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Grab a cup of coffee and browse through our articles to learn more about health insurance as well as other topics you may be interested in. We believe in honesty and transparency. We enjoy educating our clients about health insurance and helping them live better lives with peace of mind.
medical equipment
By Dalton Ousley 16 Sep, 2020
Insurance is definitely an expense, but in a global health crisis and in a country where healthcare costs as much as it does here, it is important to spend a little now rather than pay for a lot later.
doctors
By Dalton Ousley 09 Sep, 2020
To that end, buying health insurance for you or your family isn’t as straightforward as it seems. There are various packages you need to consider, making it a tricky process to complete
insurance medicine
By Dalton Ousley 02 Sep, 2020
Getting affordable health insurance heavily relies on the insurance company that you’ll get it from. This is why you must know how to choose the right insurer.
By Chandler Conrad 18 May, 2020
This list defines many common healthcare terms you might not know. Knowing these terms can help you choose a plan that meets your needs. Some of these words are common with many types of insurance. This glossary explains what the words and phrases mean for health insurance. Allowed Amount - The highest amount we will cover (pay) for a service. Benefit Period - When services are covered under your plan. It also defines the time when benefit maximums, deductibles and coinsurance limits build up. It has a start and end date. It is often one calendar year for health insurance plans. Example: You may have a plan with a benefit period of January 1 through December 31 that covers 10 physical therapy visits. The 11th or more session will not be covered. Coinsurance - A certain percent you must pay each benefit period after you have paid your deductible. This payment is for covered services only. You may still have to pay a copay. Example: Your plan might cover 80 percent of your medical bill. You will have to pay the other 20 percent. The 20 percent is the coinsurance. Coinsurance Limit (or Maximum) - The most you will pay in coinsurance costs during a benefit period. Condition - An injury, ailment, disease, illness or disorder. Contract - The agreement between an insurance company and the policyholder. Copayment (Copay) - The amount you pay to a healthcare provider at the time you receive services. You may have to pay a copay for each covered visit to your doctor, depending on your plan. Not all plans have a copay. Covered Charges - Charges for covered services that your health plan paid for. There may be a limit on covered charges if you receive services from providers outside your plan's network of providers. Covered Person - Any person covered under the plan. Covered Service - A healthcare provider’s service or medical supplies covered by your health plan. Benefits will be given for these services based on your plan. Creditable Coverage - Coverage of a person under any of these: A group health plan. This includes church and governmental plans. Health insurance coverage. Medicare (Part A or Part B of Title XVIII of the Social Security Act). Medicaid (Title XIX of the Social Security Act, other than coverage consisting only of benefits under Section 1928). The health plan for active military personnel. This includes TRICARE. The Indian Health Service or other tribal organization program. A state health benefits risk pool. The Federal Employees Health Benefits Program. A public health plan (as defined in federal regulations). A health benefit plan under section 5 (c) of the Peace Corps Act. Any other plan which gives complete hospital, medical and surgical services. Deductible - The amount you pay for your healthcare services before your health insurer pays. Deductibles are based on your benefit period (typically a year at a time). Learn about deductibles here. Example: If your plan has a $2,000 annual deductible, you will be expected to pay the first $2,000 toward your healthcare services. After you reach $2,000, your health insurer will cover the rest of the costs. Dependent Coverage - Coverage for your dependents who qualify. Emergency Medical Condition - A medical problem with sudden and severe symptoms that must be treated quickly. In an emergency, a person with no medical training and an average knowledge of health/medicine could reasonably expect the problem could: Put a person's health at serious risk. Put an unborn child's health at serious risk. Result in serious damage to the person's body and how his or her body works. Result in serious damage of a person's organ or any part of the person. Experimental or Investigational Drug, Device, Medical Treatment or Procedure - These are not approved by the U.S. Food and Drug Administration (FDA) or are not considered the standard of care. FSA (Flexible Spending Account) - An FSA is often set up through an employer plan. It lets you set aside pre-tax money for common medical costs and dependent care. FSA funds must be used by the end of the term-year. It will be sent back to the employer if you don't use it. Check with your employer's Human Resources team. The can provide a list of FSA-qualified costs that you can purchase directly or be reimbursed for. A few common FSA-qualified costs include: Copays for doctors’ visits, chiropractor and psychological sessions Hospital fees, medical tests and services (like X-rays and screenings) Physical rehabilitation Dental and orthodontic expenses (like cleaning, fillings and braces) Inpatient treatment for alcohol or drug addiction Vaccines (immunizations) and flu shots HMO (Health Maintenance Organization) - Offers healthcare services only with specific HMO providers. Under an HMO plan, you might have to choose a primary care doctor. This doctor will be your main healthcare provider. The doctor will refer you to other HMO specialists when needed. Services from providers outside the HMO plan are hardly ever covered except for emergencies. HRA (Health Reimbursement Account) - An account that lets an employer set aside funds for healthcare costs. These funds go to reimburse Covered Services paid for by employees who take part. An HRA has tax benefits for employer and employees. HSA (Health Savings Account) - An account that lets you save for future medical costs. Money put in the account is not subject to federal income tax when deposited. Funds can build up and be used year to year. They are not required to be spent in a single year. HSAs must be paired with certain high-deductible health insurance plans (HDHP). Health Assessment - A health survey that measures your current health, health risks and quality of life. Inpatient Services - Services received when admitted to a hospital and a room and board charge is made. Institution (Institutional) - A hospital or certain other facility. Legal Guardian - The person who takes care of a child and makes healthcare decision for the child. This person is the natural parent or was made caretaker by a court of law. Long-term Insurance - A type of health insurance that covers certain services over a set amount of time (typically a 12-month period). Medical Care - Medical services received from a healthcare provider or facility to treat a condition. Medically Necessary (or Medical Necessity) - Services, supplies or prescription drugs that are needed to diagnose or treat a medical condition. Also, an insurer must decide if this care is: Accepted as standard practice. It can't be experimental or investigational. Not just for your convenience or the convenience of a provider. The right amount or level of service that can be given to you. Example: Inpatient care is medically necessary if your condition can't be treated properly as an outpatient service. Medicare - A federal program for people age 65 or older that pays for certain healthcare expenses. Network Provider/In-network Provider - A healthcare provider who is part of a plan’s network. Non-covered Charges - Charges for services and supplies that are not covered under the health plan. Examples of non-covered charges may include things like acupuncture, weight loss surgery or marriage counseling. Consult your plan for more information. Non-network Provider/Out-of-network Provider - A healthcare provider who is not part of a plan’s network. Costs associated with out-of-network providers may be higher or not covered by your plan. Consult your plan for more information. Outpatient Services - Services that do not need an overnight stay in a hospital. These services are often provided in a doctor’s office, hospital or clinic. Out-of-pocket Cost - Cost you must pay. Out-of-pocket costs vary by plan and each plan has a maximum out of pocket (MOOP) cost. Consult your plan for more information. PPO (Preferred Provider Organization) - A type of insurance plan that offers more extensive coverage for the services of healthcare providers who are part of the plan's network, but still offers some coverage for providers who are not part of the plan's network. PPO plans generally offer more flexibility than HMO plans, but premiums tend to be higher. Prescription Drug - Any medicine that may not be given without a prescription because of federal or state law. Premium - Payments you make to your insurance provider to keep your coverage. The payments are due at certain times. Provider (Healthcare Provider) - A hospital, facility, physician or other licensed healthcare professional. Short-term Insurance - A type of health insurance that covers certain services for a set time period (6 months or less). Learn more about short-term insurance. Urgent Care Provider - A provider of services for health problems that need medical help right away but are not emergency medical conditions.
By Chandler Conrad 18 May, 2020
Freelance vs. self-employed, that is the question. Or is it? While you know that you’re not an employee because you don’t work for a company, you may be wondering what your employment status should actually be called. For starters, let’s define some terms. Is freelance employment the same thing as being self-employed? In casual talk, the simple answer is pretty much yes. By legal standards, freelance or self-employed are about the same thing, so why are there two terms out there? How You See Yourself The main difference between being freelance or self-employed is how you want to see yourself, and your business. Here are some questions that can help you determine how you explain what you do: What are you building? Some people don’t like the term freelancer. They think it sounds less serious than self-employed. That’s because in many people’s minds freelancers are more gig oriented. That is, they shell short bursts of time to get a project done. The term self-employed, on the other hand, brings up connotations of building a business. This often makes self-employed the preferred term for more entrepreneurial-minded people. Are you doing it alone? People who define themselves as freelancers tend to work alone. A self-employed person on the other hand is more likely to have (or want) employees, for the reasons we discussed above–building a business sometimes requires others, freelancing tends not to in terms of perception. What are you selling? There’s also the idea of selling services rather than ideas. Many people see freelancers as professionals who sell services (like content writers or graphic artists), and the self-employed as people who sell ideas. Who are you working for? Then there’s the issue of how you see your time. A freelancer can often feel like they’re still working for someone, especially if they’re working a lot of hours consistently on a project. A self-employed person tends to feel more autonomy. Again, this is a matter of outlook more than anything concrete. All that being said, when it comes to money time, there’s no clear winner in defining yourself as freelance vs. self-employed. Some independent freelancers can make way more money than a self-employed individual, even one with employees. And some self-employed people value having employees over the salary they may bring in today. The Business Side – How to Become Self-Employed Whichever way you choose to label yourself, there are certain things in common between both terms. For example, you will need to register as self-employed. How to register as self-employed? There are a number of things you’ll need to do. What exactly depends on the nature of your business, and where you live. You may want to contact a lawyer, accountant, or the local office of the Small Business Administration (SBA) to help you out. Also remember, certain professions require licensing, so make sure to take care of that before you go and register. The Taxing Side – Do Freelancers Pay Taxes? Keep in mind, paying taxes as a freelancer is your responsibility. Once you’ve registered your business with the proper authorities, there are a number of freelance business taxes you’ll need to address on the federal, state and local level. The IRS checklist is a good place to start, but you’ll also need to do a bit of research for your local and state requirements.next insurance If you’re already wondering how much you’ll pay at the end of the year, there are plenty of freelance income tax calculator tools available online to help you out. The amount you pay will of course depend on things like your age, gender, and marital status – all things you’ll need to check off on your freelance income tax form when you file. As for freelance tax deductions, there are plenty of those available. These can include obvious things like your office space, office supplies, and travel expenses. However, don’t forget to include things like any advertising and marketing services you use, premiums paid for health insurance, and even professional development courses. Doing taxes as a freelancer, bottom line, isn’t all that fun. But with good planning and a little research, it should get easier over time. Plus, if you have the budget, you can always hire a consultant of your own, in the form of a freelance or self-employed accountant or tax advisor. The Safe Side – Staying Insured Whether you’re going with calling yourself freelance vs. self-employed, your insurance needs stay the same. That means you need good coverage, for yourself and anyone you’re working with you. Needless to say, this begins with general liability coverage for your business. Other forms of insurance strongly recommended include health insurance, auto insurance (if you have a car), and workers’ comp (if you have employees).
By Chandler Conrad 18 May, 2020
Many people face the confusing proposition of choosing health insurance. To help wade through the piles of paperwork, here's a list of ten questions you should ask before picking a health care plan: 1: What Type of Plan Is It? Find out if it is an indemnity health plan or a managed care system. With indemnity health plans, also known as fee-for-service plans, you pay a percentage of the medical costs, and the insurance company pays the remaining percentage. Typically, you are allowed to choose your own doctors. With managed care -- meaning either a health maintenance organization (HMO) or a preferred provider organization (PPO) -- you have minimal out-of-pocket expenses. With an HMO, you or your employer pays a fixed monthly fee for health-care services, but you can only go to a doctor who is under contract with the HMO. Through a PPO, you or your employer gets a discount if you use physicians within the plan. You may go to a doctor outside the PPO system, but you'll pay more. 2: How Much Will I Have to Pay for Medical Care? Find out the amount of the premium. Next, ask whether you will be charged a co-payment, a small flat fee, perhaps $10, charged for health care services. Some plans have a deductible instead, an amount that you have to pay before the policy starts to cover any medical costs. Find out about this, and find out the percentage of costs that will be covered by the plan once you've met the deductible. 3: Will I Be Able to Use My Current Doctors? Ask about any limits on choosing your doctors or hospitals. Ask for a list of the doctors and hospitals that are covered to decide if the plan is right for you. 4: What Benefits Are Included? Ask if the plan covers dental, vision care, or other special services that you might need. Ask about prescriptions, too. Ask what benefits are not covered by the plan, too. 5: Are Routine Examinations Covered? Ask about mammograms, pap tests, immunizations and other routine check-ups. 6: Will I Have to Call My Doctor Before Going to the Emergency Room? Some plans require you to contact your doctor within 24 hours of going to a hospital emergency room, or your costs won't be covered. 7: What Are the Plan's Restrictions on Pre-Existing Conditions? If you or someone in your family has a chronic condition, the policy may not cover related medical costs for a period of months -- or ever. Ask for how long pre-existing conditions are excluded. 8: What Happens When I'm Away from Home? If you need to go to the doctor while traveling, how much -- if any -- of the costs will the plan cover? How do you get reimbursed? 9: Is the Insurer Financially Stable? Find out how long the company has been in business. You don't want to get a really good deal with low premiums, only to find out that you can only see a doctor during very limited hours. 10: How Does the Company Handle Disputes Over Claims? All insurance plans have procedures for appealing denied claims. Many require that you take your dispute to an arbitrator, or an independent person who hears both sides and makes a decision about the claim. Ask what the company's average turn-around time is for resolving claim disputes.

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