NAVIGATION - SEARCH

5 Tips to Avoid Surprise Bills

 

Most of us know by now that our medical care will cost a lot less if we see a doctor who participates in our health plan’s network.

But it’s gotten harder to know for certain which doctors participate and which don’t, particularly if you’re hospitalized. For example, if you visit the emergency room you likely won’t know if the doctors treating you are in your plan’s network. Even if you have surgery or deliver a baby at an in-network hospital, you could be treated by an anesthesiologist or an assistant surgeon who is not contracted with your insurer.

Even if your insurer reimburses out-of-network doctors, the doctor you saw may decide the payment wasn’t enough, and send you a bill for the balance.

That’s when surprise bills show up. According to a recent report by Consumers Union, nearly one-third of Americans with private insurance got a surprise medical bill in the last two years.

So, if you’re planning a surgery or procedure, consider these 5 steps to reduce your risk of getting surprise bills:

1. Know what your plan covers. Surprise bills can often be avoided by simply taking the time to carefully read through your plan’s benefits and by calling your insurer to ask whether the procedure you need is covered.

2. Get the names of your providers. “You should have a firm understanding not only of what is involved in the procedure you’ll be having, but who will be involved in providing your care,” says Dr. Sam Ho, chief medical officer for UnitedHealthcare.

Get in writing the names of all the healthcare professionals providing your care and make sure they are all in the network, including physician assistants, anesthesiologists, and radiologists. “You have the right to request only in-network providers,” Ho says.

3. Call about your health plan. Provider networks change all the time. Before your procedure, get in touch with your health plan to verify that the doctors you plan to see are still in-network, and be sure to take notes on who you spoke with and what you were told. If you receive an unexpected bill after your procedure, contact your health plan again for assistance.

“Some insurers will serve as an advocate on your behalf and negotiate with the physicians to either lower the out-of-network charges or waive them all together,” Ho says.

4. Ask about cost. There are a number of pricing tools available today that can help you research the estimated cost of specific treatments and procedures. Most insurers offer price estimate tools, as do many large employers. There are also plenty of apps and websites available.

Keep in mind, however, that there is no comprehensive database of healthcare prices.
And, despite all the tools, finding accurate healthcare cost information is still generally difficult.

Still, it pays to talk with your physician and/or the hospital about the cost of your care and to request an estimate in advance.

If you receive a surprise bill, ask if your provider will accept your health plan’s payment as payment in full.

5. Know your state’s rules. Federal law does not protect patients from surprise billing. But some states have policies in place that help people with at least some of the common situations that lead to unexpected charges, such as emergency room visits that involve out-of-network doctors.

If you receive a surprise bill, contact your state’s department of insurance to see if there are legal protections against balance billing.

Share or Bookmark this post…
  • Facebook

Health Insurance Options: A Guide for Young Adults

Too many healthy, young adults, skipping health insurance sounds like a fantastic idea. Health insurance is confusing, downright expensive, and doesn’t feel like it’s worth the cost, especially if you don’t need frequent medical care.

The problem, though, with not having health insurance coverage is you never know when a catastrophic accident or illness may strike. Without health insurance coverage to protect you from skyrocketing medical costs, you can quickly end up in serious financial trouble.

The bigger problem, I believe, for many young adults when it comes to getting covered is that they just don’t know where to start.

Where do I even go to get a health insurance plan? 

Is there anybody I can talk to?

How long am I allowed stay on my parent’s plan?

Should I get coverage through my job or an individual plan?

So, instead of just telling you “Hey! You need to get covered. It’s the right thing to do! and leaving it at that, we’re going to help educate you on the different options available to you as a young adult getting started in this big scary world of health care.

Health Insurance Through Your Employer

Many employers offer health coverage to employees as a benefit of employment. In addition, the ACA currently requires certain large employers (with over 50 full-time equivalent employees) to provide affordable, minimum value health coverage to their full-time employees working over 30 hours per week.

Keep in mind that the above could change under President Trump’s plan to repeal and replace the ACA, although historically most large groups have always offered benefits as a recruitment and retention tool.

There are several advantages of choosing an employer-based health plan:

  • The risk is spread among the entire group so plan premiums are usually lower.
  • Your employer may also cover part of the premium cost.
  • You may be able to choose from a number of different plans, depending on the choices offered by your employer.
  • Participants in group health plans are also covered by federal benefits laws, which guarantee things like special enrollment rights and protection from discrimination based on your health status.

Enrollment in an employer-based plan generally occurs through two regular opportunities: an initial enrollment period when you are hired (or first become eligible) and an annual open enrollment period. In many cases, the only exception to these enrollment rules is if you qualify for a special enrollment period (SEP).

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that requires employers to provide a SEP of at least 30 days following one of these situations:

  • Loss of eligibility for other coverage (such as turning 26 and losing coverage on your parent’s plan).
  • Getting married or divorced.
  • Having or adopting children.
  • Becoming eligible or losing eligibility for Medicaid.

If you’re interested in learning about your job-based coverage options, the best person to speak with is your company’s HR representative.

Health Insurance Through Your Parent’s Plan

Quite often, young adults are able to be covered under a parent’s health plan until the age of 26. If your parent’s plan offers dependent coverage, you are eligible until you turn 26, whether or not you are married, living with your parents, eligible for coverage through your own employer, financially dependent on your parent or are a student. However, it is up to your parents whether you can be covered under his or her plan.

One advantage of being enrolled in your parent’s plan is that you don’t have to shop for coverage. 

Finding your own health coverage can be an intimidating and confusing process. If you’re already familiar with the benefits and medical providers you have access to under your parent’s plan, it can be stressful to seek out new providers.

Another advantage is that the premium cost may be lower than the cost of coverage you would get on your own.

The coverage you get through your parent’s plan may be less expensive per person than individual plans, and, if there are already other dependents on your parent’s plan, adding you may not cost them anything at all.

Better yet, If you live near your parents, you can avoid paying the expensive out-of-network rates you may face if you were living far away.

Remaining on your parent’s plan has its fair share of disadvantages. 

Many employer-based plans stop providing coverage for young adults on their parent’s plan during the month of their 26th birthday leaving you high and dry to find a new plan elsewhere.

Another disadvantage is that, because policyholders receive a comprehensive summary of benefits, your parents may potentially get more information about your health care than you would like. If you prefer privacy or independence, you should consider seeking coverage on your own.

Also, if you are planning to get married or have a baby, your own dependents aren't eligible for coverage under your parent’s plan.

In order to best prepare for your future, you should consider one-day finding health insurance for you and your family.

Health Insurance Through the Marketplace

The Marketplace allows individuals to compare health insurance options and purchase coverage online. Some people are even able to receive subsidies to help pay for premiums and out-of-pocket expenses.

However, you will not be eligible for subsidies if you were offered health insurance (for example, by your employer or a spouse or parent’s plan) that was affordable and covered at least an average of 60 percent of health care costs. Even without subsidies, you may be able to find a health insurance option that fits your budget.

In addition to comprehensive health insurance coverage, you may be eligible for a “catastrophic plan.” These plans are available only to those under 30 years of age and generally have very low premiums and very high deductibles. Although this type of plan covers only the most essential health needs in order to fulfill the ACA requirements, the main purpose of this plan is to protect you from the substantial medical costs that can be incurred from a serious accident or illness.

Marketplace enrollment is only available during an annual open enrollment period unless you qualify for a SEP. The rules for SEPs in the Marketplace differ from those that apply to employer-based plans.

Health Insurance Through an Individual Plan

Many health insurance companies offer individual plans off of the Health Insurance Marketplace (otherwise known as Healthcare.gov). Obtaining health insurance through a third party may be the best fit for you if you know exactly what you want. Because this option is not a group health plan, individual health insurance may be more expensive than other options.

The level and quality of the coverage will vary, depending on the specific policy. Typically, higher quality plans come with higher premiums.

In addition, carriers may limit enrollment to specific times during the year, similar to the Marketplace.

Health Insurance Through Medicaid

Medicaid is a program that is designed to help provide health coverage to low-income adults. Medicaid does not have a specific open enrollment period, which means that you may apply at any time.

 

We’d be happy to help get you off on the right foot on your health insurance journey. If you’re in Florida and in the market for a Florida Blue plan, we can help you narrow down your choices and get you enrolled – at no additional cost.

Share or Bookmark this post…
  • Facebook

3 Health insurance options for college graduates

If you recently graduated from college, you may have new options for getting health insurance. Check out these 3 options for a range of plan types and costs:

Buy your own Health plan

You may be eligible to enroll in Csezone health insurance for the rest of 2017 if you qualify for a Special Enrollment Period. You may qualify if:

  • You’re moving to or from the place you attended school
  • You lose other health insurance, like if your student health plan has run out or you’re dropping off your parent’s plan
  • You experience other life events, like having a baby or getting married

Get added to your parent’s plan

If your parent’s health insurance plan covers dependents, you can usually be added to their plan. They may be able to add you to an existing Marketplace plan through a Special Enrollment Period, as long as you’re under 26.

See if you qualify for Medicaid or CHIP

If you’re working part-time, planning your next move, starting a business, or otherwise aren’t making much money, you may qualify for Medicaid or the Children’s Health Insurance Program (CHIP). To see if you qualify, enter your household income and size. We’ll tell you the programs you may be eligible for. If you qualify, your coverage can start right away.

Share or Bookmark this post…
  • Facebook

3 Reasons You Should Sign up for Health Insurance

Early this year, a spike in flu cases was seen across the country. According to the CDC, 104 children died across the country during the 2016-2017 flu season. The CDC doesn’t track how many adults die from influenza each year. To prevent yourself and members of your family from falling ill, being hospitalized, and missing work and school, be sure to get a flu shot. The CDC recommendations for 2017 include getting vaccinated before the end of October. If you’re wondering whether health insurance will cover the injection, the U.S. Department of Health & Human Services (HHS) says your health insurance company is required to cover flu shots without charging a co-payment, but you may need to visit a specific facility.

“Some insurance plans only cover vaccines given by your doctor or at a limited set of locations,” says the HHS.

Here are three more reasons to sign up for health insurance during the 2017 Open Enrollment period.

Accidents Happen

If you get into an accident while driving to or from work, and you don’t have health insurance, you could wind up having to pay a few thousand dollars for an emergency room visit or tens of thousands of dollars for long-term care.

Health care plans vary, but all of them at least partially cover the following:

  • Emergency room visits
  • Outpatient care
  • Inpatient care
  • Lab tests
  • Prescription drugs
  • Rehabilitation services, such as physical therapy and psychiatrist appointments
  • Dental and vision care
  • Pre- and postnatal care
  • Substance abuse rehab
  • Preventive services, such as screenings and vaccinations

In case you’re still on the fence about whether you want to part with a monthly payment, more than half of consumers who signed up for 2016 Affordable Care Act coverage selected a plan with a monthly premium of $100 or less after tax credits. That $100 per month is a lot less than you’ll spend if you’re hospitalized after a car accident and, unfortunately, odds aren’t in your favor. According to the Department of Transportation, someone was injured in an accident every two minutes and eight seconds in 2016. Additionally, the US lost 35,092 people in traffic crashes in 2015, ending a 5-decade trend of declining fatalities with a 7.2% increase in deaths from 2014.

Some Colleges Require Health Insurance

Not only may the federal government charge a penalty for not having health insurance, some universities require students to have their own plan or remain enrolled on their parents’ policy. If you’ll be attending college this year, contact the admissions department to see how this affects you.

It’s the Law

The Affordable Care Act requires everyone to have health insurance. If you don’t, you may pay a penalty to come tax time.

Should You Sign up During the 2017/2018 Open Enrollment Period?

Health insurance is a wise investment, but if you can’t afford any of the plans on the Health Care Marketplace, contact Freeway. Our friendly, knowledgeable representatives will help you find a plan that fits your budget. 

Share or Bookmark this post…
  • Facebook

The Effects of Childhood Obesity

September is not only back to school month, but it’s also Childhood Obesity Awareness Month. Childhood obesity is a growing epidemic in the United States that affects more than 30 percent of children. This number has tripled since 1980 making it one of the biggest threats to the health of American children. If trends continue, children today could be the first generation to live shorter, less healthy lives than their parents.

When you are a parent, your goal is to protect your children. While you don’t have control over everything your children encounter, you play a major part in their health and wellness. Preventing and managing childhood obesity starts in the home. It’s easy to put the TV on for the kids while you get caught up on household chores. Sometimes that’s the best fix for that particular situation. It becomes a problem when this behavior becomes a habit and a lifestyle for your family.

Why is childhood obesity a health problem?

Childhood obesity has negative immediate and long-term health concerns. Obese children are being diagnosed with health conditions that used to be only seen in adults. Unhealthy weight can lead to medical problems such as:

  • Type 2 diabetes
  • High blood pressure and cholesterol
  • Liver disease
  • Bone and joint issues
  • Eating disorders
  • Fatigue
  • Respiratory problems such as asthma
  • Sleep apnea

Unfortunately, obese children may also face psychological difficulties such as:

  • Being teased and bullied
  • Becoming a bully
  • Self-esteem issues
  • Depression
  • Poor social skills
  • Stress and anxiety

Being a parent is stressful enough without having to think about your children dealing with health and/or emotional problems. And being a child these days can’t be easy with social media and unrealistic “expectations” that exist. There are simple ways to help establish good habits and encourage healthy lifestyles for your family.

Develop healthy eating habits.

This may seem like a no-brainer, but sometimes you need a reminder on how you can encourage healthy eating at home.

  • Eat lots of veggies, fruits, and whole-grain products
  • Choose lean meats
  • Limit sugar and sugar-sweetened drinks
  • Limit saturated fat
  • Recognize portion control

Get active.

Again, this may seem like common sense, but keep in mind how easy it is for kids to get in the routine of watching TV, playing video games or spending endless hours on the iPad.  As a parent, encourage your kids to get involved in sports or other physical activities at school.

Here are few ways to sneak some physical activity into family time:

  • Make a game out of household chores. After completing a chore list, have a reward of a dance off or play catch. If you’re feeling really creative you could pretend that all the toys need to be saved from the dirty floor and put safely in the toy chest. Be as fun and creative as you want to encourage everyone to help out.
  • Take pre and post dinner walks. If it’s a struggle to get the family to get out and go on a walk, make it interactive by playing “I spy” or a similar game.
  • If you have that TV show you just have to watch, use the commercial breaks as quick fitness breaks. Get the kids up and dancing or have a sit-up or push-up contest. It’s amazing how much kids love burpees!
  • Get extra steps in whenever possible. Take the stairs, walk to the store or park at the end of the parking lot. Just like adults, kids can benefit from the extra activity.

Instill good habits into your kids while they are young so that healthy living becomes a way of life. If childhood obesity isn’t managed, it can lead to serious health issues as an adult.

Obesity not only causes serious health conditions, but also leads to increased health care costs and higher life insurance premiums. One of the first things life insurance companies look at when determining your premium is your height to weight ratio and your health status.

Here at Quotacy, our goal is to get you the best price and policy for your unique situation. We work with multiple insurance carriers to shop your case and compare pricing and options. Feel free to contact us with questions or use our free quoting tool to see how much it would cost to protect your family.

Share or Bookmark this post…
  • Facebook

How to Save Money in Your Health Insurance Plan?

Health insurance, as the word suggests, insures the risk of a person’s medical expenses. It is a type of insurance coverage that pays for all health related expenses from surgeries to small injuries or regular medical check-ups. Health insurance either reimburses the insurer or pays the medical authorities directly. It is often offered by companies to their employees to ensure quality workforce.

 

Why is Health Insurance valuable?

Health insurance is valuable owing to many reasons. People with no health insurance are likely to get poor medical services, no timely checkups, and quality health becomes a financial burden for such people. Health in Pakistan is a privilege, and health insurance makes certain that you are provided with that privilege in the best way possible.

Reasons Why Health Insurance is Expensive

Health insurance tends to get really expensive because of multiple reasons.

1: Administrative Costs

The top most reason of health insurance being so expensive is the administrative cost. The administrative cost of our health care is huge. Running the health care sector costs a huge amount of money in terms of management staff and administrative staff. More than anything else in the medical department, costs are associated with administrative costs, which is higher than any other department.

2: Drug Costs

Another major factor that makes health care an expense that is out of reach of most people is the cost of drugs. Even the government tends to understand that drugs are really expensive and people under a certain wage cannot afford basic healthcare and lose lives to easily curable diseases like pneumonia. The government tries to negotiate with the drug makers to lower the prices, but because of the fact that most drug making companies are private, they are unable to do much in this regard. Medicines that are provided by the government hospitals are free of costs for a certain class, but it is not enough. The quality of such medicines and the limited amount of the dosage provided is not enough to cure the diseases.

3: Defensive Medicine:

One reason for health care being expensive is defensive medicine. Doctors sometimes, because of their own benefit or sometimes because they are genuinely scared of being sued, do not conduct a proper diagnosis until they have run all sorts of medical tests. Multiple tests can cost a lot, and some tests are too expensive to be affordable for poor people. And the government only provides certain tests free of costs to people under a certain wage and to government employees.

4: Expensive Ways Of Treatment

Because of no or very less concern from the government on health issues, government and private practitioners offer expensive ways of treatments to patients. For example, they may prescribe a medicine from a company they have contracts with, even though a similar medicine of another brand is available at a cheaper price. Personal interests come into play and people are robbed of the opportunities to get right medical treatments. This also happens because of lack of knowledge of the patient or the family.

5: Branding

As mentioned above, the brands play a vital role in over pricing the healthcare. A certain medicine with the same salts can be available in the variety of prices. Practitioners tend to have a certain understanding with these drug making companies and they prescribe their medicine to their patients not considering if they can afford it or not. They tend to forget that not just their health but their lives are at stake.

How To Save Up on Health Insurance Plan

There are multiple health insurance companies, but how to decide which one meets all your expectation of ensuring a healthy life for you and your family? 

Here are few of the factors that you must keep in mind while choosing which plan to go for.

1) Lower Premiums are Not Always The Most Affordable Option

While lower premiums will sound great initially, it might also mean that you will have to pay more for deductibles. These things have to be kept in mind of course. For example, if you go for a high deductible policy, there are chances that you might pay less premium. But then you will have to pay more for the deductible.

2) Compare

Always calculate how much health insurance subsidy can you get and comparing different policies from different companies can help you get a much better deal.

3) Know If A Certain Health Insurance Plan Covers Insurance for All Members

If you are married and have kids, be very careful while choosing a plan. Your health insurance must cover a quality healthy life for all your family members, not just for yourself. By looking for a plan that is perfect for you and your family, you can end up saving a lot of money.

4) Compare the Coverage Of Existing Plans

Some people tend to overlook the benefits that two different insurance plans can give you. This can just help give you an advantage in a maximized way.

5) Health Insurance Waivers

Health Insurance waivers allow a person to get the space to decide with one group of insurer and then after discussing things and thinking them over, they can go for the one that benefits them the most, without any pressure on themselves for selecting a certain plan over another.

6) Health Insurance Agents

One of the wisest things to do would be to get a health insurance broker. It is their field and they can guide you the best as to which plan is perfect for you. These professionals know this field inside out and can help you find whatever you are looking for. Trust us: it is not an unnecessary step.

Health insurance is a basic necessity these days. With the increasing amount of health issues, one must ensure that they can cover their health expenses without a worry. Health insurance also provides a healthy life for your spouse and your kids and is an essential part of modern life.

Share or Bookmark this post…
  • Facebook

Lost Your Job? These Are Your Health Insurance Options

Losing a job is one of the worst feelings on the planet, especially if it’s a job you actually enjoyed.

In addition to the feelings of anger, depression, fear, and grief, you’re now saddled with the responsibility of finding new health insurance if your company was the one providing your coverage.

Luckily, you have a number of options available to you after losing job-based coverage that you should begin to explore as quickly as possible, starting with ...

Primary Options For Coverage After a Job Loss

Coverage from Your Spouse or Domestic Partner’s Employer

If your spouse or domestic partner’s insurance plan is open to family members, you may be able to join now that you no longer have insurance through your employer.

Under the Health Insurance Portability and Accountability Act (HIPAA), you have 30 days from the time that your former employer stops paying for your insurance to enroll in your spouse or domestic partner’s plan. This rule stands even if your loss of coverage doesn’t occur during an open enrollment period.

Coverage from the Marketplace

 

Under the Affordable Care Act (ACA), you can enroll in a health plan in the Marketplace during a Special Enrollment Period if you lose your job-based coverage outside of the normal open enrollment period. You may even be eligible for subsidies for reduced premiums and you might qualify for lower out-of-pocket costs.

 

Coverage from the Individual Market

 

If you don’t qualify for a subsidy for reduced premiums from the Marketplace, you can simply sign up for a new plan off of the marketplace through the individual market. Not sure whether or not you’ll qualify for a subsidy? This interactive tool on the Marketplace’s website can help you determine that.

Continuing Current Coverage Through COBRA

 

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives you the right to remain on the health plan that you had with your former employer. (COBRA does not apply if your employer had fewer than 20 employees, if your employer went out of business or if you were fired for “gross misconduct.”)

If you are eligible for COBRA benefits, you will receive notice from your former employer or the health plan and can enroll within 60 days after receiving the notice.

  • COBRA generally guarantees coverage for 18 months but may be longer depending on your circumstances.
  • Each family member can make a different COBRA election, even if your entire family was once covered under your employer’s health plan. Or, your child(ren) may elect COBRA on your plan and you may find coverage elsewhere.
  • You are responsible for paying the full COBRA premiums, which includes the amount you used to pay while employed, the amount paid by your former employer and an administrative fee. This can make COBRA coverage very expensive.

We recommend exploring the first 3 options above before looking into COBRA coverage as COBRA is likely to be your most expensive option for continuing coverage.

Secondary Options for Coverage After a Job Loss

State-Sponsored Programs

There may be state laws that complement federal COBRA regulations or other consumer protection statutes. They include:

  • Mini-COBRA plans. If you worked for an employer with 20 or fewer employees, your state may have mini-COBRA laws that allow you to obtain the same benefits by paying the full premium (or more in some states).
  • Conversion policies. If you cannot continue coverage with your former policy, your state may require insurers to convert your policy into an individual plan.

Protections Under HIPAA

Under this federal law, at least one insurer must sell you a health plan if you can meet the following conditions:

  • You previously had 18 months of coverage without a break for more than 63 days.
  • The last day of your coverage was through your employment.
  • You do not have a COBRA or mini-COBRA option available.

Trade Adjustment Assistance (TAA) Reauthorization Act and Health Coverage Tax Credit

If you lost your job due to a trade policy (moving your job overseas), you may qualify for 72.5 percent of the cost of your health insurance for up to three years under TAA. 

Medicaid, The Children’s Health Insurance Program (CHIP) or VA Coverage

Medicaid is available for low-income individuals and children, parents with dependent children, permanently disabled individuals or those over 65. Eligibility varies from state to state.

  • Though you may not qualify for full Medicaid benefits, you may be eligible for screenings for breast and cervical cancer or assistance with tuberculosis or sickle cell anemia treatments.
  • Consult your local health department for more information about public coverage options in your area.
Share or Bookmark this post…
  • Facebook