6 Common Mistakes to Avoid When Choosing a Health Insurance Plan

health insurance plan

health insurance planHealth insurance may be one of the most critical annual purchases since it impacts your physical, mental and financial wellness. Unfortunately, selecting a health insurance plan can feel overwhelming. With so many options, it can also be easy to make a mistake when selecting coverage.

This article explores six common missteps related to selecting a health insurance plan. Once armed with this information, it’ll be easier to avoid these mistakes and choose the best plan coverage for your situation.

1) Rushing Through Enrollment Options

Many people rush when buying their health insurance or only rely on recommendations from friends, family and co-workers. Others may simply reenroll with last year’s choices. But health insurance provides personal coverage, so it’s important to research and find what will work best for your health needs and budget.

When it comes time to enroll in a plan, compare different policies and understand their coverages and associated costs (e.g., premiums). One of the best ways to ensure the policy is right for your health needs is to consider your medical requirements and spending in the next year. Don’t forget to confirm in-network coverage to ensure your preferred doctor, clinic and pharmacy are connected in the new plan. Then, you can find the most suitable plan and coverage in an effort to simplify your health care and make it more affordable.

2) Overlooking Policy Documents

Another common mistake is skipping through or not thoroughly reading the policy’s terms and conditions. However, carefully reading a policy is the best way to know what to expect from the health plan and what the plan expects of you.

As such, read the fine print on each plan you consider before enrollment. Reviewing the policy’s inclusions and exclusions will help you make an informed decision and potentially avoid surprise bills later on.

3) Misunderstanding Costs

A cost-sharing charge is an amount you must pay for a medical item or service covered by the health insurance plan. Plans typically have a deductible, copays and coinsurance. Here’s what those terms mean:

  • The deductible is the amount you pay out of pocket before your health insurance starts to cover costs.
  • A copay is a flat fee you pay upfront for doctor visits, prescriptions and other health care services.
  • Coinsurance is the percentage you pay for covered health services after you’ve met your deductible.

When shopping for a plan, keep in mind that the deductible is tied to the premium. As such, a low deductible plan may seem attractive, but understand that it generally comes with a higher premium—and vice versa. Consider keeping your deductible to no more than 5% of your gross annual income. When shopping for a plan, look closely to see when you’ll have a copay and how much it will cost for various services.

4) Concealing Your Medical History

It may be tempting to avoid sharing your medical history if you’re worried about being rejected or receiving higher premiums. However, it could hurt you in the long run when insurance claims are denied for existing conditions or undisclosed medical information.

5) Ignoring Add-ons

Health insurance add-ons are often included separately and require an additional premium, which means many people don’t look at them. A standard health insurance plan may not cover certain situations, so reviewing all available options is essential. An insurance add-on could help bolster your overall health insurance coverage by offering extra protection.

Review the add-on covers offered with your health insurance policy and see if any would be helpful for you, your family or plans in the next year. For example, some common add-ons include critical illness insurance, maternity and newborn baby insurance, hospital daily expenses and emergency ambulance services.

6) Selecting Insufficient Coverage

People may hold back on purchasing certain coverage to pay a lower premium. While that may seem advantageous in the short term, you’ll be on the hook for out-of-pocket costs when facing a medical emergency. This mistake may be accompanied by physical, mental and financial health consequences.

When selecting a plan, check that the policy provides adequate coverage for your medical needs and other essentials. The right health insurance can take care of yourself and ensure financial security.

Summary

Health insurance is an essential investment for you and your family. By avoiding common mistakes while buying health insurance, you’ll be better informed to enroll in a plan and other coverages.

As health care costs continue to rise, it’s more important than ever to carefully review available policies, consider your options and health needs, and, ultimately, select the best plan to protect your health and finances.

Answers To The 7 Most Frequently Asked Benefit Questions

Frequently Asked Benefit Questions

Frequently Asked Benefit QuestionsWhen it comes to benefits, such a health insurance, many can agree that it is confusing. Unless you are involved in health insurance or Human Resources it can be hard to make sense of everything. We have compiled a list of some of the 7 most frequently asked benefit questions and their answers. We hope this makes things a little easier to understand. 

What is a Deductible?

A deductible is the amount of money you or your dependents must pay toward a health claim before your organization’s health plan makes any payments for health care services rendered. For example, lets say you have a $1,000 deductible. You would be required to pay the first $1,000, in total, of any claims during a plan year.

What is Coinsurance?

On top of your deductible, coinsurance is a provision in your health plan that shows what percentage of a medical bill you pay and the percentage a health plan pays. This usually starts after your deductible has been satisfied.

What is an Out-of-pocket Maximum (OOPM)?

An OOPM is the maximum amount (deductible and coinsurance) that you will have to pay for covered expenses under a plan. Once the OOPM is reached the plan will cover eligible expenses at 100 percent.

What is an Explanation of Benefits (EOB)?

An EOB is a description your insurance carrier sends to you. It explains the health care benefits that you received and the services for which your health care provider has requested payment. It will explain what your insurance carrier will pay and an cost your will be responsible for. This would include Deductible, Coinsurance, Copays, etc.

What is a Preferred Provider Organization (PPO)?

A PPO is a group of hospitals and physicians that contract on a fee-for-service basis with insurance companies to provide comprehensive medical service. If you have a PPO, your out-of-pocket costs may be lower than in a non-PPO plan.

What is Utilization Management (UM)?

Utilization Management is the process of reviewing the appropriateness and the quality of care provided to patients. UM may occur before (pre-certification), during (concurrent) or after (retrospective) medical services are rendered. 

For example, your health plan may require you to seek prior authorization from your UM company before admitting you to a hospital for nonemergency care. This would be an example of pre-certification. Your medical care provider and a medical professional at the UM company will discuss what is the best course of treatment for you before care is delivered. UM can reduce unnecessary hospitalizations, treatment and costs.

What is a High Deductible Health Plan (HDHP)?

An HDHP is a type of insurance plan that offers a low premium offset by a high deductible. Because of the low cost of the plan, the insurer will not cover most medical expenses until the deductible is met. As an exception, preventive care services are typically covered before the deductible is met. HDHPs are often designed to be compatible with heath savings accounts (HSAs). HSAs are tax-advantaged accounts that can be used to pay for qualified out-of-pocket medical expenses before the HDHP’s deductible is met.

We hope you found this list of 7 most frequently asked benefit questions and their answers helpful. If you did, please take a moment to share this post. 

Would you like to know more about health insurance? Click here for Individual or Click here for Employee Benefits. 

7 Mental Health Benefits of Exercise

mental health benefits of exercise








mental health benefits of exerciseWhile physical exercise is known to be good for your body, it also can help your mind. Research continues to validate that exercise can improve mental health by reducing anxiety, depression and a negative mood. When you include exercise as part of your everyday routine, you’ll be reaping both physical and mental well-being benefits.

This article explores the connection between your body and mind and the mental health benefits of physical activity.

The Connection Between Body and Mind

People who exercise regularly often report having better mental and emotional well-being. Consider the following mental health benefits of exercise:

  • Mood boost—Exercise triggers the production of endorphins, serotonin, dopamine and oxytocin, mood-boosting chemicals in the brain. Those four chemicals are responsible for feelings of happiness.
  • More energy—Increasing your heart rate and boosting oxygen circulation in your body can make you feel more energized. It may seem counterintuitive, but expending energy can actually provide a spark of vitality you may need to get through the day.
  • Better sleep—Exercise can help regulate your sleep patterns and reduce the time it takes to fall asleep. The more active you are, the more your body pushes you to sleep and reset at night. Try to exercise for at least one to two hours before bed so your brain has enough time to wind down.
  • Reduced stress—Physical activity reduces the levels of your body’s stress hormones (e.g., adrenaline and cortisol). It’s also linked to lower physiological reactivity toward stress, so exercise can also be a coping strategy for stress.
  • Improved memory—Endorphins can help you concentrate and feel mentally sharp for work or other tasks.
  • Higher self-esteem—When exercise becomes a habit, you may feel more powerful or confident. You may also feel accomplished when you meet your fitness goals.
  • Stronger resilience—Exercise is a healthy way to build resilience and cope with mental or emotional challenges instead of turning to negative behaviors, alcohol or other substances.

Any movement helps since physical activity is what can be beneficial to mental well-being. Exercise can take your mind off problems or negative thoughts by redirecting them to the activity at hand.

Getting Started

The U.S. Department of Health and Human Services recommends that adults get moderate-intensity aerobic activity for at least 150 minutes each week and muscle-strengthening activities two times per week. It may seem like a lot at first, but if you break it down, that’s 30 minutes of moderate exercise five times a week.

Even if you don’t have time for 30 minutes to exercise, find something that works for you. Any physical activity is better than none. Understandably, motivating yourself for a workout can seem more challenging if you’re battling depression, anxiety or other mental health issues. Consider these tips for incorporating exercise into your routine:

  • Start with short exercise sessions and slowly increase your time. The goal is to commit to moderate physical activity and build it into your daily routine.
  • Find an activity you enjoy and incorporate it into your routine for a body and mind boost.
  • Schedule workouts when your energy is the highest.
  • Exercise with a friend. Companionship can make it more fun, so work out with a friend or loved one to make it more enjoyable or help you stick to the routine.

It comes down to making exercise a fun part of your everyday life so you can gain both physical and mental health benefits. Talk to your doctor if you have any questions or concerns about incorporating exercise into your day.








Do You Have Allergies? 6 Helpful Tips For Allergy

Allergies








Allergies

Between the rain, new growth and house cleaning, chances are if you have allergies, you are miserable right about now. Whether you have seasonal allergies or suffer year round, there are steps you can take to help decrease your symptoms without having to stock up on medication.

Who is affected by allergies?

Though allergies can affect anyone, individuals with the following characteristics are afflicted more often:

  • Under 40 years old
  • Have at least one parent with allergies
  • Suffer from allergic conditions such as asthma

What are the symptoms?

Symptoms of allergies include:

  • Sneezing
  • Red, itchy or watery eyes
  • Dry throat
  • Stuffy nose

Tips to alleviate allergy symptoms:

To alleviate allergy symptoms, consider the following recommendations:

  1. Stay indoors when the pollen count outside is high.
  2. Keep your home clean and as dust-free as possible.
  3. Place pillows, mattresses and duvets in allergen-proof encasements.
  4. Use a vacuum cleaner with double bags, allergen-trapping bags or a HEPA filter.
  5. Avoid having pets or going near others’ pets if you have animal allergies.
  6. In your home, choose hardwood floors instead of carpeting.

Did you know?

According to the American Academy of Allergy and Immunology, about half of the U. S. population suffers from allergies. These negative reactions occur as a result of coming in contact with normally harmless substances. Some allergies change or disappear over time, while seasonal attacks will return at the same time each year for only a few weeks or months.

Healthy Hints

Treatment for most allergy symptoms is available over-the-counter or as a prescription from your physician. If your symptoms are severe or you don’t know what is causing you to have a reaction, an allergist can perform a test to pinpoint what you are allergic to. And don’t forget, allergy testing and treatment is usually covered by your health insurance.

Do you need help finding what your copay or out of pocket cost will be?

Call us today – 419-522-9892 – we can help.








Do You Understand The Benefits Offered By Your Job?

Benefits Offered By Your Job








Benefits Offered By Your JobMany employers recognize the hard work their employees do every day. In addition to a pay check, many employers will offer additional benefits to compensate their employees. Whether you are a new employee of the company, or an existing employee that has never enrolled in the benefits, understanding everything an employer has to offer can be difficult. We break this all down and help you understand the benefits offered by your job.

Common Benefits Offered By Employers

When it comes to benefits offered by employers, there is no set guideline to use. As a result, employers build their own benefits packages and can pick and choose what they want to offer. Some of the most common options include:

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • Disability Insurance
  • Life Insurance
  • Flexible Spending Account (FSA)
  • Health Savings Account (HSA)

Click here to learn more about employee benefits.

Employer-paid vs Voluntary benefits

Depending on the size of the company you work for, there may be several packages available. Some may be employer-paid, some may be voluntary and some may be in the middle where you and the employer split the cost. There could be several options for benefits offered by your job.

  • Employer-paid benefits are those that the employer pays 100% of the cost. This typically includes life insurance and disability insurance.
  • Voluntary benefits are those you the employee can choose to elect or not. You will pay 100% of the premium. This typically includes dental and vision insurance
  • Contributory benefits are those that you and the employer both pay for. The employer picks how much they will pay and then you pay the remainder. One example would be medical insurance. The employer may pay 80% of the premium, you pay the remaining 20%

What Coverages Are Included In The Benefits Offered By Employers?

This will vary for each company. They will be able to provide you with a summary of benefits that will show you basic plan information. Deductibles, copay’s, coinsurance and maximum out of pocket is standard on each summary. Employers have HR departments or an insurance agent they work with. They will be able to explain everything to you and help you enroll.

Understanding benefits offered by employers can be overwhelming. Take time to review the information provided to you and don’t be afraid to ask questions. Every individual’s situation is different however employers have specific plans in place to help you.

Have questions? Contact us today, we can help.








Disability Insurance; What You Need To Know

disability insurance








For most adults having a job and making a paycheck is crucial to make sure you have a roof over your head and food on the table. Unless you are a lottery winner or have a large savings, you most valuable asset is your ability to earn an income. But what happens when you are unable to work? That’s where disability insurance comes in. 

Disability insurance is coverage that provides you with income protection, should you lose time on the job due to an injury or illness. 

Is there different types of disability insurance?

Yes, the 2 most common are Short Term Disability (STD) and Long Term Disability (LTD) Insurance. 

  • Short Term Disability (STD) Insurance coverage is designed to cover you for a short period of time. Coverage usually starts within 1 to 15 days of the injury or sickness and typically lasts for about 10 to 26 weeks. STD coverage allows you to receive a fixed weekly amount or a set percentage of your income. 
  • Long Term Disability (LTD) Insurance coverage is designed to cover you for a longer period of time. Coverage usually starts 3 to 6 months after the injury or sickness begins. The length of coverage varies, but can range from 2 to 10 years or until you reach age 65. LTD insurance pays a set percentage of your regular income after a specific waiting period. Most LTD plans are designed to start after the STD plan has been exhausted. 

You can purchase one or both to fit your specific needs. 

Why is it important?

The risk of disability is greater than most employees realize. When you become disabled and loose time at work, your source of income is lost. Nearly 1/3 of employees will miss more than one month of pay due to injury or illness. In addition to lost income, you are likely to experience an increase in medical expenses due to your injury or illness. 

Disability insurance can be purchased on your own or sometimes through your employer. If you and your family count on your income to pay bills disability insurance is something you should consider. Let the professionals at Rinehart Insurance help you select a plan that best fits your needs. 

Click Here to contact your agent today.








The Difference Between An Emergency Room And Urgent Care








In the case of a sudden emergency, obtaining quick medical attention is crucial. Choosing the appropriate place of care ensures prompt medical attention and lower costs. Making the wrong choice can result in delayed medical attention, and may cost hundreds, if not thousands of dollars. If you or someone you know suddenly falls ill or becomes injured, how can you determine which facility is most appropriate? Do you know the difference between an emergency room and urgent care? What services does each facility provide? If you don’t know the answers, don’t worry, we can help explain the difference.

Emergency Room

The emergency room is equipped to handle life-threatening injuries and illnesses and other serious medical conditions. An emergency is a condition that may cause loss of life or permanent or severe disability if not treated immediately. Patients are seen according to the seriousness of their conditions in relation to the other patients. Go directly to the nearest emergency room if you experience any of the following:

  • Chest pain
  • Shortness of breath
  • Severe abdominal pain following an injury
  • Uncontrollable bleeding
  • Confusion or loss of consciousness, especially after a head injury
  • Poising or suspected poisoning
  • Serious burns, cuts or infections
  • Inability to swallow
  • Seizures
  • Paralysis
  • Broken Bones

Urgent Care

Urgent care facilities are not equipped to handle life-threatening injuries, illnesses or medical conditions. These centers are designed to address conditions where delayed treatment could cause serious problems or discomfort. Some examples of conditions that require urgent care are these:

  • Ear infections
  • Sprains or strains
  • Urinary tract infections
  • Vomiting, diarrhea or dehydration
  • High fever or the flu
  • Controlled bleeding or cuts that require stitches
  • Diagnostic services (X-ray, lab tests

Choosing the wrong facility

If you go to the Emergency Room with a relatively minor injury or illness, you will most likely have to wait to be seen. Depending on the severity of the other patients’ conditions, you may have to wait more than an hour to be seen. Most often you could have been seen more quickly at an urgent care facility. And, you will also end up with a higher bill by visiting an Emergency Room. Most insurance plans offer a discounted co-pay if you go to an urgent care vs going to the emergency room. For example a plan may have a $250 Emergency Room co-pay vs a $75 Urgent Care co-pay. If your plan does not have a co-pay and your visit is subject to your deductible and co-insurance you will still most likely have a lower charge from an Urgent Care facility vs an Emergency Room.

Know the difference between an Emergency Room and Urgent Care

Knowing the difference between an Emergency Room and Urgent Care will help you determine the best facility for you or a loved ones medical emergency, as well as saving you time and money if it is determined that care can be received at an Urgent Care. Understanding your health insurance plan is also important. Co-pays, deductibles and coinsurance are all very important parts of your plan.

Click here to learn more about health insurance benefits.

Please share if you found this information helpful. 








What You Need To Know About A Health Savings Account








If your employer offers health benefits, there is a chance they offer a Health Savings Account compatible plan. You may be familiar with those type of plans, or it may sound like a different language. Don’t fret if you don’t understand. That’s where we come in. Below is a basic breakdown of an HSA.

What is a Health Savings Account?

Also known as a HSA, a Health Savings Account is a savings account that you can use to pay for medial related expenses. It can be funded by tax-exempt dollars by your employer, by yourself or by anyone else on your behalf. The funds in the HSA account can help pay for eligible medical expenses not covered by an insurance plan. This can include copays, deductible, coinsurance and prescriptions.

Who is eligible for a Health Savings Account?

In order to open and contribute to a HSA plan there are a few stipulations. You are eligible if you are:

•  Covered by a high deductible health plan (HDHP)
•  Not covered under another medical plan that is not an HDHP
•  Not entitled to (eligible for AND enrolled in) Medicare benefits
•  Not eligible to be claimed on another person’s tax return

What is a HDHP?

A high deductible health plan is a plan with a minimum annual deductible and a maximum out-of-pocket limit that is set by the IRS. These limits change annually but for 2021 the limits are as follows:

Type of Coverage                    Minimum Annual Deductible                    Maximum Annual Out-of-pocket
Individual                                      $1,400 for 2021                                             $6,900 for 2021
Family                                         $2,800 for 2021                                            $13,800 for 2021

So how does it work?

Your high deductible health plan does not provide co-pays when you visit a Dr or pharmacy. That leaves you to pay the total expense of the visit or the prescription. Your claims will still be ran through your insurance company and most will be re-priced at the negotiated price from your insurance company. You can then use the funds in your HSA account to pay for those expenses. Most HSA accounts will offer checks or debit cards to make paying bills easy. The important thing is to make sure you are using those funds for qualified medical expenses. If you use the money for non medical expenses you will be subject to additional taxes and penalties.
Click here to learn how your HSA works with Retirement.

HSA Contributions

You can make a contribution to your HSA each year that you are eligible. You can contribute no more than:

•  Single coverage: $3,600 for 2021
•  Family coverage: $7,200 for 2021
Individuals ages 55 and older can also make additional “catch-up” contributions of up to $1,000 annually.

A few more things.

Unlike other accounts, a HSA is not one that you have to use or loose by the end of the year. You can contribute money into this account and not touch it for years. It will just stay in the account until you need it. The IRS also puts yearly caps on how much you can contribute each year into your HSA. You can click here to learn more.

If you have additional questions, we are are happy to help! 








Important Information About Your Health Plan and COVID-19 Vaccine








On Dec. 12, 2020, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) recommended use of Pfizer Inc.’s COVID-19 vaccine for individuals 16 years of age and older. The Food and Drug Administration (FDA) approved the vaccine one day earlier.

The ACIP recommendation triggers the requirement for non-grandfathered group health plans and health insurance issuers to cover the vaccine without cost sharing. Grandfathered plans may choose to cover the vaccine, and could be required to do so under state law or applicable insurance policies.

Coverage of COVID-19 Preventive Care Services

Non-grandfathered group health plans, and health insurance issuers offering group or individual health insurance coverage, must cover coronavirus preventive services, including recommended COVID–19 immunizations, without cost sharing. During the COVID-19 public health emergency, covered services may be provided by in-network or out-of-network providers.

Coverage of these immunizations must be provided, even if not listed for routine use on the CDC’s Immunization Schedules. Plans and issuers subject to Section 2713 of the Public Health Service Act must also cover, without cost sharing, items and services that are integral to the furnishing of recommended preventive services, including immunization administration.

Coverage Effective Date

Under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), plans and issuers must cover the vaccine within 15 business days. It is widely understood that coverage of the COVID-19 vaccine must begin no later than Jan. 1, 2021. Plans and carriers may choose to cover the vaccine before this date. As additional forms of the vaccine are approved by the FDA and recommended by ACIP, they will be required to be covered as well.

Highlights:

  • Non-grandfathered group health plans and insurance issuers must cover coronavirus preventive services without cost sharing.
  • Preventive care services include recommended immunizations.
  • During the COVID-19 public health emergency, this coverage must be provided for both in-network and out-of-network providers.








5 Strategies You Need To Know To Reduce Benefits Costs In 2021

Reduce Benefits Costs








Reduce Benefits CostsHealth benefits costs are almost certainly going to rise in 2021. They’ve been trending upward for years—over 50% in the last decade, according to the Kaiser Family Foundation—and the current state of economic uncertainty over COVID-19 won’t slow things down. Realistically, after enduring months of business closures and managing exhausted workforces, many employers will be lucky to maintain uninterrupted operations.

That’s why it’s critical for employers to think about reducing health costs right now—figure out cost-effective benefits first so money can be shuffled as needed later. Having a solid plan going into 2021 will better position organizations facing limited budgets.
Here are five strategies employers should explore when looking to reduce benefits costs:

1. Dig Into Health Costs

Employers don’t let themselves overpay for the materials they use during production, so why is health care any different? Employers should look into every health care figure they can, from overall premium costs to individual employee expenditures. Understanding where money goes can help focus cost-cutting efforts.
For instance, if employees are going to the emergency room for every health visit, employers know they must promote more health literacy among their workforce.
Speak with Rinehart, Walters & Danner for details about digging into your health plan cost data.

2. Embrace Technology

The health care landscape of today is starkly different than the one of even a few years ago. Now, the name of the game is virtual health care or “telemedicine.” There are numerous ways for individuals to take charge of their health care without the hassle—and added cost—of in-person consultations.
For example, there is tech that can monitor glucose levels to help diabetic employees without test strips; there are virtual visits available for doctors, psychiatrists and other health professionals; and there are countless wellness apps that can help individuals make proactive health choices.

3. Consider Alternative Plan Options

Not every plan option will work for every organization. For years, PPOs were the standard, but now high deductible health plans with savings options are having their moment. These plans enable greater heath consumerism and put the decision-making power into employees’ hands. Employers should consider offering mechanisms like HSAs, FSAs and HRAs to help shift costs without compromising health care quality.

4. Require Active Enrollment

Some organizations allow employees to passively enroll in their health benefits. This may seem like a nice timesaver, but it can actually hinder employee health literacy. Instead, employers should require active enrollment among employees. This approach would force employees to review all their benefits options each year before making selections. Not only does this make employees consider important life events, it also affords them an opportunity to reevaluate the benefits they’re paying for and potentially not using. Ultimately, active enrollment can make employees wiser health care consumers, improve proactive health care and lower overall health expenditures.

5. Change the Funding Structure

Another, more drastic, cost-cutting strategy is changing how health plans are funded. Most organizations use a fully insured model, where employers pay a set premium to an insurance provider, but that’s not the only option. For some employers, self-funding, level-funding or reference-based pricing models may be more attractive solutions.

Let us help you review your options to reduce benefits costs

Suffice it to say, there are a variety of ways that employers can structure their health plans—even if that means requiring employees to seek insurance in the individual health market.

Whatever your needs, know that Rinehart, Walters & Danner is here to help. Contact us today to discuss your 2021 benefits and ways to reduce benefits costs.