Often times I hear complaints about an ACA Marketplace Plan stating that it did not cover an OBGYN visit. The question that comes is, “I thought these visits are covered because of Obamacare?” The short answer is, they are. However, there are some rules that you need to know about regarding whether or not a visit is covered as free/preventative under the Affordable Care Act.
Mammograms are only covered for women who are over the age of 40. Pap smears are covered once every three years for women 21-65. These are not covered for everyone or every year.
It is important to know and understand what is or is not covered under the Affordable Care Act before you go to the doctor so you are not surprised when you receive a bill. Insurers may elect to cover these services for a broader range of customer and more often, but these are the minimum requirements.
For more information, visit healthcare.gov
Open Enrollment ended on December 15th, 2018. You will not be able to enroll in a Marketplace plan again for the 2019 plan year without a Special Enrollment Period. However, this does not mean you do not have options to get healthcare in 2019.
There are several options for people who missed the deadline. One of the main options is a short-term medical plan. These plans used to only last for three months. However, in August 2018 the rules changed and, in most states, the plans now last for up to 12 months. This is a great option for people who missed the Open Enrollment deadline.
There are other issues that may prohibit someone from buying a short-term medical plan. For those people, I recommend downloading our Free Healthcare Resources Guide. This is a brand new resource we are making available for free that tells you how you can save thousands of dollars on healthcare and prescription costs with or without insurance.
This is just one of the ways we are working to help you and your family save money on healthcare costs. Please give us a call today at 1-888-630-3826 to see how we can help you and your family this coming year on healthcare.
When was the last time you checked the market for a different health insurance plan? Why should you?
The fact is that in the era of Obamacare new plans are constantly becoming available and old plans are constantly changing or going away altogether. What does this mean? Often, people are paying too much for their health coverage without even realizing it.
Get a free review of coverage today using the link below so we can get you a quote. There is no requirement to buy and you will find out if you truly have the best coverage that is available to you.
Schedule A Free Review
Often we forget about our teeth when thinking about healthcare. But the reality is this, dental health is essential to living a healthy life. Many health concidtions (including diabetes, respiratory disease, osteoporosis, and cardiovascular disease) have direct relationships to your dental health.
Dental insurance helps keep you health in several ways.
- Regular visits to the dentist for cleanings are covered at 100% in most cases. This allows you to find any potential problems before they become major issues.
- If something major comes up, you are not footing the entire bill for major out-of-pocket costs.
Be sure when making an appointment that you ask how dental insurance can be helpful to your overall health package.
Call today at 1-888-630-3826 or Get a free quote.
Understanding A Copay
Some insurance plans offer a type of office visit payment called a copay. This term can be confusing as it does not mean the same thing every time.
Typically, a copay is the amount that you are required to pay to be seen for service. That part is easy to understand. The difficult part is whether or not the copay is all you will pay for the service that you are receiving.
Some insurance plans waive the deductible in favor of the copay. That means you do not have to meet your deductible and only have the copayment and any applicable coinsurance. However, many plans require a deductible before you get to pay a copay. This means if your office visit is normally $100 and your copay is $20, you would have to pay the full $100 if your copay has not been met.
Are Copays Right For Me?
The question of whether or not a plan with a copay is right for you depends on what you want your out of pocket costs to be for the year. Typically, plans with copays are higher in monthly premiums. However, your upfront costs for medical services may be cheaper.
This is not a question that is easy to navigate on your own. Our team is available to help explain the plans that you are looking at and to help you decide what plan will give you the best coverage at the best overall prices. Schedule a call today or submit a form to get a free quote.
Can I save money?
Every year Open Enrollment for the Affordable Care Act, also known as Obamacare, starts in November and people always ask what is the cheapest plan they can get? The answer is, it depends!
The Affordable Care Act allows for certain individuals to receive subsidies based on income levels. However, you must first meet a certain income level before you are allowed to receive a subsidy. What does this mean?
For an individual, you must make at least $16,000 per year to receive subsidies in many cases. More information can be found at healthcare.gov about specific income levels.
Is there a downside to subsidies?
As with most things, there are caveats to subsidies. At the end of each year, your subsidy level will be compared to your IRS Tax Return to make sure that you actually qualify for the subsidies you received during the year for healthcare. If your income level is higher than what you reported on your application, you will owe money back to the government for the subsidies that you did not qualify for. This can be fixed by making sure you update any income levels that may change during the year to keep your subsidies and premiums at the proper amount.
How Can I Get Help?
We are here to help you during Open Enrollment as well as the entire year. Our team can help you determine if you are eligible for a subsidy, apply for insurance, and help you keep everything updated throughout the year. To get help, book an appointment using the button below. Or request a free quote, we are happy to help!
One of the most confusing pieces about healthcare are prescription medication costs. The Affordable Care Act made stipulations on drug coverages that are almost impossible to understand, and not all carriers are uniform in the way they present their drug tiers.
Here is what you need to know:
For each type of drug you are either going to have a copay, deductible, or coinsurance. In some cases you may be paying full price regardless if you have insurance.
These prices can often be beat, depending on the drug and insurance carrier, by a prescription discount card.
How do you use the card? It is simple. Every time you get a prescription, tell the pharmacy to run the discount card and your insurance carrier and give you the cheaper of the two options.
Prescription discount cards can sometimes save up to 85% or more on the cost of the medication which can save you hundreds of dollars throughout the year.
To get a free discount card, go to the link www.davidtaylorjr.com/rxcard
It is finally here, Open Enrollment 2018!
Tomorrow you will be able to enroll for insurance plans under the Affordable Care Act for the 2018 plan year. Here is what you need to know:
- Open Enrollment lasts from November 1st to December 15th in most states.
- Premiums have increased in most areas. We have actually spoken to consumers who have been told their premiums are increasing by 50%.
- Deductibles are also going up.
There are ways to offset these new costs or eliminate them altogether. However, you will need a licensed agent to help you navigate these changes.
Our team is standing by and ready to assist you with these changes. Please call 1-888-630-3826 or schedule an appointment.
In the age of the internet anyone can go and buy an insurance plan without speaking to an agent or a broker but is this really a good idea?
Insurance is complicated and without proper training it is virtually impossible to understand all of the policies and how they work. An agent helps you understand exactly what you are getting with a policy and how it works as well as any exclusions.
With the uncertainty of the Affordable Care Act and what Congress is or is not going to do, it is more important than ever to not try and do this by yourself.
All agents are not the same. Some agents only work for one carrier and will only give you options with that carrier. That means there might be other options out there that would be better but you will never hear about those from these types of agents. These are also called “captive” agents.
Other agents are actually brokers. They work for you. You do not pay them and they can shop around for a plan from many different carriers and can build a custom plan for you that fits your budget and healthcare needs. This is the type of agent that you want to go with when shopping for insurance.
The bottom line is don’t try to do this alone. Know what you are getting with the help of a licensed agent. To get free quotes from a broker fill out this brief form today.