Prescription drugs are not cheap. The good news is, though, that the Affordable Care Act requires insurance companies to cover them. But the bad news is that your insurance doesn’t always fully cover them. In fact, you may have to pay more than half the cost of some of your prescriptions out-of-pocket. So how do you know what drugs will be covered by your plan, and at what rate? To find out which drugs are covered and how much you’ll have to pay for them. You’ll need to familiarize yourself with what’s known as your plan’s drug formularies. This drug formulary is a list of medications that your plan covers. It also tells you how much of the cost of each drug it will cover. To find out what you need to know about your plan’s formulary in order to estimate your out-of-pocket prescription drug costs. Read our guide below.
Formulary Tiers
Each insurance company creates its own drug formularies. In fact, each plan offered by each insurance company may have a different drug formulary. So, it’s important to understand how they work and look at yours carefully. The most important things to look at are your formulary’s tiers. Since the tier that your medication is placed on will determine if you’ll be responsible for a copayment or coinsurance (both of which are explained below) when you fill your prescription.
Most formularies have four to six tiers that they use to classify medications. Drugs in the highest tier will cost you the most out-of-pocket. While those in the lowest tier will cost the least. Your health insurance company may have bargained with a drug manufacturer to secure a discount on some of these medications. In exchange, your health insurance will label the drug as a “preferred drug,”. Making it available to you at a reduced copayment.
The Tiers
Tier 1 – This is the lowest tier of medications. This tier consists of mostly generic medications.
Tier 2 – Tier 2 medications have a higher copayment than Tier 1 medications and may include preferred brand name drugs as well as non-preferred generics.
Tier 3 – This tier includes both preferred and non-preferred brand-name medications and has a higher copayment.
Tiers 4, 5, and 6 – Your most expensive medications are probably going to be in Tier 4, 5, or 6 of your plan, since it includes the most specialized types of drugs. Until you reach your plan’s annual out-of-pocket maximum for your healthcare plan, your out-of-pocket costs for drugs in the highest tier may be quite high. Because you will usually be required to pay coinsurance for them, rather than a copay.
In addition to a formulary of drugs that are covered by your plan. Your insurance company may also provide a list of medications that you will be responsible for the full retail price. These might include lifestyle drugs, such as those used to treat erectile dysfunction or obesity. As well as other prescription and over-the-counter medications. But with that being said, there is no universal drug formulary. So, some of these drugs may be covered by other health insurance plans.
If you’re choosing between two or more health insurance plans, it’s in your best interest to compare the drugs covered by each. This is true not only if you’re looking for health insurance through the Marketplace. But also if your insurance company offers multiple options for coverage.
What Are Copayments and Coinsurance?
You’ll see these terms a lot when looking through your health insurance plan options. A copayment (or copay) is the fixed dollar amount you are expected to pay toward the cost of a prescription. For example, your health insurance plan might cover Tier 1 drugs with a $20 copay per fill and Tier 2 drugs at $40 per fill, so you’ll be responsible for paying those amounts at the pharmacy counter. The rest of the cost will be covered by your insurance (after you’ve met any applicable deductibles).
If your drug requires coinsurance, on the other hand, that means you pay a percentage of the total cost of the medication rather than a flat copay (typical for drugs in Tier 4 and above, even if lower-tier drugs are covered with a copay).
For example, if your plan’s Tier 5 coinsurance is 30%, and the cost of the drug you need to fill it is $1,000 (after the discount your plan has negotiated with the pharmacy). You will be responsible for paying $300 out of pocket. Drugs for certain conditions, like multiple sclerosis (MS), are all specialty drugs. Meaning they fall into Tier 4 or higher and often require coinsurance.
Reviewing Your Plan’s Drug Formulary
You should always make sure to check out any plan’s drug formulary before making a decision, but it’s especially important if you have a condition that can only be treated with a specific medication. And no matter what prescriptions you think you’ll need, it’s important to shop around, since drugs may be placed on different tiers by different insurance companies. In addition, a drug that is in Tier 1 on one company’s plan may be in Tier 2 on another plan offered by the same insurer, while some insurance companies may not cover the medication at all.
Spending some time learning about formularies is time well-spent. Because it will help you choose a plan that works for you. You’ll also find out which drugs have different copays, limits on quantity, and which require you to pay your full deductible before they’re covered.
It’s clear that ignoring a plan’s drug formulary can lead to money wasted. You’ll be in a better position to choose the right plan for your needs if you take the time to familiarize yourself with your formulary’s tiers.
Drug Formulary Restrictions
Most health plan formularies include procedures for limiting or restricting the use of specific medications. This is done to encourage your healthcare provider to use specific medications correctly, as well as to save money by avoiding medication overuse.
Some common restrictions are as follows:
Prior Authorizations – Your healthcare provider may have to obtain approval from your insurance company in order for a medication on your plan’s formulary to be covered. Typically, prior authorizations will be required for medications that may pose a safety risk, have a high risk of inappropriate use. Or have lower-cost alternatives on the formulary.
Quality Care Dosing – Your pharmacist might have to inspect medications your doctor prescribes you before you fill them to make sure that the quantity and dosage are in accordance with FDA recommendations. If the prescription doesn’t meet FDA requirements, your insurer can refuse to cover the medication.
Step Therapy – You might have to first try one medication to treat your health condition before moving on to another. The first medication is usually the less expensive option.
Exceptions
Your healthcare provider might have access to your health plan’s formulary, but they might not. So, there is a chance they might prescribe you a drug that is not covered by your plan. But if you do find that a drug you need is not on your plan’s formulary, your doctor can submit an “exceptions process” form. This lets your insurance company know that the medication they prescribed to you is medically necessary.
There are other cases in which your health insurance company might be flexible enough to allow for a few exceptions. In addition to requesting that your plan pay for a drug that is not on its formulary. You can also request that your plan continue to pay for a drug that is being taken off your plan’s formulary. You can also request that your plan’s limitations on your medication coverage be lifted. Or that your insurer lower the copayment for the medication.
If your health insurance does not cover your medication and doing so would result in you using a less effective drug or experiencing a harmful medical event, you may be eligible for one of these exceptions. And, if your request for an exception is denied, you have the option to file an appeal. The Affordable Care Act mandates that all health insurance companies offer appeals procedures. And these procedures must be accessible to all members of the public. You still have the option of having your doctor prescribe the medication if your appeal is denied. But you will be responsible for paying the full cost of the medication.
Steps To Take
If you’re in need of prescription medications, and want to make sure they’re going to be affordable for you, you’ll have to follow a few steps:
Know your plan’s formulary.
As noted, you should always familiarize yourself with your health insurance plan’s formulary. This is because formularies can vary widely from plan to plan. You can ask about each plan’s formulary when shopping for a plan, and you will receive details about the formulary and a list of all approved medications. As well as an explanation of the tier co-payments and/or coinsurance, when you sign up for coverage. Your plan’s formulary is also available online for your convenience. Call the customer service number listed on your drug card if you haven’t received a formulary. Or if you can’t find it online.
Speak with your healthcare provider.
If you’re in need of medication prescribed by a doctor, discuss the possibility of receiving a generic version of the drug. Make sure your doctor is familiar with your health insurance’s formulary. So, that if a more expensive medication is required, one that is covered by your policy can be prescribed.
Choose your plan wisely.
Look at the formularies of multiple health plans. So, you can determine which one will cover the medications you need to treat your condition. You may find that no health plan covers everything you need. But you can certainly find the one that is best for you. Speak to an EZ agent about which plan has a formulary that will cover as many of your prescription needs as possible.
If you can’t find a plan that covers everything, let us help you find the health plan that covers your most expensive medications. Keeping in mind that you may have to pay full price for the less expensive ones as a result. Again, this is a situation in which you and your doctor can discuss the possibility of switching to a different drug from the same class that is available on the formulary.
Working With EZ
If you need assistance, EZ.Insure is here to provide it. Our team of experts can quickly and accurately compare all available health insurance options in your area. A dedicated representative will be assigned to you to explain all of your options, how they cover prescription drugs, and then assist you in selecting a plan. And the best part is that we do it all for free! Enter your zip code in the box below to get your free quotes. Or give us a call at 877-670-3557 to talk to an agent.
Finding one insurance plan that’s right for you can seem like a big task. But in some cases, you might actually be wondering if it’s possible to have two health insurance plans. And the answer is yes: it is possible and legal to have two policies, a primary and secondary health insurance policy. And while it might seem like a lot of extra work to research and maintain two plans, having two different health insurance plans can actually help you save money on the overall cost of your medical care and treatment.
With that being said, having two plans can also mean paying twice as much each month for your premiums. As well as twice as much for your deductible. So if you are considering purchasing additional coverage, you’ll need to give serious thought to whether or not enrolling in a second health insurance plan would be the best option for you.
To help you make this decision, we’ve broken down how primary and secondary insurance policies work. So you can understand the difference and get a better idea of how two policies could work for you. And, as always, if you have any questions, or need help looking for the right policy – or policies – for you, contact an EZ agent!
Primary Insurance
Your primary plan will be the plan that will first cover any necessary medical care. This plan will pay before your secondary insurance plan kicks in. For instance, if you need to see a doctor or buy prescription drugs, your primary insurer will cover the costs of these services up to the coverage limits that it provides. Remember, though, as with any health insurance plan, you may still be responsible for cost-sharing, like coinsurance.
Secondary Insurance
In most cases, if you have a secondary insurance plan, it won’t begin to pay out benefits until after your primary insurance plan has exhausted its available coverage. After your primary insurer has paid its share of your medical costs, your secondary plan will begin to take effect to cover any additional costs that remain.
How to Get Two Plans
Getting secondary health insurance is similar to getting primary health insurance, but there are some differences to keep in mind. Here are the steps to getting a second policy:
Assess your primary policy – Review the policy documents for your current plan to find out what services are covered, how cost-sharing works, and what coverage limits there are. Think about your current and future health needs to find any gaps in your coverage.
Research secondary options – Options for secondary coverage range from plans that cover just one type of health service to plans that cover everything. Find out what kinds of plans are available to you and choose the one that fills in the gaps in your current coverage the best.
Understanding coordination of benefits – People can’t choose which of their two health plans is the “secondary” one. Before you sign up for another plan, make sure it will pay after the one you already have.
Apply and purchase – To sign up, follow the instructions for the plan you’ve chosen. Fill out the forms carefully and be ready to answer questions about your current health insurance. Pay your first month’s premium after getting approved for coverage.
How Does Having Two Plans Work?
When you have a medical bill, the first insurance that pays out is your primary insurance. It will pay up to its coverage limits. Then your secondary insurance will kick in and can pay part or all of the remaining costs. Please be aware that there are limits to the coverage provided by both the primary and secondary insurance. If the secondary insurer does not pay in full, the remaining balance will be your responsibility. Therefore, it is possible that you will have some remaining out-of-pocket medical costs. Even if you carry multiple health insurance policies.
There is a good chance that a Coordination of Benefits clause is included in your health insurance policy. This clause will lay out the predetermined order of how your plans will pay for your covered services. So, in the event that you or your medical provider file a claim for your care, the Coordination of Benefits document will specify which plan is accountable for making payments.
Examples of Primary and Secondary Plans
So, if you have more than one insurance policy, which policy is considered primary and which is considered secondary will be determined by your circumstances. The following are some examples of how primary and secondary plans work for different groups of people:
Married Couples – Say a wife has her own insurance but she is also covered under her husband’s group insurance from his job. The wife’s primary insurance would be her individual plan and her husband’s group coverage would be the secondary.
Minors under 26 – Under the Affordable Care Act, dependents can remain on their parents’ insurance until age 26. This means that an adult under this age could get their own health insurance policy from their employer while still being covered by the family policy. If that’s the case, the child’s health insurance would be the primary plan. And the parent’s would be the secondary plan.
Parents with separate plans – Say you are under 26 and still on your parent’s health plan. If they both have separate plans and you’re listed on both of them, you have dual coverage. The primary and secondary coverages are determined by a “birthday rule”. Meaning whichever parent’s birthday is earlier in the year will give you your primary insurance. And the one with the later birthday will give you your secondary plan. For example, if your mom’s birthday is in January and your dad’s birthday is in March. Your Mom’s insurance would be your primary coverage. This isn’t about which parent is older – the birth year doesn’t affect the order, only the birth month.
Medicare beneficiaries with group health plans – If you are 65 or older and on Medicare, but are still working and have insurance through your employer, Medicare will be your primary insurance if the company you work for has fewer than 20 employees. If your company has 20 or more employees, your group plan will be primary and Medicare will be secondary.
Out-Of-Pocket Costs
The cost of having two plans will generally be higher than the cost of having one plan. Since you will have to pay the premiums and deductibles for each of your health insurance policies. For example, consider this: you will not be able to use your secondary coverage to cover your primary’s deductible. You will also have to pay any copayments and coinsurance that are associated with each plan.
It’s also important to note that the rules of your primary plan will apply to both of your policies. So, for example, if your primary plan is a PPO plan. Your primary policy may stipulate that you can only use certain doctors and hospitals in your plan’s network. Your primary insurance won’t pay anything if you go to a doctor who isn’t in their network. The secondary insurance won’t either because you broke the primary plan’s rules by going to an out-of-network doctor.
In addition, if your provider charges you more than what your plan(s) considers to be reasonable, customary, or allowed under plan rules, you may have to pay the difference. A licensed insurance agent from EZ can help you understand the out-of-pocket costs associated with each of your plan options.
Weighing Your Options
There are positives and negatives associated with choosing to have a primary and secondary insurance plan. Just as there are with any other type of insurance. Let’s take a look at the pros and cons to help you decide if having two plans might be right for you.
Benefits
Extra Coverage – Having two plans could come in handy in the case of unanticipated medical expenses. And if you find that you frequently have to pay for your own medical expenses out-of-pocket, it may be beneficial to purchase a secondary health insurance policy.
No Gaps – Even if one of your health insurance policies lapses, you won’t experience a gap in coverage if you have a second plan. Your secondary health insurance will just become your primary automatically.
Complementary coverage – Having plans that are complementary, that cover different elements of your healthcare, will mean you’ll get more coverage and better benefits. You’ll be able to make up for what your primary health insurance doesn’t cover with your secondary plan.
Disadvantages
No guarantee – Even if you have two separate health insurance policies, your out-of-pocket costs may still not be covered in full. Keep in mind that the amount of your plans’ coverage cannot be more than the amount of your out-of-pocket expenses.
Extra expenses – Your two separate health insurance policies will still require you to make payments on the associated premiums and deductibles. This may result in additional expenses further down the road.
Overlapping – It’s possible that your coverage from two different health insurance plans will actually overlap if the plans are too similar to one another. Meaning you will not receive as many additional benefits as you might like.
FAQs
What is the birthday rule?
When children are covered by both parents’ health insurance policies, the birthday rule plays a significant role in determining which plan provides primary coverage and which provides secondary coverage. According to the birthday rule, whichever parent’s birthday falls earlier in the year will be the primary insurer. Secondary insurance is provided by the other parent’s plan. The year of birth of each parent does not come into play.
How do I know which is my primary insurance?
You don’t get to choose which plan will be your primary coverage and which will be your secondary coverage. Whenever you file a claim, your primary health plan will cover you as if you didn’t have a secondary plan. After that, your secondary health insurance will cover the rest of the bill. If you have two health plans, there are rules about how your benefits will work together. Some of these rules will be different for you based on your health insurance company and your situation.
Is having 2 plans worth it?
It depends. Having two health plans can save you money if one is free or both are inexpensive. Also, it’s best to make sure they work well together. Check to see if their coverages and benefits overlap or are too similar.
EZ Is Here to Help
Having both primary and secondary coverage can be complicated. It could work for you, but you’ll need to weigh the pros and cons carefully before deciding whether or not to invest in a secondary insurance policy. Feel free to ask EZ anything. Including if having two plans might be right for you, as well as for assistance in locating a secondary health insurance plan, if necessary. We will compare plan benefits and costs for you. And will assist you in locating affordable coverage that meets your needs. Simply enter your ZIP code below to get started with free, customized quotes right now! You can also give us a call at 877-670-3557 to have a qualified insurance professional discuss your needs and help you choose the best policy for you.
National Eating Disorders Awareness Week is from February 23rd to March 1st, and we feel it’s essential that we shed light on this important topic. After all, according to the National Eating Disorders Association (NEDA), 30 million Americans struggle with eating disorders, such as anorexia, bulimia, and binge eating. This is an overwhelming amount of people that are living with eating disorders, especially considering the impact that these conditions have on people’s lives, and on the fact that they can even be fatal.
If you or a loved one are struggling with an eating disorder, you need to know how you can get help, and if your insurance will cover your treatment. So, you should know that most insurance plans will cover some form of treatment, but how much they cover will be dependent on your plan.
Eating disorders affect a person’s relationship with food and body image. People who are living with an eating disorder tend to be hyper-focused on the food they eat, their body weight or shape, and/or how they control their intake of food.
Different types of eating disorders include:
Anorexia nervosa, whichis characterized by weight loss or maintenance through extreme dieting, starvation, or too much exercise.
Binge eating, which means frequently consuming an unhealthily large amount of food in one sitting.
Bulimia nervosa, which can involve purging (throwing up), taking laxatives, exercising, or fasting to avoid weight gain after binge eating.
Eating Disorder by the Numbers
As stated above, eating disorders are by no means minor problems. Consider the following:
Eating disorders are the third most common chronic illness among adolescent females in the United States.
A quarter of people with anorexia are male. Men have an increased risk of dying from eating disorders, because it often takes much longer to diagnose them than it does women.
The median age of eating disorder onset is 21 for binge eating disorder and 18 for anorexia and bulimia nervosa.
Roughly one person dies every hour as a direct result of an eating disorder.
Insurance Coverage for Eating Disorders
As we mentioned above, your health insurance should cover treatment for an eating disorder. But your insurer’s coverage might not be the same as another person’s. Coverage for treatment depends on your plan, the state you live in, and the severity of your disorder.
If you are considering seeking treatment for an eating disorder, it is important to ask the following questions of your insurance company:
Will coverage be applied for both inpatient and outpatient care?
Is nutritional counseling covered?
How long will my treatment be covered for, and how many trips to rehab are covered during a policy year?
Which providers are covered?
It is also important to think about your personal needs. For example, anorexia often warrants inpatient or partially hospitalized care. So treatment professionals can make sure you’re eating a balanced diet. Generally, health insurance companies will cover at least 10 days of inpatient rehab for eating disorders, where you can work on your mental health, and receive nutrition counseling to help foster a healthy approach to eating and food.
It is important to note that if you have a substance abuse problem accompanied by an eating disorder, some insurers will only make payments toward outpatient care when substance abuse is the primary issue.
Is Your Plan Sufficient?
One of the most important factors in getting the help you need for an eating disorder is your health insurance. Before purchasing a plan, make sure you understand what coverage it offers. And make sure it will cover evaluation and treatment.
If you’re not sure what plan is right for you, speak to an EZ agent! EZ agents are highly trained and knowledgeable and will sort through all available plans to make sure that treatments for eating disorders are covered in yours.
We offer a wide range of health insurance plans from top-rated insurance companies in every state. And because we work with so many companies we can can show you all of the plans available in your area. And we can find you a plan that saves you hundreds of dollars. Even if you don’t qualify for a subsidy. There is no obligation, or hassle, just free quotes on all available plans in your area. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local agent, call 888-350-1890.
It is estimated that around 4 to 5% of U.S. adults are living with attention-deficit/hyperactivity disorder, or ADHD. But, with that being said, it’s thought that many adults who have this condition don’t actually get diagnosed or treated for it, which means there may be more people who have ADHD than we are aware of.
The adults who do know they have ADHD might have been aware of their condition since childhood, since that is when it is most often detected. Some, though, might have thought that they would outgrow the condition. But most research points to the fact that it is rarely outgrown. ADHD symptoms can continue into adolescence and adulthood, although the symptoms might look different at different stages of life. So, what can you expect as an adult living with ADHD?
What Is ADHD?
ADHD is one of the most common neurodevelopmental disorders of childhood. Symptoms include inattention, hyperactivity, and impulsivity, which are considered chronic and debilitating, and can lead to low self-esteem, among other issues. It is often first identified in school-age children when it leads to disruption in class or problems with school work. It commonly affects boys more often and/or is diagnosed more in boys than in girls.
One study found that ADHD symptoms are often worse in children aged 6 to 8, and gradually decline around age 11. Symptoms of hyperactivity and impulsivity were more likely to decline with age. While symptoms of inattention were more likely to persist.
People with ADHD of the inattentive type have trouble paying attention to details, are easily distracted, often have trouble organizing or finishing tasks, and often forget routine chores (such as paying bills on time or returning phone calls).
Many children diagnosed with ADHD will continue to have the disorder later in life, and some may require ongoing treatment. In fact, many people with ADHD might not be diagnosed until their teenage or adult years. This is especially true for girls and women, who are more likely to experience inattentive ADHD. Which tends to be harder to detect. Typically, adults with ADHD are treated with medicine, psychotherapy, or a combination of both.
Symptoms in adulthood can be more varied and present in more subtle ways than in childhood. Some examples include:
Disorganization
Impulsive decision-making
Internal restlessness
Wandering attention
Procrastination
Symptoms will not get worse with age. Mainly because adults are equipped with more coping skills and resources to help manage their symptoms.
Health Insurance & ADHD
ADHD treatment falls under “mental health treatment” benefits. So, if your health insurance plan doesn’t include mental health coverage, you won’t be covered for ADHD treatment. If you have a plan that doesn’t have the coverage you need, or if you’re not sure what plan is right for you, speak to an EZ agent! EZ agents are highly trained and knowledgeable. And will sort through all available plans to make sure that you’re completely covered no matter what.
We offer a wide range of health insurance plans from top-rated insurance companies in every state. And because we work with so many companies and can offer all of the plans available in your area, we can find you a plan that saves you a lot of money – even hundreds of dollars – even if you don’t qualify for a subsidy. There is no obligation, or hassle, just free quotes on all available plans in your area. To get free instant quotes, simply enter your zip code in the bar above. Or to speak to a local agent, call 888-350-1890.
On average, nearly 20 people are physically abused by an intimate partner every minute in the United States. This equates to almost 10 million people each year suffering domestic abuse. The sad reality is that many people in this situation feel like there’s no way out. And feel that they can’t manage alone or start fresh because their partner controls every part of their lives. But it is possible to seek help and start a new life, despite the incredible stress of taking that step forward.
If you’re worried about starting over, it might be helpful to know that you can enroll in a health insurance plan when leaving a domestic abuse situation. Meaning you’ll have one less thing to stress about.
A Special Enrollment Period (SEP) is a 60-day window when people can sign up for new health insurance coverage (or change existing coverage) outside of the annual Open Enrollment Period (OEP). Various situations (known as qualifying life events) can trigger a SEP, including leaving a domestic violence situation.
Since 2015, victims of domestic violence and spousal abandonment can apply for health insurance at any point during the year. Not only that, but they will face fewer restrictions than they would with a regular Special Enrollment Period. This SEP is available to both men and women and does not require documentation.
Several forms of domestic abuse qualify for a Special Enrollment Period.
How do you qualify for this SEP? According to the Centers for Medicare and Medicaid Services (CMS), experiencing any of the following will open up a Special Enrollment Period:
Physical abuse
Psychological abuse
Sexual abuse
Emotional abuse, including efforts by the perpetrator to control, isolate, humiliate, intimidate, or undermine your ability to reason independently
Spousal abandonment, which means you are unable to locate your spouse after trying diligently and “taking all facts and circumstances into account”
Need Help?
If you are a victim of domestic violence or abuse, call the National Domestic Violence Hotline at 800-799-7233. And if you are looking to find your own health insurance plan, call the healthcare.gov call center hotline at (800) 318-2596. Tell the representative about your domestic violence or spousal abandonment situation, so you can qualify for a Special Enrollment Period. After you are granted a SEP, you have 60 days to enroll in a plan. Once you’re ready to take that step and look for a plan of your own, come to EZ.Insure. We offer a wide range of health insurance plans from top-rated insurance companies in every state. And because we work with so many companies, and can offer all of the plans available in your area. We can find you a plan that saves you a lot of money – even hundreds of dollars – even if you don’t qualify for a subsidy. There is no obligation, or hassle, just free quotes on all available plans in your area. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local agent, call 888-350-1890.
It’s been almost 3 years since the Department of Health and Human Services (HHS) first declared the Covid-19 pandemic a public health emergency. And now, the Biden Administration is indicating that the emergency declaration will not be renewed this winter. And is telling healthcare providers to begin preparing for the end of the public health emergency.
When the public health emergency does end, HHS estimates that up to 15 million people will be disenrolled from Medicaid and the Children’s Health Insurance Program (CHIP). With all of these people losing their insurance, the question becomes how will they get coverage?
“The Pandemic Is Over”
In September, President Joe Biden declared that the pandemic was over.
In September, President Joe Biden declared that the pandemic was over, even though Covid still presents a risk to Americans. His declaration means that HHS is unlikely to renew the emergency declaration that is set to expire on January 11.
HHS will give the public 60 days’ notice before lifting the public health emergency. Which not only allowed Americans to receive health insurance, but also to receive increased food benefits through government nutrition programs.
Nutrition experts fear that millions of families will face hunger. While hospitals are concerned that there will be a healthcare worker shortage. And pharmacies are concerned that it might be more difficult for people to access vaccines without a public health emergency.
“We’re in the third year of the pandemic. We’ve gone through hell. We’ve sacrificed. We’ve used all kinds of emergency powers,” said Lawrence Gostin, an expert on health law at Georgetown University in Washington, D.C.
“So if you’re going to end all that, you have to end it in a transparent way honestly with the American public about what they gain and what they lose,” Gostin said.
Millions Will Lose Coverage
More people became eligible for Medicaid and CHIP during the public health emergency. So, enrollment increased 26% during the pandemic to a record of more than 89 million people. But with the public health emergency ending, 15 million people will no longer have Medicaid and CHIP. While some of these people might be eligible for subsidized coverage through the ACA, there is a fear that many will end up uninsured.
According to HHS, in 12 states that haven’t expanded Medicaid, as many as 383,000 people are expected to fall into a gap in which their incomes are too high to meet their state’s eligibility for Medicaid, which guarantees coverage for the poor. But too low to qualify for discounted insurance under the Affordable Care Act.
If you’re unsure if you can afford a healthcare plan, it’s worth looking into what is available in your area. There are currently provisions in place that could help you save a lot of money on insurance, like:
If you earn under 400% of the federal poverty level, you can receive subsidies to purchase health insurance through the ACA Marketplace.
The American Rescue Plan Act requires that Americans pay no more than 8.5% of their income on health insurance premiums. And provides a larger tax credit to people who already receive financial assistance.
Speak to an EZ.Insure agent about what programs are available to help you save and get the coverage you need.
We get that trying to find a great plan while saving as much money as possible is not easy; it can be time-consuming and downright frustrating. But EZ is here to help. Our agents work with the top-rated insurance companies in the nation, making it easier and faster to compare plans in your area. In fact, we can compare plans in your area for you and your family in minutes! We will provide you with an agent who will find a plan that covers your medical needs. And will allow you to stay within your budget.
And unlike other companies who just want to make a dime off you, we want to help you stay healthy by finding a great plan that won’t break the bank. That’s why all of our services are free! To get free instant quotes, simply enter your zip code in the bar above. Or to speak to a licensed local agent, call 888-350-1890.
Symptoms in adulthood can be more varied and present in more subtle ways than in childhood. Some examples include:
