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Does Health Insurance Cover Treatment for Opioid Addiction?

If you’ve been paying attention to the news and other forms of media in the last few decades,  you’re probably well aware that we have been struggling with an opioid addiction epidemic in this country for many years now. According to the CDC, the opioid epidemic began in the 1990s, when overdose deaths involving prescription opioids surged, and deaths have been steadily increasing since 1999. But a clear second wave of this epidemic began in 2010,  and with these  highly addictive medications still being prescribed in the United States, abuse of them is not likely to end any time soon. So what can health insurance companies do to help people who are dealing with an opioid addiction? Do health insurance plans provide coverage for treatment?

The Mental Health Parity and Addiction Equity Act

gray illustration of a gavel
The 2008 Mental Health Parity and Addiction Equity Act requires health insurance and group health insurance plans to provide benefits for mental health and/or substance abuse treatment.

In 2008, the Mental Health Parity and Addiction Equity Act was passed, which requires health insurance and group health insurance plans to provide the same level of benefits for mental health and/or substance abuse treatment and services that they do for medical and surgical care. In short, insurance companies are now required to provide some form of both mental health care and substance abuse treatment coverage to members. In addition, the ACA regards substance abuse treatment as an essential health care benefit, so most insurers cannot completely deny coverage for treatment of substance abuse.

With that being said, your specific coverage for rehab and detox programs will depend on the state where you purchase your healthcare plan, and the specific plan that you choose, such as a PPO or HMO plan, as well as the treatment program you choose. For example, in some cases, if you are seeking  treatment, you will have to get a referral from your  primary care physician before your  insurer will pay for treatment. And while some insurance plans will cover 100% of detox and treatment expenses once you meet your deductible, others will require you to pay copayments for each service the facility charges for.

Which Insurance Carriers Cover Substance Abuse Programs?group therapy

Many health insurance companies provide substantial healthcare plans that will cover treatment for opioid addiction. But, as we pointed out above, how much they cover and how much you will have to pay out-of-pocket for a specific program will vary. 

The best way to find a plan that best suits your needs is to work with a licensed agent who is familiar with all of these plans. EZ can help you in your search, since we offer a wide range of health insurance plans from top-rated insurance companies in every state. And because we work with so many companies, and can offer all of the plans available in your area, we can find you a plan that saves you a lot of money – even hundreds of dollars – even if you don’t qualify for a subsidy. There is no obligation, or hassle, just free quotes on all available plans in your area. 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.

12 Things to Know About Children’s Eyes and Vision

As children grow, their eyes go through a lot of changes, including a lot of growth and development. In fact, their eyes will grow rapidly after birth and then will continue to grow during puberty until age 20 or 21. At this point, they will stop growing in size but will continue to increase in weight, as well as undergo age-related changes. 

It is important to pay careful attention to your children’s eyes as they grow so you can catch any problems that might arise, and deal with them immediately. August is Children’s Eye Health and Safety Month, so to raise awareness this month, we have 12 things you need to know about children’s eyes and vision. cigarette butts in an ashtray

  1. Smoking can harm an unborn baby’s eyes; in addition, if a baby is born premature, as many babies born to smokers are, they are more likely to have permanent vision loss or even blindness.
  2. By 3 months old, babies’ eyes should focus and follow objects; by 5 months old, babies are seeing in three dimensions and developing perception.
  3. At around 9 months old, a baby’s eyes have nearly turned their finalized color.
  4. Strabismus, also known as hypertropia and crossed eyes, occurs in around 4% of children in the US. This condition is a misalignment of the eyes, which causes one eye to deviate inward (esotropia) toward the nose, or outward (exotropia), while the other eye remains focused. If you suspect your child has this condition, seek evaluation so it can be corrected.
  5. Young children are more likely than adults to get eye damage from chemical burns, because these burns can permanently damage the external and internal eye structures as they are developing. That means there are multiple reasons why it’s important to make sure that children don’t have access to any cleaning products or chemicals. If an accident does happen, flush their eyes with plenty of water and go to the nearest emergency room.little boy looking at a tablet
  6. Looking at a TV screen or tablet too much can cause myopia (nearsightedness), and digital eye strain. In order to prevent myopia, it is important to have your children follow the 20-20-20 rule: make sure they look up from the screen every 20 minutes and focus at least twenty feet away for at least 20 seconds.
  7. There are some more subtle signs of childhood vision problems you should be aware of, including loss of interest in activities that they used to enjoy, losing their place when reading, and turning their head to look at something in front of them.
  8. Many people think that only older adults get cataracts, but children can get cataracts, too- they can either be born with them or develop them after birth.
  9. Taking photos of your children can help to diagnose certain eye problems. If you see what’s known as a “red reflex” on their eyes in a photo (a reflective phenomenon that creates a reddish-orange glow when light passes through the pupil and is reflected back off the retina to a viewing aperture) this is a warning sign that something might be wrong with your child’s eyes. Also, if there is a reflection of the camera flash off the retina that is white, yellow, or black in one or both eyes, this is also a sign that something is wrong.
  10. Color blindness is more common in boys than in girls, but it can be harder to detect. One of the signs to look out for is the inability to tell the difference between shades of the same or similar colors.
  11. Eye injuries are the most common cause of vision loss in children, and most often occur when they’re playing sports. Eye injuries can be prevented by having your child wear protective goggles when they are playing sports such as baseball, basketball, football, etc.
  12. Eyes can get sunburned just like skin can – a condition called photokeratitis – which causes pain, redness, and tears. Make sure your children (and you) wear sunglasses to protect their eyes from harmful UV rays.

    little boy in black glasses
    It is very important to get your children’s eyes checked as recommended by The American Academy of Ophthalmology.

Getting Checked Regularly

Eye health is very important for your children, especially as they are physically developing, and learning in school. That’s why you should never skip their regular vision screenings; these screenings can help detect and correct any eye problems early before they get worse. The American Academy of Ophthalmology recommends vision screenings for children when they are in preschool and elementary school, as well as if they are experiencing any vision problems. 

Taking your child to the eye doctor can help catch any conditions that your child’s pediatrician or school nurse cannot, but some health insurance plans don’t cover vision care – so if you are interested in a more comprehensive health insurance plan that does offer great vision care, EZ can help! Our agents work with the top-rated insurance companies in the country, and we can compare all available plans and find the best, most affordable plan for your family’s needs. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a licensed agent, call 888-350-1890. No obligation!

What Are Oral Clefts and Can They Be Prevented?

Approximately 1 in 1,000 babies in the United States each year is born with an upper lip and mouth that doesn’t form completely, a condition known as cleft lip or cleft palate. This malformation often happens early in pregnancy, generally between the 6th and 10th weeks of gestation, and can range from mild to severe. July is National Cleft and Craniofacial Awareness and Prevention Month, so to bring awareness to this issue, we want to look at what causes oral clefts and how to help prevent them.

What Causes Cleft Lip & Palate?

During the first 6 to 10 weeks of pregnancy, the bones and skin of a baby’s upper jaw, nose, and mouth normally come together to form the roof of the mouth and the upper lip. A cleft palate happens when parts of the roof of the mouth do not fuse together completely. 

Unfortunately, doctors and researchers are not 100% sure what causes oral clefts, but some believe that there are factors that can increase the risk. In general, male babies are more likely to develop an oral cleft; the other factors are usually genetic and environmental, and can include:woman holding her pregnant belly

  • A family history of oral clefts
  • Substance use during pregnancy
  • Nutrient deficiency, specifically of folic acid
  • Having diabetes before pregnancy
  • Use of certain anti-seizure medications
  • Obesity during pregnancy
  • Certain infections
  • Asian, Hispanic, or Native American descent

What Other Conditions Are Associated with Cleft Lip & Palate?

If your baby is born with an oral cleft, there could be some other complications that go beyond the physical appearance of the cleft lip and palate. Babies born with this condition can also experience:

  • Hearing difficulties
  • Speech difficulties
  • Difficulty feeding
  • Ear infections
  • Dental issues

Are Oral Clefts Preventable?

Cleft lip and palate are typically not preventable, but there are things you can do to help lower the risks of your baby developing this condition. These things include avoiding alcohol and smoking during pregnancy, maintaining a healthy weight before pregnancy, and taking at least 400 micrograms of folic acid a day before conception. It is important to note that, even if you do follow all of the recommendations for preventing oral clefts, and you still find out that your baby has developed one, it’s not your fault: this condition can happen regardless of the choices you make.

Treatment for Cleft Lips & Palateschild's cleft lip stages of surgery treatment

Children born with cleft lips and palates will need several treatments as they grow. Generally, the cleft is treated with surgery, followed by speech therapy and dental care. But before your child has surgery, there are a few techniques that can improve the outcome of the repair, including:

  • A lip-taping regimen, which can narrow the gap in your child’s cleft lip.
  • A nasal elevator, which is used to help form the correct shape of the baby’s nose.
  • A nasal-alveolar molding (NAM) device, which can be used to help mold the lip tissues into a more favorable position in preparation for the lip repair.

Around 30-40% of children with a cleft palate will need further surgeries to help improve their speech, usually after their speech is assessed between ages 4 and 5. Repairing a cleft might seem like a long process, but most children will end up being able to talk and eat without any issues with the help of surgeries and therapies.

Finding Health Insurance Coverage

One of the most important factors in getting the help your child needs for their cleft is your health insurance plan. Before purchasing a plan, make sure you understand what coverage it offers, and make sure it will cover evaluation and treatment for a cleft.

If you’re not sure what plan is right for you, speak to an EZ agent! EZ agents are highly trained and knowledgeable, and will sort through all available plans to make sure that you’re completely covered throughout the lengthy process of repairing your child’s cleft. 

We offer a wide range of health insurance plans from top-rated insurance companies in every state. And because we work with so many companies, and can offer all of the plans available in your area, we can find you a plan that saves you a lot of money – even hundreds of dollars – even if you don’t qualify for a subsidy. There is no obligation, or hassle, just free quotes on all available plans in your area. 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.

What Is a Health Insurance Plan Grace Period?

Health insurance plans need to be renewed every year. In some cases, your policy will automatically renew, but there are times when you will have to renew it on your own by speaking with your health insurance company. If you’re in this situation, and you fail to renew your health insurance policy before it expires, your insurer will usually give you more time, or a grace period, so that you can renew your plan. But once this grace period passes, your health insurance will be terminated, leaving you uninsured.

How Long Is the Grace Period?

calendar with a clock next to it
Typically the grace period for health insurance renewal will be anywhere from 15 to 30 days after your policy’s expiration.

The grace period that your insurance company offers can vary, but typically the grace period for health insurance renewal will be anywhere from 15 to 30 days after your policy’s expiration,  depending on the insurance company and the type of policy that you have. It’s important to note that your health insurance company isn’t required to offer you a grace period. If they do offer one, though, and you fail to pay your premium within this time, your policy will expire, and you will lose all the benefits and privileges you have earned over time. 

What Happens If You Miss Your Grace Period?

One of the biggest drawbacks of ignoring your grace period is that you will end up without health insurance coverage, which can be very dangerous. If you fall sick or have a medical emergency in this case, you will have to pay for any treatment completely out-of-pocket, which could be thousands of dollars. 

If you do let your policy lapse, you can purchase another one, but you might have to wait until Open Enrollment, and then you will have to wait for the plan to go into effect once you purchase it. There are other benefits that you will lose if you fail to renew your policy, including:

  • No-claim bonus– A no-claim bonus is a feature that some health insurance policies offer as an incentive for policyholders who do not make any claims throughout the year. Your insurer might give you a cumulative bonus, or a discount on your premium if you go a year without making a health insurance claim. These cumulative bonuses could mean that your coverage amount for the next year will increase, while your premium will remain the same.
  • A cheaper policy- The policy that you currently have will most likely be cheaper than a new policy. A new policy will cost you more because health insurance costs are on the rise; not only that, but you will be another year older when you apply for a new policy, which will generally mean paying higher premiums.hourglass with sand in it
  • No waiting periods for coverage of pre-existing conditions – Insurance companies can no longer deny you coverage for pre-existing conditions, but they can still have what’s called a pre-existing condition exclusion period. This means that they can limit or exclude benefits for a certain period of time, meaning some newly-purchased health insurance plans can have up to a 24 to 48-month waiting period for coverage for some pre-existing conditions. If your health insurance lapses, and you need to buy a new policy, your waiting period will restart from the beginning.

Looking For An Affordable Plan?

If you have missed your insurance plan’s grace period, and you are uninsured, come to EZ.  With our help, you can find an affordable plan: we offer a wide range of health insurance plans from top-rated insurance companies in every state. And because we work with so many companies and can offer all of the plans available in your area, we can find you a plan that saves you a lot of money – even hundreds of dollars – even if you don’t qualify for a subsidy. There is no obligation, or hassle, just free quotes on all available plans in your area. 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.

The First Signs of Juvenile Arthritis

If your child is complaining of aches and pains in their joints, you might just write them off as growing pains. But you should be aware that consistent joint pain in children can actually be a condition called juvenile arthritis, which is a chronic disease. Nearly 300,000 children under the age of 18 are affected by juvenile arthritis in the U.S., so the next time your child complains of joint pain, consider the fact that it could be one of the types of this condition. It’s important to know the symptoms so you can catch it and treat it early on.

What Is Juvenile Arthritis?

skeleton hand
Arthritis causes persistent joint inflammation and can cause problems with bone development and growth. 

Juvenile arthritis is an inflammatory disease in which the body’s immune system attacks healthy cells and tissues. Arthritis causes persistent joint inflammation; oftentimes it’s mild and does not progress to a more severe joint disease or deformities, but if left untreated it can cause serious joint and tissue damage. Not only that, but arthritis can cause problems with bone development and growth. 

This condition is idiopathic, which means that there is no exact known cause for it, but researchers believe that it might be related to genetics, certain infections, or environmental triggers. 

Different Types of Juvenile Arthritis

There are several types of juvenile arthritis. It’s normally classified based on what symptoms the child presents with, the number of joints that are affected, and the presence of markers in the blood when a blood test is performed. The different types of juvenile arthritis include:

  • Systemic arthritis– Also called Still’s disease, this type of arthritis can infect the entire body. It usually causes a high fever and rash on the arms and legs, and can affect internal organs such as the heart, spleen, and lymph nodes.
  • Oligoarthritis–  Also called pauciarticular juvenile, this type of arthritis is often outgrown by adulthood. About 50% of children with juvenile arthritis have the oligoarticular type. It affects girls more often than it does boys, with girls younger than 8 years of age most likely to develop it.
  • Polyarthritis–  Also called polyarticular juvenile idiopathic arthritis (pJIA), this type affects 5 or more joints in the first 6 months of having the disease. It can affect the joints in the jaw and neck, as well as in the hands and feet. This type is also more common in girls than in boys.
  • Enthesitis-related arthritis– This type of arthritis affects the hips, knees, ankles, eyes, and any places where tendons are attached to bones. This type of arthritis occurs mainly in boys who are older than 8 years.
  • Psoriatic arthritis– This type of arthritis causes both arthritis and the skin disorder psoriasis. 

Symptoms

Juvenile arthritis will affect all  children differently, but some symptoms to look for include:child laying in bed with a thermometer in his mouth

  • Joint stiffness
  • Pain, swelling, and tenderness in the joints
  • Persistent fever
  • Rash
  • Weight loss
  • Limping
  • Fatigue
  • Irritability
  • Blurred vision
  • Redness of the eyes or eye pain 

Treatment

The best way to beat juvenile arthritis is to catch it early on and get treatment as quickly as possible. To diagnose it, your child’s doctor will order blood tests, review your child’s medical history, and might even request x-rays to look for injuries, to rule out other conditions. 

If there are signs that your child has juvenile arthritis, a treatment plan to help control inflammation, relieve pain, and prevent any joint damage will be created. Treatment can include exercise, as well as medications that can treat pain and swelling, including:round white tablets

  • Nonsteroidal anti-inflammatory drugs – You can often find these over the counter; they include drugs like ibuprofen and Naproxen.
  • Slow-acting antirheumatic drugs – These drugs treat pain and swelling over time, and can take several weeks to work.
  • Corticosteroids – These are usually prescribed as oral medication. Steroids are often avoided in children if possible, though, because they can have side effects including poor growth and weight gain.

Finding Health Insurance Coverage

One of the most important factors in getting the help you need for your child’s arthritis is your health insurance plan. Before choosing a plan, make sure you understand what coverage it offers, and make sure it will cover evaluation and treatment for juvenile arthritis. 

We offer a wide range of health insurance plans from top-rated insurance companies in every state. And because we work with so many companies, and can see all of the plans available in your area, we can find you a plan that saves you a lot of money – even hundreds of dollars – even if you don’t qualify for a subsidy. There is no obligation, or hassle, just free quotes on all available plans in your area. 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.

How to Balance Health Insurance Costs

Health insurance is a necessity, but it can be a big expense for a lot of people. That means that some people go without it in order to “save” money. But going without insurance can backfire, and end up costing you a lot in medical bills. We get it, though, the cost of some insurance plans can be surprising, or seem out of reach – but we’re here to tell you that it is possible to find affordable health insurance without breaking the bank. The best way to get started balancing your healthcare costs is to understand your plan and know what your options are.

Get Familiar with Your Expenseshand holding a calculator with the word cost on it and a hospital room in the background

There are a lot of expenses associated with your health insurance plan, and you need to know what you’ll be paying for when it comes to your plan. Here’s a breakdown of what you should be looking at:

  • Premiums– The amount you pay monthly for your plan.
  • Deductible– The amount you have to pay before your insurance company begins to pay for services. For example, you might have a $5,000 deductible, meaning you’ll have to reach that amount in out-of-pocket healthcare expenses before your coverage kicks in.
  • Copay– A set dollar amount that you pay when you visit a healthcare provider or emergency room, or for prescription medications. For example, you might have to pay $20 upfront to see your primary care physician, $30 to see a specialist, etc. 
  • Coinsurance– The percentage of costs that you will have to pay after meeting your deductible. For example, some plans will require you to pay 20% of a covered service, meaning if your health insurance plans’ allowed amount for an office visit is $100, you’ll pay 20% of $100, or $20 (if you’ve already met your deductible).
  • Out-of-pocket maximum – Health insurance plans now have a maximum amount that you will have to pay out-of-pocket for your healthcare expenses, so if you reach that limit in a calendar year, your insurance company will begin to cover your services in full.

Once you know how much you are paying for each of these parts of your healthcare plan, you can do some comparison shopping, and make sure that you have the right plan for you.

Know How to Save

Even if you’ve got a plan that works for your budget, you can still find more ways to cut down on some of your healthcare expenses.  For example, there are ways to save in the following situations:

When You Are in an Emergency

If you have a minor medical emergency, stop and think before you go to the emergency room, since a visit to the ER can be very pricey. For things that aren’t serious, try a telemedicine visit with your primary care physician, or visiting urgent care instead of waiting for an in-person appointment, or heading to the emergency room and being hit with a big bill. Depending on the situation, telemedicine or urgent care could be sufficient, and cheaper, if the issue isn’t life-threatening.

When You Need Blood Work

hand in purple gloves holding tubes of blood
Before getting blood work done, make sure the place you go to is covered under your insurance plan!

If your doctor orders blood work, make sure you find out which lab your insurance company requires you to use. Each insurance plan will cover certain labs, and some plans might require a referral or prescription, while others will not. If you go to the wrong lab, you will be stuck with a big bill for going to an out-of-network provider.

When You Need Outpatient Care

If you have to have minor surgery or a minor procedure, such as an ACL repair or a colonoscopy, you can save money by going to an ambulatory surgery center instead of the hospital. These centers will conduct same-day surgeries that cost less and are more convenient. 

Know What You Need

What exactly are you looking for in a plan? Do you have a family you need to cover?  Do you have kids who play sports, who will require a little extra coverage? Or are you single and need the bare minimum for the what-ifs? Whatever the case may be, take the time to determine what kind of plan and coverage you need. With all of the subsidies now available, there is no better time to reconsider getting a health insurance plan, or to look at your current one to make sure it covers your needs. 

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 fits your budget. 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.

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