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Catastrophic Plans Can Be Confusing, Let Us Help

The cost of health insurance is not one size fits all. If you’re healthy, under 30, and facing financial hardship, you could have some cheaper options available to you. For people in these categories, Catastrophic health insurance plans can provide essential health benefits without breaking the bank with monthly premiums. However, you should know that, while premiums on these plans are low, they have high deductibles. If you remain healthy, then your high deductible won’t be a problem, but if you have an accident or become ill, you could end up with huge medical bills. Before you decide if a catastrophic plan is right for you let’s take a look at how they work.

Who These Plans Are For

homeless person sitting outside with a black bag full of clothes — *Catastrophic plans are ideal for people dealing with hardships such as homelessness.*

Catastrophic plans are designed for individuals who are young or struggling to afford health insurance. Not everyone qualifies for these plans. They are only available to people who are:

Under 30 or are over 30 and meet the guidelines for a hardship exemption. This includes people whose plan was canceled by their insurer or small group employer.
Dealing with hardships such as homelessness, eviction, foreclosure or bankruptcy, domestic violence, or medical debt
Considered low-income and cannot afford insurance

These plans have the lowest premiums of any plans on the ACA exchanges, but they also have the highest out-of-pocket costs.These plans do not have a copayment or coinsurance and premiums will vary depending on where you live. Generally all plans have the same high deductible: deductibles were $7,900 for 2019, and they have risen to $8,150 in 2020. Once you meet your deductible, then the insurance company will pay for all covered services.

Who They Are Not For

weekly pill container filled with pills in it with Tuesday tab open. — *If you are unhealthy with a condition, then these plans are not right for you.*

Do you see the doctor often? Do you need a lot of coverage? Do you plan on starting a family in the next year? If you answered yes to any of these questions, then a catastrophic plan is probably not the best choice for you. Because of their high deductibles, these plans are not for people who have health conditions that need constant attention. In this case, you will probably want to look for a plan with a lower deductible, even if it means a higher premium.

If you are over 30 or do not qualify for a hardship, then you can look into getting a Bronze level plan on the ACA Marketplace. These plans are very similar to Catastrophic plans, but with slightly higher premiums and without the same qualification requirements of Catastrophic plans. Even if your income isn’t low enough for a Catastrophic plan, you may still be able to get subsidies for a Bronze plan.

Just The Essentials

Catastrophic plans must include all of the ACA’s benefits, and include some free preventive care. These plans cover:

Outpatient services
Catastrophic plans cover the 10 essential benefits such as lab work.
Emergency services
Hospitalization
Pregnancy, maternity, and newborn care
Mental health and substance use disorder services, including behavioral health treatment
Prescription drugs
Rehabilitative and habilitative services and devices
Lab work
Preventive and wellness services, and chronic disease management
Pediatric services, including oral and vision care

Catastrophic plans aren’t for everyone. If you’re unsure what plan is right for you, come to EZ.Insure for help. We understand how intricate the insurance world is, and because we have been in the industry for over 10 years, we can offer you free expert advice on which direction you should go in. To get free quotes, enter your zip code in the bar above, or to speak directly to one of our experienced agents, call 888-350-1890.

Making The Most Of Your High Deductible Health Plan

High deductible health plans are rising in popularity, with more companies offering them and even more people purchasing them individually. These plans definitely have benefits, like their lower premiums, and they can be great for healthy people on a budget. On the other hand the high deductibles of these plans can be a problem, because going to the doctor or hospital can mean being stuck with a big bill. Or knowing you have a high deductible to meet might make you think twice about seeking care, and you might end up ignoring symptoms until things get worse. However, there are ways to make the most of your high deductible health plan while getting the care you need and saving money.

Utilize Your Freebies

Under the ACA, all insurance plans must provide coverage for some preventive health services with no out-of-pocket costs- this applies to high deductible health plans. These free preventive services will not have a copay and do not count towards your deductible. You can expect to get free vaccines, cholesterol and blood pressure screenings, birth control, and some cancer screenings such as mammograms and colonoscopies.

Check with your insurance plan’s details and be sure to stay in-network to avoid unexpected costs; these services are free but you still have to stay within your plan’s network.

Ask For Discount

If you are sick and need to seek treatment, but are worried about a high medical bill, ask your provider if they offer any discounts. Some doctors’ offices will offer a discount if you pay with cash, or you can ask your doctor for a discount on a service that you will have to pay for entirely out-of-pocket. If they do not offer any discounts, then ask if they offer payment plans so you can avoid medical debt.

black silhouette of a piggy bank with a gold dollar sign in the middle — *HSA accounts have triple tax advantages which can help you save money for medical expenses.*

Triple Tax Advantages With HSA

One of the major benefits of having a high deductible health insurance plan is the ability to have a health savings account (HSA) alongside it. HSAs allow you to put money aside, pre-tax, to help you pay for qualified medical expenses. These accounts offer a triple tax advantage because:

Contributions are tax-deductible
Contributions roll over and can continue to grow tax-free into the following year
Withdrawals are not taxed if you use them for qualified medical expenses.

Take note that unqualified expenses incur a 20% penalty.

Stay In Network

This is said a lot, but it is worth repeating. In order to avoid major out-of-pocket expenses, you must stay within your plan’s network. When you have a high deductible plan, it is especially important to stay within the network to avoid extra charges. Only in-network services will count towards meeting your deductible; any care you get outside of your network will not count. Make sure to double check with your insurance company and doctor’s office that any specialists you are referred to are in your plan’s network.

Do you have a high deductible health insurance plan? Are you considering one? If you are in need of help, EZ.Insure is here for you. We provide accurate quotes on all plans in your area, and our trained agents will go over each plan and will find one that fits your needs and budget. To get free quotes, simply enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

Is Medicare For All Coming? Here’s Why You Should Check Your Insurance Options Now!

The Medicare for All debate is full of disagreements between politicians in regards to it’s future. Some Democrats advocate for the single-payer healthcare system that would eliminate private health insurance companies, while others push for a government option. Republicans, on the other hand, are in favor of sticking with a private system and getting rid of the ACA. All of this uncertainty about the future of health insurance brings an uneasy feeling. Medicare for All might happen, and the ACA might disappear. No matter what the outcome, health insurance is in a safe place right now with affordable plans. There is no better time than now to check your insurance options and find a good policy.

What Is Medicare For All?

group of people with a huge red heart in the babkground — *Medicare for All is a government-run system that would replace private health insurance offered through employers.*

Under Medicare for All, a government-run system would replace private health insurance offered through employers. This single-payer system would be paid for by tax dollars, and Americans would no longer pay premiums, deductibles, or any point-of-service costs for healthcare. While some see this as a good thing that would ensure healthcare for everyone, others see it as a potential disaster that would cost too much and create long wait times for care.

A poll from the nonpartisan Kaiser Family Foundation found that 56% of Americans support Medicare for All. When people were told it could lead to higher taxes, support fell to 37%. When asked whether they would still support it if it led to delays in care, the number fell to 25%.

However, as of now, talks of Medicare for All have been silenced; in fact, any talk regarding the future of health insurance for the U.S has been notably nonexistent. Where will this leave the health insurance industry after elections? Where will this leave you? Will Medicare for All take over? Will you have the option for private insurance, and if so, will the prices rise to unobtainable rates?

The Future Of The ACA Marketplace

On the other side of the aisle, Republicans have a less concrete plan for how to move forward. Their plan is still pushing for the repeal of the ACA: Republicans have been trying to get rid of the ACA since it was introduced by former President Obama. As of now, 18 Republican attorneys general are still planning to participate in a lawsuit that could mean the repeal of the Affordable Care Act within a year. If the ACA were to be dismantled, over 20 million Americans would lose health insurance.

The threat of repeal is causing uncertainty about the future of healthcare because, as of now, no Republican lawmakers have proposed a replacement plan.

A Lot Of Uncertainty

Medicare for All is a faraway dream (or nightmare, depending on who you ask) right now, and both political parties have been generally vague about their future plans for healthcare. It is better to be covered now with a secured policy than wait until the industry changes, when there are likely going to be fewer options for coverage and higher prices. Even insurers are uncertain about prices and what they expect healthcare to look like. Usually they have an idea, but not this time.

One thing that is certain is that there are still affordable ACA plans and private health insurance plans available. Currently there are a range of plans, with different coverage and prices that can meet your health and financial needs. Recently, more ACA insurance companies announced that they have expanded into new counties around the U.S. This means there are more options than ever for getting covered. It’s a good time to take advantage of the choices available and get grandfathered into a plan, in case the insurance market changes drastically in the future.

Doing the research can be a lot of work. It can feel overwhelming when you have to compare different plans to find the one that meets your needs. We get it, and that is why EZ.Insure is here to help. We won’t try to make a profit off of your confusion, we just want to help you make an informed decision. We will provide you with your own agent, who will go over all of the coverage options and prices, and guide you towards the best plan for you for free. To get started, simply enter your zip code in the bar above, or to speak directly to an agent, call 888-350-1890.

Is It Time For A New Doctor?

The relationship you have with your doctor is an extremely important one. If you have established a great relationship with your doctor, then consider yourself lucky. Unfortunately though, not all doctors will be a good fit for everyone. If this is your case, it might be better for your health if you find a new physician.

You’re not alone if you want to make a change: according to a study conducted by the Journal of Family practice, 20% of patients studied changed their doctors over a period of 3 years. Is it time for you to move on? Here are some of the clear signs that it is time to dump your doctor, and find a new primary care physician.

persons hand with the watch being shown — *Waiting too long to see your doctor or to get an available appointment is not okay.*

You Can’t See Your Doctor

When you go to see your doctor, do you actually see your doctor? Or are you usually seen by the Physician’s Assistant or a nurse? There is nothing wrong with being seen by a PA or nurse, but if you are seeking care from a specific provider, you should get that.

When you need to see the doctor, can you get an appointment in a timely manner? These are all things to take into consideration. If you never get to see your doctor when you need to, or if you need to make appointments weeks or months in advance, then it is time to find a doctor that has time for you.

Your Doctor Is Unresponsive

If you need to speak with your doctor, do you wait for a long time for them to get back to you? Do you find yourself leaving multiple voicemails and sending many messages? Nothing is worse than not feeling good, or needing a refill on prescription medications, and not getting an answer back from your doctor.

And when you are actually speaking with your doctor, are they open to exploring your ideas or just interested in selling products or getting their other work done while you talk? This brings us to another huge red flag: feeling like you’re not being heard.

You’re Tired Of Not Being Heard

caucasian man with a white button up lifting his glasses above his eyed looking down — *If your doctor doesn’t take your concerns seriously then it might be time for a new one.*

There may be times when you express your concerns to your doctor, and they brush it off as being tired or stressed. Your doctor doesn’t take your concerns seriously and won’t order tests or recommend any form of treatment. Unfortunately this happens more often than it should, and if it happens to you, it is a very good reason to consider finding a new care provider. You should absolutely be able to question your doctor, get answers, and consider alternative diagnoses and treatments. Your health might depend on it.

You Always Feel Rushed

Not being listened to by your doctor is extremely frustrating, but just as bad as not being listened to is being rushed through appointments. If your provider is giving off impatient signals like checking their watch, the clock, sighing when you ask questions, or beginning to walk towards the door when you ask a question or are in the middle of conversation, then it might be time to seek care elsewhere.

You Just Feel Like You Need More

woman with her hands covering her face — *If you feel that your doctor does not make your health their top priority, then it is time to see a new doctor.*

Sometimes you just can’t put your finger on it. Maybe you feel like your doctor sees patients as just another number. Or maybe it’s something more concrete, like their office feels very disorganized, and they make billing mistakes, lose paperwork, overcharge you, or cancel appointments. Either way, if something doesn’t feel right to you, then move on.

Remember, you deserve more. If you feel that your doctor does not make your health their top priority, then it is time to see a new doctor. This is especially true if you are dealing with health issues, and your doctor is simply not listening or seeking the tests or treatment you need. You shouldn’t feel bad or disloyal for wanting more for yourself and your health. Take control of your health, even if that means getting a new doctor that makes you feel more cared for.

Saying goodbye to your doctor is not easy, especially if you have been with them for a long time. Finding a new doctor can be a challenge, but you can make your search easier by checking with your insurance company. Take the time to research and read reviews about different doctors after finding out which ones are in your provider’s network. This can take some time, but finding a doctor that you can trust is better (and more important) than settling for the one you have.

Can You Get Health Insurance at Any Time?

If you are unhappy with your current health insurance policy, then it might be time to shop for a different plan. But can you purchase a new plan at any time? Yes, and no. For marketplace plans, once the open enrollment period (November 10 to December 15) is over, you generally cannot get a new plan. The open enrollment period for employer-based insurance might be at a different time of year, but you will still only be able to change your plan during that enrollment period. In most cases, if you want to get health insurance or change your plan outside of the open enrollment period, you will need to qualify for a Special Enrollment Period (SEP). SEPs open up when you experience what is known as a qualifying life event.

Qualifying Life Events

caucasian couple hlding a baby girl in the middle while both are kissing each cheek — *You can get health insurance outside of open enrollment if you qualify for SEP such as getting married or having a baby.*

You have 60 days to change your plan if you:

Got married
Had a baby, adopted a child, or took in a foster child
Got divorced or legally separated. However, if you do not lose coverage due to divorce or legal separation, then you do not qualify for a Special Enrollment Period.
Had someone on your marketplace plan die
Changed residence. If you move to a new home in a new ZIP code or county, move to attend school, are a seasonal worker and move between job and home, or move from a shelter or other transitional housing to a permanent residence, you will qualify for an SEP.
Lost your health insurance. This includes losing job-based coverage, losing a plan you bought yourself, losing eligibility for Medicaid or Medicare, and losing coverage through a family member.
Gained membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
Became newly eligible for Marketplace coverage because you became a U.S. citizen
Left incarceration
Started or ended service as an AmeriCorps State and National, VISTA, or NCCC member

Short-Term Medical Plans

If you do not qualify for any of the life events listed above, all hope is not lost. You can enroll in a short-term medical plan. Short-term health insurance provides fast, flexible insurance with many benefits. These plans can be extended up to 3 years, and you can pick your deductible amount from many options. You are also able to drop coverage without a penalty if you want to change to a long term insurance option. Premiums are lower than ACA health insurance plans, and you get coverage as soon as a day after applying.

It is important to understand that short-term insurance is temporary and not ideal for those who require more comprehensive coverage or have health conditions. Short term plans are not guaranteed-issue, meaning they do not cover pre-existing conditions. They only cover the basics.

Do you qualify for a special enrollment period? If not, are you considering a short-term health insurance plan to hold you over until open enrollment begins? EZ.Insure can help. We offer accurate health insurance quotes based on your specific region, free of charge. That’s right. We will provide you with an agent who will compare all available plans for you, and help you choose a health insurance plan that is based on your health needs and budget, for free. To get your free quotes, simply enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

Is My Provider In-Network? What If They Aren’t?

Having health insurance is the best way to help keep healthcare costs manageable. When you are signed up for a health insurance plan, you have the peace of knowing that you are covered for many medical services. However, there are some cases when you may not be covered, and you may have to pay for care out of pocket. One example is receiving care from an out-of-network provider.

What Does Out-Of-Network Mean?

red arrow going up in a graph. — *If you agree to have treatment or services from this provider, then you will have to pay more out of pocket.*

A “network” in health insurance speak refers to the healthcare providers whose services are covered by your plan. Health insurance companies make agreements with providers, and these providers then participate in the insurance company’s plan with negotiated rates for services.

Being “out-of-network simply means that a doctor, or provider, does not participate, or have a contract, with your insurer. If you agree to have treatment or services from this provider, then you will have to pay more than you would have if you had gone to an in-network provider. Most plans offer some out-of-network coverage. HMO plans, for example, will usually cover out-of-network emergencies. Some plans may also offer limited reimbursement, but generally you should be careful about receiving out-of-network care, as you could end up with a giant bill.

What To Do If You Are Not Sure

Always check with your insurance company if you are uncertain whether a specialist or hospital is in-network. In some cases, your primary care physician may send you to a specialist who is out-of-network. If you don’t check ahead of time, then you may be left with a hefty bill after receiving care you assumed you were covered for.

What To Do If You See A Doctor Out-Of-Network

caucasian womans hands holding a white cell phone. — *You can request a network gap exception from your insurance company.*

There is something you can do if there is a specific out-of-network specialist that you need to see, or if you are out of town and need to go to a hospital that is not in your network. You can request a network gap exception from your insurance company. This basically means that you are asking your insurer to cover an out-of-network service as if it were in-network.

If your network gap exception is approved, then you will only have to pay your usual copays and deductible for the out-of-network care you receive. However, you will only be granted one of these exceptions if your insurance company agrees that there is no other way you can get the care you need because their network is too narrow. It is rare for insurance companies to approve these requests because they will end up paying for the extra costs.

If your insurer will not grant you the network gap exception, then you should first find out how much your out-of-network costs will be before you go seek the necessary care. You can then try to negotiate a discount or payment plan with the out-of-network doctor. If you are looking to treat a chronic condition and will need to see a particular specialist that is not in your network, then it might be time to consider another health insurance company or plan.

Shopping around is your best option to save money on necessary health services. EZ.insure can compare all the available plans within your region, and provide you with quotes within seconds. We will provide you with an agent who will search all the plans and help you find the one that covers any special care you need, for free! This will help you save more money, while still receiving the care you need. To get started, enter your zip code in the bar above, or to speak with an agent directly, call 888-350-1890.

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