UnitedHealth leaving all but a ‘handful’ of public health insurance exchanges.


Checklist for Millennials Buying Health Insurance for the First Time.

Reaching the age of 26 is a new benchmark for Millennials, as they mark a new rite of passage of buying health insurance for the first time.

Gen Y-ers lose health insurance coverage under their parents’ plan once they turn 26 and must seek an individual plan, which is mandated by the Affordable Care Act (aka Obamacare).

Becoming 26 years old is counted as a qualifying life event under the ACA, and Millennials have a 60-day time period to research and purchase a health insurance plan. Millennials are required by law to buy their own coverage or face paying the tax penalty of $695 per adult or 2.5% of your taxable income in 2016, whichever is greater.

“Your parents have the option (not the obligation) to keep you enrolled in the family health insurance plan until you turn 26,” said Nate Purpura, vice president of consumer affairs at eHealth.com, an online health insurance exchange based in Mountain View, Calif. “Once you reach that age, however, you’re on your own when it comes to health coverage.”

You can also enroll during the nationwide open enrollment period, which began on November 1 and will continue through January 31, 2016. Millennials who are shopping now for their first health insurance plan should check to see if they qualify for government subsidies and follow these other guidelines.

All Plans Offer Free Preventative Care

One of the mandates of the ACA is that every single plan must include free annual checkups from your doctor, the flu shot and other important vaccines, said Noah Lang, CEO of Stride Health, the San Francisco health insurance exchange company. The preventative care is the same regardless if you buy a bronze, silver or gold plan.

“If you never see the doctor for anything but preventive care, you’re effectively getting the same coverage whether you have a bronze or a gold plan,” said Purpura. “However, if you get sick or need to pick up prescription drugs, you’ll find that your coverage is not the same. That’s where higher metal level plans show their value.”

Qualifying for Subsidies

One major caveat – if you wind up earning more money than what was estimated, save up some money to pay it back next spring when you are filing for taxes.

“Your subsidies will be based on the money you actually earn during the year you’re receiving subsidies, so be careful not to underestimate your income or you could end up paying some of your subsidies back at tax time.


Everything You Need to Know About the New Health Tax Form So You Don’t Get Fined.


7 tips for lowering your medical bills— even if you have health insurance.

Having insurance may make it easier to get health care, but that doesn’t always translate to medical bills you can afford. High deductibles, copayments and coinsurance mean some people are avoiding medical care altogether to save money. But regular medical care is important, and you shouldn’t have to sacrifice your health to save money. By tackling your health care strategically, you may be able to avoid that tough decision.

More than 90 percent of Americans have health insurance, leaving 29 million still without coverage, according to the latest data from the federal government. But in a 2014 Associated Press survey of insured adults, one in four said they were not confident they could afford care if they or someone in their family had an unexpected medical need.

If you fear that a future medical expense may too steep, the following steps may help:

1. Find the right plan.

Saving on health care begins with selecting the right insurance plan. Consider how much the monthly premium will cost, but don’t choose your plan based on that factor alone. Instead, evaluate all of your options.

A plan that trades lower premiums for higher out-of-pocket cost — like a high deductible health plan (HDHP)— may make sense for someone with relatively few expected medical needs. Someone with a chronic condition, however, could save more with a plan that has higher premiums and lower deductibles, copays and coinsurance, as he or she will be going to the doctor more often.

Consider your medical needs for the coming year, and use them to estimate how much you’d spend with a few different plans.

2. Visit only in-network providers.
Insurance plans contract with groups of doctors and facilities to form a network that offers lower rates for members. When you use providers within that network, your care is covered at a higher rate. If you venture outside, you’ll have to pay more.

For example, one visit to an in-network family doctor for acute illness could result in a $35 copay, with your insurance picking up the remainder. A visit to an out-of-network doctor for that same illness could cost about $150, or the entire billable cost.

Always check your insurer’s website and search for doctors under your specific plan’s network.

3. Take advantage of FSA and HSA offerings.
Flexible spending accounts (FSAs) and Health Savings Accounts (HSAs) can help you budget for medical expenses while providing tax benefits. If your employer offers one, sign up. When deciding how much to contribute, estimate your medical expenses for the year and go from there. If you have a deductible, set aside at least that much.

A few important points:
● FSAs are— with few exceptions— “use it or lose it” accounts, so estimate your contribution carefully because if there are funds left at the end of the year, you may lose that money.
● HSAs are only available for people with qualifying high-deductible health plans. If you have such a plan, but your employer doesn’t offer an HSA, you can open one yourself through an outside financial institution.
● Unlike FSAs, an HSA is your account and the balance can be carried over from year to year, and even follow you as you change jobs.

READ MORE: What Exactly Is an HSA?

4. Know what’s covered under free preventive care.
Under the Affordable Care Act (ACA), insured Americans are allowed certain free preventive services and screenings. These include immunizations and screenings for some types of cancer. Take advantage of this care because it can help you stay healthy and save you money.

READ MORE: What’s Covered Under the ACA’s Free Preventive Care?

5. Save on prescription drug costs.
Prescription drugs can be a major expense, particularly if you need recurring prescriptions.

Save on your medication costs by:
● Choosing generics over brand names whenever possible.
● Asking about a therapeutic alternative when your doctor recommends a brand name with no generic available.
● Asking your doctor for samples.
● Visiting the drug maker’s website for coupons or patient assistance programs.
● Getting your medicine in larger doses and splitting the pills.
● Refilling multiple months at a time.

A money-saving example: A one-month supply of the cholesterol drug Crestor could carry a $65 copay under some plans if a generic is not available. A one-month supply of Zocor— a different brand-name drug that treats the same condition— would cost $215, as insurance wouldn’t cover the brand name because there is a generic available. The cost of a one-month supply of simvastatin, the generic version of Zocor: $15 copay.

READ MORE: How to Save on Prescription Drug Costs

6. Negotiate high medical bills.
When you receive a medical bill, don’t automatically accept the balance as the final amount due. Contact the provider’s billing office to ask if they can reduce the cost. If the person on the phone won’t offer to lower the bill, ask to speak with a supervisor. Also, ask if a monthly payment plan is possible to make the bill more manageable.

READ MORE: A Guide to Negotiating Your Own Medical Bills

7. Carry lessons into the next year.
You may find the plan you chose for this year wasn’t the best for your situation. Make sure you learn from your experience and choose a more suitable plan during your next open enrollment period

How to keep 2016 health insurance premiums in check.


Two more Obamacare health insurance plans collapse.


Co-Pay? Deductible? Premium? What Does it all Mean? Health Plan Terms to Know Before you Choose a Plan.

Co-Pay? Deductible? Premium? What Does it all Mean? Health Plan Terms to Know Before you Choose a Plan

Whether you are familiar with health plans or are shopping for one for the first time, deciphering different plans cans be confusing. Understanding the right terms is especially helpful when considering which plan is right for you, as many have cost implications associated with them. Here’s a rundown on the terms you’ll need to know to keep it all straight:

Affordable Care Act (ACA): The federal healthcare reform law passed in March 2010. Also known as Obamacare or healthcare reform.

Allowable charge: Also referred to as an ‘allowable amount’. The negotiated amount for which an in-network provider agrees to provide services. This amount is usually lower than the amount you would pay for the same service if you did not have health coverage.

Coinsurance: Your share of the fee for a service after you’ve met your deductible and before you’ve reached your out-of-pocket maximum. If your plan’s coinsurance share is 20%, you pay 20% of the allowable charge, and your plan pays the other 80% of the allowable charge.

Copay: A flat fee you pay at the time of service, such as an office visit. Copays apply toward out-of-pocket maximum.

Cost shares (or out-of-pocket costs): Costs that you pay for out of your own pocket for medical services, even if you have health coverage. Cost shares include deductibles, copays, and coinsurance.

Covered in full: Services your health plan pays for in full, at 100% of the allowable charges, and not subject to your deductible or coinsurance. For example, most preventive care is covered in full by many health plans.

Deductible: The amount you pay every year before the plan begins to pay for most services. This is similar to the deductible you pay for your car or homeowners insurance.

Exchange or marketplace: Another way to shop for health insurance, with a government (state or federal) website where you can compare plans from multiple companies and find out if you qualify for financial assistance. You can purchase your health coverage through the exchange or directly from Premera.

Formulary: A list of drugs for specific uses that the health plan covers.

Health savings account (HSA): Certain plans with higher deductibles allow you to open a special savings account to pay for many of your health care expenses. The money contributed to your account, by you or your employer, is not subject to federal income taxes when used for allowable healthcare costs, so the accounts offer tax advantages to some people. You generally have higher cost shares with these types of plans, so you should make sure you understand how they work before you consider them.

Network: A group of doctors, dentists, hospitals, and other healthcare providers that contract with your health plan to provide healthcare services at negotiated amounts, which are called allowable charges. Your costs are almost always lower when you get care from in-network providers.

Open enrollment period: The annual time period when you can apply for a new individual health plan or make changes to your current health plan. The open enrollment period for 2015 individual coverage is November 15, 2014 through February 15, 2015. If you experience certain life events, such as getting married, having a child, moving, or losing your employer’s health coverage, you can apply for coverage outside these dates.

Out-of-pocket maximum: A preset limit after which your plan pays 100% of the allowable charge.

Preferred provider organization (PPO): A health plan contracts with specific medical providers, such as doctors and hospitals, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network. You can use providers outside of the network, but you’ll pay a greater share of the cost.

Premium: The amount you and/or your employer pay (usually each month) for health coverage, regardless of whether you use any medical services.

Primary care physician (PCP): Your main or regular doctor or other healthcare provider. Some plans offer lower office visit copays if you notify them of your designated PCP.

Producer: A person or business that can help you shop for and choose health coverage. Often referred to as a broker or agent.

Individual Health Insurance

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