Health Insurance Blog and Resources

Being healthy over the holidays isn't about missing out, it's about finding the best ways to enjoy food, drink, and company. We've taken a holistic approach to gathering holiday health suggestions from experts. We've got tips on mental, emotional, and physical health, as well as food and drink consumption. Following these tips and suggestions will help you get the most out of the holidays this year and enjoy them safely. Mental and emotional health Stress managementThe holidays are often a time of festivities, joy, and celebration. There are many social activities to enjoy, and it is easy to feel over committed.Caleb Backe, health and wellness expert for Maple Holistics, warns, “Don’t forget to plan your schedule realistically this holiday season. While ‘tis indeed the season to be jolly, make sure you leave yourself time to rest as well as party. Know when to say ‘no,’ so that you can really enjoy your holidays to the fullest.”While extroverts may thrive on social interaction and engagement, introverts may need to carve some space out for themselves. Kristine Tatosyan-Jones, MD, ABIHM, who practices family medicine in the Nashville area, says, “Introverts especially tend to get very drained during the holidays when they are traveling and constantly around family. It can be very helpful to spend some alone time, ground yourself, and relax.” If you know you'll need a break from social activities, plan ahead for ways to take a break. "Having music, a podcast, or a book on tape can allow you to be physically present while taking a mental break. Especially if you’re an introvert, having a way to pull yourself out of a loud and hectic environment can be a great tool," recommends Lauren Cook, a clinician with a Master's of Marriage and Family Therapy.Family gatherings and visits with old acquaintances can also bring a lot of unnecessary and unneeded judgment into your life.Kelly Flagg, owner of Kelly Flagg Lifestyle: Fitness and Wellness for Women, advises, “"Don’t let the comments and judgments of others get to you. The same goes for judgmental family members during the holidays. Remember: they don’t live in your life. The holidays can be a time when we allow other people's opinions to define our feelings, but we don’t need to. Remember, you’re in control of how you respond.” One way to reduce stress is to maximize your time with the people you like. Tatosyan-Jones says, “Social support and spending time with friends and family who are positive and nurturing can help with decreasing stress, so choose wisely who you visit during the holidays.” Carve out time for other stress management practices. Kelly Donahue, PhD, mind-body coach, consultant, and speaker, recommends, "Maintain meditation, mindfulness, yoga, or whatever keeps you calm. If you don't have a regular practice to help with stress, it's not too late to start!" Gratitude can also help you find calmness and change your prespective of your surroundings.  "Taking a moment to focus on something for which you are grateful, like the fact that you have family who care enough to squabble, that you have the ability to fly through the sky to see loved ones, and that you can slow down and use the time in the long line to take a few deep breaths. These little moments of gratitude can shift your perspective and help you see the good around you," says Donahue. Focus on yourselfThis may seem like counterintuitive advice for the season of giving, but it’s more about not comparing your holidays to someone else’s. Steven Reigns, M.A., licensed psychotherapist and founder of Therapy for Adults, counsels, “Remember that social media can give false impressions that everyone else is having a great holiday season filled with friends, presents, cable knit sweaters, and hot chocolate. Don’t fall into the trap of comparing your life with the lives you see on Instagram.”    While there is plenty of cultural emphasis on spending the holidays with others, there is no need to feel badly about not having holiday plans or spending them alone — especially if that’s what you want.  Reigns adds, “Sometimes people, out of holiday loneliness, will agree to spend time with people or activities they aren’t fond of. Agreeing to things one doesn’t enjoy is an abandoning of the self. Leaving or ignoring one’s true desire for the sake of company compounds lonely feelings. Spend time with people you truly enjoy spending time with.” Take ownership of your holiday experience and only do the things that you want to do. Physical health Avoiding sicknessWhile holiday traditions are often a break in routine, it’s also important to keep some of those routines going. Dr. Christopher Dietz, Area Medical Director of MedExpress, says, “When people get together during the holidays, germs that cause illness often spread easily through personal contact, food, and shared spaces. Simple habits can make a substantial difference by building your immune system and reducing contact with germs.”  For example, Dietz advises, “To help keep germs at bay, always cough and sneeze into your elbow, and teach kids to do the same. Arielle Levitan, MD, co-founder of Vous Vitamin LLC, has three tips for keeping germs at bay. She says, “Hand washing never can be overstated. I advocate for real hand washing, not antibacterial gels and the like.”Dietz agrees: “I always remind my patients to get plenty of sleep and wash their hands regularly, especially before eating or preparing a meal. It’s also a good idea to wipe down frequently touched surfaces, like TV remotes, phones, doorknobs, and faucets.” Dr. Susan Besser of Mercy Medical Center suggests getting the flu shot: “You all should have had your flu shot by now, but if you didn’t, go ahead and get it because some protection is better than none. Remember it’s not just for you. You are also protecting your friends and family from the flu.”Levitan also recommends immunizations, like the pertussis vaccine and the flu shot, and taking vitamins. She says, “In addition to a daily multivitamin, taking some extra vitamins when feeling run down or particularly at risk of developing an illness can be helpful. We like a combination of extra vitamin C, D, and zinc for these times.”For those interested in consuming foods with these vitamins naturally occurring, Isabel Butler, company nutritionist at Spoon Guru, says, “Dairy products are a good source. For vegans, soy milk is a good alternative. It’s also a good idea to drink plenty of orange juice. Salmon is a good source of vitamin D, but for anyone following a vegan diet, oatmeal is good breakfast choice while mushrooms are great for lunch or dinner.”Prevent food poisoningCandess Zona-Mendola, a food and water safety advocate and editor of MakeFoodSafe.com, says, “The days after holiday meals show the highest rates of food poisoning we see during the year. Most of these illnesses can be prevented with a meat thermometer. Remember a turkey is done when its internal temp reaches 165 degrees F. Check the temperature in the innermost part of the thigh and wing and the thickest part of the breast.” Whether you’re hosting or celebrating on your own, make sure you’re preparing and handling food properly. “When the meal is over, be sure to store food in the freezer or refrigerator promptly; food should never be left in the "danger zone" for longer than 2 hours; the danger zone is between 40*-140* F, where bacteria are most likely to rapidly grow,” says Diana Gariglio-Clelland, a registered dietitian for Balance One Supplements. MedicationsSticking to a schedule can also help you if you have prescription medications. Caitlin Hoff, a health and safety investigator at Consumer Safety, says, “Many medications encourage users to consume the medication at the same time each day for best results. While this may not be a difficult thing to remember in everyday life, the holidays often disturb our routines and can make it harder to stay on schedule with these smaller daily tasks. Set a timer on your phone to remind you to take your medication if you are out and about, or if you are at a holiday event, maybe ask a friend to help remind you.” Keeping on track with prescription medications is important for maintaining health. Some medications have adverse reactions or become less effective when combined with certain foods and drinks. Hoff says, “You can easily avoid an adverse drug event by understanding what can and can't be consumed while taking your prescription medications.” No one wants to deal with a preventable trip to the ER, especially over the holidays. SleepMost of us know we need to get more sleep, but FOMO (the Fear Of Missing Out) keeps us awake. FOMO is especially strong over the holiday season, but missing out on sleep has a negative impact on our bodies. Dr. Kristine Arthur, MD, an internist at MemorialCare Orange Coast Medical Center, advisess, “Don’t skip sleep. Take advantage of this time to get some extra zzzzs. Studies show that the immune system suffers from lack of sleep.” Sleep is an important process because it helps our bodies heal and maintain our immune systems. "When we sleep, our cells enter the regeneration/reparation mode and mend all the damage done to them during the day. It’s essential to provide our body with enough resting time to be able to engage in the defense against the germs, pollution, and stress during the day," says Dr. Nikola Djordjevic, MD, medical advisor at LoudCloudHealth. Leon Turetsky, a certified personal trainer, corrective exercise specialist, and founder and CEO of BackIntelligence.com agrees: “Just by having the discipline to go to sleep at a specific time every night will give you a cut off time at night, so that you don’t go down the rabbit hole of bad habits and indulgences. This will allow you to enjoy your holidays in a sustainable and healthy way.” Keep your immune system strong so your body can effectively fight aggressive germs by getting some sleep. Sticking to a schedule of sorts will also make transitioning back to school or work much easier come January. Staying activeFollowing normal exercise routines can be challenging with all the added events that occur over the holidays, but any kind of physical activity brings benefits.Flagg suggests, “Go for a walk and get some exercise. Even if it’s just a mellow 15 minute stroll around the neighborhood, a walk can help with digestion and improve blood sugar levels."Movement is also a good way to deal with stress. “Getting into the fresh air can help reduce stress, improve blood pressure and blood sugar and keep weight under control,” says Arthur.Heart attacksLinzy Cotaya, APR, Communications Manager for the American Heart Association, says, “The holidays are the time of year when many heart attacks happen. People tend to be more stressed, getting sick, veering from the traditional eating habits, etc. It is labeled as peak heart attack season.” Pay attention to your body and any abnormalities. The American Heart Association has some useful tips on its website about making heart-healthy food choices, spending time outdoors, and taking care of blood pressure. Food and drink consumption Alcohol consumptionAnother important way to stay healthy and out of the ER over the holidays is to practice safe drinking habits.Dr. Indra Cidambi, who is board certified in general psychiatry and double board certified in addiction medicine and founder of Center for Network Therapy, recommends alternating alcoholic beverages with non-alcoholic beverages. She recommends, “I like to spice my alcohol-free beverages up by creating mocktails for easier and more festive drinking, not to mention, they significantly reduce peer pressure as they look like booze-filled treats.”Another tip is to combine drinking with eating. “Be sure to fill up with a protein and vegetable heavy meal before getting to the party to avoid drinking anything on an empty stomach — this only exacerbates the effects of alcohol,” Cidambi says.Dr. Kyle Varner, an internal medicine physician, agrees: “Remember to keep the alcohol to a minimum. Nothing exacerbates family tensions quite like excessive drinking. You'll stay healthier and enjoy the holidays more by keeping the alcohol consumption to a minimum.” Try having a cocktail without the alcohol to help lower your consumption. You can also look for other drinks. "If you’re drinking alcoholic beverages over the holidays, try to replace it with glasses of water. Your body needs water, not alcohol!! Water is essential for regulating your body functions optimally including your heart, brain, and muscles. It also helps to balance your blood sugar level," suggests Tyler Sellers, Total Shape CEO and editor-in-chief. For everyone’s safety: don’t drink and drive. Use public transportation or get an Uber or Lyft instead of driving yourself home. Food choices and dietary restrictionsMany holiday traditions revolve around good food and special treats, but sometimes people feel bad about consuming these traditional foods. Butler says, “Don’t feel guilty for joining in and enjoying the food. Listen to your body and when you feel full, that’s the time to stop as no one wants to feel sick. When choosing food make sure to include plenty of vegetables or salads on your plate to help balance out a meal.” In general, it’s healthier to limit sugar and fat intake. This is especially tricky over the holidays. Bonnie Taub-Dix, a registered dietitian nutritionist, says, “Choose foods that are unique to that particular holiday, instead of filling up in foods you can get any time of year.” Holiday parties can also be tricky to navigate for vegans, vegetarians, and others with dietary restrictions or food allergies. If you’re a host, do some internet exploring to find creative recipes and substitutions for your guests. Dietary restrictions are not as difficult as some may think; they just require more creativity. There may even be healthier ways to prepare holiday favorites that are just as tasty, except for maybe mac and cheese. Varner says, “I like to substitute mashed potatoes for mashed cauliflower to drop the glycemic index and minimize the damage. The entire holiday meal can also be cooked with minimal fattening carbohydrates. This can go a long way to preventing holiday weight gain.” There’s no need to make the party’s entire food selection based on one guest’s dietary needs, but it is a nice gesture to include one dish that meets those requirements. For those with special diets, there are things you can do to ensure that you can enjoy the holiday party food as much as everyone else. Taub-Dix says, “If you’re going to someone else’s house, volunteer to bring a dish that you are comfortable with eating and that meets the needs of your diet.” When it comes to dental health, there are a few things you can do to be nice to your teeth. “A healthy hack for your teeth is to chew gum for 20 minutes following meals or even snacks. According to the American Dental Association, chewing gum for 20 minutes after a meal/snack can help prevent decay by increasing saliva flow that neutralizes oral acidity levels and washing away food that is clinging to your teeth,” says Bill Chase, SVP of Marketing at DentalPlans.com. While chewing gum is an easy way to help keep your teeth happy, remember your dental hygene and be mindful of what you eat. "Take the time to brush and floss. Watch that you don't eat too many sticky, gooey treats, or have too many sugary, acidy drinks," advises Dr. Mike Golpa, Director of G4 by Golpa. Applying these suggestions will help you enjoy the holidays with reduced stress, good health, and tasty food. 

Updated September 10, 2021. Enrolling in health insurance is an important financial decision. Health insurance can save you money on your health care, which offers good financial protection. This season, make sure you are making the best choice for your health and financial planning. Below are some pitfalls that you’ll definitely want to avoid: Not knowing open enrollment dates Open Enrollment for health insurance coverage for the calendar year 2022 is November 1, 2021 to December 15, 2021. Don’t miss it!“Unless you have special circumstances, you will not be able to purchase a new plan or switch out of your existing plan if you miss these important deadlines,” says Dr. Nicole Rochester, MD, private health advocate, and CEO of Your GPS Doc, LLC. Some employers have a different enrollment period. Your employer’s human resources department should be reaching out to share that information with you, if it hasn’t already.A Special Enrollment period allows you to enroll in health insurance at a time aside from Open Enrollment. These occur if you have a qualifying event, like getting married, having a baby, or moving to a new state. Lingo confusion Dr. Sam Kina, Senior Vice President of Economics and Data Science at Picwell, says, “Few people understand basic terms, like deductibles, coinsurance, copayments and out-of-pocket maximums. Learn these concepts before comparing your options.”Health insurance lingo can be confusing and intimidating, especially if it’s your first time purchasing health insurance. Make sure you know the terminology so that you can better understand health insurance plans and make a good choice.BestCompany’s health insurance guide has a vocabulary section that can help clarify health insurance terms. Misunderstanding the coverage Most health plans have rules about what health services they cover, especially when it comes to pre-existing conditions. Meghan Nechrebecki, MSPH, Founder and CEO of Health Care Transformation, says, “Make sure the services you know you will need are covered by the insurance plan. This can be found in the Evidence of Coverage document.”Reading the Evidence of Coverage document will help you understand what medical services are covered and help you determine if a health plan is right for you.Health insurance plans also have networks. Seeking health services from in-network providers is often cheaper than seeking them from out-of-network providers.Suzanne Garber, executive producer and director of PBS documentary “GAUZE: Unraveling Global Healthcare,” says, “It’s important for individuals to check the in-network status of all of their current/regular doctors (primary care, pediatrician, gynecologist) along with any that might be necessary in the year ahead (obstetrician, orthopedist, cardiologist, physical therapist, etc).”Some plans don’t offer out-of-network coverage. When you look at a health insurance policy, consider how much you travel in addition to whether your current doctors are covered.Good coverage doesn’t necessarily come with lower premiums. Adam Hyers of Hyers and Associates, Inc. says, “Consumers must be aware of discount plans sold today that are not actual insurance. The rates are attractive, but the coverage is very flimsy and generally won’t pay much for a serious health incident.” Misunderstanding the cost The real cost of health care and health insurance can be tricky to pin down. Suzanne Garber says, “The lack of transparency in U.S. health care makes an educated decision about selecting a health care plan very difficult and is one of the reasons we advocate for published pricing of every procedure by every health care practitioner — most other countries mandate this already.”The amount health insurance saves you can also be difficult to understand because it depends on the medical services received and the negotiated prices agreed upon by insurance companies and health care providers. These negotiated prices vary depending by insurance company and health care provider.Garber says, “Take the time to crunch the numbers and estimate what health care will really cost you based upon what your usage has been in the past and what risks or major events are likely to come up in the new year.” Understanding what you’ll need in 2022 and what that might cost will help you look at more than just the monthly premium.Rochester says, “If you don't read the information about the deductible, copays, and coinsurance, you may end up with huge medical bills that could have been avoided by paying a little more each month in premiums.”You should also consider what out-of-network services will cost. Garber says, “Don’t overlook the maximum out-of-pocket or not properly estimate any out-of-network provider charges (usually from specialist visits), which can add up quickly.”Taking time to understand the monthly premium, in-network and out-of-network costs, and out-of-pocket expenses, like copayments and deductibles can help you evaluate the value of a health insurance plan. Coinsurance The health plan you are considering may have coinsurance instead of copays. This means that you would have to pay a percentage of the bill instead of a fixed copayment amount.“Another pitfall that individuals fall prey to is the difference between a set contribution (whether co-pay or out-of-pocket) versus a percent contribution,” says Garber.Coinsurance is a two-edged sword in health insurance plans. In some instances it may be beneficial, in others it may be detrimental.Garber says, “For example, it may look that the better option for “Emergency Room” may be a co-pay of $500 instead of 20 percent, as ER visits can be quite costly. However, if an insurance company has a contracted rate with the hospital, they may receive a discount, which may then be passed on to you. An example of this is a recent ER visit, which cost ~$700. The insurance company had a 50 percent discount, which left the remainder $350, of which I owed $35—a much better deal than had I opted for the $500 co-pay option.”Nechrebecki disagrees. She says, “Avoid coinsurance! This means you have to pay a percentage of the bill instead of a defined amount. Medical bills these days can be massive and unexpected.”Understanding the difference between coinsurance and copayments will help you evaluate the cost of a health insurance plan. Health Savings Accounts vs. Flexible Spending Accounts Some health insurance advisers recommend Health Savings Accounts (HSAs) in addition to a health insurance plan. These funds are tax-deductible and can be used for medical expenses not covered by insurance. Shobin Uralil, Co-founder and COO of Lively, says, “Instead of picking the same health plan from last year, which will likely cost you more this year, consider switching to a High Deductible Health Plan (HDHP). HDHPs will likely lower your monthly premiums and get you exclusive access to a health savings account.”If you’re at a relatively healthy point in your life, choosing an HDHP to allow greater investment in an HSA could be a good option. Kina says, “Once you pay your premiums, you never get that money back, even if you don’t use any medical care. Instead, consider taking the premium savings from switching to a low deductible plan and putting it in an HSA.”Be sure to be strict with your budget and put the money you are saving by choosing a lower premium into your HSA. This can be a smart money move for paying future health care costs not covered by insurance.“HSAs are like a 401(k) for healthcare. Because HSA money is yours for life, next year, you will already have health savings to fall back on," adds Uralil.Flexible spending accounts (FSAs) are also a great option to consider along with purchasing a health insurance plan. The difference between an FSA and an HSA is that the funds in an FSA must be used within the year or the money is lost. The money in FSAs is also not tax-deductible.Knowing the dates and understanding health insurance terms, the cost of plans, and the coverage they provide will help you make sure you have coverage and choose the best health insurance policy for you. Looking for more advice? View our article "4 Ways to Prepare for Open Enrollment" and Important Things to Know section.

Updated September 10, 2021. Open Enrollment for 2022 health insurance coverage is just around the corner. It starts November 1, 2021 and continues through December 15, 2021. You won't want to miss it. If you do, you will be unable to enroll in health insurance for 2022 unless you qualify for a special enrollment period.Health insurance can help defray the costs of medical care. Many employers make health insurance available to their full-time employees. If your employer offers health insurance as part of a benefits package, you should be getting information from them about how to enroll during open enrollment.If you do not have health insurance through an employer, you can purchase health insurance independently through government-run exchanges or by working directly with health insurance companies. Navigating the health insurance industry can be daunting, especially for those purchasing health insurance independently for the first time. Following the tips below will help you purchase health insurance confidently. Do your research This suggestion almost goes without saying. Before making a choice as significant as choosing a health insurance policy, you should understand your options and what kind of health insurance coverage you need.“It is important to spend some time researching the various options each year to find the one that is best for you,” says Dr. Nicole Rochester, MD, physician, private health advocate, and CEO of Your GPS Doc, LLC.Many resources are available to give you more information about health insurance. HealthCare.gov is a great resource with information about the laws governing health insurance. Some states have their own online health insurance marketplaces. Through the marketplace websites, you can see health insurance options and see if you qualify for a government subsidy or a government health insurance program, like Medicaid.It may also be useful for you to talk to an independent health insurance broker or financial planner to receive personalized advice about purchasing health insurance. Consider your health needs Do an assessment of your health needs to better understand what kind of coverage you should purchase. Health Care Transformation founder and CEO Meghan Nechrebecki, MSPH, says, “Weigh your options by writing down your expected utilization in the coming year (all clinic visits, prescriptions, potential emergency room visits, surgeries, hospitalizations) and then calculating the expected costs based on the deductible, premiums, coinsurance, and copayments.”Taking into account how you used your health insurance this year can help you predict your health needs for 2022.Nechrebecki adds, “You might want to also take into consideration the what-ifs (what if I get in a car accident, etc.), not just expected utilization.”In addition to considering potential unexpected events, it’s a good idea to think about how your or your family’s health may be different now than in previous years. “No one likes change, and health insurance is incredibly confusing. As a result, most individuals merely auto-enroll in the same health insurance plan year after year, without doing research to ensure that plan is still the best option for them and their family,” says Rochester.It’s also a good idea to think about your current doctors. Adria Gross, founder of MedWise Insurance Advocacy and New York State-licensed insurance broker and consultant, suggests asking: “Are your medical providers, doctors, therapists, hospitals, and medications on the health insurance plans available to you?”If you travel frequently, you may want to make sure your insurance plan has out-of-network coverage. Some health plans have strict rules about out-of-network coverage. Other plans don’t offer out-of-network coverage.Taking the opportunity to review your health needs and this year’s use of health insurance benefits will help you better predict the kind of coverage you need for 2021. It will also help you evaluate your health insurance options better. Know what’s affordable Gross recommends answering these questions as you review the cost of a health insurance policy: What is your current income and your monthly expenses? What health insurance subsidies are offered through your state? What are the copays and deductibles? How much is the premium? As you look at your current expenses, think about ways you can shift your budget to purchase health insurance or pay for an unexpected medical bill. Nechrebecki adds, “Make sure to weigh your options by adding up the upfront costs (premiums) with backend costs (deductible, coinsurance, and copayments) of expected utilization.”Understanding the full cost of health insurance and the cost of medical bills will provide a better picture of the costs and savings of your health insurance.Investigating your options for purchasing health insurance from state-run marketplaces — including what subsidies you qualify for — can also help you find more affordable insurance. Understand your options Considering all of your options when enrolling in health insurance is important, even when you’re not purchasing health insurance independently for the first time.“It is possible that your health or that of your spouse, domestic partner, or children has changed over the years. As your health needs change, the insurance plan you've had for years may no longer be the most cost-effective. In addition, the plans themselves change,” says Rochester.Health insurance plans and their availability change year-to-year. Changes to health insurance law, government policy, or company changes affect your options for health insurance.Options within the United States include the following: Government-provided health insurance (Medicaid, Medicare, CHIP, and others) On-exchange plans (sold on state-run marketplaces) Off-exchange plans Government-provided Health Insurance The government provides health insurance to certain qualifying groups: Veterans Children Elderly (65+) Low-income individuals and families People in these groups and meet other requirements can receive health insurance through the government. The Veterans’ Affairs Office takes care of U.S. military veterans. Medicare is for elderly U.S. citizens. Original Enrollment in Medicare occurs during the time that an individual turns 65. Open Enrollment for 2022 began October 15, 2021 and will continue until December 7, 2021.Medicaid plans are available to low-income individuals and families. Some insurance companies offer these plans. CHIP (Children’s Health Insurance Program) provides coverage for children whose families do not qualify for Medicaid. People enrolling in Medicaid or CHIP do not have to enroll during open enrollment; they can enroll at any time.On-exchange Plans (Marketplace Plans)On-exchange plans are sold on government-run health insurance websites. These plans have to cover basic health services, like preventive care, maternal and child care, mental health, and emergency room visits. Marketplace plans can have lower premiums for those with pre-existing conditions or come with government subsidies.Jack Glasker, Designated Partner at Affordable Healthcare Solutions, LLP, says, “Determining whether marketplace coverage makes sense depends on your income, which is roughly calculated as the adjusted gross income of the policyholder and all others who file on the policyholders tax return. If the resulting income falls below 400 percent of the Federal Poverty Level, you could qualify for an Advance Premium Tax Credit (APTC) that lowers the cost of your monthly premiums for insurance coverage.”An Advance Premium Tax Credit is an advance of the next year’s tax return that can be applied to your health insurance premium payment. Any difference between the amount of money you used for an APTC and the amount of money you were supposed to use will be reconciled when you file taxes.Even if you don’t qualify for an APTC, it still may be beneficial to enroll in a marketplace plan. “If your income is below 250 percent of the FPL, cost-sharing, like help paying copays, coinsurance, and deductibles, on silver-level plans also exists,” says Glasker.Off-exchange PlansOff-exchange plans are still required to cover essential health services like on-exchange plans. However, off-exchange plans do not have to meet all of the requirements that on-exchange plans do.In some circumstances, an off-exchange health insurance policy may be less expensive. Off-exchange options can be found by contacting insurance companies directly.As will all health insurance policies, make sure that you understand the specifics of your health insurance coverage and the cost before making the final decision to enroll. Health insurance is an important expense, and you want to be confident in your choice.Need more Open Enrollment tips? Check out these articles: Pitfalls to Avoid During Open Enrollment 4 Things to Look for In a Health Plan

The health insurance industry is permeated with acronyms. These simple three-letter abbreviations may leave you wanting to say four-letter words. A health insurance insider may casually say such nonsense as, "You can use your HSA to pay part of the OOP expenses on your HDHP plan." This stream of three-letter abbreviations sounds like gibberish and might as well be written in hieroglyphics (I'd like to sign up for the flax-owl-lasso plan, please). If you don't speak "health insurance," you may often feel in the dark. Even worse, you may not fully understand your plan or coverage. Below you will find some common acronyms to help you navigate this foreign tongue. Consider this your Rosetta Stone. Acronyms for Types of Health Insurance Plans PPO: Preferred Provider Organization Preferred Provider Organization plans allow customers to receive care from doctors and hospitals both inside and outside of their network. This type of plan usually provides customers with a list of in-network facilities and physicians who have agreed to a discounted rate. Customers can choose from a list of doctors within their network. Visits to providers outside of the network require additional costs. PPOs are the most prevalent type of health insurance plan enrolling 48% of covered workers. HDHP: High-Deductible Health Plans High-Deductible Health Plans (also known by another acronym: CDHP, or Consumer Driven Health Plan) have significantly higher deductibles than other plans. These plans usually cover free preventative services; however, any other costs are first covered by the customer. Once the deductible is met, the insurance company will cover additional charges. Though customers pay for services until they meet their deductible, they receive negotiated rates when going to in-network providers. Visiting out-of-network providers leads to extremely high costs. HDHP plans are become increasing popular, with 29% of covered workers enrolled in 2016. In addition, these plans may include a (HSA) Health Savings Account. Customers may use this savings account to pay for medical expenses. They may put aside pre-tax money for health expenses. Sometimes employers will also contribute to this account. HMO: Health Maintenance Organization Health Maintenance Organization plans allow members to choose from a list of in-network primary care physicians. They do not cover services outside of their network (except in an emergency). Typically customers will need a referral to see a specialist. These plans typically have lower premiums than PPOs. Approximately 15% of health plans are HMOs. POS: Point of Service Point of Service plans are similar to HMOs with a notable exception: customers must choose a primary care physician within the plan's network. However, customers may visit doctors out of their network, but they will pay most of the cost. However, if customers are referred to an out-of-network specialist by their primary care physician, their insurance will typical pay more of the cost than with no referral. EPO: Exclusive Provider Organization Exclusive Provider Organization plans only cover visits to providers within the plan's network (except in an emergency). Customers do not need a referral to see an in-network specialist with this type of plan. Out-of-network services are not covered. Other Acronyms PCP: Primary Care Physician A primary care physician is your main doctor, often a general practitioner. This doctor typically performs preventative exams and assists with general medical needs. HSA: Health Savings Account Health Savings Accounts often accompany HDHPs (see above). You may put pre-tax earnings into this account and use it for qualified medical expenses. ACA: Affordable Care Act The Affordable Care Act is the 2010 health care reform law. You can read more about the law here. CS: Cost Sharing Cost sharing refers to deductibles, co-payments, and other similar payments. It is the share of costs the customer must pay for covered benefits. OOP: Out of Pocket Out of pocket refers to the amount that customers pay, up to a certain maximum, in a year. Once the out-of-pocket maximum is reached the insurance covers all other expenses. Deductibles, co-payments, etc. contribute to this amount. It does not include premiums. EOB: Explanation of Benefits An explanation of benefits is a document that describes services received. It helps customers understand their coverage and the amount owed for a given service. OV: Office Visit An office visit is when a patient goes to the doctor for a specific medial problem, rather than a general check-up. CHIP: Children's Health Insurance Program The Children's Health Insurance Program provides inexpensive insurance for children in low income households who do not qualify for Medicaid. Read more information about CHIP here. QHP: Qualified Health Plan Qualified Health Plans meet the requirements described in the Affordable Care Act with specified price limits and covered benefits. In addition to this list, there are a plethora of other health insurance acronyms. Take time to learn this complex language so you can understand your insurance coverage and benefits. When choosing a health insurance company, you need the most helpful and accurate information. Check out our top rated companies and find the one that best meets your needs here.  

Open enrollment is upon us! From November 1 through December 15 people will have the opportunity to either sign up for health insurance, or make changes to their existing coverage. If you're on Medicare, the Open Enrollment Period started October 15 and ends December 7. Read these articles about Medicare Annual Enrollment and Medigap to learn more about Medicare and how to take advantage of the Annual Enrollment Period. Below are some important dates for Open Enrollment that you'll want to pay attention to as you make your decisions: November 1, 2021: Open Enrollment Starts December 15, 2021: Last Day to Enroll or Make Changes for Coverage starting January 1, 2022 Of course, if you've never signed up for health insurance before, there are some questions you'll need to ask yourself about your situation before you enroll. Health insurance in this country can be complicated, so before you can know what your options are, you need to understand how your circumstances influence your access to health insurance. Are you employed? While you don't need to be employed to have access to health insurance, it certainly helps. Many employers in the country offer some kind of health benefits to their full-time employees. Some also offer it to their part-time employees. Does your employer provide insurance? Of course, not every employer offers health insurance. As healthcare costs increase, fewer and fewer businesses can afford to provide health insurance benefits to their employees. If you're employer doesn't offer health insurance, you can see what insurance companies offer to individuals and families. You may even qualify for an income-based subsidy or another government health insurance program. Is your job-based insurance sufficient? By "sufficient" we mean, does the insurance coverage your employer provides able to meet all of your healthcare requirements? This question might be more difficult to answer than you think. How do you know if your employee benefits are enough or not? Unfortunately, the answer to this question depends on a lot of factors: your preexisting conditions, what benefits and packages are available, and whether you can afford necessary add-ons to your policy. First, it's important to do some research on the insurance provider your employer has partnered with. We've identified and reviewed some of the major health insurance companies in operation today. You should also talk to your company's human resources representative (if you have one) to discuss your specific needs, and whether your company's insurance will be able to address these needs with the packages available. If your employee benefits are enough If the insurance provided by your employer is enough to cover all your healthcare needs, then great! You're in good shape; however, it's still important to familiarize yourself with some crucial terms related to your health insurance policy. If your employee benefits aren't enough If your insurance policy does not quite cover all of your healthcare needs, that's okay! You can look at your options on your state's health insurance exchange. These Health Marketplace plans can give you access to group premium rates that may be cheaper than other options with comparable coverage. You can also consider other options through insurance companies, like off-exchange plans. Off-exchange plans do not cover all of the essential health benefits, so pay attention to what services are covered if you're looking at these plans. Is your income less than 138 percent of the Federal Poverty Level? The Federal Poverty Level is a standard against which you can determine whether you qualify for cost assistance when buying insurance through the Health Insurance Marketplaces. If you make less than 138 percent of the Federal Poverty Level, you may qualify for Medicaid or CHIP (Child Health Insurance Program), depending on whether your state has expanded Medicaid coverage (more on that later). If your income is greater than 138 percent of the Federal Poverty Level You'll still have a number of health insurance options available to you. The Health Insurance Marketplace offers a insurance packages on a sliding scale, meaning your income (along with other factors) can influence the number and variety of benefits you can potentially receive. If you fall into this group, you may also qualify for certain insurance subsidies, as follows: Premium Tax Credits Based on income, these premium tax credits can go towards paying for a portion of your health insurance costs by either lowering your premium, for factoring into your annual tax return. More specifically, if you make between 100 percent and 400 percent FPL, you may qualify for these credits. Out-of-Pocket Cost Assistance Out-of-pocket cost assistance (also known as cost sharing subsidies) will help lower the amount of money you yourself pay towards specific health insurance costs. These include deductibles, copayments, and coinsurance costs. In order to qualify for these subsidies, you must be making between 100% and 250% FPL. Has your state expanded Medicaid? Right now, one of the major issues affecting health insurance access is the expansion of Medicaid. Medicaid is a health care program (jointly funded by the federal government and the individual states) specifically designed for low-income people. It covers children, the elderly, the blind or otherwise disabled, and others who qualify for federally assisted income maintenance payments. Currently, Alabama, Georgia, Kansas, Florida, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, Wyoming are the only states that have not expanded their Medicaid programs. If your income is less than 138 percent of the Federal Poverty Level, and your state hasn't expanded Medicaid You should still apply for Medicaid coverage, as you still may qualify. However, if you still don't qualify for Medicaid and your state hasn't expanded this type of coverage, you may not be completely out of luck. In some areas, there are Federally Qualified Health Centers that offer primary care services in areas with underserved people. The Health Resources & Services Administration funds these centers through its Health Center Program. You can also buy a catastrophic health plan. These plans only offer coverage for emergency medical care and serious injuries. Because the coverage is so limited, the premiums tend to be much lower. If you're 30 or older, you have to file a hardship exemption form before you can purchase one of these plans. If your income is less than 138 percent of the Federal Poverty Level, and your state has expanded Medicaid You may qualify for Medicaid or CHIP. Rules for Medicaid will vary state to state, so it's important that you check state laws to see how Medicaid has been specifically expanded. As for CHIP, there are some important step, including visiting www.insurekidsnow.gov, selecting your state, then filling out a Marketplace application. Understanding your health insurance options In conclusion, the health insurance world doesn't need to be so intimidating. There are a lot of great resources available for first-time health insurance enrollees. Just be sure to closely examine your situation, the needs of your family, and never be afraid to ask those who have been there before. Health insurance is one of those things you'd rather have and not need, rather than need and not have. The clock on open enrollment is ticking, so sign up today!