Autism spectrum disorder (ASD) is a complicated developmental illness. It’s characterized by chronic difficulties with social communication, limited interests, and repetitive behavior. While autism is a lifelong illness, the degree of functional impairment caused by these issues differs amongst persons with autism. According to the CDC, one in every 36 kids and over 5.4 million adults are on the autism spectrum. With boys being four times more likely to be diagnosed than girls. Autism symptoms are typically noticed at 18 months or younger that usually leads to an official diagnosis by age 2. However, doctors have just begun to understand that symptoms of autism in adults can differ from those in children. Which is why more adults have been diagnosed with autism in recent years. So, how do the symptoms of autism differ between children and adults?
Autism In Infants and Toddlers
Autism signs and symptoms may be difficult to detect in this age group. But addressing the issue early will help give your child the best chance of success. One of the most obvious indicators is a young child who does not speak by the age of two or begins to speak. But then appears to regress to a pre-vocal stage. These children will also struggle to make eye contact with others. They rarely, if ever, initiate play with others and appear deafeningly silent when you speak to them. These children, unlike other babies and little children, do not desire to be touched or cuddled. They do not return smiles and are unlikely to respond to games that entail mirroring another’s action, such as patty-cake.
Autism In School-Age Children
This is the time when the signs and symptoms of autism are most visible. Children on the autism spectrum will not engage in pretend play. These children never seem to master nuances like sarcasm or irony since they not only think in images. But also accept things literally. When an autistic child is told to unwind after spinning in circles (a repetitious movement they may employ to self-soothe), they may literally start spinning in the other direction. Other self-soothing behaviors include constant rocking, watching a fan spin, or flapping one’s hands.
During this time, the inflexible personality that is characteristic of all varieties of autism manifests itself. When timetables are changed or a different route is taken to school, these children frequently get upset. They prefer their possessions to be in a specific sequence and will notice if something is moved. They may play alongside other children, but they rarely participate in group activities. Additionally, they may have an exceptional attachment to an inanimate object, such as a stuffed animal or blanket. Touch and eye contact are still avoided. This is often because their senses appear to be heightened. And they become more readily overwhelmed when exposed to loud, vivid colors, and lights.
Autism In Teens and Adults
By this age, your child may have learnt that avoiding making eye contact is considered impolite and has made changes. But may occasionally go to the extreme of staring. During these latter years, the autistic signs and symptoms of inflexible behavior and social isolation are often more visible. It’s difficult to establish friends when you don’t know how to read social cues, and by the teen and adult years, many people with autism have given up trying.
Your child may be timid, but the need for companionship might produce the opposite behavior, and he or she may become overly sociable. The latter may speak loudly and stand too close to others, not understanding why the other person is uncomfortable. The one-track mentality persists, and rules are held virtually sacred. If rules are broken, he/she has no trouble in informing others. Rigid devotion to routine has grown even more ingrained, and sudden change may cause annoyance or even fury. Understanding office politics completely escapes the adult with autism, which may prohibit him or her from progressing in their employment.
Often, it is not until an individual reaches maturity that they discover they are on the autism spectrum. This is particularly common in high functioning or Aspergers individuals. Finally, the diagnosis provides spouses, significant others, and employers with information and a justification for some of the abnormal behaviors they may have observed, as well as tips on how to interact with the individual more successfully.
Types of Autism Spectrum Disorder
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the standard resource used by medical professionals in the United States to diagnose mental disorders. The DSM-5 specifies the criteria that must be met in order for a person to be diagnosed with a certain disorder. Such as autism spectrum disorder, attention deficit hyperactivity disorder (ADHD), depression, anxiety, and so on.
Autism has varying degrees of severity, with symptoms including social and communication impairments, as well as confined or repetitive patterns of behavior. These autism levels represent the disorder’s main characteristics. Individuals with these features, however, can exhibit a wide range of symptoms associated with various forms of autism. Because of this variety, autism spectrum disorder is classified as a spectrum disorder. Furthermore, autism is divided into three unique levels to provide a more detailed knowledge of how someone experiences their individual type of autism in their daily life.
Level 1
Level 1 autism is sometimes considered to be the least severe or mildest form of autism. Although there is no single set of qualities that someone with level 1 autism might have, there are some similar traits and experiences that people with this autism level may have. For example, most people (children and adults) with level 1 autism are likely to be able to communicate verbally using words and more complex language, whereas those with level 3 autism may not be able to speak using words at all (though some people with level 3 autism can speak using vocal language).
People with level 1 autism frequently struggle with speech and social interactions. They may struggle with small talk or understanding social signs. They may struggle to make or keep friends (although some people with level 1 ASD may have a friend or two. Transitions associated with changing activities may be difficult or distressing for someone with level 1 autism.
Level 2
Level 2 Autism is in the middle of the spectrum in terms of the level of assistance a person may require to function more independently and productively in daily life. When it comes to level 2 autism diagnostic criteria, a person is stated to need “substantial support.” A person with level 2 autism requires more assistance or accommodations than someone with level 1 autism. They also frequently have more communication and social challenges than a person with level 1 autism.
A person with level 2 autism may exhibit more obvious stimming activities (also known as confined or repetitive behaviors). Stimming actions are not something to be ashamed of, however it is important to remember that in some settings, some stimming habits might have a negative impact on one’s quality of life. For example, if someone’s stimming habit includes skin plucking, this could be harmful to the person’s health. It could also have a detrimental impact on work completion (if the person is focused on skin picking rather than executing important chores), as well as on relationships or social encounters.
Skin picking, on the other hand, may be related to self-regulation and a coping activity for anxiety or discomfort, so it is critical that anyone assisting the person with autism understands the function of skin picking and is compassionate in their approach to helping the person address their stimming behaviors. Stimming behaviors should be addressed in ways that benefit the person with autism.
Level 3
The DSM-5 considers someone with level 3 autism to “require very substantial support.” This means that the individual would benefit from extra help and accommodations in their everyday life – at home, school, work, in the community, in relationships, and so on – in order to operate independently and productively. People with level 3 autism may or may not use verbal communication (but some do). They may exhibit extremely difficult behaviors such as frequent meltdowns, violence, or self-harm. They may exhibit more frequent and intense stimming behaviors. Someone with level 3 may struggle to understand others. When compared to those with level 1 or level 2 autism, someone with level 3 autism may require significantly more monitoring even as an adolescent or adult.
Treatment
While there is no “cure” for autism, there are some effective methods that can help them function better.
Applied behavioral analysis – This entails a comprehensive examination of the person’s functional issues in order to develop a structured behavioral plan for developing adaptive abilities and lowering inappropriate behavior.
Social skills training – This type of therapy, delivered in either group or individual settings, assists people with autism in improving their ability to navigate social situations.
Speech and language therapy – Working with a speech coach can help those with difficulty speaking develop speech patterns and further understand language in general
Occupational therapy – It can help the person work on adaptive skills with daily tasks as well as issues with handwriting.
Parent management training – Will help parents learn effective methods for dealing with troublesome conduct and supporting appropriate behavior in their children. Parent support groups assist parents in coping with the stresses of raising an autistic kid.
Special education services – Children with autism can reach their full academic potential if their school provides an Individual Education Plan (IEP) that fits their social communication difficulties, restricted interests, and repetitive habits. Special day classes for very young children are available to cover language, social, and life skills.
Treating co-occurring conditions – Children with autism are more likely than their peers without autism to suffer from sleeplessness, anxiety, and depression. They are also more likely to have ADHD. Autistic children may have intellectual disabilities, which must be treated. The severity of these diseases can be lessened with the right services, which include all of the above as well as psychotherapy and/or prescription treatment.
Finding Health Coverage
If you feel that you or your child may be on the autistic spectrum, it is important that you seek support so that you can learn how to live with ASD. Being insured will provide you with peace of mind. As well as the coverage you require to ensure that you can see any specialists and receive any necessary therapy.
If you’re looking for a health insurance plan, EZ can help. We offer a large variety of health insurance plans from top-rated insurance companies in every state. Additionally, since we work with so many businesses and have access to all of the plans available in your region, we may find you a plan that saves you a significant amount of money – hundreds of dollars. Even if you do not qualify for a subsidy. There is no cost or obligation, simply free quotes on all available plans in your area. To get free immediate quotes, put your zip code in the bar below. Or call 877-670-3557 to talk with a local agent.
While the holidays are a joyful time spent with loved ones, they are also a highly busy and stressful time. It may be a busy time of year at work, and running around shopping and decorating can be stressful. You could also be suffering from the Christmas blues. If you are experiencing the blues, know that you are not alone; they can afflict anyone at any age and are usually caused by a life event. Not to mention the stress of trying to impress others with gifts, attend parties, and deal with family or toxic people, all of which contribute to the blues. People also remember individuals who are no longer alive to celebrate throughout the holidays. Here is what we do to make it past the awkward hugs, the eye-rolls, and weird, invasive questions about your love life.
Organize and Budget Gifts
Organization will liberate you! Do you believe you have an insurmountable task list? As with the previous step, break them up. It will stress you out much more if you have this cloud of ideas flying about in your head. If your budget is limited, it is okay to decline gift exchanges. Instead of buying gifts for everyone, encourage them to give to charity, make a homemade gift, or organize a low-cost activity for you all to do. If traveling is too expensive for you, ask family or friends to contribute to the cost of the ticket rather than giving you gifts. If you are unable to attend, request to skype or FaceTime with the individual or persons so that you can still participate in the festivities. Plan your budget ahead of time so you know what you can afford. Here’s what to do:
Make your list – List out the names of people you’ll be seeing during the holidays that you want to buy gifts for.
Organize by priority – Once you can physically see the list, rearrange it by priority whether it be kids first, then immediate family, followed by extended family or just by the order that you plan on seeing them in.
Pick the presents – You can begin assigning present ideas to each person once you’ve determined who you’ll be buying things for. If the process starts to become stressful , brainstorm with some hot cocoa and/or play some soothing music like jazz or holiday-themed songs.
Set realistic goals – You probably have a reasonable estimate of your budget for these things, but price each item separately and sum it up. It is easier to plan when you have specific numbers to work with.
Finalize it – Top off the whole process by turning all of your information into a checklist, you can even put the dates you’ll be seeing each person to give yourself a little deadline. This way you can mark off the gifts as you go so you don’t forget anything.
It’s Okay To Say No
The holidays may be stressful, especially if you commit to too many gatherings or have unreasonable expectations. When you say yes when you should say no, it merely leads to a flood of overwhelming and resentful feelings. With work and limited vacation time, your schedule is already packed. Don’t try to be in too many places at once since you won’t be able to appreciate your time. You’ll be too preoccupied with getting to the next party or worrying about hosting your own. Take it at your own speed and learn to say no.
You can decline invitations to some gatherings in order to spend more quality time with the people you do prefer to visit. Set priorities and stick to your budget. Take the previous checklist and replace the gifts with family members you want to see. Instead of gift pricing, assign trip prices to each one. If you are unable to accommodate everyone, make plans to visit once the holiday rush has subsided. They’ll probably understand, and also appreciate the break from the hustle and bustle. Visiting after the holidays may end up being more of a gift to everyone involved.
Don’t Overindulge
Consider all of the pastries and snacks you’ll be eating and drinking throughout the holidays! Our eating habits are tested over the holiday season, with dinners, parties, and cookie tables at every turn. Overindulging can make you feel tired or sluggish. It can also cause you to gain an unhealthy amount of weight, adding to your mental stress. Take a brief walk to get some exercise. Allow yourself time to be active so that you can appreciate all of the delicious treats. Attempt to maintain a healthy diet. Consuming whole grains, vegetables, and fresh fruit is the foundation for a healthy body and mind. Eating well can also aid in leveling out your mood.
Make Self-Care A Priority
This is more than just meditation. If you have a fitness routine, don’t let it slip during family visits. Try to go to the gym or perform some home exercises. Sticking to your routines (whether self-care or otherwise) not only gives you a mental lift, but it also establishes an internal norm. You’re going to dedicate your time and energy to people you care about this Christmas season, but don’t lose sight of yourself in the process. Keep your feet on the ground. Make time for activities that make you happy. It could be reading a book, going to the movies, having a massage, listening to music, or walking your dog. It is okay to prioritize alone time when you need to refuel.
Don’t Isolate Yourself
Some people may experience loneliness during the holidays, but if you don’t want to be alone, you don’t have to be. You can join an organization, volunteer at a soup kitchen, attend community events, and meet new people. Volunteering can be a wonderful source of comfort. You can feel less lonely or isolated and more connected to your community by assisting those who are less fortunate. Start a toy or food drive and invite your neighbors, friends, and coworkers.
Be Present
Have a two-week trip planned to see relatives? Take everything one day at a time. This can work even if you are not staying for an extended period of time. One hour, one minute, one second at a time. Simply concentrate on the subject at hand and give it your undivided attention. Don’t be concerned about the rest of it. It is beneficial to employ these bite-size moments during stressful periods. Pay attention in the present moment. If you spend too much time thinking about future occurrences, you will become more stressed in the present.
Seek Professional Help
If you’re feeling overwhelmed, speak with your mental health practitioner. They can assist you in identifying particular circumstances that trigger you and develop an action plan to modify them. Keep seeing your therapist if you’re already seeing one. If you’re not already seeing one your health insurance will actually cover some mental health services due to the Mental Health Parity Act.
The Mental Health Parity Act requires insurance companies to handle coverage for mental and behavioral health and drug use problems in the same way that they treat coverage for medical and surgical care. This includes treating them equally in terms of money. For example, an insurance company cannot charge a $40 payment for a mental health professional’s office visit when most medical office visits only require a $20 copay.
In addition, the Affordable Care Act also provides protection for mental health services. Mental health is covered as an essential health benefit in all ACA-compliant plans. As with other medical illnesses, your plan should cover some or all of the cost of mental health care. All ACA-compliant plans must include the following mental health services:
Outpatient individual or group counseling and therapy
Diagnostic services like psychological testing and evaluation
Ongoing outpatient treatment such as treatment programs and medication management
Outpatient treatment for alcohol or chemical addictions
Detox services
Substance abuse recovery treatment
Inpatient mental healthcare in a psychiatric facility
Work with EZ
Any visit has the potential to cause family turmoil. You want your parents/relatives to have a good time and enjoy your visit, but the holidays may bring a whole new level of stress to the situation. Maintaining excellent relationships with friends and family has surprising health benefits, so these trips are well worth it in the long term. Just keep these pointers in mind, and you should be okay. As for finding health insurance to cover your mental health, consider us Santa’s helpers. A licensed EZ insurance agent can explain the advantages and disadvantages of each plan, while also helping you in developing the plan that is ideal for you.
Working with an agent saves you time and stress because you won’t have to decipher legal language or read fine text. Agents perform all of the heavy lifting, so you can relax knowing that your coverage is tailored to your specific financial and medical needs. Not to mention that EZ agents can save you hundreds of dollars on health insurance rates each year. We accomplish this by being able to search both on and off the market for the most cheap plans.
We can also locate and apply any discounts you may be eligible for. Also,we don’t simply provide you a strategy; we also aid you in maintaining it after the fact! We can assist in filing claims with your provider as well as renewing your coverage when the time comes. To get a quote, enter your zip code into the box below or call one of our qualified representatives at 877-670-3557.
If you want your new health insurance to start on January 1st then you must enroll before December 15th. You can still enroll until January 15th, but your policy won’t start until February. We know you’ve been hearing OEP over and over the last few months, but that’s because we can’t stress enough how important it is. Not only is this the only time you can enroll in a new plan. This is the only time you can review your current plan and make sure you have all of the coverage you need within your budget. You’re in control of your health and there’s plenty of plan and carrier options out there ready to help you stay in control.
Guaranteed Coverages
The Affordable Care Act (ACA) brought a lot of change to the health insurance industry. All of which center around making sure everyone has access to affordable coverage. The ACA introduced the “10 essential benefits”. Which are 10 health care benefits that every marketplace plan must cover regardless of tier, plan type, cost, or provider.
Ambulatory patient services
Emergency services
Hospitalization
Laboratory services
Mental health and substance use services
Pregnancy, maternity, and newborn care
Prescription medications
Preventative and wellness services and chronic disease management
Pediatric services
Rehabilitative and habilitative services
Not only are health plans required to cover these benefits. Insurers are also prohibited from denying or charging more for a plan based on pre-existing conditions. So thanks to the ACA you are guaranteed to get a plan that covers all of your basic needs without having to pay an arm and a leg.
Your Options
You’ve got nothing but options during the OEP, from plans to plan tiers to possible subsidies and then some. Let’s go over the basics and give you a good starting point in your search.
The first thing you have to do is choose a plan type. While every Marketplace plan is legally required to cover the “10 essential benefits”. Plans can offer extra benefits and they can all be structured differently. So, this step is a big one because it sets the foundation for the coverage you have.
HMOs offer you the option of choosing from a local network of participating physicians, hospitals, and other healthcare providers and facilities. As part of these health insurance policies, you must choose a primary care physician (PCP) from this network. Your primary care physician (PCP) will get to know you and help you organize all of your medical care. They are also responsible for referring you to any specialists. Without this recommendation, your HMO would not cover a specialist visit. A HMO plan’s out-of-pocket costs are frequently lower than those of other types of health plans as long as you stay in-network. In general, an HMO may make sense if you prioritize lower expenses and don’t mind using a PCP to oversee your treatment.
PPOs offer a vast network of participating providers, so you can choose from a wide range of hospitals, clinics, and healthcare facilities. Unlike HMOs, PPOs provide some coverage for providers outside of their network, but not as much as they would for an in-network provider. Another significant distinction between PPOs and HMOs is that you aren’t required to choose a PCP and you can see a specialist without a referral. A PPO is often a smart option if you want more control over your options and are willing to pay extra for it. It would be especially useful if you travel frequently because you would not have to see a primary care physician.
Exclusive Provider Organization (EPO)
EPOs also allow you to choose from a network of participating providers. Except in cases of emergency, most EPO plans do not cover care outside of their network. As a result, if you see a provider or facility that is not part of the plan’s local network, you will most likely be paying for the whole cost of services. As for PCPs, EPOs can go either way, some require you to choose a PCP and others don’t, it just depends on the insurance company you choose. In either case, as long as the specialist is in the plan’s network, you will not require a referral from your primary care physician. If you need cheaper monthly rates and are ready to pay a larger deductible when you need medical treatment, an EPO plan may be for you.
Point of Service (POS)
POS plans combine the benefits of PPOs and HMOs. A POS’s provider network, like an HMO, is often smaller than a PPO plan, and in-network care expenses are typically lower, as with a PPO. In POS plans, you must select a primary care provider (PCP) from a network of physicians and other primary care specialists. If you need to see a specialist, you have to get a referral from your PCP.
However, just like with PPO, you have the option of seeing in-network or out-of-network experts. However, if you visit an out-of-network provider, your part of the costs will be higher, and you will be responsible for submitting any claims. POS insurance plans are a terrific option for many people, especially if you’re looking to save money and don’t need out-of-network healthcare services. If you are prepared to coordinate your care through a primary care physician, a POS plan may be perfect for you.
Health Expense Accounts
There are also separate savings plans you can buy to help you save up money specifically for medical costs.
An HRA, or health reimbursement arrangement, is a form of health expense account provided and owned by your employer. Because they own the HRA, your employer is the only one who can contribute to it. They can also determine if you can roll over unused cash to the next year. The money in it is used to pay for eligible expenses including medical, pharmaceutical, dental, and vision care, as defined by the employer.
A health savings account (HSA) is a bank account that you can use to pay for qualifying health care bills or to save for retirement. An HSA is available when combined with a qualified high-deductible health plan (HDHP), which has lower premiums/plan contributions and greater deductibles than a regular health plan. If you have an employer-sponsored health plan, the account is opened through the HSA provider chosen by your company. You, your employer, and others can contribute to your HSA up to a yearly limit determined by the IRS.
Flexible Spending Account (FSA)
An FSA is an employer-sponsored savings account that helps manage out-of-pocket healthcare bills. FSAs are tax-advantaged accounts, which means you can contribute to them before taxes and spend the money tax-free. FSAs allow account holders to save for eligible healthcare expenses by deducting pre-tax money directly from their paychecks. FSA funds can be used to cover deductibles, co-pays, and medical visits for you, your spouse, and any qualified dependents. Employers may contribute to their employees’ FSAs, but they are not obligated to do so.
Health Insurance Subsidies
Marketplace plans have two types of subsidy. The first type, known as the premium tax credit, lowers your monthly insurance costs. The cost sharing reduction (CSR) is a sort of financial aid that reduces your deductibles and other out-of-pocket payments when you visit the doctor or stay in the hospital. To get either sort of financial aid, you must enroll in a health insurance Marketplace plan.
Premium Tax Credit
A premium tax credit, sometimes known as a premium subsidy, is a tax credit that reduces or eliminates the amount of money that you would otherwise have to pay for getting individual or family health insurance. Unlike other tax credits, the premium tax credit can (and typically is) given upfront and all year. Each month, the IRS gives money to your health insurer, so you don’t have to pay as much yourself. Your tax return is then compared with the premium tax credit the following spring. You can also choose to pay full price for a health plan in your state’s exchange and then get the full premium tax credit on your tax return. Few people do this, however, because the cost of coverage without the advance premium tax credit is often out of reach for those who do qualify for the premium tax credit.
You must apply for coverage through the Marketplace and give information about your age, residence, household size, citizenship status, and expected income for the following year in order to receive the premium tax credit. Following the submission of the application, you will receive a decision indicating the amount of premium tax credit you qualify for. You can then choose to have the tax credit paid in advance, claim it later when filing your tax return, or a combination of the two.
Who’s Eligible?
To be eligible for the premium tax credit beginning in 2024, you must meet the following requirements:
Have a household income of at least the Federal Poverty Level (FPL), which is $14,580 in 2024.
Lack of affordable coverage through a workplace (including a family member’s employer)
Not be eligible for Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP).
Have U.S. citizenship or proof of legal residency (Lawfully present immigrants with household incomes less than 100 percent FPL may also be eligible for tax subsidies through the Marketplace if all other eligibility standards are met).
If you’re married you must file your taxes jointly.
Cost Sharing Reduction
Cost sharing reductions are the second type of financial aid available. When you utilize covered health care services, cost sharing reductions reduce your out-of-pocket costs related to deductibles, copayments, and coinsurance. Cost sharing reductions are available to anyone who qualifies for a premium tax credit and has household incomes ranging from 100 to 250 percent of the poverty line. Cost sharing reductions (CSR) are only available through silver plans, as opposed to the premium tax credit, which can be applied to any metal level of coverage. CSRs are applied to a silver plan for qualified individuals, basically making deductibles and other cost sharing more comparable to that of a gold or platinum plan. Individuals earning between 100 and 250 percent of the FPL can use their premium tax credit to any metal level plan, but they can only receive cost sharing subsidies if they choose a silver-level plan.
Health Plan Tiers
When you buy health insurance through the federal or state Marketplace, the plans available are divided into four metal tiers: bronze, silver, gold, and platinum. The metal tiers allude to the portion of your medical treatment that each tier will cover, not the quality of care you will receive with one of these plans. Which plan tier you pick determines the amount of the bill you pay. The higher the coverage, the higher the cost, but the less you will have to pay out of pocket.
Bronze plans will cover 60% of costs; you will pay 40%
Silver plans will cover 70% of costs; you will pay 30%
Gold plans will cover 80% of costs; you will pay 20%
Platinum plans will cover 90% of costs; you will pay 10%
Why You Need Health Insurance
The most important advantage of having health insurance is having access to the care you need. Health insurance provides you with access to a vast network of doctors, specialists, hospitals, and laboratories. This network collaborates with you and with one another to assist you in focusing on prevention and wellness. In fact, the majority of healthcare plans provide free preventative services, such as immunizations and testing. To help you stay healthy and avoid illnesses and their consequences.
Furthermore, the Affordable Care Act requires Marketplace plans to cover pre-existing diseases. This means that even if you have a pre-existing condition, you can receive care without being rejected coverage or charged extra because of it. Because you’ll have regular access to the doctors and experts you need, your healthcare plan will also help you manage your care for any chronic illnesses you’re living with.
Your health insurance covers all of the greatest strategies to maintain your health. Having access to this type of continuous care can essentially lead to a longer and better quality of life. According to the National Library of Medicine, persons between the ages of 17 and 64 who did not have health insurance had a 40% higher mortality risk than those who did!
How EZ Can Help
Working with an agent saves you time and stress because you won’t have to decipher legal language or read fine text. Agents handle all of the legwork. So, you may rest assured that your coverage will best match your financial and medical requirements. Not to mention, EZ agents can save you hundreds of dollars on your health insurance premiums each year. We accomplish this by scouring the market for the most affordable plans, both on and off the market. In addition to locating and utilizing any available savings.
We don’t only assist you in finding a plan, we also assist you in keeping it up to date. When the time comes, we are also here to help you in filing claims with your insurance company and renewing your policy. To begin, enter your zip code in the box below. Alternatively, contact 877-670-3557 to speak with one of our licensed agents.
Insurance companies can’t change your premiums based on your medical history or turn you down for any pre-existing conditions. However, they can change your premiums based on other things, such as whether or not you smoke. If you regularly smoke, vape, or even chew tobacco, your health insurance can cost up to 50% more. Companies use this “tobacco surcharge” to try to keep policyholders from smoking, since chronic conditions like COPD that are caused by smoking lead to high medical costs. However, even if you’re a smoker you can still find great health insurance.
What Counts As Tobacco Use?
All tobacco products, like vape juice, cigarettes, cigars, chewing tobacco, snuff, e-cigarettes, and pipes, are charged a tobacco fee by insurance companies. If you used any of these items four times a week or more in the last six months, that is considered tobacco use. Only people who use tobacco for religious or spiritual reasons, like Native Americans, are exempt from this surcharge. At the moment, insurance companies depend on people to tell the truth. When you ask for health insurance, you have to tell the company if you smoke or not. “Have you used tobacco in the last six months?” is a question that insurance companies often ask.
If you lie about how much you smoke, it could be called insurance fraud. Depending on where you live, giving a false answer to this question could be a felony that could cost you thousands of dollars in fines, jail time, and court fees, as well as a felony charge. If you get health insurance through your job, a regular medical exam could be used to check that your answers are true. During this test, a blood or urine sample can be used to check for nicotine use.
The Cost of Tobacco Use
Under the Affordable Care Act (ACA), health insurance rates are based on the type of plan, the number of people covered by it, their age, where they live, and whether or not they smoke. Many insurance companies can use the fact that a person smokes to raise their health insurance rates. This is called a “tobacco rating”. Subsidies are also affected. The full cost of the tobacco fee falls on people who smoke. The insurance company changes the premium based on age and location, but tobacco use is taken into account before that.
The tax credit isn’t used to pay for any of the tobacco fees. Through a “tobacco surcharge,” the Affordable Care Act (ACA) lets insurance companies charge users up to 50% more (or 1.5 times more) than they charge non-smokers. Even though this is legal, not all states have chosen to adopt this charge. Surcharges on tobacco can be different in each state.
Smoking causes illness and disability, and it hurts almost all of your body’s organs. The Centers for Disease Control and Prevention (CDC) says that more than 16 million Americans have a disease caused by smoking. At least 30 people live with a serious disease caused by smoking for every person who dies because of it. About 41,000 nonsmoking adults and 400 babies die each year because they were around people who were smoking. Adults who are around people who smoke can get a stroke, lung cancer, and arterial heart disease. Children who are exposed to secondhand smoke are more likely to have Sudden Infant Death Syndrome, acute respiratory infections, middle ear disease, more serious asthma, respiratory symptoms, and slower lung growth. Smoking leads to:
Cancer
When you smoke, you can get cancer and then your body can’t fight it. Toxins in cigarette smoke can damage the body’s immune system, making it harder to kill cancer cells. When this happens, the growth of cancer cells can’t be stopped. Tobacco smoke contains poisons that can damage or change the DNA of a cell. DNA is the “instruction manual” of a cell. It controls how a cell grows and works. When DNA is broken, a cell can start to grow out of control, which can lead to cancer. Cancer can form almost anywhere in your body if you smoke, including:
Blood (acute myeloid leukemia)
Bladder
Cervix
Colon and rectum
Esophagus
Kidney and renal pelvis
Larynx
Liver
Lungs, trachea, and bronchus
Mouth and throat
Pancreas
Stomach
COPD
Chronic obstructive pulmonary disease, or COPD, is a group of illnesses that block airflow and make it hard to breathe. Emphysema and chronic asthma are both parts of COPD. COPD is usually caused by smoking, but long-term exposure to other lung toxins, like secondhand smoke, can also lead to COPD. One out of every four Americans with COPD has never smoked. However,up to 8 out of 10 COPD-related deaths are caused by smoking, and 38% of the nearly 16 million U.S. people with COPD who are still smoking. When a child or teen smokes or is exposed to secondhand smoke, it can slow the growth and development of the lungs. This can make it more likely that they will develop COPD as an adult.
Diabetes
Diabetes is a long-term illness that changes the way your body turns food into energy. Most of the food a person eats is turned into glucose, a type of sugar that gives energy to the body’s cells. The pancreas is an organ near the gut that makes insulin. This hormone helps glucose get into the cells of the body. When you have diabetes, your body either doesn’t make enough insulin or can’t use it very well. Too much sugar stays in your system when there isn’t enough insulin or when your cells stop responding to insulin. Over time, this can lead to major health problems like heart disease, vision loss, and kidney disease.
We now know that one thing that can lead to type 2 diabetes is smoking. In fact, people who smoke cigarettes are 30%–40% more likely to get type 2 diabetes than people who don’t smoke. People with diabetes who smoke are more likely to have trouble taking insulin and taking care of their health than people with diabetes who don’t smoke. If you smoke a lot, you are more likely to get type 2 diabetes.
Gum Disease
Gum disease, also called periodontal disease, is an infection of the gums that can affect the bones that hold your teeth in place. In the worst cases, it can make you lose your teeth. Bacteria (germs) on your teeth get under your gums and cause gum disease. If the germs stay on your teeth for too long, they build up into layers of plaque and tartar. This buildup can lead to gingivitis, which is an early form of gum disease. When gum disease gets worse, your gums can pull away from your teeth and leave places that can get infected.
The bone and muscle that hold your teeth in place can break down, and your teeth may become loose and need to be pulled out. In the United States, smoking is a major cause of gum disease. Your immune system, which fights off sickness, gets weaker when you smoke. This makes it harder to get rid of an infection in the gums. If your gums are already damaged, smoking makes it harder for them to get better.
Heart Disease and Stroke
Cardiovascular illnesses (CVDs) include heart disease and stroke. In the U.S., coronary heart disease, also called coronary artery disease, is the most common type. Coronary heart disease happens when plaque builds up on the walls of the arteries that bring blood to the heart. A stroke happens when the brain doesn’t get enough blood or when a blood vessel in the brain breaks, damaging or killing parts of the brain. A stroke can cause death or injury, such as paralysis, weakened muscles, trouble speaking, or loss of memory. One out of every four deaths from cardiovascular disease (CVD) is caused by smoking.
How To Quit
Now is a great time to talk to your doctor if you smoke or use any other kind of tobacco. Under the Affordable Care Act, your health insurance plan can help you stop smoking by giving you the tools you need. One of the best things you can do for your health is to stop smoking or using any kind of tobacco. The faster your body can start to heal, the sooner you should stop. This is what happens after you’ve quit smoking:
20 minutes – blood pressure and heart rate lowers
12 hours – the amount of carbon monoxide in your bloodstream reduces
3 months – your lung functions and circulation improve
9 months – coughing and shortness of breath are less common
1 year – your risk for a heart attack drops
5 years – your risk of throat, mouth, bladder, and esophagus cancer severely drops
10 years – lung cancer risk drops
15 years – coronary heart disease risk reduces
Coverage for Quitting
Quitting doesn’t just improve your health it also improves your finances. Pack-a-day smokers can save between $1,380 and $2,540 annually, depending on where you live and the brand you smoke. Most health care plans, including all plans bought through the Marketplace, cover a screening for tobacco use. During this screening, your doctor will ask if you smoke or use tobacco and give you information about how it affects your health and why you might want to stop. Your health insurance may now cover free services that can help you stop smoking. This could include, depending on your plan:
Cessation counseling
Medication to help you quit
Nicotine replacements such as gum, lozenges, patches, inhalers, and nasal sprays
Keep in mind that grandfathered health plans, which are those that were in place before the Affordable Care Act was passed and haven’t changed much, are not required to give preventive care like help to quit smoking. Find out if you’re in a grandfathered plan by asking your insurance company or HR department. Also, short-term health plans don’t have to cover any preventative care including smoking cessation.
EZ Can Help
No matter if you use tobacco products now, just quit, or are on your way to stopping, it is important to have health insurance. Many health problems can be caused by tobacco products, so it’s better to have insurance than to not have it and risk having medical bills pile up. If you smoke and want health insurance, but are worried about how much it will cost, EZ.Insure can help. We’ll look at the prices, compare plans in your area in minutes, and find you a plan that will save you money. Enter your zip code in the bar below to compare free quotes right away, or call 877-670-3557 to talk to a qualified agent.
Kids 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.
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.
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.
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.
The term “alternative medicine” is now commonly used, but chiropractic care, acupuncture, and therapeutic massage aren’t really that alternative today. Many adults and children use complementary and alternative medicine (CAM) to stay healthy and treat serious or long-lasting illnesses, according to the National Center for Complementary and Integrative Health. It’s possible that a lot more people would use some kind of alternative or complementary treatment if their insurance pays for it. A lot of insurance companies cover some services in some situations, but not most CAM treatments. This means that patients generally have to pay for them themselves.
What Is CAM?
Complementary and alternative medicine is a term that describes therapies that you can use in addition to mainstream Western medicine. Massage, meditation, biofeedback, tai chi, reiki, music therapy, guided imagery, and dietary supplements are all examples of CAM. The differences between these approaches are mainly how doctors use them.
Complementary medicine – Complementary treatments are used with standard medical approaches like drugs, immunotherapy, chemotherapy, radiation, and surgery. It “complements” these more standard medical methods.
Alternative medicine – As its name suggests, these treatments are used instead of traditional medicine. Things like homeopathy, herbal medicine, and chiropractic services are examples of alternative medicine.
Integrative medicine – While this isn’t included in the CAM acronym this type of treatment is in the same category as CAM. These treatments take into account your overall health and happiness. Not just the disease or organs that are in treatment. It looks at your health from the point of view of your mind, emotions, abilities, religion, relationships, and community.
Each type might work on a different part of your health. In general, one or more of these issues may be treated with combined approaches:
Pain
Anxiety and stress
Nausea
Mood swings
Wound care
General well being
Muscle tension
Fatigue
Circulation
Flexibility
Types of CAM
CAM treatments come in a lot of different forms. Here is a summary of the different types of treatments from each group, since most of them are in more than one category.
Massage
Massage uses the nerve endings and pressure spots in your body to help you relax. It comes in many types, such as shiatsu and reflexology. There are, however, five basic strokes that make up the most common type of Swedish massage. These are effleurage (slow, rhythmic gliding strokes that move blood toward the heart), petrissage (kneading, pressing, and rolling muscle groups), friction (steady pressure or tight circular movements, often used around joints), percussion (drumming hands on body), and vibration (shaking the muscle back and forth quickly). People have used massage to ease pain, lower worry and anxiety, boost their mood, and help them relax. If you’ve recently had surgery, massage can help the wounds heal faster and may even stop or lessen scars. It has been shown that massaging your feet can help with pain, nausea, and stress.
Chiropractic or Osteopathic
This is a hands-on method that focuses on your spine and other parts and how they connect to your nervous system. In these methods, you move your muscles and joints by stretching, applying light pressure, and adding force. They can help ease muscle pain and make it easier for you to move around and do things. This method can help make a number of conditions better, such as migraines, menstrual pain, and carpal tunnel syndrome.
Yoga is a gentle form of exercise that uses poses and breathing techniques to help you feel better. People in India have done it for thousands of years, and now people all over the world do it too. In the West, yoga is valued more for its physical benefits than its spiritual ones. For example, it can make you more flexible and energetic, and it can help you feel less stressed and tired.
Music Therapy
Music therapy is an expressive art form that helps people find balance and unity in their lives. Listening to music or playing music can both be part of music therapy. Music therapists are trained professionals who make music plans for people who need them. You can work through mental, spiritual, and behavioral problems by listening to music. Music therapy can help people deal with their feelings and calm down. It’s possible for music to either calm you down or wake you up.
Animal Assisted Therapy
Therapists will work with dogs or other animals to help you deal with your health problems, like cancer, heart disease, or mental illness. Therapy with animals can help with pain, anxiety, depression, and tiredness that come with a lot of health issues.
Biofeedback
This is a way to train yourself to gain control over your feelings, thoughts, or actions. As you go through treatment, your therapist will keep track of your body’s functions. For example, EEG will record your brain waves, ECG will record your heart rate, and EMG will record muscle contractions. As you learn new ways to cope, these measurements will change.
Reiki
Reiki is a type of mental healing that comes from Tibetan Buddhism over a thousand years ago. It’s meant to improve your health, keep you happy, and help you reach a higher level of awareness. Practitioners hold their hands over your dressed body and send “reiki energy” to parts of your body that need it. Reiki is said to bring the body’s energy centers, or “chakras,” back into balance and get rid of energy blocks that cause illness and discord. After treatment, some people may feel calm, while others may feel energized.
Acupuncture is an old Chinese method to treat health problems. It works by inserting very thin, solid pins into certain parts of your body to stop or treat certain illnesses. People think that acupuncture can help the body release endorphins, which are natural painkillers that can also make you feel better. In acupressure, the same acupoints are touched and pressed on. It may work the same way, but not as well.
Insurance Coverage For CAM
The trouble is that complementary and alternative therapy is usually only partially covered by insurance, if it is covered at all. About 60% of people who go to the chiropractor have insurance plans that only cover a certain number of visits. Only 25% of people who want acupuncture and 15% of people who need massage therapy have insurance coverage. It can be hard to get insurance to pay for integrative healthcare, especially after you’ve already been treated. One reason this is hard is that insurance companies can be very slow to offer coverage, even when study clearly shows a benefit. Researchers in a study published in the journal Global Advances in Health and Medicine said that CAM methods for chronic low back pain were not well covered, even though the American College of Physicians had suggested them.
Most state-based health programs did not take a holistic approach to treating chronic pain. It was only spinal manipulation (chiropractic or osteopathic treatment) that was covered in 46 states. Less than 10 states took care of acupuncture, neurofeedback, and massage. Mindfulness-based stress reduction, tai chi, and yoga, which have all been shown to help people with chronic pain, were not talked about at all. As a general rule, you can find your policy documents online. Reading them closely is the best way to find out if your policy covers integrative medicine or other types of holistic health insurance. You could also call your insurance company to make sure they cover the treatment before you go to the doctor. The NCCIH says that you should keep careful records of all the times you talk to or write to your insurance company.
When Insurance Won’t Cover CAM
Every insurance company might not cover alternative treatments, so you may have to pay for them yourself. You can ask the provider for a cash pay rate. Some alternative care providers offer savings or a sliding scale for people who pay for their own care. If you have a health savings account (HSA), you can pay for the services with the money in it. If not, you can check with your insurance company to see if they cover alternative medicine like acupuncture and chiropractic care. Additionally, you can also look for health insurance that covers alternative care, which is another great choice. If you can’t get your current insurance company to pay for a treatment that your doctor will write a prescription for, you might want to look into other plans in your area.
There are a lot of qualified, highly trained agents at EZ.Insure who offer health insurance. We will give you your own advisor who will look into all the plans in your area and let you know which ones cover treatment with alternative medicine. Our agent will show you all the plans in your area, tell you how much they cost, and help you understand how each plan handles alternative medicine. The best part is that you won’t have to pay anything for this. We offer all of our services for free! Enter your zip code in the box below to start comparing affordable plans that cover alternative care. You can also call 877-670-3557 to talk to an EZ agent directly.
Kids 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. 
