Most of the time, doctors and other health care workers see their patients in person at a place like a doctor’s office, clinic, or hospital. However, doctors and nurses can now diagnose, treat, and keep an eye on their patients’ care online. Thanks to computers, smartphones, and other new digital technologies. Using technology, telehealth is a way of providing health care services from a distance. It can be anything from doing medical visits over the computer to keeping an eye on a patient’s vital signs from afar.
The best part is telemedicine isn’t an expensive luxury like some people believe. In fact, according to a study done by The American Medical Association 33.1% of adults living under 100% of the federal poverty level ($14,580 per year) have used telehealth in the last year. So why is telehealth so popular and how does it benefit you? We’re glad you asked. Telehealth has a lot of treatment uses and benefits that virtually anyone can enjoy.
Telehealth Treatment
It may seem like a virtual treatment couldn’t be as thorough as an in-person appointment. While to an extent that’s true. Unless you need something like a shot or emergency care, a virtual appointment can do everything an in-person one can. All of the following things and services are possible with telehealth:
Recording vitals – You can send your weight, food intake, blood pressure, heart rate, and blood sugar levels to your doctor either manually with at home equipment or a wearable monitor.
Check test results – Telehealth isn’t just about appointments. You can also check your test results and prescription refills using the online portal. The online portal can also let you message your doctor directly or even schedule an appointment.
Coordinating care – You can share information like your test results, diagnoses, medications and exam notes between your PCP and any specialists you see. Right from the comfort of your own home.
Reminders – Telehealth includes being able to receive emails or texts as reminders for appointments, tests, or procedures.
Advantages Of Telehealth
Using technology to provide health care has many benefits. Such as saving money, being more convenient, and being able to help people who have trouble getting around or who live in distant areas without a nearby doctor or clinic. Because of these things, the use of telemedicine has grown significantly in the last ten years. Now, 76 percent of hospitals in the U.S. use telehealth to connect doctors and patients directly. Ten years ago, only 35 percent of hospitals did this.
During the COVID-19 virus outbreak, telehealth became even more important. People are more interested in and use technology to give and receive health care because they are afraid of sharing and getting the virus during in-person doctor visits. Other benefits include:
Improved access to providers
Most doctors who work in rural areas are family doctors or general practitioners. This means that they might not have access to or knowledge of more specialized kinds of medicine that rural patients need. Telehealth can help in this situation. Telemedicine software lets healthcare groups give patients in rural areas care that is more specialized. Or more up-to-date than they might otherwise be able to get. Patients are more likely to go to the doctor, now that it is easier for them since they can see providers without leaving their homes.
Flexibility
The main way that telehealth makes things better for patients is by making things easier for them. We all know that going to the doctor can be a pain. Taking time off work to drive 20–30 minutes to the doctor’s office, then sitting in the waiting room for another 20–30 minutes, having a short visit, and then driving home again is a lot of time. This makes people less likely to come in to see their healthcare provider. Telehealth cuts out almost all of that time and reduces it to a scheduled meeting that can be taken anywhere with a smartphone. It’s so much easier for patients, especially for appointments or checkups that don’t involve a physical test.
Improved patient health
Patients are much more likely to make arrangements for regular checkups and preventive care because telehealth makes it easy for them to do so. You might not think it’s worth the trouble to make an in-person meeting for something you think is small, but you could make a telehealth appointment instead. This means that you are living a healthier life generally and keeping an eye on how your health is going. Telehealth also has a lot of benefits for people who have long-term illnesses and have to follow a strict care plan. Routine checkups are much easier to do without having to go to the doctor’s office.
Remote patient monitoring and other more advanced types of virtual care can help you with chronic conditions even more by keeping track of important health data in real time so that problems can be caught as soon as they happen. Remote patient monitoring tools, such as blood pressure cuffs, smart blood glucose monitors, and heart rate monitors, can help telehealth and telemedicine appointments be more effective and improve your general health.
Disadvantages
Telehealth makes it easy and cheap to see your doctor without leaving your house, but it does have a few drawbacks. Not every kind of visit can be done from afar. You still have to go to the office for things like imaging tests, blood work, and treatments that need a more hands-on approach. Cost is another slight downside. During the COVID-19 outbreak, insurance companies are paying for more and more telehealth visits. However, some services may not be fully covered, so you may have to pay for them yourself. Additionally, telehealth requires telecommunications equipment to function properly. However, in order to gain the benefits of telehealth, many patients must have access to laptops, mobile phones, and tablets.
People in remote locations suffer with limited internet bandwidth and unpredictable connectivity. To function efficiently and without latency, video conferencing requires high internet rates. Accessing telehealth services may be challenging if you do not have a constant, stable connection.
Is Telehealth Covered By Insurance?
Telehealth services are starting to be covered by some private insurance companies, but telehealth coverage is very different from one state to the next. This is because each state has its own way of defining telehealth and paying for it. Since insurance plans vary, it’s important to check with your insurance company or the billing department of your health care provider for the most up-to-date information on how telehealth services are covered.
Preparing For A Telehealth Appointment
If you are fortunate enough to have access to the necessary equipment and internet, preparing for a telehealth appointment is fairly easy. Although, some people may find it hard to switch from in-person to online meetings, especially if they aren’t used to the technology. By taking a few steps before your appointment to prepare, you can make sure your visit goes smoothly.
1.Add it to your calendar.
Add your meeting to your calendar so you don’t forget once it’s set.
2.Use the best camera.
This can be connected to your phone, laptop, tablet, or desktop computer. If you can give your doctor a clear picture of what’s going on, he or she will be better able to understand what’s going on and help you.
3.Test your camera and microphone.
Practice with a family member or friend before your online visit with your doctor to make sure you know how to use your camera and microphone. Most devices have microphones and speakers built in, but you may need to turn them on or allow the telehealth app or website to use them. Using headphones or earbuds may make it easier for you to hear your doctor and for your doctor to hear you, but you should try them out first to see what works best.
4.Check your internet connection.
If you aren’t using Wi-Fi, try using a wired connection to your router with an ethernet cable to get the best signal. If you are using Wi-Fi, you can improve your link by being close to the internet router and having as few devices as possible connected to it.
5.Charge the device.
If you’re using a phone, laptop, or tablet that doesn’t have a cord, make sure the battery is charged enough to get you through your meeting. Try to charge it the night before your meeting.
6.Find a good spot.
Try to keep your area as clear as possible. Try to go somewhere with good lighting so that your doctor can see you well. Put your device on a stable surface so you can move around if you need to. Try moving your device so that the camera can see your head and shoulders.
7.Write down questions
If you are ready for your visit, you and your doctor will be able to talk about everything you need to. So, write out your questions or concerns and any symptoms you want to remember to bring up.
Working With EZ
This is just the beginning of how healthcare will change in the future, and many companies want to be a part of telemedicine so that more people will go to the doctor and hopefully catch a problem before it gets worse. The first thing you need to do is find the right health insurance that covers telehealth. 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.
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. We can also find and use any savings you might be able to get. Your agent won’t just help you find a plan, though. We also help you keep it up to date. We 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.
Medicare is an essential program for seniors over 65, however, many of its benefits are underutilized or misunderstood. Consider the annual “wellness” visit. During which a physician will assess your health risks, take your blood pressure and other routine measurements, test for cognitive impairment, and provide personalized health advice. It’s Free! Nonetheless, a surprising number of people do not take advantage of this benefit. This isn’t the only benefit that has gone under the radar. Many healthy seniors ignore a variety of free preventive services, ranging from bone density screening to cancer detection. Other benefits such as home health care, are also frequently unused due to their strict eligibility requirements. Below you’ll find all the ways to make sure you’re using all of your benefits and getting your money’s worth.
Choose The Right Doctor
It is important to choose a doctor who accepts Medicare assignments in order to save money. If a doctor accepts a Medicare assignment, they accept Medicare-approved amounts as full payment, and you cannot be charged more. Most physicians who treat Medicare patients will accept Medicare assignments. Providers who don’t participate fall into two categories:
Non participating providers – These providers can charge up to 15% more than the Medicare approved amount for covered services and leave you responsible for the additional costs
Opt-out providers – These providers can charge whatever they want which is outlined in a private contract with the patient.
To locate physicians in your area who accept assignment, visit Medicare.gov to find doctors and other health professionals section. The search tool displays which physicians accept Medicare payments.
If you have a Medicare Advantage plan, check your plan’s provider directory or website to ensure you’re choosing doctors in the network. Keeping in mind that doctors may be added or removed at any time. Generally, you will pay more to see non-network providers. Make sure that you research different doctors. Confirm that they accept Medicare and are willing to educate you on what is and is not covered so that you are not overcharged.
Understand Your Policy
Medicare provides coverage for skilled services such as nursing, speech therapy, and physical therapy, but there are eligibility requirements. To qualify for these services, you must be homebound. Meaning you are unable to leave your home without assistance or because of a medical condition. Many seniors mistakenly believe that they are covered for these services, only to receive a hefty bill in the end. Before assuming something is covered, carefully read your policy’s guidelines.
Look Into Medicare Advantage
Medicare Advantage plans are offered by private insurance companies and offer the convenience of having Part A, Part B, and Part D services all bundled into one plan. Whereas traditional Medicare has you sign up for each plan individually. Medicare advantage plans may also include coverage for routine dental, vision, and hearing exams. Which are not available under Original Medicare. However, the biggest benefit of Medicare Advantage is the annual out-of-pocket maximums for seniors excluding
prescription drug plans. Which as of 2023 is $8,300. With Original Medicare, there are no annual out-of-pocket maximums.
However, you should also be aware of the disadvantages of Medicare Advantage. Original Medicare is widely accepted by physicians and hospitals all over the country. Whereas a Medicare Advantage plan will have a smaller network of providers. So, it’s possible that your doctor isn’t in their network. Next, you may be required to get a referral before seeing a specialist. Which is not the case for Original Medicare enrollees. There are also certain covered services that Parts A and B that may have a high copayment under a Medicare Advantage plan. Meaning you would have higher out-of-pocket costs with Medicare Advantage than you would with Original Medicare.
If you have a chronic or serious health condition and will likely visit the doctor frequently, you may want to consider a Medicare Supplement Plan. Medicare covers the majority of eligible medical expenses for seniors, but you are still responsible for 20%-25% of the total cost of care. Medicare Supplement Plans were designed to help cover a substantial portion of the medical expenses that come from having Medicare Part A and B, that you would otherwise be responsible for.
As with Part D, private insurers offer Medicare Supplement Plans and with Part D, there are a variety of plans to choose from. So you should shop around carefully to find the plan that fits you best. While yes, Medicare Supplement Plans do have premiums and can increase your monthly expenses, the additional coverage could give you peace of mind and eliminate some of the uncertainty that comes with your out-of-pocket Medicare costs.
Save On Medications
Even if you have Medicare Part D prescription drug coverage, your out-of-pocket costs can be astronomical, in part because Part D does not have a limit for out-of-pocket expenses. After you reach the catastrophic coverage threshold of $7,400 (as of 2023), the majority of people will continue to have to pay 5% of the cost of covered drugs. In certain instances, you can reduce drug costs by forgoing your Part D plan and paying cash. Big-box stores such as Costco and Target offer a variety of generic prescriptions for much cheaper, whereas many Part D plans have a high standard copay to fill a prescription. The only problem with paying in cash and not using your coverage is that the expense won’t count towards your deductible.
If you stick with your Medicare Part D plan’s list of “preferred” pharmacies you will typically pay less for your prescriptions. Also most Part D plans separate their drug formularies (list of covered drugs) into 5 tiers: preferred generic, generic, preferred brands, non preferred, and specialty. With preferred generics being the lowest cost-sharing tier and the most affordable for enrollees. If you find a drug that is approved for your condition on a lower tier than the one you currently take, ask your doctor if you can switch to the more affordable one.
Review Your Quarterly Summary
Your quarterly Medicare summary displays services and supplies for which Medicare was billed. This summary will also indicate whether or not any claims have been denied; if so it is important to contact the provider of the denied claim. If you believe the claim is unjust, you can appeal the claim denial by following the instructions on the summary’s final page. When admitted to the hospital, for instance, you will receive a notice outlining your Medicare rights. You may request an appeal of the decision and a review of your case if you believe you were discharged prematurely.
Use Your Preventative Care
Many Medicare recipients don’t realize that there is a long list of services that they can get for free. Medicare provides numerous screenings and annual wellness visits at no cost to you. These free preventative measures are important for detecting serious illnesses early. The screenings may include depression, cardiovascular disease, and other conditions. There are free counseling sessions for tobacco and alcohol abuse, as well as free vaccinations for flu and pneumonia. Additionally, you are eligible for a free “welcome to Medicare” preventive visit within the first 12 months of receiving Medicare Part B. During this initial appointment, you can also receive free assistance planning for end-of-life care. And your physician can help you draft an advance directive that outlines all of your wishes.
Utilizing these freebies can aid doctors in detecting major health problems before they worsen, thereby preserving your health. You might also have access to free wellness benefits if you have a Medicare Advantage plan. Some Advantage plans, for instance, include SilverSneakers membership at no extra charge. This program provides a basic gym membership and access to senior-specific group exercise classes.
Plan Yearly Expenses With The Out-Of-Pocket Maximum In Mind
Individuals’ Medicare costs can vary widely based on their circumstances and the type of coverage they have. Original Medicare typically covers 80% of a beneficiary’s Part A and Part B expenses. Such as doctor visits, hospital stays, and lab work. Individuals are responsible for remaining 20% of out-of-pocket costs, with no annual cap. Medicare Advantage plans offer predictable copayments and an annual limit on out-of-pocket costs. Once you reach your plan’s out-of-pocket maximum, all Medicare-covered services for the remainder of the year are covered in full. This cap can provide peace of mind if you have a sudden illness or are preparing for a major medical procedure.
Shop Around Every Year
Original Medicare, which includes Part A (hospital insurance) and Part B (medical insurance), is relatively simple. There is no need to shop around for Parts A or B because they come in a universal package. Where you should shop around is your Medicare Part D plan and your Medicare Supplement Plans. Medicare contracts with private insurance companies that offer Part D and Medicare Supplement Plans to provide seniors with a variety of coverage options. Moreover, these coverage options and their costs can change from year to year. This means that the plan you have this year might not be the best for you next year. The worst thing you can do is automatically enroll in your previous year’s plan without comparing options. This could result in higher out-of-pocket costs and for Part D could mean less coverage for prescription medications.
Get Help From EZ
If you’re looking for a Medicare Supplement Plan or Medicare Advantage Plan, you must compare the costs and benefits of each. This requires extensive research. Which can be time-consuming, as you will need to contact multiple insurance companies to obtain rate quotes. However, if you work with one of EZ’s agents, you can compare prices in half the time. Working with a licensed agent provides you with access to a variety of carriers and plans.
In addition to providing price comparisons, your agent can explain the differences between each plan. And explain the differences between each plan. In addition, your agent can assist you in determining which plan will be the most cost-effective for you in the long run by comparing out-of-pocket costs and premium costs. Call us today at 877-670-3601 or enter your zip code in the bar below to begin comparing.
The weekend of August 6, Senate Democrats passed the Inflation Reduction Act of 2022. This legislation will help keep some of President Biden’s campaign promises, some of which are related to healthcare, like lowering the costs of prescription drugs. The revised bill is now set to be sent to the House, and if it passes as expected, it will be a massive win for Biden and the Democrats. Find out how the Inflation Reduction Act will affect you and your healthcare.
Passing the Inflation Reduction Act
The Inflation Reduction Act, which was negotiated as a result of Democratic Senator Joe Manchin’s opposition to the proposed Build Back Better Act, has finally been agreed to by all 50 Democratic senators. All 50 Republican senators opposed the bill, but Vice President Kamala Harris cast the tie-breaking vote, allowing the bill to pass in the Senate.
The bill will now be returned to the House, where the Democratic majority there is expected to approve it. It will then move on to President Biden for his signature. Biden himself lauded the compromise bill.
“Senate Democrats sided with American families over special interests, voting to lower the cost of prescription drugs, health insurance, and everyday energy costs and reduce the deficit while making the wealthiest corporations finally pay their fair share,” Biden said in a statement Sunday. “I ran for President promising to make government work for working families again, and that is what this bill does — period.”
Funding for the bill will come from raising taxes on some corporations that make over 1 billion dollars annually. There will be a 1% excise tax on the value of corporate stock buybacks, which Democrats are hoping will curtail some of these buybacks, since they produce capital gains but no immediate taxes. There has also been talk of giving more funding to the IRS to go after tax cheats.
What the Inflation Reduction Act Means for Medicare
In addition to fighting inflation, investing in domestic energy production, and fighting climate change, the bill also has provisions for helping make healthcare more affordable for Americans, especially seniors.
Medicare beneficiaries have been battling the cost of prescriptions for a long time, but this bill will allow Medicare to finally negotiate prices on prescription drugs. Once this bill passes, Medicare will be able to directly negotiate with drug companies, which will help lower the cost of medications and cap out-of-pocket drug costs for seniors.
For example:
Beginning next year, insulin copayments for Medicare recipients will be capped at $35 a month
Starting in 2024, those with costs high enough to qualify for the program’s “catastrophic coverage” benefit will no longer have to pick up 5% of the cost of every prescription
Starting in 2025, out-of-pocket costs for prescription medicines will be capped at $2,000 annually.
“This a huge policy change and one that has been a long time coming,” said Stacie Dusetzina, an associate professor of health policy at Vanderbilt University. “For people needing high-cost drugs, this will provide significant financial relief.”
On March 11, 2021, President Biden signed the American Rescue Plan Act, which expanded healthcare coverage and lowered healthcare costs by boosting subsidies for Affordable Care Act (ACA) plans. It allowed those who earn over 400% of the federal poverty level to receive subsidies to purchase health insurance through the ACA Marketplace. It also required that Americans pay no more than 8.5% of their income on health insurance premiums, and provided a larger tax credit to people who already receive financial assistance.
You can save more money by working with an EZ agent to find an affordable plan for all of your needs.
All of this was set to expire after 2 years, however, meaning by 2023 we would no longer be able to get the expanded subsidies and tax credits. But the Inflation Reduction Act will allow all Americans to continue to get subsidies for Affordable Care Act (ACA) premiums!
Looking For A Plan?
Whether you are a Medicare beneficiary looking to save money, or an individual looking for affordable health insurance, EZ can help. Our agents work with the top-rated insurance companies in the nation, which makes comparing plans easy, quick, and free – our services come at no cost to you because we just want to help you save money so you can focus on your health. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local licensed agent, call 888-753-7207 for Medicare help, and 888-350-1890 for health insurance help.
When you start a new job, you might be offered group health insurance. Employer health insurance is usually cheaper than an individual plan, which is why an attractive benefits plan is such a big deal.
However, the plans they offer could potentially cover less than what you need. In some circumstances, you can (and should) buy health insurance on your own. When making this choice, you have a lot to keep in mind, like what are their differences, and which one is better for you?
Individual Health Insurance Plan
When you look into individual or family health plans, you have the option to compare companies and their plans, then choose which one best fulfills your needs. With private insurance, you have more control over your options. These plans can be bought through the Marketplace, or directly from the insurance company via online, an agent, or broker.
The biggest advantage of an individual plan is its flexibility. This flexibility extends to your career too. You won’t have any formal insurance ties with your employer. That way if you leave or change jobs, you won’t have to worry about losing coverage.
The flexibility also goes with medical networks. You can choose a plan that includes your current doctors and hospitals. After you review your network, make sure you know when to renew or change your plan during the annual Open Enrollment period.
Healthcare can take a lot of research to find the right plans. Lucky for you, EZ.Insure can do most of that for you!
Employer Health Plan (Group Plan)
The biggest pro for employer health is how much they take off your hands. A company will do its own research, comparing the best plans in their area for employees. After purchasing a plan, the employer shares the premium cost with you. What this means is that they can get a better deal for group insurance and then help you pay for it.
As mentioned, this coverage will only be available to you when you stay with the company, so the moment you leave or are let go, the coverage ends. Also note that if their plan doesn’t include your usual doctor, you will have to choose between changing networks, or keeping your individual plan.
Other advantages of a group plan are as follows:
The company has done the research and picked the plan options already. Group health plans are guaranteed-issue, which means there is no medical underwriting.
Contributions toward your premium from your employer are not subject to federal taxes, and your contributions can be made pre-tax. This will lower your taxable income.
What It Comes Down To
Deciding whether to seek out your own individual family plan or go with an employer’s can be confusing. Your employer may not offer plan options that suit your needs. There are differences within the price, benefit options, and flexibility, not to mention the overall increase in insurance rates.
Over the years, employer insurance has seen premiums increase by about 3% for individuals and 5% for family plans, while individual health plans have increased by about 4%.
Still confused about a policy type? After you gather your info, give us a call and let us help you find the best coverage.
The average annual premium for an employer-sponsored plan is $1,242 for an individual. Compare that to the individual market, which has an average individual premium of more than $5,000 annually. This can be great (and saves you money), but there is a possibility you can find a plan for cheaper on your own.
Individual plans would be the way to go if you want to shop for the plan that exactly matches your needs. That way, you are in control of the costs and the coverage that you get. You will not have to worry about losing your plan if you lose your job or change jobs.
Group plans would be the way to go if you want to save money and are happy with the plan they offer. Their plans are also guarantee-issue, which is great if you have a pre-existing condition. If you seek an individual plan with a pre-existing condition, you can be denied, or it will be expensive. Some employers do offer incentives that lower premiums, such as quitting smoking or getting a gym membership.
All in all, the choice needs to be yours. What it comes down to in the end is what your needs are and the costs. While your boss could offer a plan that you think is too expensive, your individual plan may be even more costly.
Don’t stress out and overthink if you should opt for your employer’s plan or buy your own. If you want to seek what health insurance options are out there, EZ.Insure has your back. We will provide you with a trained agent within your region who can compare all available plans and their costs. This should make the process easier when it comes down to making a decision to go with your employers plan or not. For free quotes, enter your zip code in the bar above, or contact an advisor by calling 888-350-1890, or emailing [email protected]. Life is stressful enough, let us take some of the load off of you.
Following the recent democratic debates, Mayor of South Bend, IN, Pete Buttigieg has sparked conversations lately. The democratic debate found disagreements and controversy revolving around healthcare.
Pete Buttigieg wants to create healthcare that provides people with the option of choosing private health insurance or government healthcare.
Very few wanted Medicare For All, while the majority thought it should be up to the people whether they wanted private or government health insurance. Buttigieg introduced a middle-ground approach, allowing people to opt into the government health insurance while allowing them to keep private plans. The main point was to give people an option.
Options
Buttigieg’s proposal would not force people into a government health plan. He prefers that it be an option for the public to enroll or not. The idea behind the options is that it would force private insurance companies to compete with the government plan on price and coverage, hopefully bringing down the costs. He puts a lot of emphasis on giving Americans their right to choose and trusting them to make the right choice for themselves.
“For years, Washington politicians have allowed the pharmaceutical industry, giant insurance companies, and powerful hospital systems to profit off of people when they are at their sickest and most vulnerable,” he said. “My ‘Medicare for All Who Want It’ plan will create a health care system that puts power in the hands of each American.”
Promoting His Proposal
The mayor sponsored this proposal on Facebook saying, “Medicare for All Who Want It will create a public alternative, but unlike the Sanders-Elizabeth Warren vision, it doesn’t dictate to the American people and risk further polarizing them.” Another ad simply states, “I trust the American people to make their health care decisions for themselves.”
The Operation
The uninsured and low-income Americans who live in states without expanded Medicaid would be automatically enrolled in the government plan. Also, people with access to an employer’s plan would be able to join if that offered coverage is too expensive.
Buttigieg’s government’s plan would cover all of the 10 essential health benefits, including emergency services, hospitalization, and maternity care, which are currently mandated by the ACA. The mayor also wants to boost federal subsidies by capping premiums at 8.5% of income, and the base of subsidies would be on the Gold Plan’s cost, rather than the Silver Plans.
“Hospitals, not patients, should bear the responsibility of verifying that their providers are included in their insurance networks, whether for private plans or public programs.”
One last thing that Buttigieg would like to include in his plan, is to get rid of “surprise” medical billing. This occurs often when patients visit a doctor or hospital only to receive a hefty bill in the mail because they were out of network.
His game plan is to ensure that in-network hospitals be billed as just that–in-network. This is to be done even if the doctors and labs are out of network. “Hospitals, not patients, should bear the responsibility of verifying that their providers are included in their insurance networks, whether for private plans or public programs,” reads Buttigieg’s plan.
The mayor’s plan will cost about $1.5 trillion over 10 years, but he is hopeful that the American people will be happy with his proposal. The reason being that they will not be forced into government healthcare. The candidacy is still in its early stages, so only time will tell the future of America’s healthcare, under Buttigieg’s plan or another.
In 2014, the Affordable Care Act established the premium tax credit so that individuals or families with low or moderate income can be able to pay for health insurance through the Health Insurance Marketplace. Premium tax credits help you pay for a portion of your monthly cost of insurance premiums. Individuals and families must meet an income requirement to enroll in a health insurance plan through a state-operated insurance marketplace, or a federally-operated marketplace.
There are multiple qualifications for a premium tax credit. One is to calculate your income with the number of people in your household.
Qualifications
You must prove you do not have access to an affordable employer-sponsored program. This plan must meet minimum essential coverage meaning the employee contribution does not exceed 9.5% of the employee’s income.
You must prove you are not eligible for Medicare, Medicaid, or TRICARE
You cannot be claimed as a dependent by another taxpayer.
In the same month, you or a family member must have health coverage through a Health Insurance Marketplace.
You file a joint federal income tax return if you are married; you cannot file married filing separately tax return (unless a victim of domestic abuse or spousal abandonment).
Have a household income that falls within a certain amount.
Income Requirements
In order to be eligible for the premium tax credit, you and your family size must be at minimum 100 percent below the poverty line, but no more than 400 percent. This means the income must be between $12,060 and $48,240 for an individual and between $24,600 and $98,400 for a family of 4 in 2018.
The amount of tax credit is based on a sliding scale. This means the lower your income, then the larger credits you receive. If your income changes, then the amount of assistance you qualify for will change as well.
2019 Federal Poverty Levels
It is important to keep an eye on your household income and how much tax credit you receive. If the advance credit payments are more than the allowed credit, then you will have to repay some or all of the extra earnings. If your household income is more than 400% of the federal poverty line for your family size, then you are not allowed a premium tax credit. You will have to repay all of the advance credit payments.
Advance Tax Credits
A taxpayer can either choose to receive advanced payments, which is paid to the insurance company to lower monthly premium costs, or the taxpayer can wait to get all of the credit when they file their tax return. Eligibility for the advanced payments is determined when purchasing coverage through the marketplace. There is a difference between advance payments to your insurance company and your allowable premium tax credit amount. Form 8962 calculates your tax credit amount that is allowed when you file your tax return.
2.Use the best camera.
