It is the remaining risk to the information system after risk palliation has occurred.
B. It is a process of security authorization.
C. It is the technical implementation of the security design.
D. It is used to validate the information system. Answer: A
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https://killexams.com/exam_list/ISAISA Standards
Practical Solutions from Industry Experts
ISA standards help automation professionals streamline processes and Improve safety, cybersecurity, and efficiency in operations spanning multiple industry segments. Over 150 consensus standards and guidelines reflect the work and knowledge of more than 3,000 participating experts worldwide.
What is a Standard?
A standard sets forth requirements that a process, system, product, or material must satisfy if it is to be truthfully stated (or advertised) as meeting that standard.
ISA standards are not government regulations, but rather are voluntary documents that are sometimes referenced in regulations. In addition, contracts between private entities may include requirements to follow specific ISA standards.
Among their many benefits, standards help manufacturing and related organizations by harnessing years of experience and expert knowledge to:
increase human safety,
improve communications,
reduce design and implementation costs,
enable component and systems interchangeability,
reduce downtime and maintenance costs, and the need to keep large inventories, and
protect the natural environment.
ISA also develops two types of informative documents that support the understanding and use of ISA standards—but that do not carry the normative standing of an ISA standard:
Recommended practices (RPs) embody guidelines that may be followed or adopted to work effectively in specific applications within the scope of an ISA standards committee;
Technical reports (TRs) set forth informative material and guidelines to help users understand and apply an existing standard, or to better understand a Topic that is important within the scope of an ISA standards committee.
ISA Standards Participation is Open to Experts from Any Country
ISA is accredited by the American National Standards Institute (ANSI) to develop industry standards following approved processes to ensure openness and balance—and to prevent dominance by specific interests, companies, or organizations.
ANSI is a nonprofit organization, not a government agency. ANSI accreditation does not prevent participation in ISA standards by those outside the U.S. In fact, individuals working on ISA standards committees are based in more than 40 countries. Membership in ISA is not a requirement.
ISA Standards Committees
The key elements of ISA’s standards development program are set forth in their ANSI-accredited procedures. Those procedures call for main (oversight) committees that develop standards strictly within their approved scope areas to ensure that different committees do not work on the same or overlapping Topic areas. Main committees typically have working groups that work on specific documents or projects.
Instrumented Systems to Achieve Functional Safety (ISA84)
Batch Process Control (ISA88)
Enterprise-Control System Integration (ISA95)
Industrial Automation and Control Systems Security (ISA99)
Wireless Systems for Automation (ISA100)
Human-Machine Interface (ISA101)
Procedure Automation for Continuous Process Operations (ISA106)
Intelligent Device Management (ISA108)
SCADA Systems (ISA112)
Fossil and Nuclear Power Plants (ISA77 and ISA67)
Control Valves (ISA75) and Valve Actuators (ISA96)
Serving on ISA Standards Committees
Participation on ISA standards committees is open at no cost to automation professionals from any country who agree to abide by each of the following requirements:
To follow the ISA Standards Code of Conduct (see ANNEX A in their procedures).
To understand you serve on an ISA standards committee strictly as an individual expert, not as a company or organizational representative.
To never represent yourself in discussions, presentations, articles, or other communications as speaking for or on behalf of ISA or of a specific ISA standards committee or project without prior approval by ISA’s staff Director of Standards.
To focus strictly on the technical content of standards, with no discussion or consideration of commercial/business issues in standards committee meetings or at any other time within the context of ISA standards development. This includes pricing of components or systems, sales information, market shares, warranties, and guarantees.
To recognize and understand that ISA asserts ownership of all rights of copyright to its standards, including drafts, technical reports, recommended practices, and the completed, adopted standards for the convenience and benefit of all concerned. Specifically, ISA standards committee members:
must respect the intellectual property rights of others and must not knowingly provide or insert any copyrighted works into any committee materials for which the member has not received permission as necessary for use with the standard.
must not disclose any proprietary or confidential information in the course of ISA standards committee participation without authorization.
must agree to irrevocably transfer to ISA all right, title, and interest in and to any standard or other material developed under the auspices of ISA, including copyright, that such participant might otherwise acquire by law.
Voting and Nonvoting Members
ISA main committees include voting and nonvoting (also called information) members. The voting membership of main committees must be balanced across interest categories that include users, suppliers, integrators, consultants, government/regulators, and test/certification providers. This balance is intended to allow fair and open input from all categories without domination by any one category.
Voting members must meet active participation requirements (such as submitting content to documents) as defined by the main committees to qualify for and maintain their voting status. There may be no more than one voting member employed by the same company or organization.
New members to ISA standards committees typically join as information (nonvoting) members. Information members are observers who may submit review comments on documents and participate directly in committee work, including writing documents and leading working groups. They may apply for voting status if they can meet a committee-defined level of participation.
Working groups under a main committee may conduct informal votes on documents or other matters, but do not have official voting and nonvoting members.
Approving New or Revised ISA Standards
For details on how standards (as well as RPs and TRs) are approved by committees, see our procedures. To summarize:
Committee chairs approve the issue of a ballot on a standard, TR, or RP.
ISA standards are consensus documents, and thus unanimous approval by main committee voting members is not required.
For approval, standards require (a) a majority of the voting members to respond and (b) 2/3 approval of those voting members who responded.
TRs and RPs, being informative documents, require majority approval of the voting members.
All committee members, voting and nonvoting, may submit review comments during a ballot. All comments must be responded to in writing (typically in a spreadsheet) for viewing by the entire committee. Responses are usually prepared by the working group that developed the document.
Voting members are given a chance to change their votes based on the responses and any resulting changes to the document.
The process of voting, response, and reconsideration can sometimes go through several cycles, but when finished the document is balloted to a governing body, the ISA Standards & Practices Board, for final approval. This latter ballot is strictly to approve that ISA’s procedures have been followed properly in the development of the document. It is not a ballot on the technical content, which is solely the responsibility of the respective standards committee, being made up of technical experts.
Obtaining and Viewing ISA standards
ISA standards may be obtained at the listing of all ISA standards.
For ISA members, a major benefit of membership is free viewing of ISA-copyrighted standards, RPs, and TRs.
Do you have a suggestion for a new standard, topic, or training that ISA should consider? Please send it to ISA Standards.
Thu, 08 Jun 2023 19:30:00 -0500entext/htmlhttps://www.isa.org/standards-and-publications/isa-standardsISA Transactions: The Journal of Automation
ISA Transactions is a journal of advances and state-of-the-art in the science and engineering of measurement and automation, of value to leading-edge industrial practitioners and applied researchers.
The subjects of measurement include: sensors, perception systems, analyzers, signal processing, filtering, data compression, data rectification, fault detection, inferential measurement, soft sensors, hardware interfacing, etc.; and any of the techniques that support them such as artificial intelligence, fuzzy logic, communication systems, and process analysis. The subjects of automation include: statistical and deterministic strategies for discrete event and continuous process control, modelling and simulation, event triggers, scheduling and sequencing, system reliability, quality, maintenance, management, loss prevention, etc.; and any equipment, techniques and best practices that support them such as optimization, learning systems, strategy development, security, and human interfacing and training.
The intended audience is research and development personnel from academe and industry in the field of process instrumentation, systems, and automation.
The journal seeks to bridge the theory and practice gap. This balance of interests requires simplicity of technique, credible demonstration, fundamental grounding, and connectivity to the state of the art in both theory and practice.
Manuscript Types and Categories
We publish articles (primarily relating to research or to practice), letters, or errata.
Errata: These publications represent an authors' or editor's correction to an article.
Letters: Letters to the editor would be short, one-paragraph, or so, affirmations, questions, challenges, or answers to articles or letters.
Research Articles: These can be from either of the categories that follow, and will primarily relate to research, investigation, and to possibilities. Normally, they focus on the fundamental analysis or mathematics of a technique. Normally they are illustrated with simulations, and are written by and for those in research.
Practice Articles: These can be from either of the categories that follow, and will primarily relate to the practice or to applications. Normally, they focus on the pilot-scale or full-scale application and the heuristics and post implementation audit of an application. Normally they are concerned with application results and interpretation, and are written by and for those implementing measurement and control.
Articles (research or practice) may be from the following categories:
Analysis: Clearly develop a fundamental, mathematical analysis of a practice-relevant application or methodology. Explicitly state implications and recommendations for its application. Provide credible examples.
Design: Present a complete "how-to" guide. Connect design procedures to first principles. Explicitly state heuristics and limits of applicability. Provide evidence that the procedures are practicable.
Application: Present the results of new (or under-utilized) techniques or novel applications. Provide a complete description of results, including pilot- or plant-scale experimental data, and a revelation of heuristics and shortcomings.
Tutorial/Review: Present what might become a chapter in a text - a comprehensive exposition or survey of the analysis, design and application of a technique that is practice-important but not yet common textbook material. Include a critical review of the state of the art to guide practitioner choices.
Editorial: Present a balanced and learned perspective on the implications of historical trends or developing issues that reveal needs and direction for action or change. The concepts could be aimed at research, standards, products, criteria for evaluation, or organizations.
Technical Notes: Present new concepts or initial proof-of-concept results on innovative approaches. The manuscripts would be short, perhaps two journal pages, and would not require extensive comprehensive defence required of regular papers. However, they would be critically reviewed for compliance to ISA T Aims and Scope. Technical notes are intended to accelerate the dissemination of ideas, and will be given priority in the publication queue. The title must start with the identification "Technical Note:"
ISA Transactions is a monthly publication available online to ISA members and in print for Institutions.
For information on institutional subscriptions, both print and Science Direct, please contact Elsevier.
Wed, 26 Apr 2023 17:29:00 -0500entext/htmlhttps://www.isa.org/standards-and-publications/isa-publications/isa-transactionsResurrecting ISA Hardware
[Alex] had an old FM radio tuner card come his way. It used an ISA connector, a standard that went the way of the dodo in the mid-nineties. With the challenge of implementing an ISA-bus to configure the card he set out on his mission. What he came up with is a working radio using the ISA card and driven by a PIC 16F877. Join us after the break for schematic, code, and a few details.
The card is based on an LM7000 PLL synthesizer paired with a LC7534 tone/volume controller. With a bit of datasheet study [Alex] figured out where the data pins for the chips map to the ISA bus. Working with a prototyping board, the hardest part turned out to be finding the addresses for the chips. He ended up testing all 256 possibilities and watching for the data to be latched from the ISA bus. Alex says the hardware is capable of tuning from about 60MHz up to 125MHz.
We asked him if he’d share his code and schematic. He came through with both, and kudos to him for such a clean hand-drawn schematic. Nice work [Alex]!
Tue, 08 Jun 2010 21:17:00 -0500Mike Szczysen-UStext/htmlhttps://hackaday.com/2010/06/09/resurrecting-isa-hardware/Your HealthYour Health : NPR
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Fri, 29 Dec 2023 10:00:00 -0600entext/htmlhttps://www.npr.org/sections/your-health/Cancer patients face frightening delays in treatment approvals
Marine Corps veteran Ron Winters clearly recalls his doctor's sobering assessment of his bladder cancer diagnosis in August 2022.
"This is bad," the 66-year-old Durant, Oklahoma, resident remembered his urologist saying. Winters braced for the fight of his life.
Little did he anticipate, however, that he wouldn't be waging war only against cancer. He also was up against the Department of Veterans Affairs, which Winters blames for dragging its feet and setting up obstacles that have delayed his treatments.
Winters didn't undergo cancer treatment at a VA facility. Instead, he sought care from a specialist through the Veterans Health Administration's Community Care Program, established in 2018 to enhance veterans' choices and reduce their wait times. But he said the prior authorization process was a prolonged nightmare.
"For them to take weeks — up to months — to provide an authorization is ridiculous," Winters said. "It doesn't matter if it's cancer or not."
Ron and Teresa Winters at their home in Durant, Oklahoma. Winters blames the Department of Veterans Affairs for setting up roadblocks that have delayed treatment for his bladder cancer. Desiree Rios for KFF Health News
After his initial diagnosis, Winters said, he waited four weeks for the VA to approve the procedure that allowed his urologic oncologist at the University of Texas Southwestern Medical Center in Dallas to remove some of the cancer. Then, when he finished chemotherapy in March, he was forced to wait another month while the VA considered approving surgery to remove his bladder. Even routine imaging scans that Winters needs every 90 days to track progress require preapproval.
In a written response, VA press secretary Terrence Hayes acknowledged that a "delay in care is never acceptable." After KFF Health News inquired about Winters' case, the VA began working with him to get his ongoing care authorized.
"We will also urgently review this matter and take steps to ensure that it does not happen again," Hayes told KFF Health News.
Prior authorization isn't unique to the VA. Most private and federal health insurance programs require patients to secure preapprovals for certain treatments, tests, or prescription medications. The process is intended to reduce spending and avoid unnecessary, ineffective, or duplicative care, although the degree to which companies and agencies set these rules varies.
Insurers argue prior authorization makes the U.S. health care system more efficient by cutting waste — theoretically a win for patients who may be harmed by excessive or futile treatment. But critics say prior authorization has become a tool that insurers use to restrict or delay expensive care. It's an especially alarming issue for people diagnosed with cancer, for whom prompt treatment can mean the difference between life and death.
"I'm interested in value and affordability," said Fumiko Chino, a member of the Affordability Working Group for the Memorial Sloan Kettering Cancer Center. But the way prior authorization is used now allows insurers to implement "denial by delay," she said.
Cancer is one of the most expensive categories of disease to treat in the U.S., according to the Centers for Disease Control and Prevention. And, in 2019, patients spent more than $16 billion out-of-pocket on their cancer treatment, a report by the National Cancer Institute found.
To make matters worse, many cancer patients have had oncology care delayed because of prior authorization hurdles, with some facing delays of more than two weeks, according to research Chino and colleagues published in JAMA in October. Another accurate study found that major insurers issued "unnecessary" initial denials in response to imaging requests, most often in endocrine and gastrointestinal cancer cases.
The federal government is weighing new rules designed to Improve prior authorization for millions of people covered by Medicare, Medicaid, and federal marketplace plans. The reforms, if implemented, would shorten the period insurers are permitted to consider prior authorization requests and would also require companies to provide more information when they issue a denial.
In the meantime, patients — many of whom are facing the worst diagnosis of their lives — must navigate a system marked by roadblocks, red tape, and appeals.
"This is cruel and unusual," said Chino, a radiation oncologist. A two-week delay could be deadly, and that it continues to happen is "unconscionable," she said.
Chino's research has also shown that prior authorization is directly related to increased anxiety among cancer patients, eroding their trust in the health care system and wasting both the provider's and the patient's time.
Leslie Fisk, 62, of New Smyrna Beach, Florida, was diagnosed in 2021 with lung and brain cancer. After seven rounds of chemotherapy last year, her insurance company denied radiation treatment recommended by her doctors, deeming it medically unnecessary.
"I remember losing my mind. I need this radiation for my lungs," Fisk said. After fighting Florida Health Care Plans' denial "tooth and nail," Fisk said, the insurance company relented. The insurer did not respond to requests for comment.
Fisk called the whole process "horribly traumatic."
"You have to navigate the most complicated system on the planet," she said. "If you're just sitting there waiting for them to take care of you, they won't."
A new KFF report found that patients who are covered by Medicaid appear to be particularly impacted by prior authorization, regardless of their health concerns. About 1 in 5 adults on Medicaid reported that their insurer had denied or delayed prior approval for a treatment, service, visit, or drug — double the rate of adults with Medicare.
"Consumers with prior authorization problems tend to face other insurance problems," such as trouble finding an in-network provider or reaching the limit on covered services, the report noted. They are also "far more likely to experience serious health and financial consequences compared to people whose problems did not involve prior authorization."
In some cases, patients are pushing back.
In November, USA Today reported that Cigna admitted to making an error when it denied coverage to a 47-year-old Tennessee woman as she prepared to undergo a double-lung transplant to treat lung cancer. In Michigan, a former health insurance executive told ProPublica that the company had "crossed the line" in denying treatment for a man with lymphoma. And Blue Cross and Blue Shield of Louisiana "met its match" when the company denied a Texas trial lawyer's cancer treatment, ProPublica reported in November.
Countless others have turned to social media to shame their health insurance companies into approving prior authorization requests. Legislation has been introduced in at least 30 states — from California to North Carolina — to address the problem.
Back in Oklahoma, Ron Winters is still fighting. According to his wife, Teresa, the surgeon said if Ron could have undergone his operation sooner, they might have avoided removing his bladder.
In many ways, his story echoes the national VA scandal from nearly a decade ago, in which veterans across the country were languishing — some even dying — as they waited for care.
In 2014, for example, CNN reported on veteran Thomas Breen, who was kept waiting for months to be seen by a doctor at the VA in Phoenix. He died of stage 4 bladder cancer before the appointment was scheduled.
Winters' cancer has spread to his lungs. His diagnosis has advanced to stage 4.
"Really, nothing has changed," Teresa Winters said. "The VA's processes are still broken."
Do you have an experience with prior authorization you'd like to share?Click hereto tell your story.
KFF Health News, formerly known as Kaiser Health News, is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs atKFF— the independent source for health policy research, polling, and journalism.
Thu, 21 Dec 2023 20:00:00 -0600en-UStext/htmlhttps://www.cbsnews.com/news/cancer-patients-frightening-delays-in-treatment-approvals/Do You Know If Your Medicare Advantage Plan Requires Prior Authorization?
When it comes to Medicare Advantage plans you need to understand prior authorization.
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My 90-year-old uncle, a retired county employee, has had a Medicare Advantage preferred provider organization (PPO) plan for the last eight years. He sees his primary physician once or twice a year. However, now he has been experiencing dizzy spells and falls. His physician ordered a slew of medical tests. I asked my uncle, “Does your plan require prior authorization for these tests?” His reply was a shoulder shrug.
Because my uncle has no idea what prior authorization is, let alone whether or not his plan has those rules, I asked about any medical procedures he might have had recently. Four years ago, he had several medical tests without any issues. But that was before authorization was the big deal it is today. (In 2018, 61% of Medicare Advantage enrollees were in plans requiring authorization for procedures and lab tests. That increased to over 90% in 2021.)
It became clear that my uncle needed a crash course on prior authorization.
What is prior authorization?
Prior authorization, sometimes called preauthorization or prior approval, is a health insurer or plan’s decision that a healthcare service, treatment, prescription drug or durable medical equipment is medically necessary. Today, 99% of Medicare Advantage members are in plans that require prior approval for services including inpatient admissions, skilled nursing facility stays, mental health services, home health care, chiropractic services, outpatient surgery and services, ambulance transport, medical equipment, diagnostic tests, and laboratory and radiology services. (Plans cannot require authorization in emergency situations.)
For my uncle’s medical tests, the plan will either approve or deny the request. If the test is not authorized, the Medicare Advantage plan may not pay. In a plan’s Evidence of Coverage (EOC), the legal contract between the plan and you, there is language something like, “If prior authorization is required and not obtained, no benefits will be payable under the plan.” Translation: Pay attention to the fine print. If you don’t, you could be responsible for full payment.
How do you identify the requirements?
Prior to the fall Open Enrollment Period, Medicare Advantage plans will send a copy of the EOC or a link to it on the plan’s website. One of the easiest ways to locate whether or not these rules apply to your plan is to search the document for “prior authorization.” With his daughter’s help, my uncle accessed his EOC and found that the procedures he needs “may require” authorization. They are going to contact the physician and a plan representative for details, so he doesn’t end up on the hook.
What should you do about prior authorization?
A friend has lived with these requirements for several years. After determining that prior authorization applies in a specific situation, he follows a process that he shared with me.
Find a copy of your insurance company’s form or process. Check the website or call a plan representative. Your physician may need it and you’ll know exactly what information must be included.
Confirm that whoever in your physician’s office is in charge of this process knows that you need an authorization and the date due.
Double check that documentation is submitted, and that approval is received before the service. You may want to confirm your costs.
Remember, if you move forward without authorization, you might have to pay the full cost.
From a Medicare Advantage plan’s perspective, prior authorization can promote safe, timely, evidence-based, affordable, and efficient care. However, the American Medical Association believes that prior authorization “is overused, costly, inefficient, opaque and responsible for patient care delays” and is implementing measures to reform the process. Until then, for my uncle and all those with Medicare Advantage plans caught in the middle, it’s simply a fact of life. Knowing what to do will help you get the medical care you need.
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Wed, 01 Jun 2022 07:33:00 -0500Diane Omdahlentext/htmlhttps://www.forbes.com/sites/dianeomdahl/2022/06/01/do-you-know-if-your-medicare-advantage-plan-requires-prior-authorization/Mental HealthNo result found, try new keyword!Hilarie Burton Says She Was 'Ashamed' to Hire a Baby Nurse to Help amid Postpartum Depression: 'Humiliating' Amy Robach Recalls Racing to T.J. Holmes' Side After She Feared He Had Harmed Himself ...Wed, 06 Jun 2018 12:20:00 -0500entext/htmlhttps://people.com/tag/mental-health/Is there an ISA boost on the way?
The chancellor is reportedly planning a radical shake-up of ISAs to encourage people to take advantage of the tax-free products, and boost investment in UK companies.
According to a report in the Financial Times, Jeremy Hunt is considering introducing an additional tax-free allowance for investing in UK companies. This means that on top of the £20,000 annual ISA limit, there could be an extra allowance for holding British shares.
Treasury officials have also met investment industry bosses to discuss merging stocks and shares ISAs with cash ISAs.
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The shake-up aims to simplify the ISA regime and boost the UK stock market.
Treasury insiders said ministers want to use the Autumn Statement, which will take place on 22 November, to increase share ownership and encourage more ISA savings.
The Treasury told MoneyWeek: “HM Treasury is receptive to ideas of how they can make ISAs more attractive to encourage people to develop a savings habit and to invest in a way that works for them.”
It is understood that any ISA reforms will be announced in the chancellor’s Autumn Statement, and not before.
Does the ISA regime need simplifying?
There are six types of ISA: cash, stocks and shares, junior, lifetime, help to buy, and innovative finance. Lifetime ISAs can be opened by those under 40, and have been criticised for being too complex. Innovative finance ISAs allow investment in peer-to-peer loans but have had very low take-up. Help to buy ISAs are closed to new applicants, but customers who already have one can pay into it until November 2029.
Cash ISAs are the most popular vehicles, with the majority of savers’ money funnelled into those. According to the most accurate official statistics, savers paid £7,139,000 into cash ISAs in 2020-21, while £3,934,000 was contributed to stocks and shares ISAs. A total of £662,000 was paid into lifetime ISAs, and just £17,000 was paid into innovative finance products.
Sarah Coles, head of personal finance at the wealth manager Hargreaves Lansdown, says some simplification would be welcome, but the Treasury’s reported plans “risk over-complicating a well-established system”.
She comments: “One proposed change that initially looks like a way to make life more straightforward would, in reality, over-complicate things for savers. In merging cash and stocks and shares ISAs, it would need to be ensured that cash ISA customers would not get communications on investment issues, which could be off-putting and confusing for people who only want to keep their money in cash.”
Coles says creating a separate ISA allowance for UK investments “adds a needless extra layer of complication”.
Richard Murphy, an accounting professor, writes in a Tax Research blog that Hunt’s ISA suggestions “make no sense” as they would “increase inequality by extending tax reliefs for the well-off”.
However, the investment platform AJ Bell is supportive of radical ISA simplification, arguing that the various versions of ISAs “risk undermining a product that has proven popular with millions of investors”.
Tom Selby, head of retirement policy at AJ Bell, comments: “Combining the best features of the current landscape in a single ‘One ISA’ product would make it much easier for people to engage with the world of investing.
“Without simplification, there is a danger the battle for engagement will be won by people flogging high-risk, unregulated investments that all-too-often end up being inappropriate or complete scams.”
But he is sceptical of linking an increase in the ISA allowance to an allocation to UK-based investments, saying: “There is a danger in encouraging investing in a specific country that the benefits of diversification will be undermined.”
Increasing the ISA allowance
One potential reform that experts would like to see is boosting the £20,000 ISA limit for everyone - rather than only investors who allocate to UK shares.
“Given the ISA allowance has been frozen at its current level of £20,000 since 2017/18, there is an argument that savers are long overdue a rise,” notes Selby.
According to Coles, increasing the allowance would be a real boon for investors who have maxed out their allowances and now face harsh tax penalties on investments held outside an ISA.
“An increase in the ISA allowance would be a shot in the arm for investors battered by cuts in the allowances for dividend tax and capital gains tax. It would release pent-up demand and allow more money to naturally flow into UK stocks and shares,” says Coles.
“Increasing the existing allowance by £10,000 to £30,000 could mean capital gains savings of £35,490 over 20 years for a higher-rate taxpayer investing in stocks and shares.”
How else could ISAs be reformed?
Coles says the government should think seriously about making a couple of small tweaks to ISAs, which would make them fairer and simpler. First, it should be possible to pay into as many ISAs as you like each tax year provided you stay within the overall £20,000 ISA limit. This change would make it easier to open, subscribe and transfer ISAs, and remove a layer of needless complexity, according to Coles.
Changing the lifetime ISA should also be a high priority for Hunt. Coles explains: “Allowing the £4,000 lifetime ISA allowance to be additional to the £20,000 ISA limit would help separate these products, and boost incentives to invest.
“We also want to see the lifetime ISA penalty cut from 25% to 20%. The 25% penalty currently not only claws back the government bonus to save, but also applies an additional 6.25% penalty based on the amount invested.”
Saving towards a first home is often an uphill battle. But building up a deposit in a Lifetime Isa can offer aspiring homeowners a welcome boost. If you are looking for a way to help a child or grandchild on to the property ladder, contributing to their Lifetime Isa could help them achieve their goal months or even years sooner. In this type of Isa, you can save up to £4,000 a year and receive a 25 per cent boost from the Government. So every £4,000 is turned into £5,000 thanks to a £1,000 uplift.
Sat, 12 Mar 2022 19:10:00 -0600text/htmlhttps://www.dailymail.co.uk/money/isainvesting/index.htmlBest affordable health insurance plans of 2024
Kaiser Permanente is the best affordable health insurance company, according to their analysis.
We evaluated health insurance companies based on cost, coverage options, NCQA quality rating and consumer complaints. Use this rating as a starting point to compare providers and find the best cheap medical insurance for your situation.
Affordable health insurance companies of 2024
Why trust their health insurance experts
Our team of insurance experts evaluates hundreds of insurance products and analyzes thousands of data points to help you find the best product for your situation. They use a data-driven methodology to determine each rating. Advertisers do not influence their editorial content. You can read more about their methodology below.
129 health insurance companies analyzed.
864 health insurance plan rates reviewed.
5 levels of fact-checking.
Kaiser Permanente
Aetna
United Healthcare
Compare the best cheap health insurance companies
We analyzed the average rates of Bronze health insurance plans offered by the best health insurance companies across the nation. Those with the cheapest average cost made their rating of the best and most affordable insurance companies.
To first determine the best health insurance companies, they compared providers that sell individual health insurance plans. Each health insurance company was eligible for up to 100 points, based on its performance in the following key categories:
Cost (30 points). Health insurance companies with the lowest average monthly premium and deductible for Silver tier health insurance plans received the highest score.
Consumer complaints (25 points). Health insurance companies with the lowest levels of complaints received the highest score. They collected complaint data from the National Association of Insurance Commissioners, which shows the volume of health insurance consumer complaints against each company.
NCQA quality rating (25 points). Health insurance companies with the highest quality ratings received the highest score. They collected data from the National Committee for Quality Assurance (NCQA), an independent, nonprofit organization that accredits health plans and produces ratings based on specific metrics.
Variety of health insurance plans (10 points). Health insurance companies with the greatest variety of health insurance plans (HMO, EPO, PPO) received the highest score.
Metal tier offerings (10 points). Health insurance companies with the most options of metal tier plans received the highest score.
How to get affordable health insurance
The best way to get the cheapest health insurance is through your workplace. Many employers offer group health insurance to their employees and families. Group health insurance is cheaper than getting individual health insurance, and most employers pay a portion of the health insurance premium, making your cost more affordable.
If you can’t get coverage through your workplace, the Health Insurance Marketplace may offer low-cost health insurance. There are usually several Affordable Care Act (ACA) compliant health plans in your area, and the website can help you choose one.
You might be eligible for even cheaper health insurance through Marketplace subsidies if your household income is at or lower than 400% of the federal poverty level for your household size.
Medicaid may be another option if you have a low income. This health insurance program can offer you comprehensive health insurance coverage at little or no cost.
Another option is going directly to a health insurance company. Plans may not be ACA-compliant, however. It’s worth reviewing and comparing the summary of benefits and coverage (SBC) for each plan to determine which will best fit your needs.
How much does health insurance cost?
Health insurance costs an average of $974 a month for a Bronze plan (the lowest level plan) on the ACA Health Insurance Marketplace, which is where you can buy a health insurance plan via Healthcare.gov. The monthly average cost increases to $1,269 for a Silver plan, $1,383 for a Gold plan and $1,724 for a Platinum plan.
There are several factors that affect how much you’ll pay for health insurance, including:
Your age and the ages of your dependents.
The health insurance plan copays, deductibles, coinsurance and out-of-pocket maximums.
The health insurance coverage and metal tier you choose.
The health insurance company and plan you choose.
The type of health insurance policy (EPO, HMO, PPO, etc.) you buy.
The more the health insurance company covers, the more you’ll pay in health insurance premiums. If you choose a higher health insurance deductible and out-of-pocket maximum, you could save on your premium. Just be prepared to pay more out of pocket for your health care in exchange for that lower premium.
Average cost of health insurance by age
Average monthly cost based on unsubsidized ACA plans. Source: Healthcare.gov.
If you’re shopping for cheap health insurance, there are multiple things to consider, including the plan type, tax credits and coverage choices. They break down the most important factors to consider when comparing quotes to find cheap medical insurance.
Bronze Plans
Of all the metal tiers, Bronze plans have the lowest premiums, though you’ll pay the most for your health care costs. With a typical Bronze plan, the insurance company pays 60% of covered expenses, while you pay 40%. Expect deductibles for Bronze plans to be thousands of dollars per year.
This plan is best for someone who wants health insurance coverage for severe injuries or illnesses but can afford to pay for preventive and routine care out of pocket.
Silver Plans
Health insurance companies usually pay around 70% of health care costs on a Silver plan, while you pay 30%. This metal plan offers lower deductibles than Bronze plans but has a higher monthly premium costs. Still, Silver plan deductibles can still be in the thousands.
“If you qualify for a subsidy and reduced cost-sharing, Silver plans may be the most affordable option for you,” said Evan Tunis, president of Florida Healthcare Insurance.
If you don’t qualify for a subsidy but are willing to pay a slightly higher premium to cover more routine care, consider a Silver plan.
Gold Plans
A Gold plan might be worth the cost if you go to the doctor regularly or have high health care costs. Although it has higher premiums than Bronze and Silver plans, your deductible is lower and the insurance company pays about 80% of your cost of care.
Platinum Plans
The metal tier plan with the highest cost is the Platinum plan, but it comes with the lowest deductible. Nearly all your health care costs will be covered, as the health insurance company generally pays around 90% of your covered expenses.
Tax credits for affordable health insurance
Some people qualify for a premium tax credit, which can unlock cheap medical insurance. When you apply for health insurance on the health exchange, you’ll enter your estimated income on the application. You could receive a tax credit depending on your income and household size. You can find out if your estimated income qualifies for a subsidy on the Marketplace website.
“If your income or household makeup changes during the year, you’ll want to update your application to see if it affects your credit,” said Tunis.
Gaining a household member or losing an income could increase your credit. Losing a household member or increasing your income could lower it. Taking more of a tax credit than you’re eligible for could mean you have to pay some of it back when filing your federal tax return.
HSA vs. FSA
HSAs and FSAs are two tax-advantaged savings vehicles you can use to pay for health care expenses.
If you’re considering an HSA, check to see if the Marketplace plan has an “HSA eligible” label.
You can make pre-tax contributions and use the funds to pay for qualified medical expenses and costs to meet your deductible.
The HSA will also accrue interest, and the balance rolls over yearly. You can keep the HSA no matter your employment status and it acts like a retirement account once you turn 65. If you withdraw funds before 65 for non-medical purposes, they will be taxable.
A Flexible Savings Account (FSA) is an employee benefit some employers offer on employer-sponsored group health insurance plans. A predetermined amount of money is set aside pre-tax, which can be used for health care expenses and eligible dependent care.
Out-of-network coverage
Going “out of network” means seeing a health provider not contracted with your health insurance company or plan. If you go out of network to see a doctor, you’ll usually pay a higher coinsurance amount — the percentage you pay for covered services after you’ve met your deductible — than you would to see an in-network doctor.
“Knowing your out-of-network coverage can help you save money in the long run, especially for those who travel frequently or live near a state border,” said Tunis.
Out-of-network coverage can vary depending on the type of health insurance plan you buy. For example, if you have a Health Maintenance Organization (HMO) plan, your insurance might not cover out-of-network care unless it’s an emergency.
If you like your doctor or specialist and want to keep going to them, make sure they’re in network for the health insurance plan you’re considering.
Out-of-pocket maximum
Your out-of-pocket maximum is the most you’ll pay toward covered health care for your plan year. Once you’ve paid your deductibles, coinsurance and copayments and have met your annual out-of-pocket limit, your plan will pay 100% for covered expenses.
The following expenses do not go towards your out-of-pocket maximum:
Health insurance premiums.
Out-of-network expenses.
Costs your provider charges above the allowed amount.
Cost of services not covered.
The 2023 out-of-pocket limit varies for Marketplace plans but cannot exceed $9,100 for individuals and $18,200 for family coverage.
How to find the best affordable health insurance for your needs
Comparing health insurance quotes can be overwhelming, but these tips can help you find the best cheap health insurance plan for you.
Consider your health care needs. If you don’t anticipate going to the doctor much, you could save by choosing an HDHP. But a Gold or Platinum plan may be worth it if you have chronic health conditions or expect to see the doctor regularly.
Which plan type is best? An exclusive provider organization (EPO) plan only covers in-network care. A health management organization (HMO) plan will cover out-of-network care, but only for urgent or emergency care. A preferred provider organization (PPO) plan will cover out-of-network care without a referral for an additional cost.
Check for pharmacy benefits. A formulary, or drug list, is a list of prescription drugs your insurance will cover and what category and cost a particular drug falls under. Todd Ackerman, president of World Insurance Associates, advises considering, “With prescription drug costs rising like they are, what are your prescription costs, and where do your prescriptions fall in the formulary on the plan you’re moving to?”
Ask your healthcare providers what insurance plans they accept. Before you buy a health plan, call your doctor to make sure they take the specific plan. The health insurance company’s online directory could be out-of-date or not accurate.
Verify the health plan cost. The cost isn’t just the premium. You should also consider the coinsurance, copay, deductible and out-of-pocket maximum.
Are there other options? You might be able to get health insurance through your employer or get added to your spouse’s or parent’s plan. These options may be cheaper than getting an individual health insurance plan.
Cheap health insurance FAQs
Kaiser Permanente has the best cheap health insurance, according to their analysis. But it is only available to members in eight states and Washington, D.C. The next best options are Aetna and UnitedHealthcare, which offer health insurance in all 50 states and Washington, D.C.
The cheapest health insurance for you may vary because the age of all household members and income factor into health insurance costs. Bronze and catastrophic plans offer the least coverage but have cheaper rates. Choosing ahigh-deductible health plan(HDHP) can also make health insurance more affordable.
The least expensive way to get the best health insurance depends on your income level.
If you qualify forMedicaidor Marketplace subsidies, you could pay little to no cost for health insurance.
If you don’t, a catastrophic orhigh-deductible health plan(HDHP) can be less expensive than other Marketplace plans.
Medicaidis a government-based health insurance program for low-income people and is usually the least expensive. With a low income, you may not have any premium costs with Medicaid and minimal cost-sharing.
Qualifying for a subsidy through the Health Insurance Marketplace can lower yourhealth insurance premiumand cost-sharing, sometimes down to $0.
Short-term health insurance plans, employer-based health insurance or catastrophic plans may be the cheapest options if you don’t qualify for Medicaid or subsidies.
Mon, 01 Jan 2024 14:31:00 -0600en-UStext/htmlhttps://www.usatoday.com/money/blueprint/health-insurance/best-cheap-health-insurance/
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