If You’re a College Student or Recent Grad, These Healthcare Solutions Got You Covered

Summer has settled in across the country, and we’ve all got something to celebrate in this warm weather. As a college student or recent grad, you certainly have your fair share of reasons and opportunities to celebrate as well. But according to a recent poll, 72% of those in your shoes – or in your caps and gowns as the case may be – are facing a challenge: finding affordable health insurance.

With 40% of your fellow college students and recent grads mostly concerned about the cost of premiums and 20% concerned about high out-of-pocket costs, you will undoubtedly have questions about your options this summer. You may be coming off coverage through your university or your parents’ health plan or you may be waiting for coverage sponsored by your new employers to begin. You may also be priced out of traditional major medical coverage as well. Short-term medical plans may help you address your healthcare needs.

STM plans can include benefits and features such as:

  • Flexibility in length of coverage  in cost depending on benefits selected
  • Variety of deductible and coinsurance options
  • Benefits that are paid in a similar manner to traditional major medical plans
  • Wellness options
  • Little to no waiting periods
  • Next day coverage for some carriers
  • Relatively inexpensive premiums due to lower and more restricted benefits
  • Low-cost doctor and specialist copays depending on the plan selected
  • Open network of physicians, specialists, and hospital depending on the plan selected

Your family may also have concerns about your coverage options as well. When you research your options, talk with them about what STM plans can offer. This level of coverage is available at any time in the year and you can cancel it at any time as well. It can also offer access to providers of your choice, including providers you visited through their parents’ health coverage. If you’re looking to change providers, STM plans can provide you the opportunity to file your own claim and submit for reimbursement if needed.

However, STM coverage does not provide the minimum essential health benefits required by the Affordable Care Act (ACA) and will not help you avoid the penalty for not carrying health insurance. At this time, STM plans have a maximum duration of 3 months at which point you must re-apply to continue coverage. There may be limits on how many times you can re-apply as well. In addition, pre-existing conditions are not covered. Benefits vary by plan and state and may not include those that are listed above. Before making a purchasing decision, review any plan details carefully.

If you find that you aren’t eligible for STM coverage and that you’re priced out of ACA coverage, you may find health benefit insurance plans (commonly known as limited benefit medical plans) to fit your lifestyle and healthcare needs.

Health benefit insurance plans provide a basic insurance coverage that is capped at specific amounts for services provided due to accidental injuries, sickness, inpatient surgical care, outpatient care, and even pre-existing conditions. Plans vary as to the specific, fixed amounts provided and which specific medical services they will provide benefits for, but often times, this level of coverage may provide little to no waiting periods and benefits for critical illness and/or accidental death.

HBI coverage can also offer benefits and features such as:

  • Guaranteed issue coverage
  • Next day coverage or little to no waiting periods for accidental injuries or sickness
  • 12 month waiting period for pre-existing conditions
  • Ability to supplement existing coverage
  • Access to non-insurance benefits such as a prescription savings program, 24/7/365 video and phone access to quality physicians, and a patient advocacy service

But remember: like STM plans, HBI plans do not count as minimum essential coverage required by the Affordable Care Act and is not suitable to serve as your only medical coverage. Although the premiums may be lower than a major medical plan, the benefits are also lower and more restricted.

Benefits offered vary by plan and state. Not available in all states. Make sure to review any plan details carefully prior to making a purchasing decision.

 

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Let’s Fact-Check These 4 Common Short-Term Medical Misconceptions

Misconceptions about short-term medical plans are common. While STM plans can provide quality benefits that meet a variety of budget needs, they fall outside of traditional healthcare coverage options, and you may have questions about how they work.

Healthcare costs continue to rise. Political debates and legislative updates continue to impact your wallet and how you are able to access care for your family. There is no better time to ensure you have a thorough understanding of your health coverage options, including short-term medical plans.

Short-term medical plans, also known as temporary health insurance, are medical plans that have a limited duration. They are designed to bridge gaps in health care coverage during a period of transition, like graduating from college, or starting a new job.

Here are 4 common misconceptions about short-term medical plans:

Myth #1: Only a limited number of doctors accept short-term medical plans.

Many providers and facilities across the nation accept short-term medical plans. You may have the option to see an in-network provider and your claim will be handled by the doctor’s office. Or you may choose to see an out-of-network provider, pay for the service up front, and then submit a claim to your claims administrator yourself so that you’re reimbursed. Keep in mind using an out-of-network provider could mean a much higher out-of-pocket cost.

Talk to your agent and your insurance carrier to learn more about what your specific plan allows and how services are covered. This includes knowing how and where to access your member ID card, what number to call with questions about benefits, what number to call with questions about claims, and where to access an up-to-date provider directory and pertinent details of your coverage.

Myth #2: Only those who are young and in good health are good candidates for short-term medical coverage.  

This level of coverage may fit your needs if you are:

  • Transitioning between jobs
  • Waiting for employer insurance to begin
  • Graduating from college
  • Rolling off parents’ coverage
  • Waiting for Medicare coverage to become effective
  • Seeking healthcare coverage options outside of Open Enrollment

While benefits may be limited, this level of coverage may suit your needs and help you tackle healthcare realities.

Disclaimer: STM coverage is not intended to be a replacement or alternative to ACA or other major medical plans nor does it provide the minimum essential health benefits that are required and it won’t help to avoid the fee for not carrying health insurance. They can have exclusions and limitations, which may not make them a valid option for some clients.

Myth #3: Short-term medical coverage is expensive and doesn’t provide quality coverage.

Premiums for STM plans are often lower than major medical premiums. This is due to the fact that these plans have more limitations and/or restricted benefits. That said, STM plans can provide a range of valuable insurance benefits for individuals and families such as:

  • Preventive care and routine doctor visits
  • Emergency care*
  • Inpatient and outpatient surgery and hospital care*

Similar to major medical insurance, you may also enjoy added non-insurance benefits such as:

  • Mobile access to board-certified doctors who can treat many common illnesses
  • Patient advocacy service that can help navigate the world of healthcare and negotiate medical bills
  • Prescription savings membership that can lower out-of-pocket costs
  • Digital fitness tool to help track your wellness journey

However, the coverage provided by short-term medical plans does not include:

  • Immediate benefits for hospital stays, surgery or anesthesia for conditions you already have
  • Benefits for prescription drugs

STM plans do not have coverage requirements, so plans vary in what is covered. Review any plan details carefully before purchasing. Additionally, STM does not cover pre-existing conditions. Applicants are subject to underwriting approval based on answers to medical questions. Coverage is limited to a time period of no longer than three months.

*Typically not covered for for pre-existing conditions

Myth #4: Short-term medical plans can help those enrolled avoid the Affordable Care Act’s tax penalty.

While a short-term medical plan can be an affordable and quality option if you are looking to help bridge the gap in your health coverage, it does not qualify as minimum essential coverage under the Affordable Care Act. That means that you are likely to face tax penalties. If you are without minimum essential coverage for less than 3 months within a year and if you belong to certain groups such as non-citizens, you may be exempt from the penalty.

 

With our leading edge tools and technologies, we’re upgrading how you experience your choice of coverage.

Stay tuned to our next blog post!

Click here to join our Facebook community for more information about your health and your healthcare coverage.

 

 

man and woman hiking with backpacks

5 Ways to Build Your Summer Body Confidence

The skies are clear and blue, the temperatures are on the rise, and outdoor activities are calling your name. There’s no doubt that summer has arrived, and it’s likely that you’re thinking about your fitness routine. Fitness and wellness guru Caroline Jordan has some advice for you: “There is no better time than right now to get started on some serious body love. I encourage you to practice your body love push-ups daily and build your body confidence strength.”

Let’s take a look at some ways you can make Jordan’s advice and your fitness goals your reality this summer:
  1. Hold yourself accountable.

Make a workout schedule and stick to it. Use an app, a fitness tracker, or even just a simple notebook to record your activity. Journal the accomplishments you make. Burn a high number of calories? Increase your speed or your weight load? Feel successful after trying a new exercise? Reflect on these experiences in your journal. Doing so can not only help you see how much you improve from week to week but it can also keep you motivated to do even more.

  1. Appreciate food as fuel.

Eating for comfort may lead you to eat too much, but seeing food as the enemy may cause you to deprive your body of the nutrients it needs. Question your relationship with food and why you make the decisions to eat what you do. Read about the science of nutrition and how different foods can do different things for your body. Do your body a favor by complementing your workout with the fuel it needs; don’t cancel out your efforts by treating yourself to foods that work against your goals.

  1. Try something new.

Is there a dance or fitness or yoga class you’ve always wanted to try? Is there a new sports league forming at your work? Have your friends or coworkers invited you out for a hike or a bike ride? Schedule it, sign up, and say yes! You could find something new that you enjoy and that you want to invest your time in. You could also give your body a chance to surprise you with its ability and strength. Who knows – it could even lead to a new project or a new connection in your professional life.

  1. Build confidence in yourself.

Wouldn’t it be nice if building confidence in yourself were as easy as hanging a motivational poster in your workspace or on your fridge and looking at it every day? Building that confidence and staying motivated to do more for yourself and for your fitness goals take time and concerted effort, but small steps can lead to a significant shift in how you see yourself. Tell yourself how proud you are of your accomplishments every day. If you’re new to fitness and you’ve just committed to climbing the stairs every day instead of taking the elevator, pat yourself on the back. If you’ve walked back into the gym this week or you’re back in the kitchen to do meal prep after a vacation full of treats and time off, give yourself some applause.

  1. Learn how to make your healthcare coverage work for your goals.

Explore your options when it comes to different types of coverage. In addition to major medical coverage, there are short-term medical plans and health benefit insurance plans (commonly known as limited medical coverage) that may help you meet your coverage needs and come with features that help you achieve your health and fitness goals. Check to see if the coverage you choose has the following:

  • Deductibles that meet your budget needs
  • Affordable doctor’s office visits so seeing your doctor is within your budget
  • Mental health coverage to provide resources, support, and/or benefits for you or your covered loved ones in need
  • Wellness initiatives to provide nutrition and/or fitness resources and/or programs
  • Telemedicine feature to provide you with video and/or phone access to doctors when you need it
  • Patient advocacy feature to help you navigate the healthcare system
Here are some features of several different types of coverage to help you decide what works best for you and your goals:

Short-Term Medical Coverage

  • Helpful if you (or a loved one) are facing life-altering transition periods such as pre-Medicare retirement, change in employment status, rolling off parental or student insurance, bridging a gap in major medical coverage or if you missed Open Enrollment (This coverage is designed solely to provide healthcare coverage during unexpected coverage gaps)
  • Flexibility in coverage length and cost (coverage duration varies by state and is non-renewable)
  • Variety of deductible and coinsurance options
  • Low copay options for in-network benefits
  • Limited preventive care available
  • Ability to cancel at any time without penalty (benefits may be limited and subject to exclusions and restrictions)
  • Does not cover pre-existing conditions
  • Coverage is not guaranteed
  • Not intended to be a replacement or alternative to ACA or other major medical plans and does not provide the minimum essential health benefits that are required; may result in a tax penalty.

Health Benefit Insurance Coverage 

  • Helpful if you (or a loved one) are anticipating rising medical expenses, are unable to afford major medical, are not eligible for short-term medical, and/or are looking for supplemental coverage to major medical plans
  • Guaranteed issue coverage if eligibility is met and available in state
  • Premiums often lower than major medical
  • Benefits such as $50-$100 paid toward doctor and specialist visits available
  • Not required to use a network of doctors – freedom to see any doctor or visit any facility of your choice (*Note: you may still exceed eligible benefit)
  • Preventive care available for as low as $50
  • Next day coverage available or little to no waiting periods for accidental injuries or sickness
  • 12 month waiting period for pre-existing conditions (limitations and exclusions may apply)
  • Not a replacement for major medical coverage
  • Does not count as minimum essential coverage required by the Affordable Care Act and is not suitable to serve as sole medical coverage

ACA Coverage

  • Helpful if you (or a loved one) are seeking major medical but may not be able to afford it, have a pre-existing condition, and/or need a broad array of health benefits
  • Option to change plan every year and to stay on policy as long as needed
  • Renews annually
  • Provides coverage for pre-existing conditions; you can’t be rejected based on health
  • Provides preventive care
  • Provides the option for subsidies to lower costs
  • Provides minimum essential health benefits
  • Must enroll during the Open Enrollment period, the Special Enrollment period, or when a qualifying life event occurs

Note: It is important to keep in mind that while short-term and health benefit insurance coverage can provide valuable benefits, neither one is intended to be a replacement nor an alternative to ACA or other major medical plans. These types of coverage do not provide the minimum essential health benefits that are required and will not help to avoid the fee for not carrying health insurance.

 

With our leading edge tools and technologies, we’re upgrading how you experience your choice of coverage.

Stay tuned to our next blog post!

Click here to join our Facebook community for more information about your health and your healthcare coverage.

 

crisp dollar bill in front of white brick wall

Understanding Your Out of Pocket Expenses 101

There’s no doubt that the world of health insurance is challenging. Whether you’re researching new coverage or trying to understand your current coverage, you may feel overwhelmed with the laundry list of options, features, and expenses. It’s likely that you depend on your agent’s guidance and expertise to help you select the coverage that fits your health realities and your lifestyle.

It’s a good idea to have an agent you can trust, but it’s also a good idea to have an understanding of out of pocket expenses before choosing an agent. This will help you understand how a policy will impact your wallet and help you identify which questions to ask your agent before making a final decision.

Let’s take a look at some of these expenses and consider how those they relate to two popular coverage options: short-term medical and health benefit insurance plans.

Deductible

This refers to the amount you pay for yourself before your insurance carrier pays benefits.

If you’re concerned about the cost of deductibles when facing common illnesses such as a cold, an ear infection, pink eye, or strep throat, you may be interested in coverage that includes a telemedicine as a feature.

Telemedicine meets you where you are by allowing you to connect with doctors via phone, video, smartphone, or computer and reducing travel time, anxiety, and time away from family and responsibilities. This feature is available with many short-term medical and health benefit insurance plans as well as traditional healthcare coverage plans.

Copay

This refers to the amount you pay to your providers at the time of service. The amount may vary depending on the type of service you receive and typically does not count toward your deductible.

Affordability is undoubtedly one of your primary concerns when choosing healthcare coverage. Many short-term medical plans offer low out of pocket copays for doctor’s office visits and wellness care. However, the benefits may be more restricted as well since these plans do not need to meet the 10 essential health benefits. They also do not cover preexisting conditions.

If you need another type of coverage and/or if you are considering supplementing your major medical coverage, you may benefit from health benefit insurance, as this type of policy may be cost effective and provides cash benefits to pay for a variety of expenses, including copays. Keep in mind that there may be limitations and/or restrictions, so be sure to fully review the circumstances under which payment can be received.

Coinsurance

This refers to the amount you pay to your provider for services rendered after you pay your deductible and after your carrier covers its portion. This amount is a form of cost sharing and is in addition to the copay that is paid at the time of the visit.

Short-term medical plans offer a variety of coinsurance options, including a 100%/0% option. This can allow you to circumvent a coinsurance payment and would task your carrier with paying 100% of the fees. Keep in mind that short term insurance plans do not cover preexisting conditions and are not required to cover 10 essential health benefits, including maternity and newborn care, mental health and substance abuse disorder services. Check any plan details carefully to understand what is covered.

Health benefit insurance plans do not offer coinsurance options, as they provide fixed cash benefits for specific covered expenses.

 

Note: It is important to keep in mind, that while short-term and health benefit insurance coverage can provide valuable benefits benefits, neither one is intended to be a replacement nor an alternative to ACA or other major medical plans. These types of coverage do not provide the minimum essential health benefits that are required and will not help to avoid the fee for not carrying health insurance.

 

With our leading edge tools and technologies, we’re upgrading how you experience your choice of coverage.

Stay tuned to our next blog post!

Click here to join our Facebook community for more information about your health and your healthcare coverage.

Holiday safety with construction hat

Protect the Children in Your Family this Holiday Season with Safe Toys and Gifts

As you prepare to hit the stores this holiday season, Prevent Blindness America, encourages you to consider your choice of gifts. This non-profit group is dedicated to advocating for healthy vision and has declared December as Safe Toys and Gifts Awareness Month to help adults make smart purchase decisions.

Consider these stats:

  • Hospital emergency rooms treated an estimated 265,000 toy-related injuries in 2012 throughout the United States1.
  • 72% were people less than 15 years of age1.
  • Close to 90,000 were people less than 5 years of age1.
  • Each year, thousands of children aged 14 and younger suffer from eye injuries and even blindness from toys2.

Understandably, you are likely excited to indulge your children as well as children in your family.

However, Prevent Blindness America urges you to keep important safety guidelines in mind as well as the age range for toys you purchase:

  • Read all warnings and instructions on the box.
  • Consider if the toy is appropriate for your child’s ability and age.
  • Avoid purchasing toys with sharp or rigid points, spikes, rods, or dangerous edges.
  • Check the lenses and frames of your children’s sunglasses; many can break and cause injuries.
  • Buy toys that will withstand impact and not break into dangerous shards.
  • Look for the letters “ASTM.” This designation means the product meets the national safety standards set by ASTM International.
  • Avoid toys that shoot or include parts that fly off.
  • Inspect toys for safe, sturdy construction.
  • Fix or throw away broken toys.
  • Keep your young children away from toys meant for older children.
  • Make sure your children store toys properly after play to avoid risks or falls.
  • Supervise your children’s craft projects (scissors and glue can be extremely dangerous to a child’s eyesight).
  • Have your children wear the right eye protection for sports (face shields, helmets, eyeguards).

Make recommendations to your family and loved ones this holiday season when it comes to toys and gifts you feel are safe and appropriate for your children. It may feel as if your concern is gratuitous, but taking extra precautions may help prevent an injury and will help you enjoy the holidays in your home, not in your local urgent care center or emergency room.

 

With our leading edge tools and technologies, we’re upgrading how you experience your choice of coverage.

Stay tuned to our next blog post!

Click here to join our Facebook community for more information about your health and your healthcare coverage.

 

Sources:

1: “Safe Toys and Gifts Awareness Month.” Prevent Blindness America. https://www.preventblindness.org/safe-toys-and-gifts-awareness-month

2: “Safe Toy Checklist.” Prevent Blindness America. https://www.preventblindness.org/safe-toy-checklist

This blog is for informational purposes only, and is not intended to provide any purchasing recommendations. Before making any purchasing decisions, review any policy exclusions, limitations, benefits, and costs. We encourage you to speak with a licensed insurance professional regarding your specific needs.

Family sitting by fire during Open Enrollment

Open Enrollment is Coming to Town: Holidays and Your Loved Ones’ Health

The holiday season and Open Enrollment have arrived, and so have opportunities to spend time with your loved ones. Food, laughs, and gifts are likely on your agenda, but something else – something more important – may be as well: protecting the health of your loved ones.

Maybe you’re catching up with Aunt Linda who is facing an illness after losing her job. Maybe you’re hanging out with your roommate Ruben who has a pre-existing condition and can’t afford major medical coverage. No matter who you’re talking to, the topic of healthcare is likely to arise . What do you know about your available coverage options? Let’s take a look at some of the features you and your loved ones can take advantage of:

Limited Medical Coverage

  • Helpful if you (or a loved one) are anticipating rising medical expenses, are unable to afford major medical, are not eligible for short-term medical, and/or are looking for supplemental coverage to major medical plans
  • Guaranteed issue coverage if eligibility is met and available in state
  • Premiums often lower than major medical
  • Benefits such as $50-$100 paid toward doctor and specialist visits available
  • Not required to use a network of doctors – freedom to see any doctor or visit any facility of your choice (*Note: you may still exceed eligible benefit)
  • Preventive care available for as low as $50
  • Next day coverage available or little to no waiting periods for accidental injuries or sickness
  • 12 month waiting period for pre-existing conditions (limitations and exclusions may apply)
  • Does not count as minimum essential coverage required by the Affordable Care Act and is not suitable to serve as sole medical coverage

Short-Term Medical Coverage

  • Helpful if you (or a loved one) are facing life-altering transition periods such as pre-Medicare retirement, change in employment status, rolling off parental or student insurance, bridging a gap in major medical coverage or if you missed Open Enrollment (This coverage is designed solely to provide healthcare coverage during unexpected coverage gaps)
  • Flexibility in coverage length and cost (coverage duration varies by state and is non-renewable)
  • Variety of deductible and coinsurance options
  • Low copay options for in-network benefits
  • Limited preventive care available
  • Ability to cancel at any time without penalty (benefits may be limited and subject to exclusions and restrictions)
  • Does not cover pre-existing conditions
  • Coverage is not guaranteed
  • Not intended to be a replacement or alternative to ACA or other major medical plans and does not provide the minimum essential health benefits that are required; may result in a tax penalty.

ACA Coverage

  • Helpful if you (or a loved one) are seeking major medical but may not be able to afford it, have a pre-existing condition, and/or need a broad array of health benefits
  • Option to change plan every year and to stay on policy as long as needed
  • Renews annually
  • Provides coverage for pre-existing conditions; you can’t be rejected based on health
  • Provides preventive care
  • Provides the option for subsidies to lower costs
  • Provides minimum essential health benefits
  • Must enroll during the Open Enrollment period, the Special Enrollment period, or when a qualifying life event occurs

Critical Illness Coverage 

  • Helpful if you (or a loved one) are seeking an added layer of financial protection in the face of critical health concerns
  • Pays benefits directly to you or your designee(s)
  • Benefits can be used to pay living expenses such as mortgage, rent, and car payments as well as prescriptions, copays, medical bills, and a myriad of other costs
  • Benefits available up to $50,000
  • Limitations and exclusions may apply
  • Little to no waiting period

Talk to your loved ones this holiday season about Open Enrollment, their health concerns, and their current coverage. You’re already adding extra layers of clothes to stay warm; now may be a good time for you and your loved ones to consider adding extra layers of coverage to stay protected from potentially costly health events.

 

With our leading edge tools and technologies, we’re upgrading how you experience your choice of coverage.

Stay tuned to our next blog post!

Click here to join our Facebook community for more information about your health and your healthcare coverage.

 

 

 

stethoscope during Open Enrollment

Prepare for Your 2018 Healthcare Coverage Needs

Open Enrollment is just around the corner, and it’s the ideal time to evaluate your healthcare coverage needs in the coming year. Consider the following:

  • Do you anticipate seeing your provider more frequently?
  • Are you facing an illness?
  • Will you need to need to see a specialist?
  • Does your current plan meet your budget needs?
  • What changes to your healthcare budget are you considering?
  • Has your family size changed?
  • What coverage changes do you need to make to account for family members?

With the confusion surrounding healthcare legislation, it’s more important now than ever to seek the expertise of those well versed in coverage options and updates.

If you’re considering ACA coverage, here are some important dates to remember:

November 1, 2017

Open Enrollment Period begins

December 15, 2017

Open Enrollment Period ends

January 1, 2018

Plans sold during Open Enrollment become effective

If you’re considering other options, short-term medical coverage may be an appropriate fit for your needs. This type of coverage addresses the needs of those who are:

  • Graduating from college and/or in need of replacing their student insurance
  • Transitioning between jobs
  • Waiting for employer insurance to begin
  • Rolling off parents’ coverage
  • Retiring soon and waiting for Medicare coverage to become effective

Additionally, if you miss the Open Enrollment period, short-term medical coverage may help you face your healthcare needs. You can enroll in that type of coverage at any time!

It’s important to understand that short-term medical coverage plans are limited in duration to a maximum 3-month term. After the plan expires, you will no longer receive benefits under it. You must reapply to receive coverage after the plan expires. Additionally, there may be limits on how many times you can renew short-term medical coverage.

Short-term medical plans can provide features such as:

  • Flexibility in timing of enrollment – there is no special enrollment period enrollment period
  • Preventive care for you and for your family
  • Lower rates than other types of plans
  • Access to providers of your choice
  • Convenience of filing a claim in your provider’s office with an additional option to submit your own claims for reimbursement

Short-term medical coverage is not a replacement for major medical insurance or ACA plans. It does not provide the minimum essential health benefits that are required and it won’t help avoid the fee for not carrying health insurance.

Additionally, there are restrictions and limitations of short-term medical plans. For example, pre-existing conditions are often not covered. Before you make a decision to purchase a short-term medical plan, fully review the benefits, limitations, restrictions, and costs associated with the plan.

 

With our leading edge tools and technologies, we’re upgrading how you experience your choice of coverage.

Stay tuned to our next blog post!

Click here to join our Facebook community for more information about your health and your healthcare coverage.