We came across a recent article written by a colleague of ours in which he compares buying health insurance to replacing the roof on your house — for most of us, if we tried to replace our own roof, we would have no idea where to begin, what kind of shingles to use, or how to do the job. We like the comparison! And it is very true. Most Americans
Understanding Health Insurance Deductibles
What is a health insurance deductible? A plan’s deductible is the amount of money you must pay for your medical care before your health insurance begins to pay. Here are 6 things you need to know about health insurance deductibles: 1. Unlike other types of insurance (e.g., auto or homeowners insurance) where claims are not covered at all until the policy deductible has been met, most health insurance plans do
How Long is My Health Insurance Coverage Effective?
In general, health insurance policies are effective for 12 months, and the period during which coverage is provided is called the plan’s benefit year. For individual health insurance policies — whether purchased on or off the exchange — the benefit year runs on a calendar basis, from January 1 – December 31. However, not all policies will be effective for the full 12 months. This is because the start date
News for Anthem Individual Health Insurance Policyholders in Virginia
Attention Virginia Anthem Health Insurance Policyholders If you have a non-grandfathered* individual Anthem policy with a December 1, 2014 renewal date, we have some important news. We just received word from Anthem of a change regarding the options you will have when your policy renews this December 1. Until now, we had been told that Anthem would no longer offer your current plan, and you would need to switch to
Which Preventive Services for Women are Covered Under ACA?
Now that you have health insurance, you may be wondering what’s covered and what’s not, specifically for women. By law (namely, the Affordable Care Act — ACA), certain preventive services for women must be covered at 100%. This means no copayment, no coinsurance charge, and regardless of whether or not you have met your annual deductible. You must receive all services listed on this page from an in-network provider for
Understanding Halbig v. Burwell – Can I Still Collect a Health Insurance Subsidy?
We recently learned the outcome of an important legal case with potential implications for health insurance reform. At issue in Halbig v. Burwell was whether or not the language in the Affordable Care Act (in the law itself) gives the IRS and the federal health insurance exchange the authority to distribute premium tax credits to individual policyholders. The argument is that the law states subsidies are available for policies purchased
Which Preventive Services and Immunizations Are Covered for Children Under ACA?
Now that you have health insurance, you may be wondering what’s covered and what’s not for your dependent child(ren). By law (namely, the Affordable Care Act — ACA), certain preventive services for children through age 18 must be covered at 100%. This means no copayment, no coinsurance charge, and regardless of whether or not you have met your annual deductible. Your child must receive these services from an in-network provider
Which Preventive Services and Immunizations are Covered for Adults Under ACA?
Now that you have health insurance, you may be wondering what’s covered and what’s not. By law (namely, the Affordable Care Act — ACA), certain preventive services must be covered at 100%. This means no copayment, no coinsurance charge, and regardless of whether or not you have met your annual deductible. You must receive these services from an in-network provider for your plan to cover 100% of the charge. Preventive
Preventive vs. Diagnostic Medical Services Under the Affordable Care Act
The Affordable Care Act (ACA) mandates that all qualified health insurance plans (except grandfathered plans purchased prior to March 23, 2010 and still in place) include coverage for ten essential health benefits. That does not mean these medical services are necessarily free, merely that your health insurance will cover some or all of the cost. But certain preventive services are free. This means your health insurance must cover 100% of
What is the Employer Mandate?
One of the provisions of the Affordable Care Act (ACA) is the employer mandate. Employer Mandate Companies with 50 or more full-time or full-time equivalent employees must offer full-time employees and their dependents (i.e., children up to age 26) coverage that is affordable* and provides minimum value**. * affordable = employee pays no more than 9.5% of his/her household income ** minimum value = plan pays at least 60% of
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