Common Health Insurance Terms

Common Health Insurance Terms

Common Health Insurance Terms

We understand that navigating the insurance maze can be daunting. Insurance companies use terms like, “Copay” and “Out of Pocket” and sometimes their terms can seem like a foreign language. Here are some of the most common terms you may hear and what they mean.

 

Insurance Premium– This is the cost of your plan, the monthly bill you, or your employer, pays for insurance coverage.

 

Deductible-This is the amount you pay BEFORE your insurance plan kicks and pays for certain services.

 

Copay– This is the upfront fee you pay to your doctor for services and office visits. This also applies to some medications.

 

Coinsurance– This is the amount you pay for services after your deductible has been met.

 

Total Member Responsibility-The amount that you owe for services AFTER your insurance plan has paid their portion. This can include deductibles, copays and coinsurance.

 

Out of Pocket Maximum– This the MOST you will be required to pay towards your deductible, copays and coinsurance. When you meet the Out of Pocket Maximum, all eligible charges for medical services are covered at 100% for the rest of the year.

 

Have questions? Give us a call!

Tips for Keeping New Year’s Resolutions

Many of us make a list of resolutions in the beginning of a new year, fresh starts, new beginnings and all, right? Often, keeping those resolutions or goals can be difficult, as we settle into our old habits and patterns. Here are a few ideas to help keep you motivated.

  1. Keep them realistic. If you make a goal to lose 50 pounds this year, you may be setting yourself up for failure. Start with a more attainable goal that you can achieve in a relatively short amount of time.
  2. Start with one goal, and write it down. Having a visible reminder can help you stick to it.
  3. Make new goals, don’t repeat the same one you failed at in the past. Change it up, change your approach and keep in mind that change is a process.
  4. Don’t wait until the end of the year, or the last minute. Plan a head and keep moving forward.
  5. Celebrate all small victories towards your goal. This will help keep you motivated and when results are achieved, no matter how small, you will feel like you are accomplishing something and you will eventually conquer it.

Lastly, don’t be hard on yourself or let setbacks get you down. Use your family and friends for support, try using those relapses as learning opportunities towards growth and ultimately, change.

Amazon Partners with Blue Cross, Medical Supplies Now Available for Purchase

Great news for Amazon shoppers and Regence Blue Cross members.

Retail medical supplies and equipment can now be purchased through an Amazon Local Associates shopping page. Blue Cross members can shop, buy and file a claim through the Regence website at:

https://www.regence.com/web/regence_producer/

“Once members have accessed this page:

1)     Members will be prompted to sign an authorization agreement opting them into the program

2)     They will be given a unique, one-time 10% off discount code that they can apply in the discount coupon field on the Amazon checkout page for applicable equipment and supplies

3)     The member is then redirected to the Amazon Local Associates shopping page where they can shop for and purchase medical equipment and supplies

o   Please remember to apply your unique discount code upon checkout to receive the 10%            discount.

o   This program will be in place until the end of September, with the potential to extend further based on member engagement.”

 

 

Source: https://www.regence.com/web/regence_producer/

 

 

 

Yoga can Benefit both your Mental and Physical Health

The practice of yoga has been around for centuries. Originating in India, yoga was introduced to America in the late 1800’s. Since then, yoga has grown in popularity, and people who practice yoga are now in the millions, in fact, yoga can now be found in schools, hospitals, senior centers, prisons and office spaces.

The health benefits of practicing yoga are abundant, both mentally and physically. Yoga helps to build strength and increase flexibility, while also training your mind to improve concentration, reduce stress and find a balance in your emotional state.

Yoga class teaches you to move your body, train your mind to help reduce anxiety and focus on being kinder to oneself. It is a philosophy that helps you connect to your inner self by nourishing the part of us that makes us compassionate and kind.

Yoga is a peaceful practice, centered around a mindfulness that directs us to a higher level of consciousness, where in the moment, we take a mental time out and focus on the movement and the connections.

Basic yoga poses to try;

Forward Fold– Keeping your knees straight, slowly bend forward as far as you can comfortably go, place your hands on the ground in front of you or on the back of your calves.

Plank– Place your hands on the ground, arms straight over your wrists and walk back until your feet are directly behind you, creating a straight line from your shoulders to your heels.

Down Dog– From the plank position, shift your weight onto your heals and life your hips upward, leaving your heels as close to the ground as possible.

Tree– Stand with your hips shoulder-width apart, open your toes to distribute weight evenly on right food. Set your left foot on the inside of your right thigh. Bring hand together with open palms, and lift over head. TIP: Focus on an object at eye level to assist with balance.

Corpse pose– Working your way on to your back, lay flat with your arms to your side. Close your eyes and focus on your breathing.

Namaste

 

Special Enrollment Period (SEP)

Did you know that certain life changes may qualify you to enroll in health insurance coverage outside of the standard enrollment period?

Did you or anyone in your household lose qualifying health coverage in the last 60 days? If so, you would qualify for the special enrollment period.

Here are some examples of qualifying events:

  • Marriage
  • Birth of a child
  • Gained or became a dependent
  • Divorce or legal separation resulting in lose of health insurance
  • Death
  • Change in income
  • Change in zip code/primary place of living
  • Denied Medicaid or CHIP
  • Gained citizenship in the United States
  • Released from incarceration

 

If any of these apply to you or your family, please give us a call for a quote today!

 

 

Recent Study Looks At Health Care Pricing

According to a recently published healthcare economics paper, different insurers pay varied prices for the same services and procedures at the same hospital, indicating that bargaining leverage really does impact healthcare prices.

 

Authors took actual data from claims for three national insurers. Studies showed that dominate hospitals can dictate how much they are going to get paid for specific services and procedures. For hospitals that hold an monopoly in their area, that number was 12.5% higher than those who had nearby competitors. For more concentrated markets, providers can shift more risk to insurers, which affects the ability to keep prices at a set standard.

 

“The two main types of contracts use prospectively set prices that pay a fixed dollar amount based on the DRG classification code, or a model that sets payments as a percentage of hospital charges.
Hospitals are likely to prefer the latter because they get paid for every service they provide, and thus bear less risk. This drives prices up and also places less pressure on the hospital to reduce costs.”

 

In simply terms, it’s about negotiation. The hospital may charge $50,000 for a hip replacement, but the negotiated price may be more like $22,000, Medicare reimbursements would be even less.

 

“Researchers also found that prices increased by more than 6% when merging hospitals were less than 5 miles apart. They didn’t find significant price impact when the hospitals were separated by at least 25 miles.”

 

 

 

 

Sources: The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured Zack Cooper (Yale University) Stuart V. Craig (University of Pennsylvania) Martin Gaynor (Carnegie Mellon University and NBER) John Van Reenen (Massachusetts Institute of Technology, CEP, and NBER)

Modernhealthcare.com

Health Care Cost Institute

 

 

It’s Allergy Season | Be Prepared

With spring weather comes allergy season. Plants are starting to bloom and pollen is in the air to fertilize other plants. Pollen can also pollinate your nasal passages which can bring discomfort.

Be Prepared for Allergy Season

Common sources of allergies, sometimes referred as  ‘hay fever’ come from weeds, flowers, grasses, and trees. Symptoms include sneezing, itchy and watery eyes, and runny nose.

Your physcian can perform a skin prick test to help determine what you are allergic to so you can use the most appropriate treatment.

These simple tips can also help prevent reactions.

  1. Limit your time outdoors on high pollen days and keep your windows closed.  The local news is a great resource for sharing this information.
  2. Take over the counter medication after consulting with your physician.
  3. Change your bedding once a week to remove any pollen you may have brought indoors.
  4. Remove your shoes in the house to avoid dragging it in from outside.

Safe Opioid Disposal

Did you know that eighty percent of people addicted to heroin started with a legal prescription of an opioid?

Opioids are a common medication given to treat pain. Often, a patient prescribed these medications does not need the entire prescribed amount, leaving extra pills unused. Opioids can also be very addictive, thus a safe way to dispose of any unused amounts is important.

Some common opioids include:

  • Hydrocodone (Norco, Lortab, Vicodin, Zohydro)
  • Oxycodone (OxyContin, Percocet, Percodan, Roxicodone)
  • Morphine (MSIR, MS Contin)
  • Codeine (Tylenol #3, Phenergan with codeine)
  • Fentanyl  (Duragesic, Actiq)
  • Hydromorphone (Dilaudid)
  • Oxymorphone (Opana)
  • Meperidine (Demerol)
  • Tramadol (Ultram, ConZip)
  • Buprenorphine (Subutex, Suboxone, Butrans, Zubsolv)
  • Methadone (Dolophine, Methadose)

Intermountain Community Pharmacies provide collection sites for free.

For more information on safe disposal visit  http://useonlyasdirected.org/

 

 

 

Source: Use Only As Directed 

 

Specialized Caregivers, you do not have to go it alone.

Being a caregiver for a special needs child or an elderly adult can be met with fear and uncertainty. After all, when a diagnosis is made or the aging process leaves a parent in need of continual help, an uncharted territory lies ahead for the caregiver.

No person needs to take on the role alone. Resources exist to connect caregivers with a community of other caregivers and organizations that can provide both financial and emotional support.

In fact, make that step number one.

 

  • Find a support system, build your tribe. That can be neighbors, friends, people from your congregation etc. People that understand [to the best of their ability] the situation and may even be a similar one. Take to the internet and seek out local organizations that deal with the same specific issue, talk and share with others.

 

  • Knowledge is power. Ask questions, find out everything you can about the diagnosis. Do your research and stay up to date on the latest treatments etc. for the condition. Being armed with the latest information is empowering.

 

  • Take care of you! The stresses of caring for others nonstop can be overwhelming. Take a break from time to time, ask for help from a trusted family member or friend. Often people around us wish to help, they just need to be told how. Local care agencies are another great resource to explore if you need it.

 

 

Opticare of Utah offers Discount of Lasik

Opticare of Utah has very rich discounts at Standard Optical for LASIK, Normally it is $250 discount per eye compared to the 15% discount with most other carriers, this is a definite advantage and a great benefit, offer ends 3/31/2018!

 

Visit https://www.facebook.com/StandardOptical/

Source: Opticare of Utah