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Tag: Open Enrollment Period

Missed The OEP? Don’t Worry, You Can Still Get Great Health Insurance!

Life can get hectic, and it’s easy to forget about the little things – or even the big things, like getting health insurance! And if you were one of the people who completely forgot to look into health insurance during the Open Enrollment Period (OEP), you’re probably stressing out about what you can do. But you don’t have to stress about it! There are ways to enroll in a health insurance plan outside of the OEP, so you don’t have to wait until next year to find a plan. In fact, you can still find an affordable plan that will keep you covered until the next Open Enrollment Period, with the help of an EZ agent.a clear hourglass that indicates time is up on a black background with the article title

Why the Open Enrollment Period Exists

Before the Affordable Care Act (ACA) was passed in 2010, insurance companies could raise insurance premiums. Or refuse coverage to a person based on their medical history and conditions. But the Affordable Care Act made it illegal for insurance companies to deny coverage. Or charge more based on someone’s pre-existing conditions. But in order to ensure that people don’t only purchase health insurance once they get sick, the ACA set up a specific time during the year when people are allowed to purchase health insurance on the ACA Marketplace – the Open Enrollment Period. 

Your Options Outside of the Open Enrollment Period

While it might sound like there’s no way to get health insurance now that the OEP is over, there are actually a few ways. For example: 

A Special Enrollment Period Based on Qualifying Life Events

If you experience a major change in your life, known as a qualifying life event, you will be eligible for a Special Enrollment Period (SEP). Which allows you 60 days to enroll in a health insurance plan or change your current plan. What exactly are the qualifying life events that trigger a SEP?

 

A qualifying life event is a significant change in your life that would make you eligible to enroll outside of an Open Enrollment Period. These changes include:

  • Getting  married
  • Getting  divorced (specifically, if you were getting your health insurance through your spouse’s employer)
  • Having a baby, adopting a baby, or placing a child up for adoption or into foster care
  • Losing your spouse/partner, and being left without health insurance
  • Your spouse/partner losing their job (specifically if you had coverage through their employer)
  • Losing your job and employer-based coverage
  • No longer being a full-time employee eligible for workplace coverage
  • Moving outside your plan’s coverage area
  • Leaving jail/prison
  • Gaining citizenship

Short-Term Plans

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Short term plans are cheaper than ACA plans!

If you do not qualify for a Special Enrollment Period, the next step is to consider a short-term plan. These plans are much cheaper than ACA plans but do not offer as much coverage. They are worth considering, though: short-term healthcare plans provide fast, flexible insurance with many benefits. You can pick your deductible amount from many options. And you can drop coverage without a penalty for a long-term insurance option.

 

You can get one of these policies at any time and it will cover you for 364 days. It’s important to note that they do not have to cover pre-existing conditions. So premiums can be based on your medical history. 

 

These plans are considered minimum essential coverage because they are not regulated by the Affordable Care Act. Because they are not subject to ACA rules, these plans do not have to cover all the ACA’s 10 essential health benefits, which include:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services, and chronic disease management
  • Pediatric services

How EZ Can Help

Missing the Open Enrollment Period is more common than you might think, so don’t feel alone. And even if you missed it, you don’t have to go uninsured. EZ.Insure wants to make sure that you are protected from any catastrophic and unexpected healthcare emergencies. We will compare all available short-term plans in your area to find a plan that gives you the most coverage with the most savings. And because we just want to make sure you are properly insured, we offer all of our services at no cost to you. We will provide you with your own personal agent who will go over your needs and find a great short-term plan that can temporarily insure you until the next Open Enrollment Period. To get free quotes, simply enter your zip code in the bar above, or to speak to a licensed agent, call 888-350-1890.

Do You Have to Apply for Health Insurance Every Year During the OEP?

Each year, starting on November 1st, Americans have the opportunity to make changes to their health insurance plans. It’s important to take advantage of this time, because a lot of things can change in your life throughout the year, such as having a child, getting married, or changing your job, which could require changes to your health insurance plan, as well. But what if you haven’t had any major changes in your life? Is it necessary to apply for a new health insurance plan every year? Well, it depends.

Do You Have To Apply?apply now button on a keyboard

The Open Enrollment Period (OEP) is the one time during the year when you can change, cancel, or purchase a new health insurance plan. Depending on what state you live in, it begins on November 1st and lasts until mid-to-late January. It is the perfect time to assess your current health insurance plan, check if it’s going to change in the new year, and decide if it will fit your future needs, or if it’s time to get a new plan.

A common misconception every year when the health insurance Open Enrollment Period begins is that you have to make changes to your current plan. That’s not necessarily true. If you have reviewed any changes to your current plan that will be going into effect for the following year, and you are happy with the changes,  there is no need to find or apply for a different plan.

However…

It’s in your best interest to review all of your available options so you know if there are policies out there that might be better for you. You should look carefully at the different types of plans available, including the different metal tiers, which offer a range of coverage options and price points. Generally, the difference between the tiers lies in what percentage of your expenses the plan covers. 

In addition, you should look into subsidies that you might qualify for, especially now that they have been extended through the American Rescue Plan Act. You may now qualify for subsidies that you might not have qualified for a year or two ago. This is why it’s very important to work with a knowledgeable agent who can go over all of your needs to make sure you find the perfect plan for you and your family.

Need Help?

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If you do not know where to begin, EZ will make the process quicker and easier by comparing available plans in your area in minutes.

When trying to select the right health insurance plan for you and your family, you will come across many different choices. The right one for you will depend on your lifestyle, the doctors you want to see, and any medical equipment you need or medications that you take regularly.

Comparing plans is the best way to find an affordable plan that provides the right level of coverage for you. Before you start doing the work of comparing on your own, come to EZ. We will make the process quicker and easier by comparing available plans in your area in minutes. Our licensed agents work with all the top-rated insurance companies in the nation and can go over your budget and needs, and find the best plan for you and your family. We compare plans and offer guidance at no cost to you. To get free quotes, simply enter your zip code in the bar above, or to speak directly with an agent, call 888-350-1890.

4 Things That Can Turn Into an Out-of-Pocket Nightmare

Keeping on top of your health is one of your top priorities – or at least it should be! You know you shouldn’t put off getting that weird pain you’ve been feeling or that mole on your arm checked out, so that whatever is going on doesn’t get any worse. But maybe you’re avoiding a trip to the doctor because you’re worried about the cost. And we get it: if you don’t have health insurance you could be facing a big, and we mean BIG bill from any medical provider you see; but even if you do have insurance, you could still find yourself stuck with a big bill if you don’t have the right health insurance plan. Find out which things besides co-pays and deductibles can turn into out-of-pocket nightmares, especially if you’re uninsured or underinsured.

1. Ambulance Rides

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Ambulance services charge by the mile, and trips can easily cost you $1,000 or more!

As if having to take the ride to the hospital in an ambulance isn’t scary enough, wait until you see the amount that ambulance services charge. While ambulance rides are often covered by health insurance, your plan will usually not pay 100% of the bill: depending on your coverage and your policy limits, you could end up paying an average of around $550 out-of-pocket. And if you don’t have insurance? Ambulance services charge by the mile, and trips can easily exceed $1,000 and occasionally even reach $2,000. If you need an air ambulance, you’ll be looking at a bill of around  $27,000.

2. Your Lifestyle

Are you a dare-devil? Like tough mudder runs? Or maybe just want to stay as fit as possible so you work out regularly? That’s all great, but if you break a bone, tear a ligament, or injure yourself in any other way, you could end up with thousands of dollars in medical bills. If you don’t have health insurance or if you don’t have enough coverage, your active lifestyle could mean paying a lot of out-of-pocket. 

3. Outpatient Services

Surprisingly, outpatient services can land you with some large out-of-pocket bills. The average outpatient visit in the United States costs nearly $500, with recent studies showing that outpatient services account for 49% of medical debt. Doctors and specialists often push to provide services, including surgeries, at outpatient facilities rather than in the hospital; while these facilities are cheaper than hospitals, they are still expensive, and will often tack on extra fees that your health insurance will not pay for. 

4. Hospital Expenses

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If you are not admitted, and are only under observation in the hospital, you can face some unexpected charges.

Studies show that the most common unexpected charges include emergency room visits, health-related tests, and specialist visits while a patient is staying in the hospital “under observation.” If you are not admitted to the hospital, but only “under observation” and your doctor requests tests, or visits you, these services are not simply covered under your hospital stay (which you would normally have a one-time copay for). Instead, you will pay for each doctor or specialist visit as a copay as if it was a visit to your doctor’s office, and you will have to pay the coinsurance for each lab work and/or test conducted in the hospital. All of these things can add up to a few hundred dollars. In addition, if you need any medical equipment afterward, such as a boot or crutches, these will also cost you a lot of money out-of-pocket. 

The health insurance Open Enrollment Period is still open until January 15 (depending on your state), so now is the perfect time to reconsider getting a health insurance plan or looking into your current one and making sure it will cover all of the above-mentioned costs. And if your plan doesn’t cover everything you need it to, it’s time to find a plan that does, so you can save as much money as possible. If you’re shopping for a plan, your best bet is to speak to a licensed EZ agent. Our agents work with the top-rated insurance companies in the nation, so we can compare plans in minutes. We will not only find a plan that has all the benefits you’re looking for, but we will also make sure the plan meets your financial needs. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local agent, call 888-350-1890. No obligation.

Questions To Ask When Requesting Health Insurance Quotes

The Open Enrollment Period is coming to an end soon, and if you still haven’t looked into your health insurance options for the new year, now is the time to do so. But we get that picking a plan can be overwhelming because of all the options out there, so we want to give you the inside scoop on finding the best plan for you: your best bet is to work with an insurance agent. They know the ins and outs of health insurance and work with every insurance company, so they can get you the best possible plan. The best part? If you work with an EZ agent, we will compare plans for you for free! So if you’re ready to get started, we’ve got the most important questions to ask when requesting health insurance quotes from your EZ agent.

What Types Of Plans Are Available?

There are a lot of plans – and we mean A LOT – of different plans out there to choose from. There are metal tier plans, HMOs, PPOs, POSs, EPOs, and more. Each plan offers different levels of flexibility, coverage options, and rates; your available options also depend on where you live, so be sure to ask your EZ agent which plans are available in your region. We will gladly go over every single option and discuss the difference between each plan, so we can help you determine which one is right for you and your family.

What Are The Metal Tiers?

Health plans available on the ACA Exchange are separated into four metal tiers. These tiers do not indicate the level of care you will receive; rather, the tiers let you know how much you will pay for care and how much your insurer will pay. The tiers are: different colored badges, one silver, one gold, and one bronze

  • Bronze– Lower monthly premiums, but a higher deductible and copays. You will usually pay an average of 40% of costs of care, and your insurer will pay 60%. 
  • Silver– Moderate monthly premiums and moderate medical costs. You will pay 30%, and your insurer will pay 70%.
  • Gold– Higher monthly premiums with lower out-of-pocket costs. You will pay 20% and your insurer will pay 80%. 
  • Platinum– Highest monthly premiums and lowest out-of-pocket costs. You will pay 10% and your insurer will pay 90%. 

We will be able to go over this in more detail, including what each type of plan will cover and how much you will pay, so you can have a better understanding of how these plans work.

Can I Add Supplemental Insurance?

Dental and vision are considered supplemental insurance plans; some health insurance plans do not offer these, so you will have to ask if they are part of the plan you are looking into. If they are not, we can help you find affordable dental and vision plans. 

What is A HDHP & Will It Work For Me?

High deductible health plans are exactly what they sound like: these plans have high deductibles, but in exchange, you will have low affordable monthly premiums. These plans are generally for healthy people who only see the doctor for annual physical exams and do not have any chronic conditions that require constant medical attention, and who will most likely not have to pay their whole deductible. For 2022, the Internal Revenue Service has defined a HDHP as any plan with a deductible of at least $1,400 for an individual, or $2,800 for a family.

How Are Medications Covered?

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Medications are covered differently on plan’s drug formulary, which determines how much your medications cost.

Figuring out the cost of your prescriptions can be a little complicated since different insurance companies can charge differently for the same drug – some drugs might even be covered differently by the same insurer depending on the plan you choose. Basically, insurers put medications into  a drug formulary, which is divided into four tiers:

  1. Tier 1– Inexpensive generic drugs
  2. Tier 2- Brand name drugs and more expensive generic drugs
  3. Tier 3– Non-formulary drugs, generic or brand name
  4. Tier 4- Specialty drugs

To find out which plans cover your medications and how much you will be charged based on their placement in the insurer’s drug formulary, you need to speak with an EZ agent. We will review each plan available in your area and their drug formularies to make sure that your medications are covered, and that they will not cost you an arm and a leg. 

What About Out-of-Network Coverage?

Some plans, like HMOs, will not cover out-of-network coverage, but PPO and POS plans do cover out-of-network coverage in case of an emergency. If you travel or visit family in other parts of the country often, you’ll definitely want to consider a plan that covers out-of-network emergencies; otherwise, if you have an accident while away from home, you could be stuck with a bill that you have to pay out-of-pocket.  

Do I Need Referrals?

With some plans, you’ll need a referral from your primary care physician (PCP) to see a specialist, like a gastroenterologist or an orthopedic doctor. If you want to skip this step and see a specialist whenever you feel necessary, we can help you find a plan that does not require a referral. You’ll have more flexibility with a plan that doesn’t require referrals, and you won’t have to pay a PCP copay just to get a referral to see a specialist.

There are so many things to think about when looking for a health insurance plan for you and your family. Do you want more flexibility? Supplemental insurance? Cheaper prescriptions? The easiest way to find the right plan for you and get the answers to these questions is to work with an EZ agent. We will compare plans, go over every option, discuss your needs, and help you sign up for the plan you need, all at no cost to you. Our services are completely free, with no hassle and no obligation. Speak to an EZ agent now, before the OEP ends! Get free health insurance quotes by entering your zip code in the bar above, or to speak with a local agent, call 888-350-1890.

How to Avoid Astronomical Out-of-Pocket Medical Bills in 2022, Even if You Contract Covid

New reports surfacing show that people who dealt with Covid-19 in 2021 are now facing thousands of dollars in out-of-pocket medical costs from their hospitals, doctors, and ambulance companies. When the pandemic first started in 2020, doctors and hospitals were waiving fees such as co-pays and deductibles, when it came to Covid patients. That is no longer the case, leaving many people surprised with devastating out-of-pocket medical bills of $3,000 or more. Find out how you can avoid these debilitating costs this year. 

Average Medical Charges

evelope with the words final notice on it coming out of a red mailbox
People have been getting astronomical medical charges due to Covid hospitalization and treatment. 

The average Covid hospitalization costs approximately $40,000, researchers have found; many patients with job-related or self-purchased private insurance who did not have a waiver for medical services had to pay on average about $3,800 out-of-pocket for hospital care or other medical services due to Covid.

The study also suggests that insurer cost-sharing waivers for COVID-19 hospitalizations don’t always cover all hospital-related care. Overall, about 71% of insured patients who had a waiver still received a bill for any hospitalization, with an average cost of $788. 

So why were Covid patients required to pay so much more out-of-pocket medical bills in 2021 than they were in 2020? Well, as already pointed out above, most insurance companies stopped waiving fees,  changing their policies once the Covid vaccines became readily available to the public. 

“Many insurers claim that it is justified to charge patients for COVID-19 hospitalizations now that COVID-19 vaccines are widely available,” said study lead author Dr. Kao-Ping Chua, a health policy researcher and pediatrician at Michigan Medicine in Ann Arbor.

“However, some people hospitalized for COVID-19 aren’t eligible for vaccines, such as young children, while others are vaccinated patients who experienced a severe breakthrough infection. Our study suggests these patients could [have] substantial bills,” Chua said in a university news release.

How Can You Avoid These Charges?

The first way to avoid these charges? Protect yourself by getting the Covid vaccine. With that being said, even if you are vaccinated, you can still get a breakthrough infection, and you can still expect a bill if you seek care. So, the best way to avoid these charges is with a comprehensive and affordable health insurance plan: there are plenty of health insurance plans that will cover the majority of the costs, you just need to find the right one. In fact, with the right insurance plan, you could receive a waiver if you are hospitalized due to Covid, saving you usually around $2,000 or more.two hands shaking with a red heart in the background

Fortunately, you still have time: the Open Enrollment Period (OEP) has been extended until January 15 this year, so speak to an EZ agent now about how to enroll in a great plan without having to wait for a Special Enrollment Period qualification. Nobody should have to go without health insurance, especially during these difficult times, so if you would like to review options in your area, contact a local licensed EZ agent. Our agents are highly trained and work with the top-rated insurance companies in the nation, making comparing plans fast and easy. To get free quotes, simply enter your zip code in the bar above, or to speak with a licensed agent, call 888-350-1890.

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