CALL TODAY FOR MORE INFORMATION!

(888) 540-1620

CLICK TO CALL US TODAY!

A Guide To Understanding Health Insurance

The most important questions you need to ask

  • What does my plan cover?
  • How much does the plan cost?
  • Which doctors and hospitals are in it?

Expert Interview Series: Dr. Marlene Mahea of TeleMental Health Institute


Online training

Marlene M. Maheu, PhD is the founder and Executive Director of the TeleMental Health Institute, where she oversees the development and delivery of professional training to behavioral health practitioners from around the world through their online training platform at www.telehealth.org.

We recently checked in with Marlene to learn about what Telemental Health is, as well as the benefits and drawbacks for patients. Here’s what she had to say:

Tell us about Telemental Health. What is it?

Telemental health refers to the delivery of behavioral services across geographical distance via a wide variety of technologies (telephone, video, email, test messaging, apps) for a wide variety of services (e.g., clinical care, education, billing, consultation).

How did you become interested in Telemental Health? How has the field evolved since you got your start?

Drawn to technology in 1994 to explore how to reach many more people than prior, I started an online magazine that further opened my eyes to how health consumers from around the world clamored for information. I began asking questions about legal and ethical issues, and soon learned that very few of my colleagues in the large professional associations had begun to consider the realities of practicing via technology. That sparked my interest further, and has since led me to be a worldwide leader in legal and ethical issues (best practices) for the spectrum of behavioral professionals, from psychiatry, psychology, counseling, social works, marriage and family therapy, substance use and behavior analysis.

What do you think is the future for how providers offer behavioral health services?

We are just seeing the tip of the iceberg. Within a decade, using technology in routine medical and behavioral care will be the norm. We will interact regularly with our smart phone, tablets and other mobile devices to not only communicate with each other and our treating clinicians and their staff, but also with ourselves. Many of us will be wearing sensors that communicate much more about ourselves than most people can imagine today.

Much of that information will be stripped of identifying elements, and fed up to large cloud-based systems that will give us (and those with whom we choose to share) regular feedback about how we are doing with respect to the goals we have set for ourselves; our physical and emotional states; how we are sleeping; the medication or supplements we take; the food we eat; the water we drink; our exercise; our interactions with others, etc.

What are the benefits of telemental health to patients?

The largest benefit is related to access. That is, access to practitioners, to information, to other people who share our interests and concerns about healthcare, to other resources that can help us.

What about the potential drawbacks for patients?

Patients can be easily misled by uninformed practitioners who haven’t taken the time and energy that is ethically mandated to learn what they should about technology before they offer it to their patients. For example, practitioners have made their services available through technology that does not meet federal requirements for privacy and security, leaving their patients vulnerable to hacking and other violations. These practitioners are unwittingly acting as if they know wheat they are doing, when they frankly, have been cavalier about technology.

What considerations should patients make when using telemental health providers versus more traditional mental health providers?

Just as it is wise to ask a surgeon how many surgeries they have performed of the specific type being recommended, it is wise to ask clinicians how many hours of formal legal and ethical training they have received before jumping aboard with any technology they recommend.

In today’s day and age, a clinician’s knowing how to turn on a video system is simply not enough. All responsible clinicians have taken several hours of legal and ethical professional training to know how to protect their patient’s privacy, security and other issues when working across distance with whatever they choose for technology. For instance, many clinicians are practicing over state lines without a license, leaving the patient vulnerable if they ever feel the need to file a malpractice complaint against the professional involved. Others readily sign on with “life coaches” who practice worldwide, but are completely unregulated, meaning they never have to prove their credentials to a government entity, and cannot be held to professional standards by any law.

Patients then, ought to thoroughly inquire about any clinician’s legal and ethical as well as technical training with regard to any technology they are directed to use.

Is telemental health typically covered by insurance? How can patients find providers that will be covered by insurance?

In many states, TMH is covered by insurance. Consumers can inquire with their insurance plans to find approved providers. Many will also find some online, but I would caution against approaching services that hire unwitting, uneducated licensed professionals to do things such as offer anonymous care, which is illegal when offered by licensed professionals because those professionals cannot engage in a number of mandated services. Another example where licensed professionals are asked by some online companies to engage in illegal activities is when they practice over state and national borders.

What advice can you offer patients on shopping for insurance that will cover telemental options?

This really isn’t complicated. Ask your insurer if they cover telemental health, and if not, ask if they are required to do so by state law. That ought to get an interesting answer … The majority of states do require coverage by insurers on par with in-person benefits for insurance carriers.

If you can’t get a straight answer, go to the American Telemedicine Association’s website and look for their “report card” of states and how well they are doing with telemental health.

What trends or innovations in healthcare are you following right now for how they’ll benefit patients?

  • -mhealth
  • -Patient engagement tools
  • -Video-based tools
  • -Sensors
  • -Apps that are evidence-based (most are not)
  • -Technology platforms that offer a wide range of educational and clinical services for specialized populations, such as seniors, drug and alcohol patients, minorities

What health insurance headlines are you following right now? Why?

We are tracking legislative news related to state adoption and dissemination of telemental health services. We also track grants that will help our colleagues get funded for specialized service development.

We also are keenly interested in how the professional licensing boards are beginning to address telemental health with their licensees. We regularly get asked to consult or deliver professional training in conjunction with these regulatory boards to help them understand the scientific literature, the emerging technology and how other boards are dealing with the challenges of practitioners who are not bothering to educate themselves before delivering technology-based care to the clients and patients they serve.

Need help finding quality health insurance on a budget? View our plans.

Expert Interview Series: Sean Parnell of Selfpay Patient


Sean Parnell is the author of The Self-Pay Patient: Affordable Healthcare in the Age of Obamacare, a guide for patients who pay directly for medical services and avoid bureaucratic intrusion.

We recently checked in with Sean to learn more about what self-pay healthcare is and how it works. Here’s what he had to say:

Tell us about your professional background. How did you become interested in healthcare and public policy?

I have been involved in public policy and politics for nearly 20 years, and from the beginning have been interested in health care as an issue. One of my earliest jobs was working for a congressman from Iowa who was a surgeon before getting elected, and he played a significant role in promoting legislation known as the Patients’ Bill of Rights, which was a response to what were seen as abusive or at least unnecessary practices that restricted access to care for many who were covered by an HMO. Working for him I developed an appreciation for how third-party payers intruded on health care decisions, and my later work allowed me to continue looking at this issue.

How did you become interested in self-pay patients?

I had written a few articles on related topics, such as cash-only pharmacies and healthcare sharing ministries, when I worked at a free-market think tank. Later, during the time when the Affordable Care Act was being debated and passed, I heard people saying that they would “opt out” of Obamacare and forego insurance. I knew from my past work that it was possible and even desirable, but I saw that most people planning to opt out didn’t have the information on how to do it without taking significant risks. I thought that a guide book for people who don’t get care through insurance coverage might be a good idea, and that was when I decided to write the book.

What are your observations about the current climate of healthcare in the U.S.?

It’s difficult to have conversations with people because the issue is so tightly wound up in politics. I have my views, and in my other work I promote what I generally call “free-market healthcare” but I’m happy that my work on behalf of self-pay patients is largely devoid of politics.

What is a self-pay patient?

A self-pay patient is anyone who pays directly for some, most, or all of their health care services. Often they are uninsured or have a high-deductible plan, but sometimes people with what is considered more comprehensive coverage find themselves as self-pay patients too, usually in cases where the insurance company refuses to cover a particular treatment or a provider they want to see is out-of-network.

Why would someone chose to become a self-pay patient? What are the benefits?

There are many different reasons. In some cases it’s simply to escape what I call bureaucratic medicine, where an insurance company inserts itself between the patient and doctor and tries to dictate what sort of treatments are appropriate. It can also provide better access to care – patients in the conventional third-party payer system might have to wait longer to see a specialist or primary care provider, and that visit might be very short, eight minutes or even less with an actual doctor. If a self-pay patient can find a doctor or other provider that caters to self-pay patients, the visits tend to be much longer, allowing for greater patient-doctor interaction. There’s no downside I can see to that scenario.

Some want to escape what they see as government intrusion in health care, for example electronic health records that potentially give prying eyes the opportunity to examine what should be private medical files.

For other people, it’s a terrific way to save money – by not paying expensive insurance premiums and simply paying directly for the care that you need, most (but not all) self-pay patients will save a bundle, thousands or even tens of thousands of dollars a year. In many cases this is driven by the fact that a visit to a cash-only doctor is frequently less expensive than a visit to a doctor through insurance, and self-pay rates for surgeries can be much less as well, particularly if the patient is willing to travel.

And, of course, there are some people for whom it’s simple economic necessity – they cannot afford coverage, or all they can afford is a high-deductible plan that covers them from catastrophic bills but leaves them to pay directly for the bulk of their care.

What about the cons of self paying?

It can be tough to find doctors, hospitals, pharmacies and other providers that cater to self-pay patients and will give them a fair, simple price. And it requires a bit of thought and maybe even work – there’s no identified network of doctors, you might need to research which providers cater to self-pay patients, and you might need to negotiate for a lower price than what is listed. And it is crucial, in my opinion, to have some form of catastrophic coverage, such as a health care sharing ministry, a critical illness policy, or even a conventional high-deductible policy. If you can’t or won’t do the homework necessary to be a self-pay patient, it can get expensive in a hurry.

How are self-pay patients typically received by health care providers today?

More providers are switching over to either cash-only or at least cash-friendly every year, but it’s still a minority, perhaps 10 percent at most. But there is a growing awareness by providers that there is a self-pay community out there and that by catering to it, they can bring in new patients and avoid the hassle of dealing with insurance companies.

For those not wanting to try the self-pay option, what advice can you offer on shopping for affordable health insurance options?

The most important thing is to get a plan that meets your needs. If you are relatively healthy and rarely visit the doctor, then the size of the network probably shouldn’t be a big concern, and accepting a high deductible likely won’t be a problem either. On the other hand if you expect to visit health care providers on a semi-regular basis, more than five or six times a year, then having an adequate network is likely to be vital. One of the concerns with many of the polices being sold on the Affordable Care Act exchanges is that they are basically Medicaid policies, and Medicaid is horrible coverage.

How can Americans get better insurance rates?

I’m not sure that’s an option under current law or even the current paradigm, in which third-party payer is the dominant feature of the health care system. The Affordable Care Act basically took a broken health care market and built on it without really addressing the underlying problems. On the plus side more people have coverage, on the minus side that coverage isn’t all that great – I don’t think high premiums, narrow networks, and high deductibles was the direction anybody wanted to go, and yet that’s basically where we find ourselves. So I don’t have an answer to how to get better insurance rates, but I do have an answer for how to get better prices on healthcare – become a self-pay patient.

What healthcare news or trends are you following right now? Why?

The biggest news and trend I’m following is the significant rise in insurance premiums in the individual market. I think there is a very real possibility that the 6 million to 10 million Americans who are in the individual market but don’t receive any subsidies at all will begin to drop out and join the uninsured over the next several years as a “death spiral” plays out. This will add millions more to the self-pay market who need medical care but cannot afford high premiums. I think the so-called “public option” will be interesting to watch, but it will still basically be a Medicaid product that attracts few other than those with substantial subsidies and few options. And of course I’m watching the 2016 election for some signs of where health policy is headed – I know it’s headed toward a bad end, the question is, which bad end – single payer or a continuation of the current mess? Either way I expect the number of people ditching the dominant third-party payer system to grow.

Searching for affordable health coverage, but not ready to commit to self pay? View our plans.

Why Obamacare Has Increased Demand for Short-Term Health Insurance

When the Affordable Care Act (ACA, also called Obamacare) was being developed, it was supposed to do away with the need for short-term health insurance, which is insurance traditionally used to bridge brief coverage gaps.



The theory was, between the expansion of Medicaid in many states, and the competition in the online health insurance exchanges, everyone could have major medical coverage at all times. This would be the case starting January 1, 2014, when most ACA provisions went into effect. Reality, however, proved not to be nearly as straightforward, and sales of short-term health insurance plans have actually escalated in the past couple of years.

2014: The Individual Mandate Goes into Effect

Beginning in 2014, everyone except for those who qualified for a waiver was required to have major medical insurance, whether obtained through an employer, through government programs, purchased privately, or purchased through the ACA exchanges. At that time, penalties for not being insured were being phased in, so they weren’t very steep at first. Now, however, the penalty for those who do not obtain healthcare coverage and do not qualify for a waiver has increased to several hundred dollars for an individual. Yet even this penalty has not been sufficient to force people to buy qualifying plans. Why? Because plans have been far more expensive than expected for many people.

Expenses Have Been Too Much for Some Consumers

Though many people qualify for tax credits that help pay for health insurance under the ACA, those who do not have found that monthly premiums are prohibitively high in some cases. And high monthly premiums are a trend that shows every sign of persisting into 2017 and beyond. What has resulted is a large swath of the population that can afford health insurance, but paradoxically, cannot afford actual healthcare. Most plans have high deductibles, and it’s not easy for most people to fork over a couple thousand dollars out of pocket before enjoying co-insurance coverage. It puts many working people between the proverbial rock and hard place.

Short Term Health Insurance: Cheaper Even with a Penalty?



A subset of the population has found that financially, their best strategy is to accept the penalty associated with not fulfilling the individual mandate and purchase short term health insurance (which does not qualify under the ACA and does not prevent a person from being penalized). Even with the penalty, some people come out ahead in terms of overall healthcare expenses by using short-term health insurance. Foregoing insurance altogether, of course, would be cheaper – at least until that first illness or injury requiring treatment more than offset those savings. Non-wealthy people realize that going without health insurance altogether is entirely too big a financial risk.

Traditional Reasons for Temporary Health Insurance

Historically, people have purchased temporary health insurance when they knew they would be without coverage for a few weeks or months. Say, if a recent college graduate, who no longer qualified for student health coverage, was to start a job with benefits within a few months, a temporary health insurance policy would make perfect sense to prevent any gaps in coverage.

Someone between jobs, or who retired before being able to enroll in Medicare would also be a good candidate for temporary health insurance. The ACA, rather than eliminating the need for short-term health insurance, has ironically created a new group of people for whom it is a viable financial option: those who come out ahead with temporary insurance while taking the tax penalty.

Temporary or short term health insurance isn’t just for people between jobs anymore. For some ordinary consumers who might otherwise enroll in ACA plans, temporary health insurance plans can be more financially savvy, even when the penalty is factored in. We invite you to view our plans and evaluate all your options as the upcoming ACA Open Enrollment period approaches.

Does Obamacare Really Make Health Insurance More Affordable?

The United States Department of Labor recently reported that healthcare spending in August 2016 rose by the largest amount since 1984. Overall medical treatment costs increased by 1% in August, which by itself doesn’t sound threatening. But when tiny cost increases are sustained month after month, they really add up, and that 1% was the largest of repeated monthly increases over a span of 30 years.



Breaking the figure down to a more granular level, hospital services costs rose by 1.7% in August, and the average prescription medication cost rose by 1.3%. Over the past year, prescription drug prices have risen 6.3%, a faster rate than in previous years. Affordable health insurance is more necessary now than it ever has been.

More People Have Medical Insurance, and That’s Good

The percentage of uninsured US adults has fallen since the “individual mandate” part of the Affordable Care Act (ACA) took effect in 2014. In 2013, 17.3% of adults were uninsured, and the rate so far in 2016 is 10.8%. In terms of numbers, that means over 16 million more adults now have insurance than did in 2013. The biggest decreases in uninsured rates have been documented for minorities, younger adults, and those with lower incomes. States that expanded Medicaid have seen greater declines in uninsured rates than states that did not. But these figures don’t paint a complete picture.

Insurance Covers Fewer Costs while Consumers Cover More Costs

More American adults have health insurance so that risk is being spread more widely, which is good. However, health insurance policies themselves have changed significantly since Obamacare took effect, and it is changing the way people define “affordable health insurance.” While many Americans qualify for tax credits that help pay monthly premiums, many insurance plans have raised deductibles considerably in an effort to contain costs. The deductible is the part the consumer must pay out of pocket before insurance starts covering most of the cost of care. A policy with a $10,000 deductible may never reach the point where the insurer’s 80% co-insurance kicks in during the course of a year.



The main reasons consumers are paying a larger chunk of their healthcare costs have to do with insurers who want to make monthly premiums more palatable (but must raise deductibles to do so) and the simple fact of medical costs continuing to increase faster than inflation.

Going Without Medical Insurance Is Phenomenally Risky

Despite the fact that insurance policies pay a smaller percentage of total healthcare costs and consumers pay a larger percentage, it’s still not a reason to consider going without coverage, even for a short time. Suppose you have a two-week gap between leaving your current job and starting your next one. That’s not a long time, but a single accident or unexpected illness can generate huge medical bills in a very short time period. Going without medical insurance should not be considered an option because of the potential for ruining both your health and your bank account.

Finding Affordable Health Insurance Coverage

For brief (weeks- or months-long) gaps in health insurance coverage, short-term medical insurance is a smart investment. Premiums are lower than you might expect, and the peace of mind from having continual medical coverage can be priceless. Short-term medical insurance can also be a great option for young adults who age out of parents’ health insurance plans a few months before the next Obamacare Open Enrollment period, and it can be perfect for graduating students who lose student health coverage but won’t have job-related health insurance for a period of time.

There’s no “open enrollment” or “special enrollment” period with short-term medical insurance, and coverage can usually be obtained quickly, so you never have to go uninsured. We invite you to give us a call at 888-540-1620 with questions, or to discuss your options for affordable health insurance. Your health and your finances are too important to leave unprotected.

How Health Insurance Premiums & Deductibles Are Related

Health insurance premiums and deductibles can be envisioned as two ends of a see-saw. Typically, as one goes up, the other goes down. Your health insurance deductible is the amount you have to pay out of pocket before your co-insurance coverage is triggered.



For example, if your insurance plan has a $1,000 deductible and 80/20 co-insurance, once you have spent $1,000 out of pocket on covered medical expenses, 80% of the costs for your next covered medical services will be paid for by your insurance. You’ll be responsible for the other 20% until you reach a yearly or lifetime out of pocket maximum, after which your insurance will cover everything.

If you want the lowest monthly premiums, then you generally have to accept the highest plan deductibles. But if you want the lowest deductible before your co-insurance coverage begins, you will probably have to accept higher monthly premiums. Here is some more information about how health insurance premiums and deductibles are related.

Modest Premium Increases May Be Masked by Big Deductible Increases

Perhaps you are interested in renewing your health insurance policy for another year and are pleasantly surprised that your premiums have hardly increased at all. When this happens, it’s essential to look at your deductible, because insurance plans can mask premium hikes by raising deductibles. Most people give monthly premiums the most weight when choosing health insurance because it’s a predictable cost that they know they will have to pay. Ignoring deductibles, however, can result in financial pain. If you go an entire year without meeting your deductible, it essentially means you have paid all your medical costs out of pocket, and paid monthly premiums.

Hedging Your Bets Against Out of Pocket Costs

Choosing between a high deductible plan (with lower premiums) and a low deductible plan (with higher premiums) is somewhat of a calculated risk. Take into account your overall health history and the state of your finances. If you have a steady income, but no savings, you may consider choosing a plan with higher premiums so that you won’t have to meet a high deductible before your co-insurance takes effect. Additionally, if you tend to need medical services frequently, it may be worthwhile to choose a plan with higher monthly premiums and a lower deductible so that your medical spending will be more predictable.

Who Can Benefit Most from a High Deductible Medical Insurance Policy?



If you are healthy and have money in savings, you might consider choosing a high deductible plan and creating a tax-advantaged Health Savings Account (HSA) to take some of the sting out of your out-of-pocket costs. If you rarely need medical services, particularly if your finances are in good shape, choosing a high deductible plan may be your most cost-effective approach. Staying healthy all year and paying a low premium, plus keeping money in an HSA (which, unlike Flexible Spending Accounts, can be rolled over year to year) can keep your healthcare spending to an absolute minimum while offering you the protection you need.

Affordable Health Insurance Means Comparing Premiums and Deductibles

Personal healthcare spending is rarely predictable, but knowing your health history and your financial history can help you make the best choice and find the most affordable health insurance policy. The health insurance deductible is important, so don’t neglect to compare deductibles as well as premiums when choosing health insurance coverage.

Finally, the worst thing you can do is try to go without health insurance coverage. Even if it’s only a few weeks between jobs, or you’ve retired a couple of months before qualifying for Medicare, that’s still plenty of time for an unexpected illness or accident to result in enormous medical bills. Short-term medical insurance is designed specifically for these situations, and the premiums are often surprisingly low.

Short-term medical insurance can be the perfect solution to brief gaps in health insurance coverage. And unlike Obamacare insurance, there are no Open Enrollment periods to wait around for. You can obtain coverage at any time. We encourage you to view our plans and see how easy and affordable it is to protect your health and your finances.

What’s Your Out of Pocket Maximum?

If you were to receive a large medical bill, how big a check could you write towards that amount? When you learn how to choose a health insurance plan, you encounter the term “out of pocket maximum.” That is the maximum amount the insured person (you) will pay for covered healthcare services over the course of a year, and it’s a way insurance helps you control financial risk.

Out of pocket maximum

After you have paid your out of pocket maximum for the year, your insurer pays 100% of covered healthcare expenses. In an ideal world, your policy’s out of pocket maximum would be a lower amount than the amount you could come up with if you were faced with a major medical bill.

Insurance Out of Pocket Maximum Should Align with Your Own

If you can only reasonably afford to pay, say $5,000 out of your own pocket for non-covered medical expenses, then it doesn’t make sense to choose a health insurance policy with an out-of-pocket maximum of $8,000. It’s not always possible to find affordable health insurance with an out-of-pocket maximum that closely aligns with your personal out-of-pocket maximum, but it’s an extremely important consideration that helps you with not only healthcare planning, but also overall financial planning.

Affordable Health Insurance Isn’t Just About Premiums

Most people, when searching for affordable health insurance, want to know what the monthly premiums are. It’s a straightforward amount, and planning for it is simple, plus insurance policies are available with a range of premium rates depending on coverage. But super low premiums may only be worthwhile if you are a healthy person who rarely needs medical care, and in those cases, you should also consider your policy’s deductible, which is how much you pay before your insurance coverage kicks in. For most people, considering the out of pocket maximum is essential to selecting the right health insurance policy.

Why Out of Pocket Maximum Is Such an Important Number

Out of pocket maximum gives you a sort of worst case scenario for your medical spending. You could, for example, use your out of pocket maximum as a target goal for a savings account, so that if you do have medical bills, paying for them won’t require extraordinary measures. Out of pocket maximums may be as low as $1,000 for an individual, or as high as $11,000 for a family. Keep in mind that in general, the lower the monthly premiums, the higher the out of pocket maximum, and vice versa.

Out of pocket maximum

Affordability Is Made Up of Many Components

Knowing how to choose a health insurance plan requires learning some basic health insurance terminology, like the definitions of premiums, deductibles, coinsurance and out of pocket maximums. These four factors influence each other, and finding the policy with the lowest out of pocket maximum may mean paying a higher monthly premium than you want, accepting a higher deductible than you may prefer, or having a lower co-insurance percentage (say, 80% instead of 90%). You’re best examining all of these factors in light of your general health status and your overall finances. Then you’ll make the smartest choice.

Going Without Insurance Isn’t “Affordable”

For all but the wealthiest people, doing without health insurance is phenomenally risky. Not only could you choose to forego necessary medical care, any major care you ended up needing could completely wreck your finances. Medical bankruptcy is a real possibility, even for comfortably middle-class families without adequate insurance.

The smart way to cope with weeks- or months-long gaps in health insurance coverage is through temporary or short term health insurance. These policies are designed for short periods of time, and the premiums are often surprisingly affordable. They can offer you the exact peace of mind you need if you’re between jobs, a few months short of qualifying for Medicare, or have recently aged out of a parent’s health insurance plan. We invite you to get a free quote and take that first step toward protecting both your health and your finances.

Your 5 Best Health Insurance Policies

Americans spend a lot of time thinking about how to find quality health insurance because healthcare costs can so easily spiral out of control.

Naturally, your best health insurance protection is an actual health insurance policy, whether it’s coverage you obtain through work, through the Affordable Care Act, through your state’s Medicaid program, or with a short-term health insurance policy.


Health insurance policies

But there are countless everyday, regular steps you can take that can also keep you healthy and keep you from having to access expensive healthcare services unnecessarily. Many accidental injuries can be prevented, and, in fact, many illnesses can be prevented if you know how to protect yourself. Here are your five best health insurance policies that don’t come with an ID card.

1. Basic Safety in the Home

If you don’t have smoke detectors, get them. Many local fire stations have grants that allow them to give away smoke detectors to people who have trouble affording them. Check the batteries every month, and change the batteries at least every year. Keep hallways and staircases well lit, secure loose floor coverings, and practice good electrical cord management to prevent tripping and shocks. Make sure stairway handrails are sturdy and in good repair, and place non-slip traction strips in bathtubs to prevent falls.

2. Safety Behind the Wheel

Wear your seat belt on every trip, no matter how short, and secure your young children in approved car seats until they’re big enough to wear ordinary seatbelts. If you ride a motorcycle or bicycle, wear a safety helmet – even if you’re not required to by law. Never drive after consuming alcohol, and know how any prescription medications you take regularly affect you so you’ll know whether it’s safe to drive while taking them. If you wear eyeglasses, update your lens prescription as needed. And never, ever text and drive.

3. Doing Those Boring Things Doctors Say You Should Do

The advice almost goes in one ear and out the other:

  • Eat a healthy diet based on vegetables, whole grains, and lean protein sources
  • Exercise regularly
  • Quit smoking cigarettes
  • Learn to manage stress
  • Maintain a healthy weight
  • Don’t drink alcohol to excess

Yet healthcare providers advise these things because they actually make a positive difference. If you have a smartphone, you can find apps that will help you with every one of these lifestyle improvements, and professional help is available if you need it too.

Remember: help quitting smoking is far less expensive than a bypass operation.

Health insurance policies

4. Controlling Your Diabetes Instead of Letting It Control You

Diabetes has become so common that many people don’t realize how serious it is. What’s more, many people who have Type-2 diabetes don’t even know it. If you’re diabetic, take your medications as directed, particularly if you take insulin.

The advice above about eating healthy, maintaining a healthy weight, and exercising regularly is especially important for diabetics because it can help in maintaining tight control over blood sugar levels. Practicing simple, everyday care for diabetes can prevent many hospitalizations and other complications.

5. Investing in Preventative Screenings

Think of screenings as an investment in your health – one that can pay off tremendously. Your doctor can recommend which screenings you should have and how often, based on your general health, age, sex, and other factors. Other preventative steps you can take include making sure that your and your children’s vaccinations are up to date, and getting an annual flu shot.

Many serious illnesses that put people in the hospital (and that can cause death) are preventable through vaccination, and regular health screenings can identify major health problems – including mental health problems – earlier when they’re easier (and less expensive) to treat.

Cheap health insurance isn’t always about purchasing a policy, though you should do that too. Simply taking care of yourself and investing in simple, preventative measures can keep you healthy, help you avoid hospitalizations, and keep your overall healthcare costs under control.

If you find yourself between major medical insurance policies, perhaps due to changing jobs, a short term health insurance policy is a financially savvy way to help protect your health and your finances. Premiums are often lower than you think, and the peace of mind of knowing you always have coverage can be priceless.

We invite you to get a free quote and explore your possibilities. Your health and your family’s health are too important to risk.

The Best Healthcare Option – Preventive Care

Americans only use preventive healthcare services at about half the rate recommended by doctors. Preventive services, however, can be one of the best investments a person can make in their physical and financial well-being.

Avoiding preventive healthcare can rapidly become “penny wise and pound foolish” when a preventable condition manifests and costs far more to treat than it would have to prevent. For example, the cost of a flu shot is negligible compared to the misery of having the flu, and the potential for dangerous and expensive complications from it.


In many ways, preventive healthcare is the best healthcare, because it can save pain, time, and money. Even if you are normally healthy you can benefit from preventive health services.

Most Common Preventive Healthcare Services

It’s not a waste of time to visit your healthcare provider periodically even when you’re feeling fine. Preventive services may include screening for diseases like high blood pressure or diabetes (which often have no symptoms at first), to assess risk for conditions like heart disease, to update vaccinations, and generally to build a comprehensive, ongoing health record with your provider.

Some of the most common preventive services include tests and screening for:

  • Blood pressure
  • Blood sugar
  • Cholesterol levels
  • Colon cancer
  • Depression
  • Risk for ovarian or breast cancer
  • Sexually transmitted diseases

Not all preventive healthcare actions take place at the doctor’s office. Some are things you do yourself, perhaps with advice and help from your healthcare provider. For example, improving your diet to include more leafy greens and whole grains, exercising regularly, maintaining a healthy weight, and giving up smoking can all be considered preventive health measures.

Reasons Why Americans Forego Preventive Healthcare

Unfortunately, cost is one of the major barriers Americans face when it comes to accessing preventive healthcare. This is true for people with and without insurance. Some cheap health insurance plans may not offer comprehensive coverage of preventive services, but costs can go toward a policy’s deductible, and of course, preventing a major health condition costs less than having to deal with it in the future.


Other reasons people avoid preventive care include assuming they are healthy or that they are living on a low income, or, sometimes, language barriers. People without health insurance tend not to seek medical care until they can no longer ignore a condition. Unfortunately, this can mean requiring more invasive and expensive care. In other words, preventive care should be a priority for everyone, regardless of health insurance status.

Health Insurance Plans Lower Barriers to Preventive Care

Health insurance plans generally make getting preventive care easier and less costly. After all, people who cannot afford health insurance generally don’t have the disposable income necessary to have regular health screenings. It’s important to assess your health insurance options, which might include Medicaid coverage if you live in a state that has expanded Medicaid eligibility in recent years. Many people also qualify for credits toward the premium costs of plans offered by the Affordable Care Act (ACA), though it’s not always easy to enroll in an ACA plan outside the end-of-year Open Enrollment period.

Health Insurance Options to Ensure You Never Go Without

The best option for making sure you never have to go without health insurance is short-term health insurance. These plans are ideal for the person who is between jobs (and benefits), the person whose work-sponsored health insurance doesn’t become available until after a certain period of time on the job, young adults who become too old to remain on a parent’s health insurance plan, and older adults who leave the workforce a few weeks or months shy of qualifying for Medicare.

Premiums for short-term health insurance plans can be refreshingly low, and you don’t have to worry about open enrollment periods, because you can obtain coverage at any time – often as soon as the next day. We encourage you to view our plans and learn the ways you can incorporate health insurance into your life and your budget. You’ll have an easier time affording preventive care, and better chances of avoiding expensive care that comes from postponing preventive services.

How Wearable Technology Is Transforming Healthcare

If you haven’t already heard of the internet of things (IoT), you soon will. It refers to the interconnection of everyday devices so they can collect and exchange data. The so-called “smart home” products like the Amazon Echo and the Nest “learning thermostat” are examples of IoT technology.


Wearable technology is part of the IoT that is changing how people live their everyday lives, allowing them to track steps, activity levels, sleep, and even physiological measures like heart rate. Wearable technologies have the potential to transform healthcare. These technologies could ultimately lead to earlier diagnoses, and lower healthcare costs.

Could Health Data Collection Lead to Cheap Health Insurance?

Wearable devices and apps that people use on their smartphones and tablets make it easy to collect valuable personal health data and to integrate that data with a person’s normal activities. An app that counts how many steps someone takes might show a burst of activity corresponding to the user having to chase down a dog that has inadvertently escaped. Heart rate data could be easily correlated with activity or stress levels, and blood glucose data could be matched up with mealtimes, insulin use, and even shopping habits.

When wearable devices and apps collect data and generate feedback based on user input, medical care becomes more personalized and accurate. The cost of these apps and of the data collection are minimal, and researchers are still learning the best ways to use the data to help people be healthier. Details can be gathered that are difficult to collect during routine doctor visits. Ultimately, the result should be less wasted time, more prompt diagnoses and care, and lower care costs.

Examples of Apps and Wearable Technology Use in Healthcare

Apps and wearables are already affecting ordinary people’s healthcare. Some health insurance plans encourage the use of apps that collect health data. Today there is an FDA-approved smartphone compatible blood glucose meter that automatically uploads glucose measurements for access by both patients and their doctors. It can drastically reduce the annual cost of treating a person with diabetes due to reduced need for emergency visits.

A San Francisco-based digital health company recently secured funding for commercializing a pregnancy wearable product that automatically detects and tracks contractions in pregnant women, displaying the information on a smartphone. And Royal Philips has developed HIPAA-compatible wearables that can monitor blood pressure and temperature.


Patient Privacy Issues Must Be Accounted For

Data privacy is a concern of most non-health app users, and it is an enormous concern for healthcare apps, particularly when data is automatically uploaded to patient web accounts. The rules in place for ensuring patient privacy are still in effect, but they are expected to continue to evolve as technology advances.

Patients themselves seem willing to share health data with their doctors and nurses, according to recent surveys. They’re less agreeable when it comes to sharing health data from wearables, apps, and IoT devices with employers or health insurers, however. Striking the right balance between data availability and privacy concerns will require concerted effort, but the results may help revolutionize healthcare, making it less clinic-centered and more patient-centered.

While mobile health devices and apps have the potential to make healthcare services better and less expensive, it’s always wise to understand your health insurance options, because no one expects healthcare costs to plummet. People who experience brief time periods between major medical insurance policies (due to missing the Affordable Care Act Open Enrollment period, being between jobs, or aging out of a parent’s health insurance plan before another plan is in place) can protect their health and their finances through short term health insurance.

Short term health insurance is generally very affordable, and can be obtained quickly, and at any time, since there are no designated open enrollment times. Going without health insurance is tremendously risky. Fortunately, short term health insurance policies offer people peace of mind of knowing they are covered should they be ill or injured. Why not get a free quote and learn more about your health insurance options? We would be happy to hear from you.

How Do I Know What Health Insurance Is Right for Me?

We all need health insurance because the medical and financial risks without it are too great for the non-wealthy person to cope with. But there are countless plans, and determining the relative merits of each can overwhelm many ordinary consumers.


Health insurance

The plan that works best for your parent may be completely different from the one that will work best for you. Determining which health insurance plans make sense requires knowing your own probable healthcare needs and how much you have spent on healthcare in the past. It also requires a bit of prognostication since, of course, many medical issues are unexpected. Here are the factors to consider to determine the best health insurance plans for your needs.

Learn to Navigate Health Insurance Alphabet Soup

Four main acronyms you should understand are HMO, PPO, EPO, and POS. With an HMO (Health Maintenance Organization), you are only covered in your HMO network, except for emergencies. Seeing a specialist requires a referral from your primary care physician.

PPOs are Preferred Provider Organizations that provide significantly higher benefits when you remain within the PPO network. You don’t need a referral from your primary physician if you want to see a specialist, but to keep costs reasonable, you generally need to choose specialists that belong to your PPO network.

Exclusive Provider Organizations (EPOs) require you to use in-network physicians except for emergencies. Unlike HMOs, however, EPOs don’t require you to obtain a referral from your primary care physician in order to see a specialist.

Point of Service (POS) plans have networks within which you have greater coverage, but going out of network requires a referral. These type plans work well for people who have a strong relationship with their primary doctor and trust him or her to coordinate care and give referrals when they need to go out of network.

Look at Health Insurance Plan’s Networks

Once you know the different types of networks and decide which type is best for your needs, look at the networks themselves. It’s fairly easy to find out whether your doctor belongs to various insurers’ networks. Usually, you can find out from insurer websites, but you can also call doctors and ask. The practice’s billing manager should be able to tell you if the physicians in that practice belong to a particular plan from a particular insurer. Regardless of which type of healthcare network you choose, in-network care will cost less than out-of-network care.


Health insurance

Compare Relative Figures for Premiums, Deductibles, Copays, and Coinsurance

Premiums, deductibles, copays, and coinsurance vary with respect to one another. For example, you might find a plan with a network to which your doctor belongs, and the premiums are refreshingly low. But once you look more closely, you may find that deductibles (the amount you must pay out of pocket before your coverage starts) are unreasonably high. Generally, plans with higher deductibles and copays and lower coinsurance percentages go along with lower premiums. Conversely, low-deductible plans with lower copays and greater coinsurance usually have much higher monthly premiums.

Explore the Scope of Different Plans’ Benefit Coverage

Finally, before choosing a particular plan, look at each candidate plan and what is covered. Choose a plan with coverage that matches well with the type of health problems you have. If, say, you have asthma, your plan should include the specialists you need in their network and make it easy for you receive care on short notice. Or if you have a mental health condition, you will want to select a plan with good mental health benefits, even if it is short on other benefits you probably won’t need. For example, if you’re a young, healthy man with depression, look for plans with excellent mental health coverage and don’t worry about coverages you’ll never need (like OBGYN services).

Selecting among health insurance plans is challenging, so it’s important to take the necessary time to make the wisest choice for your healthcare needs. Temporary gaps in coverage can easily be handled with a temporary or short-term health insurance plan, so you need never go without insurance coverage. With short-term plans, you can enroll at any time, and premiums are often significantly lower than you might expect. If you require short-term coverage or expect to, we encourage you to get a free quote. It can set your mind at ease and help ensure you never go without the peace of mind or the coverage that health insurance provides.

Why Are Health Insurance Premiums So High?

Affordable health insurance may seem like a fantasy, particularly in the face of rapidly rising health insurance premiums. Premiums are calculated based on a number of factors, including your zip code, age, and smoking status.


Health insurance

One reason premiums are rising in these early years of Obamacare is that sicker people are signing up for insurance and receiving more medical services than anticipated. But health insurance premiums are also rising because healthcare services are becoming more expensive.

High Premiums Are Primarily Due to High Medical Costs

Health insurance pays for medical claims, and the prices of the services provided by doctors have been going up at a faster rate than general inflation. One particular area of strong inflation is in the cost of prescription drugs.

The prices that Medicare pays providers are determined by the federal government. With private insurers, each provider negotiates with each insurer to set prices.

In the private sector, price varies because prices are not set by the government, and the result is that the same medical procedure can cost significantly different amounts, even within the same geographic area, due to how negotiations between providers and insurers end up being settled. As demand increases (due to an aging population and more people buying insurance), prices will tend to increase as well. Here are some ballpark figures for several common medical procedures. They drive home why you should never go without health insurance.

Appendectomy

If you were able to “shop around” for an appendectomy in generic small town America, (an unlikely scenario since appendectomies are often performed in emergency situations), you would find costs ranging from around $11,599 to $13,096, based on amounts health plans pay on claims. But these numbers are a bit slippery since some insurers pay based on bundled pricing and some don’t, and insurers are often able to negotiate lower rates from providers. If you get an estimate for a surgical procedure, ask whether facility, physician and anesthesiologist fees are included.

Coronary Artery Bypass

Heart bypass surgery is one of the more common invasive cardiac surgeries, and you can expect it to cost over $40,000, not including diagnostics, testing, and follow-up care. Since this is an inpatient procedure, you can expect costs to vary significantly based on where it is performed. And again, that $40,000 figure is based on what insurers pay, which may well be below “sticker price.”

Knee Replacement


Health insurance

If you have to have knee replacement surgery, expect it to cost over $23,000. Again, since this is an inpatient procedure, prices will vary significantly among hospitals, and whether an insurer pays costs based on bundled or individual services. Even with good health insurance, your out-of-pocket costs can easily be in the thousands of dollars.

Hysterectomy

The typical cost for a hysterectomy is almost $13,000. Around 600,000 hysterectomies are performed each year in the United States. It is the second most frequently performed major surgery among women of reproductive age. Most hysterectomies are performed for non-cancerous conditions and, by age 60, one-third of American women will have had one.

Spinal Fusion

Lumbar spinal fusion is a surgical procedure that permanently connects two or more vertebrae in the spine so that there is no motion between them. During the procedure, the surgeon places bone, or bonelike material between two spinal vertebrae, and then metal screws, rods, and plates are often used to hold the vertebrae together as they heal. It’s an expensive procedure, costing over $40,000.

Healthcare Bluebook and Fair Health Consumer Cost Lookup are two websites where you can get estimates of the cost of medical procedures based on your location. But it’s important to remember that, even within one city, costs can vary quite a bit from one provider to another.

Clearly, unless you’re very wealthy, you need affordable health insurance to cover you in the event you need an expensive medical procedure. But does cheap health insurance exist? In some cases, the answer is yes.

Short-term health insurance policies are designed to provide healthcare coverage for a period of weeks or months and are perfect when you face a gap in coverage. Premiums are often lower than you’d expect, and short-term health insurance is often used by young adults aging out of a parent’s plan, people between jobs, and people who retire a few months before qualifying for Medicare.

Selective Healthcare encourages you to view our plans and learn about your affordable health insurance options. Nobody, however healthy, should try to get by without health insurance due to the medical and financial risks that uninsured people face.

 

Obamacare Exchanges Are Collapsing – What Can You Do?

Despite having a few years of Obamacare, healthcare costs continue to spiral upward. This upward spiral in the cost of healthcare means health insurance premiums are rising rapidly, and now enrollment in Obamacare plans is lower than expected. Some pundits go so far as to predict that the healthcare exchanges under the Affordable Care Act (ACA) could be gone within a year.


In the first quarter of 2016, enrollment in healthcare exchanges dropped by 1.6 million, and there are concerns that enrollment could drop below 10 million by December due to exchange customers being unable to pay premiums.

UHC, Others Pull Out of Exchanges

United Healthcare (UHC) is the nation’s largest insurer, and it is pulling out of exchanges in all but a few states. Blue Cross Blue Shield programs in several states may pull out as well, citing major losses from selling on the ACA exchanges. For example, Blue Cross Blue Shield of Minnesota plans to exit that state’s market after having lost half a billion dollars. Blue Cross affiliates in New Mexico will be leaving, and Blue Cross plans are losing money in many states, to the tune of hundreds of millions of dollars. In states where they plan to remain, premium hikes of more than 20% are expected.

ACA customers can expect premiums to jump for 2017 regardless of whether their insurer pulls out of the exchanges. Plans on California’s exchange are expected to increase by more than 13% next year, while Anthem and Blue Shield will raise premiums by closer to 20% – significantly greater annual increases than in the past two years.

Healthcare Cooperatives Shut Down

Sixteen out of 23 non-profit, state-chartered co-ops created by Obamacare to sell affordable insurance plans have gone bankrupt. These co-ops were set up under the ACA with the goal of increasing competition with more established insurers, but with only seven remaining in business, that goal is more elusive than ever.

One of the biggest unspoken problems with co-ops shutting down in the middle of the year is patients who have to change insurance face sizeable challenges. For example, when starting over with a new insurer, patients also will have to start over toward meeting their annual deductible. Furthermore, the network of their new insurer may not overlap sufficiently with their previous one, which can result in problems with continuity of care.

Is Affordable Health Insurance Just a Dream?


All this is enough to make people wonder if affordable health insurance will ever become reality. Fortunately, around two-thirds of non-elderly Americans are able to obtain health insurance through their employer, with employers usually paying part of the premium and employees kicking in the remaining premium amounts. Still, for those without employer-sponsored insurance, the options may not look that good for 2017. Some may indeed choose to pay the non-enrollment penalty imposed by the ACA and take their chances. But remaining insured should always be a top priority.

Remaining Insured Despite ACA Problems Still the Wisest Choice

Despite the problems with Obamacare, going without insurance is still too much risk for most people to bear. With the simplest emergency department visit costing hundreds, if not thousands, of dollars, healthcare costs for people without insurance can quickly overtake their income and savings. Bankruptcies due to lack of health insurance are far from uncommon. So what is a person to do if they cannot obtain employer-sponsored insurance and if the options available under the ACA are too limited to serve their needs? One alternative that more people should know about is short-term health insurance.

Cheap Health Insurance Options Outside the ACA

Short-term health insurance is a non-ACA option that makes sense for people in many situations. Suppose your healthcare co-op under the ACA goes bankrupt a few months before the next ACA Open Enrollment period. Starting over with another ACA plan can cause overall healthcare costs to increase sharply. But a short-term health insurance policy can bridge the coverage gap until the next Open Enrollment period at a much lower cost. Short-term, or temporary health insurance policies generally have significantly lower premiums than do traditional major medical policies. What’s more, there are no open enrollment times with short-term health insurance policies, and many people can obtain coverage quickly – often within a day.

Selective Healthcare invites you to view our plans and see what your affordable health insurance options outside the ACA are. Going without is too risky. Fortunately, you have options.

Confused About Copays, Co-Insurance and Deductibles?

Insurance is one of the more complicated financial tools the average person uses, so don’t despair if you have trouble understanding your health insurance policy. Health insurance policies have become more complex in recent years as insurers struggle to cope with rising costs of medical services.


When you evaluate personal health insurance policies, there are three important elements you should evaluate closely before making your decision: copays, co-insurance, and deductibles. The right combination of these three for you may be different than the right combination for your mother or your neighbor. Here’s what you should know about copays, co-insurance, and deductibles.

Insurance Copays

Insurance copays are the flat fees you pay each time you visit a healthcare provider. They average around $24 for a visit to a primary care provider, $37 for a visit to a specialty care provider, and just over $300 for hospital admissions. If you have to make a lot of visits to a primary care doctor or specialist, you should consider the copay amounts various insurance policies require. If you are generally healthy and don’t have to visit a doctor often, copays may be less of a concern to you than your co-insurance amount should you have a catastrophic illness or injury. In general, you can expect plans with lower premiums to have higher copays and vice versa.

Co-Insurance

Co-insurance is the percentage of covered benefits that you are responsible for paying for. It kicks in after you have met your deductible. Suppose your personal health insurance policy has a $1,000 deductible and a 20% co-insurance. After you have spent $1,000 out of your own pocket to cover your deductible, you break your ankle and visit an orthopedist to have it treated. At that point, you’re responsible for 20% of the orthopedist’s charges, while your insurance policy pays the other 80%. Co-insurance percentages vary (typically from 10% to 40%), and you should evaluate policy co-insurance amounts based on how likely you think you are to meet your deductible in a given year.

Insurance Deductibles


When you buy a personal health insurance policy, you will be assigned a deductible. This is the amount that you have to pay out of pocket before your insurance benefits begin. It’s like when you’re in a fender-bender in your car, and you have to pay $200 or $500 out of pocket before your car insurance kicks in to pay for the repair. If for example, your policy has a $2,000 deductible, you will pay the first $2,000 of bills for covered services yourself. After that, you will only be responsible for a copay or co-insurance amount for covered services. Health insurance deductibles have been growing rapidly due to rising healthcare costs over the past few years.

High deductibles aren’t as much of a problem for people who are healthy and rarely need medical care, but they can be financially challenging for people who have extensive medical needs and a high-deductible policy. Choose a health insurance policy with a deductible that is reasonable for your typical healthcare needs and your financial capabilities.

Evaluating Your Personal Health Insurance Choices

When you evaluate health insurance policies, you want to consider “total cost of ownership” based on your general health status and your financial situation. There’s no way of knowing how much medical care you’ll need in the coming year, but you can get an idea based on past history. Are you more likely to need a number of relatively low-cost services? Are you likely to need fewer, more expensive services? Or do you rarely need medical services? Answering these questions in light of your finances can help you prioritize whether the copay, co-insurance, or deductible is the most important factor in the plan you choose.

Many people who prioritize low premiums find that temporary or short-term health insurance policies are perfect for covering gaps in insurance that occur due to job changes, aging out of a parent’s health care plan, or other lapses in coverage. Such plans can be perfect for providing short-term coverage until a new job with healthcare benefits begins, until the next Open Enrollment plan under the Affordable Care Act (ACA), or until you are eligible for Medicare. If you want to better understand your choices in health insurance policies, we encourage you to call us today at 888-540-1620. We would be more than happy to answer your questions.

Obamacare Meltdown – What Does It Mean?

The upcoming Open Enrollment period for Obamacare health insurance will deliver key information to whoever takes office as President next January. This year’s Open Enrollment period is the fourth one, and health insurance experts will be watching closely, particularly to see how many healthy young adults enroll.


There are some young adults who have done the math and concluded that they’re better off paying the tax penalty associated with foregoing health insurance than signing up for one of the health insurance plans for which they’re eligible. Some choose low-cost short-term health insurance plans to bridge coverage gaps and reduce financial vulnerability in the event of an accident or other unforeseen medical issue. Here’s what you should expect with the upcoming Open Enrollment period.

Expect Obamacare Insurance Premiums to Go Up

Drug and healthcare costs continue to increase, and along with these come higher health insurance premiums. Medical insurance quotes will almost certainly be higher than they were last year for most people, and in some cases, significantly higher. How much of an increase you might see depends on many factors, including market shifts.

Premium hikes will vary by state, and even within markets, but the overall trend is predicted to be higher premiums. Last year, the premium on the most popular “silver” plans jumped by 11% on average. Deductibles also increased significantly. Many insurers have struggled to remain profitable while operating on state healthcare exchanges, and some are considering pulling out of Obamacare altogether.

Factors Causing Upward Pressure on Premiums

General increases in healthcare expenditures account for much of the upward pressure on premium rates. In 2014, healthcare spending in the US increased by 5.3%, and medical costs are generally expected to increase year after year. Rising drug prices, particularly for specialty drugs and cancer drugs, have caused insurers to scramble to restructure formularies so consumers can maintain most of their prescription drug coverage, but in some cases, drug price increases have been astronomical.

It isn’t just higher healthcare service and drug costs driving the prices of health insurance plans upward. Under the Affordable Care Act (ACA), there is a cap on insurer profits, and insurers must insure anyone, regardless of pre-existing health conditions. These factors, along with other specifics of how plans must be structured under the ACA, are influencing premiums.

Aetna, UHC Scaling Back Health Insurance Plans Significantly


Aetna was once an enthusiastic participant in the ACA marketplace, but the insurer has recently done an about-face. Aetna recently called off a planned expansion and gave hints that it could abandon the ACA market altogether. The company cites higher than expected costs, particularly on specialty pharmaceuticals. Aetna had hoped to break even in 2016, but recently announced it will lose $300 million from individual policies it sells through the ACA.

Other major insurers, like UnitedHealth and Humana, have said they’re scaling back 2017 participation in ACA exchanges, and some smaller, nonprofit cooperatives are going away completely after experiencing big losses in recent years.

Risk Mitigation Programs End in 2017

Currently, there are three federal risk mitigation programs that were created under the ACA, and two of them expire in 2017. The purpose of these programs was to protect insurance companies from big losses due to providing insurance on the ACA exchanges. UnitedHealth, for one, had difficulty anticipating costs for covering sicker and older people and, in some cases, set premiums that were inadequate. With risk mitigation programs going away in 2017, insurers may take the opportunity to increase premiums significantly, or pull out of the ACA altogether.

The “risk corridors” marketplace stabilization program has actually been too cash-depleted to pay back insurers who tried to make claims under the plan. Specifically, the risk corridor pool has only had about $1 to cover every $10 in claims from insurers.

You Still Have Choices

Some people, particularly young, healthy people, have come to the conclusion that paying the tax penalty for not buying ACA-qualified health insurance plans, and then enrolling in low-cost short-term health insurance plans is a better way to spend their healthcare dollars.

Short-term policies generally have low premiums, and they’re not tied to the ACA exchanges, so there’s no waiting around for an Open Enrollment period to buy short-term policies. Selective Healthcare understands all your options for healthcare coverage, and we encourage you to call us today at 888-540-1620 for medical insurance quotes and explore the many ways you can pay for healthcare coverage in 2017.

Why Go to a Doctor When You Feel Fine?

You’ve heard all the old adages. “An ounce of prevention is worth a pound of cure.” Or perhaps, “A stitch in time saves nine.” What they’re essentially telling you is that taking care of small issues right now can prevent you from having to deal with major problems later on. It holds true in many areas of life, including housekeeping, car maintenance, and child-rearing.


And, of course, it applies to your health. Think how much easier it is for your dentist to fill a tiny cavity than to have to excavate an enormous one and possibly have to replace the natural tooth with a crown. The momentary pinch of a vaccination is nothing compared to the misery of preventable diseases, some of which can be deadly. In short, you should see a doctor regularly even though you feel fine so problems can be dealt with early, or prevented altogether.

Preventative Healthcare Services Often Affordable

Many healthcare providers, including hospitals, clinics, and private medical practices, work hard to make preventative healthcare services affordable, often working with insurers to get outstanding value for patients who are candidates for a yearly mammogram or PSA test. Some providers even offer specials depending on the time of year. For example, since October is Breast Cancer Awareness Month, many hospitals offer reduced cost screenings during that month to encourage women to take better control of their health.

Caught Early, Health Issues Easier to Deal With

Of course, screening itself doesn’t prevent disease, but it can often identify problems well before they cause physical symptoms. A small, suspicious mole can be removed and biopsied with minimal fuss while, if it’s left unattended, it could grow into a major health problem requiring serious intervention. The same is true for many common conditions, including heart disease. By identifying elevated cholesterol and triglycerides early, patients have far more options for coping and preventing serious problems later on.

Another Obvious Case for Preventative Healthcare: Flu Vaccines

Annual flu vaccinations are another “no brainer” as far as preventative healthcare. In fact, many health care plans cover the cost of flu vaccination, since complications from flu can be extremely expensive to treat (and in some people, deadly). If you’ve ever had flu, you probably understand that the tiny needle-stick you endure to get vaccinated is nothing compared to the days you can spend in bed, in pain and miserable while your body tries to fight off the flu virus. Many other vaccinations are available too, and are advisable for certain populations. For example, people can be vaccinated against shingles and certain types of pneumonia.


You Should Also Prevent Gaps in Your Healthcare Coverage

Just as you should prevent health problems by having regular checkups, screenings, and preventative services, you should prevent major financial difficulties by ensuring you don’t have any gaps in your healthcare coverage. Short term health care plans are perfect for bridging coverage gaps that can arise from being between jobs, aging out of a parent’s health insurance plan, or graduating college and having to wait a few weeks or months before gaining employer-sponsored health coverage.

Not everyone knows about temporary or short term health care plans, but they can be the ideal solution for certain life situations. They don’t necessarily provide coverage as extensive as traditional major medical health care plans, but they do offer catastrophic coverage, and often come with surprisingly low premiums. What’s more, unlike with many employer-sponsored plans or plans offered as part of the Affordable Care Act (ACA), you don’t have to wait around for designated open enrollment periods to sign up for short term health care plans. In fact, coverage can often be obtained within a day, so you can minimize the amount of time you’re without health insurance coverage.

Preventative healthcare services should be a part of every adult’s life. So should preventative financial practices, like ensuring you never go without healthcare coverage. With the costs of healthcare continuing to spiral upward, nobody can afford to be without health insurance, even for a short time. Temporary or short term health insurance plans are like preventative healthcare for your finances, preventing financial and health disaster by ensuring you can get the care you need when you need it. Selective Healthcare invites you to get a free quote and discover how affordable short term health care plans can be. There’s simply no reason to go any time without healthcare coverage when you have so many great options.

What Are the Odds You’ll Go to the Hospital?

Maybe you eat properly, exercise regularly and safely, wear your seatbelt every time you ride in a car, and get flu shots every year. That’s terrific. You should keep it up, but there’s simply no way to completely avoid the possibility of being hospitalized. Even if you do what you can to avoid major health problems, you can reduce, but not totally eliminate the possibility of ending up in a hospital or hospital emergency department.


Even the briefest hospital stays are expensive, even if you have health insurance. If you don’t have health insurance and aren’t wealthy, a short hospitalization can completely wreck your finances. Let’s look at the statistics and gain a better understanding of the chances you’ll require hospital care. You might be surprised.

Ballpark Probability of Hospitalization by Age Range

One personal finance site calculated estimates of probability of requiring hospitalization broken down by age group as follows:

  • Under age 15 – 1 in 24.7 (Approximate odds of 24:1)
  • Ages 15-44 – 1 in 18.8 (Approximate odds of 18:1) (not including childbirth)
  • Ages 45-64 – 1 in 7.1 (Approximate odds of 6:1)
  • Ages 65 and older – 1 in 2.6 (Approximate odds of 1.63:1)

Are you surprised? Even for kids and teens, who are typically healthy and bounce back quickly, the odds of ending up in the hospital aren’t that long. And once a person reaches retirement age, the odds are quite short.

Emergency Department Visits Are Common, and Expensive

What about emergency department visits? They’re definitely more common than hospitalizations, and they can be extremely expensive. The National Center for Health Statistics reports there are approximately 136.3 million emergency department visits per year in the U.S., where the total population is 319 million. Obviously there are some people who make repeated ER visits (like people with uncontrolled asthma), but that still represents a fair chance that you’ll end up seeking ER care. Just over 40.2 million ER visits are due to injuries, and 2.1 million visits result in admission to a critical care unit.

Hospital Stays Don’t Just Happen to Older People


Accidents and illnesses happen at every stage of life. Being young and in good health is no guarantee you won’t need hospitalization. Hospitalizations per age group are lowest for people under age 15 (accounting for 7% of hospital patients) and highest for those over age 65 (accounting for 38% of hospital patients). The next highest percentage is in the 15-44 age group, which accounts for 31% of hospital patients, including women in childbirth. The 45-64 age group accounts for the remaining one-quarter of hospital patients.

Hospital Visits Per 100 Persons Per Year

If you look at the population as a whole, there are 41 outpatient hospital visits per 100 persons per year, according to the U.S. Centers for Disease Control. While you may well be one of those 59 out of hundred people who avoids hospitalization, the odds aren’t overwhelmingly in your favor, and these visits can be costly. If you don’t have health insurance, you could put a serious crimp in your budget at best, or experience major financial problems at worst. Even if you have a brief time period during which you’re without health insurance, you’re wise to take steps to bridge these coverage gaps.

Short-term health insurance is designed precisely for these situations, and it can help save your health and your finances should you become ill or experience an injury. The premiums for short-term health insurance are generally lower than the premiums for regular major medical insurance, so it’s practical if, for example, you’re between jobs, or retire a few months short of Medicare eligibility.

If you’re facing a gap in health insurance coverage, you owe it to yourself to explore the options for short-term health insurance. We invite you to get a free quote and see for yourself how affordable, short-term health insurance can be one of the smartest financial moves you can make.

Accidents Happen. Are You Prepared?

Some people seem to never get sick. Maybe they’re just phenomenally lucky, or maybe they take meticulous care of their bodies, eating well, exercising, and reducing risk factors for illness as much as reasonably possible.

The problem is, there’s no vaccine against being struck by a car because someone was texting and driving. Injuries can happen to anyone and, when injuries are involved, choosing care is often based on how quickly care can be delivered, with worries about costs shelved until later, as they should be.

Injuries Often Result in Expensive Emergency Care

If you are injured, a top emergency department is exactly where you want to go. The doctors, nurses, and technicians that work in emergency medicine, as well as the paramedics and emergency medical technicians that transport injured and ill people to the hospital, have extensive training on how to cope with any type of injury.

A broken leg or head injury won’t wait for you to compare care costs. In many injury cases, the sooner you can have emergency care, the better your prognosis. Yes, emergency care is expensive, but when you’re involved in an accident or are the victim of violence, concern for treatment and healing takes precedence over concern over cost.

Car Accidents Are Still Distressingly Common

In the United States alone, more than 37,000 people die in car crashes every year, and another 2.35 million are injured or disabled. And with U.S. citizens traveling abroad, road crashes are the single biggest cause of death. In fact, globally, 1.3 million people die in road crashes per year, which averages out to nearly 3,300 deaths per day.

While awareness of the risks of drunk or impaired driving has increased, a newer threat is making roads more dangerous than they should be: texting and driving. People simply cannot concentrate on the two separate things with sufficient attention. Texting requires a level of attention that doesn’t allow for sufficient concentration on driving. If someone messes up a text, the worst consequence may be embarrassment, but if they take their attention away from the road, consequences can be far worse.

Injuries and Age Groups

Car crashes, of course, aren’t the only ways people are injured. When it comes to nonfatal injuries treated in the emergency departments of hospitals in the U.S., unintentional falls are number one in all age groups except 10-14 and 15-24. The second most common nonfatal injury treated in emergency departments is unintentionally being struck by or against something. Unintentional cuts, bites, stings, and punctures are common injuries treated in ERs, as are accidental burns and pedal cycle accidents.


The top three fatal injuries in the U.S. are unintentional poisoning, car accidents, and unintentional falls. However careful someone is with their health, the risk of accidental injury is always there and, depending on your location, the risk of being the victim of a violent crime can also be high.

Still Think You Don’t Need Healthcare Insurance?

Without healthcare insurance, your financial situation could be ruined due to an unexpected accident or injury. You may think, “I’m a great driver, so it would be the other person’s fault, and they would have to pay,” but first of all, this isn’t necessarily true, and second, it can take months or years between the time medical charges are billed and the time all insurers and parties involved come to some kind of settlement.

The average ER visit in 2014 cost $1,233. That average is across everything from catastrophic accidents to minor illnesses to health crises like heart attacks. Costs can easily spiral much higher. If an injury requires that the patient be hospitalized, costs add up at a dizzying pace. Even if you make a decent wage, a few days in the hospital can seriously damage your financial situation.

Healthcare insurance is a necessity. If you’re between jobs or between major medical policies, short term health insurance can provide coverage so you never have to do without. It only takes a split second to end up facing thousands of dollars in medical expenses, but you can protect your health and your finances with short term health insurance. Policies often have surprisingly low premiums, and enrolling can often be done within one day, so there’s no waiting around for open enrollment periods. Take a look at our short term health insurance plans and learn how easy it can be to avoid financial catastrophe in the event of an accident, injury, or illness.

Preventive Care vs. Diagnostic Care – What You Need to Know

Obtaining health insurance quotes is about more than just finding out what your premium payments will be. The more health problems you have or expect to have based on family history and your own experience, the more you need to pay attention to aspects of health insurance plans like deductibles and yearly out-of-pocket maximum expenditures.


 

Understanding health insurance quotes isn’t always easy.
 

One aspect of health insurance plans that people are paying more attention to is the coverage of preventive versus diagnostic services. What’s required to be covered and exactly how it is to be covered depends on factors like whether the health insurance plan conforms to the requirements of the Affordable Care Act (ACA). Understanding your need for preventive care versus your coverage for it can help you find the health insurance plan that makes the most sense for your life and your financial situation.

Some Health Insurance Plans Cover Preventive Care

Health insurance plans that cover preventive care often waive co-pays for services like routine annual physical exams and age- or gender-appropriate screenings. Preventive care services also typically include services like flu vaccines, vaccination against hepatitis A and B, and other necessary immunizations. Your health plan may or may not send you an explanation of benefits (EOB) statement after you have preventive services.

If you visit your doctor and new health problems are discovered, or you find out you have a condition that must be addressed, such as diabetes, the services are generally not considered preventive, since they didn’t prevent a problem. Some travel vaccines (malaria, typhoid, etc.) aren’t considered preventive care because they’re not immunizations that people routinely receive. If a preventive screening, like a mammogram indicates that follow-up is needed, the follow-up tests are generally considered diagnostic care.

Preventive Care vs. Diagnostic Care

Here are some examples of preventive care, though the specifics vary based on the particulars of health insurance plans:

• Screenings (like mammograms and colonoscopies in certain age groups)

• Routine immunizations

• Certain routine lab tests

• Other care intended to prevent illness or detect problems before symptoms appear

And here are examples of diagnostic medical care, though again, the specifics of various health insurance plans determine if and how these are covered.

• Mammogram as follow-up to discovery of a breast lump

• Colonoscopy after complaint of rectal bleeding

As you can see, a service may be considered preventive in some contexts, yet diagnostic in others. This usually affects how much of the charges you are responsible for out of your own pocket.

Know What Your Health Insurance Quotes Cover


 

Independent insurance agents are trained to understand and explain coverage choices.

In addition to knowing your doctor’s billing policy, it’s essential to know what health insurance quotes cover when you’re comparing plans. If a preventive service leads to an additional procedure on the spot (like a doctor removing a suspicious mole during a routine physical), it may no longer be covered as preventive. Something that may be considered preventive for some people may not be considered so for you due to your age or gender.

With non-preventive services, which are diagnostic services, you’ll be responsible for co-pays, deductibles, and co-insurance responsibilities. If you don’t understand the circumstances under which a preventive service becomes a diagnostic service, ask your insurer or insurance agent. They’re trained to know these things, and you’re entitled to know.

Your Stage of Life and Circumstances Should Inform Your Choices

Preventive care needs generally increase with age. The otherwise healthy young college graduate may not require much in the way of preventive healthcare, while the person who is close to Medicare qualification age may require multiple preventive services. Consider your stage in life, whether you have dependents, and your overall health when you compare health insurance quotes. Know what those quotes play out a few scenarios to understand your potential best-case and worst-case scenarios.

Sometimes Short-Term Health Insurance Is the Smartest Choice

If your needs are shorter term, like if you will soon start a job with major medical coverage as a fringe benefit, or if you’re retiring a few months short of qualifying for Medicare, short-term health insurance is well worth considering and is sometimes your smartest choice. Premiums are generally lower than premiums with traditional major medical coverage. If you have questions about differences between preventive and diagnostic care, what’s typically covered, and what you can expect premiums to cover, we invite you to call us today at 888-540-1620. We’re more than happy to assist you and answer your questions.

More Questions to Ask When Buying Healthcare Insurance

Cheap health insurance doesn’t have to be an impossibility as long as you are an informed consumer and ask plenty of questions before enrolling in a plan.


Health insurance

Being informed is step one to finding affordable health insurance.

In a previous post, we covered the top questions you should ask before signing up for health insurance. Here we offer several additional important questions that can help you evaluate your options and choose wisely. Be sure to get answers to the following questions for each health plan you consider.

Do I need a Referral for Procedures and Specialists?

Most affordable health insurance plans are Preferred Provider Organizations (PPOs) or Health Maintenance Organizations (HMOs), with defined networks of healthcare providers you’re allowed to visit to receive covered treatment. Generally, HMOs are the strictest about staying within the network. They often require that you see your primary care physician and obtain a referral to any specialist you may need. Pre-authorization for certain procedures is also common. If your plan requires a referral and you don’t get one, you could be on the hook for the entire cost of the specialist services.

What Documents Will I Need for Enrollment in this Health Insurance Plan?

If you’re purchasing health insurance on the private market, identity information is the primary documentation you’ll need to provide. If you are applying through the Affordable Care Act (ACA, or Obamacare) and think you may be eligible for a tax credit to cover some or all of your premium, you will need documents (like tax returns) that verify your income. The same is true if you plan to enroll in your state’s Medicaid program. The Medicaid Expansion states require proof of income and household size before enrolling people in the program. If you have children you plan to enroll, you’ll need identity documentation for them too.

How Would I Appeal a Denial of Benefits?


Health insurance
Do you know what to do if your insurer denies a claim?

Sometimes you think a medical service is covered under your insurance, but you’re then informed that it isn’t. There can be any number of reasons for denial of coverage, from the simplest (an identifier misspelled or entered incorrectly) to the most complex (a determination has been made that the “medical necessity” of a procedure hasn’t been proven, for example). Every insurer has its own process for appealing a denial of benefits. The amount and type of documentation you’ll have to provide depends on the reason for denial. Hopefully, you won’t ever have to appeal a denial of benefits, but it’s smart to know what to do in that eventuality.

Can I Join my Parents’ Plan if I Don’t Live with Them?

If you’re under age 26, you may be eligible to enroll on a parent’s insurance plan. In fact, if you have siblings who are already enrolled on it and you qualify, this can be one of the most affordable health insurance options for a young adult. The major issue you must be aware of, if you enroll in a parent’s plan and you don’t live near them, is that you may have to see doctors in the network that are geographically close to them. That could be a problem. Explore the extent of their provider network thoroughly before committing to being on your parent’s health insurance plan.

What if I Only Need Coverage for a Short Period of Time?

Any number of situations may arise where you only need insurance for a period of weeks or months. Perhaps you graduated from college and your new job with health insurance benefits doesn’t start for a couple of months. Or, maybe you’re between jobs. Perhaps you have retired a few months short of qualifying for Medicare. In these situations, a temporary or short-term health insurance policy can be your best option for preventing gaps in coverage. Premiums are surprisingly affordable, and the peace of mind you’ll gain from knowing you have health insurance coverage can be priceless. We invite you to get a free quote from us and take that first step to enrolling in the coverage you need to live the life you want.

Top 5 Questions to Ask When Buying Healthcare Insurance

Buying health insurance should be an informed, considered process. Unfortunately, you may be put in a situation where you must act quickly to prevent coverage gaps, and you may not feel like you have the time you need to gather all the necessary information.


Answers to health insurance questions depend on your stage of life, dependents, and risk tolerance.

But, if you know which key elements of a plan add up to the most affordable health insurance, you can make a smart decision without wasting time. Here are the top five questions to ask when buying health insurance.

1. Who Participates in Your Preferred Provider Network?

Most plans today have preferred provider networks from which you choose healthcare providers to maximize insurance benefits. Many plans have large, extensive networks that incorporate a variety of specialties, practices, and facilities. It’s important to find out whether the health insurance policy is part of a network, and who participates in it. Often, it’s a matter of a simple online search to learn whether your doctor, hospital, or other provider is included in the network. Going outside the network typically means significantly higher out-of-pocket costs and can turn cheap health insurance expensive quickly.

2. What Are Out-of-Pocket Maximums with This Health Insurance?

Policies that meet the criteria of the Affordable Care Act (ACA, or Obamacare) are required to conform to certain annual out-of-pocket maximums for individuals and families. These can vary from one policy to another. Plans that do not conform to ACA rules may or may not have out-of-pocket maximums, so it’s important to ask. How much of an out-of-pocket maximum you’re willing to risk should depend on your general health, your income, how likely you are to be able to meet your annual deductible, and past experiences with health insurance.

3. Is the Medication I Take Covered Under This Plan?

An estimated 60% of Americans take at least one medication regularly, and an estimated 15% take five or more. Whether the medications you take are covered under your policy can make a tremendous difference in the amount you spend on healthcare in a given year. It’s also important to understand which drugs are covered as brand name drugs, which are only covered as generics, and what the various “tiers” of copayments are for different types of drugs. Each insurer that offers prescription drug coverage has what is called a formulary, which spells out which drugs are covered and how. Your insurance agent can provide this information. You can often find it online as well.

4. What Are my Deductible, Copay, and Coinsurance Amounts?

Knowing deductible, copay, and coinsurance amounts helps you envision worst- and best-case scenarios.

High-deductible plans are more common than ever, because higher deductibles tend to go along with lower monthly premiums. If you’re in good health and have no dependents and a steady income, a high-deductible plan may be ideal for your particular risk profile. Copays are the amounts you pay when you visit your doctor, and are typically $25 to $50. Naturally, if you visit the doctor frequently, you would prefer lower copays. Coinsurance is how much is covered once you meet your deductible. Does the plan cover 80% of expenses after that? Some plans may cover 100% of after-deductible costs, while others may only cover 50%, so be sure to ask.

5. When Does Coverage Take Effect?

If you enroll in an ACA plan, coverage may not take effect immediately. Enrolling during the end-of-year Open Enrollment period generally means that coverage takes effect the following January 1. If you qualify for a special enrollment period at another time, coverage may not take effect for 30 days. It’s important to find out so you’ll know exactly when any coverage gaps may exist. If you choose to enroll in a temporary health insurance plan as a cheap health insurance option between major medical policies, the good news is you can usually obtain coverage quickly – often by the next day. These policies can be the perfect way to ensure you’re covered affordably when it will be a few weeks or months until your major medical plan kicks in.

Health insurance needs may have more than one solution and, as a consumer, you need to know your options. If you are experiencing a temporary coverage gap while waiting for a new job to start, while waiting to qualify for Medicare eligibility, or for any other reason, we encourage you to view our plans. Temporary health insurance coverage can provide you with peace of mind about both your health and your finances.

What They Didn’t Teach You About Health Insurance in College

If you have graduated from college, then clearly you have the initiative and commitment to finish what you start. Whether or not you have accepted employment, understanding and possibly changing your health insurance situation is important as you leave student life behind.


 

Adult responsibilities await you, but they need not be overwhelming.

Health insurance isn’t the most exciting topic, but taking care of it right now is something your future self will thank you for. It need not be overly complicated, and if, like many young adults, you’re healthy and don’t have dependents, you have more options than most people for affordable health insurance. Here are some things you probably didn’t learn as part of your college education, but that are important to making the best start in life.

Young and Healthy Does Not Equal Invulnerable

It can be awfully tempting to do without health insurance, but there are two big reasons to avoid this temptation. First, most people are required under the Affordable Care Act (ACA) to have health insurance, and you could be hit with a tax penalty if you don’t obtain coverage. Second, you’re not immortal. Nobody expects to become seriously ill or be involved in an accident, and if this should happen to you and you don’t have health insurance, your problems will grow far beyond just getting well. You could ruin your finances before you ever establish good credit.

Understand the Limitations of Remaining on a Parent’s Plan

If you had student health coverage while you were in school and lost it when you graduated, if you’re under age 26 you can be carried on a parent’s health insurance policy. Sometimes this is the easiest and best option, particularly if a parent already has family coverage that includes your siblings.

The main problem with parents’ health insurance plans is that they may be part of a restricted network of providers. This isn’t a problem if you live in the same area as your parents, but if you live farther away, you could find yourself limited to providers located nowhere near you.

Congratulations: You’ve Had a Qualifying Life Event

The good news is that graduating college and no longer being eligible for student health insurance plans is a “qualifying life event” under the ACA, which means if you want to enroll in an ACA plan, you don’t have to wait until the next Open Enrollment period in November to choose a plan.


 

As a new college grad, you shouldn’t have to wait to enroll in a health insurance plan.

But not everyone is interested in ACA health insurance plans. You may have a job lined up in a couple of months that will provide health insurance, which is great, but what will you do in the meantime? There are more options than you might know.

What Are Your Options in Health Insurance Plans?

In addition to being added to a parent’s plan or signing up for an ACA plan due to your qualifying event of losing student coverage, consider temporary health insurance plans, particularly if you have employment with health insurance benefits lined up. Temporary plans represent an affordable health insurance option, and the premiums are often far lower than they are for traditional health insurance.

Another great thing about temporary health insurance plans is that there’s no such thing as an “Open Enrollment” period, so you can sign up today. You can often have coverage within a day or two, so you can minimize the time you spend without insurance. Temporary health plans rarely cover things like maternity care, but for the single, healthy college graduate, they can provide tremendous peace of mind at an affordable cost. A temporary plan could bridge your coverage gap until your new job starts, or if you plan on getting married within a few months to someone who can then add you to their plan, it can fill in the coverage gap perfectly.

Don’t put off obtaining health insurance. You have more options than you may think, and affordable health insurance is more widely available to young college grads than many other age groups. Understand all your choices, and if you face a period of time without coverage, explore your temporary health insurance plan options, because the risks of going without are too high. We invite you to view our plans and find out for yourself just how affordable health insurance can be, and how easy it is to obtain the peace of mind that comes from knowing you’re covered.

What It Costs to be Hospitalized

It is not a “spoiler” to say that hospitalization is expensive. Exactly how expensive depends on countless factors, but there are organizations that collect data from insurance claims to develop ballpark figures. While some hospitals may offer discounts for uninsured people who can afford to pay cash, those people are rare.


Short term medical insurance

Sure, medical insurance is a monthly expense on top of all your others, but arguments to buy health insurance heavily outweigh arguments for going without. Knowing exact hospital costs in advance is almost impossible because they are made up of room costs, procedure costs, costs to pay clinicians, and overhead. However, let’s look at some representative prices so you can get an idea how quickly your out-of-pocket costs add up, even with insurance.

Room Costs: A Major Part of Your Hospital Bill

A 2014 survey by Kaiser State Health Facts found that an average inpatient day that year cost $1,974 at government-run hospitals, $2,346 at nonprofit hospitals, and $1,798 at for-profit hospitals. All these figures represented increases over those for 2013, and there’s little reason to believe they will not continue increasing.

Room costs are only part of the picture, however. You will be charged for what happens in that room. Moreover, if your hospital stay includes, say, surgery, you will have charges related to using of the operating room and the people who take care of you there. So your room costs are typically only a fraction of your total hospital bill.

The Cost of Procedures Adds Up Quickly

Procedures, from injections to sutures to surgery, plus the related tests that go along with them add up quickly. Some tests may be repeated during your stay, and you are billed for each instance. Pinning down figures for procedures and tests is difficult because costs vary by hospital and geographic region. Parts of the country where the overall cost of living is high (New York, San Francisco) generate costlier testing and procedure bills than areas where the cost of living is lower.


Short term medical insurance

If you live where the general cost of living is high, expect medical costs to be correspondingly high.

As just one snapshot in time of one zip code, these costs for relatively standard procedures were calculated by fairhealthconsumer.org, a nonprofit organization that gathers data from medical insurance claims to promote medical pricing transparency. The longer you remain in the hospital, the more these costs add up, so even two or three days as an inpatient can cause significant bills.


Short term medical insurance

Miscellaneous Charges

With costs of being a hospital patient, expect the unexpected. You may choose your hospital and surgeon from your insurer’s preferred network, but not everyone who cares for you at that hospital is necessarily in the network. Your radiologist, for example, may be out-of-network, and you will be billed at a higher rate (though some states have laws protecting against this). Some physicians call in multiple consulting physicians for their expertise when treating patients, and your bill increases each time one of these consulting physicians sees you.

There’s also the uncomfortable fact that a high percentage of medical bills contain errors. It is not easy for the layperson to read an itemized bill and understand what the terms mean, and whether a procedure you are billed for actually happened.

There’s Every Reason to Buy Health Insurance

Short term medical insurance is an option if you will be without healthcare coverage for a limited amount of time. Don’t be tempted to go without insurance, even for a brief period. Short term or temporary health insurance can be remarkably affordable, and you can often get next-day coverage, so there’s no waiting around for an “open enrollment” period.

With short-term medical insurance, instead of throwing yourself on the mercy of an emergency department when you need care, you may seek care at a far less expensive urgent care center, and, should you be seriously ill or injured, you will have far fewer worries about your financial situation. This peace of mind allows you to focus on getting well. More than half of Americans under age 65 report having problems paying medical bills, which is a clear indicator of just how expensive medical care is. Selective Healthcare invites you to call us today at 888-540-1620 to learn more about your temporary health insurance options.

What Could One Month Without Healthcare Coverage Cost?

Short term medical insurance

There could be many answers to that question, the best of which is, “Nothing.”

On the other hand, there is the true story we are going to share, of a gentleman who chose to roll the dice. Here is his story in his own words.

I was unwillingly unemployed. I had lost my job in early 2010, just as thousands of other Americans had in the wake of the 2008-2009 financial crisis. I worked diligently for about 12 hours every day, sending out resumes and making phone calls. However, after 18 months had passed I was staring at the impending end of my COBRA coverage. That ended November 30, 2011.

My best chance for health insurance was through my wife’s employer’s plan, but their open enrollment period did not start until January 1, 2012. I didn’t realize that there were options like short-term healthcare insurance, so we crossed our fingers and hoped to make it through the month. After all, I had had a complete physical in October and there was no indication of any problem.

I spent most of the month of December preparing for Christmas. I was looking forward to it with great anticipation. I had done what I considered to be a terrific job of getting just the right gifts for my wife. I wanted it to be special.

Turns out, it was special. I’d like to tell you how special, but I can’t. I don’t remember anything about it. Everything I know about that Christmas Day is based solely on what my wife and doctors have told me since.

I passed out on the living room floor. My wife called 911 and I was transported by ambulance to the local hospital. A ER doctor wrote “morbid” on the admission papers.

I was rushed to ICU because my blood glucose level had reached 2239 (which may be a world record for a living human being). I had never had any inclination that I was diabetic, yet here I was in ICU with acute pancreatitis and ketoacidosis. My heart rate was 222 and my blood pressure was 47/22. I was dying.


Short term medical insurance

Actual photo in ICU on life support.

My internal organs began shutting down. I was put on life-support and given medications that would gradually reduce my glucose level and heart rate, as well as keep me breathing, which I was no longer able to do on my own. I would remain on the ventilator for eight days – the exact number of days left until open enrollment began.

Frankly, during the first 72 hours, the doctors gave me less than a 1% chance of surviving. On the afternoon of the fifth day, my kidneys began functioning. At the point the prognosis changed. They then said that I would live, but I would be severely incapacitated physically or mentally.

Long story short, I was in ICU for 10 days and spent an additional seven days in hospital.

What could possibly go wrong going without medical insurance for just one month? Nearly half-a-million dollars of wrong in my case. If it happened to me, it could happy to you.

I have two more things to say. First, I am fairly healthy mentally and physically. It took an entire year to be able to say that. Second, going without health insurance is something no one should ever do – not even for 30 days.

If you are currently without health insurance, I urge you to investigate the opportunities for coverage to which this website can connect you. There are plans available for you. All you have to do is learn about them. It is not worth exposing yourself to the risks of going without – for you or your family.

Call us today at 888-540-1620. It’s far cheaper than calling 911 when you are needlessly without insurance.

Note: The author of this post is the regular editor for our Selective Healthcare blog. This is his true story.

Expert Interview Series: Dennis Jay of The Coalition Against Insurance Fraud

Insurance fraud

Dennis Jay is the executive director at the Coalition Against Insurance Fraud, a nonprofit organization devoted to combating fraud, educating the public and offering anti-fraud advice. Here Dennis offers an overview of how common insurance fraud is in the U.S. and its impact on healthcare. Read on:

What led to the creation of the Coalition Against Insurance Fraud?

The Coalition is unifying the fight against insurance fraud and protecting consumers. We’re doing so by bringing consumers, insurers and government agencies together – force-multiplying their efforts.

It all started back in 1993. Insurers and consumers were at odds over many issues. But they agreed they could cooperate on a common scourge that affected everyone – insurance fraud. They founded the Coalition to give the fraud fight a focal point for action.

How common is insurance fraud?

Insurance fraud steals at least $80 billion a year. Those dollar bills would stretch to the moon and back 16 times.

Insurance fraud raises your premiums. People’s savings also are stolen by fraud schemes. Victims are maimed and disfigured by botched medical treatments designed to steal. Victims also suffer humiliation and despair. People die in arson fires. Investigators even were killed by fraud suspects.

What are the most common types of medical insurance fraud you’re observing right now?

Healthcare scams are the 800-pound gorilla of the fraud world. They dwarf all other insurance schemes in total dollars stolen.

Smaller scams by normally honest consumers also are common – such as inflating a claim for stolen or burned home electronics.

Drivers also torch their car and lie that someone stole it. Their goal: Get out from under expensive payments. People burn down their homes when they get behind in payments. Innocent neighbors have been hurt by these fires.

Uninsured drivers get into crashes, quickly buy coverage then lie that the crash happened after they bought the policy.

What type of climate do you think contributes to increased cases of insurance fraud?

Too many people view insurance fraud as a harmless money grab. People even joke and brag about bilking insurers on Twitter and Facebook. We must convince more people to view fraud as a dead-end street. They’ll get caught, and get ruined.

Especially, we must reach younger consumers on social media, where so many of their attitudes are formed. We’re making progress. Still, we need far more resources to turn the corner.

Criminal medical rings view insurance fraud as easy money and a path to the good life. They see a low risk of getting caught. Staged-crash and Medicare rings think they can get away with stealing insurance money.

Fraud fighters are stepping up the pressure. Computer programs can spot scams almost in real time. Courts are handing down longer sentences for many insurance crimes.

Most consumers are honest. Yet convincing more people that fraud is dumb and not worth the risk will take years and far more resources.

What are the most common types of medical insurance fraud you’re observing right now?

Medicare scams are common – rampant theft of your taxpayer dollars. Fraudsters charge millions of dollars for phantom home healthcare visits. Or huge amounts of unneeded prescription painkillers for addicts.

Con artists bill $8,000 each for fancy power wheelchairs while delivering low-cost models worth a small fraction.

Elderly patients sell their Medicare numbers to crime rings. The swindlers use the numbers to overbill Medicare for treatments nobody ever delivered. Drug dealers are getting into Medicare fraud. They think insurance scamming is safer and more-profitable than street crime.

What are some of the classic hallmarks of a medical insurance scam?

Fraudsters often steal people’s identities and bill their insurance policies. Patients find expensive charges on their statements for surgeries they never received. One patient – with two healthy legs – was billed for an amputation.

Crooked medical providers have billed insurers for more hours than there are in a day – or for when they were traveling in Europe. Simple toenail clipping at nursing homes is billed as foot surgery.

Dishonest doctors get caught because they get greedy – their billings might be 10 times the norm for that region or procedure. Insurers notice those clues and investigate.

How can consumers be more savvy at detecting fraud?

Check your health-insurance statements. Look for procedures you don’t recognize – were you even in town on that date? Also regularly check your credit report. Identity thieves secretly bill your insurance policy for treatments, then disappear without paying. Your credit rating can drop – making it harder for you to get a mortgage, car or loan for your kids’ tuition.

Protect your medical identifiers from thieves. It’s surprising how often friends and family members steal a person’s health-insurance card or other identifiers for free medical treatment at your expense.

Also, get a second and third opinion for life-altering surgery. Dishonest surgeons have done spine and heart operations on healthy patients just to steal insurance money – millions worth. Some patients were left permanently disabled and lost their jobs.

Be wary of friendly cold-callers who say they’re from “Obamacare” or “Medicare.” They ask for your Social Security Number, health-insurance info and other personal identifiers. They want to “update federal records” or issue you a new “health-insurance card.” They’re fakers who want to steal your identity. Just hang up, and don’t engage them in conversation.

What should consumers do if they believe they’ve been scammed?

Place a fraud alert with the credit agencies if your medical ID is stolen. Also, contact your medical providers and correct your healthcare records. You might be allergic to medicine an ID thief received, or have an incompatible blood type. This can be a life-or-death error on you medical records.

If you’re a senior and think your Medicare account was scammed, call the Medicare hotline at 800-447-8477 or go online.

Call your insurer’s fraud hotline if you think your private health-insurance account was compromised. Your insurer has investigators trained to root out fraud.

What advice do you find yourself repeating over and over again when it comes to medical insurance fraud?

Verify, verify, verify. Have you checked your credit ratings and hospital statements? Gotten a second opinion before surgery? Know the warning signs you might get scammed – and stay alert.

Call us today at 888-540-1620.

8 Very Real Risks of Going Without Healthcare Insurance

During the first quarter of 2015, 29 million Americans were uninsured, representing nearly 10% of the population.

Medical insurance

Trying to get along without health insurance presents serious risks to both health and finances, as outlined in a recent report by the Kaiser Family Foundation: “Going without coverage can have serious health consequences for the uninsured because they receive less preventive care, and delayed care often results in more serious illness requiring advanced treatment. Being uninsured also can have serious financial consequences.”

Here are just 8 of the many risks of going without health insurance.

1. Only Emergency Departments Are Obligated to Care for the Uninsured

Some people have the misconception that if they don’t buy health insurance, they can receive treatment in their local hospital’s emergency department. But emergency departments are only required by federal law to screen and stabilize people who seek treatment there. This alone can result in large medical bills, and doesn’t include follow-up care, which can also be expensive.

2. People without Medical Insurance Forego Preventative Care

Many medical insurance plans include 100% coverage of preventative healthcare services such as age-appropriate screenings and flu vaccinations. People without personal health insurance are unlikely to pay out of pocket for these valuable services. Therefore, they are at higher risk of preventable illnesses and, when diagnosed with a serious condition, are often further along in the disease process.

3. The Uninsured Are Less Healthy than Those with Personal Health Insurance

People who do not have health insurance are at higher risk for misdiagnosis of serious health conditions and, when they are diagnosed with a chronic condition, they’re less likely to manage that condition. The result is declining health. Cancers and other serious diseases are typically diagnosed later among the uninsured, and mortality rates among the uninsured are higher than for the insured.

4. Uninsured People Forego Medications Due to Cost

It’s not just medical care and screening that uninsured people skip due to costs. Many also choose not to have prescriptions filled because of high prices. Many people with health insurance have some degree of prescription drug coverage and are somewhat shielded from high drug prices. Uninsured people do not have that price protection, and often face astronomical prescription drug costs.

Medical insurance

5. Uninsured Patients Are Often Charged More than Insured Patients Are

Medical insurance companies negotiate with physicians, hospitals, and other healthcare providers for lower procedure costs in exchange for providing a steady stream of patients. People who don’t have insurance have no one to negotiate these costs on their behalf and, therefore, they often pay the highest “sticker” price for medical procedures.

6. Medical Bills Cause Severe Financial Hardship for Uninsured People

Inability to afford medical bills can ultimately affect all areas of life. Money devoted to paying out of pocket for medical care is money that isn’t being used for other bills, healthy foods, preventative healthcare, education, and other worthwhile expenses. This situation can lead to stress and anxiety, which can ultimately affect overall health and lead to the need for more medical services.

7. Anxiety Over Lack of Insurance Can Cause Interpersonal Problems

When someone lacks insurance and either doesn’t get medical care, or is saddled with large medical bills that must be paid out of pocket, the stress of trying to cover expenses can also increase stress in the household and on the job. Results can include the need for expensive mental health care, employment problems, and a worsening financial situation.

8. Medical Debt Accounts for Over Half of Collections Reported on Credit Reports

Medical debt now accounts for more than half of the collections reported on the credit reports produced by the major credit reporting agencies. Having such debts show up on credit reports lowers a person’s credit score, which makes it harder to obtain credit. Furthermore, when credit is obtained, it is often at a higher interest rate than what someone would pay if they had a higher credit score.

You may have more options than you think when it comes to buying health insurance. In addition to purchasing plans through work or under the Affordable Care Act (which you can typically only do during the Open Enrollment period at the end of the year), people can also purchase temporary medical insurance policies that are particularly useful for bridging brief (weeks- or months-long) lapses in health insurance coverage. Selective Healthcare invites you to view our plans and see for yourself how affordable they are. Going without health insurance is simply too big a medical and financial risk.

5 Things You Can Do to Make Your Healthcare Coverage More Affordable

Most of the burden is on you, the consumer, to do what you can to get the most affordable healthcare coverage. The task isn’t always easy. The cheapest health insurance may not cover the things you need, yet you don’t want to overpay for coverage you’ll never use.

Health insurance plans

It’s not as easy as it was in the days when you signed up for employer-sponsored healthcare your first day on the job and then never gave it another thought. The good news is you probably have more options than you think to keep your healthcare spending under control. Here are five things you can do to make healthcare coverage more affordable.

1. Determine Whether You’re Eligible for Medicaid

If you are an adult living in one of the Medicaid expansion states, and you earn a moderate to low income, it’s worth your time to contact your local Medicaid office or go to healthcare.gov to find out if you qualify for Medicaid. If you do, then this is likely to be your cheapest health insurance option. In states that are not expanding Medicaid, you’re unlikely to qualify, even if you have a low income.

2. Scope Out Options for Children’s Health Insurance Plans

If you have children under age 18, you have even more options for obtaining coverage for them. The Children’s Health Insurance Program (CHIP) is part of Medicaid, and your children may qualify even if you yourself earn too much to qualify. In some states, CHIP also covers pregnant women. You can answer a few questions on Healthcare.gov to learn if your children qualify for CHIP. If not, is your child eligible for coverage under your own or their other parent’s insurance?

3. Go Beyond Healthcare.gov for Medical Insurance Quotes

Health insurance plans

Obtaining medical insurance quotes from Healthcare.gov is a straightforward option, but it isn’t your only option. You also have the option to ask for quotes from private insurance companies and insurance agents, both online and offline. Don’t automatically assume this is a waste of time. Particularly if you don’t qualify for a tax credit to help offset the cost of coverage purchased through Healthcare.gov, you owe it to yourself to obtain quotes from other sources, because you might find a better policy at a lower price.

4. Understand “Total Cost of Ownership”

Premiums are only part of the story. Low premiums don’t help much if your insurance doesn’t cover the things you need. You could end up spending more out of pocket if you choose a policy for its low premiums and then experience a health condition that isn’t covered. On the flip side, some people (particularly young, single, healthy people) find that, by purchasing a temporary health insurance policy (known for having affordable premiums) and paying the tax penalty for foregoing insurance that qualifies under the Affordable Care Act (ACA), they come out ahead in terms of health coverage spending.

5. Don’t Try to Do Without

The one thing you shouldn’t do is conclude it’s too complicated and give up altogether. For one thing, unless you qualify for an exemption under the ACA, you’ll still have to pay a (possibly hefty) tax penalty. The main concern, of course, is what happens if you are sick or injured. There’s simply no way of guaranteeing neither of those things will happen, and even a relatively minor illness or injury can result in thousands of dollars’ worth of medical bills. A single trip to the hospital could wreck your finances and your credit, so foregoing health insurance should not be considered an option.

If you’re only going to be without coverage for a matter of weeks or months, say, until you start your new job, qualify for Medicare, or reach the ACA Open Enrollment period, a temporary health insurance policy may be the perfect choice for your needs. While coverage is less comprehensive than traditional major medical coverage, it can save both your health and your finances should a health problem arise. Premiums for temporary health insurance policies are often surprisingly low, and the peace of mind they confer can be invaluable. Selective Healthcare invites you to get a free quote and explore all your options for obtaining health insurance coverage on our website.

Two Reasons You May Lose Your Employer’s Healthcare Coverage

The passage of the Affordable Care Act (ACA, also known as Obamacare) brought about many new business requirements, particularly for “large employers” – those that employ 50 or more full-time-equivalent (FTE) employees.

For example, these employers may have to pay an excise tax if at least one of their FTE employees receives a premium tax credit for ACA Exchange coverage and they:
-Fail to offer coverage to FTE employees and their dependents or
-Offer coverage to FTE employees that doesn’t meet value or affordability standards

As you may imagine, it’s relatively easy for a large employer to run afoul of Obamacare insurance rules, and there are some ways that employers are skirting these rules altogether. These could affect you, so it’s important to be aware of them.

Reducing Employee Hours to Under 30 Per Week

The ACA changed the definition of “full-time employee” from someone who works 40 hours per week to someone who works 30 hours per week. By lowering this threshold for full-time employment, the government put a greater financial burden on businesses that are just barely qualified as “large employers.” That can cause these employers to decided to reduce everyone’s hours to below 30 per week. When this happens, many employees take second jobs to make up for reduced earnings. This setup isn’t exactly ideal for workers. When full-time employees (and part-time employees who work too few hours) become a financial liability and healthcare costs go up, employees may bear the costs, in terms of either losing their jobs altogether, or having their work hours reduced each week.

Reducing Employee Headcount to Under 50

If a company employs something close to 50 FTE employees, couldn’t they just cut the number of FTEs they employ to escape having to comply with ACA rules? Yes. How prevalent this action will be is yet to be seen, since companies with 50 or more FTE employees were only subject to ACA compliance starting this year. However, early studies have found that around 4% of employers said they were reducing their number of FTE employees they planned to hire due to ACA mandates. It may not be that employers actively reduce their FTE payroll below 50, but if they happen to fall below 50 FTE employees by attrition, they may elect not to hire enough FTE employees to exceed the threshold in order to avoid ACA requirements.

Your Low Cost Health Insurance Options

You do have health insurance options in addition to those provided by employers or the ACA exchanges. Many people believe that it is illegal to not have health insurance under the ACA, but this is not strictly true. You can opt out of ACA coverage even if you don’t have employer-sponsored health insurance, as long as you’re willing to pay the tax penalty for doing so. For some people this tax penalty will be big enough to make acquiring health insurance worthwhile, but for others, obtaining alternative low cost health insurance can be the best financial choice, even when the tax penalty is factored in.

Temporary health insurance plans have been around for a long time, and they can still be a smart option for today’s health insurance consumer. Not only are these low cost health insurance options easy and fast for consumers to access, they can be ideal for people experiencing weeks- or months-long gaps in coverage. For example, if someone doesn’t have a qualifying event that would open up a 60-day ACA enrollment period and the next ACA Open Enrollment period isn’t for several months, health insurance quotes for temporary policies are well worth obtaining. The same is true for the person who is between full-time jobs, or who is retiring a few months short of being able to qualify for Medicare.

Since employers with 50 or more FTE employees have only recently fallen under ACA requirements, we don’t really know how many companies with right around 50 FTE employees will cut their FTE headcount to avoid ACA restrictions. Nor is it yet clear how many employers will reduce employee hours below 30 per week to avoid these new requirements. But it’s definitely a risk, and if you either work for a company close to the 50-FTE level or are used to working 30 to 39 hours per week, you’re wise to scope out all your health insurance options. Selective Healthcare invites you to obtain health insurance quotes for free, because nobody should risk going without health insurance today.

5 Things That Can Save You Money When Buying Health Insurance

The percentage of Americans experiencing difficulty finding money to pay for healthcare has dropped over the past few years. This is despite the fact that the cost of healthcare for a family of four that has employer-sponsored insurance has more than tripled in the past 15 years.

Health insurance quotes

Today, employees are paying a larger share of the cost of health insurance premiums, plus higher deductibles. Therefore, it’s important for the informed consumer to understand all options to make the optimum choice. Here are five ways you can save money when choosing health insurance.

1. Understand the Major Types of Health Plans

Many of today’s plans, whether employer-sponsored, Obamacare insurance, or privately purchased insurance, are managed care plans. The major types of managed care plans are health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Though the specifics differ, in both, healthcare accessed from within the organization’s network is reimbursed at a higher rate than healthcare accessed outside the network.

In addition, HMOs in particular have strict rules about accessing specialist care, with most requiring that a primary care physician give a referral before specialist care is covered. The traditional fee-for-service insurance plans that were popular a few decades ago are rarer now. These plans have a deductible and pay a percentage of costs after the deductible is met, regardless of whether a provider is inside or outside a defined network.

2. Know What Your Healthcare Needs Are

How often do you and your family typically visit a doctor in a year? How much have these visits cost you in the past? Does anyone in your family require regular access to a specialist provider? By the same token, consider services you don’t need. For example, if you’re a single man or an older woman, you don’t need a policy that covers maternity care. It is possible to be over-insured, which means you’re paying for services you don’t use.

There are also insurance policies that offer extra benefits, such as benefits specifically for cancer diagnoses, or even death benefits. These may be standard or add-ons. It’s important to know which is which and understand whether you need them. When you obtain health insurance quotes, make sure you know what premiums do and do not cover.

3. Do What You Can to Take Care of Your Health

Health insurance quotes

Simply doing your part to take care of your health can make a positive difference in your health insurance spending. Quitting smoking, getting cholesterol and blood glucose levels under control, and eating healthier foods can make a tremendous difference in how often you need medical services. Many insurance policies cover preventative care. If yours does, taking advantage of these services can help identify health problems while they’re still more manageable and less serious. Taking charge of your health and well-being can make a serious difference in your healthcare expenditures.

4. Understand All You Can About the Affordable Care Act

The Affordable Care Act, or ACA, has implemented many changes in the nation’s healthcare system. Employers are affected by the law, as are individuals. The “individual mandate” that encourages everyone to purchase health insurance carries a financial penalty for people who don’t purchase insurance and who don’t qualify for an exemption.

On the other hand, it’s not illegal to forego Obamacare insurance. If you can’t get insurance that meets ACA requirements elsewhere and don’t qualify for an exemption from the individual mandate, you will owe a tax penalty. However, in some situations, buying temporary health insurance (a form of low cost health insurance) works out better financially, even with the tax penalty.

5. Consider Low Cost Health Insurance Options to Bridge Coverage Gaps

There are situations in which people don’t have employer-provided insurance and can’t access Obamacare insurance. For example, someone who quits one job, then waits a few weeks before starting a new one (with new insurance coverage) may not qualify for a special 60-day enrollment period under the ACA. If it doesn’t happen to be ACA Open Enrollment season, this person could be out of luck. Fortunately, low cost health insurance is available in the form of temporary or short-term policies that bridge these coverage gaps perfectly. With these policies, you don’t have to wait around for an enrollment period, and coverage can often begin as soon as the following day.

Selective Healthcare is ready to walk you through all your options for health insurance. We encourage you to call us today at 888-540-1620.

Busting the Pre-Existing Condition Myth

One of the most important bones of contention during the debate leading up to passage of the Affordable Care Act (ACA) was how insurers were supposed to contain costs if they weren’t allowed to screen people for pre-existing conditions. The existence of pre-existing conditions often incurred limited coverage under older, employer-sponsored health insurance practices.

The ACA mandated that insurance policies sold through the healthcare exchanges could not turn people down or refuse to cover pre-existing health conditions. This was supposed to be an incentive to get more people to buy insurance, potentially swelling insurance population pools with healthier people, and thus keeping premiums under control.

The problem is, if you need to buy health insurance outside the ACA Open Enrollment period and do not have a condition that would qualify you for a special, 60-day enrollment period, you could face huge costs if you buy a policy privately.

Pre-Existing Conditions Under the Affordable Care Act

Pre-existing conditions are exactly what they sound like: health issues that people have at the time they enroll in a health insurance plan. They may be defined by an “objective standard,” saying that pre-existing conditions are any condition for which the patient has already received medical care, or they may be defined by a “prudent person” definition. The prudent person definition is easier on consumers because it defines pre-existing conditions as conditions where symptoms were present and a prudent person would have sought treatment. Regardless of definition, you can’t be turned down for insurance under the ACA for pre-existing conditions.

Short-Term Health Insurance Policies Aren’t Subject to ACA Rules

Suppose you’re in a situation of having to purchase a private insurance policy because it isn’t Open Enrollment season under the ACA and you don’t have a “qualifying event” to trigger a special enrollment period. If you have a pre-existing condition, you could face astronomical premiums when you buy privately.

However, short-term (or temporary) medical insurance policies are not required to cover pre-existing conditions as are plans under the ACA. While this may sound bad, it can actually be good, because it can make health insurance affordable. Say you have a pre-existing heart murmur. Your temporary insurance policy may not cover care related to it, but if you come down with, say, strep throat, your insurance will offer coverage. In other words, you won’t have to go completely without health insurance coverage.

Low Cost Medical Insurance Is Not Necessarily Out of Reach

Many people are surprised to learn that temporary policies are a form of affordable health insurance. One of the main reasons is that, not only are these policies in effect for a matter of weeks or months rather than years, but also when they don’t cover pre-existing conditions, they can still offer low premiums that will cover other health issues.

So, if you have a pre-existing health condition and are faced with buying a health insurance policy between jobs, until you qualify for Medicare, or until the next ACA Open Enrollment period, the temporary policy can be one of your best low-cost medical insurance options.

Do Not Risk Going Uninsured if You Have Existing Medical Conditions

Doing without medical insurance altogether while waiting for a new job to start, or for your next policy to become effective is exceptionally risky both medically and financially. Even if you have a pre-existing condition, evaluating your affordable health insurance options, including temporary medical insurance policies is your wisest choice. If you’re uninsured, a single trip to the ER, or even a brief hospitalization, can cause serious financial problems that could take years to overcome. Low cost medical insurance exists, and even if it doesn’t cover pre-existing conditions, it covers other conditions, and can bring you tremendous peace of mind compared to going without insurance altogether.

Temporary medical insurance policies can offer affordable premiums partly because they don’t have to comply with ACA rules (like mandatory coverage of pre-existing conditions). For the person who needs health insurance only for a few weeks or months, it can be the best possible alternative to going uninsured. What’s more, short-term health insurance policies can be purchased at any time, regardless of ACA Open Enrollment season and, in many cases, you can have coverage as soon as the following day. At Selective Healthcare, we invite you to get a free quote, and take that first step of making sure your healthcare coverage needs are met, for a healthier, more financially secure future.

What to Do When You Lose Health Insurance Coverage Through Your Job

The Affordable Care Act (ACA) has added a new option for obtaining insurance after involuntary job loss. However, a person who loses their job has multiple options for remaining insured. The choice that is right for one individual depends on several factors, including whether they’ve met their company health insurance’s annual deductible, whether family members have plans that can add members, or how long it will be until the next ACA Open Enrollment period (at the end of the calendar year).

COBRA Coverage: Is This the Right Choice?

Thirty years ago, Congress passed the Consolidated Omnibus Budget Reconciliation Act (COBRA), which provides an option for employees to continue purchasing group health insurance when it might otherwise be terminated, such as after a layoff. If you lose your job (voluntarily or involuntarily), you can continue coverage under COBRA as long as you’re willing to pay the entire premium. Most employers pay a large chunk of employees’ medical insurance premiums, so costs under COBRA can be alarmingly high.

But, in some cases, continuing coverage under COBRA can be smart. For example, if you have already met your employer-sponsored plan’s high deductible and would be faced with starting all over if you switched insurers, you may come out ahead by paying the full COBRA premium and taking advantage of having met your deductible.

Qualifying Events and ACA Enrollment

If you lose your job through downsizing or a layoff, the scenario is considered a “qualifying event” under the ACA. What this means is, if it doesn’t happen to be Open Enrollment season, the ACA will open a 60-day enrollment period that you can take advantage of by enrolling in an ACA plan. For many people, this can be a cost-effective choice, because tax credits under the ACA can bring costs down below the cost of using COBRA coverage.

The main problem with ACA enrollment is that not every type of job separation counts as a qualifying event. For example, if you voluntarily leave your job and don’t relocate, you have to wait until the next Open Enrollment period to join an ACA plan. Furthermore, ACA administrators are becoming stricter about evaluating potential qualifying events under pressure from insurance companies who don’t want people to enroll unless they truly are eligible.

Getting onto a Family Member’s Insurance

Say your spouse has health insurance through her job and you lose your job. Chances are, if her employer-sponsored insurance allows the addition of family members, this will be one of your easiest ways to maintain insurance. Naturally, going from an individual plan to a family plan will mean higher costs for your spouse, but these costs are often significantly lower than the cost of continuing coverage through COBRA, and may also be lower than you would pay under the ACA if you lose your job involuntarily and have a qualifying event.

Affordable Health Insurance for the Short Term

Suppose you don’t have a qualifying event, COBRA costs more than you can afford, and it’s several months until the next ACA open enrollment period (or until you start a new job). Temporary medical insurance is an option you should know about. This is a type of affordable health insurance that is perfect for bridging coverage gaps where the ACA, COBRA, and family member plans are not viable options. Temporary medical insurance isn’t as comprehensive as traditional major medical insurance, but it can prevent the enormous risks that come from trying to get by without medical insurance.

Being Uninsured Should Not Be a Consideration

Taking a chance and skipping insurance altogether should not be a consideration. The risks to your health and your finances can be catastrophic. Moreover, unless you qualify for an exemption against having to buy insurance under the ACA, you will have to pay a penalty under that law for not purchasing insurance. You could end up without coverage, and several hundred – or thousand – dollars out of pocket for not enrolling under the ACA.

You have options for remaining insured if you lose your job, and though none may seem ideal, you should evaluate them thoroughly. And, if you need some time to do this, you can purchase a temporary medical insurance policy quickly, for a short time period, and often have next-day coverage, which can greatly increase your peace of mind. Call Selective Healthcare today at 888-540-1620 to learn more about how temporary medical insurance may be your most affordable option after losing coverage through your job.

What Happened to Freedom of Choice in Healthcare?

America was founded by people who wanted freedom of choice on important matters in life and, over 240 years, that theme has been a continual thread woven throughout American history and culture. Put plainly, Americans don’t want the government making decisions for them on matters that are foundational to their lives. Many believe that recent legislation has limited healthcare choices and taken away some of the power individuals have to shape their own lives.

Before the Affordable Care Act (ACA, also known as Obamacare insurance) was passed and signed into law, the American public was told that, if they liked their current doctor, they could keep going to him or her. But it hasn’t worked out that way in many cases. Hundreds of thousands have lost the plans they had and liked and, in addition, they have had to find new doctors in many cases.

Plans Banned for Being Noncompliant

One of the overarching features of ACA plans is that they have to meet a number of criteria in order to be sold on the ACA exchanges. For example, insurance plans sold through the ACA can no longer reject people based on pre-existing medical conditions, and the law places caps on corporate profits of insurance companies. Insurance plans that do not meet Obamacare insurance qualifications can still be sold, but they don’t “count” toward the individual mandate that essentially requires everyone to buy health insurance unless they qualify for a limited range of exemptions. Right off the bat, this limited the number of plans available to people.

Obamacare Insurance and Doctor Networks

Like the insurance you may be accustomed to from your employer, physician networks are an important part of ACA health insurance plans. While researching health insurance quotes on the ACA exchanges, it’s essential to learn whether or not your doctor is part of the network for the plan in which you’re interested. He or she may not be, and if not, you could be in for an unpleasant surprise when you try to make an appointment with your preferred physician under your ACA plan. And, in many cases, the networks under ACA plans are narrower than networks people are used to with their employer-provided plans.

Narrowing Networks to Keep Costs Down

One of the few ways left that insurers have to contain costs is to make their healthcare provider networks smaller. That means that the doctor that was covered under your health insurance last year may not be part of your insurer’s network next year. So the doctor you have been happy with, and who knows your health status best, could no longer be an option for you, unless you’re willing to pay all your costs for visiting that doctor out of pocket. Most people simply can’t afford to do this.

You Don’t Have to Participate in the ACA

Though it may appear as if you’re legally obligated to participate in Obamacare insurance, it’s perfectly legal not to, as long as you understand the implications. Many people are exempt from the individual mandate, including people who don’t have sufficient income to purchase an ACA plan, people who participate in health-sharing organizations, and certain Native American tribal members. If you’re not exempt, you can still privately buy a policy that meets ACA minimum standards. But some people, particularly those who are young, healthy, and fit, find that the most cost-effective choice is to purchase temporary health insurance and pay the ACA non-participation penalty. Temporary insurance doesn’t qualify as ACA compliant, but it may provide the right level of coverage for those in certain situations.

Getting medical insurance quotes doesn’t have to be an ordeal if you want to find out more about temporary health insurance options. There are people for whom Obamacare insurance is more expensive, or, in some cases, not available due to Open Enrollment limitations. In these cases, temporary health insurance can bridge coverage gaps at remarkably affordable rates, and many policies are provided by insurers with whom you’re familiar and allow you to choose which doctor you see. Selective Healthcare is happy to provide health insurance quotes based on your specific needs, and we invite you to come to us with your questions or for more information on your alternatives to Obamacare.

You CAN Get Affordable Health Insurance

The Affordable Care Act (ACA) has had a mixed reception among American consumers and healthcare providers. By rewriting rules for private health insurance that people purchase directly (as opposed to through their employers), the goal was to make coverage more widely available and more comprehensive.

Whereas before, insurance providers could offer major medical coverage that left out certain benefits (like mental health benefits) or could refuse to insure people with existing medical problems, policies must now offer specific benefits and, under the ACA, cannot be denied to people with pre-existing conditions.

The result has been higher policy costs, as reflected in higher premiums, and, in some cases, insurers have canceled some of their old plans altogether. Though tax credits can offset some premium costs, they don’t apply to people with higher incomes. Ultimately, people who lost their old plans because of the ACA are among the law’s biggest critics. Many of them say their health insurance is not more affordable, and some don’t like being compelled by law to purchase health insurance.

Complaints About the Individual Mandate

The so-called individual mandate associated with the ACA means that, unless a person meets certain exemption criteria, he or she must buy health insurance through an employer or through the ACA. It’s not straight-up illegal not to buy health insurance, but people who don’t, and who don’t qualify for an exemption, may face steep fines, depending on income and how many family members go without insurance. Still, some people are willing to risk fines and utilize other insurance options. In some cases, this can actually be the most cost-effective option.

Taxes That Help Pay for the ACA

Paying for the ACA is, as you might guess, a major undertaking, and a number of new taxes were created to help pay for it. Those new taxes include taxes on the sales of medical devices and pharmaceuticals. People with higher incomes also face new taxes, and part of the cost of the ACA is supposed to be covered by savings in Medicare payments by the government. People with higher incomes are not pleased with the tax changes to pay for the ACA and, in many cases, these are not the people using the ACA to obtain health insurance.

Signing Up Isn’t Always Simple or Straightforward

You might imagine that signing up for a plan under the ACA would be possible at any time, but that is not the case. Like health insurance enrollment periods offered by employers, which occur in the last couple of months of the calendar year, the ACA has its own Open Enrollment period at the end of the year. If you need health insurance and it doesn’t happen to be Open Enrollment season, you might be out of luck. Some life events qualify people for special ACA enrollment periods outside Open Enrollment, but there are no guarantees. It’s entirely possible to need health insurance and be told you can’t enroll until the next Open Enrollment period, which could be several months away.

What Are Your Other Options?

Low cost health insurance doesn’t necessarily require eligibility for a tax credit under the ACA. There may even be cases where paying the penalty for not participating in the ACA is cost-effective. Suppose you’re a young, healthy person who needs personal health insurance for a defined period – say between graduating college and starting a job, or between jobs that offer insurance. Temporary health insurance policies can be remarkably affordable, even if the cost of the penalty fine is included.

Short-term health insurance policies don’t qualify as major medical coverage under the ACA because they don’t have to cover everything ACA plans do, and they still can deny coverage for pre-existing conditions. But for many people, short-term coverage is the best possible, low cost health insurance option due to the lower premiums these policies typically have. They can not only help ensure that people remain healthy by getting the medical care they need, they can prevent financial catastrophe in the event of an accident or major illness.

Selective Healthcare helps consumers like you through qualified insurance agents who are experts in temporary personal health insurance. They know options you may not find on your own, and they know the policies well enough to help you match up with the one that makes the most of your healthcare dollars. In fact, you can get a free quote right now. There are truly affordable alternatives to the ACA for protecting your health and finances.

What Is a PPO?

However you acquire health insurance, whether through your employer, through the Affordable Care Act (ACA), or through a government provider like Medicaid or Medicare, making the best choice often means being immersed in an alphabet soup of acronyms. HMOs, PPOs, EPOs, COBRA, and EOB are just a few.

It might seem like a chore, but familiarizing yourself with what these abbreviations stand for can help you make the wisest choice for your particular health status, stage of life, and insurance needs. One of the most common acronyms you’ll see when researching health insurance plans is PPO. Here’s what you should know about them.

What Does PPO Stand For?

PPO stands for Preferred Provider Organization. It is a type of subscription-based healthcare arrangement and consists of a network of physicians and other healthcare providers to which you can go and receive a significant discount compared with costs of providers outside the PPO. A PPO earns money by charging an insurance company a fee for access to the network. Within the PPO, set fee schedules are negotiated, and PPOs also sometimes deal with disputes between healthcare providers and insurers. They’re popular because they offer patients relatively good premium rates and significant flexibility in provider choice.

How Does a PPO Work?

To you, the healthcare consumer, choosing insurance that’s part of a PPO means that you’ll pay less when you visit healthcare providers and facilities that belong to your PPO’s network. If you choose providers and facilities outside the network, you will have to pay a higher portion of the cost for healthcare services. If you choose one of the many PPO health insurance plans, it is essential that you make sure the provider you want to see is part of that insurance plan’s PPO network so you receive maximum benefits. Usually you will have an annual deductible you’ll have to cover before the plan starts covering costs, and you may have to make co-payments (typically $20 to $30) for routine healthcare visits.

A PPO Is Less Restrictive Than an EPO

While a PPO is a “preferred” network, an EPO is an Exclusive Provider Organization. But unlike a PPO, an EPO doesn’t cover care outside the defined network. A PPO will cover out-of-network care at a lower reimbursement rate than in-network care, but if you’re part of an EPO and go outside the network, you’ll be footing the bills yourself. For this reason, EPOs are less popular, despite often negotiating much more favorable fee schedules for policyholders. Should you experience an emergency and require service from an out-of-network provider, the EPO will cover some of the costs, but for planned healthcare services, you have to stay in the network to receive benefits at all.

Short-Term Health Insurance Plans and PPOs

Short-term health insurance plans, like traditional major medical plans, may incorporate a PPO so as to encourage use of network healthcare providers and negotiate more favorable rates for insurers and patients. Short-term health insurance plans are excellent, cost-effective methods for people who are between jobs, have only a few months until qualifying for Medicare, or have to wait for the next ACA Open Enrollment period.

With short-term health insurance, “open enrollment” is any time, and consumers can often get coverage quickly – sometimes as soon as the next business day. These plans are not as comprehensive as traditional major medical insurance, and they won’t prevent you from the possibility of paying the ACA penalty tax for not having insurance, but they offer many advantages. For one thing, premium rates are generally low, which is an important consideration for someone between jobs. For another, quick coverage and lack of open enrollment periods protect consumers from potentially catastrophic medical bills.

Choosing the right short-term health insurance plan, whether or not it’s a PPO plan, is best done with the help of an insurance agent specializing in these plans. They may know about plans you won’t encounter in an online search, and since they’re experts in how short-term health insurance plans work, they can help you determine the best cost-benefit ratio for your particular situation. Selective Healthcare invites you to get a free quote so you can be that much closer to having the short-term health insurance plan that’s right for your needs.

What is an HMO?

In the US, health maintenance organizations (HMOs) are health insurance plans with certain key features concerning how they’re administered and how patients seek care. An HMO is essentially an insurance group that offers health services for a fixed annual fee. It’s a form of managed care that many Americans first encountered in the 1980s, though HMOs have been around in various forms long before that.

As early as the 1910s and 20s, prepaid health plans resembling HMOs existed, primarily serving manufacturers and municipal workers. But it wasn’t until the Nixon Administration in the early 1970s that managed care in what we would now call an HMO moved into the mainstream. One of the most important things to understand about HMO health insurance plans is the importance of the primary care physician (PCP).

How HMOs Differ from Traditional Indemnity Plans

Under an HMO structure, doctors and other providers agree by contract to treat patients in accordance with HMO guidelines. In exchange, they’re basically guaranteed a steady stream of patients. The main difference between HMOs and other types of health insurance plans is that if you’re in an HMO, seeing a specialist requires seeing your PCP first, or else the HMO won’t reimburse your costs. Under a preferred provider organization (PPO), by contrast, you can see any primary care physician or specialist within the PPO’s defined network, and do not have to visit a PCP to get a referral to a specialist.

The PCP as Gatekeeper

The typical HMO requires members to select a PCP upon signup. The PCP functions as a gatekeeper to more specialized medical services. Usually, PCPs are family doctors, general practitioners, pediatricians, or internists, and the HMO is designed so that people are encouraged to get the majority of their healthcare from the PCP, and not expensive specialists, unless the PCP determines that a specialist is needed. So, if you’re interested in joining an HMO and already have a primary physician you’re satisfied with, you’ll need to ensure your physician is in the designated HMO network.

Emergency Services Covered Regardless

HMOs sound like a great idea, but many people wonder what happens in a medical emergency. After all, if you think you’re having a heart attack, or are involved in an accident, contacting a PCP isn’t always practical or possible. Fortunately, however, HMOs cover emergency care whether or not the emergency provider is within the HMO network, and HMO members are not expected to “ask permission” to seek emergency healthcare services when they are clearly warranted.

Knowing if an HMO Is Right for You

With HMOs, your premiums and out-of-pocket expenses are usually lower than with traditional health insurance plans. This can be a big plus for someone who is generally healthy and rarely has to see a specialist. Also, if you prefer that specialist care be coordinated through your primary physician anyway, an HMO might be a good choice. Step one after joining an HMO is designating a primary care physician. Many HMOs offer online tools to help you find a PCP if you don’t have one, or if your previous doctor isn’t in the HMO network. For those who must see specialists regularly, or who want more flexibility in choosing healthcare providers, PPOs and other traditional health insurance plans may be a better choice.

Do You Need Temporary Health Insurance?

Sometimes people are in the market for short-term or temporary health insurance, and some of these plans are HMO plans. Temporary health insurance is designed for the person who only needs short-term coverage to allay the risk of medical and financial disaster. Someone who is in between jobs that provide coverage is a strong candidate for temporary health insurance, as is the retiree who still has a few months to go before qualifying for Medicare. People who quit a job with insurance coverage during the part of the year outside the Affordable Care Act (ACA) Open Enrollment period can quickly obtain temporary health insurance to bridge the coverage gap.

Selecting a temporary health insurance plan, whether it’s an HMO, PPO, or other type of plan, is best done with the assistance of an insurance agent who specializes in temporary health insurance. These experts understand temporary health insurance inside and out, and assist customers with finding the plan that makes the most sense for them in terms of cost and benefits. If you would like to learn more, Selective Healthcare encourages you to call us today at 888-540-1620.

The Two Reasons You Need Health Insurance

There’s little debate about whether healthcare and insurance are expensive. Whether you obtain major medical coverage through your employer or purchase a plan through the channels made available by the Affordable Care Act (Obamacare), you have most likely seen your premiums increase faster than the general rate of inflation. Many employers are requiring that their employees shoulder a larger share of the costs of their health insurance, and have subscribed to plans that have much higher deductibles than used to be typical.

There are some people for whom there are additional alternatives to Obamacare, and in many cases, trying to enroll in an ACA plan outside the set Open Enrollment period at the end of the year is not possible. But even if you don’t have access to an ACA plan or employer provided coverage, you should explore your options for short term health insurance. There are two major reasons for this: to protect your financial assets and to increase your access to healthcare.

Having Insurance Helps Protect Your Assets

Depending on your financial situation, a single trip to the emergency room or a brief hospital stay can have a severely damaging effect on your finances. But it isn’t only inpatient costs that can be high. Many outpatient procedures and tests can quickly add up to thousands of dollars in costs, and if you don’t have health insurance, you are the one responsible for paying for them.

People sometimes have to declare bankruptcy due to high medical bills, even if they’re able to work with a hospital or provider to develop a payment plan. Not only can your savings be wiped out, so can your credit. If your short term health insurance is used even one time when you’re between major medical plans, it can mean the difference between financial survival and disaster.

Insurance Improves Your Access to Healthcare

Theoretically, people have access to emergency care even if they don’t have health insurance. The problem is, without health insurance, people are apt to try to “ride out” injuries and illnesses, and in some cases, they get worse rather than better. The result is the need for more care, and higher costs for that care.

Short term health insurance policies generally offer low premiums because they don’t cover things like maternity care, but they do offer sufficient coverage that you won’t be tempted to wait out that flu that seems to be getting worse. Which usually means that simpler, less expensive care will be all that’s needed. Sometimes simply knowing you have coverage that allows you to seek non-emergency healthcare when you need it helps ensure you remain healthier.

Young, Single People May Have More Options Than They Realize

If you’re a young, single adult who is in generally good health, low cost health insurance outside Obamacare and employer coverage may be an option worth exploring. While short term health insurance policies won’t prevent you from having to pay the “uninsured tax” that is levied on people who don’t have employer health insurance, don’t buy an ACA plan, and don’t qualify for an ACA exemption, the low premiums may ultimately be a better deal financially, even if you have to pay the tax penalty.

An insurance agent who specializes in low cost health insurance can help you evaluate your needs and match them with a plan that makes sense for your life and your finances. Yes, health insurance can be expensive, but going without it puts both your health and your finances at unacceptable risk.

For some people, particularly if they’re between jobs, short term health insurance is the perfect solution for ensuring they can get the care they need to remain healthy and won’t put their finances at undue risk if a medical emergency should arise. We invite you to look over our plans and call us today at 888-540-1620. We know how to keep you covered while finding the lowest premiums on plans that fit your needs.

Don’t Kid Yourself. You Need Healthcare Coverage.

You’re relatively young, you’re healthy, you don’t have any terrible vices: how risky could it be to go for a month or two without health insurance? The answer is “incredibly risky.” You may not have had so much as a head cold in years, but make no mistake, in any unexpected meet-up between you and a car, the car will win, and your medical costs could spiral out of control within a matter of hours.

If you should be diagnosed with a previously unknown disorder during your hiatus from medical insurance, your finances and your credit could be ruined. But don’t think that if you avoid being hospitalized you’re protected against high medical bills. More tests and procedures are done on an outpatient basis today, and outpatient costs can ratchet upward at a fast pace too. In other words, don’t assume you can “get by” without health insurance for a couple of months.

Starting a New Career, but Open Enrollment Isn’t Available Yet

Suppose you’re starting your own business, say, as a freelancer. You separate from your regular job before Open Enrollment under the Affordable Care Act (ACA) begins, and you don’t qualify for a Special Enrollment period under the ACA. Perhaps you can be added to a spouse’s work coverage, but that won’t take effect for 30 days. Maybe you think, “I’ll just be extra careful between now and when my new medical insurance kicks in.” This can lead to damage to your health and your finances.

Communicable illnesses like flu are spread easily in public, and some major health conditions can strike without warning. And of course there’s always some risk of unexpected injury, even if you’re at home most of the time. That’s because statistically, more accidents happen at home than any other place.

Here’s How Much Hospitalization Costs

Statistics from 2013 compiled by Kaiser State Health Facts reported that in the US, the average cost for one day of hospitalization was $1,878 for state and government hospitals, $2,289 in nonprofit hospitals, and $1,791 in for-profit hospitals. Figures compiled by the National Institutes of Health for 2014 found that the median cost for an emergency room visit was $1,233, while other estimates were as high as $2,168. So suppose you’re injured in an accident, taken to the ER, and subsequently admitted to the hospital. Even if you get to go home in a couple of days, you suddenly have thousands of dollars’ worth of medical expenses for which you are responsible.

Could You Qualify for Medicaid? Don’t Count on It

Maybe you figure since you’re out of work and don’t have health insurance, you would qualify for Medicaid if you found yourself in a health crisis. But that’s far from a reasonable expectation. There are currently 31 Medicaid Expansion states (plus the District of Columbia) that, under the ACA, expand coverage to more low-income families through Medicaid. Even so, you may exceed income limits for qualifying. And, if you live in one of the 19 states that chose not to expand Medicaid access, your chances for qualifying are slim to none.

Temporary Health Insurance Can Avert Disaster

Temporary health insurance can bridge gaps between your major medical insurance coverage under employer-sponsored healthcare, through your spouse’s coverage, or under the ACA. Temporary health insurance offers low premiums because it is not designed to substitute for major medical insurance. But what it offers is catastrophic coverage that can save your finances (or potentially your life) should you require medical care when you’re without insurance. These policies are designed for short periods of time, and can be perfect for bridging the gap until you qualify for enrollment in traditional medical insurance.

Enrolling in temporary health insurance can be done at any time, so there’s no waiting for open or special enrollment periods. Furthermore, coverage can be obtained quickly – often as soon as the next day, so you minimize your time without health insurance coverage. Temporary health insurance is offered by major carriers with which you’re probably familiar, like UnitedHealthcare, and finding the right policy for your time frame, stage of life, and financial situation is easy when you work with an agent who specializes in temporary health insurance. We invite you to get a free quote and take that first step toward obtaining temporary health insurance. It’s an investment that could save your finances and your health.

Young, Single, Uninsured? Short Term Health Insurance May Be Right for You

Part of the Affordable Care Act (ACA, or “Obamacare”) requires that everyone have health insurance unless they qualify for an exemption. People who don’t qualify for an exemption and who go without essential health benefits for more than three months must pay a tax penalty.

For 2016, that penalty is 2.5% of your total household adjusted gross income, or $695 per adult (whichever is greater) and $347.50 per child up to a maximum of $2,085. You qualify for an exemption from this rule if

  • -the most affordable coverage costs more than 8% of your household income, you don’t file taxes because your income is too low
  • -you’re incarcerated
  • -your religion objects to insurance
  • -you’re homeless, or
  • -you have lived abroad for more than a year

It’s not that easy to qualify for an exemption. Some young, single, uninsured people have discovered that even with the tax penalty, temporary health insurance makes more financial sense for their situation than buying a major medical plan under the ACA.

How Temporary Health Insurance Works

Temporary health insurance doesn’t provide the comprehensive coverage that a major medical plan obtained through the ACA or through an employer does. For example, temporary health insurance plans often don’t cover pre-existing conditions, maternity care, or prescription drugs. However, for the young, single person who is healthy, not planning a family, and not taking expensive prescription drugs, it represents a low cost health insurance option that many don’t even know about. Temporary health insurance is a niche product, but in some cases it is the best alternative to going without health insurance, even if it causes a person to have to pay a tax penalty.

You’re a Prime Candidate for Low Cost Health Insurance

Temporary health insurance offers something that’s almost unheard of in the insurance world: low-cost coverage. Low cost health insurance is not a myth, because the premiums with temporary health insurance plans are significantly lower than they are for a traditional major medical plan acquired through the ACA or your employer. In some cases, the premiums are low enough to more than offset the cost of the tax penalty, so you have backstop health coverage in the event of a serious medical problem, but without high premiums if you’re young and generally healthy. It’s worth running the numbers to see if temporary health insurance, even factoring in the tax penalty, saves money over a traditional plan.

Your New Job’s Insurance May Not Be Effective Right Away

One reason the young, single person may turn to short term health insurance as a low-cost health insurance option is to bridge a coverage gap when transitioning from school to the workplace. Maybe you’re too old to be carried on your parent’s policy, but your new job’s health insurance doesn’t go into effect for 90 days. This is exactly the type of coverage gap temporary health insurance is designed to cover. You can enjoy low premiums and will appreciate the peace of mind that comes from knowing you’re not living your life with the financial and medical risks that occur when you go without health insurance.

Temporary Health Insurance Can Be Arranged Quickly

Another reason a young, single person may turn to a temporary policy is that there are no worries about Open Enrollment (the period near the end of the year when people sign up for ACA plans), or qualifying for a Special Enrollment period outside that time frame. It’s always “open enrollment” with temporary health insurance plans, which means you can apply today and there’s a good chance you can have coverage tomorrow. If you work with an insurance agent, you can learn about all your options, including options you won’t find online, and can determine which one is the perfect one for you.

Low-cost health insurance isn’t a pipe dream for someone who is young, single, and generally healthy. Temporary health insurance fills a need for catastrophic coverage while offering low premiums and the convenience of not having to wait for open enrollment periods or trying to qualify for a special enrollment period. In some cases, the savings are enough to more than offset the cost of any tax penalty you might incur. We invite you to get a free quote and start exploring your health coverage options today.

6 Good Reasons to Get Short Term Health Coverage

Low cost health insurance may seem like a contradiction in terms, but when you need temporary coverage, it’s a realistic option. Temporary health insurance is designed to fill coverage gaps at a reasonable cost, so you don’t take undue risks with your health or your finances if you’re between jobs, or if it will be a few months before you qualify for Medicare.

Some people dismiss the idea of temporary health insurance as impractical, but that is definitely not the case. It can be one of the best, low-cost health insurance options available, and is worth exploring if you’re facing a temporary gap in healthcare coverage. Here are six good reasons to get short term health coverage.

1. Temporary Health Insurance Has Low Premiums

Short term health insurance is a different product than the major medical insurance you acquire through your job or under the Affordable Care Act (ACA). While it generally doesn’t cover pre-existing conditions or have perks like prescription drug benefits, the premiums are often significantly lower than with major medical insurance. In 2014, the average individual premium for temporary health insurance was only $110, compared with nearly three times that much for ACA plans.

2. You Can Lock in Your Premium Rate

When you select a plan during Open Enrollment under the ACA, you know your premium for that year, which helps with budgeting. Likewise, temporary health insurance plans typically allow you to lock in your premium rate for the duration of your coverage. That’s great news for the person who is between jobs, or who is waiting a few months until qualifying for Medicare, because it helps make budgeting more accurate and less stressful.

3. You Can Be Covered Quickly

When you enroll in an ACA plan during Open Enrollment, you have to wait for coverage to start, usually on January 1st of the following year. Low cost health insurance with a temporary plan can start right away. When you apply for temporary health insurance, you can often qualify within 24 hours of submitting your application. Once you’re approved, coverage can begin as soon as the very next day, so there’s minimal waiting around for benefits to become effective.

4. “Open Enrollment” Is Always Open

Under the ACA, most people select and join a health insurance plan during the weeks at the end of the year known as the Open Enrollment period. In some cases, people can qualify for a Special Enrollment period outside this time frame, but there are no guarantees. With temporary health insurance, however, it’s completely different. If it’s not Open Enrollment season and you need health insurance right away, you can apply for temporary coverage right now and have coverage within a couple of days. You don’t have to wait around for a designated time of year to apply.

5. Qualifying Is Easy

While it’s possible to be turned down for temporary health insurance due to existing health problems, one survey found that 84% of applicants qualified for it. Many users of this low-cost health insurance are Millennials who are young and healthy, and they usually have no difficulty in qualifying. If you have pre-existing health conditions, you may be offered a policy that covers other health problems without covering your pre-existing condition, so it can still offer tremendously valuable coverage.

6. People Are Usually Happy with Their Temporary Health Insurance

A 2015 survey by eHealth found that the majority of people with temporary health insurance were satisfied with the coverage provided, with only 5% being unhappy with coverage. Nearly 90% of users of temporary health insurance said that they were able to see the doctors they wanted to see while covered by their temporary health insurance plan. In other words, this type of low-cost health insurance empowers people to take care of their health with trusted doctors, without the financial risks of not having insurance.

Low cost health insurance isn’t a figment of your imagination, but is the reality of most temporary health insurance plans. These plans are offered by major insurers with whom you’re familiar, like UnitedHealthcare, and they can prevent medical and financial catastrophe for people who have a temporary gap in their health coverage. We invite you to call us today at 888-540-1620 to discuss your temporary health insurance needs or to answer any questions you may have.

You Missed Open Enrollment! Now What?

Open Enrollment periods were established under the Affordable Care Act (ACA, also known as “Obamacare”) as an annual time period when people can enroll in ACA health insurance plans. It happens during the first 90 days of the national government’s fiscal year. For example, the next Open Enrollment period begins November 1, 2016 and ends January 31, 2017.

During Open Enrollment, people access their state’s health insurance exchanges or Healthcare.gov, compare plans and prices, learn if they’re eligible for tax credits to help pay premiums, and can sign up for a plan. People who have health insurance as a benefit through work can enroll in an ACA plan, but often they find that the cost versus benefit comparison is more favorable if they stick with their employer’s plan.

But What About Special Enrollment Periods?

What happens when a person finds himself or herself without health insurance and it’s not during an Open Enrollment period? In some cases, it’s still possible to enroll in an ACA plan. For example, if you involuntarily lose health insurance through work, if you relocate, marry, or have a child, you qualify for a 60-day Special Enrollment period under the ACA. During that time, you can compare plans and sign up for one just as people do during Open Enrollment.

Not everyone qualifies for Special Enrollment. Suppose you leave one job, and have another lined up, but the new one doesn’t start for a couple of months. Unless you fulfill one of the other qualifications for Special Enrollment, you’re out of luck. But temporary health insurance can fill these coverage gaps affordably.

Temporary Health Insurance Perfect for Filling Coverage Gaps

It can be tempting to go without health insurance if you know you’re going to have insurance again in two or three months, but the risks are staggering. Even a short hospital stay can run into the tens of thousands of dollars. Most people encounter serious financial difficulties if they’re hit with big medical bills while uninsured. Temporary health insurance typically doesn’t cover as many contingencies as health insurance you get through your job or under the ACA, but it’s designed to be an affordable step that can save you from financial (and medical) catastrophe during times you can’t access traditional insurance.

Yes, Low Cost Health Insurance Exists

Everyone is so used to the costs of health insurance spiraling upward that the idea of affordable health coverage may seem absurd to some. But the truth is, many short-term health plans offer low cost health insurance with monthly premiums that are affordable to the person between jobs. The reason such low cost health insurance exists is that it does not have to conform to the requirements that ACA and employer plans do. Temporary health insurance can, for example, exclude coverage for pre-existing conditions. But by doing so, they can offer affordable premiums and provide a financial backstop that offers tremendous peace of mind when you’re between regular health insurance policies.

How Long Until You Can Enroll in Obamacare Insurance?

Say you miss ACA Open Enrollment by one day. You’ll have to wait nine months for the next Open Enrollment period to occur. And if you’re between jobs, you may face a waiting period after commencing a new job before your healthcare coverage goes into effect. Temporary health insurance is perfect for filling the gaps when you don’t have work coverage and are unable to enroll in Obamacare insurance.

Moreover, temporary health insurance is easy to get. Work with an insurance agent who knows the plans forward and backward, and you can quickly determine which one fits your needs and enroll right away. It’s one less big thing to worry about when you’re between insurance policies. If you’ve missed Open Enrollment, we invite you to view our plans. It’s the first step to ensuring you always have the coverage you need.

Thought Leader Series: Why Obamacare Is Hurting Seniors

Stephan Baldwin is the Director of Business Development for www.AssistedLivingcenter.com, an online resource for senior living communities.

The Affordable Care Act (ACA), better known as Obamacare, was advertised to the American people as the solution for all Americans to have access to low cost health insurance. Insurance companies would be mandated to provide coverage for everyone and life would be great.

Healthcare is expensive and the money for Obamacare insurance needs to come from somewhere. One of these places is Medicare, where some big cuts are being made to fund the ACA.

Medicare Budget Cuts Under The Affordable Care Act

Just how much is getting cut from Medicare? According to Medicare.net, the total amount is about $716 billion.

The most devoted ACA supporters will argue that the cuts won’t happen all at once, and will be worked in gradually over 10 years. $71 billion a year for a decade is still an incredible amount of money especially when you consider how quickly our population is aging.

Current projections estimate 10,000 baby boomers turn 65 every day, a figure that will likely continue for the next 18 years according to US News. That’s a lot of seniors that will be eligible for Medicare benefits that will be shrinking for years to come.

Where The Cuts Are Being Made

First on the list is hospitals. For a total amount of $260 billion, hospitals are expected to overcome the largest cut in the group. Hospital administrators aren’t going to tighten their belts and take the loss in their budgets. Expect these cuts to be made up other ways, typically over-charging for other items and assessing additional fees. Anyone who has received a hospital bill knows how creative they can be when it comes to getting the most money per patient.

Medicare Advantage will have to get by with $156 billion less in funding. The Medicare Advantage Plan provides money to small, private medical insurance companies that cover seniors. These insurance companies allow seniors to have more flexibility when choosing their doctor. In an article in the NY Daily News over 2,000 doctors received cancellation notices of contracts that covered almost 8,000 patients in New York alone.

There will be $66 billion less funding for the home healthcare industry, an incredibly popular option for many seniors who need temporary or long-term care, but prefer to be at home instead of a medical facility.

Nursing homes will see $39 billion less in funding while end-of-life hospice services will be cut by $17 billion. Steep cuts for the oldest and most vulnerable seniors.

Changes To Medicare Premiums And Payments

Cutting benefits is bad enough, but that’s not where the changes end. Some seniors will see a higher premium for their Medicare health care plans.

Medicare Part A will still be free for most seniors, but Part B and Part D require premuims. Part B currently has a standard premium of $104.90 per month for individuals who made less than $85,000 a year. If you earned more than that expect higher premiums for your medical insurance.

Paying More For Prescription Medications

Medicare Part D covers prescription drugs for beneficiaries. Some seniors may see an increase in the prices they pay for medicine as a result of increased the increased premiums mentioned above.

In addition to higher premiums, additional fees may be added to certain parts of coverage for beneficiaries. It’s hard to calculate what those fees will add up to now, but seniors can expect to receive a different bill than what they’re used to, if they haven’t already.

Cutting benefits must feel like a bait and switch for many aging adults who have worked their entire lives contributing to Medicare and other benefits only to have it cut at a point in their lives where they’re too old to change their plans.

Campaign promises sold us on cheap health care plans, but for many seniors the Affordable Care Act is looking pretty costly.

Is Obamacare not working for you? See how Selective Healthcare can help you, contact us today!

What Are The Best Short-Term Health Insurance Options?

Going without health insurance, even for a brief period of time, is inadvisable. It only takes one medical emergency to seriously strain finances, and cause financial catastrophe if severe enough.
Read more…

Flexibility of Short-Term Health Insurance for Individuals

People don’t usually think of “health insurance” and “flexibility” as being compatible. After all, if you try to read a health insurance policy, it’s clear that every possible contingency is mapped out, along with what does and does not qualify for coverage. People who have tried to purchase health insurance outside of the Affordable Care Act (ACA) Open Enrollment periods have generally encountered inflexibility there as well.
Read more…

Short-Term Medical Insurance for Independent Contractors

From May 2014 to May 2015, the number of independent contractors in the United States grew by approximately one million, a trend that is expected to continue. Independent contractors, also known as freelancers, are people who are self-employed. There are over 15 million of them. They may be attorneys, accountants, programmers, designers, or involved in any number of other professions. Because they are self-employed, they don’t have the option of employer-sponsored health insurance.
Read more…

What Are Some Quality and Inexpensive Health Insurance Options?

Health insurance is one of the biggest financial burdens that many people face today. Purchasing a health insurance plan on the open exchange is expensive for anyone, even if you are in good health. However, the good news is that there are some inexpensive health insurance options on the market today. Whenever there is a job change or a job loss, it is important to know your options. Not having health insurance is a dangerous game that many people play. One accident can have a huge impact on your finances. There are a lot of people who regret not getting some sort of low-cost coverage during transition periods.
Read more…

What to Do When You Can’t Afford the Affordable Care Act

The Affordable Care Act (ACA) has been in effect for several years now and, in some cases, it has allowed people who otherwise could not afford health insurance to purchase it with the help of tax credits. It has also protected consumers against being denied health coverage due to pre-existing medical conditions and put an end to lifetime dollar limits and annual limits on essential health benefits.
Read more…

How Can I Find the Best Affordable Health Insurance?

Most people understand that they “should” get health insurance, but the fear of being unable to find low cost health insurance can be off-putting. You probably have more options than you think and, depending on factors like age and general health, cheap health insurance may be within the realm of possibility.
Read more…

Suddenly Uninsured? You Don’t Have to Stay That Way!

There are a number of situations that can result in losing your health insurance, and losing your health insurance can be scary. Maybe you have started a new job, and your employer-based coverage doesn’t start right away. Maybe you’re a few months away from Medicare eligibility. You might be between jobs, or you might be out of seasonal work. Some activities require proof of insurance before you can participate and you don’t want to miss out.
Read more…

Health Insurance for People in Transition

You’re between jobs. Maybe you’re starting a new job in a few weeks. Maybe you’re realizing a long-held dream – striking out on your own to start a business. Maybe you’ve become a consultant and will be working on your own with several companies as clients. Maybe your company had a round of layoffs, and now you’re looking for the next opportunity.
Read more…

Mississippi Health Insurance and the ObamaCare Market: Understanding Consumer Healthcare Options for Mississippi Residents (2015)

I. Introduction

Mississippi residents still uncertain of the effects of the recent healthcare reform laws on their options and responsibilities to obtain health insurance coverage for the year 2015 need pay attention to one important detail: February 15th Read more…

Health Insurance for Temporary Lifestyle Changes

Like many Americans, you may be undergoing a change in your lifestyle. Perhaps your work hours were recently cut from full-time to part-time. Or maybe you’re in between jobs and are trying to hold onto as much of your savings as possible. You may have even moved to another state to search for a better-paying job.

Regardless of how your life has changed, you need to safeguard your health. Doing so means having health insurance that’s stable, flexible, and affordable. Short-term health plans have all three benefits. Read more…

Health Insurance for Recent College Graduates

If you recently graduated from college, you’re probably excited and apprehensive about starting your career. You now have one of the many things that employers require of you: a four-year degree. But you must still convince them to hire you and pay you a decent salary. That process might take some time.

While you seek the ideal job, you still need a way to keep your expenses manageable. Doing so will probably mean finding a balance between paying the rent, buying food, making student loan payments, and finding affordable health insurance. Read more…

Affordable Health Insurance for the Unemployed

It’s hard to cover basic expenses when you’re unemployed. Your regular paycheck is gone, and you probably want to keep your retirement account intact. But having health insurance is part of preserving your wealth. After all, a large, unexpected medical bill can bankrupt you.

The problem is that health plans can seem out of reach when you’re looking for a job.

That’s why it’s best to evaluate all your options and choose health insurance that’s affordable, provides the best access to doctors and hospitals, and contains the most predictable out-of-pocket expenses. Read more…

Temporarily Bypassing Obamacare

You might soon find that it’s a bit less affordable to buy health insurance offered through the Affordable Care Act, the health care law known as Obamacare.

Recent articles from CNN Money and The Fiscal Times have determined that some health plans meeting the requirements of Obamacare could be more expensive for consumers in 2015.1,2

In Florida, some residents will face truly significant health insurance expenses. According to a September 2014 article from Miami Today, the Florida Office of Insurance Regulation projected that there would be hikes in health insurance premiums averaging 13.2 percent for individual plans for 2015.3

Read more…

Will Texas Accept Obamacare?

In Texas, there’s been opposition to the rollout of the Affordable Care Act, the health care law known as Obamacare.

In particular, there’s been a lack of official support in the Lone Star State for three core components of the law: the Health Insurance Marketplace, Medicaid expansion, and navigators.

The Health Insurance Marketplace is the location where consumers can enroll in health plans that meet the requirements of Obamacare. Read more…

Can Florida Benefit From Obamacare?

The American health care system has been changed by the Affordable Care Act, the law known as Obamacare.

This law protects the public by requiring health insurance companies to offer insurance to people who have pre-existing medical conditions.

Obamacare also sets new health care standards. It does so by requiring insurance companies to cover several categories of medical services in health plans that are sold through Health Insurance Marketplaces. These Marketplaces are Websites where people can buy health insurance that meets government requirements. Read more…

Choosing Critical Illness Insurance and Life Insurance

We live in stressful times. ZeroHedge.com, a financial news Website, reported in January 2014 that 91.8 million Americans were not in the labor force.1 So, it’s more difficult than ever for the average American to pay bills and raise a family.

That’s why it’s important to protect yourself and your family from the expenses associated with life-threatening illnesses. Such expenses can add up, resulting in big medical bills. If you’re treated for a life-threatening illness and the treatment is unsuccessful, a big funeral bill could be the result.

But there are two types of insurance that can help you plan for the cost of critical care medicine or a funeral: critical illness insurance and life insurance.

Read more…

How to Choose Dental Insurance

It’s easy to overlook the importance of oral health. But it’s vital to visit a dentist every year to prevent painful and costly damage to your teeth and gums and to safeguard your overall health.

That’s why it’s important to get preventive dental care and to make that care affordable through dental insurance.

Assurant Health and UnitedHealthcare both have dental plans that provide cost-effective ways to get one of the most important types of preventive dental care: a dental exam.

Read more…

How to Shop for Health Insurance

Get ready for open enrollment. That’s the time period when you can enroll in a health plan that meets the requirements of the Affordable Care Act, which is the health care law that’s also known as Obamacare.

HealthCare.gov, the government’s official Health Insurance Marketplace for Obamacare, lists the open enrollment period as starting on November 15, 2014 and ending on February 15, 2015.1

Read more…

The Benefits of Short-Term Health Insurance

Now that open enrollment for health insurance is right around the corner, many Americans are starting to shop for health plans.

But, if you’re between jobs or you recently graduated from college, you might not have the financial resources to pay for a traditional health plan. That’s why you should consider short-term health insurance.

If you have no pre-existing medical conditions, you can use this type of insurance as an affordable way to safeguard your health while you seek stable employment.

Read more…

Is Short-Term Health Insurance More Affordable?

Has your lifestyle suddenly changed? Are you spending more but earning less?

You’re not alone. If you’re like many Americans, you may be struggling to survive due to declining job opportunities and the rising cost of food and health care.

Let’s face it: The American economy is a mess.

ZeroHedge.com, a financial news Website, recently noted that in June 2014, the number of full-time jobs fell by 523,000 and the number of part-time jobs rose by 799,000. 1

Read more…

How Health Insurance Agents and Brokers Can Help

It can be hard to understand health insurance. Fees for medical care such as doctor visits, surgery, diagnostic tests, emergency room services, and prescription drugs can vary from plan to plan.

In addition, some plans only cover health services administered through a specific network of providers. This network usually includes a limited number of doctors, hospitals, and facilities in a designated geographic area.

The most confusing aspects of choosing health insurance can involve determining how much health care you might need, how much that care will cost, and how much you can afford to spend.

Read more…

Understanding the Pros and Cons of Obamacare

Now that the Affordable Care Act has been around for a while, Americans finally have a chance to assess the pros and cons of this relatively new health care law.

The law is often referred to it as Obamacare, a name that implies that the U.S. Government has taken over the health care sector. The truth is quite the contrary. According to New York Magazine, half of new enrollees in government-approved and subsidized health plans have purchased those plans from insurance companies. 1

So, the U.S. Government isn’t running the health care industry. Instead, the government has set new standards for what the industry must provide.

Read more…

How to Use a Health Insurance Marketplace

There’s a new place to pick a health plan: the Health Insurance Marketplace. It’s a type of market where only government-approved health plans can be sold to the public.

What made this market possible? Well, the government set new standards for the quality and affordability of health insurance by passing a new law ― the Affordable Care Act.

You may have heard people refer to this law as Obamacare. It puts health care within reach of more Americans than ever before.

Read more…

How to Understand the Affordable Care Act

In March 2010, a new health care law was signed by President Obama. Some people call it Obamacare. But the official name is the Affordable Care Act.

The purpose of the law is to make quality, affordable health insurance more accessible to individuals, families, and small businesses and to provide consumer health care protection.

Some people might find the Affordable Care Act to be confusing, though. The actual law is thousands of pages long, and state and federal officials use an abundance of new terms to describe how the law provides access to health care.

Read more…

ENROLL NOW!

It’s simple, easy, and FREE!

Expert Interview Series: Dr. Marlene Mahea of TeleMental Health Institute


Online training

Marlene M. Maheu, PhD is the founder and Executive Director of the TeleMental Health Institute, where she oversees the development and delivery of professional training to behavioral health practitioners from around the world through their online training platform at www.telehealth.org.

We recently checked in with Marlene to learn about what Telemental Health is, as well as the benefits and drawbacks for patients. Here’s what she had to say:

Tell us about Telemental Health. What is it?

Telemental health refers to the delivery of behavioral services across geographical distance via a wide variety of technologies (telephone, video, email, test messaging, apps) for a wide variety of services (e.g., clinical care, education, billing, consultation).

How did you become interested in Telemental Health? How has the field evolved since you got your start?

Drawn to technology in 1994 to explore how to reach many more people than prior, I started an online magazine that further opened my eyes to how health consumers from around the world clamored for information. I began asking questions about legal and ethical issues, and soon learned that very few of my colleagues in the large professional associations had begun to consider the realities of practicing via technology. That sparked my interest further, and has since led me to be a worldwide leader in legal and ethical issues (best practices) for the spectrum of behavioral professionals, from psychiatry, psychology, counseling, social works, marriage and family therapy, substance use and behavior analysis.

What do you think is the future for how providers offer behavioral health services?

We are just seeing the tip of the iceberg. Within a decade, using technology in routine medical and behavioral care will be the norm. We will interact regularly with our smart phone, tablets and other mobile devices to not only communicate with each other and our treating clinicians and their staff, but also with ourselves. Many of us will be wearing sensors that communicate much more about ourselves than most people can imagine today.

Much of that information will be stripped of identifying elements, and fed up to large cloud-based systems that will give us (and those with whom we choose to share) regular feedback about how we are doing with respect to the goals we have set for ourselves; our physical and emotional states; how we are sleeping; the medication or supplements we take; the food we eat; the water we drink; our exercise; our interactions with others, etc.

What are the benefits of telemental health to patients?

The largest benefit is related to access. That is, access to practitioners, to information, to other people who share our interests and concerns about healthcare, to other resources that can help us.

What about the potential drawbacks for patients?

Patients can be easily misled by uninformed practitioners who haven’t taken the time and energy that is ethically mandated to learn what they should about technology before they offer it to their patients. For example, practitioners have made their services available through technology that does not meet federal requirements for privacy and security, leaving their patients vulnerable to hacking and other violations. These practitioners are unwittingly acting as if they know wheat they are doing, when they frankly, have been cavalier about technology.

What considerations should patients make when using telemental health providers versus more traditional mental health providers?

Just as it is wise to ask a surgeon how many surgeries they have performed of the specific type being recommended, it is wise to ask clinicians how many hours of formal legal and ethical training they have received before jumping aboard with any technology they recommend.

In today’s day and age, a clinician’s knowing how to turn on a video system is simply not enough. All responsible clinicians have taken several hours of legal and ethical professional training to know how to protect their patient’s privacy, security and other issues when working across distance with whatever they choose for technology. For instance, many clinicians are practicing over state lines without a license, leaving the patient vulnerable if they ever feel the need to file a malpractice complaint against the professional involved. Others readily sign on with “life coaches” who practice worldwide, but are completely unregulated, meaning they never have to prove their credentials to a government entity, and cannot be held to professional standards by any law.

Patients then, ought to thoroughly inquire about any clinician’s legal and ethical as well as technical training with regard to any technology they are directed to use.

Is telemental health typically covered by insurance? How can patients find providers that will be covered by insurance?

In many states, TMH is covered by insurance. Consumers can inquire with their insurance plans to find approved providers. Many will also find some online, but I would caution against approaching services that hire unwitting, uneducated licensed professionals to do things such as offer anonymous care, which is illegal when offered by licensed professionals because those professionals cannot engage in a number of mandated services. Another example where licensed professionals are asked by some online companies to engage in illegal activities is when they practice over state and national borders.

What advice can you offer patients on shopping for insurance that will cover telemental options?

This really isn’t complicated. Ask your insurer if they cover telemental health, and if not, ask if they are required to do so by state law. That ought to get an interesting answer … The majority of states do require coverage by insurers on par with in-person benefits for insurance carriers.

If you can’t get a straight answer, go to the American Telemedicine Association’s website and look for their “report card” of states and how well they are doing with telemental health.

What trends or innovations in healthcare are you following right now for how they’ll benefit patients?

  • -mhealth
  • -Patient engagement tools
  • -Video-based tools
  • -Sensors
  • -Apps that are evidence-based (most are not)
  • -Technology platforms that offer a wide range of educational and clinical services for specialized populations, such as seniors, drug and alcohol patients, minorities

What health insurance headlines are you following right now? Why?

We are tracking legislative news related to state adoption and dissemination of telemental health services. We also track grants that will help our colleagues get funded for specialized service development.

We also are keenly interested in how the professional licensing boards are beginning to address telemental health with their licensees. We regularly get asked to consult or deliver professional training in conjunction with these regulatory boards to help them understand the scientific literature, the emerging technology and how other boards are dealing with the challenges of practitioners who are not bothering to educate themselves before delivering technology-based care to the clients and patients they serve.

Need help finding quality health insurance on a budget? View our plans.

Expert Interview Series: Sean Parnell of Selfpay Patient


Sean Parnell is the author of The Self-Pay Patient: Affordable Healthcare in the Age of Obamacare, a guide for patients who pay directly for medical services and avoid bureaucratic intrusion.

We recently checked in with Sean to learn more about what self-pay healthcare is and how it works. Here’s what he had to say:

Tell us about your professional background. How did you become interested in healthcare and public policy?

I have been involved in public policy and politics for nearly 20 years, and from the beginning have been interested in health care as an issue. One of my earliest jobs was working for a congressman from Iowa who was a surgeon before getting elected, and he played a significant role in promoting legislation known as the Patients’ Bill of Rights, which was a response to what were seen as abusive or at least unnecessary practices that restricted access to care for many who were covered by an HMO. Working for him I developed an appreciation for how third-party payers intruded on health care decisions, and my later work allowed me to continue looking at this issue.

How did you become interested in self-pay patients?

I had written a few articles on related topics, such as cash-only pharmacies and healthcare sharing ministries, when I worked at a free-market think tank. Later, during the time when the Affordable Care Act was being debated and passed, I heard people saying that they would “opt out” of Obamacare and forego insurance. I knew from my past work that it was possible and even desirable, but I saw that most people planning to opt out didn’t have the information on how to do it without taking significant risks. I thought that a guide book for people who don’t get care through insurance coverage might be a good idea, and that was when I decided to write the book.

What are your observations about the current climate of healthcare in the U.S.?

It’s difficult to have conversations with people because the issue is so tightly wound up in politics. I have my views, and in my other work I promote what I generally call “free-market healthcare” but I’m happy that my work on behalf of self-pay patients is largely devoid of politics.

What is a self-pay patient?

A self-pay patient is anyone who pays directly for some, most, or all of their health care services. Often they are uninsured or have a high-deductible plan, but sometimes people with what is considered more comprehensive coverage find themselves as self-pay patients too, usually in cases where the insurance company refuses to cover a particular treatment or a provider they want to see is out-of-network.

Why would someone chose to become a self-pay patient? What are the benefits?

There are many different reasons. In some cases it’s simply to escape what I call bureaucratic medicine, where an insurance company inserts itself between the patient and doctor and tries to dictate what sort of treatments are appropriate. It can also provide better access to care – patients in the conventional third-party payer system might have to wait longer to see a specialist or primary care provider, and that visit might be very short, eight minutes or even less with an actual doctor. If a self-pay patient can find a doctor or other provider that caters to self-pay patients, the visits tend to be much longer, allowing for greater patient-doctor interaction. There’s no downside I can see to that scenario.

Some want to escape what they see as government intrusion in health care, for example electronic health records that potentially give prying eyes the opportunity to examine what should be private medical files.

For other people, it’s a terrific way to save money – by not paying expensive insurance premiums and simply paying directly for the care that you need, most (but not all) self-pay patients will save a bundle, thousands or even tens of thousands of dollars a year. In many cases this is driven by the fact that a visit to a cash-only doctor is frequently less expensive than a visit to a doctor through insurance, and self-pay rates for surgeries can be much less as well, particularly if the patient is willing to travel.

And, of course, there are some people for whom it’s simple economic necessity – they cannot afford coverage, or all they can afford is a high-deductible plan that covers them from catastrophic bills but leaves them to pay directly for the bulk of their care.

What about the cons of self paying?

It can be tough to find doctors, hospitals, pharmacies and other providers that cater to self-pay patients and will give them a fair, simple price. And it requires a bit of thought and maybe even work – there’s no identified network of doctors, you might need to research which providers cater to self-pay patients, and you might need to negotiate for a lower price than what is listed. And it is crucial, in my opinion, to have some form of catastrophic coverage, such as a health care sharing ministry, a critical illness policy, or even a conventional high-deductible policy. If you can’t or won’t do the homework necessary to be a self-pay patient, it can get expensive in a hurry.

How are self-pay patients typically received by health care providers today?

More providers are switching over to either cash-only or at least cash-friendly every year, but it’s still a minority, perhaps 10 percent at most. But there is a growing awareness by providers that there is a self-pay community out there and that by catering to it, they can bring in new patients and avoid the hassle of dealing with insurance companies.

For those not wanting to try the self-pay option, what advice can you offer on shopping for affordable health insurance options?

The most important thing is to get a plan that meets your needs. If you are relatively healthy and rarely visit the doctor, then the size of the network probably shouldn’t be a big concern, and accepting a high deductible likely won’t be a problem either. On the other hand if you expect to visit health care providers on a semi-regular basis, more than five or six times a year, then having an adequate network is likely to be vital. One of the concerns with many of the polices being sold on the Affordable Care Act exchanges is that they are basically Medicaid policies, and Medicaid is horrible coverage.

How can Americans get better insurance rates?

I’m not sure that’s an option under current law or even the current paradigm, in which third-party payer is the dominant feature of the health care system. The Affordable Care Act basically took a broken health care market and built on it without really addressing the underlying problems. On the plus side more people have coverage, on the minus side that coverage isn’t all that great – I don’t think high premiums, narrow networks, and high deductibles was the direction anybody wanted to go, and yet that’s basically where we find ourselves. So I don’t have an answer to how to get better insurance rates, but I do have an answer for how to get better prices on healthcare – become a self-pay patient.

What healthcare news or trends are you following right now? Why?

The biggest news and trend I’m following is the significant rise in insurance premiums in the individual market. I think there is a very real possibility that the 6 million to 10 million Americans who are in the individual market but don’t receive any subsidies at all will begin to drop out and join the uninsured over the next several years as a “death spiral” plays out. This will add millions more to the self-pay market who need medical care but cannot afford high premiums. I think the so-called “public option” will be interesting to watch, but it will still basically be a Medicaid product that attracts few other than those with substantial subsidies and few options. And of course I’m watching the 2016 election for some signs of where health policy is headed – I know it’s headed toward a bad end, the question is, which bad end – single payer or a continuation of the current mess? Either way I expect the number of people ditching the dominant third-party payer system to grow.

Searching for affordable health coverage, but not ready to commit to self pay? View our plans.

Why Obamacare Has Increased Demand for Short-Term Health Insurance

When the Affordable Care Act (ACA, also called Obamacare) was being developed, it was supposed to do away with the need for short-term health insurance, which is insurance traditionally used to bridge brief coverage gaps.



The theory was, between the expansion of Medicaid in many states, and the competition in the online health insurance exchanges, everyone could have major medical coverage at all times. This would be the case starting January 1, 2014, when most ACA provisions went into effect. Reality, however, proved not to be nearly as straightforward, and sales of short-term health insurance plans have actually escalated in the past couple of years.

2014: The Individual Mandate Goes into Effect

Beginning in 2014, everyone except for those who qualified for a waiver was required to have major medical insurance, whether obtained through an employer, through government programs, purchased privately, or purchased through the ACA exchanges. At that time, penalties for not being insured were being phased in, so they weren’t very steep at first. Now, however, the penalty for those who do not obtain healthcare coverage and do not qualify for a waiver has increased to several hundred dollars for an individual. Yet even this penalty has not been sufficient to force people to buy qualifying plans. Why? Because plans have been far more expensive than expected for many people.

Expenses Have Been Too Much for Some Consumers

Though many people qualify for tax credits that help pay for health insurance under the ACA, those who do not have found that monthly premiums are prohibitively high in some cases. And high monthly premiums are a trend that shows every sign of persisting into 2017 and beyond. What has resulted is a large swath of the population that can afford health insurance, but paradoxically, cannot afford actual healthcare. Most plans have high deductibles, and it’s not easy for most people to fork over a couple thousand dollars out of pocket before enjoying co-insurance coverage. It puts many working people between the proverbial rock and hard place.

Short Term Health Insurance: Cheaper Even with a Penalty?



A subset of the population has found that financially, their best strategy is to accept the penalty associated with not fulfilling the individual mandate and purchase short term health insurance (which does not qualify under the ACA and does not prevent a person from being penalized). Even with the penalty, some people come out ahead in terms of overall healthcare expenses by using short-term health insurance. Foregoing insurance altogether, of course, would be cheaper – at least until that first illness or injury requiring treatment more than offset those savings. Non-wealthy people realize that going without health insurance altogether is entirely too big a financial risk.

Traditional Reasons for Temporary Health Insurance

Historically, people have purchased temporary health insurance when they knew they would be without coverage for a few weeks or months. Say, if a recent college graduate, who no longer qualified for student health coverage, was to start a job with benefits within a few months, a temporary health insurance policy would make perfect sense to prevent any gaps in coverage.

Someone between jobs, or who retired before being able to enroll in Medicare would also be a good candidate for temporary health insurance. The ACA, rather than eliminating the need for short-term health insurance, has ironically created a new group of people for whom it is a viable financial option: those who come out ahead with temporary insurance while taking the tax penalty.

Temporary or short term health insurance isn’t just for people between jobs anymore. For some ordinary consumers who might otherwise enroll in ACA plans, temporary health insurance plans can be more financially savvy, even when the penalty is factored in. We invite you to view our plans and evaluate all your options as the upcoming ACA Open Enrollment period approaches.

Does Obamacare Really Make Health Insurance More Affordable?

The United States Department of Labor recently reported that healthcare spending in August 2016 rose by the largest amount since 1984. Overall medical treatment costs increased by 1% in August, which by itself doesn’t sound threatening. But when tiny cost increases are sustained month after month, they really add up, and that 1% was the largest of repeated monthly increases over a span of 30 years.



Breaking the figure down to a more granular level, hospital services costs rose by 1.7% in August, and the average prescription medication cost rose by 1.3%. Over the past year, prescription drug prices have risen 6.3%, a faster rate than in previous years. Affordable health insurance is more necessary now than it ever has been.

More People Have Medical Insurance, and That’s Good

The percentage of uninsured US adults has fallen since the “individual mandate” part of the Affordable Care Act (ACA) took effect in 2014. In 2013, 17.3% of adults were uninsured, and the rate so far in 2016 is 10.8%. In terms of numbers, that means over 16 million more adults now have insurance than did in 2013. The biggest decreases in uninsured rates have been documented for minorities, younger adults, and those with lower incomes. States that expanded Medicaid have seen greater declines in uninsured rates than states that did not. But these figures don’t paint a complete picture.

Insurance Covers Fewer Costs while Consumers Cover More Costs

More American adults have health insurance so that risk is being spread more widely, which is good. However, health insurance policies themselves have changed significantly since Obamacare took effect, and it is changing the way people define “affordable health insurance.” While many Americans qualify for tax credits that help pay monthly premiums, many insurance plans have raised deductibles considerably in an effort to contain costs. The deductible is the part the consumer must pay out of pocket before insurance starts covering most of the cost of care. A policy with a $10,000 deductible may never reach the point where the insurer’s 80% co-insurance kicks in during the course of a year.



The main reasons consumers are paying a larger chunk of their healthcare costs have to do with insurers who want to make monthly premiums more palatable (but must raise deductibles to do so) and the simple fact of medical costs continuing to increase faster than inflation.

Going Without Medical Insurance Is Phenomenally Risky

Despite the fact that insurance policies pay a smaller percentage of total healthcare costs and consumers pay a larger percentage, it’s still not a reason to consider going without coverage, even for a short time. Suppose you have a two-week gap between leaving your current job and starting your next one. That’s not a long time, but a single accident or unexpected illness can generate huge medical bills in a very short time period. Going without medical insurance should not be considered an option because of the potential for ruining both your health and your bank account.

Finding Affordable Health Insurance Coverage

For brief (weeks- or months-long) gaps in health insurance coverage, short-term medical insurance is a smart investment. Premiums are lower than you might expect, and the peace of mind from having continual medical coverage can be priceless. Short-term medical insurance can also be a great option for young adults who age out of parents’ health insurance plans a few months before the next Obamacare Open Enrollment period, and it can be perfect for graduating students who lose student health coverage but won’t have job-related health insurance for a period of time.

There’s no “open enrollment” or “special enrollment” period with short-term medical insurance, and coverage can usually be obtained quickly, so you never have to go uninsured. We invite you to give us a call at 888-540-1620 with questions, or to discuss your options for affordable health insurance. Your health and your finances are too important to leave unprotected.

How Health Insurance Premiums & Deductibles Are Related

Health insurance premiums and deductibles can be envisioned as two ends of a see-saw. Typically, as one goes up, the other goes down. Your health insurance deductible is the amount you have to pay out of pocket before your co-insurance coverage is triggered.



For example, if your insurance plan has a $1,000 deductible and 80/20 co-insurance, once you have spent $1,000 out of pocket on covered medical expenses, 80% of the costs for your next covered medical services will be paid for by your insurance. You’ll be responsible for the other 20% until you reach a yearly or lifetime out of pocket maximum, after which your insurance will cover everything.

If you want the lowest monthly premiums, then you generally have to accept the highest plan deductibles. But if you want the lowest deductible before your co-insurance coverage begins, you will probably have to accept higher monthly premiums. Here is some more information about how health insurance premiums and deductibles are related.

Modest Premium Increases May Be Masked by Big Deductible Increases

Perhaps you are interested in renewing your health insurance policy for another year and are pleasantly surprised that your premiums have hardly increased at all. When this happens, it’s essential to look at your deductible, because insurance plans can mask premium hikes by raising deductibles. Most people give monthly premiums the most weight when choosing health insurance because it’s a predictable cost that they know they will have to pay. Ignoring deductibles, however, can result in financial pain. If you go an entire year without meeting your deductible, it essentially means you have paid all your medical costs out of pocket, and paid monthly premiums.

Hedging Your Bets Against Out of Pocket Costs

Choosing between a high deductible plan (with lower premiums) and a low deductible plan (with higher premiums) is somewhat of a calculated risk. Take into account your overall health history and the state of your finances. If you have a steady income, but no savings, you may consider choosing a plan with higher premiums so that you won’t have to meet a high deductible before your co-insurance takes effect. Additionally, if you tend to need medical services frequently, it may be worthwhile to choose a plan with higher monthly premiums and a lower deductible so that your medical spending will be more predictable.

Who Can Benefit Most from a High Deductible Medical Insurance Policy?



If you are healthy and have money in savings, you might consider choosing a high deductible plan and creating a tax-advantaged Health Savings Account (HSA) to take some of the sting out of your out-of-pocket costs. If you rarely need medical services, particularly if your finances are in good shape, choosing a high deductible plan may be your most cost-effective approach. Staying healthy all year and paying a low premium, plus keeping money in an HSA (which, unlike Flexible Spending Accounts, can be rolled over year to year) can keep your healthcare spending to an absolute minimum while offering you the protection you need.

Affordable Health Insurance Means Comparing Premiums and Deductibles

Personal healthcare spending is rarely predictable, but knowing your health history and your financial history can help you make the best choice and find the most affordable health insurance policy. The health insurance deductible is important, so don’t neglect to compare deductibles as well as premiums when choosing health insurance coverage.

Finally, the worst thing you can do is try to go without health insurance coverage. Even if it’s only a few weeks between jobs, or you’ve retired a couple of months before qualifying for Medicare, that’s still plenty of time for an unexpected illness or accident to result in enormous medical bills. Short-term medical insurance is designed specifically for these situations, and the premiums are often surprisingly low.

Short-term medical insurance can be the perfect solution to brief gaps in health insurance coverage. And unlike Obamacare insurance, there are no Open Enrollment periods to wait around for. You can obtain coverage at any time. We encourage you to view our plans and see how easy and affordable it is to protect your health and your finances.

What’s Your Out of Pocket Maximum?

If you were to receive a large medical bill, how big a check could you write towards that amount? When you learn how to choose a health insurance plan, you encounter the term “out of pocket maximum.” That is the maximum amount the insured person (you) will pay for covered healthcare services over the course of a year, and it’s a way insurance helps you control financial risk.

Out of pocket maximum

After you have paid your out of pocket maximum for the year, your insurer pays 100% of covered healthcare expenses. In an ideal world, your policy’s out of pocket maximum would be a lower amount than the amount you could come up with if you were faced with a major medical bill.

Insurance Out of Pocket Maximum Should Align with Your Own

If you can only reasonably afford to pay, say $5,000 out of your own pocket for non-covered medical expenses, then it doesn’t make sense to choose a health insurance policy with an out-of-pocket maximum of $8,000. It’s not always possible to find affordable health insurance with an out-of-pocket maximum that closely aligns with your personal out-of-pocket maximum, but it’s an extremely important consideration that helps you with not only healthcare planning, but also overall financial planning.

Affordable Health Insurance Isn’t Just About Premiums

Most people, when searching for affordable health insurance, want to know what the monthly premiums are. It’s a straightforward amount, and planning for it is simple, plus insurance policies are available with a range of premium rates depending on coverage. But super low premiums may only be worthwhile if you are a healthy person who rarely needs medical care, and in those cases, you should also consider your policy’s deductible, which is how much you pay before your insurance coverage kicks in. For most people, considering the out of pocket maximum is essential to selecting the right health insurance policy.

Why Out of Pocket Maximum Is Such an Important Number

Out of pocket maximum gives you a sort of worst case scenario for your medical spending. You could, for example, use your out of pocket maximum as a target goal for a savings account, so that if you do have medical bills, paying for them won’t require extraordinary measures. Out of pocket maximums may be as low as $1,000 for an individual, or as high as $11,000 for a family. Keep in mind that in general, the lower the monthly premiums, the higher the out of pocket maximum, and vice versa.

Out of pocket maximum

Affordability Is Made Up of Many Components

Knowing how to choose a health insurance plan requires learning some basic health insurance terminology, like the definitions of premiums, deductibles, coinsurance and out of pocket maximums. These four factors influence each other, and finding the policy with the lowest out of pocket maximum may mean paying a higher monthly premium than you want, accepting a higher deductible than you may prefer, or having a lower co-insurance percentage (say, 80% instead of 90%). You’re best examining all of these factors in light of your general health status and your overall finances. Then you’ll make the smartest choice.

Going Without Insurance Isn’t “Affordable”

For all but the wealthiest people, doing without health insurance is phenomenally risky. Not only could you choose to forego necessary medical care, any major care you ended up needing could completely wreck your finances. Medical bankruptcy is a real possibility, even for comfortably middle-class families without adequate insurance.

The smart way to cope with weeks- or months-long gaps in health insurance coverage is through temporary or short term health insurance. These policies are designed for short periods of time, and the premiums are often surprisingly affordable. They can offer you the exact peace of mind you need if you’re between jobs, a few months short of qualifying for Medicare, or have recently aged out of a parent’s health insurance plan. We invite you to get a free quote and take that first step toward protecting both your health and your finances.

Your 5 Best Health Insurance Policies

Americans spend a lot of time thinking about how to find quality health insurance because healthcare costs can so easily spiral out of control.

Naturally, your best health insurance protection is an actual health insurance policy, whether it’s coverage you obtain through work, through the Affordable Care Act, through your state’s Medicaid program, or with a short-term health insurance policy.


Health insurance policies

But there are countless everyday, regular steps you can take that can also keep you healthy and keep you from having to access expensive healthcare services unnecessarily. Many accidental injuries can be prevented, and, in fact, many illnesses can be prevented if you know how to protect yourself. Here are your five best health insurance policies that don’t come with an ID card.

1. Basic Safety in the Home

If you don’t have smoke detectors, get them. Many local fire stations have grants that allow them to give away smoke detectors to people who have trouble affording them. Check the batteries every month, and change the batteries at least every year. Keep hallways and staircases well lit, secure loose floor coverings, and practice good electrical cord management to prevent tripping and shocks. Make sure stairway handrails are sturdy and in good repair, and place non-slip traction strips in bathtubs to prevent falls.

2. Safety Behind the Wheel

Wear your seat belt on every trip, no matter how short, and secure your young children in approved car seats until they’re big enough to wear ordinary seatbelts. If you ride a motorcycle or bicycle, wear a safety helmet – even if you’re not required to by law. Never drive after consuming alcohol, and know how any prescription medications you take regularly affect you so you’ll know whether it’s safe to drive while taking them. If you wear eyeglasses, update your lens prescription as needed. And never, ever text and drive.

3. Doing Those Boring Things Doctors Say You Should Do

The advice almost goes in one ear and out the other:

  • Eat a healthy diet based on vegetables, whole grains, and lean protein sources
  • Exercise regularly
  • Quit smoking cigarettes
  • Learn to manage stress
  • Maintain a healthy weight
  • Don’t drink alcohol to excess

Yet healthcare providers advise these things because they actually make a positive difference. If you have a smartphone, you can find apps that will help you with every one of these lifestyle improvements, and professional help is available if you need it too.

Remember: help quitting smoking is far less expensive than a bypass operation.

Health insurance policies

4. Controlling Your Diabetes Instead of Letting It Control You

Diabetes has become so common that many people don’t realize how serious it is. What’s more, many people who have Type-2 diabetes don’t even know it. If you’re diabetic, take your medications as directed, particularly if you take insulin.

The advice above about eating healthy, maintaining a healthy weight, and exercising regularly is especially important for diabetics because it can help in maintaining tight control over blood sugar levels. Practicing simple, everyday care for diabetes can prevent many hospitalizations and other complications.

5. Investing in Preventative Screenings

Think of screenings as an investment in your health – one that can pay off tremendously. Your doctor can recommend which screenings you should have and how often, based on your general health, age, sex, and other factors. Other preventative steps you can take include making sure that your and your children’s vaccinations are up to date, and getting an annual flu shot.

Many serious illnesses that put people in the hospital (and that can cause death) are preventable through vaccination, and regular health screenings can identify major health problems – including mental health problems – earlier when they’re easier (and less expensive) to treat.

Cheap health insurance isn’t always about purchasing a policy, though you should do that too. Simply taking care of yourself and investing in simple, preventative measures can keep you healthy, help you avoid hospitalizations, and keep your overall healthcare costs under control.

If you find yourself between major medical insurance policies, perhaps due to changing jobs, a short term health insurance policy is a financially savvy way to help protect your health and your finances. Premiums are often lower than you think, and the peace of mind of knowing you always have coverage can be priceless.

We invite you to get a free quote and explore your possibilities. Your health and your family’s health are too important to risk.

The Best Healthcare Option – Preventive Care

Americans only use preventive healthcare services at about half the rate recommended by doctors. Preventive services, however, can be one of the best investments a person can make in their physical and financial well-being.

Avoiding preventive healthcare can rapidly become “penny wise and pound foolish” when a preventable condition manifests and costs far more to treat than it would have to prevent. For example, the cost of a flu shot is negligible compared to the misery of having the flu, and the potential for dangerous and expensive complications from it.


In many ways, preventive healthcare is the best healthcare, because it can save pain, time, and money. Even if you are normally healthy you can benefit from preventive health services.

Most Common Preventive Healthcare Services

It’s not a waste of time to visit your healthcare provider periodically even when you’re feeling fine. Preventive services may include screening for diseases like high blood pressure or diabetes (which often have no symptoms at first), to assess risk for conditions like heart disease, to update vaccinations, and generally to build a comprehensive, ongoing health record with your provider.

Some of the most common preventive services include tests and screening for:

  • Blood pressure
  • Blood sugar
  • Cholesterol levels
  • Colon cancer
  • Depression
  • Risk for ovarian or breast cancer
  • Sexually transmitted diseases

Not all preventive healthcare actions take place at the doctor’s office. Some are things you do yourself, perhaps with advice and help from your healthcare provider. For example, improving your diet to include more leafy greens and whole grains, exercising regularly, maintaining a healthy weight, and giving up smoking can all be considered preventive health measures.

Reasons Why Americans Forego Preventive Healthcare

Unfortunately, cost is one of the major barriers Americans face when it comes to accessing preventive healthcare. This is true for people with and without insurance. Some cheap health insurance plans may not offer comprehensive coverage of preventive services, but costs can go toward a policy’s deductible, and of course, preventing a major health condition costs less than having to deal with it in the future.


Other reasons people avoid preventive care include assuming they are healthy or that they are living on a low income, or, sometimes, language barriers. People without health insurance tend not to seek medical care until they can no longer ignore a condition. Unfortunately, this can mean requiring more invasive and expensive care. In other words, preventive care should be a priority for everyone, regardless of health insurance status.

Health Insurance Plans Lower Barriers to Preventive Care

Health insurance plans generally make getting preventive care easier and less costly. After all, people who cannot afford health insurance generally don’t have the disposable income necessary to have regular health screenings. It’s important to assess your health insurance options, which might include Medicaid coverage if you live in a state that has expanded Medicaid eligibility in recent years. Many people also qualify for credits toward the premium costs of plans offered by the Affordable Care Act (ACA), though it’s not always easy to enroll in an ACA plan outside the end-of-year Open Enrollment period.

Health Insurance Options to Ensure You Never Go Without

The best option for making sure you never have to go without health insurance is short-term health insurance. These plans are ideal for the person who is between jobs (and benefits), the person whose work-sponsored health insurance doesn’t become available until after a certain period of time on the job, young adults who become too old to remain on a parent’s health insurance plan, and older adults who leave the workforce a few weeks or months shy of qualifying for Medicare.

Premiums for short-term health insurance plans can be refreshingly low, and you don’t have to worry about open enrollment periods, because you can obtain coverage at any time – often as soon as the next day. We encourage you to view our plans and learn the ways you can incorporate health insurance into your life and your budget. You’ll have an easier time affording preventive care, and better chances of avoiding expensive care that comes from postponing preventive services.

How Wearable Technology Is Transforming Healthcare

If you haven’t already heard of the internet of things (IoT), you soon will. It refers to the interconnection of everyday devices so they can collect and exchange data. The so-called “smart home” products like the Amazon Echo and the Nest “learning thermostat” are examples of IoT technology.


Wearable technology is part of the IoT that is changing how people live their everyday lives, allowing them to track steps, activity levels, sleep, and even physiological measures like heart rate. Wearable technologies have the potential to transform healthcare. These technologies could ultimately lead to earlier diagnoses, and lower healthcare costs.

Could Health Data Collection Lead to Cheap Health Insurance?

Wearable devices and apps that people use on their smartphones and tablets make it easy to collect valuable personal health data and to integrate that data with a person’s normal activities. An app that counts how many steps someone takes might show a burst of activity corresponding to the user having to chase down a dog that has inadvertently escaped. Heart rate data could be easily correlated with activity or stress levels, and blood glucose data could be matched up with mealtimes, insulin use, and even shopping habits.

When wearable devices and apps collect data and generate feedback based on user input, medical care becomes more personalized and accurate. The cost of these apps and of the data collection are minimal, and researchers are still learning the best ways to use the data to help people be healthier. Details can be gathered that are difficult to collect during routine doctor visits. Ultimately, the result should be less wasted time, more prompt diagnoses and care, and lower care costs.

Examples of Apps and Wearable Technology Use in Healthcare

Apps and wearables are already affecting ordinary people’s healthcare. Some health insurance plans encourage the use of apps that collect health data. Today there is an FDA-approved smartphone compatible blood glucose meter that automatically uploads glucose measurements for access by both patients and their doctors. It can drastically reduce the annual cost of treating a person with diabetes due to reduced need for emergency visits.

A San Francisco-based digital health company recently secured funding for commercializing a pregnancy wearable product that automatically detects and tracks contractions in pregnant women, displaying the information on a smartphone. And Royal Philips has developed HIPAA-compatible wearables that can monitor blood pressure and temperature.


Patient Privacy Issues Must Be Accounted For

Data privacy is a concern of most non-health app users, and it is an enormous concern for healthcare apps, particularly when data is automatically uploaded to patient web accounts. The rules in place for ensuring patient privacy are still in effect, but they are expected to continue to evolve as technology advances.

Patients themselves seem willing to share health data with their doctors and nurses, according to recent surveys. They’re less agreeable when it comes to sharing health data from wearables, apps, and IoT devices with employers or health insurers, however. Striking the right balance between data availability and privacy concerns will require concerted effort, but the results may help revolutionize healthcare, making it less clinic-centered and more patient-centered.

While mobile health devices and apps have the potential to make healthcare services better and less expensive, it’s always wise to understand your health insurance options, because no one expects healthcare costs to plummet. People who experience brief time periods between major medical insurance policies (due to missing the Affordable Care Act Open Enrollment period, being between jobs, or aging out of a parent’s health insurance plan before another plan is in place) can protect their health and their finances through short term health insurance.

Short term health insurance is generally very affordable, and can be obtained quickly, and at any time, since there are no designated open enrollment times. Going without health insurance is tremendously risky. Fortunately, short term health insurance policies offer people peace of mind of knowing they are covered should they be ill or injured. Why not get a free quote and learn more about your health insurance options? We would be happy to hear from you.

How Do I Know What Health Insurance Is Right for Me?

We all need health insurance because the medical and financial risks without it are too great for the non-wealthy person to cope with. But there are countless plans, and determining the relative merits of each can overwhelm many ordinary consumers.


Health insurance

The plan that works best for your parent may be completely different from the one that will work best for you. Determining which health insurance plans make sense requires knowing your own probable healthcare needs and how much you have spent on healthcare in the past. It also requires a bit of prognostication since, of course, many medical issues are unexpected. Here are the factors to consider to determine the best health insurance plans for your needs.

Learn to Navigate Health Insurance Alphabet Soup

Four main acronyms you should understand are HMO, PPO, EPO, and POS. With an HMO (Health Maintenance Organization), you are only covered in your HMO network, except for emergencies. Seeing a specialist requires a referral from your primary care physician.

PPOs are Preferred Provider Organizations that provide significantly higher benefits when you remain within the PPO network. You don’t need a referral from your primary physician if you want to see a specialist, but to keep costs reasonable, you generally need to choose specialists that belong to your PPO network.

Exclusive Provider Organizations (EPOs) require you to use in-network physicians except for emergencies. Unlike HMOs, however, EPOs don’t require you to obtain a referral from your primary care physician in order to see a specialist.

Point of Service (POS) plans have networks within which you have greater coverage, but going out of network requires a referral. These type plans work well for people who have a strong relationship with their primary doctor and trust him or her to coordinate care and give referrals when they need to go out of network.

Look at Health Insurance Plan’s Networks

Once you know the different types of networks and decide which type is best for your needs, look at the networks themselves. It’s fairly easy to find out whether your doctor belongs to various insurers’ networks. Usually, you can find out from insurer websites, but you can also call doctors and ask. The practice’s billing manager should be able to tell you if the physicians in that practice belong to a particular plan from a particular insurer. Regardless of which type of healthcare network you choose, in-network care will cost less than out-of-network care.


Health insurance

Compare Relative Figures for Premiums, Deductibles, Copays, and Coinsurance

Premiums, deductibles, copays, and coinsurance vary with respect to one another. For example, you might find a plan with a network to which your doctor belongs, and the premiums are refreshingly low. But once you look more closely, you may find that deductibles (the amount you must pay out of pocket before your coverage starts) are unreasonably high. Generally, plans with higher deductibles and copays and lower coinsurance percentages go along with lower premiums. Conversely, low-deductible plans with lower copays and greater coinsurance usually have much higher monthly premiums.

Explore the Scope of Different Plans’ Benefit Coverage

Finally, before choosing a particular plan, look at each candidate plan and what is covered. Choose a plan with coverage that matches well with the type of health problems you have. If, say, you have asthma, your plan should include the specialists you need in their network and make it easy for you receive care on short notice. Or if you have a mental health condition, you will want to select a plan with good mental health benefits, even if it is short on other benefits you probably won’t need. For example, if you’re a young, healthy man with depression, look for plans with excellent mental health coverage and don’t worry about coverages you’ll never need (like OBGYN services).

Selecting among health insurance plans is challenging, so it’s important to take the necessary time to make the wisest choice for your healthcare needs. Temporary gaps in coverage can easily be handled with a temporary or short-term health insurance plan, so you need never go without insurance coverage. With short-term plans, you can enroll at any time, and premiums are often significantly lower than you might expect. If you require short-term coverage or expect to, we encourage you to get a free quote. It can set your mind at ease and help ensure you never go without the peace of mind or the coverage that health insurance provides.

Why Are Health Insurance Premiums So High?

Affordable health insurance may seem like a fantasy, particularly in the face of rapidly rising health insurance premiums. Premiums are calculated based on a number of factors, including your zip code, age, and smoking status.


Health insurance

One reason premiums are rising in these early years of Obamacare is that sicker people are signing up for insurance and receiving more medical services than anticipated. But health insurance premiums are also rising because healthcare services are becoming more expensive.

High Premiums Are Primarily Due to High Medical Costs

Health insurance pays for medical claims, and the prices of the services provided by doctors have been going up at a faster rate than general inflation. One particular area of strong inflation is in the cost of prescription drugs.

The prices that Medicare pays providers are determined by the federal government. With private insurers, each provider negotiates with each insurer to set prices.

In the private sector, price varies because prices are not set by the government, and the result is that the same medical procedure can cost significantly different amounts, even within the same geographic area, due to how negotiations between providers and insurers end up being settled. As demand increases (due to an aging population and more people buying insurance), prices will tend to increase as well. Here are some ballpark figures for several common medical procedures. They drive home why you should never go without health insurance.

Appendectomy

If you were able to “shop around” for an appendectomy in generic small town America, (an unlikely scenario since appendectomies are often performed in emergency situations), you would find costs ranging from around $11,599 to $13,096, based on amounts health plans pay on claims. But these numbers are a bit slippery since some insurers pay based on bundled pricing and some don’t, and insurers are often able to negotiate lower rates from providers. If you get an estimate for a surgical procedure, ask whether facility, physician and anesthesiologist fees are included.

Coronary Artery Bypass

Heart bypass surgery is one of the more common invasive cardiac surgeries, and you can expect it to cost over $40,000, not including diagnostics, testing, and follow-up care. Since this is an inpatient procedure, you can expect costs to vary significantly based on where it is performed. And again, that $40,000 figure is based on what insurers pay, which may well be below “sticker price.”

Knee Replacement


Health insurance

If you have to have knee replacement surgery, expect it to cost over $23,000. Again, since this is an inpatient procedure, prices will vary significantly among hospitals, and whether an insurer pays costs based on bundled or individual services. Even with good health insurance, your out-of-pocket costs can easily be in the thousands of dollars.

Hysterectomy

The typical cost for a hysterectomy is almost $13,000. Around 600,000 hysterectomies are performed each year in the United States. It is the second most frequently performed major surgery among women of reproductive age. Most hysterectomies are performed for non-cancerous conditions and, by age 60, one-third of American women will have had one.

Spinal Fusion

Lumbar spinal fusion is a surgical procedure that permanently connects two or more vertebrae in the spine so that there is no motion between them. During the procedure, the surgeon places bone, or bonelike material between two spinal vertebrae, and then metal screws, rods, and plates are often used to hold the vertebrae together as they heal. It’s an expensive procedure, costing over $40,000.

Healthcare Bluebook and Fair Health Consumer Cost Lookup are two websites where you can get estimates of the cost of medical procedures based on your location. But it’s important to remember that, even within one city, costs can vary quite a bit from one provider to another.

Clearly, unless you’re very wealthy, you need affordable health insurance to cover you in the event you need an expensive medical procedure. But does cheap health insurance exist? In some cases, the answer is yes.

Short-term health insurance policies are designed to provide healthcare coverage for a period of weeks or months and are perfect when you face a gap in coverage. Premiums are often lower than you’d expect, and short-term health insurance is often used by young adults aging out of a parent’s plan, people between jobs, and people who retire a few months before qualifying for Medicare.

Selective Healthcare encourages you to view our plans and learn about your affordable health insurance options. Nobody, however healthy, should try to get by without health insurance due to the medical and financial risks that uninsured people face.

 

Obamacare Exchanges Are Collapsing – What Can You Do?

Despite having a few years of Obamacare, healthcare costs continue to spiral upward. This upward spiral in the cost of healthcare means health insurance premiums are rising rapidly, and now enrollment in Obamacare plans is lower than expected. Some pundits go so far as to predict that the healthcare exchanges under the Affordable Care Act (ACA) could be gone within a year.


In the first quarter of 2016, enrollment in healthcare exchanges dropped by 1.6 million, and there are concerns that enrollment could drop below 10 million by December due to exchange customers being unable to pay premiums.

UHC, Others Pull Out of Exchanges

United Healthcare (UHC) is the nation’s largest insurer, and it is pulling out of exchanges in all but a few states. Blue Cross Blue Shield programs in several states may pull out as well, citing major losses from selling on the ACA exchanges. For example, Blue Cross Blue Shield of Minnesota plans to exit that state’s market after having lost half a billion dollars. Blue Cross affiliates in New Mexico will be leaving, and Blue Cross plans are losing money in many states, to the tune of hundreds of millions of dollars. In states where they plan to remain, premium hikes of more than 20% are expected.

ACA customers can expect premiums to jump for 2017 regardless of whether their insurer pulls out of the exchanges. Plans on California’s exchange are expected to increase by more than 13% next year, while Anthem and Blue Shield will raise premiums by closer to 20% – significantly greater annual increases than in the past two years.

Healthcare Cooperatives Shut Down

Sixteen out of 23 non-profit, state-chartered co-ops created by Obamacare to sell affordable insurance plans have gone bankrupt. These co-ops were set up under the ACA with the goal of increasing competition with more established insurers, but with only seven remaining in business, that goal is more elusive than ever.

One of the biggest unspoken problems with co-ops shutting down in the middle of the year is patients who have to change insurance face sizeable challenges. For example, when starting over with a new insurer, patients also will have to start over toward meeting their annual deductible. Furthermore, the network of their new insurer may not overlap sufficiently with their previous one, which can result in problems with continuity of care.

Is Affordable Health Insurance Just a Dream?


All this is enough to make people wonder if affordable health insurance will ever become reality. Fortunately, around two-thirds of non-elderly Americans are able to obtain health insurance through their employer, with employers usually paying part of the premium and employees kicking in the remaining premium amounts. Still, for those without employer-sponsored insurance, the options may not look that good for 2017. Some may indeed choose to pay the non-enrollment penalty imposed by the ACA and take their chances. But remaining insured should always be a top priority.

Remaining Insured Despite ACA Problems Still the Wisest Choice

Despite the problems with Obamacare, going without insurance is still too much risk for most people to bear. With the simplest emergency department visit costing hundreds, if not thousands, of dollars, healthcare costs for people without insurance can quickly overtake their income and savings. Bankruptcies due to lack of health insurance are far from uncommon. So what is a person to do if they cannot obtain employer-sponsored insurance and if the options available under the ACA are too limited to serve their needs? One alternative that more people should know about is short-term health insurance.

Cheap Health Insurance Options Outside the ACA

Short-term health insurance is a non-ACA option that makes sense for people in many situations. Suppose your healthcare co-op under the ACA goes bankrupt a few months before the next ACA Open Enrollment period. Starting over with another ACA plan can cause overall healthcare costs to increase sharply. But a short-term health insurance policy can bridge the coverage gap until the next Open Enrollment period at a much lower cost. Short-term, or temporary health insurance policies generally have significantly lower premiums than do traditional major medical policies. What’s more, there are no open enrollment times with short-term health insurance policies, and many people can obtain coverage quickly – often within a day.

Selective Healthcare invites you to view our plans and see what your affordable health insurance options outside the ACA are. Going without is too risky. Fortunately, you have options.

Confused About Copays, Co-Insurance and Deductibles?

Insurance is one of the more complicated financial tools the average person uses, so don’t despair if you have trouble understanding your health insurance policy. Health insurance policies have become more complex in recent years as insurers struggle to cope with rising costs of medical services.


When you evaluate personal health insurance policies, there are three important elements you should evaluate closely before making your decision: copays, co-insurance, and deductibles. The right combination of these three for you may be different than the right combination for your mother or your neighbor. Here’s what you should know about copays, co-insurance, and deductibles.

Insurance Copays

Insurance copays are the flat fees you pay each time you visit a healthcare provider. They average around $24 for a visit to a primary care provider, $37 for a visit to a specialty care provider, and just over $300 for hospital admissions. If you have to make a lot of visits to a primary care doctor or specialist, you should consider the copay amounts various insurance policies require. If you are generally healthy and don’t have to visit a doctor often, copays may be less of a concern to you than your co-insurance amount should you have a catastrophic illness or injury. In general, you can expect plans with lower premiums to have higher copays and vice versa.

Co-Insurance

Co-insurance is the percentage of covered benefits that you are responsible for paying for. It kicks in after you have met your deductible. Suppose your personal health insurance policy has a $1,000 deductible and a 20% co-insurance. After you have spent $1,000 out of your own pocket to cover your deductible, you break your ankle and visit an orthopedist to have it treated. At that point, you’re responsible for 20% of the orthopedist’s charges, while your insurance policy pays the other 80%. Co-insurance percentages vary (typically from 10% to 40%), and you should evaluate policy co-insurance amounts based on how likely you think you are to meet your deductible in a given year.

Insurance Deductibles


When you buy a personal health insurance policy, you will be assigned a deductible. This is the amount that you have to pay out of pocket before your insurance benefits begin. It’s like when you’re in a fender-bender in your car, and you have to pay $200 or $500 out of pocket before your car insurance kicks in to pay for the repair. If for example, your policy has a $2,000 deductible, you will pay the first $2,000 of bills for covered services yourself. After that, you will only be responsible for a copay or co-insurance amount for covered services. Health insurance deductibles have been growing rapidly due to rising healthcare costs over the past few years.

High deductibles aren’t as much of a problem for people who are healthy and rarely need medical care, but they can be financially challenging for people who have extensive medical needs and a high-deductible policy. Choose a health insurance policy with a deductible that is reasonable for your typical healthcare needs and your financial capabilities.

Evaluating Your Personal Health Insurance Choices

When you evaluate health insurance policies, you want to consider “total cost of ownership” based on your general health status and your financial situation. There’s no way of knowing how much medical care you’ll need in the coming year, but you can get an idea based on past history. Are you more likely to need a number of relatively low-cost services? Are you likely to need fewer, more expensive services? Or do you rarely need medical services? Answering these questions in light of your finances can help you prioritize whether the copay, co-insurance, or deductible is the most important factor in the plan you choose.

Many people who prioritize low premiums find that temporary or short-term health insurance policies are perfect for covering gaps in insurance that occur due to job changes, aging out of a parent’s health care plan, or other lapses in coverage. Such plans can be perfect for providing short-term coverage until a new job with healthcare benefits begins, until the next Open Enrollment plan under the Affordable Care Act (ACA), or until you are eligible for Medicare. If you want to better understand your choices in health insurance policies, we encourage you to call us today at 888-540-1620. We would be more than happy to answer your questions.

Obamacare Meltdown – What Does It Mean?

The upcoming Open Enrollment period for Obamacare health insurance will deliver key information to whoever takes office as President next January. This year’s Open Enrollment period is the fourth one, and health insurance experts will be watching closely, particularly to see how many healthy young adults enroll.


There are some young adults who have done the math and concluded that they’re better off paying the tax penalty associated with foregoing health insurance than signing up for one of the health insurance plans for which they’re eligible. Some choose low-cost short-term health insurance plans to bridge coverage gaps and reduce financial vulnerability in the event of an accident or other unforeseen medical issue. Here’s what you should expect with the upcoming Open Enrollment period.

Expect Obamacare Insurance Premiums to Go Up

Drug and healthcare costs continue to increase, and along with these come higher health insurance premiums. Medical insurance quotes will almost certainly be higher than they were last year for most people, and in some cases, significantly higher. How much of an increase you might see depends on many factors, including market shifts.

Premium hikes will vary by state, and even within markets, but the overall trend is predicted to be higher premiums. Last year, the premium on the most popular “silver” plans jumped by 11% on average. Deductibles also increased significantly. Many insurers have struggled to remain profitable while operating on state healthcare exchanges, and some are considering pulling out of Obamacare altogether.

Factors Causing Upward Pressure on Premiums

General increases in healthcare expenditures account for much of the upward pressure on premium rates. In 2014, healthcare spending in the US increased by 5.3%, and medical costs are generally expected to increase year after year. Rising drug prices, particularly for specialty drugs and cancer drugs, have caused insurers to scramble to restructure formularies so consumers can maintain most of their prescription drug coverage, but in some cases, drug price increases have been astronomical.

It isn’t just higher healthcare service and drug costs driving the prices of health insurance plans upward. Under the Affordable Care Act (ACA), there is a cap on insurer profits, and insurers must insure anyone, regardless of pre-existing health conditions. These factors, along with other specifics of how plans must be structured under the ACA, are influencing premiums.

Aetna, UHC Scaling Back Health Insurance Plans Significantly


Aetna was once an enthusiastic participant in the ACA marketplace, but the insurer has recently done an about-face. Aetna recently called off a planned expansion and gave hints that it could abandon the ACA market altogether. The company cites higher than expected costs, particularly on specialty pharmaceuticals. Aetna had hoped to break even in 2016, but recently announced it will lose $300 million from individual policies it sells through the ACA.

Other major insurers, like UnitedHealth and Humana, have said they’re scaling back 2017 participation in ACA exchanges, and some smaller, nonprofit cooperatives are going away completely after experiencing big losses in recent years.

Risk Mitigation Programs End in 2017

Currently, there are three federal risk mitigation programs that were created under the ACA, and two of them expire in 2017. The purpose of these programs was to protect insurance companies from big losses due to providing insurance on the ACA exchanges. UnitedHealth, for one, had difficulty anticipating costs for covering sicker and older people and, in some cases, set premiums that were inadequate. With risk mitigation programs going away in 2017, insurers may take the opportunity to increase premiums significantly, or pull out of the ACA altogether.

The “risk corridors” marketplace stabilization program has actually been too cash-depleted to pay back insurers who tried to make claims under the plan. Specifically, the risk corridor pool has only had about $1 to cover every $10 in claims from insurers.

You Still Have Choices

Some people, particularly young, healthy people, have come to the conclusion that paying the tax penalty for not buying ACA-qualified health insurance plans, and then enrolling in low-cost short-term health insurance plans is a better way to spend their healthcare dollars.

Short-term policies generally have low premiums, and they’re not tied to the ACA exchanges, so there’s no waiting around for an Open Enrollment period to buy short-term policies. Selective Healthcare understands all your options for healthcare coverage, and we encourage you to call us today at 888-540-1620 for medical insurance quotes and explore the many ways you can pay for healthcare coverage in 2017.

Why Go to a Doctor When You Feel Fine?

You’ve heard all the old adages. “An ounce of prevention is worth a pound of cure.” Or perhaps, “A stitch in time saves nine.” What they’re essentially telling you is that taking care of small issues right now can prevent you from having to deal with major problems later on. It holds true in many areas of life, including housekeeping, car maintenance, and child-rearing.


And, of course, it applies to your health. Think how much easier it is for your dentist to fill a tiny cavity than to have to excavate an enormous one and possibly have to replace the natural tooth with a crown. The momentary pinch of a vaccination is nothing compared to the misery of preventable diseases, some of which can be deadly. In short, you should see a doctor regularly even though you feel fine so problems can be dealt with early, or prevented altogether.

Preventative Healthcare Services Often Affordable

Many healthcare providers, including hospitals, clinics, and private medical practices, work hard to make preventative healthcare services affordable, often working with insurers to get outstanding value for patients who are candidates for a yearly mammogram or PSA test. Some providers even offer specials depending on the time of year. For example, since October is Breast Cancer Awareness Month, many hospitals offer reduced cost screenings during that month to encourage women to take better control of their health.

Caught Early, Health Issues Easier to Deal With

Of course, screening itself doesn’t prevent disease, but it can often identify problems well before they cause physical symptoms. A small, suspicious mole can be removed and biopsied with minimal fuss while, if it’s left unattended, it could grow into a major health problem requiring serious intervention. The same is true for many common conditions, including heart disease. By identifying elevated cholesterol and triglycerides early, patients have far more options for coping and preventing serious problems later on.

Another Obvious Case for Preventative Healthcare: Flu Vaccines

Annual flu vaccinations are another “no brainer” as far as preventative healthcare. In fact, many health care plans cover the cost of flu vaccination, since complications from flu can be extremely expensive to treat (and in some people, deadly). If you’ve ever had flu, you probably understand that the tiny needle-stick you endure to get vaccinated is nothing compared to the days you can spend in bed, in pain and miserable while your body tries to fight off the flu virus. Many other vaccinations are available too, and are advisable for certain populations. For example, people can be vaccinated against shingles and certain types of pneumonia.


You Should Also Prevent Gaps in Your Healthcare Coverage

Just as you should prevent health problems by having regular checkups, screenings, and preventative services, you should prevent major financial difficulties by ensuring you don’t have any gaps in your healthcare coverage. Short term health care plans are perfect for bridging coverage gaps that can arise from being between jobs, aging out of a parent’s health insurance plan, or graduating college and having to wait a few weeks or months before gaining employer-sponsored health coverage.

Not everyone knows about temporary or short term health care plans, but they can be the ideal solution for certain life situations. They don’t necessarily provide coverage as extensive as traditional major medical health care plans, but they do offer catastrophic coverage, and often come with surprisingly low premiums. What’s more, unlike with many employer-sponsored plans or plans offered as part of the Affordable Care Act (ACA), you don’t have to wait around for designated open enrollment periods to sign up for short term health care plans. In fact, coverage can often be obtained within a day, so you can minimize the amount of time you’re without health insurance coverage.

Preventative healthcare services should be a part of every adult’s life. So should preventative financial practices, like ensuring you never go without healthcare coverage. With the costs of healthcare continuing to spiral upward, nobody can afford to be without health insurance, even for a short time. Temporary or short term health insurance plans are like preventative healthcare for your finances, preventing financial and health disaster by ensuring you can get the care you need when you need it. Selective Healthcare invites you to get a free quote and discover how affordable short term health care plans can be. There’s simply no reason to go any time without healthcare coverage when you have so many great options.

What Are the Odds You’ll Go to the Hospital?

Maybe you eat properly, exercise regularly and safely, wear your seatbelt every time you ride in a car, and get flu shots every year. That’s terrific. You should keep it up, but there’s simply no way to completely avoid the possibility of being hospitalized. Even if you do what you can to avoid major health problems, you can reduce, but not totally eliminate the possibility of ending up in a hospital or hospital emergency department.


Even the briefest hospital stays are expensive, even if you have health insurance. If you don’t have health insurance and aren’t wealthy, a short hospitalization can completely wreck your finances. Let’s look at the statistics and gain a better understanding of the chances you’ll require hospital care. You might be surprised.

Ballpark Probability of Hospitalization by Age Range

One personal finance site calculated estimates of probability of requiring hospitalization broken down by age group as follows:

  • Under age 15 – 1 in 24.7 (Approximate odds of 24:1)
  • Ages 15-44 – 1 in 18.8 (Approximate odds of 18:1) (not including childbirth)
  • Ages 45-64 – 1 in 7.1 (Approximate odds of 6:1)
  • Ages 65 and older – 1 in 2.6 (Approximate odds of 1.63:1)

Are you surprised? Even for kids and teens, who are typically healthy and bounce back quickly, the odds of ending up in the hospital aren’t that long. And once a person reaches retirement age, the odds are quite short.

Emergency Department Visits Are Common, and Expensive

What about emergency department visits? They’re definitely more common than hospitalizations, and they can be extremely expensive. The National Center for Health Statistics reports there are approximately 136.3 million emergency department visits per year in the U.S., where the total population is 319 million. Obviously there are some people who make repeated ER visits (like people with uncontrolled asthma), but that still represents a fair chance that you’ll end up seeking ER care. Just over 40.2 million ER visits are due to injuries, and 2.1 million visits result in admission to a critical care unit.

Hospital Stays Don’t Just Happen to Older People


Accidents and illnesses happen at every stage of life. Being young and in good health is no guarantee you won’t need hospitalization. Hospitalizations per age group are lowest for people under age 15 (accounting for 7% of hospital patients) and highest for those over age 65 (accounting for 38% of hospital patients). The next highest percentage is in the 15-44 age group, which accounts for 31% of hospital patients, including women in childbirth. The 45-64 age group accounts for the remaining one-quarter of hospital patients.

Hospital Visits Per 100 Persons Per Year

If you look at the population as a whole, there are 41 outpatient hospital visits per 100 persons per year, according to the U.S. Centers for Disease Control. While you may well be one of those 59 out of hundred people who avoids hospitalization, the odds aren’t overwhelmingly in your favor, and these visits can be costly. If you don’t have health insurance, you could put a serious crimp in your budget at best, or experience major financial problems at worst. Even if you have a brief time period during which you’re without health insurance, you’re wise to take steps to bridge these coverage gaps.

Short-term health insurance is designed precisely for these situations, and it can help save your health and your finances should you become ill or experience an injury. The premiums for short-term health insurance are generally lower than the premiums for regular major medical insurance, so it’s practical if, for example, you’re between jobs, or retire a few months short of Medicare eligibility.

If you’re facing a gap in health insurance coverage, you owe it to yourself to explore the options for short-term health insurance. We invite you to get a free quote and see for yourself how affordable, short-term health insurance can be one of the smartest financial moves you can make.

Accidents Happen. Are You Prepared?

Some people seem to never get sick. Maybe they’re just phenomenally lucky, or maybe they take meticulous care of their bodies, eating well, exercising, and reducing risk factors for illness as much as reasonably possible.

The problem is, there’s no vaccine against being struck by a car because someone was texting and driving. Injuries can happen to anyone and, when injuries are involved, choosing care is often based on how quickly care can be delivered, with worries about costs shelved until later, as they should be.

Injuries Often Result in Expensive Emergency Care

If you are injured, a top emergency department is exactly where you want to go. The doctors, nurses, and technicians that work in emergency medicine, as well as the paramedics and emergency medical technicians that transport injured and ill people to the hospital, have extensive training on how to cope with any type of injury.

A broken leg or head injury won’t wait for you to compare care costs. In many injury cases, the sooner you can have emergency care, the better your prognosis. Yes, emergency care is expensive, but when you’re involved in an accident or are the victim of violence, concern for treatment and healing takes precedence over concern over cost.

Car Accidents Are Still Distressingly Common

In the United States alone, more than 37,000 people die in car crashes every year, and another 2.35 million are injured or disabled. And with U.S. citizens traveling abroad, road crashes are the single biggest cause of death. In fact, globally, 1.3 million people die in road crashes per year, which averages out to nearly 3,300 deaths per day.

While awareness of the risks of drunk or impaired driving has increased, a newer threat is making roads more dangerous than they should be: texting and driving. People simply cannot concentrate on the two separate things with sufficient attention. Texting requires a level of attention that doesn’t allow for sufficient concentration on driving. If someone messes up a text, the worst consequence may be embarrassment, but if they take their attention away from the road, consequences can be far worse.

Injuries and Age Groups

Car crashes, of course, aren’t the only ways people are injured. When it comes to nonfatal injuries treated in the emergency departments of hospitals in the U.S., unintentional falls are number one in all age groups except 10-14 and 15-24. The second most common nonfatal injury treated in emergency departments is unintentionally being struck by or against something. Unintentional cuts, bites, stings, and punctures are common injuries treated in ERs, as are accidental burns and pedal cycle accidents.


The top three fatal injuries in the U.S. are unintentional poisoning, car accidents, and unintentional falls. However careful someone is with their health, the risk of accidental injury is always there and, depending on your location, the risk of being the victim of a violent crime can also be high.

Still Think You Don’t Need Healthcare Insurance?

Without healthcare insurance, your financial situation could be ruined due to an unexpected accident or injury. You may think, “I’m a great driver, so it would be the other person’s fault, and they would have to pay,” but first of all, this isn’t necessarily true, and second, it can take months or years between the time medical charges are billed and the time all insurers and parties involved come to some kind of settlement.

The average ER visit in 2014 cost $1,233. That average is across everything from catastrophic accidents to minor illnesses to health crises like heart attacks. Costs can easily spiral much higher. If an injury requires that the patient be hospitalized, costs add up at a dizzying pace. Even if you make a decent wage, a few days in the hospital can seriously damage your financial situation.

Healthcare insurance is a necessity. If you’re between jobs or between major medical policies, short term health insurance can provide coverage so you never have to do without. It only takes a split second to end up facing thousands of dollars in medical expenses, but you can protect your health and your finances with short term health insurance. Policies often have surprisingly low premiums, and enrolling can often be done within one day, so there’s no waiting around for open enrollment periods. Take a look at our short term health insurance plans and learn how easy it can be to avoid financial catastrophe in the event of an accident, injury, or illness.

Preventive Care vs. Diagnostic Care – What You Need to Know

Obtaining health insurance quotes is about more than just finding out what your premium payments will be. The more health problems you have or expect to have based on family history and your own experience, the more you need to pay attention to aspects of health insurance plans like deductibles and yearly out-of-pocket maximum expenditures.


 

Understanding health insurance quotes isn’t always easy.
 

One aspect of health insurance plans that people are paying more attention to is the coverage of preventive versus diagnostic services. What’s required to be covered and exactly how it is to be covered depends on factors like whether the health insurance plan conforms to the requirements of the Affordable Care Act (ACA). Understanding your need for preventive care versus your coverage for it can help you find the health insurance plan that makes the most sense for your life and your financial situation.

Some Health Insurance Plans Cover Preventive Care

Health insurance plans that cover preventive care often waive co-pays for services like routine annual physical exams and age- or gender-appropriate screenings. Preventive care services also typically include services like flu vaccines, vaccination against hepatitis A and B, and other necessary immunizations. Your health plan may or may not send you an explanation of benefits (EOB) statement after you have preventive services.

If you visit your doctor and new health problems are discovered, or you find out you have a condition that must be addressed, such as diabetes, the services are generally not considered preventive, since they didn’t prevent a problem. Some travel vaccines (malaria, typhoid, etc.) aren’t considered preventive care because they’re not immunizations that people routinely receive. If a preventive screening, like a mammogram indicates that follow-up is needed, the follow-up tests are generally considered diagnostic care.

Preventive Care vs. Diagnostic Care

Here are some examples of preventive care, though the specifics vary based on the particulars of health insurance plans:

• Screenings (like mammograms and colonoscopies in certain age groups)

• Routine immunizations

• Certain routine lab tests

• Other care intended to prevent illness or detect problems before symptoms appear

And here are examples of diagnostic medical care, though again, the specifics of various health insurance plans determine if and how these are covered.

• Mammogram as follow-up to discovery of a breast lump

• Colonoscopy after complaint of rectal bleeding

As you can see, a service may be considered preventive in some contexts, yet diagnostic in others. This usually affects how much of the charges you are responsible for out of your own pocket.

Know What Your Health Insurance Quotes Cover


 

Independent insurance agents are trained to understand and explain coverage choices.

In addition to knowing your doctor’s billing policy, it’s essential to know what health insurance quotes cover when you’re comparing plans. If a preventive service leads to an additional procedure on the spot (like a doctor removing a suspicious mole during a routine physical), it may no longer be covered as preventive. Something that may be considered preventive for some people may not be considered so for you due to your age or gender.

With non-preventive services, which are diagnostic services, you’ll be responsible for co-pays, deductibles, and co-insurance responsibilities. If you don’t understand the circumstances under which a preventive service becomes a diagnostic service, ask your insurer or insurance agent. They’re trained to know these things, and you’re entitled to know.

Your Stage of Life and Circumstances Should Inform Your Choices

Preventive care needs generally increase with age. The otherwise healthy young college graduate may not require much in the way of preventive healthcare, while the person who is close to Medicare qualification age may require multiple preventive services. Consider your stage in life, whether you have dependents, and your overall health when you compare health insurance quotes. Know what those quotes play out a few scenarios to understand your potential best-case and worst-case scenarios.

Sometimes Short-Term Health Insurance Is the Smartest Choice

If your needs are shorter term, like if you will soon start a job with major medical coverage as a fringe benefit, or if you’re retiring a few months short of qualifying for Medicare, short-term health insurance is well worth considering and is sometimes your smartest choice. Premiums are generally lower than premiums with traditional major medical coverage. If you have questions about differences between preventive and diagnostic care, what’s typically covered, and what you can expect premiums to cover, we invite you to call us today at 888-540-1620. We’re more than happy to assist you and answer your questions.

More Questions to Ask When Buying Healthcare Insurance

Cheap health insurance doesn’t have to be an impossibility as long as you are an informed consumer and ask plenty of questions before enrolling in a plan.


Health insurance

Being informed is step one to finding affordable health insurance.

In a previous post, we covered the top questions you should ask before signing up for health insurance. Here we offer several additional important questions that can help you evaluate your options and choose wisely. Be sure to get answers to the following questions for each health plan you consider.

Do I need a Referral for Procedures and Specialists?

Most affordable health insurance plans are Preferred Provider Organizations (PPOs) or Health Maintenance Organizations (HMOs), with defined networks of healthcare providers you’re allowed to visit to receive covered treatment. Generally, HMOs are the strictest about staying within the network. They often require that you see your primary care physician and obtain a referral to any specialist you may need. Pre-authorization for certain procedures is also common. If your plan requires a referral and you don’t get one, you could be on the hook for the entire cost of the specialist services.

What Documents Will I Need for Enrollment in this Health Insurance Plan?

If you’re purchasing health insurance on the private market, identity information is the primary documentation you’ll need to provide. If you are applying through the Affordable Care Act (ACA, or Obamacare) and think you may be eligible for a tax credit to cover some or all of your premium, you will need documents (like tax returns) that verify your income. The same is true if you plan to enroll in your state’s Medicaid program. The Medicaid Expansion states require proof of income and household size before enrolling people in the program. If you have children you plan to enroll, you’ll need identity documentation for them too.

How Would I Appeal a Denial of Benefits?


Health insurance
Do you know what to do if your insurer denies a claim?

Sometimes you think a medical service is covered under your insurance, but you’re then informed that it isn’t. There can be any number of reasons for denial of coverage, from the simplest (an identifier misspelled or entered incorrectly) to the most complex (a determination has been made that the “medical necessity” of a procedure hasn’t been proven, for example). Every insurer has its own process for appealing a denial of benefits. The amount and type of documentation you’ll have to provide depends on the reason for denial. Hopefully, you won’t ever have to appeal a denial of benefits, but it’s smart to know what to do in that eventuality.

Can I Join my Parents’ Plan if I Don’t Live with Them?

If you’re under age 26, you may be eligible to enroll on a parent’s insurance plan. In fact, if you have siblings who are already enrolled on it and you qualify, this can be one of the most affordable health insurance options for a young adult. The major issue you must be aware of, if you enroll in a parent’s plan and you don’t live near them, is that you may have to see doctors in the network that are geographically close to them. That could be a problem. Explore the extent of their provider network thoroughly before committing to being on your parent’s health insurance plan.

What if I Only Need Coverage for a Short Period of Time?

Any number of situations may arise where you only need insurance for a period of weeks or months. Perhaps you graduated from college and your new job with health insurance benefits doesn’t start for a couple of months. Or, maybe you’re between jobs. Perhaps you have retired a few months short of qualifying for Medicare. In these situations, a temporary or short-term health insurance policy can be your best option for preventing gaps in coverage. Premiums are surprisingly affordable, and the peace of mind you’ll gain from knowing you have health insurance coverage can be priceless. We invite you to get a free quote from us and take that first step to enrolling in the coverage you need to live the life you want.

Top 5 Questions to Ask When Buying Healthcare Insurance

Buying health insurance should be an informed, considered process. Unfortunately, you may be put in a situation where you must act quickly to prevent coverage gaps, and you may not feel like you have the time you need to gather all the necessary information.


Answers to health insurance questions depend on your stage of life, dependents, and risk tolerance.

But, if you know which key elements of a plan add up to the most affordable health insurance, you can make a smart decision without wasting time. Here are the top five questions to ask when buying health insurance.

1. Who Participates in Your Preferred Provider Network?

Most plans today have preferred provider networks from which you choose healthcare providers to maximize insurance benefits. Many plans have large, extensive networks that incorporate a variety of specialties, practices, and facilities. It’s important to find out whether the health insurance policy is part of a network, and who participates in it. Often, it’s a matter of a simple online search to learn whether your doctor, hospital, or other provider is included in the network. Going outside the network typically means significantly higher out-of-pocket costs and can turn cheap health insurance expensive quickly.

2. What Are Out-of-Pocket Maximums with This Health Insurance?

Policies that meet the criteria of the Affordable Care Act (ACA, or Obamacare) are required to conform to certain annual out-of-pocket maximums for individuals and families. These can vary from one policy to another. Plans that do not conform to ACA rules may or may not have out-of-pocket maximums, so it’s important to ask. How much of an out-of-pocket maximum you’re willing to risk should depend on your general health, your income, how likely you are to be able to meet your annual deductible, and past experiences with health insurance.

3. Is the Medication I Take Covered Under This Plan?

An estimated 60% of Americans take at least one medication regularly, and an estimated 15% take five or more. Whether the medications you take are covered under your policy can make a tremendous difference in the amount you spend on healthcare in a given year. It’s also important to understand which drugs are covered as brand name drugs, which are only covered as generics, and what the various “tiers” of copayments are for different types of drugs. Each insurer that offers prescription drug coverage has what is called a formulary, which spells out which drugs are covered and how. Your insurance agent can provide this information. You can often find it online as well.

4. What Are my Deductible, Copay, and Coinsurance Amounts?

Knowing deductible, copay, and coinsurance amounts helps you envision worst- and best-case scenarios.

High-deductible plans are more common than ever, because higher deductibles tend to go along with lower monthly premiums. If you’re in good health and have no dependents and a steady income, a high-deductible plan may be ideal for your particular risk profile. Copays are the amounts you pay when you visit your doctor, and are typically $25 to $50. Naturally, if you visit the doctor frequently, you would prefer lower copays. Coinsurance is how much is covered once you meet your deductible. Does the plan cover 80% of expenses after that? Some plans may cover 100% of after-deductible costs, while others may only cover 50%, so be sure to ask.

5. When Does Coverage Take Effect?

If you enroll in an ACA plan, coverage may not take effect immediately. Enrolling during the end-of-year Open Enrollment period generally means that coverage takes effect the following January 1. If you qualify for a special enrollment period at another time, coverage may not take effect for 30 days. It’s important to find out so you’ll know exactly when any coverage gaps may exist. If you choose to enroll in a temporary health insurance plan as a cheap health insurance option between major medical policies, the good news is you can usually obtain coverage quickly – often by the next day. These policies can be the perfect way to ensure you’re covered affordably when it will be a few weeks or months until your major medical plan kicks in.

Health insurance needs may have more than one solution and, as a consumer, you need to know your options. If you are experiencing a temporary coverage gap while waiting for a new job to start, while waiting to qualify for Medicare eligibility, or for any other reason, we encourage you to view our plans. Temporary health insurance coverage can provide you with peace of mind about both your health and your finances.

What They Didn’t Teach You About Health Insurance in College

If you have graduated from college, then clearly you have the initiative and commitment to finish what you start. Whether or not you have accepted employment, understanding and possibly changing your health insurance situation is important as you leave student life behind.


 

Adult responsibilities await you, but they need not be overwhelming.

Health insurance isn’t the most exciting topic, but taking care of it right now is something your future self will thank you for. It need not be overly complicated, and if, like many young adults, you’re healthy and don’t have dependents, you have more options than most people for affordable health insurance. Here are some things you probably didn’t learn as part of your college education, but that are important to making the best start in life.

Young and Healthy Does Not Equal Invulnerable

It can be awfully tempting to do without health insurance, but there are two big reasons to avoid this temptation. First, most people are required under the Affordable Care Act (ACA) to have health insurance, and you could be hit with a tax penalty if you don’t obtain coverage. Second, you’re not immortal. Nobody expects to become seriously ill or be involved in an accident, and if this should happen to you and you don’t have health insurance, your problems will grow far beyond just getting well. You could ruin your finances before you ever establish good credit.

Understand the Limitations of Remaining on a Parent’s Plan

If you had student health coverage while you were in school and lost it when you graduated, if you’re under age 26 you can be carried on a parent’s health insurance policy. Sometimes this is the easiest and best option, particularly if a parent already has family coverage that includes your siblings.

The main problem with parents’ health insurance plans is that they may be part of a restricted network of providers. This isn’t a problem if you live in the same area as your parents, but if you live farther away, you could find yourself limited to providers located nowhere near you.

Congratulations: You’ve Had a Qualifying Life Event

The good news is that graduating college and no longer being eligible for student health insurance plans is a “qualifying life event” under the ACA, which means if you want to enroll in an ACA plan, you don’t have to wait until the next Open Enrollment period in November to choose a plan.


 

As a new college grad, you shouldn’t have to wait to enroll in a health insurance plan.

But not everyone is interested in ACA health insurance plans. You may have a job lined up in a couple of months that will provide health insurance, which is great, but what will you do in the meantime? There are more options than you might know.

What Are Your Options in Health Insurance Plans?

In addition to being added to a parent’s plan or signing up for an ACA plan due to your qualifying event of losing student coverage, consider temporary health insurance plans, particularly if you have employment with health insurance benefits lined up. Temporary plans represent an affordable health insurance option, and the premiums are often far lower than they are for traditional health insurance.

Another great thing about temporary health insurance plans is that there’s no such thing as an “Open Enrollment” period, so you can sign up today. You can often have coverage within a day or two, so you can minimize the time you spend without insurance. Temporary health plans rarely cover things like maternity care, but for the single, healthy college graduate, they can provide tremendous peace of mind at an affordable cost. A temporary plan could bridge your coverage gap until your new job starts, or if you plan on getting married within a few months to someone who can then add you to their plan, it can fill in the coverage gap perfectly.

Don’t put off obtaining health insurance. You have more options than you may think, and affordable health insurance is more widely available to young college grads than many other age groups. Understand all your choices, and if you face a period of time without coverage, explore your temporary health insurance plan options, because the risks of going without are too high. We invite you to view our plans and find out for yourself just how affordable health insurance can be, and how easy it is to obtain the peace of mind that comes from knowing you’re covered.

What It Costs to be Hospitalized

It is not a “spoiler” to say that hospitalization is expensive. Exactly how expensive depends on countless factors, but there are organizations that collect data from insurance claims to develop ballpark figures. While some hospitals may offer discounts for uninsured people who can afford to pay cash, those people are rare.


Short term medical insurance

Sure, medical insurance is a monthly expense on top of all your others, but arguments to buy health insurance heavily outweigh arguments for going without. Knowing exact hospital costs in advance is almost impossible because they are made up of room costs, procedure costs, costs to pay clinicians, and overhead. However, let’s look at some representative prices so you can get an idea how quickly your out-of-pocket costs add up, even with insurance.

Room Costs: A Major Part of Your Hospital Bill

A 2014 survey by Kaiser State Health Facts found that an average inpatient day that year cost $1,974 at government-run hospitals, $2,346 at nonprofit hospitals, and $1,798 at for-profit hospitals. All these figures represented increases over those for 2013, and there’s little reason to believe they will not continue increasing.

Room costs are only part of the picture, however. You will be charged for what happens in that room. Moreover, if your hospital stay includes, say, surgery, you will have charges related to using of the operating room and the people who take care of you there. So your room costs are typically only a fraction of your total hospital bill.

The Cost of Procedures Adds Up Quickly

Procedures, from injections to sutures to surgery, plus the related tests that go along with them add up quickly. Some tests may be repeated during your stay, and you are billed for each instance. Pinning down figures for procedures and tests is difficult because costs vary by hospital and geographic region. Parts of the country where the overall cost of living is high (New York, San Francisco) generate costlier testing and procedure bills than areas where the cost of living is lower.


Short term medical insurance

If you live where the general cost of living is high, expect medical costs to be correspondingly high.

As just one snapshot in time of one zip code, these costs for relatively standard procedures were calculated by fairhealthconsumer.org, a nonprofit organization that gathers data from medical insurance claims to promote medical pricing transparency. The longer you remain in the hospital, the more these costs add up, so even two or three days as an inpatient can cause significant bills.


Short term medical insurance

Miscellaneous Charges

With costs of being a hospital patient, expect the unexpected. You may choose your hospital and surgeon from your insurer’s preferred network, but not everyone who cares for you at that hospital is necessarily in the network. Your radiologist, for example, may be out-of-network, and you will be billed at a higher rate (though some states have laws protecting against this). Some physicians call in multiple consulting physicians for their expertise when treating patients, and your bill increases each time one of these consulting physicians sees you.

There’s also the uncomfortable fact that a high percentage of medical bills contain errors. It is not easy for the layperson to read an itemized bill and understand what the terms mean, and whether a procedure you are billed for actually happened.

There’s Every Reason to Buy Health Insurance

Short term medical insurance is an option if you will be without healthcare coverage for a limited amount of time. Don’t be tempted to go without insurance, even for a brief period. Short term or temporary health insurance can be remarkably affordable, and you can often get next-day coverage, so there’s no waiting around for an “open enrollment” period.

With short-term medical insurance, instead of throwing yourself on the mercy of an emergency department when you need care, you may seek care at a far less expensive urgent care center, and, should you be seriously ill or injured, you will have far fewer worries about your financial situation. This peace of mind allows you to focus on getting well. More than half of Americans under age 65 report having problems paying medical bills, which is a clear indicator of just how expensive medical care is. Selective Healthcare invites you to call us today at 888-540-1620 to learn more about your temporary health insurance options.

What Could One Month Without Healthcare Coverage Cost?

Short term medical insurance

There could be many answers to that question, the best of which is, “Nothing.”

On the other hand, there is the true story we are going to share, of a gentleman who chose to roll the dice. Here is his story in his own words.

I was unwillingly unemployed. I had lost my job in early 2010, just as thousands of other Americans had in the wake of the 2008-2009 financial crisis. I worked diligently for about 12 hours every day, sending out resumes and making phone calls. However, after 18 months had passed I was staring at the impending end of my COBRA coverage. That ended November 30, 2011.

My best chance for health insurance was through my wife’s employer’s plan, but their open enrollment period did not start until January 1, 2012. I didn’t realize that there were options like short-term healthcare insurance, so we crossed our fingers and hoped to make it through the month. After all, I had had a complete physical in October and there was no indication of any problem.

I spent most of the month of December preparing for Christmas. I was looking forward to it with great anticipation. I had done what I considered to be a terrific job of getting just the right gifts for my wife. I wanted it to be special.

Turns out, it was special. I’d like to tell you how special, but I can’t. I don’t remember anything about it. Everything I know about that Christmas Day is based solely on what my wife and doctors have told me since.

I passed out on the living room floor. My wife called 911 and I was transported by ambulance to the local hospital. A ER doctor wrote “morbid” on the admission papers.

I was rushed to ICU because my blood glucose level had reached 2239 (which may be a world record for a living human being). I had never had any inclination that I was diabetic, yet here I was in ICU with acute pancreatitis and ketoacidosis. My heart rate was 222 and my blood pressure was 47/22. I was dying.


Short term medical insurance

Actual photo in ICU on life support.

My internal organs began shutting down. I was put on life-support and given medications that would gradually reduce my glucose level and heart rate, as well as keep me breathing, which I was no longer able to do on my own. I would remain on the ventilator for eight days – the exact number of days left until open enrollment began.

Frankly, during the first 72 hours, the doctors gave me less than a 1% chance of surviving. On the afternoon of the fifth day, my kidneys began functioning. At the point the prognosis changed. They then said that I would live, but I would be severely incapacitated physically or mentally.

Long story short, I was in ICU for 10 days and spent an additional seven days in hospital.

What could possibly go wrong going without medical insurance for just one month? Nearly half-a-million dollars of wrong in my case. If it happened to me, it could happy to you.

I have two more things to say. First, I am fairly healthy mentally and physically. It took an entire year to be able to say that. Second, going without health insurance is something no one should ever do – not even for 30 days.

If you are currently without health insurance, I urge you to investigate the opportunities for coverage to which this website can connect you. There are plans available for you. All you have to do is learn about them. It is not worth exposing yourself to the risks of going without – for you or your family.

Call us today at 888-540-1620. It’s far cheaper than calling 911 when you are needlessly without insurance.

Note: The author of this post is the regular editor for our Selective Healthcare blog. This is his true story.

Expert Interview Series: Dennis Jay of The Coalition Against Insurance Fraud

Insurance fraud

Dennis Jay is the executive director at the Coalition Against Insurance Fraud, a nonprofit organization devoted to combating fraud, educating the public and offering anti-fraud advice. Here Dennis offers an overview of how common insurance fraud is in the U.S. and its impact on healthcare. Read on:

What led to the creation of the Coalition Against Insurance Fraud?

The Coalition is unifying the fight against insurance fraud and protecting consumers. We’re doing so by bringing consumers, insurers and government agencies together – force-multiplying their efforts.

It all started back in 1993. Insurers and consumers were at odds over many issues. But they agreed they could cooperate on a common scourge that affected everyone – insurance fraud. They founded the Coalition to give the fraud fight a focal point for action.

How common is insurance fraud?

Insurance fraud steals at least $80 billion a year. Those dollar bills would stretch to the moon and back 16 times.

Insurance fraud raises your premiums. People’s savings also are stolen by fraud schemes. Victims are maimed and disfigured by botched medical treatments designed to steal. Victims also suffer humiliation and despair. People die in arson fires. Investigators even were killed by fraud suspects.

What are the most common types of medical insurance fraud you’re observing right now?

Healthcare scams are the 800-pound gorilla of the fraud world. They dwarf all other insurance schemes in total dollars stolen.

Smaller scams by normally honest consumers also are common – such as inflating a claim for stolen or burned home electronics.

Drivers also torch their car and lie that someone stole it. Their goal: Get out from under expensive payments. People burn down their homes when they get behind in payments. Innocent neighbors have been hurt by these fires.

Uninsured drivers get into crashes, quickly buy coverage then lie that the crash happened after they bought the policy.

What type of climate do you think contributes to increased cases of insurance fraud?

Too many people view insurance fraud as a harmless money grab. People even joke and brag about bilking insurers on Twitter and Facebook. We must convince more people to view fraud as a dead-end street. They’ll get caught, and get ruined.

Especially, we must reach younger consumers on social media, where so many of their attitudes are formed. We’re making progress. Still, we need far more resources to turn the corner.

Criminal medical rings view insurance fraud as easy money and a path to the good life. They see a low risk of getting caught. Staged-crash and Medicare rings think they can get away with stealing insurance money.

Fraud fighters are stepping up the pressure. Computer programs can spot scams almost in real time. Courts are handing down longer sentences for many insurance crimes.

Most consumers are honest. Yet convincing more people that fraud is dumb and not worth the risk will take years and far more resources.

What are the most common types of medical insurance fraud you’re observing right now?

Medicare scams are common – rampant theft of your taxpayer dollars. Fraudsters charge millions of dollars for phantom home healthcare visits. Or huge amounts of unneeded prescription painkillers for addicts.

Con artists bill $8,000 each for fancy power wheelchairs while delivering low-cost models worth a small fraction.

Elderly patients sell their Medicare numbers to crime rings. The swindlers use the numbers to overbill Medicare for treatments nobody ever delivered. Drug dealers are getting into Medicare fraud. They think insurance scamming is safer and more-profitable than street crime.

What are some of the classic hallmarks of a medical insurance scam?

Fraudsters often steal people’s identities and bill their insurance policies. Patients find expensive charges on their statements for surgeries they never received. One patient – with two healthy legs – was billed for an amputation.

Crooked medical providers have billed insurers for more hours than there are in a day – or for when they were traveling in Europe. Simple toenail clipping at nursing homes is billed as foot surgery.

Dishonest doctors get caught because they get greedy – their billings might be 10 times the norm for that region or procedure. Insurers notice those clues and investigate.

How can consumers be more savvy at detecting fraud?

Check your health-insurance statements. Look for procedures you don’t recognize – were you even in town on that date? Also regularly check your credit report. Identity thieves secretly bill your insurance policy for treatments, then disappear without paying. Your credit rating can drop – making it harder for you to get a mortgage, car or loan for your kids’ tuition.

Protect your medical identifiers from thieves. It’s surprising how often friends and family members steal a person’s health-insurance card or other identifiers for free medical treatment at your expense.

Also, get a second and third opinion for life-altering surgery. Dishonest surgeons have done spine and heart operations on healthy patients just to steal insurance money – millions worth. Some patients were left permanently disabled and lost their jobs.

Be wary of friendly cold-callers who say they’re from “Obamacare” or “Medicare.” They ask for your Social Security Number, health-insurance info and other personal identifiers. They want to “update federal records” or issue you a new “health-insurance card.” They’re fakers who want to steal your identity. Just hang up, and don’t engage them in conversation.

What should consumers do if they believe they’ve been scammed?

Place a fraud alert with the credit agencies if your medical ID is stolen. Also, contact your medical providers and correct your healthcare records. You might be allergic to medicine an ID thief received, or have an incompatible blood type. This can be a life-or-death error on you medical records.

If you’re a senior and think your Medicare account was scammed, call the Medicare hotline at 800-447-8477 or go online.

Call your insurer’s fraud hotline if you think your private health-insurance account was compromised. Your insurer has investigators trained to root out fraud.

What advice do you find yourself repeating over and over again when it comes to medical insurance fraud?

Verify, verify, verify. Have you checked your credit ratings and hospital statements? Gotten a second opinion before surgery? Know the warning signs you might get scammed – and stay alert.

Call us today at 888-540-1620.

8 Very Real Risks of Going Without Healthcare Insurance

During the first quarter of 2015, 29 million Americans were uninsured, representing nearly 10% of the population.

Medical insurance

Trying to get along without health insurance presents serious risks to both health and finances, as outlined in a recent report by the Kaiser Family Foundation: “Going without coverage can have serious health consequences for the uninsured because they receive less preventive care, and delayed care often results in more serious illness requiring advanced treatment. Being uninsured also can have serious financial consequences.”

Here are just 8 of the many risks of going without health insurance.

1. Only Emergency Departments Are Obligated to Care for the Uninsured

Some people have the misconception that if they don’t buy health insurance, they can receive treatment in their local hospital’s emergency department. But emergency departments are only required by federal law to screen and stabilize people who seek treatment there. This alone can result in large medical bills, and doesn’t include follow-up care, which can also be expensive.

2. People without Medical Insurance Forego Preventative Care

Many medical insurance plans include 100% coverage of preventative healthcare services such as age-appropriate screenings and flu vaccinations. People without personal health insurance are unlikely to pay out of pocket for these valuable services. Therefore, they are at higher risk of preventable illnesses and, when diagnosed with a serious condition, are often further along in the disease process.

3. The Uninsured Are Less Healthy than Those with Personal Health Insurance

People who do not have health insurance are at higher risk for misdiagnosis of serious health conditions and, when they are diagnosed with a chronic condition, they’re less likely to manage that condition. The result is declining health. Cancers and other serious diseases are typically diagnosed later among the uninsured, and mortality rates among the uninsured are higher than for the insured.

4. Uninsured People Forego Medications Due to Cost

It’s not just medical care and screening that uninsured people skip due to costs. Many also choose not to have prescriptions filled because of high prices. Many people with health insurance have some degree of prescription drug coverage and are somewhat shielded from high drug prices. Uninsured people do not have that price protection, and often face astronomical prescription drug costs.

Medical insurance

5. Uninsured Patients Are Often Charged More than Insured Patients Are

Medical insurance companies negotiate with physicians, hospitals, and other healthcare providers for lower procedure costs in exchange for providing a steady stream of patients. People who don’t have insurance have no one to negotiate these costs on their behalf and, therefore, they often pay the highest “sticker” price for medical procedures.

6. Medical Bills Cause Severe Financial Hardship for Uninsured People

Inability to afford medical bills can ultimately affect all areas of life. Money devoted to paying out of pocket for medical care is money that isn’t being used for other bills, healthy foods, preventative healthcare, education, and other worthwhile expenses. This situation can lead to stress and anxiety, which can ultimately affect overall health and lead to the need for more medical services.

7. Anxiety Over Lack of Insurance Can Cause Interpersonal Problems

When someone lacks insurance and either doesn’t get medical care, or is saddled with large medical bills that must be paid out of pocket, the stress of trying to cover expenses can also increase stress in the household and on the job. Results can include the need for expensive mental health care, employment problems, and a worsening financial situation.

8. Medical Debt Accounts for Over Half of Collections Reported on Credit Reports

Medical debt now accounts for more than half of the collections reported on the credit reports produced by the major credit reporting agencies. Having such debts show up on credit reports lowers a person’s credit score, which makes it harder to obtain credit. Furthermore, when credit is obtained, it is often at a higher interest rate than what someone would pay if they had a higher credit score.

You may have more options than you think when it comes to buying health insurance. In addition to purchasing plans through work or under the Affordable Care Act (which you can typically only do during the Open Enrollment period at the end of the year), people can also purchase temporary medical insurance policies that are particularly useful for bridging brief (weeks- or months-long) lapses in health insurance coverage. Selective Healthcare invites you to view our plans and see for yourself how affordable they are. Going without health insurance is simply too big a medical and financial risk.

5 Things You Can Do to Make Your Healthcare Coverage More Affordable

Most of the burden is on you, the consumer, to do what you can to get the most affordable healthcare coverage. The task isn’t always easy. The cheapest health insurance may not cover the things you need, yet you don’t want to overpay for coverage you’ll never use.

Health insurance plans

It’s not as easy as it was in the days when you signed up for employer-sponsored healthcare your first day on the job and then never gave it another thought. The good news is you probably have more options than you think to keep your healthcare spending under control. Here are five things you can do to make healthcare coverage more affordable.

1. Determine Whether You’re Eligible for Medicaid

If you are an adult living in one of the Medicaid expansion states, and you earn a moderate to low income, it’s worth your time to contact your local Medicaid office or go to healthcare.gov to find out if you qualify for Medicaid. If you do, then this is likely to be your cheapest health insurance option. In states that are not expanding Medicaid, you’re unlikely to qualify, even if you have a low income.

2. Scope Out Options for Children’s Health Insurance Plans

If you have children under age 18, you have even more options for obtaining coverage for them. The Children’s Health Insurance Program (CHIP) is part of Medicaid, and your children may qualify even if you yourself earn too much to qualify. In some states, CHIP also covers pregnant women. You can answer a few questions on Healthcare.gov to learn if your children qualify for CHIP. If not, is your child eligible for coverage under your own or their other parent’s insurance?

3. Go Beyond Healthcare.gov for Medical Insurance Quotes

Health insurance plans

Obtaining medical insurance quotes from Healthcare.gov is a straightforward option, but it isn’t your only option. You also have the option to ask for quotes from private insurance companies and insurance agents, both online and offline. Don’t automatically assume this is a waste of time. Particularly if you don’t qualify for a tax credit to help offset the cost of coverage purchased through Healthcare.gov, you owe it to yourself to obtain quotes from other sources, because you might find a better policy at a lower price.

4. Understand “Total Cost of Ownership”

Premiums are only part of the story. Low premiums don’t help much if your insurance doesn’t cover the things you need. You could end up spending more out of pocket if you choose a policy for its low premiums and then experience a health condition that isn’t covered. On the flip side, some people (particularly young, single, healthy people) find that, by purchasing a temporary health insurance policy (known for having affordable premiums) and paying the tax penalty for foregoing insurance that qualifies under the Affordable Care Act (ACA), they come out ahead in terms of health coverage spending.

5. Don’t Try to Do Without

The one thing you shouldn’t do is conclude it’s too complicated and give up altogether. For one thing, unless you qualify for an exemption under the ACA, you’ll still have to pay a (possibly hefty) tax penalty. The main concern, of course, is what happens if you are sick or injured. There’s simply no way of guaranteeing neither of those things will happen, and even a relatively minor illness or injury can result in thousands of dollars’ worth of medical bills. A single trip to the hospital could wreck your finances and your credit, so foregoing health insurance should not be considered an option.

If you’re only going to be without coverage for a matter of weeks or months, say, until you start your new job, qualify for Medicare, or reach the ACA Open Enrollment period, a temporary health insurance policy may be the perfect choice for your needs. While coverage is less comprehensive than traditional major medical coverage, it can save both your health and your finances should a health problem arise. Premiums for temporary health insurance policies are often surprisingly low, and the peace of mind they confer can be invaluable. Selective Healthcare invites you to get a free quote and explore all your options for obtaining health insurance coverage on our website.

Two Reasons You May Lose Your Employer’s Healthcare Coverage

The passage of the Affordable Care Act (ACA, also known as Obamacare) brought about many new business requirements, particularly for “large employers” – those that employ 50 or more full-time-equivalent (FTE) employees.

For example, these employers may have to pay an excise tax if at least one of their FTE employees receives a premium tax credit for ACA Exchange coverage and they:
-Fail to offer coverage to FTE employees and their dependents or
-Offer coverage to FTE employees that doesn’t meet value or affordability standards

As you may imagine, it’s relatively easy for a large employer to run afoul of Obamacare insurance rules, and there are some ways that employers are skirting these rules altogether. These could affect you, so it’s important to be aware of them.

Reducing Employee Hours to Under 30 Per Week

The ACA changed the definition of “full-time employee” from someone who works 40 hours per week to someone who works 30 hours per week. By lowering this threshold for full-time employment, the government put a greater financial burden on businesses that are just barely qualified as “large employers.” That can cause these employers to decided to reduce everyone’s hours to below 30 per week. When this happens, many employees take second jobs to make up for reduced earnings. This setup isn’t exactly ideal for workers. When full-time employees (and part-time employees who work too few hours) become a financial liability and healthcare costs go up, employees may bear the costs, in terms of either losing their jobs altogether, or having their work hours reduced each week.

Reducing Employee Headcount to Under 50

If a company employs something close to 50 FTE employees, couldn’t they just cut the number of FTEs they employ to escape having to comply with ACA rules? Yes. How prevalent this action will be is yet to be seen, since companies with 50 or more FTE employees were only subject to ACA compliance starting this year. However, early studies have found that around 4% of employers said they were reducing their number of FTE employees they planned to hire due to ACA mandates. It may not be that employers actively reduce their FTE payroll below 50, but if they happen to fall below 50 FTE employees by attrition, they may elect not to hire enough FTE employees to exceed the threshold in order to avoid ACA requirements.

Your Low Cost Health Insurance Options

You do have health insurance options in addition to those provided by employers or the ACA exchanges. Many people believe that it is illegal to not have health insurance under the ACA, but this is not strictly true. You can opt out of ACA coverage even if you don’t have employer-sponsored health insurance, as long as you’re willing to pay the tax penalty for doing so. For some people this tax penalty will be big enough to make acquiring health insurance worthwhile, but for others, obtaining alternative low cost health insurance can be the best financial choice, even when the tax penalty is factored in.

Temporary health insurance plans have been around for a long time, and they can still be a smart option for today’s health insurance consumer. Not only are these low cost health insurance options easy and fast for consumers to access, they can be ideal for people experiencing weeks- or months-long gaps in coverage. For example, if someone doesn’t have a qualifying event that would open up a 60-day ACA enrollment period and the next ACA Open Enrollment period isn’t for several months, health insurance quotes for temporary policies are well worth obtaining. The same is true for the person who is between full-time jobs, or who is retiring a few months short of being able to qualify for Medicare.

Since employers with 50 or more FTE employees have only recently fallen under ACA requirements, we don’t really know how many companies with right around 50 FTE employees will cut their FTE headcount to avoid ACA restrictions. Nor is it yet clear how many employers will reduce employee hours below 30 per week to avoid these new requirements. But it’s definitely a risk, and if you either work for a company close to the 50-FTE level or are used to working 30 to 39 hours per week, you’re wise to scope out all your health insurance options. Selective Healthcare invites you to obtain health insurance quotes for free, because nobody should risk going without health insurance today.

5 Things That Can Save You Money When Buying Health Insurance

The percentage of Americans experiencing difficulty finding money to pay for healthcare has dropped over the past few years. This is despite the fact that the cost of healthcare for a family of four that has employer-sponsored insurance has more than tripled in the past 15 years.

Health insurance quotes

Today, employees are paying a larger share of the cost of health insurance premiums, plus higher deductibles. Therefore, it’s important for the informed consumer to understand all options to make the optimum choice. Here are five ways you can save money when choosing health insurance.

1. Understand the Major Types of Health Plans

Many of today’s plans, whether employer-sponsored, Obamacare insurance, or privately purchased insurance, are managed care plans. The major types of managed care plans are health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Though the specifics differ, in both, healthcare accessed from within the organization’s network is reimbursed at a higher rate than healthcare accessed outside the network.

In addition, HMOs in particular have strict rules about accessing specialist care, with most requiring that a primary care physician give a referral before specialist care is covered. The traditional fee-for-service insurance plans that were popular a few decades ago are rarer now. These plans have a deductible and pay a percentage of costs after the deductible is met, regardless of whether a provider is inside or outside a defined network.

2. Know What Your Healthcare Needs Are

How often do you and your family typically visit a doctor in a year? How much have these visits cost you in the past? Does anyone in your family require regular access to a specialist provider? By the same token, consider services you don’t need. For example, if you’re a single man or an older woman, you don’t need a policy that covers maternity care. It is possible to be over-insured, which means you’re paying for services you don’t use.

There are also insurance policies that offer extra benefits, such as benefits specifically for cancer diagnoses, or even death benefits. These may be standard or add-ons. It’s important to know which is which and understand whether you need them. When you obtain health insurance quotes, make sure you know what premiums do and do not cover.

3. Do What You Can to Take Care of Your Health

Health insurance quotes

Simply doing your part to take care of your health can make a positive difference in your health insurance spending. Quitting smoking, getting cholesterol and blood glucose levels under control, and eating healthier foods can make a tremendous difference in how often you need medical services. Many insurance policies cover preventative care. If yours does, taking advantage of these services can help identify health problems while they’re still more manageable and less serious. Taking charge of your health and well-being can make a serious difference in your healthcare expenditures.

4. Understand All You Can About the Affordable Care Act

The Affordable Care Act, or ACA, has implemented many changes in the nation’s healthcare system. Employers are affected by the law, as are individuals. The “individual mandate” that encourages everyone to purchase health insurance carries a financial penalty for people who don’t purchase insurance and who don’t qualify for an exemption.

On the other hand, it’s not illegal to forego Obamacare insurance. If you can’t get insurance that meets ACA requirements elsewhere and don’t qualify for an exemption from the individual mandate, you will owe a tax penalty. However, in some situations, buying temporary health insurance (a form of low cost health insurance) works out better financially, even with the tax penalty.

5. Consider Low Cost Health Insurance Options to Bridge Coverage Gaps

There are situations in which people don’t have employer-provided insurance and can’t access Obamacare insurance. For example, someone who quits one job, then waits a few weeks before starting a new one (with new insurance coverage) may not qualify for a special 60-day enrollment period under the ACA. If it doesn’t happen to be ACA Open Enrollment season, this person could be out of luck. Fortunately, low cost health insurance is available in the form of temporary or short-term policies that bridge these coverage gaps perfectly. With these policies, you don’t have to wait around for an enrollment period, and coverage can often begin as soon as the following day.

Selective Healthcare is ready to walk you through all your options for health insurance. We encourage you to call us today at 888-540-1620.

Busting the Pre-Existing Condition Myth

One of the most important bones of contention during the debate leading up to passage of the Affordable Care Act (ACA) was how insurers were supposed to contain costs if they weren’t allowed to screen people for pre-existing conditions. The existence of pre-existing conditions often incurred limited coverage under older, employer-sponsored health insurance practices.

The ACA mandated that insurance policies sold through the healthcare exchanges could not turn people down or refuse to cover pre-existing health conditions. This was supposed to be an incentive to get more people to buy insurance, potentially swelling insurance population pools with healthier people, and thus keeping premiums under control.

The problem is, if you need to buy health insurance outside the ACA Open Enrollment period and do not have a condition that would qualify you for a special, 60-day enrollment period, you could face huge costs if you buy a policy privately.

Pre-Existing Conditions Under the Affordable Care Act

Pre-existing conditions are exactly what they sound like: health issues that people have at the time they enroll in a health insurance plan. They may be defined by an “objective standard,” saying that pre-existing conditions are any condition for which the patient has already received medical care, or they may be defined by a “prudent person” definition. The prudent person definition is easier on consumers because it defines pre-existing conditions as conditions where symptoms were present and a prudent person would have sought treatment. Regardless of definition, you can’t be turned down for insurance under the ACA for pre-existing conditions.

Short-Term Health Insurance Policies Aren’t Subject to ACA Rules

Suppose you’re in a situation of having to purchase a private insurance policy because it isn’t Open Enrollment season under the ACA and you don’t have a “qualifying event” to trigger a special enrollment period. If you have a pre-existing condition, you could face astronomical premiums when you buy privately.

However, short-term (or temporary) medical insurance policies are not required to cover pre-existing conditions as are plans under the ACA. While this may sound bad, it can actually be good, because it can make health insurance affordable. Say you have a pre-existing heart murmur. Your temporary insurance policy may not cover care related to it, but if you come down with, say, strep throat, your insurance will offer coverage. In other words, you won’t have to go completely without health insurance coverage.

Low Cost Medical Insurance Is Not Necessarily Out of Reach

Many people are surprised to learn that temporary policies are a form of affordable health insurance. One of the main reasons is that, not only are these policies in effect for a matter of weeks or months rather than years, but also when they don’t cover pre-existing conditions, they can still offer low premiums that will cover other health issues.

So, if you have a pre-existing health condition and are faced with buying a health insurance policy between jobs, until you qualify for Medicare, or until the next ACA Open Enrollment period, the temporary policy can be one of your best low-cost medical insurance options.

Do Not Risk Going Uninsured if You Have Existing Medical Conditions

Doing without medical insurance altogether while waiting for a new job to start, or for your next policy to become effective is exceptionally risky both medically and financially. Even if you have a pre-existing condition, evaluating your affordable health insurance options, including temporary medical insurance policies is your wisest choice. If you’re uninsured, a single trip to the ER, or even a brief hospitalization, can cause serious financial problems that could take years to overcome. Low cost medical insurance exists, and even if it doesn’t cover pre-existing conditions, it covers other conditions, and can bring you tremendous peace of mind compared to going without insurance altogether.

Temporary medical insurance policies can offer affordable premiums partly because they don’t have to comply with ACA rules (like mandatory coverage of pre-existing conditions). For the person who needs health insurance only for a few weeks or months, it can be the best possible alternative to going uninsured. What’s more, short-term health insurance policies can be purchased at any time, regardless of ACA Open Enrollment season and, in many cases, you can have coverage as soon as the following day. At Selective Healthcare, we invite you to get a free quote, and take that first step of making sure your healthcare coverage needs are met, for a healthier, more financially secure future.

What to Do When You Lose Health Insurance Coverage Through Your Job

The Affordable Care Act (ACA) has added a new option for obtaining insurance after involuntary job loss. However, a person who loses their job has multiple options for remaining insured. The choice that is right for one individual depends on several factors, including whether they’ve met their company health insurance’s annual deductible, whether family members have plans that can add members, or how long it will be until the next ACA Open Enrollment period (at the end of the calendar year).

COBRA Coverage: Is This the Right Choice?

Thirty years ago, Congress passed the Consolidated Omnibus Budget Reconciliation Act (COBRA), which provides an option for employees to continue purchasing group health insurance when it might otherwise be terminated, such as after a layoff. If you lose your job (voluntarily or involuntarily), you can continue coverage under COBRA as long as you’re willing to pay the entire premium. Most employers pay a large chunk of employees’ medical insurance premiums, so costs under COBRA can be alarmingly high.

But, in some cases, continuing coverage under COBRA can be smart. For example, if you have already met your employer-sponsored plan’s high deductible and would be faced with starting all over if you switched insurers, you may come out ahead by paying the full COBRA premium and taking advantage of having met your deductible.

Qualifying Events and ACA Enrollment

If you lose your job through downsizing or a layoff, the scenario is considered a “qualifying event” under the ACA. What this means is, if it doesn’t happen to be Open Enrollment season, the ACA will open a 60-day enrollment period that you can take advantage of by enrolling in an ACA plan. For many people, this can be a cost-effective choice, because tax credits under the ACA can bring costs down below the cost of using COBRA coverage.

The main problem with ACA enrollment is that not every type of job separation counts as a qualifying event. For example, if you voluntarily leave your job and don’t relocate, you have to wait until the next Open Enrollment period to join an ACA plan. Furthermore, ACA administrators are becoming stricter about evaluating potential qualifying events under pressure from insurance companies who don’t want people to enroll unless they truly are eligible.

Getting onto a Family Member’s Insurance

Say your spouse has health insurance through her job and you lose your job. Chances are, if her employer-sponsored insurance allows the addition of family members, this will be one of your easiest ways to maintain insurance. Naturally, going from an individual plan to a family plan will mean higher costs for your spouse, but these costs are often significantly lower than the cost of continuing coverage through COBRA, and may also be lower than you would pay under the ACA if you lose your job involuntarily and have a qualifying event.

Affordable Health Insurance for the Short Term

Suppose you don’t have a qualifying event, COBRA costs more than you can afford, and it’s several months until the next ACA open enrollment period (or until you start a new job). Temporary medical insurance is an option you should know about. This is a type of affordable health insurance that is perfect for bridging coverage gaps where the ACA, COBRA, and family member plans are not viable options. Temporary medical insurance isn’t as comprehensive as traditional major medical insurance, but it can prevent the enormous risks that come from trying to get by without medical insurance.

Being Uninsured Should Not Be a Consideration

Taking a chance and skipping insurance altogether should not be a consideration. The risks to your health and your finances can be catastrophic. Moreover, unless you qualify for an exemption against having to buy insurance under the ACA, you will have to pay a penalty under that law for not purchasing insurance. You could end up without coverage, and several hundred – or thousand – dollars out of pocket for not enrolling under the ACA.

You have options for remaining insured if you lose your job, and though none may seem ideal, you should evaluate them thoroughly. And, if you need some time to do this, you can purchase a temporary medical insurance policy quickly, for a short time period, and often have next-day coverage, which can greatly increase your peace of mind. Call Selective Healthcare today at 888-540-1620 to learn more about how temporary medical insurance may be your most affordable option after losing coverage through your job.

What Happened to Freedom of Choice in Healthcare?

America was founded by people who wanted freedom of choice on important matters in life and, over 240 years, that theme has been a continual thread woven throughout American history and culture. Put plainly, Americans don’t want the government making decisions for them on matters that are foundational to their lives. Many believe that recent legislation has limited healthcare choices and taken away some of the power individuals have to shape their own lives.

Before the Affordable Care Act (ACA, also known as Obamacare insurance) was passed and signed into law, the American public was told that, if they liked their current doctor, they could keep going to him or her. But it hasn’t worked out that way in many cases. Hundreds of thousands have lost the plans they had and liked and, in addition, they have had to find new doctors in many cases.

Plans Banned for Being Noncompliant

One of the overarching features of ACA plans is that they have to meet a number of criteria in order to be sold on the ACA exchanges. For example, insurance plans sold through the ACA can no longer reject people based on pre-existing medical conditions, and the law places caps on corporate profits of insurance companies. Insurance plans that do not meet Obamacare insurance qualifications can still be sold, but they don’t “count” toward the individual mandate that essentially requires everyone to buy health insurance unless they qualify for a limited range of exemptions. Right off the bat, this limited the number of plans available to people.

Obamacare Insurance and Doctor Networks

Like the insurance you may be accustomed to from your employer, physician networks are an important part of ACA health insurance plans. While researching health insurance quotes on the ACA exchanges, it’s essential to learn whether or not your doctor is part of the network for the plan in which you’re interested. He or she may not be, and if not, you could be in for an unpleasant surprise when you try to make an appointment with your preferred physician under your ACA plan. And, in many cases, the networks under ACA plans are narrower than networks people are used to with their employer-provided plans.

Narrowing Networks to Keep Costs Down

One of the few ways left that insurers have to contain costs is to make their healthcare provider networks smaller. That means that the doctor that was covered under your health insurance last year may not be part of your insurer’s network next year. So the doctor you have been happy with, and who knows your health status best, could no longer be an option for you, unless you’re willing to pay all your costs for visiting that doctor out of pocket. Most people simply can’t afford to do this.

You Don’t Have to Participate in the ACA

Though it may appear as if you’re legally obligated to participate in Obamacare insurance, it’s perfectly legal not to, as long as you understand the implications. Many people are exempt from the individual mandate, including people who don’t have sufficient income to purchase an ACA plan, people who participate in health-sharing organizations, and certain Native American tribal members. If you’re not exempt, you can still privately buy a policy that meets ACA minimum standards. But some people, particularly those who are young, healthy, and fit, find that the most cost-effective choice is to purchase temporary health insurance and pay the ACA non-participation penalty. Temporary insurance doesn’t qualify as ACA compliant, but it may provide the right level of coverage for those in certain situations.

Getting medical insurance quotes doesn’t have to be an ordeal if you want to find out more about temporary health insurance options. There are people for whom Obamacare insurance is more expensive, or, in some cases, not available due to Open Enrollment limitations. In these cases, temporary health insurance can bridge coverage gaps at remarkably affordable rates, and many policies are provided by insurers with whom you’re familiar and allow you to choose which doctor you see. Selective Healthcare is happy to provide health insurance quotes based on your specific needs, and we invite you to come to us with your questions or for more information on your alternatives to Obamacare.

You CAN Get Affordable Health Insurance

The Affordable Care Act (ACA) has had a mixed reception among American consumers and healthcare providers. By rewriting rules for private health insurance that people purchase directly (as opposed to through their employers), the goal was to make coverage more widely available and more comprehensive.

Whereas before, insurance providers could offer major medical coverage that left out certain benefits (like mental health benefits) or could refuse to insure people with existing medical problems, policies must now offer specific benefits and, under the ACA, cannot be denied to people with pre-existing conditions.

The result has been higher policy costs, as reflected in higher premiums, and, in some cases, insurers have canceled some of their old plans altogether. Though tax credits can offset some premium costs, they don’t apply to people with higher incomes. Ultimately, people who lost their old plans because of the ACA are among the law’s biggest critics. Many of them say their health insurance is not more affordable, and some don’t like being compelled by law to purchase health insurance.

Complaints About the Individual Mandate

The so-called individual mandate associated with the ACA means that, unless a person meets certain exemption criteria, he or she must buy health insurance through an employer or through the ACA. It’s not straight-up illegal not to buy health insurance, but people who don’t, and who don’t qualify for an exemption, may face steep fines, depending on income and how many family members go without insurance. Still, some people are willing to risk fines and utilize other insurance options. In some cases, this can actually be the most cost-effective option.

Taxes That Help Pay for the ACA

Paying for the ACA is, as you might guess, a major undertaking, and a number of new taxes were created to help pay for it. Those new taxes include taxes on the sales of medical devices and pharmaceuticals. People with higher incomes also face new taxes, and part of the cost of the ACA is supposed to be covered by savings in Medicare payments by the government. People with higher incomes are not pleased with the tax changes to pay for the ACA and, in many cases, these are not the people using the ACA to obtain health insurance.

Signing Up Isn’t Always Simple or Straightforward

You might imagine that signing up for a plan under the ACA would be possible at any time, but that is not the case. Like health insurance enrollment periods offered by employers, which occur in the last couple of months of the calendar year, the ACA has its own Open Enrollment period at the end of the year. If you need health insurance and it doesn’t happen to be Open Enrollment season, you might be out of luck. Some life events qualify people for special ACA enrollment periods outside Open Enrollment, but there are no guarantees. It’s entirely possible to need health insurance and be told you can’t enroll until the next Open Enrollment period, which could be several months away.

What Are Your Other Options?

Low cost health insurance doesn’t necessarily require eligibility for a tax credit under the ACA. There may even be cases where paying the penalty for not participating in the ACA is cost-effective. Suppose you’re a young, healthy person who needs personal health insurance for a defined period – say between graduating college and starting a job, or between jobs that offer insurance. Temporary health insurance policies can be remarkably affordable, even if the cost of the penalty fine is included.

Short-term health insurance policies don’t qualify as major medical coverage under the ACA because they don’t have to cover everything ACA plans do, and they still can deny coverage for pre-existing conditions. But for many people, short-term coverage is the best possible, low cost health insurance option due to the lower premiums these policies typically have. They can not only help ensure that people remain healthy by getting the medical care they need, they can prevent financial catastrophe in the event of an accident or major illness.

Selective Healthcare helps consumers like you through qualified insurance agents who are experts in temporary personal health insurance. They know options you may not find on your own, and they know the policies well enough to help you match up with the one that makes the most of your healthcare dollars. In fact, you can get a free quote right now. There are truly affordable alternatives to the ACA for protecting your health and finances.

What Is a PPO?

However you acquire health insurance, whether through your employer, through the Affordable Care Act (ACA), or through a government provider like Medicaid or Medicare, making the best choice often means being immersed in an alphabet soup of acronyms. HMOs, PPOs, EPOs, COBRA, and EOB are just a few.

It might seem like a chore, but familiarizing yourself with what these abbreviations stand for can help you make the wisest choice for your particular health status, stage of life, and insurance needs. One of the most common acronyms you’ll see when researching health insurance plans is PPO. Here’s what you should know about them.

What Does PPO Stand For?

PPO stands for Preferred Provider Organization. It is a type of subscription-based healthcare arrangement and consists of a network of physicians and other healthcare providers to which you can go and receive a significant discount compared with costs of providers outside the PPO. A PPO earns money by charging an insurance company a fee for access to the network. Within the PPO, set fee schedules are negotiated, and PPOs also sometimes deal with disputes between healthcare providers and insurers. They’re popular because they offer patients relatively good premium rates and significant flexibility in provider choice.

How Does a PPO Work?

To you, the healthcare consumer, choosing insurance that’s part of a PPO means that you’ll pay less when you visit healthcare providers and facilities that belong to your PPO’s network. If you choose providers and facilities outside the network, you will have to pay a higher portion of the cost for healthcare services. If you choose one of the many PPO health insurance plans, it is essential that you make sure the provider you want to see is part of that insurance plan’s PPO network so you receive maximum benefits. Usually you will have an annual deductible you’ll have to cover before the plan starts covering costs, and you may have to make co-payments (typically $20 to $30) for routine healthcare visits.

A PPO Is Less Restrictive Than an EPO

While a PPO is a “preferred” network, an EPO is an Exclusive Provider Organization. But unlike a PPO, an EPO doesn’t cover care outside the defined network. A PPO will cover out-of-network care at a lower reimbursement rate than in-network care, but if you’re part of an EPO and go outside the network, you’ll be footing the bills yourself. For this reason, EPOs are less popular, despite often negotiating much more favorable fee schedules for policyholders. Should you experience an emergency and require service from an out-of-network provider, the EPO will cover some of the costs, but for planned healthcare services, you have to stay in the network to receive benefits at all.

Short-Term Health Insurance Plans and PPOs

Short-term health insurance plans, like traditional major medical plans, may incorporate a PPO so as to encourage use of network healthcare providers and negotiate more favorable rates for insurers and patients. Short-term health insurance plans are excellent, cost-effective methods for people who are between jobs, have only a few months until qualifying for Medicare, or have to wait for the next ACA Open Enrollment period.

With short-term health insurance, “open enrollment” is any time, and consumers can often get coverage quickly – sometimes as soon as the next business day. These plans are not as comprehensive as traditional major medical insurance, and they won’t prevent you from the possibility of paying the ACA penalty tax for not having insurance, but they offer many advantages. For one thing, premium rates are generally low, which is an important consideration for someone between jobs. For another, quick coverage and lack of open enrollment periods protect consumers from potentially catastrophic medical bills.

Choosing the right short-term health insurance plan, whether or not it’s a PPO plan, is best done with the help of an insurance agent specializing in these plans. They may know about plans you won’t encounter in an online search, and since they’re experts in how short-term health insurance plans work, they can help you determine the best cost-benefit ratio for your particular situation. Selective Healthcare invites you to get a free quote so you can be that much closer to having the short-term health insurance plan that’s right for your needs.

What is an HMO?

In the US, health maintenance organizations (HMOs) are health insurance plans with certain key features concerning how they’re administered and how patients seek care. An HMO is essentially an insurance group that offers health services for a fixed annual fee. It’s a form of managed care that many Americans first encountered in the 1980s, though HMOs have been around in various forms long before that.

As early as the 1910s and 20s, prepaid health plans resembling HMOs existed, primarily serving manufacturers and municipal workers. But it wasn’t until the Nixon Administration in the early 1970s that managed care in what we would now call an HMO moved into the mainstream. One of the most important things to understand about HMO health insurance plans is the importance of the primary care physician (PCP).

How HMOs Differ from Traditional Indemnity Plans

Under an HMO structure, doctors and other providers agree by contract to treat patients in accordance with HMO guidelines. In exchange, they’re basically guaranteed a steady stream of patients. The main difference between HMOs and other types of health insurance plans is that if you’re in an HMO, seeing a specialist requires seeing your PCP first, or else the HMO won’t reimburse your costs. Under a preferred provider organization (PPO), by contrast, you can see any primary care physician or specialist within the PPO’s defined network, and do not have to visit a PCP to get a referral to a specialist.

The PCP as Gatekeeper

The typical HMO requires members to select a PCP upon signup. The PCP functions as a gatekeeper to more specialized medical services. Usually, PCPs are family doctors, general practitioners, pediatricians, or internists, and the HMO is designed so that people are encouraged to get the majority of their healthcare from the PCP, and not expensive specialists, unless the PCP determines that a specialist is needed. So, if you’re interested in joining an HMO and already have a primary physician you’re satisfied with, you’ll need to ensure your physician is in the designated HMO network.

Emergency Services Covered Regardless

HMOs sound like a great idea, but many people wonder what happens in a medical emergency. After all, if you think you’re having a heart attack, or are involved in an accident, contacting a PCP isn’t always practical or possible. Fortunately, however, HMOs cover emergency care whether or not the emergency provider is within the HMO network, and HMO members are not expected to “ask permission” to seek emergency healthcare services when they are clearly warranted.

Knowing if an HMO Is Right for You

With HMOs, your premiums and out-of-pocket expenses are usually lower than with traditional health insurance plans. This can be a big plus for someone who is generally healthy and rarely has to see a specialist. Also, if you prefer that specialist care be coordinated through your primary physician anyway, an HMO might be a good choice. Step one after joining an HMO is designating a primary care physician. Many HMOs offer online tools to help you find a PCP if you don’t have one, or if your previous doctor isn’t in the HMO network. For those who must see specialists regularly, or who want more flexibility in choosing healthcare providers, PPOs and other traditional health insurance plans may be a better choice.

Do You Need Temporary Health Insurance?

Sometimes people are in the market for short-term or temporary health insurance, and some of these plans are HMO plans. Temporary health insurance is designed for the person who only needs short-term coverage to allay the risk of medical and financial disaster. Someone who is in between jobs that provide coverage is a strong candidate for temporary health insurance, as is the retiree who still has a few months to go before qualifying for Medicare. People who quit a job with insurance coverage during the part of the year outside the Affordable Care Act (ACA) Open Enrollment period can quickly obtain temporary health insurance to bridge the coverage gap.

Selecting a temporary health insurance plan, whether it’s an HMO, PPO, or other type of plan, is best done with the assistance of an insurance agent who specializes in temporary health insurance. These experts understand temporary health insurance inside and out, and assist customers with finding the plan that makes the most sense for them in terms of cost and benefits. If you would like to learn more, Selective Healthcare encourages you to call us today at 888-540-1620.

The Two Reasons You Need Health Insurance

There’s little debate about whether healthcare and insurance are expensive. Whether you obtain major medical coverage through your employer or purchase a plan through the channels made available by the Affordable Care Act (Obamacare), you have most likely seen your premiums increase faster than the general rate of inflation. Many employers are requiring that their employees shoulder a larger share of the costs of their health insurance, and have subscribed to plans that have much higher deductibles than used to be typical.

There are some people for whom there are additional alternatives to Obamacare, and in many cases, trying to enroll in an ACA plan outside the set Open Enrollment period at the end of the year is not possible. But even if you don’t have access to an ACA plan or employer provided coverage, you should explore your options for short term health insurance. There are two major reasons for this: to protect your financial assets and to increase your access to healthcare.

Having Insurance Helps Protect Your Assets

Depending on your financial situation, a single trip to the emergency room or a brief hospital stay can have a severely damaging effect on your finances. But it isn’t only inpatient costs that can be high. Many outpatient procedures and tests can quickly add up to thousands of dollars in costs, and if you don’t have health insurance, you are the one responsible for paying for them.

People sometimes have to declare bankruptcy due to high medical bills, even if they’re able to work with a hospital or provider to develop a payment plan. Not only can your savings be wiped out, so can your credit. If your short term health insurance is used even one time when you’re between major medical plans, it can mean the difference between financial survival and disaster.

Insurance Improves Your Access to Healthcare

Theoretically, people have access to emergency care even if they don’t have health insurance. The problem is, without health insurance, people are apt to try to “ride out” injuries and illnesses, and in some cases, they get worse rather than better. The result is the need for more care, and higher costs for that care.

Short term health insurance policies generally offer low premiums because they don’t cover things like maternity care, but they do offer sufficient coverage that you won’t be tempted to wait out that flu that seems to be getting worse. Which usually means that simpler, less expensive care will be all that’s needed. Sometimes simply knowing you have coverage that allows you to seek non-emergency healthcare when you need it helps ensure you remain healthier.

Young, Single People May Have More Options Than They Realize

If you’re a young, single adult who is in generally good health, low cost health insurance outside Obamacare and employer coverage may be an option worth exploring. While short term health insurance policies won’t prevent you from having to pay the “uninsured tax” that is levied on people who don’t have employer health insurance, don’t buy an ACA plan, and don’t qualify for an ACA exemption, the low premiums may ultimately be a better deal financially, even if you have to pay the tax penalty.

An insurance agent who specializes in low cost health insurance can help you evaluate your needs and match them with a plan that makes sense for your life and your finances. Yes, health insurance can be expensive, but going without it puts both your health and your finances at unacceptable risk.

For some people, particularly if they’re between jobs, short term health insurance is the perfect solution for ensuring they can get the care they need to remain healthy and won’t put their finances at undue risk if a medical emergency should arise. We invite you to look over our plans and call us today at 888-540-1620. We know how to keep you covered while finding the lowest premiums on plans that fit your needs.

Don’t Kid Yourself. You Need Healthcare Coverage.

You’re relatively young, you’re healthy, you don’t have any terrible vices: how risky could it be to go for a month or two without health insurance? The answer is “incredibly risky.” You may not have had so much as a head cold in years, but make no mistake, in any unexpected meet-up between you and a car, the car will win, and your medical costs could spiral out of control within a matter of hours.

If you should be diagnosed with a previously unknown disorder during your hiatus from medical insurance, your finances and your credit could be ruined. But don’t think that if you avoid being hospitalized you’re protected against high medical bills. More tests and procedures are done on an outpatient basis today, and outpatient costs can ratchet upward at a fast pace too. In other words, don’t assume you can “get by” without health insurance for a couple of months.

Starting a New Career, but Open Enrollment Isn’t Available Yet

Suppose you’re starting your own business, say, as a freelancer. You separate from your regular job before Open Enrollment under the Affordable Care Act (ACA) begins, and you don’t qualify for a Special Enrollment period under the ACA. Perhaps you can be added to a spouse’s work coverage, but that won’t take effect for 30 days. Maybe you think, “I’ll just be extra careful between now and when my new medical insurance kicks in.” This can lead to damage to your health and your finances.

Communicable illnesses like flu are spread easily in public, and some major health conditions can strike without warning. And of course there’s always some risk of unexpected injury, even if you’re at home most of the time. That’s because statistically, more accidents happen at home than any other place.

Here’s How Much Hospitalization Costs

Statistics from 2013 compiled by Kaiser State Health Facts reported that in the US, the average cost for one day of hospitalization was $1,878 for state and government hospitals, $2,289 in nonprofit hospitals, and $1,791 in for-profit hospitals. Figures compiled by the National Institutes of Health for 2014 found that the median cost for an emergency room visit was $1,233, while other estimates were as high as $2,168. So suppose you’re injured in an accident, taken to the ER, and subsequently admitted to the hospital. Even if you get to go home in a couple of days, you suddenly have thousands of dollars’ worth of medical expenses for which you are responsible.

Could You Qualify for Medicaid? Don’t Count on It

Maybe you figure since you’re out of work and don’t have health insurance, you would qualify for Medicaid if you found yourself in a health crisis. But that’s far from a reasonable expectation. There are currently 31 Medicaid Expansion states (plus the District of Columbia) that, under the ACA, expand coverage to more low-income families through Medicaid. Even so, you may exceed income limits for qualifying. And, if you live in one of the 19 states that chose not to expand Medicaid access, your chances for qualifying are slim to none.

Temporary Health Insurance Can Avert Disaster

Temporary health insurance can bridge gaps between your major medical insurance coverage under employer-sponsored healthcare, through your spouse’s coverage, or under the ACA. Temporary health insurance offers low premiums because it is not designed to substitute for major medical insurance. But what it offers is catastrophic coverage that can save your finances (or potentially your life) should you require medical care when you’re without insurance. These policies are designed for short periods of time, and can be perfect for bridging the gap until you qualify for enrollment in traditional medical insurance.

Enrolling in temporary health insurance can be done at any time, so there’s no waiting for open or special enrollment periods. Furthermore, coverage can be obtained quickly – often as soon as the next day, so you minimize your time without health insurance coverage. Temporary health insurance is offered by major carriers with which you’re probably familiar, like UnitedHealthcare, and finding the right policy for your time frame, stage of life, and financial situation is easy when you work with an agent who specializes in temporary health insurance. We invite you to get a free quote and take that first step toward obtaining temporary health insurance. It’s an investment that could save your finances and your health.

Young, Single, Uninsured? Short Term Health Insurance May Be Right for You

Part of the Affordable Care Act (ACA, or “Obamacare”) requires that everyone have health insurance unless they qualify for an exemption. People who don’t qualify for an exemption and who go without essential health benefits for more than three months must pay a tax penalty.

For 2016, that penalty is 2.5% of your total household adjusted gross income, or $695 per adult (whichever is greater) and $347.50 per child up to a maximum of $2,085. You qualify for an exemption from this rule if

  • -the most affordable coverage costs more than 8% of your household income, you don’t file taxes because your income is too low
  • -you’re incarcerated
  • -your religion objects to insurance
  • -you’re homeless, or
  • -you have lived abroad for more than a year

It’s not that easy to qualify for an exemption. Some young, single, uninsured people have discovered that even with the tax penalty, temporary health insurance makes more financial sense for their situation than buying a major medical plan under the ACA.

How Temporary Health Insurance Works

Temporary health insurance doesn’t provide the comprehensive coverage that a major medical plan obtained through the ACA or through an employer does. For example, temporary health insurance plans often don’t cover pre-existing conditions, maternity care, or prescription drugs. However, for the young, single person who is healthy, not planning a family, and not taking expensive prescription drugs, it represents a low cost health insurance option that many don’t even know about. Temporary health insurance is a niche product, but in some cases it is the best alternative to going without health insurance, even if it causes a person to have to pay a tax penalty.

You’re a Prime Candidate for Low Cost Health Insurance

Temporary health insurance offers something that’s almost unheard of in the insurance world: low-cost coverage. Low cost health insurance is not a myth, because the premiums with temporary health insurance plans are significantly lower than they are for a traditional major medical plan acquired through the ACA or your employer. In some cases, the premiums are low enough to more than offset the cost of the tax penalty, so you have backstop health coverage in the event of a serious medical problem, but without high premiums if you’re young and generally healthy. It’s worth running the numbers to see if temporary health insurance, even factoring in the tax penalty, saves money over a traditional plan.

Your New Job’s Insurance May Not Be Effective Right Away

One reason the young, single person may turn to short term health insurance as a low-cost health insurance option is to bridge a coverage gap when transitioning from school to the workplace. Maybe you’re too old to be carried on your parent’s policy, but your new job’s health insurance doesn’t go into effect for 90 days. This is exactly the type of coverage gap temporary health insurance is designed to cover. You can enjoy low premiums and will appreciate the peace of mind that comes from knowing you’re not living your life with the financial and medical risks that occur when you go without health insurance.

Temporary Health Insurance Can Be Arranged Quickly

Another reason a young, single person may turn to a temporary policy is that there are no worries about Open Enrollment (the period near the end of the year when people sign up for ACA plans), or qualifying for a Special Enrollment period outside that time frame. It’s always “open enrollment” with temporary health insurance plans, which means you can apply today and there’s a good chance you can have coverage tomorrow. If you work with an insurance agent, you can learn about all your options, including options you won’t find online, and can determine which one is the perfect one for you.

Low-cost health insurance isn’t a pipe dream for someone who is young, single, and generally healthy. Temporary health insurance fills a need for catastrophic coverage while offering low premiums and the convenience of not having to wait for open enrollment periods or trying to qualify for a special enrollment period. In some cases, the savings are enough to more than offset the cost of any tax penalty you might incur. We invite you to get a free quote and start exploring your health coverage options today.

6 Good Reasons to Get Short Term Health Coverage

Low cost health insurance may seem like a contradiction in terms, but when you need temporary coverage, it’s a realistic option. Temporary health insurance is designed to fill coverage gaps at a reasonable cost, so you don’t take undue risks with your health or your finances if you’re between jobs, or if it will be a few months before you qualify for Medicare.

Some people dismiss the idea of temporary health insurance as impractical, but that is definitely not the case. It can be one of the best, low-cost health insurance options available, and is worth exploring if you’re facing a temporary gap in healthcare coverage. Here are six good reasons to get short term health coverage.

1. Temporary Health Insurance Has Low Premiums

Short term health insurance is a different product than the major medical insurance you acquire through your job or under the Affordable Care Act (ACA). While it generally doesn’t cover pre-existing conditions or have perks like prescription drug benefits, the premiums are often significantly lower than with major medical insurance. In 2014, the average individual premium for temporary health insurance was only $110, compared with nearly three times that much for ACA plans.

2. You Can Lock in Your Premium Rate

When you select a plan during Open Enrollment under the ACA, you know your premium for that year, which helps with budgeting. Likewise, temporary health insurance plans typically allow you to lock in your premium rate for the duration of your coverage. That’s great news for the person who is between jobs, or who is waiting a few months until qualifying for Medicare, because it helps make budgeting more accurate and less stressful.

3. You Can Be Covered Quickly

When you enroll in an ACA plan during Open Enrollment, you have to wait for coverage to start, usually on January 1st of the following year. Low cost health insurance with a temporary plan can start right away. When you apply for temporary health insurance, you can often qualify within 24 hours of submitting your application. Once you’re approved, coverage can begin as soon as the very next day, so there’s minimal waiting around for benefits to become effective.

4. “Open Enrollment” Is Always Open

Under the ACA, most people select and join a health insurance plan during the weeks at the end of the year known as the Open Enrollment period. In some cases, people can qualify for a Special Enrollment period outside this time frame, but there are no guarantees. With temporary health insurance, however, it’s completely different. If it’s not Open Enrollment season and you need health insurance right away, you can apply for temporary coverage right now and have coverage within a couple of days. You don’t have to wait around for a designated time of year to apply.

5. Qualifying Is Easy

While it’s possible to be turned down for temporary health insurance due to existing health problems, one survey found that 84% of applicants qualified for it. Many users of this low-cost health insurance are Millennials who are young and healthy, and they usually have no difficulty in qualifying. If you have pre-existing health conditions, you may be offered a policy that covers other health problems without covering your pre-existing condition, so it can still offer tremendously valuable coverage.

6. People Are Usually Happy with Their Temporary Health Insurance

A 2015 survey by eHealth found that the majority of people with temporary health insurance were satisfied with the coverage provided, with only 5% being unhappy with coverage. Nearly 90% of users of temporary health insurance said that they were able to see the doctors they wanted to see while covered by their temporary health insurance plan. In other words, this type of low-cost health insurance empowers people to take care of their health with trusted doctors, without the financial risks of not having insurance.

Low cost health insurance isn’t a figment of your imagination, but is the reality of most temporary health insurance plans. These plans are offered by major insurers with whom you’re familiar, like UnitedHealthcare, and they can prevent medical and financial catastrophe for people who have a temporary gap in their health coverage. We invite you to call us today at 888-540-1620 to discuss your temporary health insurance needs or to answer any questions you may have.

You Missed Open Enrollment! Now What?

Open Enrollment periods were established under the Affordable Care Act (ACA, also known as “Obamacare”) as an annual time period when people can enroll in ACA health insurance plans. It happens during the first 90 days of the national government’s fiscal year. For example, the next Open Enrollment period begins November 1, 2016 and ends January 31, 2017.

During Open Enrollment, people access their state’s health insurance exchanges or Healthcare.gov, compare plans and prices, learn if they’re eligible for tax credits to help pay premiums, and can sign up for a plan. People who have health insurance as a benefit through work can enroll in an ACA plan, but often they find that the cost versus benefit comparison is more favorable if they stick with their employer’s plan.

But What About Special Enrollment Periods?

What happens when a person finds himself or herself without health insurance and it’s not during an Open Enrollment period? In some cases, it’s still possible to enroll in an ACA plan. For example, if you involuntarily lose health insurance through work, if you relocate, marry, or have a child, you qualify for a 60-day Special Enrollment period under the ACA. During that time, you can compare plans and sign up for one just as people do during Open Enrollment.

Not everyone qualifies for Special Enrollment. Suppose you leave one job, and have another lined up, but the new one doesn’t start for a couple of months. Unless you fulfill one of the other qualifications for Special Enrollment, you’re out of luck. But temporary health insurance can fill these coverage gaps affordably.

Temporary Health Insurance Perfect for Filling Coverage Gaps

It can be tempting to go without health insurance if you know you’re going to have insurance again in two or three months, but the risks are staggering. Even a short hospital stay can run into the tens of thousands of dollars. Most people encounter serious financial difficulties if they’re hit with big medical bills while uninsured. Temporary health insurance typically doesn’t cover as many contingencies as health insurance you get through your job or under the ACA, but it’s designed to be an affordable step that can save you from financial (and medical) catastrophe during times you can’t access traditional insurance.

Yes, Low Cost Health Insurance Exists

Everyone is so used to the costs of health insurance spiraling upward that the idea of affordable health coverage may seem absurd to some. But the truth is, many short-term health plans offer low cost health insurance with monthly premiums that are affordable to the person between jobs. The reason such low cost health insurance exists is that it does not have to conform to the requirements that ACA and employer plans do. Temporary health insurance can, for example, exclude coverage for pre-existing conditions. But by doing so, they can offer affordable premiums and provide a financial backstop that offers tremendous peace of mind when you’re between regular health insurance policies.

How Long Until You Can Enroll in Obamacare Insurance?

Say you miss ACA Open Enrollment by one day. You’ll have to wait nine months for the next Open Enrollment period to occur. And if you’re between jobs, you may face a waiting period after commencing a new job before your healthcare coverage goes into effect. Temporary health insurance is perfect for filling the gaps when you don’t have work coverage and are unable to enroll in Obamacare insurance.

Moreover, temporary health insurance is easy to get. Work with an insurance agent who knows the plans forward and backward, and you can quickly determine which one fits your needs and enroll right away. It’s one less big thing to worry about when you’re between insurance policies. If you’ve missed Open Enrollment, we invite you to view our plans. It’s the first step to ensuring you always have the coverage you need.

Thought Leader Series: Why Obamacare Is Hurting Seniors

Stephan Baldwin is the Director of Business Development for www.AssistedLivingcenter.com, an online resource for senior living communities.

The Affordable Care Act (ACA), better known as Obamacare, was advertised to the American people as the solution for all Americans to have access to low cost health insurance. Insurance companies would be mandated to provide coverage for everyone and life would be great.

Healthcare is expensive and the money for Obamacare insurance needs to come from somewhere. One of these places is Medicare, where some big cuts are being made to fund the ACA.

Medicare Budget Cuts Under The Affordable Care Act

Just how much is getting cut from Medicare? According to Medicare.net, the total amount is about $716 billion.

The most devoted ACA supporters will argue that the cuts won’t happen all at once, and will be worked in gradually over 10 years. $71 billion a year for a decade is still an incredible amount of money especially when you consider how quickly our population is aging.

Current projections estimate 10,000 baby boomers turn 65 every day, a figure that will likely continue for the next 18 years according to US News. That’s a lot of seniors that will be eligible for Medicare benefits that will be shrinking for years to come.

Where The Cuts Are Being Made

First on the list is hospitals. For a total amount of $260 billion, hospitals are expected to overcome the largest cut in the group. Hospital administrators aren’t going to tighten their belts and take the loss in their budgets. Expect these cuts to be made up other ways, typically over-charging for other items and assessing additional fees. Anyone who has received a hospital bill knows how creative they can be when it comes to getting the most money per patient.

Medicare Advantage will have to get by with $156 billion less in funding. The Medicare Advantage Plan provides money to small, private medical insurance companies that cover seniors. These insurance companies allow seniors to have more flexibility when choosing their doctor. In an article in the NY Daily News over 2,000 doctors received cancellation notices of contracts that covered almost 8,000 patients in New York alone.

There will be $66 billion less funding for the home healthcare industry, an incredibly popular option for many seniors who need temporary or long-term care, but prefer to be at home instead of a medical facility.

Nursing homes will see $39 billion less in funding while end-of-life hospice services will be cut by $17 billion. Steep cuts for the oldest and most vulnerable seniors.

Changes To Medicare Premiums And Payments

Cutting benefits is bad enough, but that’s not where the changes end. Some seniors will see a higher premium for their Medicare health care plans.

Medicare Part A will still be free for most seniors, but Part B and Part D require premuims. Part B currently has a standard premium of $104.90 per month for individuals who made less than $85,000 a year. If you earned more than that expect higher premiums for your medical insurance.

Paying More For Prescription Medications

Medicare Part D covers prescription drugs for beneficiaries. Some seniors may see an increase in the prices they pay for medicine as a result of increased the increased premiums mentioned above.

In addition to higher premiums, additional fees may be added to certain parts of coverage for beneficiaries. It’s hard to calculate what those fees will add up to now, but seniors can expect to receive a different bill than what they’re used to, if they haven’t already.

Cutting benefits must feel like a bait and switch for many aging adults who have worked their entire lives contributing to Medicare and other benefits only to have it cut at a point in their lives where they’re too old to change their plans.

Campaign promises sold us on cheap health care plans, but for many seniors the Affordable Care Act is looking pretty costly.

Is Obamacare not working for you? See how Selective Healthcare can help you, contact us today!

What Are The Best Short-Term Health Insurance Options?

Going without health insurance, even for a brief period of time, is inadvisable. It only takes one medical emergency to seriously strain finances, and cause financial catastrophe if severe enough.
Read More…

Flexibility of Short-Term Health Insurance for Individuals

People don’t usually think of “health insurance” and “flexibility” as being compatible. After all, if you try to read a health insurance policy, it’s clear that every possible contingency is mapped out, along with what does and does not qualify for coverage. People who have tried to purchase health insurance outside of the Affordable Care Act (ACA) Open Enrollment periods have generally encountered inflexibility there as well.
Read More…

Short-Term Medical Insurance for Independent Contractors

From May 2014 to May 2015, the number of independent contractors in the United States grew by approximately one million, a trend that is expected to continue. Independent contractors, also known as freelancers, are people who are self-employed. There are over 15 million of them. They may be attorneys, accountants, programmers, designers, or involved in any number of other professions. Because they are self-employed, they don’t have the option of employer-sponsored health insurance.
Read More…

What Are Some Quality and Inexpensive Health Insurance Options?

Health insurance is one of the biggest financial burdens that many people face today. Purchasing a health insurance plan on the open exchange is expensive for anyone, even if you are in good health. However, the good news is that there are some inexpensive health insurance options on the market today. Whenever there is a job change or a job loss, it is important to know your options. Not having health insurance is a dangerous game that many people play. One accident can have a huge impact on your finances. There are a lot of people who regret not getting some sort of low-cost coverage during transition periods.
Read More…

What to Do When You Can’t Afford the Affordable Care Act

The Affordable Care Act (ACA) has been in effect for several years now and, in some cases, it has allowed people who otherwise could not afford health insurance to purchase it with the help of tax credits. It has also protected consumers against being denied health coverage due to pre-existing medical conditions and put an end to lifetime dollar limits and annual limits on essential health benefits.
Read More…

How Can I Find the Best Affordable Health Insurance?

Most people understand that they “should” get health insurance, but the fear of being unable to find low cost health insurance can be off-putting. You probably have more options than you think and, depending on factors like age and general health, cheap health insurance may be within the realm of possibility.
Read More…

Suddenly Uninsured? You Don’t Have to Stay That Way!

There are a number of situations that can result in losing your health insurance, and losing your health insurance can be scary. Maybe you have started a new job, and your employer-based coverage doesn’t start right away. Maybe you’re a few months away from Medicare eligibility. You might be between jobs, or you might be out of seasonal work. Some activities require proof of insurance before you can participate and you don’t want to miss out.
Read More…

Health Insurance for People in Transition

You’re between jobs. Maybe you’re starting a new job in a few weeks. Maybe you’re realizing a long-held dream – striking out on your own to start a business. Maybe you’ve become a consultant and will be working on your own with several companies as clients. Maybe your company had a round of layoffs, and now you’re looking for the next opportunity.
Read More…

Mississippi Health Insurance and the ObamaCare Market: Understanding Consumer Healthcare Options for Mississippi Residents (2015)

I. Introduction

Mississippi residents still uncertain of the effects of the recent healthcare reform laws on their options and responsibilities to obtain health insurance coverage for the year 2015 need pay attention to one important detail: February 15th Read More…

Health Insurance for Temporary Lifestyle Changes

Like many Americans, you may be undergoing a change in your lifestyle. Perhaps your work hours were recently cut from full-time to part-time. Or maybe you’re in between jobs and are trying to hold onto as much of your savings as possible. You may have even moved to another state to search for a better-paying job.

Regardless of how your life has changed, you need to safeguard your health. Doing so means having health insurance that’s stable, flexible, and affordable. Short-term health plans have all three benefits. Read More…

Health Insurance for Recent College Graduates

If you recently graduated from college, you’re probably excited and apprehensive about starting your career. You now have one of the many things that employers require of you: a four-year degree. But you must still convince them to hire you and pay you a decent salary. That process might take some time.

While you seek the ideal job, you still need a way to keep your expenses manageable. Doing so will probably mean finding a balance between paying the rent, buying food, making student loan payments, and finding affordable health insurance. Read More…

Affordable Health Insurance for the Unemployed

It’s hard to cover basic expenses when you’re unemployed. Your regular paycheck is gone, and you probably want to keep your retirement account intact. But having health insurance is part of preserving your wealth. After all, a large, unexpected medical bill can bankrupt you.

The problem is that health plans can seem out of reach when you’re looking for a job.

That’s why it’s best to evaluate all your options and choose health insurance that’s affordable, provides the best access to doctors and hospitals, and contains the most predictable out-of-pocket expenses. Read More…

Temporarily Bypassing Obamacare

You might soon find that it’s a bit less affordable to buy health insurance offered through the Affordable Care Act, the health care law known as Obamacare.

Recent articles from CNN Money and The Fiscal Times have determined that some health plans meeting the requirements of Obamacare could be more expensive for consumers in 2015.1,2

In Florida, some residents will face truly significant health insurance expenses. According to a September 2014 article from Miami Today, the Florida Office of Insurance Regulation projected that there would be hikes in health insurance premiums averaging 13.2 percent for individual plans for 2015.3

Read More…

Will Texas Accept Obamacare?

In Texas, there’s been opposition to the rollout of the Affordable Care Act, the health care law known as Obamacare.

In particular, there’s been a lack of official support in the Lone Star State for three core components of the law: the Health Insurance Marketplace, Medicaid expansion, and navigators.

The Health Insurance Marketplace is the location where consumers can enroll in health plans that meet the requirements of Obamacare. Read More…

Can Florida Benefit From Obamacare?

The American health care system has been changed by the Affordable Care Act, the law known as Obamacare.

This law protects the public by requiring health insurance companies to offer insurance to people who have pre-existing medical conditions.

Obamacare also sets new health care standards. It does so by requiring insurance companies to cover several categories of medical services in health plans that are sold through Health Insurance Marketplaces. These Marketplaces are Websites where people can buy health insurance that meets government requirements. Read More…

Choosing Critical Illness Insurance and Life Insurance

We live in stressful times. ZeroHedge.com, a financial news Website, reported in January 2014 that 91.8 million Americans were not in the labor force.1 So, it’s more difficult than ever for the average American to pay bills and raise a family.

That’s why it’s important to protect yourself and your family from the expenses associated with life-threatening illnesses. Such expenses can add up, resulting in big medical bills. If you’re treated for a life-threatening illness and the treatment is unsuccessful, a big funeral bill could be the result.

But there are two types of insurance that can help you plan for the cost of critical care medicine or a funeral: critical illness insurance and life insurance.

Read More…

How to Choose Dental Insurance

It’s easy to overlook the importance of oral health. But it’s vital to visit a dentist every year to prevent painful and costly damage to your teeth and gums and to safeguard your overall health.

That’s why it’s important to get preventive dental care and to make that care affordable through dental insurance.

Assurant Health and UnitedHealthcare both have dental plans that provide cost-effective ways to get one of the most important types of preventive dental care: a dental exam.

Read More…

How to Shop for Health Insurance

Get ready for open enrollment. That’s the time period when you can enroll in a health plan that meets the requirements of the Affordable Care Act, which is the health care law that’s also known as Obamacare.

HealthCare.gov, the government’s official Health Insurance Marketplace for Obamacare, lists the open enrollment period as starting on November 15, 2014 and ending on February 15, 2015.1

Read More…

The Benefits of Short-Term Health Insurance

Now that open enrollment for health insurance is right around the corner, many Americans are starting to shop for health plans.

But, if you’re between jobs or you recently graduated from college, you might not have the financial resources to pay for a traditional health plan. That’s why you should consider short-term health insurance.

If you have no pre-existing medical conditions, you can use this type of insurance as an affordable way to safeguard your health while you seek stable employment.

Read More…

Is Short-Term Health Insurance More Affordable?

Has your lifestyle suddenly changed? Are you spending more but earning less?

You’re not alone. If you’re like many Americans, you may be struggling to survive due to declining job opportunities and the rising cost of food and health care.

Let’s face it: The American economy is a mess.

ZeroHedge.com, a financial news Website, recently noted that in June 2014, the number of full-time jobs fell by 523,000 and the number of part-time jobs rose by 799,000. 1

Read More…

How Health Insurance Agents and Brokers Can Help

It can be hard to understand health insurance. Fees for medical care such as doctor visits, surgery, diagnostic tests, emergency room services, and prescription drugs can vary from plan to plan.

In addition, some plans only cover health services administered through a specific network of providers. This network usually includes a limited number of doctors, hospitals, and facilities in a designated geographic area.

The most confusing aspects of choosing health insurance can involve determining how much health care you might need, how much that care will cost, and how much you can afford to spend.

Read More…

Understanding the Pros and Cons of Obamacare

Now that the Affordable Care Act has been around for a while, Americans finally have a chance to assess the pros and cons of this relatively new health care law.

The law is often referred to it as Obamacare, a name that implies that the U.S. Government has taken over the health care sector. The truth is quite the contrary. According to New York Magazine, half of new enrollees in government-approved and subsidized health plans have purchased those plans from insurance companies. 1

So, the U.S. Government isn’t running the health care industry. Instead, the government has set new standards for what the industry must provide.

Read More…

How to Use a Health Insurance Marketplace

There’s a new place to pick a health plan: the Health Insurance Marketplace. It’s a type of market where only government-approved health plans can be sold to the public.

What made this market possible? Well, the government set new standards for the quality and affordability of health insurance by passing a new law ― the Affordable Care Act.

You may have heard people refer to this law as Obamacare. It puts health care within reach of more Americans than ever before.

Read More…

How to Understand the Affordable Care Act

In March 2010, a new health care law was signed by President Obama. Some people call it Obamacare. But the official name is the Affordable Care Act.

The purpose of the law is to make quality, affordable health insurance more accessible to individuals, families, and small businesses and to provide consumer health care protection.

Some people might find the Affordable Care Act to be confusing, though. The actual law is thousands of pages long, and state and federal officials use an abundance of new terms to describe how the law provides access to health care.

Read More…