4 EZ Tips For First Time Health Plan Shoppers

The world of health insurance can be intimidating. There are so many industry terms, as well as different types of plans with different coverage options and prices. Doing all of the necessary research to find the plan that fits your needs can feel overwhelming. You can opt for a short-term insurance plan that offers the basics and are fairly cheap, or a more comprehensible insurance plan. On top of trying to figure out which type of plan suits you, there are ways to save money on insurance that you could miss out on if you don’t know where to look. Here at EZ, we understand how intimidating it can all be, which is why we have some tips for making the process a little less unnerving. 

1. Know The Terminology health insurance terms around the word health insurance

The first thing you should do when jumping into the world of health insurance is familiarize yourself with the terminology. All of these terms can seem confusing, but they don’t have to be. Here’s a breakdown of some of the most important ones to know:

  • Premium– the fixed monthly rate that you pay the insurance company to cover you and your family. Premiums do not count  towards meeting your deductible.
  • Deductible a fixed amount you must pay before the insurance company either reimburses you or covers medical expenses. For example, if your deductible is $1,500, and you go to the doctor and get a procedure $3500 done, then you must pay $1500 first. Then, your company should take care of the last $2000, minus the amount of coinsurance you owe.
  • Coinsurance Once your deductible is met, any insurance-covered procedure, treatment or service will result in a medical expense. The most common division of coinsurance is 80/20- health insurance companies pay 80%, you pay the remaining 20%. For example, in the above-mentioned scenario, you would have to pay 20% of it $2,000. 
  • Copayment– a set amount you pay whenever you use a specific type of healthcare service. You can have a copay for primary doctor visits, specialist doctor visits, ER visits, as well as pharmaceutical copays on prescription drugs.

2. Know Your Budgetcalculator next to a paper with pens on it and coins below it

Before you start choosing specific insurance plans, weigh how much you are willing and able to pay for health insurance against your healthcare needs. Are you relatively healthy and just need the basics, or do you have a chronic condition and need more comprehensive coverage? These factors will play a big part in how much your monthly premiums will be versus how much your deductible will be. 

If you are healthy, then a high-deductible health plan might be your best option. These plans offer low premiums and a high deductible- the thinking behind choosing a plan like this is that, since you are healthy, you will hopefully never have to pay your full  deductible. It sounds like a bit of a gamble, but it can be worth it to save money on premiums.

If you need more coverage, then an ACA plan, or private plan that is offered by brokers or agents will work best because these plans offer more comprehensive coverage. There are different types of plans such as HMO plans with limited network coverage, and PPO plans that offer more in-network coverage (which costs more).

3. Know How To Save Money

After you’ve explored the different plan options available to you, don’t forget to look into the money saving options that come with some of these plans! You can save some extra money with:

    • Subsidies– If you make between 100%-400% of the poverty line, then you are eligible for subsidies when purchasing plans on the ACA Marketplace. There are different kinds of subsidies:
      • Cost-sharing reductions- Cost-sharing reductions are discounts that lower your deductibles, copayments, and coinsurance. Your eligibility for these extra savings is determined by your household income.
      • Advance Premium Tax Credit– This is a tax credit that you can use to lower your monthly premiums. When applying for Marketplace health insurance, you estimate your expected income for the year. If you qualify, you will receive an advance tax credit that you can apply to the cost of your monthly premiums.
  • pile of coins growing in a row with a persons hand holding coins over the last pileHealth Savings Accounts (HSAs)- If you do go the route of getting a high deductible health plan (HDHP), then an HSA will help you save money. These accounts allow you to save up money to use for qualified medical expenses.You can contribute money to this account tax-free and allow it to roll over every year, but you can only have one of these plans alongside a qualified HDHP.  

4. Get A Good Agent

If you are in the market for a health insurance plan, eliminate the hassle of doing all the research yourself and contact an agent. EZ.Insure offers highly trained agents in your area who can answer questions about all of these topics, and more. With us, you’ll speak with an actual human being, not an automated phone system. We will provide you with your own personal agent who will search and compare all available plans in your area, for free. Get the answers you are looking for quickly and at no cost. No pressure, no gimmicks. To get instant quotes, enter your zip code in the bar above. Or if you would like to get specific answers, speak to an agent by calling 888-350-1890.

Healthcare Mergers Continue, What This Means For Consumers

Healthcare boundaries have recently begun to blur, starting with CVS and Aetna merging, and continue to blur. Insurance companies, doctors, and hospitals have teamed up in order to cut costs due to the Republicans halting subsidy payments. The halt will cut some federal programs funding. Now, UnitedHealth has plans to buy a large physician group, DaVita. These mergers are an attempt to provide quality care for consumers at affordable lower costs.

Because Republicans halted subsidy payments, companies are beginning to merge.
Because Republicans halted subsidy payments, companies are beginning to merge in order to save and provide quality care.

First CVS and Aetna have plans to create “hubs” for customers to come in and receive care, which will result in better care at a lower cost. Now, joining the bandwagon, UnitedHealth’s Optum unit plans to merge with DaVita to do the same.

The Plan

UnitedHealth Optum manages pharmacy benefits and provides health services. The merge will now add more doctors to UnitedHealth’s existing 30,000 doctors, giving people more variety within their network.

DaVita is a for-profit organization that has chains of dialysis centers. They operate nearly 300 clinics that serve 1.7 million patients across six different states. The states are California, Florida, Colorado, Washington, New Mexico, and Nevada. They will add to UnitedHealth’s 250 Med Express urgent care centers and 200 surgical centers.

“I am so proud of the DaVita Medical Group accomplishments, including our excellent clinical outcomes,” said Kent Thiry, DaVita chairman and CEO. “The combination of DaVita Medical Group and Optum should lead to even higher levels of performance.”

In a statement, Larry C. Renfo, Optum’s chief executive said “Combining DaVita Medical Group and Optum advances our shared goal of supporting physicians in delivering exceptional patient care in innovative and efficient ways.”

The merge between UnitedHealth and DaVita is hopeful for the future of healthcare costs and care.
The merge between UnitedHealth and DaVita is hopeful for the future of healthcare costs and care.

When This Will Happen

The $49 billion merge is expected to close next year.  The goal is to offer clinics that give a lot of the same care an emergency room at much lower rates. They will offer nearly 50 percent cheaper costs for procedures such as outpatient surgery.

Other industries are taking note of UnitedHealth Optum’s move, making it appealing for them to create a design of their own possible merge. As insurance companies, doctors, hospitals, and pharmacies begin to unite, it seems that not only will they benefit, but consumers as well. Healthcare lines continue to blue with these mergers. If all goes accordingly, then consumers will be offered a large range of doctors, and quality care at almost half the costs.