Insurance companies can’t change your premiums based on your medical history or turn you down for any pre-existing conditions. However, they can change your premiums based on other things, such as whether or not you smoke. If you regularly smoke, vape, or even chew tobacco, your health insurance can cost up to 50% more. Companies use this “tobacco surcharge” to try to keep policyholders from smoking, since chronic conditions like COPD that are caused by smoking lead to high medical costs. However, even if you’re a smoker you can still find great health insurance.
What Counts As Tobacco Use?
All tobacco products, like vape juice, cigarettes, cigars, chewing tobacco, snuff, e-cigarettes, and pipes, are charged a tobacco fee by insurance companies. If you used any of these items four times a week or more in the last six months, that is considered tobacco use. Only people who use tobacco for religious or spiritual reasons, like Native Americans, are exempt from this surcharge. At the moment, insurance companies depend on people to tell the truth. When you ask for health insurance, you have to tell the company if you smoke or not. “Have you used tobacco in the last six months?” is a question that insurance companies often ask.
If you lie about how much you smoke, it could be called insurance fraud. Depending on where you live, giving a false answer to this question could be a felony that could cost you thousands of dollars in fines, jail time, and court fees, as well as a felony charge. If you get health insurance through your job, a regular medical exam could be used to check that your answers are true. During this test, a blood or urine sample can be used to check for nicotine use.
The Cost of Tobacco Use
Under the Affordable Care Act (ACA), health insurance rates are based on the type of plan, the number of people covered by it, their age, where they live, and whether or not they smoke. Many insurance companies can use the fact that a person smokes to raise their health insurance rates. This is called a “tobacco rating”. Subsidies are also affected. The full cost of the tobacco fee falls on people who smoke. The insurance company changes the premium based on age and location, but tobacco use is taken into account before that.
The tax credit isn’t used to pay for any of the tobacco fees. Through a “tobacco surcharge,” the Affordable Care Act (ACA) lets insurance companies charge users up to 50% more (or 1.5 times more) than they charge non-smokers. Even though this is legal, not all states have chosen to adopt this charge. Surcharges on tobacco can be different in each state.
Smoking causes illness and disability, and it hurts almost all of your body’s organs. The Centers for Disease Control and Prevention (CDC) says that more than 16 million Americans have a disease caused by smoking. At least 30 people live with a serious disease caused by smoking for every person who dies because of it. About 41,000 nonsmoking adults and 400 babies die each year because they were around people who were smoking. Adults who are around people who smoke can get a stroke, lung cancer, and arterial heart disease. Children who are exposed to secondhand smoke are more likely to have Sudden Infant Death Syndrome, acute respiratory infections, middle ear disease, more serious asthma, respiratory symptoms, and slower lung growth. Smoking leads to:
Cancer
When you smoke, you can get cancer and then your body can’t fight it. Toxins in cigarette smoke can damage the body’s immune system, making it harder to kill cancer cells. When this happens, the growth of cancer cells can’t be stopped. Tobacco smoke contains poisons that can damage or change the DNA of a cell. DNA is the “instruction manual” of a cell. It controls how a cell grows and works. When DNA is broken, a cell can start to grow out of control, which can lead to cancer. Cancer can form almost anywhere in your body if you smoke, including:
Blood (acute myeloid leukemia)
Bladder
Cervix
Colon and rectum
Esophagus
Kidney and renal pelvis
Larynx
Liver
Lungs, trachea, and bronchus
Mouth and throat
Pancreas
Stomach
COPD
Chronic obstructive pulmonary disease, or COPD, is a group of illnesses that block airflow and make it hard to breathe. Emphysema and chronic asthma are both parts of COPD. COPD is usually caused by smoking, but long-term exposure to other lung toxins, like secondhand smoke, can also lead to COPD. One out of every four Americans with COPD has never smoked. However,up to 8 out of 10 COPD-related deaths are caused by smoking, and 38% of the nearly 16 million U.S. people with COPD who are still smoking. When a child or teen smokes or is exposed to secondhand smoke, it can slow the growth and development of the lungs. This can make it more likely that they will develop COPD as an adult.
Diabetes
Diabetes is a long-term illness that changes the way your body turns food into energy. Most of the food a person eats is turned into glucose, a type of sugar that gives energy to the body’s cells. The pancreas is an organ near the gut that makes insulin. This hormone helps glucose get into the cells of the body. When you have diabetes, your body either doesn’t make enough insulin or can’t use it very well. Too much sugar stays in your system when there isn’t enough insulin or when your cells stop responding to insulin. Over time, this can lead to major health problems like heart disease, vision loss, and kidney disease.
We now know that one thing that can lead to type 2 diabetes is smoking. In fact, people who smoke cigarettes are 30%–40% more likely to get type 2 diabetes than people who don’t smoke. People with diabetes who smoke are more likely to have trouble taking insulin and taking care of their health than people with diabetes who don’t smoke. If you smoke a lot, you are more likely to get type 2 diabetes.
Gum Disease
Gum disease, also called periodontal disease, is an infection of the gums that can affect the bones that hold your teeth in place. In the worst cases, it can make you lose your teeth. Bacteria (germs) on your teeth get under your gums and cause gum disease. If the germs stay on your teeth for too long, they build up into layers of plaque and tartar. This buildup can lead to gingivitis, which is an early form of gum disease. When gum disease gets worse, your gums can pull away from your teeth and leave places that can get infected.
The bone and muscle that hold your teeth in place can break down, and your teeth may become loose and need to be pulled out. In the United States, smoking is a major cause of gum disease. Your immune system, which fights off sickness, gets weaker when you smoke. This makes it harder to get rid of an infection in the gums. If your gums are already damaged, smoking makes it harder for them to get better.
Heart Disease and Stroke
Cardiovascular illnesses (CVDs) include heart disease and stroke. In the U.S., coronary heart disease, also called coronary artery disease, is the most common type. Coronary heart disease happens when plaque builds up on the walls of the arteries that bring blood to the heart. A stroke happens when the brain doesn’t get enough blood or when a blood vessel in the brain breaks, damaging or killing parts of the brain. A stroke can cause death or injury, such as paralysis, weakened muscles, trouble speaking, or loss of memory. One out of every four deaths from cardiovascular disease (CVD) is caused by smoking.
How To Quit
Now is a great time to talk to your doctor if you smoke or use any other kind of tobacco. Under the Affordable Care Act, your health insurance plan can help you stop smoking by giving you the tools you need. One of the best things you can do for your health is to stop smoking or using any kind of tobacco. The faster your body can start to heal, the sooner you should stop. This is what happens after you’ve quit smoking:
20 minutes – blood pressure and heart rate lowers
12 hours – the amount of carbon monoxide in your bloodstream reduces
3 months – your lung functions and circulation improve
9 months – coughing and shortness of breath are less common
1 year – your risk for a heart attack drops
5 years – your risk of throat, mouth, bladder, and esophagus cancer severely drops
10 years – lung cancer risk drops
15 years – coronary heart disease risk reduces
Coverage for Quitting
Quitting doesn’t just improve your health it also improves your finances. Pack-a-day smokers can save between $1,380 and $2,540 annually, depending on where you live and the brand you smoke. Most health care plans, including all plans bought through the Marketplace, cover a screening for tobacco use. During this screening, your doctor will ask if you smoke or use tobacco and give you information about how it affects your health and why you might want to stop. Your health insurance may now cover free services that can help you stop smoking. This could include, depending on your plan:
Cessation counseling
Medication to help you quit
Nicotine replacements such as gum, lozenges, patches, inhalers, and nasal sprays
Keep in mind that grandfathered health plans, which are those that were in place before the Affordable Care Act was passed and haven’t changed much, are not required to give preventive care like help to quit smoking. Find out if you’re in a grandfathered plan by asking your insurance company or HR department. Also, short-term health plans don’t have to cover any preventative care including smoking cessation.
EZ Can Help
No matter if you use tobacco products now, just quit, or are on your way to stopping, it is important to have health insurance. Many health problems can be caused by tobacco products, so it’s better to have insurance than to not have it and risk having medical bills pile up. If you smoke and want health insurance, but are worried about how much it will cost, EZ.Insure can help. We’ll look at the prices, compare plans in your area in minutes, and find you a plan that will save you money. Enter your zip code in the bar below to compare free quotes right away, or call 877-670-3557 to talk to a qualified agent.
Kids and adults actually have a lot of the same dental issues, but since kids’ teeth are still growing, they are more likely to have problems. If you don’t treat tooth problems early, they can get worse and cause their adult teeth to come out of place. If kids of any age don’t take good care of their teeth and gums, they can get cavities and gum issues. So, in addition to teaching your kids how important it is to brush and floss, you should also take them to the dentist regularly so they can get care from a professional. Like many parents, you may be worried about how much good dental care for kids will cost. Luckily, health insurance can help you pay for every visit without going into debt.
Kids dental problems
Tooth Decay
One of the most common teeth problems that children have are cavities. As a matter of fact, the CDC says that 20% of kids ages 5 to 11 have at least one tooth that is slowly dying. A major contributor is plaque, which is made up of bacteria that sticks to teeth and eats away at the enamel, which in turn causes cavities. Tooth decay can be avoided by brushing and cleaning their teeth every day. A healthy diet that limits sweet and carbohydrate-rich foods which cause cavities is also important.
Bad Breath
Sometimes we all have halitosis, which is the professional term for bad breath. However, if your child’s breath smells bad all day, there is probably a bigger problem. Bad breath is caused by bacteria that grow in the mouth from leftover food and sticks to the gums. These bacteria give off hydrogen sulfide which has an odor to it. Halitosis can be caused by many things, such as dry mouth, bad oral hygiene, digestive problems, and even some medicines. The best way to keep bad breath away is to take care of your teeth and have your child’s doctor clean their teeth regularly.
Sensitive Teeth
If your child gets pain from air or hot or cold foods, he or she may have sensitive teeth. Children can also have sensitive teeth because their enamel is thinner and can wear down faster from plaque. Your child’s dentist can fix this by putting sealants on the places that are broken. These will fix any cracks in the enamel and make it stronger. To keep the enamel from wearing away, you should always use a soft toothbrush.
Teeth Misalignment
Thumb sucking is fine for babies and toddlers, but it can hurt a child’s oral growth if they keep doing it after age 5. Both baby and adult teeth can grow in wrong by thumb sucking too much. It can also make it hard to speak because it can change the way your teeth fit together. Talk to your child’s doctor about how to stop this habit.
Not Losing Baby Teeth
Baby teeth don’t always fall out. This is known as having over-retained primary teeth. This usually takes place because there isn’t a permanent tooth to replace the baby tooth. Misaligned jaws, blockages, damage, infections, and oral pathology are some other possible reasons. Tooth decay and other oral problems could happen if you don’t treat over-retained teeth. The baby tooth can be taken out by your child’s doctor so the adult tooth can grow in without any problems. Orthodontics can fix any kind of imbalance.
Gum Disease
The gum disease known as gingivitis can also happen to kids. If you don’t take care of their teeth properly, this gum inflammation can happen, which can cause bone loss. Plaque that builds up on the bottom of teeth hurts the gums and makes them swell and turn red. The teeth will start to pull away from the gums over time and bleed easily, especially after brushing.
Worn Down Teeth
It is normal for kids to grind their teeth, which is also called bruxism. Sometimes this happens when teeth aren’t lined up right, when you’re in pain, or when you’re stressed. Even though most people with bruxism don’t need treatment, if it doesn’t stop, both the baby and adult teeth could wear away. Inflammation, headaches, and pain in the jaw are common signs. If your child grinds their teeth at night, your pediatric dentist can give them a night guard instead.
Does Health Insurance Cover Kids Dental?
Dental care for kids up to 18 years old is required by the Affordable Care Act (ACA). The law says that all health plans sold in the Marketplace, the individual market, and through businesses with 50 or fewer workers must include dental benefits for children. This kind of insurance can be part of a medical plan or bought separately from your medical insurance. You should look at how much coverage each of these choices gives you. It’s possible that a separate dental plan will pay for more.
Dental Coverage Through An ACA Plan
Kids’ oral care must be covered if you buy a plan from your state’s health insurance marketplace, or at least be an option. Plans vary from state to state, but most plans will cover these things:
Dental exams every 6 months
Cleanings
Fluoride treatments
X-rays
A portion of the cost of braces.
The perks may be different in your state and plan. To get these benefits, your plan may also say that you have to go to a dentist in their network. Before you buy a plan, make sure you know what dental care is covered and what isn’t.
Dental insurance can be helpful, especially when you need to pay for pricey treatments, checkups, and braces. Dental insurance can help pay for the following:
Exams
X-rays
Cleanings
Preventive care
Treatment for cavities and early childhood caries
Emergency treatment of injuries and damage caused by accidents
Fluoride treatments
Orthodontics for aligning teeth and fixing bite problems
At this point, you may be thinking if you really need to get your child dental insurance. When do kids need to have dental insurance? You can get coverage for your baby so that they can see the doctor when their first tooth comes in. Additionally, giving a child this kind of protection at such a young age can be a smart move because the dentist will be able to watch their mouth grow and spot any problems that need to be fixed right away.
Pediatric Dentistry Timeline
For the first 24 months of their life, your child’s mouth changes a lot. On the inside, tiny teeth are breaking through the gums, getting them ready for solid food. To avoid cavities, the American Academy of Pediatric Dentistry says that kids should go to the doctor every six months. It is very important that their tooth health improves properly and on time. If you know when your child’s teeth should be at certain stages, you can avoid problems as they grow.
In Utero
Good mouth health starts before the baby is born. Women who are expecting should see a dentist before, during, and after the pregnancy. It is a good idea to see a doctor before getting pregnant if you are thinking about it. People often forget to take care of their teeth, but problems with oral health can be harmful to both mom and baby.
0-4 Months
A baby’s mouth is getting ready for teeth to come in. Even though it might not seem like much needs to be done yet, you should start wiping your baby’s gums with a damp cloth. You could also use a soft rubber finger toothbrush to finish the job. To start, wipe their gums for two to three seconds at least twice a day. This will help keep your baby’s mouth clean and ready for their first teeth. Also, stay away from sugar that isn’t necessary for the new teeth.
4-6 Months
At this point in the child’s development, teething is starting to happen. Go ahead and wipe your child’s gums some more. Their mouth and new teeth may feel sensitive at first, but sticking to your oral care routine will help because plaque can start to form even on baby teeth. Now is a good time to start looking for a doctor for your child. Your dentist and the oral history of your family may decide that you need a check-up every six months to a year from now on. Stay away from foods that are high in citric acid and sugar that they don’t need. These foods can cause early tooth loss and plaque formation.
1 Year
Your child should have been to the doctor for the first time by the time they are one year old. Your child’s doctor should advise you that they should go to the dentist every six months. Checkups like these are done regularly to make sure that development and growth are going as planned. This lets the dentist see any problems that might come up as the teeth come in.
Now is a good time to get your child used to a toothbrush with soft bristles. Little kids will start to learn how to properly brush their teeth and spit out toothpaste. Start using toothpaste without fluoride until you can do this. You could also skip using toothpaste altogether and just use water. When their teeth start to touch on the sides, you should start flossing regularly. It’s best to do this after every meal. Setting up good oral care habits, like flossing every day, can keep them from having dental problems in the future.
2-3 Years Old
Now is when a lot of parents start to work on changing their kids’ pacifier habits. Pacifiers can be bad for their teeth. Too much use of a pacifier can change the way their mouth looks and how their teeth come in. Starting now, parents should help their child brush their teeth at least twice a day, but after every meal is even better. Fluoride toothpaste can be used from now on, as long as the child can spit. Since almost all 20 baby teeth should be in by age 3, you should now regularly floss. It is suggested that you see the doctor twice a year.
3-6 Years Old
When kids reach this age, they may be able to do more of their own oral care, but use your best judgment and help and watch them as needed. Some parts of a child’s mouth are hard to reach or can be missed, so make sure to check their teeth are clean. Your doctor should have looked at your child’s teeth with an x-ray by now to see how they look and how healthy they are. For even more peace of mind, you can talk about tooth sealants.
6-10 Years Old
At this age, your child should be able to clean their teeth on their own more. They should stick to a set schedule, whether it’s in the morning, at night, or both. It’s best to brush your kids’ teeth every day with them and praise them at the same time. This lets you keep an eye on their habits and teach them how important it is to brush and floss their teeth every day. Around age 7, if your child is having problems with their growth, their dentist may suggest that they see an orthodontist. As baby teeth turn into fixed adult teeth, regular trips to the dentist every six months will catch any damage to the teeth’s structure.
10+ Years Old
At this point, your child should be able to do everything on their own without your help. The right oral hygiene habits and routines will have been taught to your child, and they will be proud of their teeth. In fact, it’s important that it become a habit and be done every day. Regularly checking in with your child will show them how important it is to take care of their teeth.
Besides their wisdom teeth, all of your child’s adult teeth should be in their mouths by the time they are 13. They should still go to the doctor every six months to make sure their teeth are growing and developing properly. If there are major problems, they will be pointed out and fixed. If they haven’t already been checked out for braces, now is the time.
The Bottom Line
It might not always seem important to have health insurance, but it is, because the health of your teeth can affect the health of your whole body. Oral problems, like gum disease, can lead to heart problems, strokes, and breathing problems if they are not handled. Your mouth and body will stay healthy if you have dental insurance. Plus, you won’t have to worry about big medical bills. One of our qualified agents can help you decide between health insurance that covers dental care and a separate dental plan. Call 877-670-3557 today. You can also use the bar below to type in your zip code and see quotes online.
The term “alternative medicine” is now commonly used, but chiropractic care, acupuncture, and therapeutic massage aren’t really that alternative today. Many adults and children use complementary and alternative medicine (CAM) to stay healthy and treat serious or long-lasting illnesses, according to the National Center for Complementary and Integrative Health. It’s possible that a lot more people would use some kind of alternative or complementary treatment if their insurance pays for it. A lot of insurance companies cover some services in some situations, but not most CAM treatments. This means that patients generally have to pay for them themselves.
What Is CAM?
Complementary and alternative medicine is a term that describes therapies that you can use in addition to mainstream Western medicine. Massage, meditation, biofeedback, tai chi, reiki, music therapy, guided imagery, and dietary supplements are all examples of CAM. The differences between these approaches are mainly how doctors use them.
Complementary medicine – Complementary treatments are used with standard medical approaches like drugs, immunotherapy, chemotherapy, radiation, and surgery. It “complements” these more standard medical methods.
Alternative medicine – As its name suggests, these treatments are used instead of traditional medicine. Things like homeopathy, herbal medicine, and chiropractic services are examples of alternative medicine.
Integrative medicine – While this isn’t included in the CAM acronym this type of treatment is in the same category as CAM. These treatments take into account your overall health and happiness. Not just the disease or organs that are in treatment. It looks at your health from the point of view of your mind, emotions, abilities, religion, relationships, and community.
Each type might work on a different part of your health. In general, one or more of these issues may be treated with combined approaches:
Pain
Anxiety and stress
Nausea
Mood swings
Wound care
General well being
Muscle tension
Fatigue
Circulation
Flexibility
Types of CAM
CAM treatments come in a lot of different forms. Here is a summary of the different types of treatments from each group, since most of them are in more than one category.
Massage
Massage uses the nerve endings and pressure spots in your body to help you relax. It comes in many types, such as shiatsu and reflexology. There are, however, five basic strokes that make up the most common type of Swedish massage. These are effleurage (slow, rhythmic gliding strokes that move blood toward the heart), petrissage (kneading, pressing, and rolling muscle groups), friction (steady pressure or tight circular movements, often used around joints), percussion (drumming hands on body), and vibration (shaking the muscle back and forth quickly). People have used massage to ease pain, lower worry and anxiety, boost their mood, and help them relax. If you’ve recently had surgery, massage can help the wounds heal faster and may even stop or lessen scars. It has been shown that massaging your feet can help with pain, nausea, and stress.
Chiropractic or Osteopathic
This is a hands-on method that focuses on your spine and other parts and how they connect to your nervous system. In these methods, you move your muscles and joints by stretching, applying light pressure, and adding force. They can help ease muscle pain and make it easier for you to move around and do things. This method can help make a number of conditions better, such as migraines, menstrual pain, and carpal tunnel syndrome.
Yoga is a gentle form of exercise that uses poses and breathing techniques to help you feel better. People in India have done it for thousands of years, and now people all over the world do it too. In the West, yoga is valued more for its physical benefits than its spiritual ones. For example, it can make you more flexible and energetic, and it can help you feel less stressed and tired.
Music Therapy
Music therapy is an expressive art form that helps people find balance and unity in their lives. Listening to music or playing music can both be part of music therapy. Music therapists are trained professionals who make music plans for people who need them. You can work through mental, spiritual, and behavioral problems by listening to music. Music therapy can help people deal with their feelings and calm down. It’s possible for music to either calm you down or wake you up.
Animal Assisted Therapy
Therapists will work with dogs or other animals to help you deal with your health problems, like cancer, heart disease, or mental illness. Therapy with animals can help with pain, anxiety, depression, and tiredness that come with a lot of health issues.
Biofeedback
This is a way to train yourself to gain control over your feelings, thoughts, or actions. As you go through treatment, your therapist will keep track of your body’s functions. For example, EEG will record your brain waves, ECG will record your heart rate, and EMG will record muscle contractions. As you learn new ways to cope, these measurements will change.
Reiki
Reiki is a type of mental healing that comes from Tibetan Buddhism over a thousand years ago. It’s meant to improve your health, keep you happy, and help you reach a higher level of awareness. Practitioners hold their hands over your dressed body and send “reiki energy” to parts of your body that need it. Reiki is said to bring the body’s energy centers, or “chakras,” back into balance and get rid of energy blocks that cause illness and discord. After treatment, some people may feel calm, while others may feel energized.
Acupuncture is an old Chinese method to treat health problems. It works by inserting very thin, solid pins into certain parts of your body to stop or treat certain illnesses. People think that acupuncture can help the body release endorphins, which are natural painkillers that can also make you feel better. In acupressure, the same acupoints are touched and pressed on. It may work the same way, but not as well.
Insurance Coverage For CAM
The trouble is that complementary and alternative therapy is usually only partially covered by insurance, if it is covered at all. About 60% of people who go to the chiropractor have insurance plans that only cover a certain number of visits. Only 25% of people who want acupuncture and 15% of people who need massage therapy have insurance coverage. It can be hard to get insurance to pay for integrative healthcare, especially after you’ve already been treated. One reason this is hard is that insurance companies can be very slow to offer coverage, even when study clearly shows a benefit. Researchers in a study published in the journal Global Advances in Health and Medicine said that CAM methods for chronic low back pain were not well covered, even though the American College of Physicians had suggested them.
Most state-based health programs did not take a holistic approach to treating chronic pain. It was only spinal manipulation (chiropractic or osteopathic treatment) that was covered in 46 states. Less than 10 states took care of acupuncture, neurofeedback, and massage. Mindfulness-based stress reduction, tai chi, and yoga, which have all been shown to help people with chronic pain, were not talked about at all. As a general rule, you can find your policy documents online. Reading them closely is the best way to find out if your policy covers integrative medicine or other types of holistic health insurance. You could also call your insurance company to make sure they cover the treatment before you go to the doctor. The NCCIH says that you should keep careful records of all the times you talk to or write to your insurance company.
When Insurance Won’t Cover CAM
Every insurance company might not cover alternative treatments, so you may have to pay for them yourself. You can ask the provider for a cash pay rate. Some alternative care providers offer savings or a sliding scale for people who pay for their own care. If you have a health savings account (HSA), you can pay for the services with the money in it. If not, you can check with your insurance company to see if they cover alternative medicine like acupuncture and chiropractic care. Additionally, you can also look for health insurance that covers alternative care, which is another great choice. If you can’t get your current insurance company to pay for a treatment that your doctor will write a prescription for, you might want to look into other plans in your area.
There are a lot of qualified, highly trained agents at EZ.Insure who offer health insurance. We will give you your own advisor who will look into all the plans in your area and let you know which ones cover treatment with alternative medicine. Our agent will show you all the plans in your area, tell you how much they cost, and help you understand how each plan handles alternative medicine. The best part is that you won’t have to pay anything for this. We offer all of our services for free! Enter your zip code in the box below to start comparing affordable plans that cover alternative care. You can also call 877-670-3557 to talk to an EZ agent directly.
The average person in the United States spends about $3,400 a year on health insurance. If you’re going to spend a lot of money on health insurance, you should make sure you’re getting the most out of it. You’re already paying for the benefits so why not use them and get your money’s worth. To get the most out of your plan you can do things like stay in-network, take advantage of routine screenings, and recommended exams. Use these easy tips to maximize all of the perks in your plan to keep yourself healthy.
Review Your Plan Annually
You need to know what’s in your plan before you can figure out how to use it. Many people don’t use the benefits of their health insurance policy because they don’t know about them. You know those packets your health insurance company sends you when you start a plan or when it renews? In there is an easy simple to read summary of all your plan’s benefits and perks, you can also create an account of the company’s website to access that summary online. Your health insurance company may do more than just help pay for your care. For example, they may give you savings at the gym or help you deal with your asthma. Don’t pass up any of these extra benefits. Some common perks are:
Discounted vision and hearing services
Gym memberships
Wellness programs
Mental health services
Telemedicine
Insurance companies often make changes to benefits and policy terms that take effect when the policy is renewed. So, even if you’ve had the same plan for a long time and you’re pretty sure you know what it covers, take a few minutes to read that summary every year. Going over it could show you new perks or even perks you need taken away. Not to mention, your health changes as you get older so coverage that you didn’t need or care about before might become a deal breaker with that plan.
Things To Consider
You don’t know if rates or perks have changed, so don’t assume it’s the same as the last one. Cost is important, but it shouldn’t be the only thing you think about. You should also think about the provider’s image and the plan’s network.
By paying a premium, you can keep getting the perks listed in your health insurance plan. You can pay it every month, every three months, every six months, or once a year. Premiums for health plans change based on a number of things. There is no perfect amount for a premium, but it must be reasonable all year long.
Before your health insurance starts to pay for your health care costs, you have to pay a certain amount out of pocket each year. If you need a lot of medical care, a health plan with a low deductible is generally best. If you reach it sooner, your plan will start paying for your costs sooner. However, if you are in good health, a plan with a high deductible may be better because it will save you money on your premium.
A copay is one way that you and your health plan provider share the costs. It means that you have to pay a set amount for each service before you can get it. Your copay depends on what kind of service you need, but it’s usually at least $10. You will always spend the same amount on health care, no matter how much it costs all together. This makes your health costs consistent.
Network
Your network is the group of doctors or other health care providers whose services are covered by your health plan. Most of the time, your source won’t pay for services that aren’t in their network. Check to see if your favorite doctors, clinics, or labs are in the network for your plan. They should be, if possible. If not, you may have to choose between what you want and how much it will cost.
Carefully Pick Your Primary Care Provider
It’s very important to have a doctor who knows you well, especially over a long period of time. If you don’t have a primary care provider, you end up going to different doctors and clinics when you’re sick. They don’t know what your normal is as far as your vital signs, labs, and medical history. So all they can do is treat the immediate symptoms rather than have a full care plan which you may sometimes need more than just putting a bandaid on your symptoms. A good doctor who knows your family background and your normal vital signs and symptoms. They can help you stay healthy by letting you know about screenings you are qualified for, finding problems before they become big problems, and sending you to a specialist if you need one.
Keep in mind while you’re picking your primary care doctor make sure they’re in-network for your insurance company. No matter what type of plan you have you will always save more money by seeing an in-network provider.
Use Your Plan’s Preventative Care
Even if you have a basic plan with a high premium, you should be covered for any screenings or other “preventive” care you need. This means you don’t have to pay a copay or other out-of-pocket costs. This includes getting tested for diabetes, high cholesterol, and high blood pressure. Most tests for breast cancer and immunizations, such as the flu shot, are also free.
Schedule Procedures Strategically
We know an emergency surgery isn’t something you can plan, but you can be smart about when you schedule visits and procedures. If you can plan ahead for a big medical treatment, there are a few ways to schedule it to get the most out of your health insurance. Some people won’t get a big procedure until they’ve met their deductible. If you don’t have much money saved up, this might make sense.
If you get health care services throughout the year that count toward your deductible and then plan surgery after you’ve met it, it’s more likely that your insurance will pay most of the cost of the surgery and you won’t have to pay a big bill out of pocket. Others who have the money up front might choose to plan a more expensive procedure to meet their deductible early in the year, knowing that the rest of their healthcare costs that year will be covered by insurance.
Save Important Contacts
We can’t always predict when we’ll need quick medical help or to go to the nearest urgent care or emergency room. Costs can be kept down by going to care workers in your network. It’s better to get ready ahead of time. To get started, call your insurance company. Their team will help you figure out where to go or who to call. Put this information in your phone or address book as soon as you have it. So, if you need to ask a question or get to urgent care quickly, you’ll have all the information you need.
While you’re saving contacts in your phone don’t forget your support team. Your care is made better by the people who help you. Save the important phone numbers for your insurance company, like the member services line and the nurse advice line. This makes it easy to get in touch with them if you need help or answers. Some apps and websites show the email addresses of their support teams, which you can add to your email contacts. Some also have chat functions or pages that you can save for later use. If you can, write down the hours of operation so you know when you’re most likely to get in touch with someone on the support team.
Work With an EZ Agent
It can be hard to figure out your own health insurance because there are so many things to think about. No one likes to spend hours reading about different plan perks and costs, so why not let a professional do all the hard work for free? There is a way to get cheap health insurance without having to go through a lot of trouble. A qualified EZ insurance agent can explain what each plan’s pros and cons are. And help you come up with the plan that works best for you.
Working with an EZ agent saves you time and stress because you don’t have to try to figure out legal jargon or read small print. Agents do all the hard work, so you can relax knowing that your coverage will meet your financial and medical needs the best.
Not to mention that EZ agents can save you hundreds of dollars a year on your health insurance bills. We do this by being able to look for the cheapest rates both on and off the market. EZ can also find and use any savings you might be able to get. We don’t just help you find a plan, though. We also help you keep it up to date. EZ can help you make claims with your insurance company and help you renew your policy when it’s time. To get started, just type your zip code into the box below or call 877-670-3557 to talk to one of our certified agents.
The health insurance Open Enrollment Period (OEP) is coming, and you might feel a little lost. It can be hard to sort through all of the different health insurance options in your area, but you know that you and your family need health insurance to stay healthy. Don’t worry though. You can always work with a licensed EZ agent, who will help you find a plan that fits your budget and your needs. Before you do that, let’s look at everything you need to know about the OEP.
What Is The OEP?
The Open Enrollment Period (OEP) is the only time of the year when you can change, cancel, or buy a new health insurance plan. Depending on which state you live in, it starts on November 1st and goes until mid-to late-January. Now is a good time to look at your current health insurance plan, see if it will change in the new year, and decide if it will meet your needs in the future or if you need a new plan.
When Is The OEP?
The open enrollment period for Obamacare plans is from November 1, 2023 to January 15, 2024. Any plan you buy by December 15 will cover you starting on January 1, 2024. If you buy a plan during open enrollment, which is between Dec. 15 and Jan. 1, it should take effect by Jan. 15, 2024, as long as you pay your first premium on time. Also, if you buy a plan between Jan. 1 and Jan. 15, your plan should start on Feb. 1, 2024. Some states’ open enrollment periods are longer than others, but this can change. At the moment, these states have longer periods for signing up:
California – November 1st, 2023, to January 31st, 2024
Idaho – October 15th, 2023, to December 15th, 2023
Maryland – November 1st, 2023, to December 15th, 2023
Massachusetts – November 1st, 2023, to January 23rd, 2024
New Jersey – November 1st, 2023, to January 31st, 2024
New York – November 16th, 2023, to January 31st, 2024
Rhode Island – November 1st, 2023, to December 31st, 2023
If you get your health insurance through your job, your employer can choose when your open enrollment period is.
Marketplace Plan Tiers
Since the Affordable Care Act (ACA) went into effect in 2010, most people buy traditional health insurance plans on the insurance marketplace during the OEP. When you buy plans this way, they come in four levels called “metal tiers.” Bronze, Silver, Gold, and Platinum are the tiers. The plans in these tiers are different in terms of price and how much you’ll have to pay out of pocket, not in terms of the quality of care you’ll get.
Bronze
The monthly premiums for bronze plans are the cheapest, but you have to pay the most out of pocket. With these plans, your insurance company will pay 60% of each of your medical bills. The other 40% will be your responsibility. Also, the deductibles for these plans, which are the amount you have to pay out of pocket for medical costs before your insurance plan starts to pay for them, can be in the thousands of dollars each year. Bronze plans are a good choice if you don’t use medical services very often but need a low-cost plan to protect yourself against the worst-case medical scenarios, like getting sick or hurt badly. Your monthly premium will be low, but since the deductible and cost-sharing percentage are both so high, you will have to pay for most of your routine care.
Silver
The monthly premiums and out-of-pocket costs for silver-tier plans aren’t too high or too low. These plans cover 70% of the cost of your medical care. You pay the other 30%. The deductibles for this tier are often lower than those for Bronze plans, so if you’re willing to spend a little more to have more of your routine care covered, these plans are a great choice. When you qualify for cost-sharing discounts, you have to choose a Silver plan to get the extra savings. If you are on the Silver plan and stop getting cost-sharing reductions, you will have a Special Enrollment Period. If you want to switch plans, you can sign up for the Bronze, Silver, or Gold plan that fits your needs and budget the best.
Gold
Even though the premiums for Gold plans are high, the out-of-pocket costs of care are lower than for the plans above it. These plans have low deductibles, and your plan will pay for 80% of your care while you only pay 20%. If you need a lot of medical care, a Gold plan might be a good choice for you because it will cover more of your care.
Platinum
Platinum has the highest monthly premiums of all the tiers. While the premiums will be high, your out-of-pocket costs will be the lowest of any type of plan, and since the deductibles are so low, your insurance company will pay more of your costs throughout the year. Since these plans cover 90% of all your medical costs, they can be a good deal for people who need a lot of medical services.
In addition to the different types of metal tiers, there are also different types of plans to choose from during the OEP. Some plans only let you choose from a small number of doctors, hospitals, pharmacies, and other health care providers, or they force you to use only those in their network. On the other hand, some plans will pay a bigger share of the bill for healthcare providers outside of the plan’s network. Depending on where you live, you might find plans in any or all of these categories at each metal tier level:
Health Maintenance Organization (HMO) – A type of health insurance plan that usually only pays for medical services from doctors who work for the plan or have contracts with it. Most of the time, out-of-network care is not covered, unless it is an emergency.
Preferred Provider Organization (PPO) – A type of health plan that has a network of providers but doesn’t force you to only see those providers. But your out-of-pocket costs will be lower if you use providers in the network. You can use medical professionals, facilities, and suppliers outside the network if you pay extra and don’t have a referral.
Exclusive Provider Organization (EPO) – A managed care plan is one in which treatments are only covered if you go to doctors, hospitals, or other healthcare providers in the network, unless it’s an emergency.
Point of Service (POS) – A type of plan where you pay less if you go to hospitals, doctors, and other healthcare providers in the plan’s network. To see a specialist, you need to get a referral from your primary care doctor.
How To Buy Health Insurance During The OEP
If your employer gives you health insurance, they should tell you when and how to choose coverage for the next year. If you don’t get health insurance through your job, you can use the marketplace to look for and buy a plan. Another way to buy health insurance during this time is to work with an EZ agent who can help you shop through all of the plans available and help you enroll. Most states use the federal marketplace, healthcare.gov, but 17 states and Washington, D.C., have their own state-based marketplaces where people can buy coverage. States that run their own health insurance exchanges may also offer longer sign-up periods. These are the states that have their own insurance markets where people can buy plans for 2024:
Residents of all other states should shop for and sign up for their next health insurance plan on the federal exchange.
Things To Consider During The OEP
As Open Enrollment for Individual and Family Health Insurance in 2024 gets closer, there are a few important steps to take when choosing your plan.
Review Your Current Plan
If you already have health insurance, look it over to see if it still meets your needs. Think about any changes in your health, finances, or lifestyle recently that might mean you need a different health insurance.
Explore Options
During Open Enrollment, it’s important to look at different plan options to find one that fits your healthcare needs and budget. Look for plans that have a network of doctors and hospitals that fit your needs and preferences.
Consider Subsidies
As you look at and compare insurance plans on the Marketplace, make sure to update your personal information, especially your financial information. If you make less than a certain amount of money, you may be able to get health insurance subsidies that can lower your monthly premium by a lot. Also, Silver Marketplace plans offer cost-sharing reductions, which can lower your out-of-pocket costs by lowering your deductible, copays, and coinsurance.
Consider Additional Coverages
Even though Marketplace health insurance plans cover a wide range of medical services and include prescription drug coverage, you may want to think about getting more coverage, like dental and vision plans, to make sure your health is well-rounded.
What If I Miss The OEP?
If you miss the Marketplace’s Open Enrollment Period, you might not be able to sign up for an ACA health insurance plan unless you qualify for a Special Enrollment Period. With a Special Enrollment Period, you can sign up for a plan outside of the Open Enrollment if you have a qualifying life event. This is an event that affects your current coverage, like losing your job or getting divorced. You might also be able to sign up for a health plan through your employer. Some plans offered by employers have their own enrollment periods that may differ from the Marketplace. Also, if you change jobs, you may be able to sign up for your new job’s health plan outside of the normal enrollment period.
Need Help?
The best way to find a cheap plan with the right level of coverage for you is to compare plans. Come to EZ first before you start comparing things on your own. We’ll make the process faster and easier by letting you compare plans in your area in just a few minutes. Our licensed insurance agents work with all of the best insurance companies in the country. They can talk to you about your budget, needs, and help you choose the best plan for you and your family. We compare plans and give you advice for free. Enter your zip code in the bar above to get free quotes or call 877-670-3557 to talk to a real person.
Want to spend less on health insurance? You’re not alone! Most of us feel like health care costs go up every year, making it harder and harder to save money. Health insurance is the most expensive part of healthcare for nearly everyone, but if you think that the cost of health insurance is a reason not to get it, you should think again. Recent studies have found that uninsured medical bills are the cause of more than half of all bankruptcies. About 530,000 American families file for bankruptcy each year due to unpaid medical bills and medical problems.
While health insurance can be pricey, having no coverage or the wrong coverage could cost you even more. The last thing you want to worry about in a medical crisis is finances. So, health insurance is a must, but there are things you can do to make it affordable. Below we’ll look at how to save money on your health insurance so you stay covered without breaking the bank.
Health Insurance Costs
The amount you pay for health insurance will depend on what kind of health insurance you have, and of course what kind of services you need. Below are all of the costs associated with having health insurance that you should keep in mind when choosing your plan.
The amount you pay each month for your health insurance coverage is called your premium. This is probably the health care cost you know best because you pay it every month, even if you didn’t use any health services during that time. The average cost of premiums monthly by tier is:
Catastrophic – $332
Bronze – $440
Silver – $560
Gold – $604
Platinum – $737
These prices vary depending on you, your plan, your insurer, and your location. Premiums can also increase or decrease yearly.
A copay is a flat fee you pay for certain types of health care. If your insurance requires a $45 copay and you go to your primary care doctor, you’ll have to pay $45 at the time of your visit. Do your homework ahead of time so you know exactly what to expect.
Deductible
A health insurance deductible is the amount you have to pay for health care each year before your insurance starts to pay for some of your costs. For example, if your deductible is $1,500, you’ll have to pay the first $1,500 of all the costs that are covered. Keep in mind that some tests and annual checkups are covered by your insurance even if you haven’t met your deductible yet. Most plans don’t count copayments toward your deductible. Depending on your health insurance plan, the details can be different, so it’s important to know what it covers.
Coinsurance
Even after you’ve met your deductible, your health insurance won’t cover all of the costs. Instead, you’ll pay a percentage of the costs until you reach your out-of-pocket maximum. Coinsurance is the part of your health care costs that you are responsible for paying. So, if your coinsurance is 15%, you’ll have to pay 15% of the covered costs after you’ve met your deductible. The remaining 15% is paid for by your insurance company. That means you will have to pay $30 of a $200 bill.
Ways To Save On Health Insurance
We’ve talked a lot about prices. You might be thinking, “Wow, that’s a lot of ways to spend money!” How can I get money back? Wonderful question. We’re glad to say that we can help. These simple ideas can help make healthcare more affordable:
Shop Around
Most people don’t think about their plan for the next year and just keep the same one year after year. If you don’t look into your options, it could cost you a lot of money because your premiums could go up or the services that are covered could change. This is why it’s important to shop around not just for price, but also for services and coverage. Plans with low premiums will have higher out-of-pocket costs like deductibles and copays. People who know they won’t meet their deductible should choose these plans, as it is cheaper monthly.
On the other hand, there are plans with higher premiums, but lower deductibles. This is better for people who need more healthcare and have a better chance at meeting their deductible. Shopping around and comparing different insurance companies and plans can take a lot of time and hard work. With our highly trained agents who are experts in your area, EZ.Insure does all the work for you. Your advisor will do the work for you and sign you up for a plan that fits your needs in terms of coverage and price- all for free.
Stay In-Network
You’ll almost always save money by going to doctors, clinics, and hospitals in your plan’s network. In exchange for being part of the plan’s network, these in-network providers agree to charge less for their services. Getting care outside of your plan’s network could cost you more depending on your plan. If you have an HMO plan it’s likely you’ll have to pay the full cost of care from a provider who isn’t in their network. If you have a PPO or a POS plan on the other hand, some of your out-of-network care might be covered, but even with some coverage, you’ll still have to pay more for going out of network.
Look For Discounts
Even after you’ve chosen the best plan for your needs and budget, you can still save money. You can also look for discounts on health care that you might be able to get. Some doctors will give you a discount if you pay for a procedure ahead of time. If you know you need a colonoscopy, ask your doctor if you can save money if you pay for it in advance.
Understand You Plan’s Limitations
All plans have limitations to what they will cover. You can’t just assume that certain services and procedures will be covered. Instead, you should read the fine print to learn about the specific benefits and limits of your plan. You don’t want to get a surprise medical bill because you thought you were covered for a service.
Consider a Tax Advantaged Savings Plan
Several plans that help you save money on taxes can help you pay for health care. People with high-deductible health plans (HDHPs) can open a health savings account (HSA). You put money into your HSA and can take it out tax-free to pay for things like deductibles, copayments, and coinsurance. Your employer may offer an HSA, but you can also start one on your own and keep the money. Employers set up and pay for health reimbursement arrangements (HRAs). Employees can’t put money into their accounts, but they can take money out for medical costs that qualify.
Employers also offer FSAs, which stand for flexible spending accounts. Employees put money into the account before taxes are taken out, and they can take money out tax-free for qualified medical expenses. HRAs and FSAs don’t need a health plan with a high deductible, but you usually have to spend the money by the end of the year, and if you quit your job, you lose the account.
Find Out If You Qualify For A Premium Tax Credit
You might be eligible for the Premium Tax Credit if you buy your insurance on the open market. The government made a tax credit for people whose household income is between 100% and 400% of the federal poverty line. This helps make the cost of getting a plan through the Health Insurance Marketplace more affordable. This is for people who make too much to qualify for Medicaid or Medicare but still can’t afford health insurance. You can apply for a premium tax credit when you file your taxes to help pay for your premiums.
Work With An EZ Agent
An insurance agent can help you compare the costs and benefits of different insurance plans to find the one that gives you the coverage you need at the price you want. We can help you deal with all of this at EZ. By working with one of our licensed, highly trained agents, you can get all the answers you need in one place. They can compare all of your plans to make sure you get the best coverage for you. They can also explain all the legal jargon in your insurance information packet from step 1. All of this is done for free! No bother, and nothing to do. To get started, enter your zip code in the box below to get free instant quotes, or call 877-670-3557 to talk to one of our agents.
Kids and adults actually have a lot of the same dental issues, but since kids’ teeth are still growing, they are more likely to have problems. If you don’t treat tooth problems early, they can get worse and cause their adult teeth to come out of place. If kids of any age don’t take good care of their teeth and gums, they can get cavities and gum issues. So, in addition to teaching your kids how important it is to brush and floss, you should also take them to the dentist regularly so they can get care from a professional. 
Most people don’t think about their plan for the next year and just keep the same one year after year. If you don’t look into your options, it could cost you a lot of money because your premiums could go up or the services that are covered could change. This is why it’s important to shop around not just for price, but also for services and coverage. Plans with low premiums will have higher out-of-pocket costs like deductibles and copays. People who know they won’t meet their deductible should choose these plans, as it is cheaper monthly. 
