Tag Archives: health insurance

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How Do I Get Health Insurance for my Child?

people, family, love and harmony concept - happy mother and daugOne question that I get asked periodically is, “How do I get health insurance for my kids?” This particularly comes up during pregnancy when parents start thinking ahead to the birth of their baby.

Getting health insurance for your kids doesn’t need to be complicated. You will usually go to your own health insurance company and add them to your plan.

If you receive your health insurance through your employer, you can go to your human resources department and add the child to the health plan when the child is born. If you are receiving health insurance from another carrier, you will contact the company directly to add your child to your health plan.

If you don’t have insurance (remember: under current regulations, everyone should) or can’t insure your child on your plan, the next place to look is Medicaid. Medicaid offers a Children’s Health Insurance Program, aptly named CHIP. It offers early and periodic screening, diagnostic, and treatment, just as other health plans do.

There are income restrictions for CHIP, however, so if your income doesn’t qualify you, then you’ll want to go through the health exchange (that is, Obamacare) to get your kids insured.

One standard that Obamacare brought with it, which now applies to most health plans, is that parents can keep their children on their health plan until the age of 26, as long as the child is enrolled in school.

This has made it easier to ensure that children have health insurance.

As you would for your own health plan, shop around to find the best solution for your family. Make sure your children have a health plan that covers their specific needs.

Want to know more about choosing health plans? Get my ebook set Easy Healthcare: Set Two. It included Choosing Your Health Insurance, and Obamacare, as wells as What You Need First. It is available in all major ebook formats. Get it here.

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What is the difference between HMO, PPO, POS, and EPS?

Young girl listening to young boy's heartbeat with stethoscopeMany of our readers have come to us with questions about the different types of health plans sold on the individual market.

Understandably, there is a lot of confusion about the types of plans because there are no industry-wide definitions and because state standards are different.

To help you better understand the different types of plans, here are some generalities:

Health Maintenance Organizations (HMO): HMOs only cover care provided by doctors and hospitals within the network.

Preferred Provider Organizations (PPO): PPOs cover care in and out of the plan provider’s network. There is typically a higher percentage of the cost for care provided out-of-network, paid for by the members.

Exclusive Provider Organizations (EPO): EPOs generally do not cover care outside of the plan provider’s network. They are similar to HMOs, but members may not need a referral to see a specialist.

Point of Service (POS): POS plans often combine aspects of HMOs and PPOs. There may be coverage for out-of-network care that comes with higher cost sharing. Members also may need a referral to see a specialist.

There is a lot of variety from one plan to the next, despite how the plans are labeled.

When looking at plans, make sure to ask some basic questions about coverage, such as:

  • If members are required to have a primary care physician,
  • If members are required to get referrals for specialists or services,
  • If any healthcare services need to be pre-authorized,
  • If there is out-of-network coverage, and
  • If there is out-of-network coverage, does spending count toward the out-of-pocket maximum?

All this month we are answering your questions and we will be answering even more in this month’s webinar Ask Lori-Ann Your Healthcare Questions on January 27, 2016 at 2 p.m. Eastern. Reserve your spot now! Bring your questions to the webinar or submit them in advance by email or on Facebook or Twitter.

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One Question Could Save You from Unexpected Medical Bills

Mother and baby in home officeYou’re scheduling an appointment with a doctor. It could be a well visit or one to discuss a particular concern. You’ve agreed upon a time and asked whether the doctor accepts your insurance. You’re all set, right?

Maybe not. Many doctor’s offices will accept your insurance even though they don’t participate in your insurance plan. The doctor may not have signed a contract with your insurance company agreeing on a total charge for the visit. This means your insurance may not cover the visit as you are expecting. It may cover a smaller than normal amount and you’ll be stuck with bills to pay the difference.

You can avoid a situation like this by asking a different question. When you call to schedule your appointment ask if the doctor “participates” in your insurance plan.

“Do you participate in my insurance plan?” This question could save you a ton of money.

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It is also important to recognize that some doctor’s offices are very large and have a number of doctors in the facility. If you have a specific doctor that you want to see, make sure your particular doctor and the office as a whole participate in your insurance plan. For instance, if you have Medicare or Medicaid some doctors in your practice may accept those, while others in your practice do not.

Avoid unexpected medical bills by ensuring that your doctor and the doctor’s office participate in your insurance. All it takes is the right question: “Do you participate in my insurance plan?”

Would you like to make empowered healthcare choices? Get started with the free MyHealthSpin Toolkit. Filled with free ebooks, workbooks, and videos, you will be able to spin your healthcare your way. GET YOUR TOOLKIT NOW