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Impact of the No Surprises Act

General

The No Surprises Act (NSA) established new federal protections against surprise medical bills that took effect in 2022. Surprise medical bills pose financial burdens on consumers when health plans deny out-of-network claims or apply higher out-of-network cost sharing; consumers also face “balance billing” from out-of-network providers that have not contracted to accept discounted payment rates from the health plan. The federal government estimates the NSA will apply to about 10 million out-of-network surprise medical bills a year. 

This act will protect consumers from surprise medical bills by:

  • Requires private health plans to cover out-of-network claims and apply in-network costs. This law applies to job-based and non-group plans, including grandfathered plans
  • Prevents patients from receiving surprise charges and getting charged more out-of-network than in-network by doctors, hospitals, and medical providers

The NSA also institutes a procedure in the event of surprise out-of-network medical bills would lead to negotiations between plans and the providers. If those negotiations don’t succeed, then an independent dispute resolution (IDR) process would begin.

Federal protections now apply to most surprise bills in the following settings:

Emergency services– applies to emergency rooms, freestanding emergency departments, urgent cares, air ambulance transportation, however it doesn’t include ground ambulances

Post-emergency stabilization services– post-stabilization care equals emergency care until a physician determines the patient can travel safely to another in-network facility using non-medical transport, the facility is able to accept the transfer, and that the transfer will not cause the patient other unreasonable burdens. The NSA also requires patients to receive written notice and give written consent to transfer.

Non-emergency services provided at in-network facilities– the NSA allows non-emergency services by out-of-network providers at in-network facilities. The doctor working in the hospital will bill them independently and don’t participate in the same network as the hospital. The federal government estimates about 1.8 million in-network non-emergency hospital stays involve at least one out-of-network claim.

Doctors are not able to bill patients more than the in-network cost sharing for surprise bills. If they do, a penalty of up to $10,000 for each violation can apply. Some providers can ask their patients to waive their rights. They should not ask any patient if they are impaired or otherwise limited in their decision-making. Health plans, providers and facilities will most likely work in good faith to comply with NSA requirements. Even if compliance rates are high, with 10 million surprise medical bills annually, hundreds of thousands of problems could nonetheless arise. In such cases, it could fall to the consumer to recognize when surprise billing protections should apply and to seek help.

What can patients do in case of wrong doing?

Providers and facilities will most likely act in good faith with the No Surprises Act, although with an estimated 10 million surprise medical bills annually, there will no doubt be some issues. In some areas it could be up to the consumer to recognize surprise billing arise and seek help resolving them. The Affordable Care Act (ACA) helped establish state Consumer Assistance Programs (CAP) to aid privately insured consumers about their health coverage needs. The NSA gives consumers the opportunity to appeal health plan decisions that wrongly deny or apply out-of-network cost sharing to surprise medical bills to the health plan first, then if the plan upholds the decision, an external viewer will help resolve the claim.

The NSA was a big step making it easier for patients to get emergency care without being penalized for out-of-network care. To see what plans have your doctors in network, click here!

August 17, 2022
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Small Group Health Insurance Frequently Asked Questions (FAQ’s)

General

 

There are often many questions regarding the qualifications and specifics of small business health insurance (or group) policies. We want to provide some insight so you have the information pertinent to cover your employee’s health care needs.

How many employees do you need for a group policy?

Surprisingly you only need two employees including yourself to qualify for a group policy. This often means the owner and one full time equivalent employee, or common law employee, basically someone who works at least 30 hours weekly, and is not your spouse. If you have a small business with three employees and one isn’t your spouse, then you still may qualify for group coverage. In certain states, you may even qualify for a group policy with only 1 person. According to the Affordable Care Act (ACA) the maximum amount for small group coverage is 50 employees.

How do group insurance policies work?

These plans are purchased by organizations and companies, then offered to their members or employees. Plans can only be purchased by groups, meaning individuals cannot purchase this coverage. 70% participation is required for these plans to be valid. No two plans are ever the same due to many differences in insurers, types, costs, and terms and conditions. When a group or organization chooses a plan, the members or individuals are given the option to accept or decline the coverage.

What are the benefits of a group insurance plan?

The main advantage of a group plan is that it divides risk across a pool of individuals. This is beneficial due to the fact that it keeps the group member’s premiums low, and insurance companies can manage risk because they have a better idea of who they are covering. Insurers can gain even greater control over the costs through Health Maintenance Organizations (HMO’s), where providers contract with insurers to administer care to members.

HMO’s tend to keep costs low, with a pre-selected network of providers for your care. Preferred provider organizations (PPO’s) give the patient a wider choice of doctors and more access to specialists but tend to have higher premiums than an HMO.

49.6% of the U.S. population is covered by group health insurance. [1]

How Much Does Group Health Insurance Cost?

$7,400 is the average group health insurance policy cost for an individual annually. Employers pay approximately 80% and employees the other portion. Family policies averaged slightly more than $21,000. [2]

Is Group Health Insurance Required?

There is no law requiring small business owners to provide health insurance. However, the ACA made significant changes that small business owners should be aware of when deciding whether to provide insurance for their employees. 

Large companies may face penalties if they do not provide coverage under the Affordable Care Act. A small business will not be penalized if they have less than 50 full-time-equivalent employees. If you have at least 50 full-time-equivalent employees but none receive an individual premium tax credit or cost-sharing reductions (both based on income), there’s no penalty—whether or not you offer health insurance.

For more information, quotes, and enrolling your business in some of the nation’s best small business health benefits click here!

Works Cited:

  1. “Group Health insurance” www.Investopedia.com
  2. “2020 Employer Health Benefits Survey” KFF.org
July 28, 2022
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Benefits with U.S. Healthcare in a Post-Pandemic World?

General

The COVID-19 Pandemic utterly transformed the healthcare landscape worldwide. But as a U.S. citizen, you will enjoy the new conveniences afforded by these changes.

Before the Pandemic, telehealth had just begun to break ground, with the rise of popular apps such as BetterHealth making waves on social media.

But the world screeched to a halt when COVID-19 hit, including many health professionals usually available in person. Testing for COVID, treatment for the virus, and hospital emergency-only procedures took precedence over less urgent health concerns.

As the global shutdown continued, the world witnessed a virtual takeover. Everyone found themselves forced to go completely online and remote.

The change also affected healthcare professionals and their patients.

Telehealth began to boom, proving itself a Pandemic-proof industry.

Teladoc is one such leading corporation that skyrocketed exponentially. It especially saw success when the globe transitioned into the virtual space on a social and professional level. Many different types of business models (for example, the automobile industry) saw a dramatic decrease in sales. Meanwhile, companies like Teladoc that offer virtual services in a widely used industry enjoyed a massive spike in sales and new customers.

This trend shows the future of U.S. healthcare and how it will slide from in-person clinics and hospital offices to the home and digital space.

Gone are the days when doctors and medical practitioners would offer in-person-only services. The option to meet with your doctor in person or on a telehealth app is now a widespread phenomenon. More and more healthcare businesses are noting the trend towards offering out-of-office medical services, which means that you will have a broad range of options, regardless of what healthcare company you use.

How will these changes in the U.S. healthcare market affect you and your loved ones? How will it affect your business?

Selecting a healthcare provider now can be a bit more overwhelming since more and more companies are offering both virtual and face-to-face services. Finding out which insurance provider fits your financial needs the best is the first step to setting yourself up for future success in a post-pandemic world.

For information about finding the right healthcare plan for you and your family, call 855-522-2201 or Click Here!

June 15, 2022
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What You Need To Know Before Enrolling ACA

General
What You Need To Know Before Enrolling ACA

Is it your first time enrolling in an Affordable Care Act plan or are you re-enrolling? It may be confusing to change plans or just simply enroll, so we are here to help you figure out what it is that you need to know before purchasing. So what exactly is the Affordable Care Act (ACA) Open Enrollment? 

Open enrollment is the annual window during which individuals and families may sign up for ACA-compliant individual and family health insurance. Or, make changes to their existing coverage. Only during Open Enrollment can Americans sign up for a plan or switch to a different health plan.

For millions of Americans, this year’s open enrollment period vastly differed from past periods. More consumers than ever are now eligible for premium tax credits. The American Rescue Plan (ARP), made law in 2021, included subsidy enhancements that allow an unprecedented number of Americans to qualify for premium tax credits. Subsequently, this increases the amount of the subsidies.

Open enrollment for 2023 health coverage begins nationwide in November of 2022 and will continue through January of 2023.

Enrollments in most states needed to be completed by December of the calendar year in order to have a plan that took effect on January 1. Several states gave residents until December 31 to sign up for a plan with a January 1 effective date. In nearly every state, enrollments completed after December 15 but before the end of open enrollment had a February 1 effective date. However, there are some states such as DC, Kentucky and New York, where a March effective date. So, what should you do before your ACA enrollment to make the most of your options? Here’s a short list of things that you can do. 

Assess your salary for the coming year

Premium tax credits, or subsidies, are based on your adjusted gross income for the coming year. Assessing your income will help you figure out the amount of subsidies you qualify for and what plans best meet your budget and needs. 

Estimating your salary can also help prevent you from overpaying for your insurance.

If you end up making less than you guess, you’ll get back the difference you’re owed on your tax refund. 

Call doctors and check ACA provider directories

Insurance companies offer provider directories that make it easier to find in-network doctors, so be sure you check your current or new plan’s directory, especially if you’re keen on keeping a particular doctor. You can also call doctors’ offices to see if they’re still accepting a specific plan. You must confirm that your providers accept the plan and are in network before purchasing it. 

Check for new ACA plans in your region

Plans and prices change every year, and more insurance companies are offering coverage this year. This means that you have more options than you did in previous years, so you should take time to review them to shop for a plan.

Utilize subsidies around you

Affordable Care Act enrollees who make below certain income limits may qualify for cost-sharing reductions. These extra benefits lower your out-of-pocket costs (such as deductibles, out-of-pocket spending limits, and copays). But, they can be used only with a silver plan, Riggs says. The catch? Silver plans might have higher monthly premiums than other options (such as bronze-tier coverage). But you’ll usually pay less out of pocket when you use your silver coverage.

Visit us through Healthedly or give one of our agents a call to learn more about ACA enrollment. 

For more information on health insurance or healthy tips, visit us through Healthedly Insurance Services to learn more.

June 9, 2022
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Is The Answer To Saving the Earth in Lab-Grown Meat?

General
Is The Answer To Saving the Earth in Lab-Grown Meat?

Lab-grown meat, also known as cellular agriculture or cultured meat, is a promising solution for reducing the environmental impact of animal agriculture. Here are a few reasons why meat cultivated in a lab could help address climate change:

Fewer greenhouse gas emissions:

Animal agriculture is a significant contributor to greenhouse gas emissions, particularly methane and nitrous oxide. Lab-grown meat, on the other hand, could be created with a much lower carbon footprint.

Less land and water use:

Traditional animal agriculture requires vast amounts of land and water. Lab-grown meat, on the other hand, could get produced in a much more efficient and sustainable manner. Hence, potentially this type of meat would use a fraction of the resources required for traditional animal agriculture.

Lab-grown meat is better for animal welfare:

Scientists could produce lab-grown meat without the need for animal slaughter. This could improve animal welfare and reduce the ethical concerns associated with traditional animal agriculture.

Increased food security:

As the global population continues to grow, it will be increasingly important to find sustainable ways to produce food. Lab-produced meat could be an important part of the solution. It could be produced in a way that is both environmentally and economically sustainable.

Overall, lab-grown meat has the potential to significantly reduce the environmental impact of animal agriculture. This makes it an important solution for addressing climate change.

Are you seeking a health insurance plan that is affordable and fitting of your family’s needs? If yes, then Healthedly can be your solution! Our licensed agents will answer any questions you have about getting enrolled.

June 6, 2022
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FDA investigation: fresh strawberries could be linked to Hepatitis A outbreak

General
FDA investigation: fresh strawberries could be linked to Hepatitis A outbreak

The US FDA (Food and Drug Administration) is investigating a link between a hepatitis A outbreak and fresh organic strawberries.

The FDA with the US CDC, the Public Health Agency of Canada, the Canadian Food Inspection Agency and state and local partners, said the strawberries were branded as FreshKampo as well as HEB and purchased between March 5 and April 25.

Where did you purchase?

A number of retailers sold these strawberries, including Aldi, HEB, Kroger, Sprouts Farmers Market, Safeway, Walmart, Trader Joe’s, Weis Markets and WinCo Foods.

The potentially affected strawberries have exceeded their shelf life, but people who froze them to use later should not eat them.

If you do not remember where you purchased your strawberries, just discard them to be safe rather than sorry.

Seventeen hepatitis cases have been identified in California, Minnesota and North Dakota. Each of these cases have led to 12 hospitalizations. Traceback investigations show that cases in California, Minnesota and Canada reported having purchased the strawberries. An investigation continues into other organic produce products. People became ill between March 28 and April 30.

What do you need to look out for?

If you don’t know for sure if you already received a Hepatitis A vaccination, you think you have already consumed infected strawberries, and if you are now experiencing symptoms, the FDA recommends you consult your health care provider.

Hepatitis A symptoms typically appear 2-7 weeks after infection, and typically last less than two months. However, some people can be ill up to six months. Keep in mind that not all infected people become symptomatic.

Symptoms can include jaundice, lack of appetite, stomach pain or discomfort, vomiting, fever, light colored stools or dark urine, diarrhea, joint pain and lack of energy. Adults are far more likely than children to experience noticeable symptoms if they are infected.

For more information on health insurance or healthy tips, visit us through Healthedly Insurance Services to learn more.

Remember to use these resources for further information: 

  • ACA
  • Medicare
  • Group Health
  • Life 
  • Travel Health

June 3, 2022
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How fast you walk could be a sign of dementia

General

A new study involving a small test group of elderly subjects shows a link between mobility decline and memory issues. A possible cause maybe due to a shrinking in the right hippocampus. This part of the brain is associated with cognitive ability.

Dementia is not always indicated from all signs of mild cognitive impairment (MCI). Between 10% and 20% of people 65 or older with MCI develop dementia over the next year. In many cases, the symptoms of MCI may stay the same or even improve. “In many cases, the symptoms of MCI may stay the same or even improve,” the National Institute of Aging proclaims.

There’s also a much larger study of 17,000 adults over age 65 that shows people who walk about 5% slower or more each year. They also exhibit signs of slower mental processing were more likely to develop dementia. This study published Tuesday in the journal JAMA Network Open.

This new study over the course of 7 years tracked a group of Americans over 65 and Australians over 70. Every other year, the participants in the study tested to measure overall cognitive decline, processing speed, memory, and verbal fluency.

To determine the person’s typical gait, the study averaged together the results of two tests. They gave these tests every other year. They measured the time it took the subjects to walk 3 meters or about 10 feet in distance.

The research indicated the highest risk of dementia was for the individuals who walked slower and also declined cognitively.

A substantial component of decreasing cognitive decline involves aerobic activities and physical movement. This activates the hippocampus in the brain. Subsequently, this can lead to an increase in size on that part of the brain. Located in the temporal lobe, the hippocampus is responsible for tasks like remembering directions and spatial navigation.

In a 2011 randomized clinical trial, subjects who aerobically exercised increased the size of the of the hippocampus by 2%. This reversed age-related loss in the organ by one to two years. Comparatively, the subjects only doing stretching exercises had on average, a decline of about 1.43% over the same time frame.

For more information on health insurance or healthy tips, visit us through Healthedly Insurance Services to learn more.

Also, utilize these resources to help navigate what you’re looking for: 

  • ACA
  • Medicare
  • Group Health
  • Life 
  • Travel Health

May 31, 2022
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4 Benefits and 2 Drawbacks of Taking CBD Supplements

General

CBD, a non psychoactive cannabinoid, has gained traction in holistic circles and even among medical professionals in recent years. Proponents of CBD supplements boast of its benefits for your health. However, there are a couple of reported cons to taking it worth considering. Read on to learn four possible advantages and two drawbacks to taking CBD. 

Pros of taking CBD: 

Can ease pain and inflammation

Are you suffering from sore muscles or a migraine? CBD has properties in it known for reducing inflammation. Taking a CBD herbal supplement can do as good a job as common medications like ibuprofen or Tylenol.

Used as a calming supplement

CBD is swiftly becoming a popular calming supplement among holistic medicine users. If you have anxiety, ask your doctor about trying CBD.

Helps to manage weight since it is a shredding agent.

Studies show that CBD breaks down fat in the body and paired with regular exercise, can be a useful supplement for those looking to manage their weight.

Supports post-fitness recovery

Those who take CBD post-workout have claimed to experience beneficial results from this cannabinoid. Thus, athletes claim boosts in energy and reduced soreness when taking CBD.

Cons of taking CBD: 

Can cause nausea

This symptom doesn’t arise frequently. Nonetheless some people still suffer from an unsettled stomach after ingesting CBD. 

May cause a dry mouth

Some users report experiencing dry mouth after taking CBD supplements. This symptom does not often manifest, but reports of this side effect exist.

There you have it. CBD reportedly boasts more pros than cons, which should indicate its positive track record and beneficial attributes. Want to ask a medical expert about CBD and its possible benefits, but you aren’t sure who you can afford? Start by getting a free quote today to understand what healthcare you qualify for. 

May 27, 2022
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US is offering vaccines to certain people exposed to monkeypox. Here’s what you should know

General
US is offering vaccines to certain people exposed to monkeypox. Here’s what you should know

Is there a vaccine for this new virus?

There is currently no vaccine available specifically for monkeypox. However, people who have been vaccinated against smallpox may be protected against monkeypox. The viruses that cause the two diseases are closely related. The smallpox vaccine is no longer routinely given, as smallpox has been eradicated. However, it is still available for people who are at high risk of contracting monkeypox. For example, laboratory workers who work with the monkeypox virus qualify.

Please note that the smallpox vaccine is not recommended for the general public. This is due to the fact that it can have serious side effects, including fever, muscle aches, and a rash. The vaccine should only be given to people who are at high risk of contracting this virus. They must be fully informed about the potential risks and benefits of the vaccine.

What is Monkeypox?

Monkeypox is a rare viral disease that is similar to smallpox, but generally less severe. It is caused by the monkeypox virus, which is a member of the same family of viruses as the smallpox virus. This virus is found primarily in certain parts of Africa, and it is spread to humans through contact with infected animals, such as monkeys, rats, and squirrels.

Symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes, and a rash that starts on the face and spreads to other parts of the body. The rash eventually forms into bumps that become filled with fluid and then crust over. The disease can be severe, especially in people with weakened immune systems, and it can be fatal in rare cases.

There is no specific treatment for this virus, and no vaccine is available for it. The best way to prevent monkeypox is to avoid contact with infected animals and to practice good hygiene, such as washing your hands frequently.

Healthedly’s mission is to find the best possible health insurance for you, whether you are a business owner or seeking coverage for your family. Give us a call at 855-522-2201 to get a free quote and your questions answered about health insurance.

May 26, 2022
https://healthedly.com/wp-content/uploads/2022/08/Healthedly-Blog.png 900 1366 Jamie Thomas https://healthedly.com/wp-content/uploads/2022/06/Healthedly.svg Jamie Thomas2022-05-26 16:21:002023-01-05 12:35:01US is offering vaccines to certain people exposed to monkeypox. Here’s what you should know

US Birth Rate Finally Rises After Steep Drop Off in 2020

General
US Birth Rate Finally Rises After Steep Drop Off in 2020

The U.S. birth rate saw a steep drop off in 2020 due to the COVID-19 pandemic and its economic effects. However, recent data suggests that the birth rate may be on the rise again. This is an interesting development, as the U.S. has seen a long-term decline in the birth rate for several decades. In this blog post, we’ll explore the factors that may be contributing to the recent uptick in the U.S. birth rate and discuss the potential implications of this trend.

First, let’s take a look at some of the data surrounding the U.S. birth rate. According to the Centers for Disease Control and Prevention (CDC), the U.S. birth rate reached a record low in 2020, with 3.6 million births, the lowest number in 35 years. This represents a drop of 8% from the previous year, and the largest single-year decline in the U.S. birth rate since the government started keeping track in 1909.

There are several reasons why the U.S. birth rate dropped off in 2020. One major factor was the COVID-19 pandemic, which had a significant impact on people’s ability to have children. The pandemic disrupted fertility treatments and caused many potential parents to delay having children due to economic uncertainty and other concerns.

Additionally, the economic downturn caused by the pandemic likely played a role in the decline in the birth rate. The unemployment rate soared to its highest level since the Great Depression, and many people faced financial insecurity and uncertainty. This may have caused some people to delay having children or to decide not to have children at all.

However, recent data suggests that the U.S. birth rate may be on the rise again. The CDC reported that the number of births in the U.S. increased by 5% in the third quarter of 2021, compared to the same period in 2020. This marks the first increase in the U.S. birth rate in over a year, and it’s likely that the trend will continue as the economy recovers and the pandemic wanes.

So, what’s driving this uptick in the U.S. childbirth rate? It’s likely that a combination of factors are at play. One possibility is that people who delayed having children due to the pandemic and economic downturn are now starting to have them. This is supported by data from the CDC, which shows that the number of births to women in their 30s and 40s increased in the third quarter of 2021, while the number of births to women in their 20s declined.

Another factor that may contribute to the increase in the U.S. childbirth rate is the widespread distribution of vaccines against COVID-19. With more people being vaccinated, there is likely to be less concern about the risks associated with the pandemic. This may make some people feel more comfortable about having children.

It’s also possible that the rise in the U.S. childbirth rate is due to changes in societal attitudes toward children. In recent years, there has been a growing trend towards having smaller families or not having children at all. However, it’s possible that the pandemic and economic downturn may have caused some people to reconsider their decision not to have children. Hence, this led to an increase in the childbirth rate.

There are a few potential implications of the recent increase in the U.S. childbirth rate. One is that it could lead to a baby boom similar to the one that occurred after World War II. This could have significant economic and social consequences. It could lead to an increase in demand for childcare and other family-related services.

Another potential implication? The increase in the U.S. birth rate could lead to an increase in the overall population of the U.S. This could have both positive and negative consequences. On the one hand, a growing population could lead to increased economic growth and development. On the other hand, a larger population could also put more strain on natural resources and the environment. This could exacerbate issues such as overcrowding and pollution.

In conclusion, the U.S. birth rate saw a steep drop off in 2020. This is due to the COVID-19 pandemic and its economic effects. However, recent data suggests that the birth rate may be on the rise again. This is likely due to a combination of factors such as people who delayed having children starting to have them. Or, it could be due to the widespread distribution of vaccines, and changes in societal attitudes toward having children. The increase in the U.S. birth rate could have significant economic and social implications. This includes the potential for a baby boom and an increase in the overall population of the U.S. It will be interesting to see how this trend develops in the coming years. If you are expecting and in need of insurance coverage, visit Healthedly.com or call 855-522-2201 for more information.

May 25, 2022
https://healthedly.com/wp-content/uploads/2021/02/Healthedly-Blog.png 900 1366 Jamie Thomas https://healthedly.com/wp-content/uploads/2022/06/Healthedly.svg Jamie Thomas2022-05-25 15:37:272023-01-05 12:43:44US Birth Rate Finally Rises After Steep Drop Off in 2020
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