What is a network? A network (also called provider network or preferred providers) is a group of medical providers (hospitals, doctors, specialists, pharmacies, etc.) that have contracted with an insurance company to provide medical care at an agreed-upon rate. What is in-network vs. out-of-network care? In-network care is medical care obtained from a provider within your plan’s network. Out-of-network care is medical care obtained from providers outside of your plan’s
Why Should I Buy Health Insurance if I am Young and Healthy?
Why should the young and healthy have health insurance? The glitches and delays experienced with the October 1 roll-out of the online health care exchanges have left many wondering if young, healthy Americans will give up and simply not enroll in a health insurance plan by January 1, 2014. However, the Affordable Care Act (ACA) — aka Obamacare — makes having health insurance mandatory for most Americans beginning on January
Health Insurance Premiums Under Affordable Care Act
How will health insurance premiums be calculated in 2014, under Affordable Care Act (ACA)? A policy’s premium is the monthly fee paid to the insurance carrier for health insurance coverage. In pre-ACA policies, insurance carriers can charge differing premiums based upon many factors including, most notably, a person’s age and current health status. Today, the premium paid by someone with a medical condition is typically much higher than that of
Will Young Adults Purchase Health Insurance?
Young adults. Traditionally, buying individual health insurance has been low on the priority list for this demographic. Rarely seeking medical attention, many young adults who are not offered coverage from their employer and are too old to be covered on their parents’ plan simply do not have it. There has been much debate about whether this overall healthy and self-described invincible group of younger, uninsured consumers will buy in to
How Much Will Health Insurance Cost Me in 2014?
With the Affordable Care Act (aka Obamacare) front-and-center in the news these days, people naturally want to know how much it will cost them when health insurance becomes mandatory on January 1, 2014. The health insurance exchanges (or “marketplaces”) are slated to open on October 1, 2013 for plans with an effective date of January 1, 2014. Until exact figures are released, the Kaiser Family Foundation has a great tool
Important Questions to Ask When Seeking Medical Care
When you visit a doctor or other medical provider, knowing the right questions to ask will make you a smarter consumer when it comes to your own health care. Here are some suggestions: Do you take my health insurance? If so, are you in my network? (Hint: this is becoming increasingly important as provider networks may be shrinking. Read more.) What are my health care options? (Hint: it’s best
Understanding Health Insurance Premiums
States are beginning to release premium rates for policies that will be sold on their health insurance exchanges beginning on October 1. The news can be confusing, however, and subject to interpretation — and “spin”. On a single day in July, for example, the Washington Post ran this headline: “Maryland Issues Insurance Rates That Are Among the Lowest in U.S.” On the same day, the Baltimore Sun ran this: “Premiums
Early Renewal for Health Insurance Plans
Why Renew Early? With the next phase of the Affordable Care Act (ACA) going into effect in just under six months, many small businesses that currently provide group insurance for their workers are concerned about the law’s impact on the cost of doing so. Individuals, too, are wondering if their costs will increase under ACA. Under the law, new health plans must cover the essential health benefits, but at the
Health Insurance Glossary
Shopping for health insurance? Deciphering the costs and provisions of the various plans out there can be very confusing. Here are some key terms that will help — whether you’re selecting a new plan or just trying to figure out your existing one. Quick-Reference Guide to Health Insurance Terms Allowed Amount – (also known as eligible expense, payment allowance, or negotiated rate) Your health insurance company has negotiated a pre-agreed
Policies Sold in the Health Care Exchanges May Offer Fewer Providers
Mandatory health insurance coverage under the Affordable Care Act (ACA) for most Americans starting on January 1, 2014 will cause a flood into the market of previously-uninsured individuals and those needing to get new coverage. Coupled with the fact that insurance plans will be required to cover a comprehensive list of essential health benefits, insurance companies and government officials are trying to find ways to hold down medical costs. Renegotiating
