If you choose to enlist the help of a professional insurance agent in deciding on a health plan, the following are some important questions to ask before committing to a policy:
With the 2020s underway, let’s take a look back at seven key milestones and issues that marked the evolution of healthcare over the past 25 years. 1. The Affordable Care Act became law Just months into 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. The Affordable Care Act, often referred to as the ACA or Obamacare, changed the nation’s health insurance landscape and brought about numerous provisions to help make health insurance more affordable and accessible to as many Americans as possible. Some key provisions include: The creation of a health insurance marketplace in every state to provide consumers with a place to purchase health insurance.Income-based subsidies, including premium tax credits and cost-sharing reductions, for those who purchase individual coverage through the health insurance marketplace (i.e., the state-based and federal exchanges).A requirement that insurance plans cover young adults on their parents’ policies to age 26.Guaranteed issue and renewal of policies.Medicaid expansion to those with incomes below 138% of the federal poverty level, in participating states. Ten years later, uninsured rates have declined. In 2010, nearly 16% of Americans were uninsured. But in 2016, the uninsured rate hovered just above 8% - its lowest point in the decade. Although, it started to increase again slightly in 2017.2. Short-term health insurance kept its strideShort-term health insurance is temporary insurance that provides coverage in certain medical situations like an unexpected accident or illness. However, it doesn't include the same essential health benefits that ACA plans do, making it a more affordable insurance option for many.Short-term health plans remained a relevant health insurance option throughout the decade with sales increasing sharply after the ACA took full effect in 2014. These plans became an attractive option for people who were exempt from the individual mandate or opted to pay a penalty for not having an ACA-compliant health plan.Obama limits short-term policiesConcerned that short-term health insurance was impacting ACA enrollment, the Obama administration created regulations that limited their availability. In 2016, short-term policies were capped at three months.Trump expands short-term policiesIn 2018, the Trump administration lifted Obama-era limits. Policies can now last up to 12 months and can be renewed for up to 36 months, depending on state laws. Arizona, for example, has adopted the Trump administration’s regulation. Some states, such as Oregon, still limit short-term plans to less than 90 days.3. High-deductible health plans grew in popularityHigh-deductible health plans, called HDHPs, were introduced in the early 2000s and were considered "mainstream plans" by 2012. People obtained these plans usually through their employer group-based coverage (if offered), the healthcare exchange, or from private insurers. Here are some interesting facts:HDHP enrollment jumped from 10 million people to 11.4 million people in one year (from January 2010 to January 2011).By 2015, HDHPs accounted for 60% to 80% of plans offered in the individual health insurance marketplace. In 2019, the IRS classified high-deductible health plans as any plan with a deductible of at least $1,350 for an individual and $2,700 for a family. The average annual deductible for individual coverage through a group plan was $1,655 in 2019.But while consumers can appreciate the lower monthly premium of a high-deductible insurance plan, they also tend to delay or skip medical care because of the high out-of-pocket costs associated with HDHPs.The popularity of HDHP may be slowing - at least in the group market. The percentage of employers offering a high-deductible health plan as the only option is projected to decrease in 2020, with more employers beginning to offer additional coverage options.4. Healthcare spending continues to climbIf it seems like your healthcare costs increased throughout the past decade, it probably did. In 2018, the average American household spent $5,000 on healthcare, with nearly 70% of the $5,000 going towards health insurance.The more staggering fact: medical bills are reported to be the number one cause of bankruptcies nationwide. And today, medical costs are considered America’s "real healthcare crisis". And while politicians continue to debate issues including health insurance reform and prescription drug pricing, they have not agreed upon a clear solution.Until things change, consumers must continue to find ways to save on their own, from finding flexible and affordable health insurance options and taking advantage of preventive care, to comparing provider rates before seeking services and getting alternative healthcare through options like telemedicine.5. An opioid epidemic devastates our nationThe opioid epidemic might be the most daunting and complex public health crisis of our time. Heroin-related overdoses increased 286% from 2002 to 2013, with a significant spike around 2010. Another wave of opioid-related deaths hit around 2013 and this time, synthetic opioids like fentanyl were behind the surge. The crisis continued to escalate from there, with prescription drugs playing a significant role. Here are some of the most shocking reports:Opioid overdoses accounted for more than 42,000 deaths and increased to 47,600 people in 2017. By 2019, more than 90 Americans per day were dying from opioid overdose. And prescription opioid abuse was costing the nation $78.5 billion per year.The epidemic impacted people in both rural and urban environments. But overdose deaths in rural communities surpass deaths in urban settings. So what’s being done about it? In early 2019, the Trump administration launched a $353 million initiative to cut opioid overdoses by 40% over the next three years. The federal government is also working to hold drug companies accountable. For example, top executives at Insys Therapeutics were found guilty of racketeering conspiracy—a charge typically assigned to drug dealers and mob bosses. In 2018, the CDC reported that drug overdose deaths decreased for the first time since 1990.6. Covid-19 pandemic and the U.S. healthcare systemThe 2020 pandemic was not only the biggest health event in the U.S. in the past decade, but a major burden on an already fragile healthcare system. From shortages of hospital beds and staff to healthcare facilities having to ration medical supplies to keep up with COVID-19 cases, we’ve seen how our healthcare infrastructure is in need of improvements to better prepare for crises. Not only that, researchers at the Massachusetts Institute of Technology assert that the pandemic revealed some deeper issues in our healthcare system, such as disproportionate access to care among marginalized groups and the country’s dependence on healthcare services from underpaid workers.7. Medicare enrollment: Medicare Advantage Plans and Original Medicare Medicare Advantage plans, which are an alternative to Original Medicare, have seen a steady increase in enrollment each year over the past decade. As of 2022, there are 28.4 million Medicare Advantage enrollees which account for 48% of the Medicare-eligible population. People enrolled in MA plans back in 2012 represented about a quarter of all beneficiaries, so enrollment rates have just about doubled.Another interesting fact as reported by Kaiser Family Foundation is that “the average Medicare beneficiary in 2022 has access to 39 Medicare Advantage plans, the largest number of options available in more than a decade.”Here’s a breakdown of MA plan enrollment:About two-thirds (18.7M) of the Medicare population are enrolled in a plan available through individual enrollment.Roughly 5.1 million beneficiaries have coverage through an employer or union group plan available to retirees.More than 4.6 million people are enrolled in Special Needs Plans, the majority of which (89%) are those eligible for both Medicare and Medicaid. The healthcare debate continuesDiscussions about healthcare reform and our healthcare landscape did not stop when the ACA was passed. Conversations about legal challenges continue to this day. There has been proposed legislation to repeal and replace the ACA under the Trump administration. Trump administration removes individual mandateNew tax legislation passed in December 2017, which changed one key aspect of the ACA. Previously, you could be penalized for not having health insurance, but Congress and President Trump eliminated the mandate rule for all coverage beginning Jan. 1, 2019. Individual mandate challenged as unconstitutionalThe 5th Circuit also ruled in Texas vs. United States that the individual mandate is unconstitutional, at which time, a A Texas Judge was deciding what, if any, of the ACA still stands. But in 2021, the Supreme Court ruled that states don’t have any grounds to challenge the constitutionality of the ACA mandate.The 2020 electionWith the Presidential election in 2020, Democrats were focused on building upon the ACA with tactics like a “Medicare for all” national health insurance system. However, this agenda never took effect with the Democratic party winning the election. Now twelve years after the passing of the ACA, the Biden-Harris administration has promised to continue upholding the ACA and making affordable health insurance accessible. With ongoing talks of a universal health insurance option for Americans and how to navigate health-related issues post pandemic, there’s no doubt that healthcare legislation will continue to make headlines over the next decade. From Obamacare to the opioid epidemic to the Covid-19 pandemic, healthcare-related issues have made major headlines. And it’s inevitable that they’ll only continue to evolve and impact our lives for years to come. We’ll continue to follow the trends and changes as well as their impacts on our nation.
More than 6.65 million Americans filed for unemployment benefits over the last week alone – a bleak result of the Coronavirus pandemic. But those impacted aren’t just losing their jobs: They’re often losing their health insurance benefits too. And now is the time, especially, when health insurance may be extra crucial to you as you work to maintain good health or need coverage if you do get sick. Before weighing your options, take these steps: Know your budget and what you can afford each month. Make a list of your current health conditions and medications. List any doctors any healthcare providers you want to keep. Determine if you need dental or vision coverage. If you’ve lost your job and job-based insurance coverage, here are six options for you: 1. Join your spouse’s plan You may be able to obtain coverage through your spouse’s job-based health insurance plan, as long as your spouse or partner is already covered, which can be a cost-effective option. Ask your spouse to talk to his or her HR or benefits team to see if this is an option and what the associated healthcare costs may be for you. 2. COBRA You’ll likely receive a COBRA enrollment notice that includes information to continue your health insurance through your employer. Pros: You can keep your current health plan and continue to use your doctors and pharmacists under a policy you’re already familiar with. Your copays and deductibles will remain the same. Your spouses and children are eligible. Cons: You will likely face a higher premium because your employer will not subsidize the cost, and you’ll be charged a 2% administrative fee for continuing the plan. You can stay on COBRA for a limited time – typically up to 18 months. Some employers don’t offer this option, so be proactive and ask about it if you’re interested. 3. ACA (Obamacare) Plans Though the 2020 open enrollment period has ended, losing your job may qualify you for a special enrolment period exception. You can see if you can get coverage for an ACA plan through the Health Insurance Marketplace. Pros: Offers comprehensive major medical coverage for the 10 essential health benefits. You can’t be denied for pre-existing conditions. Tax credits are available if you meet the qualifications. Cons: You may not qualify to enroll in a plan at this time.* Can be costly if you don’t qualify for a subsidy. Plans can have narrow networks, so it’s wise to check if your doctors and providers are in-network. *Note: U.S. officials are also considering a special enrollment period to help uninsured Americans during the COVID-19 crisis. 4. Short-Term Health Insurance This type of temporary health insurance is designed to be a cost-effective and flexible insurance option if you’ve lost your job and have a gap in health insurance coverage. Pros: Flexible plan duration: Your coverage period can range from 30 to 364 days, with policy renewal of up to three years, depending on your state’s rules. Cancel anytime: You can choose how long you want to be covered (anywhere from 30 to 364 days). Plus, you can cancel your plan anytime. Enroll anytime: You can apply for and enroll in a temporary health insurance plan any time of year. And you can get coverage as soon as the day after you apply. Cons: There’s no coverage for pre-existing conditions. There are limits on prescription drug coverage: Most short-term health plans do not cover prescription drugs, but a few do offer add-on benefits and include prescription drug coverage after a deductible is met. There are limits on the number of covered doctor visits. Does not cover all of the 10 essential health benefits. You can be denied coverage. 5. Medicaid Medicaid is based on your income, family size and asset level. Though each state can set its own requirements, the limit is typically 133% of the Federal Poverty Level. If you do qualify for Medicaid, you’ll receive low-cost health insurance through your state which may cover you for: Inpatient care (hospital-type visits) Outpatient care (doctor’s office visits) Home health care Nursing care Dental, vision and hearing (in many cases) Again, benefits vary by state. And Medicaid should not be confused with Medicare (here’s how to know the differences between the two). 6. Telemedicine (not health insurance – but a way to get care) Though telemedicine isn’t a form of insurance, it’s a helpful service that people are turning to during a time of social distancing and stay-at-home orders. With telemedicine, you pay a monthly membership fee and, when you use the service, you may also pay a charge for the ‘televisit.’ Telemedicine connects you with virtual doctors who can diagnose and treat your non-emergency medical conditions, including: Allergies Asthma Behavioral and mental health services Common cold Fever Flu Men’s health issues Nausea and vomiting Pink eye Sore throat Skin conditions Sinus infections Women’s health issues Telemedicine doctors can also prescribe medications for certain conditions and submit the order to your pharmacy of choice. You can get a telemedicine quote with no obligation to you. We will continue to provide educational resources to you throughout the Coronavirus pandemic: Follow us on Facebook for news about COVID-19, telemedicine, health insurance and more. Visit our feed to get frequent updates on COVID-19 news.
Did you know that 66% of people who file for bankruptcy cite medical issues as a key contributor to their financial downfall? It's no wonder why rising healthcare costs continue to be a hot topic of conversation. So finding creative ways to save on healthcare costs should be top of mind for you. Whether you have Medicare, coverage through your employer, or insurance through the marketplaces, here are 9 ways to save on medical costs. 1. Incorporate Healthy Habits Finding ways to improve your general health and wellness can lower your out-of-pocket health care costs. After all, fewer trips to the doctor means fewer copays and less money spent on healthcare. Here are 4 simple actions you can take to live a healthier lifestyle. Less sugar, more water. Drink plenty of water and eat foods high in water: Think cucumbers, watermelon and celery. Sit less, more movement. Stand up throughout the day, stretch, take the stairs, and park further away: These are just a few ways to move more. Get rest. When thinking of healthy habits, sleep often falls low on the list. But chronic sleep deprivation can increase heart disease, diabetes, stroke, obesity, and many other illnesses. Wash your hands. The coronavirus pandemic serves as a major reminder to wash our hands frequently and correctly. Wash your palms, fingernails, and the backs of your hands thoroughly for at least 20 seconds. 2. Reduce Stress Stress often increases with age, leading to a host of health problems. Finding ways to lower your stress can go a long way. There are many simple ways to reduce stress in your daily life. Try things like working out or moving daily, spending more time with friends and family, and reducing your caffeine intake. And don't forget to laugh more. 3. Save Money on Medications The cost of prescription drugs can really take a lot out of your wallet. So if you're used to getting brand-name medications, consider asking your doctor for a generic alternative. It could save you money in the long run. For seniors especially, the cost of medications continues to rise at an alarming rate. One of the simplest ways for seniors to save is to find and compare Prescription Drug Plans (Medicare Part D). Start by comparing quotes, or talking to an insurance agent who is willing to research the medications you take. The right agent will have knowledge of all the pharmacies close to your home and plans available in your area. He or she can also help you identify ways to save on your prescriptions. 4. Use a Health Savings Account (HSA) You may have access to a Health Savings Account (HSA) through your employer (or previous employer). Using an HSA can save you money because your contributions are pre-tax dollars and can accrue interest. And unlike a Flexible Savings Account (FSA), the HSA is owned by you, so it can carry over into your retirement. And there is no deadline on when you can spend the funds. 5. Know The Difference Between Emergency Care and Urgent Care Some people don't know the difference between emergency care and urgent care. But knowing which option to use in a given situation can save you money: Emergency room visits can cost far more than urgent care center visits. Your initial reaction might be to go to the ER when you need medical treatment but can't see your primary care doctor. But in many cases, an urgent care facility will serve you just as well at a lower cost. Start by keeping a list of nearby ERs and urgent care centers handy. An urgent care visit is good for a minor illness or injury, but if your condition is life-threatening, always go to the ER. You might also consider going the telemedicine route, which entails talking to a doctor online, rather than going to an in-person appointment. Telemedicine usage also gained momentumduring the coronavirus pandemic. Overall, turning to telehealth may not only reduce your healthcare costs - it could save you time and keep you out of the waiting room. 6. Ask If All Tests Are Necessary You may think that doctor-ordered tests are standard protocol, but those tests could get expensive fast. Be sure to ask your doctor if all diagnostic tests are necessary for your health. Don't be afraid to ask your doctor if all diagnostic tests are necessary for your health. Here are some questions to get the conversation started. Why is the test being done? What steps does the test involve? How long will it take to get the results? What will the test cost? 7. Request Outpatient Services When Possible Did you know that some inpatient procedures can be performed on an outpatient basis? Often, doctors choose to have a procedure performed on an inpatient basis, simply for the convenience of the patient and the medical staff. Many procedures do require a medically supervised period of recovery, but not all of them. There's nothing wrong with asking your doctor if a procedure can be performed in an outpatient clinic rather than at the hospital. If so, the savings can be significant. 8. Choose Your Doctors Wisely Just because a physician or facility accepts your health insurance or Medicare plan doesn't mean that your costs will be controlled. If you're on Medicare, consider these two steps: First, check if the provider accepts assignment. This means that the provider has agreed to accept the Medicare-approved amount as full payment for services. If your provider doesn't accept assignment, then your out-of-pocket costs may be higher. Second, choose the right doctor for you. The ideal provider has specialized experience with those age 65 and over, which can save you repeated visits to the doctor. One way to shop around for doctors and specialists is through the physician compare feature on Medicare.gov. You can use this tool to compare providers in your area, or you may opt to discuss the topic with a licensed insurance agent. In general, researching and shopping around for the right healthcare provider could save you money over time. 9. Use Your Medicare Benefits It may sound contradictory, but going to the doctor can ultimately lower your healthcare costs. Most insurance plans, including Medicare Advantage, come with certain wellness benefits. Getting regular physicals and patient-specific tests can uncover minor health problems before they become major ones. Let's say a man gets a routine PSA blood test done, which reveals the possibility of low-grade prostate cancer. Early intervention makes the treatment cost far less early on, resulting in fewer trips to the doctor and fewer copays. In other words: lower cost. You Can Save On Healthcare Costs Bottom line: Don't be afraid to do your research, ask the right questions, and incorporate healthy habits to decrease healthcare costs. You can also find more tips to avoid medical debt in this article.