Here’s a fast-fact for you on 2018 Mental Health Awareness Day: ALL ACA-compliant health insurance plans MUST contain mental health benefits. That’s a fact. 

Healthcare reform (a.k.a. Obamacare, a.k.a. the Affordable Care Act) required that “ACA qualified health insurance plans” MUST contain “essential health benefits.” One of these essential health benefits is access to mental healthcare.

Here’s what you should know about which health plans MUST contain mental health benefits:

  • follow site Individual & Family Plans: if you purchase an individual/family plan from the health insurance marketplace, or directly from an insurance company, these plans http://tracychristensen.com/portfolio/carousel/tracy-christensen-costume-design-carousel-english-national-opera-2017-sm-8/ MUST contain mental health benefits.
  • Small Employer Health Plans: nearly all small employer plans usually contain mental health benefits. The size of a small employer is defined state-by-state. Many states recognize a small employer as a company with less that 50 full time equivalent employees. Some states recognize a small employer as a company with less than 100 full time equivalent employees.
  • i want to buy methotrexate Large Employer Health Plans: large employer health plans (usually employers with over 100 employees) are not required to contain mental health benefits, however MOST do. Make sure to do some research into your plan, to see what kind of mental health benefits are included.
  • Self Funded Health Plans: self funded health plans are NOT required to contain mental health benefits, but again, MOST of them do. Self funded plans are most typically provided by large (to very large) employers (examples: state employees, hospitals, very large corporations, etc). If you have a self funded plan, make sure to check whether-or-not you have access to mental health benefits.

In conclusion, mental health benefits can be IMPORTANT. There is a reason that they are contained in MOST health insurance plans. On Mental Health Awareness Day, we want to raise awareness that you most likely have access to these kinds of important “essential benefits.” For questions regarding individual and employer health insurance in the state of California, contact us anytime. 

Thanks for stopping by, we hope you found our information to be helpful. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.PolicyAdvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

YouTube: http://www.youtube.com/PolicyAdvantage

Pinterest: http://www.pinterest.com/PolicyAdvantage

Word Press: http://www.policyadvantage.wordpress.com

Here’s the down-low on “short term” health insurance plans in California. Short term health insurance plans were used as an alternative to “Obamacare” (ACA) plans if someone needed coverage for a short period of time (previously less than 3 months, and more recently, less than 12 months).

People who missed the individual and family plan open enrollment could enroll in these plans at anytime throughout the year. Additionally, people who were trying to “bridge a gap” in coverage (example: going from an employer plan to an individual plan, or an employer plan to a NEW employer plan), could utilize these short term plans to cover themselves during that period of time.

Short term health insurance plans are able to exclude certain benefits that “Obamacare” plans are required to contain (these requirements are called “essential health benefits”). For example, a short term health insurance plan can exclude things like maternity, mental health benefits, and can also utilize pre-existing condition exclusions when underwriting the plan. For these reasons, short term health insurance plans have a tendency to be much less expensive than “Obamacare” plans.

Recently, the Trump Administration officially released HHS/DOL guidance that expanded access to these plans nationwide, allowing people to participate in them for up to three years (instead of under 12 months). Also, the federal tax reform bill passed in December of 2017 removed the requirement for individuals to have health insurance, or pay a tax penalty. For these two reasons, there was anticipated to be MUCH more participation in short term health insurance plans, nationwide. 

However in 2018, California legislators recently passed S.B. 910, a bill that banned short term health insurance plans in the state ENTIRELY, starting on January 1st, 2019. The argument is that these short term plans are “junk plans” because they do not include the comprehensive “essential health benefits” that “Obamacare” plans ARE required to contain, as described previously in the blog post. Additionally, it’s the consensus that legislators would like to maintain participation in the state’s “Obamacare” (ACA) marketplace, in order to keep rates/premiums more stable.

Residents of California will have three choices in the individual marketplace in 2019:

  • Participate in an Obamacare/ACA plan individually, or at Covered California.
  • Find an alternative option to health insurance, like a health ministry plan, or an association health plan (if eligible).
  • Go uninsured (because there is no tax penalty anymore).

For further assistance finding affordable options in the state of California, be sure to contact us. We’ll put a comprehensive consultation together for you, so you’re able to see what health plan options are available in your zip code. Our recommendation is always to not go uninsured, when it comes to your health.

Thanks for stopping by, we hope you found our information to be helpful. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.PolicyAdvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

YouTube: http://www.youtube.com/PolicyAdvantage

Pinterest: http://www.pinterest.com/PolicyAdvantage

Word Press: http://www.policyadvantage.wordpress.com

 

 

PolicyAdvantage.com is proud to announce that we offer Oscar Health Insurance individual and family plans in San Francisco. PS: “O” is for OSCAR in the blog post image.

These plans are available to individuals, families, single parent families, and individual children under the age of 18. Additionally… plan information, health insurance applications, and access to a California licensed agent are all available online at PolicyAdvantage.com.

This groundbreaking, high-demand, hi-tech health insurance product is “trending” with our current individual & family plan clients. We’ve been offering Oscar Health plans to our individual and family members since 2015 in select areas of California (available direct through Oscar Health, and also through the state health insurance exchange Covered California).

Oscar Health Insurance offers a variety of “features” within their plans that are unlike many other health insurance companies. Some of these features include:

  • Your personal, dedicated concierge team of four members, which includes a nurse. These members can help you navigate anything from selecting proper healthcare services, to managing billing.
  • A proprietary Oscar App that can help you find the information you need about your health plan.
  • Simplified, smart health insurance that is “policyholder-centric” and easy to understand.
  • High quality, world-class hospital networks, with an easy-to-use Oscar doctor search tool.
  • An affordable EPO (Exclusive Provider Network), that gives you convenient access to specialists in the Oscar network, without a need for a referral. AFFORDABLE: Oscar is currently one of the more affordable insurance plans available.

This is an exciting, value-added, high quality product that we are very pleased to be offering to our individual and family plan clients at PolicyAdvantage.com.

Individuals and families in San Francisco: contact us to improve your current coverage, and possibly save money. Our agents at PolicyAdvantage.com are ready to help. Quotes and info are easy to get. Phone: 1(800) 617-0089, Email: info@policyadvantage.com. Or visit our contact page here:www.PolicyAdvantage.com/Contact.

Don’t miss these very good info-graphics about Oscar Health Insurance, available exclusively to our clients and followers in .PDF format (click to see forms):

Oscar_California_IndividualAndFamilyPlanOverviews

OscarConciergeTeam

FindingADoctor_AtOscar

Access to affordable prescriptions can be very important. Prescription drug coverage is a common necessity. You may have a simple cold and need an antibiotic, or, you may require expensive, on-going specialty or brand-name drugs that treat chronic illnesses. Whatever the situation, many people need to utilize prescription drug coverage often.

As a result, people have a tendency to “shop” extensively for their prescription drug coverage, when they need it. This is especially true if you’re paying cash, out-of-pocket, or have a large co-pay or cost-share for prescriptions. 

If you’re someone who’s shopping for prescriptions, www.GoodRx.com NEEDS to be your new best friend. With a simple search at their website for the drug you need, you can find discounted prices of 20%, 50%, 80%, and even MORE sometimes. For example, the estimated regular cash price for generic Zocor (which treats cholesterol) is $47.00 per 30 day supply. When you use a Zocor voucher from GoodRx.com, the cost is reduced to $4.80 per 30 day supply.

GoodRx truly does save the consumer (you) money, and it REALLY works. Simply print out your coupon/voucher at GoodRx.com, and present it at your local applicable pharmacy when you fill your prescription.

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.PolicyAdvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

YouTube: http://www.youtube.com/PolicyAdvantage

Pinterest: http://www.pinterest.com/PolicyAdvantage

Word Press: http://www.policyadvantage.wordpress.com

PolicyAdvantage.com is proud to announce that we’re now offering small group health insurance plans (1-100 employees) from Oscar Health Insurance, as of June 1st, 2018. These plans will be available to small groups in Los Angeles & Orange County.

This groundbreaking, high-demand, hi-tech health insurance product is “trending” with our current individual & family plan clients. We’ve been offering Oscar Health plans to our individual and family members since 2015 in select areas of California (available through the state health insurance exchange, Covered California).

Now available for businesses, Oscar Health Insurance offers a variety of “features” within their plans that are unlike many other health insurance companies. Some of these features include:

  • Your personal, dedicated concierge team of four members, which includes a nurse. These members can help you navigate anything from selecting proper healthcare services, to managing billing.
  • A proprietary Oscar App that can help you find the information you need about your health plan.
  • Simplified, smart health insurance that is “policyholder-centric” and easy to understand.
  • High quality, world-class hospital networks in both Los Angeles (UCLA Health, plus others), and Orange County (Hoag, plus others). See our .PDF attachments at the end of this article.
  • An affordable EPO (Exclusive Provider Network), that gives you convenient access to specialists in the Oscar network, without a need for a referral. AFFORDABLE: Oscar is currently one of the more affordable small group health plans available. 

We are now quoting for small businesses as of June 1st, 2018, going forward. This is an exciting, value-added, high quality product that we are very pleased to be offering to our small group clients at PolicyAdvantage.com. 

Small businesses in LA & OC: contact us to improve your current coverage, and possibly save money. Our agents at PolicyAdvantage.com are ready to help. Quotes and info are easy to get. Phone: 1(800) 617-0089, Email: info@policyadvantage.com. Or visit our contact page here: www.PolicyAdvantage.com/Contact

Don’t miss these three very good info-graphics about Oscar Health Insurance, available exclusively to our clients and followers in .PDF format (click to see forms):

About_Oscar_LA_OC

About_Oscar_For_Business

LA_OC_OscarHealth_HospitalList

FindingADoctor_AtOscar

 

 

So you’re passionate about… TRAVEL. We hear you, travel bloggers. And that’s why we’ve put together a portfolio of TOP world-wide, affordable health insurance products for you. They can help you cover your health while you’re globe-trotting. 

We know you like the fun stuff: the pictures, the food, the “must see” tourist destinations, and those OH-SO outstanding “off-the-beaten-path” gems that must be seen. You’re working hard, and sharing those outstanding travel tips and experiences to a global audience. BUT… have you ever thought about the importance of your health while you’re on the go?

Your health is IMPORTANT while you travel. Accidents can happen. Maybe you fall ill. In certain instances, you might even need a medical evacuation. Are you prepared? PolicyAdvantage.com is happy to tell you that we’ve got you covered by HIGH QUALITY mobile travel health insurance plans, that will cover you while you make your rounds throughout the world. All for a few dollars a day. These companies include:

  • Cigna Global
  • Anthem GeoBlue
  • IMG Global
  • Allianz Worldwide Care

The BEST part? You can get information, brochures, talk to a licensed insurance agent, and apply for coverage ALL online at our website. Start by visiting PolicyAdvantage.com/NorthAmerica (for travel bloggers with a passport from a country in North America). From here, you can run your own personal quotes, and get information. Need help from an agent? Click the chat box on the lower right hand side. We’re on it for you.

EUROPEAN expats: we’ve got you covered too. Visit PolicyAdvantage.com/Europe, and do the same as above. We can cover European expats from MOST European countries (mainland, and others). Have a question? Hit-up our chat agents.

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.PolicyAdvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

YouTube: http://www.youtube.com/PolicyAdvantage

Pinterest: http://www.pinterest.com/PolicyAdvantage

Word Press: http://www.policyadvantage.wordpress.com

Renewal for 2017 individual health insurance plans is just around the corner, and you’ve probably noticed that your rates might be increasing quite substantially next year. For example, in California alone, individual health insurance policies are expected to rise more than 13% in 2017 (that’s 3 times the increase over the past two years).

So… why is this happening? And… what can you do about it? To answer the first question: healthcare reform is a big part of the reason your rates are going up. We’ll explain what you can do about it later in this article.

In case you’re not familiar, changes to the individual health insurance marketplace were at the core of Obamacare. There were a number of different provisions that went into place, but the two big ones were:

  • A) Guaranteed Issue,
  • And B) Essential Health Benefits.

“Guaranteed Issue” is the requirement that if you apply for health coverage, you have to be accepted. In other words, if you have a preexisting condition, you cannot be denied coverage. Since this concept took effect on January 1st of 2014, thousands and thousands of people with existing health conditions have enrolled in individual health insurance plans nationwide. Many of these people have had a substantial need for various treatments: prescription drug coverage, surgeries, hospitalizations, and other kinds of medical services. As a result, costs to the insurance companies have gone up, and those costs are now finally catching-up to the consumer (you) in the form of premium increases.

Additionally, “Essential Health Benefits” are new benefits that are now mandated by Obamacare, and must be included in all individual health insurance policies. Prior to 2014, individual health plans were not required to include these “essential benefits” (examples: things like maternity, mental health benefits, and others). As a result, the addition of these benefits has caused prices to increase because there are more health services that need to be covered.

Given the combination of the two concepts listed above, we’re now starting to see substantial increases in premiums in 2017, in order to conform. In fact, in many cases, the cost of providing healthcare services under healthcare reform has been more than what was originally anticipated. As a result, certain insurance companies throughout the country have decided to exit the health insurance exchanges altogether, because of heavy financial losses.

So what can you do if your individual/family health insurance plan is increasing this year? Here are some ideas:

  1. Shop. Make sure to take a good look at all of the available options within your zip code this year. There may be new (and/or alternative) plans available in your area that can save you money. Find a good health insurance broker who can assist you.
  2. Leverage the Strength of Small Business Plans. If you’re a small business owner (especially a SMALL business owner of like 2-3 employees), consider setting up a small group health insurance plan with your partners so you can exit the individual marketplace. Small group plans are not seeing price increases at nearly the same rate as individual plans. One big reason why, is that small group plans haven’t been affected as much by having to “on-board” so many people with preexisting conditions like the individual marketplace has. You could reduce your costs substantially with this strategy.
  3. Consumer Direct. Consumer directed healthcare is when you participate in a higher deductible plan, and then pair it up with an HSA (Health Savings Account). This can help you lower your premium, and then retain funds in your HSA that would normally go to the insurance companies.
  4. Look into the “Little Guy” Insurance Companies. In California (especially Southern California), there are many smaller regional insurance companies that are participating on the Obamacare health insurance exchange. In many cases, these smaller insurance companies are actually thriving under the conditions created by healthcare reform. You might be pleasantly surprised that the prices, service, and plans are actually pretty good. Check with your broker for local recommendations.
  5. Don’t Panic. 2017 could be the “big year” for price increases, and they may stabilize again next year. Just because there are big increases this year, doesn’t necessarily mean there will be again next year. If your increase this year is manageable (ie: not breaking the bank) and you like your current plan, consider sticking with it for another year. You can always change it next year.

Be sure to contact us at PolicyAdvantage.com if we can assist you with your current individual health plan this year (Phone: 800-617-0089, Email: info@policyadvantage.com). We may have recommendations that can help you improve coverage and save money. 

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.PolicyAdvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

YouTube: http://www.youtube.com/PolicyAdvantage

Pinterest: http://www.pinterest.com/PolicyAdvantage

Word Press: http://www.policyadvantage.wordpress.com

 

 

 

RXPrescription drug coverage in health insurance plans can sometimes be confusing. We’ve put together a simple, short guide that outlines the four “tiers” of prescription drug coverage found in most individual health insurance plans, so that you can understand your options better. 

Most individual health insurance plans will have four (4) different tiers of prescription drug coverage. It’s important to understand the difference between these four tiers, and how the deductibles and co-payments work within them. 

We’ll briefly explain the different tiers, and how they function. Keep in mind that this is just a general overview, and if you have questions about your specific plan, contact us. *Remember: most individual health insurance plans will contain these four tiers of coverage. Here are the four tiers:

  1. Tier 1 Prescription Drugs: these are usually what are called “generic” prescription drugs. They typically have the lowest co-payments, and most of the time there is not a deductible involved. 
  2. Tier 2 Prescription Drugs: these are what are called “preferred brand name” prescription drugs. This tier moves out of generic prescription coverage, and into brand name drugs. “Preferred” means that they are preferred by the insurance companies because of their lower cost. Certain generic drugs can also sometimes be included in this tier. Co-payments are usually higher (compared to tier 1 generic drugs), and sometimes there is an additional annual deducible involved (depending on your plan).
  3. Tier 3 Prescription Drugs: these are usually referred to as “NON preferred brand-name” prescription drugs. They are considered higher cost pharmaceuticals, and are therefore “non preferred” by the insurance companies. Many times, your insurer will try to find alternatives in the lower two tiers. Co-payments are usually higher, prior authorizations (doctor approvals) are more prevalent, and sometimes there are additional deductibles involved. Certain specialty drugs (Tier 4 drugs) can also be included in this list. 
  4. Tier 4 Prescription Drugs: these are usually what are called “specialty” prescription drugs. They are considered the highest-cost pharmaceuticals, and are most often highly expensive specialty drugs. Prior authorizations (doctor approvals) are highly prevalent, and cost-sharing is the highest. Typically there is what is called co-insurance at this point, where you pay a percentage of the entire cost of the drug, and the insurance company pays the remainder. 

Prescription drug coverage is an important concept to understand. Having a good handle on the concepts above can help you improve coverage, save time, and save money.

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.PolicyAdvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

YouTube: http://www.youtube.com/PolicyAdvantage

Pinterest: http://www.pinterest.com/PolicyAdvantage

Word Press (you are here): http://www.policyadvantage.wordpress.com

EROne of the biggest questions we get at Policy Advantage Insurance Services is:

  • What’s the difference between the Emergency Room (ER) and the Urgent Care Center?

This is an important question for everyone to understand, because there are big differences between the two when it comes to treatments and costs.

Here’s when you should go to the Emergency Room (ER):

If a medical condition is life or limb threatening, and involves severe wounds or amputations.

These are examples of reasons you may need to visit the Emergency Room:

  • Signs of stroke
  • Severe shortness of breath
  • Poisoning
  • Signs of heart attach/chest pain
  • Severe wounds or amputation
  • Coughing up or vomiting blood
  • Suicidal or homicidal feelings

Here’s when you should go to the Urgent Care Center:

If a medical condition is NOT life or limb threatening.

These are examples of reasons you may need to visit the Urgent Care Center:

  • Stomach bugs (flu)
  • Fever
  • Sprains
  • Dislocations
  • Minor cuts (stitches)
  • Minor broken bones

At an Urgent Care Center, you can receive prompt treatment for your minor injury or illness, and the costs (co-payments) are much less expensive than the Emergency Room. 

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.policyadvantage.com

Twitter: http://www.twitter.com/policyadvantage

Facebook: http://www.facebook.com/policyadvantage

YouTube: http://www.youtube.com/policyadvantage

Pinterest: http://www.pinterest.com/policyadvantage

Word Press (you are here): http://www.policyadvantage.wordpress.com

At Policy Advantage Insurance Services, we specialize in helping small businesses when it comes to their health benefits planning. Here’s why:

  • Many times, small businesses don’t have a Human Resources Department to help them sort-out their employee benefits. Therefore, small business owners can end up spending a lot of time and energy researching all the different options and planning strategies. At PolicyAdvantage.com, we can do the “heavy lifting” for you. We’ll put together a custom program tailored to your fit your budget and necessities.
  • With the onset of healthcare reform, there are now many additional options when it comes to health coverage… and many of them are geared towards small businesses. At PolicyAdvantage.com, we know (and understand) how the health insurance industry works. We have broad-based and in-depth knowledge about what programs are available, and how you can put these pieces together to fit your business best.
  • Lastly… we like to help our clients grow and improve. Outside of just health coverage, we know that employee benefits can add a lot of value to an organization. We take great pride in taking good care of your employees, and helping them find the benefits they want or need. We want to help you attract and retain the quality employees that are going to take your business to the next level.

If you’re an employer between 2 to 50 employees, we want to talk with you. There’s often a misinterpretation that brokerages are looking for the “big fish” clients… not-so at PolicyAdvantage.com. We can’t wait to help you improve your small business. For a free consultation, please contact us at our dedicated customer service line: 1(800) 617-0089, or shoot us an email at info@policyadvantage.com.

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.policyadvantage.com

Twitter: http://www.twitter.com/policyadvantage

Facebook: http://www.facebook.com/policyadvantage

YouTube: http://www.youtube.com/policyadvantage

Pinterest: http://www.pinterest.com/policyadvantage

Word Press: http://www.policyadvantage.wordpress.com