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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:

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?

money made out of medication pills — *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:

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

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.

Can You Be Denied Coverage During the Open Enrollment Period?

The ACA Open Enrollment Period is the only time of the year when everyone can enroll in a health insurance plan. But can literally anyone enroll, or is there any reason you can be denied coverage during this time? The short answer to this question is no: the whole idea behind the creation of the Affordable Care Act (ACA) was to make sure everyone could get insurance. But being allowed to get insurance is different from insurance being accessible to all – so how does the ACA remove all the barriers to getting insurance and make everyone truly able to get the plan they need?

What The ACA Has Done for Millions

Before the ACA was passed in 2010, you could have been denied a health insurance plan simply because you had a pre-existing condition. That meant a huge amount of Americans were unable to find affordable health insurance: approximately 43% of U.S. households report having pre-existing conditions. And indeed, health insurance was out of reach for many before 2010: when the ACA went into effect approximately 46.5 million people, or 17.8% of the total nonelderly population, were uninsured.

But the ACA, with its Patients’ Bill of Rights that prohibits insurers from discriminating based on pre-existing conditions or revoking your coverage because of an unintentional mistake on an application, changed everything. 31 million people have enrolled in health insurance plans through the Affordable Care Act since it was enacted, and that is a huge accomplishment! But there has been criticism over the years that health insurance, while available to everyone, was still not accessible to everyone – but that has all changed.

President Biden’s American Rescue Plan

illustration of a cell phone with a money sign on it and dollar bills behind it — *The American Rescue Plan Act has offered more people the ability to save more money on their health insurance premiums.*

save afcad

Earlier this year, President Biden passed the American Rescue Plan (ARP), which has made health insurance far more affordable for far more people. It extended premium tax credits to more Americans by allowing people who earn over 400% of the federal poverty level to receive subsidies to purchase health insurance through the ACA Marketplace; it also requires that Americans pay no more than 8.5% of their income on health insurance premiums, and provides a larger tax credit to people who already receive financial assistance.

What all of this means is cheaper premiums! For most people, premiums will be at least $50 per month cheaper, while some people might pay $0 in premiums. With the new law:

An individual making $19,000 or less per year will not have to pay a monthly premium for health insurance.
Couples who earn less than $70,000 together will save $1,000 per month on their health insurance monthly premiums.
A family of 4 with an income of $90,000 will pay about $200 less in health insurance premiums.

The bottom line is you can never be denied health insurance coverage during the Open Enrollment Period; not only that, but insurance is now affordable for everyone, so there is no reason you can’t get a plan that is right for you. It is important to note, though, that the Open Enrollment Period is the only time you will be able to get coverage: if you miss the OEP, you will have to wait until next year’s OEP, unless you qualify for a Special Enrollment Period. Don’t let this period pass you by – it’s the perfect (and only) time to get a great affordable health insurance plan!

Need Help?

If you have any further questions, or need help finding a plan during the Open Enrollment Period, an EZ agent can help you. We will provide you with a local licensed agent who will search all available plans in your area and find the best one for your medical and financial needs. We will also double check to see if you qualify for any subsidies to save you even more money. All of our services are done in minutes and at no cost to you. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local licensed agent call 888-350-1890.

What Happens If I Don’t Do Anything During The Open Enrollment Period?

The ACA Open Enrollment Period only comes around once a year, usually lasting from November 1- December 15, although this year the deadline has been extended to January 15. During this period, you can enroll in a new health insurance plan, or make changes to your current plan. If you’re happy with your current plan, though, you might opt to not do anything at all during the Open Enrollment Period – but not doing anything can have certain consequences, depending on your situation.

You Could Get Stuck With Your Current Plan

This might not necessarily be a bad thing if you are happy with your current plan, but if your plan isn’t quite right for you, you will unfortunately be stuck with it until the next Open Enrollment Period opens up again.

You’ll Miss The Opportunity To Change Your Plan

If you don’t take the opportunity to review your current plan and do nothing during the Open Enrollment Period, you won’t be able to change your plan. What this really means is that your health insurance might:

Not provide enough coverage for the following year, which will cost you money.
Have too much coverage that you don’t need, essentially leaving you to pay for insurance that you don’t need.
Be too expensive. If you don’t change your plan during the OEP, you’ll be stuck with the rise in rates and costs for the following year.

Options Are Limited Afterwards

If you don’t have health insurance and are looking to enroll in a plan, but you do nothing during the Open Enrollment Period, you won’t be able to get a Marketplace or exchange health insurance plan – in other words, you won’t be able to get an ACA-compliant health plan. With that being said, you do have other options even if you miss the OEP, but you should be aware that they are very limited. For example, you can opt to get a short-term health insurance plan that covers the essentials and nothing more; this type of 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.

You Will Need To Qualify For an SEP

The only way to get an affordable health insurance plan that is ACA-compliant outside of the OEP is to qualify for a Special Enrollment Period, or SEP. A Special Enrollment Period is only available to those who have a qualifying life event, including: movers with boxes and a truck and houses in the background

Change in residence (moving to a different zip code or county)
Change in household size (having a baby or adopting a child, getting married, or getting divorced)
Loss of health insurance (losing employment, turning 26 and getting kicked off of a parent’s plan, or a death in the family)
Changes in income

Don’t Do Nothing…

Compare plans! There’s no harm in comparing plans and seeing your options before the Open Enrollment Period ends. But we get that it can be a headache to try and research all the different plans around, so we’re here to help! Our highly trained agents will take the time to talk with you and thoroughly explain all of your options. Once you are ready to enroll, they will search through all the plans in your area and find the right plan for you, making sure the plan fits your needs and budget. EZ always provides you with your own personal agent, so there’s never any need to worry about bouncing around from agent to agent or getting hassled by endless sales calls. To get started, enter your zip code in the bar above, or to speak to an agent directly, call 888-350-1890.

Find Out Which Premium Tax Credits You Qualify For This Open Enrollment Period

In case you haven’t heard, earlier this year, President Biden passed the American Rescue Plan Act (ARP), which extended health insurance premium tax credits to more Americans. What this means is that you can now qualify for premium tax credits that you probably couldn’t have before. So, how much can you save exactly? Well, to find out how much you and your family can save on health insurance premiums, speak with a licensed EZ agent. Our agents will make sure to find the most savings for you – you could save anywhere from $50-$1000 a month!

What Is The Premium Tax Credit?

gold money signs with a green background — *Premium tax credits help you pay for a portion of your monthly insurance premiums, so you can save more money.*

In 2014, the Affordable Care Act (ACA) established the premium tax credit so that individuals or families with low or moderate incomes could afford health insurance on the Health Insurance Marketplace. Premium tax credits help you pay for a portion of your monthly insurance premiums; you can choose to have payments of the premium tax credit go directly to insurers to pay a share of your monthly insurance premiums, or wait until you file taxes to claim them.

Do You Qualify?

Since the passage of Biden’s American Rescue Plan Act, premium tax credits are now available to individuals or families with incomes between the federal poverty line and 400% of the federal poverty line. It also requires that Americans pay no more than 8.5% of their income on health insurance premiums, and provides a larger tax credit to people who already receive financial assistance. To qualify:

You must prove you do not have access to an affordable employer-sponsored plan.
You must prove you are not eligible for Medicare, Medicaid, or TRICARE.
You cannot be claimed as a dependent by another taxpayer.
You must file a joint federal income tax return if you are married; you cannot file a married filing separately tax return (unless you’re a victim of domestic abuse or spousal abandonment).
You must have a household income that falls within a certain amount.

It is important to note that you will not be eligible for the premium tax credit if you buy a plan outside of the Marketplace or exchange.

How Much Will You Save With An EZ Agent?

Our agents are highly trained and work with the top-rated insurance companies in the nation, making it easier for them to compare plans and find ways to save you the most money. Between the premium tax credits and your agent’s comparison shopping, you can expect to see a drop in premiums of $50 a month or more! With the new law:

An individual making $19,000 or less will not have to pay a monthly premium for health insurance.
Couples who earn more than $70,000 together will save $1,000 per month on their health insurance monthly premiums.
A family of 4 with an income of $90,000 will pay about $200 less in health insurance premiums.

If you buy a health insurance plan during the Open Enrollment Period, or switch plans, you will be able to receive the tax credits. So, what better time than now to find an affordable plan and save money? Comparing plans is the best way to find an affordable plan that provides the right level of coverage for you, but 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.

How Will Your Health Insurance Plan Change in 2022?

All health insurance plans change every year: you’ve probably noticed that your prices go up, or that different things are covered from year to year. But sometimes, the rules surrounding health insurance plans also change, as they are set to in 2022. Next year, aside from the newly extended Open Enrollment Period and the Special Enrollment Period for low-income applicants, there will also be some updated rules and regulations for the ACA and the Marketplaces put into a document called the Notice of Benefit and Payment Parameters. Knowing what changes are coming next year will help you make an informed decision about your health insurance plan during the Open Enrollment Period.

Out-of-Pocket Maximum Capped

hundred dollar bills sticking out of a pocket — *New out-of-pocket maximums for 2022 are $8,700 for individuals, and $17,400 for a family.*

For 2022 health coverage, the out-of-pocket maximum, or the most you have to pay for covered services in a plan year, will be $8,700 for individuals, and $17,400 for a family. The only plans that this does not apply to are grandmothered or grandfathered plans, as well as short-term plans and fixed indemnity plans.

The proposed out-of-pocket cap for 2022 was originally $9,100 for individuals and $18,200 for families, but this was changed after the Department of Health and Human Services (HHS) listened to public comments. The HHS decided that they would lower the limits, with some health plans having out-of-pocket limits well below $8,700 for individuals. These plans include employer-based health plans and metal tiered plans for family and individuals.

And if you qualify for cost-sharing reductions, your maximum out-of-pocket limits will be even lower. You can receive cost-sharing reductions if your household income is no more than 250% of the poverty level and you select a Silver plan.

The out-of-pocket maximum for you plan depends on your household income; the new income levels and limits for 2022 are:

If your income is between 100% and 200% of the poverty level, your out-of-pocket maximum will be approximately $2,900 for an individual and $5,800 for a family.
If your income is above 200% but no more than 250% of the poverty level, your out-of-pocket maximum will be approximately $6,950 for an individual and $13,900 for a family.

A New Special Enrollment Period

If you lose your health insurance coverage because of a job loss, you qualify for a Special Enrollment Period (SEP), which allows you to buy a health insurance plan outside of the Open Enrollment Period. But what if you are on a government- or employer-sponsored COBRA plan? What happens when that plan ends? Well, if your subsidy ended on or after September 30, 2021, a SEP will open up to you. That means you now have the option to transition to a plan on the exchange after your subsidy ends; you can also receive the ACA’s premium tax credits if you are eligible based on President Biden’s new subsidy extensions.

If you need more information on the changes coming to plans for next year, or need help finding a plan during the Open Enrollment Period, an EZ agent can help you. We will provide you with a local licensed agent who will search all available plans in your area and find the best one for your medical and financial needs. We will also double check to see if you qualify for any subsidies to save you even more money. All of our services are done in minutes and at no cost to you. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local licensed agent call 888-350-1890.

Tag: health insurance open enrollment