The Importance of Your Child’s Dental Health

The Importance of Your Child's Dental Health text overlaying image of a little girl holding a toothbrush and toothpasteKids and adults actually have a lot of the same dental issues, but since kids’ teeth are still growing, they are more likely to have problems. If you don’t treat tooth problems early, they can get worse and cause their adult teeth to come out of place. If kids of any age don’t take good care of their teeth and gums, they can get cavities and gum issues. So, in addition to teaching your kids how important it is to brush and floss, you should also take them to the dentist regularly so they can get care from a professional. Like many parents, you may be worried about how much good dental care for kids will cost. Luckily, health insurance can help you pay for every visit without going into debt.

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Kids dental problems

Tooth Decay

One of the most common teeth problems that children have are cavities. As a matter of fact, the CDC says that 20% of kids ages 5 to 11 have at least one tooth that is slowly dying. A major contributor is plaque, which is made up of bacteria that sticks to teeth and eats away at the enamel, which in turn causes cavities. Tooth decay can be avoided by brushing and cleaning their teeth every day. A healthy diet that limits sweet and carbohydrate-rich foods which cause cavities is also important.

Bad Breath

Sometimes we all have halitosis, which is the professional term for bad breath. However, if your child’s breath smells bad all day, there is probably a bigger problem. Bad breath is caused by bacteria that grow in the mouth from leftover food and sticks to the gums. These bacteria give off hydrogen sulfide which has an odor to it. Halitosis can be caused by many things, such as dry mouth, bad oral hygiene, digestive problems, and even some medicines. The best way to keep bad breath away is to take care of your teeth and have your child’s doctor clean their teeth regularly.

Sensitive Teeth

If your child gets pain from air or hot or cold foods, he or she may have sensitive teeth. Children can also have sensitive teeth because their enamel is thinner and can wear down faster from plaque. Your child’s dentist can fix this by putting sealants on the places that are broken. These will fix any cracks in the enamel and make it stronger. To keep the enamel from wearing away, you should always use a soft toothbrush.

Teeth Misalignment

Thumb sucking is fine for babies and toddlers, but it can hurt a child’s oral growth if they keep doing it after age 5. Both baby and adult teeth can grow in wrong by thumb sucking too much. It can also make it hard to speak because it can change the way your teeth fit together. Talk to your child’s doctor about how to stop this habit.

Not Losing Baby Teeth

Baby teeth don’t always fall out. This is known as having over-retained primary teeth. This usually takes place because there isn’t a permanent tooth to replace the baby tooth. Misaligned jaws, blockages, damage, infections, and oral pathology are some other possible reasons. Tooth decay and other oral problems could happen if you don’t treat over-retained teeth. The baby tooth can be taken out by your child’s doctor so the adult tooth can grow in without any problems. Orthodontics can fix any kind of imbalance.

Gum Disease

The gum disease known as gingivitis can also happen to kids. If you don’t take care of their teeth properly, this gum inflammation can happen, which can cause bone loss. Plaque that builds up on the bottom of teeth hurts the gums and makes them swell and turn red. The teeth will start to pull away from the gums over time and bleed easily, especially after brushing.

Worn Down Teeth

It is normal for kids to grind their teeth, which is also called bruxism. Sometimes this happens when teeth aren’t lined up right, when you’re in pain, or when you’re stressed. Even though most people with bruxism don’t need treatment, if it doesn’t stop, both the baby and adult teeth could wear away. Inflammation, headaches, and pain in the jaw are common signs. If your child grinds their teeth at night, your pediatric dentist can give them a night guard instead.

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Does Health Insurance Cover Kids Dental?

Dental care for kids up to 18 years old is required by the Affordable Care Act (ACA). The law says that all health plans sold in the Marketplace, the individual market, and through businesses with 50 or fewer workers must include dental benefits for children. This kind of insurance can be part of a medical plan or bought separately from your medical insurance. You should look at how much coverage each of these choices gives you. It’s possible that a separate dental plan will pay for more. 

Dental Coverage Through An ACA Plan

Kids’ oral care must be covered if you buy a plan from your state’s health insurance marketplace, or at least be an option. Plans vary from state to state, but most plans will cover these things:

 

  • Dental exams every 6 months
  • Cleanings
  • Fluoride treatments
  • X-rays
  • A portion of the cost of braces.

The perks may be different in your state and plan. To get these benefits, your plan may also say that you have to go to a dentist in their network. Before you buy a plan, make sure you know what dental care is covered and what isn’t.

Coverage Through Dental Insurance

Dental insurance can be helpful, especially when you need to pay for pricey treatments, checkups, and braces. Dental insurance can help pay for the following:

 

  •  Exams    
  •  X-rays   
  • Cleanings
  • Preventive care
  • Treatment for cavities and early childhood caries
  • Emergency treatment of injuries and damage caused by accidents
  • Fluoride treatments
  • Orthodontics for aligning teeth and fixing bite problems 

At this point, you may be thinking if you really need to get your child dental insurance. When do kids need to have dental insurance? You can get coverage for your baby so that they can see the doctor when their first tooth comes in. Additionally, giving a child this kind of protection at such a young age can be a smart move because the dentist will be able to watch their mouth grow and spot any problems that need to be fixed right away.  

Pediatric Dentistry Timeline

For the first 24 months of their life, your child’s mouth changes a lot. On the inside, tiny teeth are breaking through the gums, getting them ready for solid food. To avoid cavities, the American Academy of Pediatric Dentistry says that kids should go to the doctor every six months. It is very important that their tooth health improves properly and on time. If you know when your child’s teeth should be at certain stages, you can avoid problems as they grow. 

In Utero

Good mouth health starts before the baby is born. Women who are expecting should see a dentist before, during, and after the pregnancy. It is a good idea to see a doctor before getting pregnant if you are thinking about it. People often forget to take care of their teeth, but problems with oral health can be harmful to both mom and baby. 

0-4 Months

A baby’s mouth is getting ready for teeth to come in. Even though it might not seem like much needs to be done yet, you should start wiping your baby’s gums with a damp cloth. You could also use a soft rubber finger toothbrush to finish the job. To start, wipe their gums for two to three seconds at least twice a day. This will help keep your baby’s mouth clean and ready for their first teeth. Also, stay away from sugar that isn’t necessary for the new teeth.

4-6 Months

At this point in the child’s development, teething is starting to happen. Go ahead and wipe your child’s gums some more. Their mouth and new teeth may feel sensitive at first, but sticking to your oral care routine will help because plaque can start to form even on baby teeth. Now is a good time to start looking for a doctor for your child. Your dentist and the oral history of your family may decide that you need a check-up every six months to a year from now on. Stay away from foods that are high in citric acid and sugar that they don’t need. These foods can cause early tooth loss and plaque formation.

1 Year

Your child should have been to the doctor for the first time by the time they are one year old. Your child’s doctor should advise you that they should go to the dentist every six months. Checkups like these are done regularly to make sure that development and growth are going as planned. This lets the dentist see any problems that might come up as the teeth come in.

 

Now is a good time to get your child used to a toothbrush with soft bristles. Little kids will start to learn how to properly brush their teeth and spit out toothpaste. Start using toothpaste without fluoride until you can do this. You could also skip using toothpaste altogether and just use water. When their teeth start to touch on the sides, you should start flossing regularly. It’s best to do this after every meal. Setting up good oral care habits, like flossing every day, can keep them from having dental problems in the future.

2-3 Years Old

Now is when a lot of parents start to work on changing their kids’ pacifier habits. Pacifiers can be bad for their teeth. Too much use of a pacifier can change the way their mouth looks and how their teeth come in. Starting now, parents should help their child brush their teeth at least twice a day, but after every meal is even better. Fluoride toothpaste can be used from now on, as long as the child can spit. Since almost all 20 baby teeth should be in by age 3, you should now regularly floss. It is suggested that you see the doctor twice a year.

3-6 Years Old

When kids reach this age, they may be able to do more of their own oral care, but use your best judgment and help and watch them as needed. Some parts of a child’s mouth are hard to reach or can be missed, so make sure to check their teeth are clean. Your doctor should have looked at your child’s teeth with an x-ray by now to see how they look and how healthy they are. For even more peace of mind, you can talk about tooth sealants.

6-10 Years Old

At this age, your child should be able to clean their teeth on their own more. They should stick to a set schedule, whether it’s in the morning, at night, or both. It’s best to brush your kids’ teeth every day with them and praise them at the same time. This lets you keep an eye on their habits and teach them how important it is to brush and floss their teeth every day. Around age 7, if your child is having problems with their growth, their dentist may suggest that they see an orthodontist. As baby teeth turn into fixed adult teeth, regular trips to the dentist every six months will catch any damage to the teeth’s structure.

10+ Years Old

At this point, your child should be able to do everything on their own without your help. The right oral hygiene habits and routines will have been taught to your child, and they will be proud of their teeth. In fact, it’s important that it become a habit and be done every day. Regularly checking in with your child will show them how important it is to take care of their teeth.

 

Besides their wisdom teeth, all of your child’s adult teeth should be in their mouths by the time they are 13. They should still go to the doctor every six months to make sure their teeth are growing and developing properly. If there are major problems, they will be pointed out and fixed. If they haven’t already been checked out for braces, now is the time. 

The Bottom Line

It might not always seem important to have health insurance, but it is, because the health of your teeth can affect the health of your whole body. Oral problems, like gum disease, can lead to heart problems, strokes, and breathing problems if they are not handled. Your mouth and body will stay healthy if you have dental insurance. Plus, you won’t have to worry about big medical bills. One of our qualified agents can help you decide between health insurance that covers dental care and a separate dental plan. Call 877-670-3557 today. You can also use the bar below to type in your zip code and see quotes online.

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Tips To Maximize Your Health Insurance Plan

Tips To Maximize Your Health Insurance Plan text overlaying image of building blocks showing money going to different pointsThe average person in the United States spends about $3,400 a year on health insurance. If you’re going to spend a lot of money on health insurance, you should make sure you’re getting the most out of it. You’re already paying for the benefits so why not use them and get your money’s worth. To get the most out of your plan you can do things like stay in-network, take advantage of routine screenings, and recommended exams. Use these easy tips to maximize all of the perks in your plan to keep yourself healthy.

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Review Your Plan Annually

You need to know what’s in your plan before you can figure out how to use it. Many people don’t use the benefits of their health insurance policy because they don’t know about them. You know those packets your health insurance company sends you when you start a plan or when it renews? In there is an easy simple to read summary of all your plan’s benefits and perks, you can also create an account of the company’s website to access that summary online. Your health insurance company may do more than just help pay for your care. For example, they may give you savings at the gym or help you deal with your asthma. Don’t pass up any of these extra benefits. Some common perks are:

 

  • Discounted vision and hearing services
  • Gym memberships
  • Wellness programs
  • Mental health services
  • Telemedicine 

Insurance companies often make changes to benefits and policy terms that take effect when the policy is renewed. So, even if you’ve had the same plan for a long time and you’re pretty sure you know what it covers, take a few minutes to read that summary every year. Going over it could show you new perks or even perks you need taken away. Not to mention, your health changes as you get older so coverage that you didn’t need or care about before might become a deal breaker with that plan.

Things To Consider

You don’t know if rates or perks have changed, so don’t assume it’s the same as the last one. Cost is important, but it shouldn’t be the only thing you think about. You should also think about the provider’s image and the plan’s network.

Premium

By paying a premium, you can keep getting the perks listed in your health insurance plan. You can pay it every month, every three months, every six months, or once a year. Premiums for health plans change based on a number of things. There is no perfect amount for a premium, but it must be reasonable all year long. 

Deductible

Before your health insurance starts to pay for your health care costs, you have to pay a certain amount out of pocket each year. If you need a lot of medical care, a health plan with a low deductible is generally best. If you reach it sooner, your plan will start paying for your costs sooner. However, if you are in good health, a plan with a high deductible may be better because it will save you money on your premium.

Copay

A copay is one way that you and your health plan provider share the costs. It means that you have to pay a set amount for each service before you can get it. Your copay depends on what kind of service you need, but it’s usually at least $10. You will always spend the same amount on health care, no matter how much it costs all together. This makes your health costs consistent.

Network

Your network is the group of doctors or other health care providers whose services are covered by your health plan. Most of the time, your source won’t pay for services that aren’t in their network. Check to see if your favorite doctors, clinics, or labs are in the network for your plan. They should be, if possible. If not, you may have to choose between what you want and how much it will cost.

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Carefully Pick Your Primary Care Provider

It’s very important to have a doctor who knows you well, especially over a long period of time. If you don’t have a primary care provider, you end up going to different doctors and clinics when you’re sick. They don’t know what your normal is as far as your vital signs, labs, and medical history. So all they can do is treat the immediate symptoms rather than have a full care plan which you may sometimes need more than just putting a bandaid on your symptoms. A good doctor who knows your family background and your normal vital signs and symptoms. They can help you stay healthy by letting you know about screenings you are qualified for, finding problems before they become big problems, and sending you to a specialist if you need one.

 

Keep in mind while you’re picking your primary care doctor make sure they’re in-network for your insurance company. No matter what type of plan you have you will always save more money by seeing an in-network provider.

Use Your Plan’s Preventative Care

Even if you have a basic plan with a high premium, you should be covered for any screenings or other “preventive” care you need. This means you don’t have to pay a copay or other out-of-pocket costs. This includes getting tested for diabetes, high cholesterol, and high blood pressure. Most tests for breast cancer and immunizations, such as the flu shot, are also free.

Schedule Procedures Strategically

We know an emergency surgery isn’t something you can plan, but you can be smart about when you schedule visits and procedures. If you can plan ahead for a big medical treatment, there are a few ways to schedule it to get the most out of your health insurance. Some people won’t get a big procedure until they’ve met their deductible. If you don’t have much money saved up, this might make sense.

 

If you get health care services throughout the year that count toward your deductible and then plan surgery after you’ve met it, it’s more likely that your insurance will pay most of the cost of the surgery and you won’t have to pay a big bill out of pocket. Others who have the money up front might choose to plan a more expensive procedure to meet their deductible early in the year, knowing that the rest of their healthcare costs that year will be covered by insurance.

Save Important Contacts

We can’t always predict when we’ll need quick medical help or to go to the nearest urgent care or emergency room. Costs can be kept down by going to care workers in your network. It’s better to get ready ahead of time. To get started, call your insurance company. Their team will help you figure out where to go or who to call. Put this information in your phone or address book as soon as you have it. So, if you need to ask a question or get to urgent care quickly, you’ll have all the information you need. 

 

While you’re saving contacts in your phone don’t forget your support team. Your care is made better by the people who help you. Save the important phone numbers for your insurance company, like the member services line and the nurse advice line. This makes it easy to get in touch with them if you need help or answers. Some apps and websites show the email addresses of their support teams, which you can add to your email contacts. Some also have chat functions or pages that you can save for later use. If you can, write down the hours of operation so you know when you’re most likely to get in touch with someone on the support team.

Work With an EZ Agent

It can be hard to figure out your own health insurance because there are so many things to think about. No one likes to spend hours reading about different plan perks and costs, so why not let a professional do all the hard work for free? There is a way to get cheap health insurance without having to go through a lot of trouble. A qualified EZ insurance agent can explain what each plan’s pros and cons are. And help you come up with the plan that works best for you. 

 

Working with an EZ agent saves you time and stress because you don’t have to try to figure out legal jargon or read small print. Agents do all the hard work, so you can relax knowing that your coverage will meet your financial and medical needs the best. 

Not to mention that EZ agents can save you hundreds of dollars a year on your health insurance bills. We do this by being able to look for the cheapest rates both on and off the market. EZ can also find and use any savings you might be able to get. We don’t just help you find a plan, though. We also help you keep it up to date. EZ can help you make claims with your insurance company and help you renew your policy when it’s time. To get started, just type your zip code into the box below or call 877-670-3557 to talk to one of our certified agents.

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Can I Have Two Health Insurance Plans?

can i have 2 health insurance plans? text overlaying image of a woman sitting on the floor thinkingFinding 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!

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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:

 

  1. 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. 
  2. 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.
  3. 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. 
  4. 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.

 

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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.

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HHS Announces New Policy to Make Coverage More Accessible and Affordable for Millions of Americans in 2023

In April, the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) announced that they have new measures that will allow consumers to more easily find the right form of quality, affordable health care coverage. Beginning November 1st, 2022, health insurance coverage will be more accessible and affordable to millions of Americans.

The 2023 Notice of Benefits and Payment Parameters Final Rule

gavel next to a book
The new policy, beginning November 1st, will help grant health insurance access to millions of Americans.

This new policy will make regulatory changes in the individual and small-group health insurance market, establishing parameters and requirements.

“The Affordable Care Act has successfully expanded coverage and provided hundreds of health plans for consumers to choose from,” said Health and Human Services Secretary Xavier Becerra. “By including new standardized plan options on HealthCare.gov, we are making it even easier for consumers to compare quality and value across health care plans. The Biden-Harris Administration will continue to ensure coverage is more accessible to every American by building a more competitive, transparent, and affordable health care market.” 

“The recent Open Enrollment Period demonstrated the demand for high-quality, affordable health coverage. These steps increase the value of health care coverage on HealthCare.Gov and further strengthen the health insurance Marketplace,” said CMS Administrator Chiquita Brooks-LaSure. “This policy will make it easier for people to choose the best plan that meets their needs by standardizing plan options, like maximum out-of-pocket limitations, deductibles, and cost-sharing features.”

Policies Include:

Advancing Standardized Plan Options -President Biden’s Executive Order 14036 on Promoting Competition in the American Economy helps simplify the consumer shopping experience by establishing standardized plan options for issuers offering Qualified Health Plans (QHPs) to maximum out-of-pocket limitations, deductibles, and cost-sharing features.

Implementing New Network Adequacy Requirements – Patients will have access to the right provider at the right time, and inaccessible locations. The new rule also set standards requiring routine Primary Care appointments to be available within 15 business days of the enrollee’s request, as well as review the distance between provider and enrollees, and make sure that it is not an issue that they are not too far apart.

Increasing Value of Coverage for Consumers – The CMS will be updating the allowable range and medical coverage levels for non-grandfathered individual and small-group market plans.

hundreds of people
The new policy will expand health insurance access to essential community providers.

Increasing Access for Consumers and Removing Barriers to Coverage – This will protect consumers from discriminatory practices related to the coverage of essential health benefits. They will refinance the EMS non-discrimination policy, specifically, the one that limits coverage for essential health benefits on a base that is protected from discrimination.

Expanding Access to Essential Community Providers – CMS is increasing the Essential Community Provider (ECP) threshold from 20% to 35% of available ECPs in each plan’s service area to participate in the plan’s provider network. The higher ECP threshold will increase access to a variety of providers for consumers who are low-income or medically underserved.

The health insurance Open Enrollment Period is open until January 15 (depending on your state), so now is the perfect time to reconsider getting a health insurance plan or looking into your current one and making sure it will cover all of the above-mentioned costs. And if your plan doesn’t cover everything you need it to, it’s time to find a plan that does, so you can save as much money as possible. If you’re shopping for a plan, your best bet is to speak to a licensed EZ agent. Our agents work with the top-rated insurance companies in the nation, so we can compare plans in minutes. We will not only find a plan that has all the benefits you’re looking for, but we will also make sure the plan meets your financial needs. 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. No obligation.

Coping With Pregnancy and Infant Loss

October is Pregnancy and Infant Loss Awareness Month. 1 in 4 women are affected by pregnancy or infant loss, meaning there is a good chance someone you know has gone through the terrible tragedy of miscarriage, stillbirth, sudden infant death syndrome (SIDS), or other death of an infant. While the loss of a pregnancy and or an infant are topics that some might consider to be taboo, the goal of the creation of National Pregnancy and Infant Loss Awareness Month in 1988 was to undo that stigma.

Why Was Pregnancy And Infant Loss Awareness Month Created?

pink and blue ribbon
October is National Pregnancy and Infant Loss Awareness Month.

On October 15, 1988, President Ronald Reagan declared October as National Pregnancy and Infant Loss Awareness Month. When the proclamation was issued, Reagan said, “National observance of Pregnancy and Infant Loss Awareness Month offers us the opportunity to increase our understanding of the great tragedy involved in the deaths of unborn and newborn babies. It also enables us to consider how, as individuals and communities, we can meet the needs of bereaved parents and family members and work to prevent causes of these problems.”

There has long been a stigma or sense of shame associated with the loss of a baby that is undeserved. The term “miscarriage” implies that a mistake was made, which is hurtful, untrue, and unfair. Pain and grief can isolate us but destigmatizing infant loss is crucial to coping and healing.

Advocates then and now want grieving parents and families to know that losses don’t need to be hidden behind closed doors. People who haven’t experienced infant or pregnancy loss may feel uncomfortable talking about it, but this only increases the perceived shame and stigma associated with this type of loss. Observing Pregnancy and Infant Loss Awareness Month every October is a way to acknowledge loss, deal with the stigma, and help bereaved parents find ways to cope with the pain and move forward.

How Can You Support a Grieving Parent?

Unfortunately life doesn’t come with a manual. If it did, we would know how to support someone who has experienced pregnancy or infant loss. But fortunately, with the creation of Pregnancy and Infant Loss Awareness Month, information has become more readily available to help navigate relationships where there has been a loss. Here are some things to keep in mind if you are supporting a grieving parent or family:

  • Acknowledge the loss. Ignoring the subject sends the message that their loss is invisible or didn’t happen at all. 
  • Do NOT use “at least” statements. Using statements like “at least you have another child” or “at least you were able to get pregnant in the first place” belittles the griever’s situation, and can feel hurtful and unsympathetic. 
  • Be there to help with the big things AND the little things. Ask what you can do to help: Maybe the grieving parents need help bringing other children back and forth to school, or perhaps you can pick up groceries or run other small errands. Depending on your relationship with the parents, it may be appropriate to offer help with funeral arrangements or removing items from the baby’s room at home. 
  • Continue to be present and offer support long after the initial loss. There will be days known as “grief hot spots,” which could be obvious, such as the anniversary of the death or a special holiday. There will also be ones that might spark grief that aren’t so obvious, such as the baby’s due date. The grief that surrounds parents will never go away, so it’s important to be there as they navigate their new normal of life after loss.

How Can You Cope As a Survivor of Pregnancy or Infant Loss?

As a survivor of pregnancy or infant loss, you might feel like the pain is insurmountable. You’ve found yourself thrust into a club that nobody wants to belong to, and might feel like you’re in a fog. But know that you are not alone, and that there are resources available to help you cope and heal. The following are some ways to cope with the tragic loss of a pregnancy or infant:

  • Give yourself time to process the loss. Let your employer know that you will need some time off, and have your doctor fill out any paperwork necessary to have your request approved. As far as your personal life goes, share with friends and family that you will probably need some time to deal with the trauma and grief.
  • Take it one day at a time. The range of emotions you’ll face will change moment to moment, and might feel overwhelming. Practice self-care and really pay attention to how you talk to yourself and how you physically treat yourself. woman and man talking
  • Share your feelings with your partner but realize that you most likely will grieve differently. You have a unique bond since you went through the loss together, but you must have a mutual understanding and acceptance that you will both deal with it in your own way. Remind yourself and each other there is no right or wrong way to cope with loss.
  • Get help from a psychiatrist or support group, especially if you have depression, posttraumatic stress disorder, or suicidal thoughts. Your doctor or midwife will be able to point you in the right direction. A lot of health insurance plans cover mental health services, so check to see if you’re covered. 

If you need healthcare coverage, contact EZ to find a plan that’s right for you. Our agents are highly trained and can help provide you with free, no obligation, hassle-free quotes. Because we work with so many companies and can offer all of the plans available in your area, we can help find a plan that will save you money. For free instant quotes, simply enter your zip code in the bar above or call 888-350-1890 to speak to a local agent.

What Are Oral Clefts and Can They Be Prevented?

Approximately 1 in 1,000 babies in the United States each year is born with an upper lip and mouth that doesn’t form completely, a condition known as cleft lip or cleft palate. This malformation often happens early in pregnancy, generally between the 6th and 10th weeks of gestation, and can range from mild to severe. July is National Cleft and Craniofacial Awareness and Prevention Month, so to bring awareness to this issue, we want to look at what causes oral clefts and how to help prevent them.

What Causes Cleft Lip & Palate?

During the first 6 to 10 weeks of pregnancy, the bones and skin of a baby’s upper jaw, nose, and mouth normally come together to form the roof of the mouth and the upper lip. A cleft palate happens when parts of the roof of the mouth do not fuse together completely. 

Unfortunately, doctors and researchers are not 100% sure what causes oral clefts, but some believe that there are factors that can increase the risk. In general, male babies are more likely to develop an oral cleft; the other factors are usually genetic and environmental, and can include:woman holding her pregnant belly

  • A family history of oral clefts
  • Substance use during pregnancy
  • Nutrient deficiency, specifically of folic acid
  • Having diabetes before pregnancy
  • Use of certain anti-seizure medications
  • Obesity during pregnancy
  • Certain infections
  • Asian, Hispanic, or Native American descent

What Other Conditions Are Associated with Cleft Lip & Palate?

If your baby is born with an oral cleft, there could be some other complications that go beyond the physical appearance of the cleft lip and palate. Babies born with this condition can also experience:

  • Hearing difficulties
  • Speech difficulties
  • Difficulty feeding
  • Ear infections
  • Dental issues

Are Oral Clefts Preventable?

Cleft lip and palate are typically not preventable, but there are things you can do to help lower the risks of your baby developing this condition. These things include avoiding alcohol and smoking during pregnancy, maintaining a healthy weight before pregnancy, and taking at least 400 micrograms of folic acid a day before conception. It is important to note that, even if you do follow all of the recommendations for preventing oral clefts, and you still find out that your baby has developed one, it’s not your fault: this condition can happen regardless of the choices you make.

Treatment for Cleft Lips & Palateschild's cleft lip stages of surgery treatment

Children born with cleft lips and palates will need several treatments as they grow. Generally, the cleft is treated with surgery, followed by speech therapy and dental care. But before your child has surgery, there are a few techniques that can improve the outcome of the repair, including:

  • A lip-taping regimen, which can narrow the gap in your child’s cleft lip.
  • A nasal elevator, which is used to help form the correct shape of the baby’s nose.
  • A nasal-alveolar molding (NAM) device, which can be used to help mold the lip tissues into a more favorable position in preparation for the lip repair.

Around 30-40% of children with a cleft palate will need further surgeries to help improve their speech, usually after their speech is assessed between ages 4 and 5. Repairing a cleft might seem like a long process, but most children will end up being able to talk and eat without any issues with the help of surgeries and therapies.

Finding Health Insurance Coverage

One of the most important factors in getting the help your child needs for their cleft is your health insurance plan. Before purchasing a plan, make sure you understand what coverage it offers, and make sure it will cover evaluation and treatment for a cleft.

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 throughout the lengthy process of repairing your child’s cleft. 

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.