Health Insurance Archives - Page 12 of 52

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.
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.

What Are We Doing about Health Equity in the US?

One of the good things about the Affordable Care Act of 2010 (ACA) is that it has led to a reduction in racial, ethnic, and other disparities in the healthcare system in America. But, unfortunately, it seems that it has not been enough to create health equity for everyone. We are still seeing high rates of uninsured or underinsured people in this country: in a survey released by the Centers for Disease Control and Prevention (CDC), an estimated 9.6% of U.S. residents, or 31.1 million people, lacked health insurance when surveyed in the first six months of 2021, and the numbers have not gotten much better since then.

So now, to reduce uninsured rates and help increase access to healthcare coverage, some states are taking matters into their own hands: California, Connecticut, the District of Columbia, and Massachusetts are implementing strategies in an attempt to improve health equity for all. In addition, the Center for Medicare and Medicaid Services is trying to step up efforts to get everyone equal access to care.

What Is Health Inequity?

black scale with one side lower than the other — *Health inequity is still an issue in America.*

What do we mean when we say health inequity? This term refers to the non-clinical factors (often called the social determinants of health) that can affect health outcomes for people. Some examples of things that can affect health inequity include, but are not limited to:

Redlining, which can still be seen in limited financial, educational, or health resources
Limited career opportunities
Income disparities
Neighborhood safety
Access to nutritious food

According to the Robert Wood Johnson Foundation, “Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”

And while health inequity is different from health disparity, which refers to differences between health and healthcare between different groups, it is health inequity that leads to health disparities. So how can we address this issue, and are we actually doing so effectively anywhere in the country?

Addressing Health Equity

Researchers have found that health equity goals are similar in every state, but after collecting data, the above-mentioned states are the ones that are taking further steps to apply financial incentives to improve healthcare equity among different racial and ethnic groups. Each state tracked the health equity for underserved populations using the data to identify goals to help insure these populations, and these states came out on top.

But these states and Washington D.C. have come up against federal regulations regarding healthcare that have slowed some of their progress: federal law restricts deviation in plan design to an extent. For example, when the District of Columbia attempted to create an equity-based insurance design, the district was restricted on the changes it could make to cost-sharing due to federal regulations.

CMS Involvement

But, on the other hand, in order to try and create more health equity in the entire country, and not just these four states, the Centers for Medicare and Medicaid Services (CMS) is stepping up their efforts to get healthcare to those who need it most. CMS Administrator Chiquita Brooks-LaSure has charged each CMS office with building health equity into their core work, with the aim of better identifying and responding to inequities in health outcomes, barriers to coverage, and access to care.

According to cms.gov, this includes:

Promoting culturally and linguistically appropriate services to ensure respectful care and services in people’s preferred languages, as well as to promote health literacy.
Building on outreach efforts to enroll eligible people.
Expanding and standardizing the collection and use of data, including race, ethnicity, preferred language, sexual orientation, gender identity, disability, income, geography, and other factors across CMS programs.
Evaluating policies to determine how CMS can support safety net providers caring for underserved communities.
Ensuring engagement with, and accountability to, the communities served by CMS in regards to policy development and the implementation of CMS programs.
Incorporating screening for, and promoting broader access to, health-related social needs, including greater adoption of related quality measures, coordination with community-based organizations, and collection of social needs data in standardized formats.
Ensuring CMS programs serve as a model and catalyst to advance health equity through the nation’s healthcare system, including with states, providers, plans, and other stakeholders.

“Advancing health equity is the core work of the Centers for Medicare & Medicaid Services. We can’t achieve our health system goals until everyone can attain the highest level of health. That’s why I am inviting the healthcare industry to work alongside CMS as we transform the way patients are cared for in our country,” says CMS Administrator Chiquita Brooks-LaSure. “Health equity will be embedded within the DNA of CMS and serve as the lens through which we view all of our work. Our vision is clear and our goal is straightforward — we will not stop until every person has a fair and just opportunity to attain their optimal health.”

Let’s hope that we can achieve those goals!

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:

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:

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 Expenses

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.

What the No Surprises Act Means for You

One in five Americans have received a surprise medical bill from an emergency department, and another one in five have gotten unexpected bills from non-emergency hospital stays. Surprise medical bills have been a huge problem for Americans, but on January 1, 2022, the No Surprises Act took effect. This law establishes federal protections against most surprise medical bills that come after you receive out-of-network care during a hospital visit. Find out what the No Surprises Act means for you.

Surprise Bills

illustration of a person looking at their laptop with exclamation points — *Surprise bills can be scary and overwhelming, but now you can worry no more!*

In some cases, when you receive medical treatment (especially in an emergency situation), you will be unable to choose the provider who treats you, and so you end up unexpectedly receiving care from an out-of-network provider. Or, you might visit an in-network facility, but unknowingly see an out-of-network provider during your stay there.

Your insurance company will often pay some amount to the out-of-network provider, but typically less than the provider’s list price for the services. In most cases, the provider who treated you will then “balance bill” you for the difference between their list price and the insurer’s payment. In other cases, your insurer will offer little to no coverage of your unexpected out-of-network care. And in both of these scenarios, you’ll end up getting an unexpected bill, known as a “surprise” medical bill.

Getting a surprise medical bill in the mail can be a source of a lot of anxiety for many people. Two out of three Americans say they worry about being able to afford unexpected medical bills, and nearly half can’t afford to pay surprise bills in full.

Ending Surprise Bills

But the No Surprises Act will now make surprise medical bills a thing of the past. The law bans:

Surprise bills for most emergency services, even if you get them out-of-network and without approval beforehand.
Out-of-network cost-sharing (like coinsurance or copayments) for most emergency and some non-emergency services, so you can’t be charged more than in-network cost-sharing for these services.
Out-of-network charges and balance bills for certain additional services (like anesthesiology or radiology) administered by out-of-network providers as part of a patient’s visit to an in-network facility.

In addition, according to the law, you can’t be asked to waive your protections against balance billing in emergencies or for certain non-emergency services, such as ancillary services (anesthesia, pathology, radiology) associated with emergency care, or diagnostic services such as radiology or labs. It will be up to medical providers and insurers to identify which bills are subject to the Act.

“This law puts an end to the practice of charging patients exorbitant bills for unexpected, out-of-network care,” Sen. Patty Murray, chair of the Senate Health, Education, Labor, and Pensions Committee, said.

What the No Surprises Act Does Not Cover

Unfortunately, the bill does not ban all surprise and out-of-network bills. It will exclude: illustration of an ambulance

Ambulance rides– The law applies to air ambulances, but not ground ones.
Certain facilities– The law applies to hospitals and emergency departments, but not to other facilities, such as urgent care facilities.

If you are unsure if a bill you received in the mail falls under the No Surprises Act, or if you have general questions about the new law, contact the newly established No Surprises Help Desk at 800-985-3059.

Find A Better Health Plan

Unfortunately, sometimes you will find that your health insurance plan doesn’t cover everything you need it to, leaving you with a big bill that you will have to pay out-of-pocket. If your plan isn’t adequate for your needs, it’s time to find a plan that is, 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.

What Are the Federal Poverty Levels (FPL)?

Your salary and any other money your family brings into the household determine how much you will pay for health insurance. Why? Because, depending on what your salary is in relation to the Federal Poverty Level (FPL), you could qualify for tax subsidies that will reduce your premiums. Learning about the Federal Poverty Level can help you in your search for an affordable health insurance plan.

Federal Poverty Levels for 2022

To know if, and what kind of, subsidies you qualify for when it comes to health insurance, you’ll need to know how your salary relates to the Federal Poverty Level. The following are the 2022 Poverty Guidelines for salaries in the 48 Contiguous States and the District of Columbia: silhouette of a family of 4

$13,590 for individuals
$18,310 for a family of 2
$23,030 for a family of 3
$27,750 for a family of 4
$32,470 for a family of 5
$37,190 for a family of 6
$41,910 for a family of 7
$46,630 for a family of 8

For families/households with more than 8 persons, add $5,900 for each additional person.

Federal Poverty Level amounts are higher in Alaska and Hawaii. Alaska starts at $16,990 for an individual, and Hawaii starts at $15,630 for an individual.

Federal Poverty Level Cut-Offs

The FPL for a given calendar year plays a key factor in determining eligibility for reduced-cost health care and health insurance. If your salary is at or below certain percentages of the Federal Poverty Level, you qualify for Marketplace subsidies. The FPL cut-off is:

Annual income between 100% and 400% of the FPL

In all states, if your income level is in this range, you will qualify for premium tax credits for ACA health coverage, which can lower your monthly premium for a Marketplace health insurance plan.

moneybag with bills in it — *Now you can save even more money thanks to Biden’s Rescue Plan Act.*

This cut-off is fairly new: President Biden extended subsidies to more Americans with the American Rescue Plan Act, so that those who earn up to 400% of the Federal Poverty Level can now receive subsidies to purchase health insurance through the ACA Marketplace. The ARP 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.

As of April 1 of this year, anyone buying their health insurance through the ACA Marketplace is able to receive the tax credits if they qualify.

Looking for health insurance? 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.

Tag: Health Insurance