The 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.
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.
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.
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.
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.
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.
The health insurance Open Enrollment Period (OEP) is coming, and you might feel a little lost. It can be hard to sort through all of the different health insurance options in your area, but you know that you and your family need health insurance to stay healthy. Don’t worry though. You can always work with a licensed EZ agent, who will help you find a plan that fits your budget and your needs. Before you do that, let’s look at everything you need to know about the OEP.
What Is The OEP?
The Open Enrollment Period (OEP) is the only time of the year when you can change, cancel, or buy a new health insurance plan. Depending on which state you live in, it starts on November 1st and goes until mid-to late-January. Now is a good time to look at your current health insurance plan, see if it will change in the new year, and decide if it will meet your needs in the future or if you need a new plan.
When Is The OEP?
The open enrollment period for Obamacare plans is from November 1, 2023 to January 15, 2024. Any plan you buy by December 15 will cover you starting on January 1, 2024. If you buy a plan during open enrollment, which is between Dec. 15 and Jan. 1, it should take effect by Jan. 15, 2024, as long as you pay your first premium on time. Also, if you buy a plan between Jan. 1 and Jan. 15, your plan should start on Feb. 1, 2024. Some states’ open enrollment periods are longer than others, but this can change. At the moment, these states have longer periods for signing up:
California – November 1st, 2023, to January 31st, 2024
Idaho – October 15th, 2023, to December 15th, 2023
Maryland – November 1st, 2023, to December 15th, 2023
Massachusetts – November 1st, 2023, to January 23rd, 2024
New Jersey – November 1st, 2023, to January 31st, 2024
New York – November 16th, 2023, to January 31st, 2024
Rhode Island – November 1st, 2023, to December 31st, 2023
If you get your health insurance through your job, your employer can choose when your open enrollment period is.
Marketplace Plan Tiers
Since the Affordable Care Act (ACA) went into effect in 2010, most people buy traditional health insurance plans on the insurance marketplace during the OEP. When you buy plans this way, they come in four levels called “metal tiers.” Bronze, Silver, Gold, and Platinum are the tiers. The plans in these tiers are different in terms of price and how much you’ll have to pay out of pocket, not in terms of the quality of care you’ll get.
Bronze
The monthly premiums for bronze plans are the cheapest, but you have to pay the most out of pocket. With these plans, your insurance company will pay 60% of each of your medical bills. The other 40% will be your responsibility. Also, the deductibles for these plans, which are the amount you have to pay out of pocket for medical costs before your insurance plan starts to pay for them, can be in the thousands of dollars each year. Bronze plans are a good choice if you don’t use medical services very often but need a low-cost plan to protect yourself against the worst-case medical scenarios, like getting sick or hurt badly. Your monthly premium will be low, but since the deductible and cost-sharing percentage are both so high, you will have to pay for most of your routine care.
Silver
The monthly premiums and out-of-pocket costs for silver-tier plans aren’t too high or too low. These plans cover 70% of the cost of your medical care. You pay the other 30%. The deductibles for this tier are often lower than those for Bronze plans, so if you’re willing to spend a little more to have more of your routine care covered, these plans are a great choice. When you qualify for cost-sharing discounts, you have to choose a Silver plan to get the extra savings. If you are on the Silver plan and stop getting cost-sharing reductions, you will have a Special Enrollment Period. If you want to switch plans, you can sign up for the Bronze, Silver, or Gold plan that fits your needs and budget the best.
Gold
Even though the premiums for Gold plans are high, the out-of-pocket costs of care are lower than for the plans above it. These plans have low deductibles, and your plan will pay for 80% of your care while you only pay 20%. If you need a lot of medical care, a Gold plan might be a good choice for you because it will cover more of your care.
Platinum
Platinum has the highest monthly premiums of all the tiers. While the premiums will be high, your out-of-pocket costs will be the lowest of any type of plan, and since the deductibles are so low, your insurance company will pay more of your costs throughout the year. Since these plans cover 90% of all your medical costs, they can be a good deal for people who need a lot of medical services.
In addition to the different types of metal tiers, there are also different types of plans to choose from during the OEP. Some plans only let you choose from a small number of doctors, hospitals, pharmacies, and other health care providers, or they force you to use only those in their network. On the other hand, some plans will pay a bigger share of the bill for healthcare providers outside of the plan’s network. Depending on where you live, you might find plans in any or all of these categories at each metal tier level:
Health Maintenance Organization (HMO) – A type of health insurance plan that usually only pays for medical services from doctors who work for the plan or have contracts with it. Most of the time, out-of-network care is not covered, unless it is an emergency.
Preferred Provider Organization (PPO) – A type of health plan that has a network of providers but doesn’t force you to only see those providers. But your out-of-pocket costs will be lower if you use providers in the network. You can use medical professionals, facilities, and suppliers outside the network if you pay extra and don’t have a referral.
Exclusive Provider Organization (EPO) – A managed care plan is one in which treatments are only covered if you go to doctors, hospitals, or other healthcare providers in the network, unless it’s an emergency.
Point of Service (POS) – A type of plan where you pay less if you go to hospitals, doctors, and other healthcare providers in the plan’s network. To see a specialist, you need to get a referral from your primary care doctor.
How To Buy Health Insurance During The OEP
If your employer gives you health insurance, they should tell you when and how to choose coverage for the next year. If you don’t get health insurance through your job, you can use the marketplace to look for and buy a plan. Another way to buy health insurance during this time is to work with an EZ agent who can help you shop through all of the plans available and help you enroll. Most states use the federal marketplace, healthcare.gov, but 17 states and Washington, D.C., have their own state-based marketplaces where people can buy coverage. States that run their own health insurance exchanges may also offer longer sign-up periods. These are the states that have their own insurance markets where people can buy plans for 2024:
Residents of all other states should shop for and sign up for their next health insurance plan on the federal exchange.
Things To Consider During The OEP
As Open Enrollment for Individual and Family Health Insurance in 2024 gets closer, there are a few important steps to take when choosing your plan.
Review Your Current Plan
If you already have health insurance, look it over to see if it still meets your needs. Think about any changes in your health, finances, or lifestyle recently that might mean you need a different health insurance.
Explore Options
During Open Enrollment, it’s important to look at different plan options to find one that fits your healthcare needs and budget. Look for plans that have a network of doctors and hospitals that fit your needs and preferences.
Consider Subsidies
As you look at and compare insurance plans on the Marketplace, make sure to update your personal information, especially your financial information. If you make less than a certain amount of money, you may be able to get health insurance subsidies that can lower your monthly premium by a lot. Also, Silver Marketplace plans offer cost-sharing reductions, which can lower your out-of-pocket costs by lowering your deductible, copays, and coinsurance.
Consider Additional Coverages
Even though Marketplace health insurance plans cover a wide range of medical services and include prescription drug coverage, you may want to think about getting more coverage, like dental and vision plans, to make sure your health is well-rounded.
What If I Miss The OEP?
If you miss the Marketplace’s Open Enrollment Period, you might not be able to sign up for an ACA health insurance plan unless you qualify for a Special Enrollment Period. With a Special Enrollment Period, you can sign up for a plan outside of the Open Enrollment if you have a qualifying life event. This is an event that affects your current coverage, like losing your job or getting divorced. You might also be able to sign up for a health plan through your employer. Some plans offered by employers have their own enrollment periods that may differ from the Marketplace. Also, if you change jobs, you may be able to sign up for your new job’s health plan outside of the normal enrollment period.
Need Help?
The best way to find a cheap plan with the right level of coverage for you is to compare plans. Come to EZ first before you start comparing things on your own. We’ll make the process faster and easier by letting you compare plans in your area in just a few minutes. Our licensed insurance agents work with all of the best insurance companies in the country. They can talk to you about your budget, needs, and help you choose the best plan for you and your family. We compare plans and give you advice for free. Enter your zip code in the bar above to get free quotes or call 877-670-3557 to talk to a real person.
Want to spend less on health insurance? You’re not alone! Most of us feel like health care costs go up every year, making it harder and harder to save money. Health insurance is the most expensive part of healthcare for nearly everyone, but if you think that the cost of health insurance is a reason not to get it, you should think again. Recent studies have found that uninsured medical bills are the cause of more than half of all bankruptcies. About 530,000 American families file for bankruptcy each year due to unpaid medical bills and medical problems.
While health insurance can be pricey, having no coverage or the wrong coverage could cost you even more. The last thing you want to worry about in a medical crisis is finances. So, health insurance is a must, but there are things you can do to make it affordable. Below we’ll look at how to save money on your health insurance so you stay covered without breaking the bank.
Health Insurance Costs
The amount you pay for health insurance will depend on what kind of health insurance you have, and of course what kind of services you need. Below are all of the costs associated with having health insurance that you should keep in mind when choosing your plan.
The amount you pay each month for your health insurance coverage is called your premium. This is probably the health care cost you know best because you pay it every month, even if you didn’t use any health services during that time. The average cost of premiums monthly by tier is:
Catastrophic – $332
Bronze – $440
Silver – $560
Gold – $604
Platinum – $737
These prices vary depending on you, your plan, your insurer, and your location. Premiums can also increase or decrease yearly.
A copay is a flat fee you pay for certain types of health care. If your insurance requires a $45 copay and you go to your primary care doctor, you’ll have to pay $45 at the time of your visit. Do your homework ahead of time so you know exactly what to expect.
Deductible
A health insurance deductible is the amount you have to pay for health care each year before your insurance starts to pay for some of your costs. For example, if your deductible is $1,500, you’ll have to pay the first $1,500 of all the costs that are covered. Keep in mind that some tests and annual checkups are covered by your insurance even if you haven’t met your deductible yet. Most plans don’t count copayments toward your deductible. Depending on your health insurance plan, the details can be different, so it’s important to know what it covers.
Coinsurance
Even after you’ve met your deductible, your health insurance won’t cover all of the costs. Instead, you’ll pay a percentage of the costs until you reach your out-of-pocket maximum. Coinsurance is the part of your health care costs that you are responsible for paying. So, if your coinsurance is 15%, you’ll have to pay 15% of the covered costs after you’ve met your deductible. The remaining 15% is paid for by your insurance company. That means you will have to pay $30 of a $200 bill.
Ways To Save On Health Insurance
We’ve talked a lot about prices. You might be thinking, “Wow, that’s a lot of ways to spend money!” How can I get money back? Wonderful question. We’re glad to say that we can help. These simple ideas can help make healthcare more affordable:
Shop Around
Most people don’t think about their plan for the next year and just keep the same one year after year. If you don’t look into your options, it could cost you a lot of money because your premiums could go up or the services that are covered could change. This is why it’s important to shop around not just for price, but also for services and coverage. Plans with low premiums will have higher out-of-pocket costs like deductibles and copays. People who know they won’t meet their deductible should choose these plans, as it is cheaper monthly.
On the other hand, there are plans with higher premiums, but lower deductibles. This is better for people who need more healthcare and have a better chance at meeting their deductible. Shopping around and comparing different insurance companies and plans can take a lot of time and hard work. With our highly trained agents who are experts in your area, EZ.Insure does all the work for you. Your advisor will do the work for you and sign you up for a plan that fits your needs in terms of coverage and price- all for free.
Stay In-Network
You’ll almost always save money by going to doctors, clinics, and hospitals in your plan’s network. In exchange for being part of the plan’s network, these in-network providers agree to charge less for their services. Getting care outside of your plan’s network could cost you more depending on your plan. If you have an HMO plan it’s likely you’ll have to pay the full cost of care from a provider who isn’t in their network. If you have a PPO or a POS plan on the other hand, some of your out-of-network care might be covered, but even with some coverage, you’ll still have to pay more for going out of network.
Look For Discounts
Even after you’ve chosen the best plan for your needs and budget, you can still save money. You can also look for discounts on health care that you might be able to get. Some doctors will give you a discount if you pay for a procedure ahead of time. If you know you need a colonoscopy, ask your doctor if you can save money if you pay for it in advance.
Understand You Plan’s Limitations
All plans have limitations to what they will cover. You can’t just assume that certain services and procedures will be covered. Instead, you should read the fine print to learn about the specific benefits and limits of your plan. You don’t want to get a surprise medical bill because you thought you were covered for a service.
Consider a Tax Advantaged Savings Plan
Several plans that help you save money on taxes can help you pay for health care. People with high-deductible health plans (HDHPs) can open a health savings account (HSA). You put money into your HSA and can take it out tax-free to pay for things like deductibles, copayments, and coinsurance. Your employer may offer an HSA, but you can also start one on your own and keep the money. Employers set up and pay for health reimbursement arrangements (HRAs). Employees can’t put money into their accounts, but they can take money out for medical costs that qualify.
Employers also offer FSAs, which stand for flexible spending accounts. Employees put money into the account before taxes are taken out, and they can take money out tax-free for qualified medical expenses. HRAs and FSAs don’t need a health plan with a high deductible, but you usually have to spend the money by the end of the year, and if you quit your job, you lose the account.
Find Out If You Qualify For A Premium Tax Credit
You might be eligible for the Premium Tax Credit if you buy your insurance on the open market. The government made a tax credit for people whose household income is between 100% and 400% of the federal poverty line. This helps make the cost of getting a plan through the Health Insurance Marketplace more affordable. This is for people who make too much to qualify for Medicaid or Medicare but still can’t afford health insurance. You can apply for a premium tax credit when you file your taxes to help pay for your premiums.
Work With An EZ Agent
An insurance agent can help you compare the costs and benefits of different insurance plans to find the one that gives you the coverage you need at the price you want. We can help you deal with all of this at EZ. By working with one of our licensed, highly trained agents, you can get all the answers you need in one place. They can compare all of your plans to make sure you get the best coverage for you. They can also explain all the legal jargon in your insurance information packet from step 1. All of this is done for free! No bother, and nothing to do. To get started, enter your zip code in the box below to get free instant quotes, or call 877-670-3557 to talk to one of our agents.
Everyone needs health insurance to cover them in case of an emergency or unexpected illnesses. It’s also best to have health insurance for things like checkups and medications that keep you from getting sick in the first place. Unfortunately, there are so many choices in health plans that it can be hard to figure out which type is best for you. To make sure you’re covered when you need it, it’s important to choose a plan that not only fits your needs but also your wallet. A Point-of-Service (POS) plan is one of the many things you can do. Even though these plans aren’t as common as HMOs and PPOs, it’s still a good idea to look into them.
What Is A Point-of-Service Plan?
A point-of-service (POS) plan is a type of managed-care health insurance plan that gives different benefits based on whether the policyholder uses in-network or out-of-network healthcare providers. You can choose whether or not to stay in the network each time you need health care services. With this type of insurance, all of your costs rely on the “point” of service, which is the doctor or hospital where you get care. A Point of Service (POS) plan has some of the same benefits as HMO and PPO plans, but the amount of benefits depends on whether you get your care from a provider in the health insurance company’s network or from a provider outside of the network.
How Point-Of-Service Plans Work
A POS plan begins like an HMO plan, you have to choose a primary care provider (PCP). Your PCP is in charge of coordinating your health as well as giving you referrals to see specialists, which will not be covered without a referral. A POS is also similar to a PPO in that it still covers some services that you get out-of-network, but you will have to pay more than you would for in-network care. The POS plan will pay more for a service outside of the network if the primary care doctor sends the policyholder there instead of the policyholder going outside the network without a recommendation.
The premiums for a POS plan are between those of an HMO, which are cheaper, and a PPO, which are higher. Co-payments are usually only $10 to $25 per visit when you go to a doctor who is in your plan’s network. POS plans also don’t have fees for services that are covered by the plan. This is a big difference from PPOs. POS plans cover the whole country, which is good for patients who move a lot. Out-of-network costs tend to be high for POS plans, which is a bad thing. When a deductible is high, it means that patients who use services outside of their plan’s network will have to pay the full cost of their care until they hit the deductible. If a patient never uses out-of-network services on a POS plan, they might be better off with an HMO because the premiums are cheaper.
Point-of-Service Cost
On the Affordable Care Act (ACA) marketplace, a POS plan costs an average of $505 per month for a 30-year-old, $568 per month for a 40-year-old, and $794 per month for a 50-year-old. On the ACA marketplace, the price of a POS health insurance plan relies on a number of things. Some of the things that affect how much you pay for health insurance are:
Age
Where you live
Tobacco use
Plan tier
Dependents
Plan design
Insurance Company
Additionally, the costs of your plan rely on where you get coverage. For instance, the cost of individual health insurance plans bought directly from an insurance company is different from the cost of plans bought through the ACA marketplace. If your workplace offers a POS plan, you can expect to pay much less because the premiums for employer-sponsored plans are subsidized.
Advantages and Disadvantages of Point-of-Service Plans
POS plans often cost less than other types of health insurance, but they only cover a smaller number of doctors. You can see doctors who are not in their network, which is a good thing, but it will cost you more. Each type of insurance plan has pros and cons. Knowing the pros and cons of POS insurance plans can help you decide if it’s the right choice for you and your family.
Advantages
Affordability – Since POS plans are a mix of PPOs and HMOs, their premiums aren’t always the cheapest. However they are still affordable. In fact they actually cost less than PPOs. Affordability comes into play with in-network copays. POS plans don’t make you pay your deductible before getting coverage. Instead, you pay a copay every time you see an in-network provider. This is beneficial if you’re working within a budget.
Out-of-Pocket Limits – With a POS plan, you have to meet your deductible before any out-of-network care will be covered, but the deductible is lower than a PPO plan, and there are limits. The out-of-pocket limit is set so that you will never spend more than a certain amount for healthcare in a year. Once you meet that limit, your insurance will pay for all of your doctor visits and treatment, both in and out of the network.
Flexibility – With a POS insurance plan, you have to pay your deductible before you can get coverage from a provider who is not in your network. However, the yearly cost is less than PPO deductibles, and you can’t pay more than a certain amount during the year. Once the out-of-pocket limit is met, your insurance will pay for all of your doctor visits and treatments.
Disadvantages
Costs – Even though POS plans are cheaper than PPO plans, which is a benefit, they can still be as expensive as HMO rates. If you don’t fully understand your plan, you may be paying more than you would for another type of health insurance. For example, if your PCP is not in the network, you’ll pay more to see them than if they were in the network of your HMO.
Confusing – Since POS insurance plans are less popular than HMOs and PPOs, they can be hard to understand, making it hard to know how much you’ll pay when you see a doctor or specialist.
Paperwork – These plans also require a lot of paperwork if you want to see a doctor who isn’t in their network and pay their fees up front, which may not be possible with your budget. After seeing the doctor, you’ll need to file a claim for repayment and wait for a decision, which can be scary.
Most of the time, HMO plans cost less than other plans. The premiums and out-of-pocket costs for HMO health insurance are much cheaper than those for POS plans. Even though HMO health insurance is less expensive than POS health insurance, it has fewer benefits. Unless it’s an emergency, HMO plans don’t cover care from doctors who aren’t in their network. If you go to a source who is not in your network, you have to pay for the whole service. HMO plans require you to work with a primary care provider and get a referral to see an expert, just like POS plans. Because care from outside the network isn’t covered, HMO members have access to a much smaller network of general care providers, specialists, and hospitals.
One of the most popular types of health insurance is PPO. You don’t need a referral to see an expert if you have PPO health insurance, and you can see a doctor in or out of your network. PPO health insurance is often a good choice if you don’t mind taking care of yourself. In the ACA marketplace, the average monthly rates for PPO and POS plans are about the same.
POS Vs. EPO
An Exclusive Provider Organization (EPO) plan is similar to an HMO plan. An EPO plan pays for medical services when you go to a source in the plan’s network. If you go to a doctor who is not in your network, you will have to pay the whole price (except in an emergency). However, if you have EPO insurance, you usually don’t need a primary care provider or a referral to see an expert. If an expert is part of the EPO’s network, your insurance company should pay for the service. POS plans tend to be more expensive than EPO plans in terms of cost. In general, health insurance plans that cover care outside of the plan’s network cost more than plans that only cover care within the network.
Working With EZ
There are a lot of different kinds of health insurance plans to choose from. So, it all comes down to what you want, how much money you have, and how healthy you are. The best way to find the right plan for you is to look into what each plan has to offer. So, you can get the most service for as little money as possible. Remember that health insurance is important, even if you’re in good health most of the time. You never know what could happen, so it’s best to be safe. 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.
Most of the time, doctors and other health care workers see their patients in person at a place like a doctor’s office, clinic, or hospital. However, doctors and nurses can now diagnose, treat, and keep an eye on their patients’ care online. Thanks to computers, smartphones, and other new digital technologies. Using technology, telehealth is a way of providing health care services from a distance. It can be anything from doing medical visits over the computer to keeping an eye on a patient’s vital signs from afar.
The best part is telemedicine isn’t an expensive luxury like some people believe. In fact, according to a study done by The American Medical Association 33.1% of adults living under 100% of the federal poverty level ($14,580 per year) have used telehealth in the last year. So why is telehealth so popular and how does it benefit you? We’re glad you asked. Telehealth has a lot of treatment uses and benefits that virtually anyone can enjoy.
Telehealth Treatment
It may seem like a virtual treatment couldn’t be as thorough as an in-person appointment. While to an extent that’s true. Unless you need something like a shot or emergency care, a virtual appointment can do everything an in-person one can. All of the following things and services are possible with telehealth:
Recording vitals – You can send your weight, food intake, blood pressure, heart rate, and blood sugar levels to your doctor either manually with at home equipment or a wearable monitor.
Check test results – Telehealth isn’t just about appointments. You can also check your test results and prescription refills using the online portal. The online portal can also let you message your doctor directly or even schedule an appointment.
Coordinating care – You can share information like your test results, diagnoses, medications and exam notes between your PCP and any specialists you see. Right from the comfort of your own home.
Reminders – Telehealth includes being able to receive emails or texts as reminders for appointments, tests, or procedures.
Advantages Of Telehealth
Using technology to provide health care has many benefits. Such as saving money, being more convenient, and being able to help people who have trouble getting around or who live in distant areas without a nearby doctor or clinic. Because of these things, the use of telemedicine has grown significantly in the last ten years. Now, 76 percent of hospitals in the U.S. use telehealth to connect doctors and patients directly. Ten years ago, only 35 percent of hospitals did this.
During the COVID-19 virus outbreak, telehealth became even more important. People are more interested in and use technology to give and receive health care because they are afraid of sharing and getting the virus during in-person doctor visits. Other benefits include:
Improved access to providers
Most doctors who work in rural areas are family doctors or general practitioners. This means that they might not have access to or knowledge of more specialized kinds of medicine that rural patients need. Telehealth can help in this situation. Telemedicine software lets healthcare groups give patients in rural areas care that is more specialized. Or more up-to-date than they might otherwise be able to get. Patients are more likely to go to the doctor, now that it is easier for them since they can see providers without leaving their homes.
Flexibility
The main way that telehealth makes things better for patients is by making things easier for them. We all know that going to the doctor can be a pain. Taking time off work to drive 20–30 minutes to the doctor’s office, then sitting in the waiting room for another 20–30 minutes, having a short visit, and then driving home again is a lot of time. This makes people less likely to come in to see their healthcare provider. Telehealth cuts out almost all of that time and reduces it to a scheduled meeting that can be taken anywhere with a smartphone. It’s so much easier for patients, especially for appointments or checkups that don’t involve a physical test.
Improved patient health
Patients are much more likely to make arrangements for regular checkups and preventive care because telehealth makes it easy for them to do so. You might not think it’s worth the trouble to make an in-person meeting for something you think is small, but you could make a telehealth appointment instead. This means that you are living a healthier life generally and keeping an eye on how your health is going. Telehealth also has a lot of benefits for people who have long-term illnesses and have to follow a strict care plan. Routine checkups are much easier to do without having to go to the doctor’s office.
Remote patient monitoring and other more advanced types of virtual care can help you with chronic conditions even more by keeping track of important health data in real time so that problems can be caught as soon as they happen. Remote patient monitoring tools, such as blood pressure cuffs, smart blood glucose monitors, and heart rate monitors, can help telehealth and telemedicine appointments be more effective and improve your general health.
Disadvantages
Telehealth makes it easy and cheap to see your doctor without leaving your house, but it does have a few drawbacks. Not every kind of visit can be done from afar. You still have to go to the office for things like imaging tests, blood work, and treatments that need a more hands-on approach. Cost is another slight downside. During the COVID-19 outbreak, insurance companies are paying for more and more telehealth visits. However, some services may not be fully covered, so you may have to pay for them yourself. Additionally, telehealth requires telecommunications equipment to function properly. However, in order to gain the benefits of telehealth, many patients must have access to laptops, mobile phones, and tablets.
People in remote locations suffer with limited internet bandwidth and unpredictable connectivity. To function efficiently and without latency, video conferencing requires high internet rates. Accessing telehealth services may be challenging if you do not have a constant, stable connection.
Is Telehealth Covered By Insurance?
Telehealth services are starting to be covered by some private insurance companies, but telehealth coverage is very different from one state to the next. This is because each state has its own way of defining telehealth and paying for it. Since insurance plans vary, it’s important to check with your insurance company or the billing department of your health care provider for the most up-to-date information on how telehealth services are covered.
Preparing For A Telehealth Appointment
If you are fortunate enough to have access to the necessary equipment and internet, preparing for a telehealth appointment is fairly easy. Although, some people may find it hard to switch from in-person to online meetings, especially if they aren’t used to the technology. By taking a few steps before your appointment to prepare, you can make sure your visit goes smoothly.
1.Add it to your calendar.
Add your meeting to your calendar so you don’t forget once it’s set.
2.Use the best camera.
This can be connected to your phone, laptop, tablet, or desktop computer. If you can give your doctor a clear picture of what’s going on, he or she will be better able to understand what’s going on and help you.
3.Test your camera and microphone.
Practice with a family member or friend before your online visit with your doctor to make sure you know how to use your camera and microphone. Most devices have microphones and speakers built in, but you may need to turn them on or allow the telehealth app or website to use them. Using headphones or earbuds may make it easier for you to hear your doctor and for your doctor to hear you, but you should try them out first to see what works best.
4.Check your internet connection.
If you aren’t using Wi-Fi, try using a wired connection to your router with an ethernet cable to get the best signal. If you are using Wi-Fi, you can improve your link by being close to the internet router and having as few devices as possible connected to it.
5.Charge the device.
If you’re using a phone, laptop, or tablet that doesn’t have a cord, make sure the battery is charged enough to get you through your meeting. Try to charge it the night before your meeting.
6.Find a good spot.
Try to keep your area as clear as possible. Try to go somewhere with good lighting so that your doctor can see you well. Put your device on a stable surface so you can move around if you need to. Try moving your device so that the camera can see your head and shoulders.
7.Write down questions
If you are ready for your visit, you and your doctor will be able to talk about everything you need to. So, write out your questions or concerns and any symptoms you want to remember to bring up.
Working With EZ
This is just the beginning of how healthcare will change in the future, and many companies want to be a part of telemedicine so that more people will go to the doctor and hopefully catch a problem before it gets worse. The first thing you need to do is find the right health insurance that covers telehealth. 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.
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. We can also find and use any savings you might be able to get. Your agent won’t just help you find a plan, though. We also help you keep it up to date. We 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.
In the last few years mental illness has steadily become a topic of conversation for many people. We’re seeing people take their mental health more seriously. It’s important to take care of your mental health. In fact, it’s just as important as your physical health. Insurers haven’t always seen it this way, though. In the past, many health insurance companies covered physical health problems greater than mental health problems. However, thanks to the Mental Health Parity Act and the Affordable Care Act, health insurance covers mental health the same way it covers physical health. Below we’ll look at both of these laws and why mental health is so important.
Mental Health Parity Law
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Act was passed in 2008. The law is more commonly known as the mental health parity law or the federal parity law. It says that insurance companies must treat coverage for mental illness and behavioral health and substance use disorders the same as coverage for medical and surgical care. This includes treating them the same financially. For example, an insurance company can’t charge a $40 copay for an office visit to a mental health professional when they only charge a $20 copay for most medical office visits.
The parity law also covers limits on treatment that are not related to money. For example, it used to be common to put limits on the number of visits to mental health care that could be made in a year. The law has pretty much done away with these annual limits, but it doesn’t stop the insurance company from putting limits in place that have to do with “medical necessity.”
Health Plans Affected By The Mental Health Parity Law
In general, the following types of health insurance are covered by the mental health parity law:
Employer group health coverage for companies with more than 50 employees
Plans bought through a health insurance exchange
Children’s Health Insurance Program (CHIP)
Most Medicaid programs, however requirements can vary from one program to another
Some other plans and programs run by the government are still not covered by the parity law. The federal parity law does not apply to Medicare, but it does apply to Medicaid. Some state employee plans, like those that cover teachers and people who work at state universities, can choose not to follow the parity rules.
Diagnoses Covered By The Mental Health Parity Law
The federal parity law covers all mental health and substance-use disorders that a health plan covers. But a health plan can choose to not cover certain diagnoses, whether they are in the physical/medical realm or the behavioral/mental health realm. This is because the parity law doesn’t require insurers to offer mental health benefits. Instead, it says that if mental health benefits are offered, they can’t have stricter requirements than physical health benefits. Your plan’s description of mental health benefits should tell you about any exceptions.
Mental Health And The Affordable Care Act
The Affordable Care Act (ACA) was passed in 2010, and its goal was to make healthcare more affordable. Plans that follow the ACA guidelines include mental health care as one of the “10 essential health benefits”. This means that if you sign up for an ACA-compliant health plan, your mental health services are covered. The ACA also says that insurance companies have to put a limit on how much customers have to pay out of pocket and that there can’t be limits on how much mental health care is covered annually or for a person’s whole life. These steps make sure that people can get mental health insurance and that it is affordable.
What Mental Health Services Are Covered?
All ACA compliant plans should cover mental health as an essential health benefit. Your plan should cover some or most of the cost of mental health services, just like it would for other medical conditions. All plans under the ACA must cover the following mental illness 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
Why Mental Health Coverage Is So Important
There are many reasons why having health insurance that covers mental health needs is a good idea. Mental health issues can happen to almost anyone at any time, with most of these issues needing treatment. The cost of therapy and medication can quickly add up and get expensive. If you don’t have insurance for mental health, you would end up paying out-of-pocket for your care. It could easily amount to tens of thousands of dollars. On top of being financially beneficial, mental health coverage can also save lives. If you have a mental health condition, it’s hard to put a price on how important treatment is. Let’s look further into the impact mental health has.
Physical Health
Studies show a link between mental health and physical health. Mental illness can cause stress and make our immune systems less effective. Because of this, our bodies may not be able to handle illness as well. When your mind is sick, you might develop anxiety or depression, which can make it difficult if not impossible to stay active. Which can lead to letting your physical health deteriorate and struggle to correct it.
Relationships
One of the most interesting reasons why mental health is so important is that it affects your personal relationships. Mental illness can change the way you talk to your friends and family. People with mental illness are often passive-aggressive, hostile, and unable to join social activities. This can cause problems within your emotional support system. Mental illness can make us want to hurt people we care about for no apparent reason. Taking care of our mental health on our own and, if needed, taking medicine can help us live a mentally stable life and keep our relationships.
Emotional Well-Being
How you feel on the inside every day is just as important as how healthy your body is. Advice about mental health shows how a negative mind can make you feel sad, angry, or uneasy. Taking care of your emotional health can help you be more productive and effective at work and in your daily life. You can get advice about your mental health from friends, family, and a psychologist to keep an eye on your emotional and overall health.
Prevent Suicide
A study by the National Alliance on Mental Health (NAMI) found that 46% of people who kill themselves have a known mental health problem. In another study, the US Department of Health and Human Services found that about 60% of people who killed themselves had a mental illness like major depression, bipolar disorder, or dysthymia. This shows the link between mental health and suicide, as well as how early medical intervention and self-care can help reduce the number of suicide deaths. It is important to follow advice to keep our mental health in good shape and to always be aware of the mental health of those around us If you or someone you care about is in trouble, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). This number is toll-free. Anyone can use this service 24 hours a day, 7 days a week.
Prevents Criminal Behaviors
Some studies show that if you have a mental health condition, you are more likely to commit violent crimes. The risk is even higher if you use drugs and alcohol and refuse to get proper treatment. Mental health conditions are often the cause of someone committing crimes against their family or friends.
Financial Stability
One of the many reasons it’s important to take care of your mental health is that it makes you more productive and financially secure. According to research published in the American Journal of Psychiatry, people with serious mental conditions earn 40% less than people without. The World Health Organization also says that depression alone causes nearly 200 million lost workdays every year. It is well known that people with poor mental health are less productive, which hurts their finances. It is important to take care of mental health in the right way if we want good work performance and financial security.
EZ Can Help
Getting help for any signs of mental illness shouldn’t be hard because of how much it costs. We can help if you think you can’t get help because you don’t have enough insurance or can’t afford health insurance. You don’t have to worry about paying for EZ’s help to find an affordable health insurance plan because it is free. We want to make sure that you get the help you need. We’ll give you your own agent, who will compare all the plans available in your area and give you quotes in minutes. We won’t just help you find the best plan, we’ll also sign you up for free. Enter your zip code in the bar below to get free instant quotes, or call 877-670-3557 to talk to a live agent.
Most people don’t think about their plan for the next year and just keep the same one year after year. If you don’t look into your options, it could cost you a lot of money because your premiums could go up or the services that are covered could change. This is why it’s important to shop around not just for price, but also for services and coverage. Plans with low premiums will have higher out-of-pocket costs like deductibles and copays. People who know they won’t meet their deductible should choose these plans, as it is cheaper monthly. 
POS Vs. EPO
2.Use the best camera.
