Knowing the Difference Between the ER and Urgent Care Could Save You Thousands

Not knowing where to go when you or your child gets sick can be terrifying. Your family doctor may not always be available when you need them, but your circumstances may not be severe enough to warrant a trip to the ER.

But how do you know if a visit to an urgent care center will work just as well and save you money?

Seeking Urgent Care

Thousands of urgent care centers and walk-in clinics have sprung up around the country to help families receive quick medical attention for a variety of issues. According to a December 2019 Forbes article, the number of urgent care centers in the U.S. (9,272) increased by 6% from the previous year. This is just the latest in a series of positive annual growth statistics specific to the urgent care industry.

Many of these locations can test, diagnose, and treat common viral infections, administer stitches to minor lacerations, and much more. But not all urgent care centers or walk-in clinics provide the same services. Before making an appointment or visiting a physical location, be sure to find out which services they offer first (most will have their range of services listed online).

Another increasingly popular service, telehealth, is helping to bring the doctor’s office to the convenience of your couch. Telehealth (also known as telemedicine) has provided relief for overwhelmed doctors offices and urgent care centers alike throughout the COVID-19 crisis and has allowed families to get the care they need while staying safe.

Regardless of how you seek treatment, you may be referred to an ER, specialist, or follow-up appointment if your condition warrants further medical attention.

When to Visit an Emergency Room

Going to an ER may seem scary (not to mention, expensive) but in some cases, it may be necessary.

According to Scripps, if you are experiencing any of the following symptoms you should be evaluated in an emergency room, where medical professionals have access to a full range of resources to treat you:

  • Chest pain
  • Breathing difficulties
  • Weakness or numbness on one side of the body
  • Slurred speech
  • Fainting
  • Changes in mental state
  • Serious burns
  • Head or eye injury
  • Broken bones or dislocated joints
  • Fever accompanied by a rash
  • Seizures
  • Severe cuts
  • Facial lacerations
  • Severe cold or flu symptoms
  • Vaginal bleeding with pregnancy

Covering the Cost of Care

Major medical health insurance can help cover the cost of these types of healthcare. The annual open enrollment period for ACA-compliant health plans runs from November 1 to December 15. If you’ve experienced a qualifying life event (QLE) outside of that period, you may be eligible for a special enrollment period. For more information on QLEs, as well as non-ACA “short-term” health insurance plans (which are available all year long), visit https://fcachiro.memberbenefits.com/health-insurance/.

adult couple reviewing bills and open enrollment materials

4 Myths About the Individual Health Insurance Open Enrollment Period

We’ve heard a lot of Open Enrollment myths over the years and want to set the record straight.

Myth #1 “There are fewer insurers to choose from.”

Many carriers who initially fled the federal exchange have returned and now offer plans alongside others who have entered the marketplace. This increase in the number of plans being offered has allowed many individuals and families to re-examine their needs and adjust their coverage amounts accordingly.

In addition to having access to the same carriers and plans listed on the federal exchange, the FCA Private Insurance Exchange can offer members even more options. To view the full range of available ACA-compliant health plans, please visit https://fcachiro.memberbenefits.com/.

Myth #2 “The premiums are too expensive.”

Now that the federal exchange marketplace has stabilized, there may be lower-cost options for ACA-compliant health plans than past Open Enrollment periods. For example, Blue Cross Blue Shield has filed for a 2.03% decrease in premiums in Texas.

Even if your coverage needs remain the same, you may be able to find a lower premium being offered by a different insurer. We recommend always reviewing the health insurance options available to you during the annual Open Enrollment period.

Myth #3 “You’ll be penalized at tax time for not having insurance.”

In previous years, if an individual did not have health insurance for more than 2 months of the year and did not qualify for an exemption they would face a tax penalty of $695 or 2.5% of their taxable income (whichever amount was greater). As of January 1, 2019, the tax penalty known as the individual mandate has been repealed, though some states may still enforce penalties on individuals who don’t have health insurance.

Myth #4 “Applications are processed instantly.”

On average, our team will process an enrollment application within 24 business hours and submit it to the carrier. Once the application is with the carrier, their team will take over and require an additional 10-15 business days to process the application.

The carriers often get overwhelmed with applications during the Open Enrollment period, so we recommend enrollees submit their health insurance applications as early as possible.

Securing ACA-Complaint Coverage for 2020

This year, Open Enrollment runs from November 1 through December 15 with a coverage effective date of January 1, 2020. This is the one time of year where individuals and families can enroll in ACA-compliant health insurance plans.

Ready to start shopping? Visit https://fcachiro.memberbenefits.com/ to shop ACA-compliant health plans today.

Not sure where to start? Schedule an appointment with one of our licensed benefits counselors and let us walk you through finding the best health insurance fit for your needs.

happy family on couch browsing health insurance options on tablet

Getting the Most out of Open Enrollment

With 2020 Open Enrollment period in full swing, families across the country are reviewing their current insurance coverages and seeing what other options may be available to them. Below are a few tips to help you navigate the process.

  1. Learn the Language

Insurance jargon may be enough to make some people’s heads spin but learning just a few key terms could help you pick the best health coverage for you and your family. To make it easy, here are a few words we feel you should know:

  • ACA-compliant” refers to plans that follow all the guidelines and regulations in the Affordable Care Act. These plans are only available during the annual Open Enrollment period or through a Special enrollment period, if you have a qualifying event.
  • Non-ACA plans” also known as short term health plans do not adhere to all of the Affordable Care Act’s guidelines and regulations.
  • Deductible” the amount of money you must pay out of pocket before your insurance kicks in
  • Premium” the amount you pay to your insurance company every month
  • In-network” refers to a provider that has a contract with your insurance provider
  • Out-of-network” refers to a provider that does not have a contract with your insurance provider
  1. Think of the Future

No one can predict the future, but you may be able to take an educated guess as to what the next 12 months could hold. Thinking about the coming year could help you determine how much coverage is right for you and your family. Have you had any health issues in the past year? Are you taking any medications? By examining your current health status and concerns you may be able to narrow down your health insurance plan options.

  1. Utilize Your Resources

Did you know as a benefit of your FCA membership, you have access to our team of licensed Benefits Counselors? Our Benefits Counselors are experts in their field and are standing by to help you navigate the Open Enrollment process and find the best health insurance for you and your family’s needs.

We’ve been providing health insurance answers and guidance for over 30 years. Be sure to visit the FCA Private Insurance Exchange for access to appointment scheduling services, webinar replays, and other informational resources designed to help make the Open Enrollment process as quick and easy as possible.

  1. Know Your Deadlines

Like last year, the annual individual health insurance Open Enrollment period began on November 1 and will run until December 15. For those who enroll in one of these ACA-compliant plans, you can expect an effective date of January 1.

Non-ACA plans typically do not follow the ACA open enrollment period dates and are available in most states year-round.

Ready to make your decision? Visit https://fcachiro.memberbenefits.com/health-insurance/ today to secure ACA-compliant coverage for you and your family in 2020.

businessman in cafe talking on cell phone smiling at his lap top

I Missed Open Enrollment and Need Health Coverage — What Are My Options?

The next official ACA Open Enrollment period isn’t slated to begin until November 1, 2019. But depending on your circumstances, you may not have to wait that long to obtain coverage.

Qualifying Life Events and Special Enrollment Periods

Sometimes our circumstances change, and if they change due to specific events, you and your dependents may be able to secure health insurance through a Special Enrollment Period. When this occurs, it is called a Qualifying Life Event, otherwise referred to as a QLE.

There are several types of Qualifying Life Events that may grant you a Special Enrollment Period. Some of the most common examples include:

  • Loss of health coverage
    • Losing existing health coverage – including job-based, individual, and student plans
    • Losing eligibility for Medicare, Medicaid, or CHIP
    • Turning 26 and losing coverage through a parent’s plan
  • Changes in household size
    • Getting married or divorced
    • Having a baby or adopting a child
    • Death in the family
  • Changes in residence
    • Moving to a different ZIP code or county
    • A student moving to or from the place they attend school
    • A seasonal worker moving to or from the place they both live and work
    • Moving to or from a shelter or other transitional housing
  • Other qualifying events
    • Changes in your income that affect the coverage you qualify for
    • Gaining membership in a federally recognized tribe, or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
    • Becoming a U.S. citizen
    • Leaving incarceration (jail or prison)
    • AmeriCorps members starting or ending their service

Non-ACA Health Plans

Haven’t experienced a QLE but still need health coverage? A non-ACA health plan could be the answer. Also referred to as Short Term Medical Plans, recent legislative changes have loosened the restrictions surrounding these plans and have increased their appeal.

Previously, a Short-Term Medical plan could only provide coverage for up to 90 days. But due to recent regulatory changes, these plans can now be continued for up to a year.  Additionally, in some cases applicants may now renew their plan for up to three years.

Because Short-Term Medical Plans are considered non-ACA health plans, it is worth noting that they may not cover all that an ACA health plan would. For example, applicants could be denied coverage due to a pre-existing medical condition, maternity care may not be covered, and there could be an annual dollar limit on coverage. However, these plans are also typically less expensive than ACA plans and could be a good alternative for individuals seeking more affordable options.

Know Your Options

Do you think you may qualify for a Special Enrollment period? Are you interested in hearing more about non-ACA plans and if they may be the right fit for you? Our Benefits Counselors are always on hand to help answer your questions and guide you in the direction that will make the most sense for your unique needs.

Visit your association website to learn more about the Health Insurance offerings that may be available to you, or schedule an appointment with one of our licensed Benefits Counselors today.

mother with breast cancer smiling and hugging her young daughter

What You Should Know: Home Breast Cancer DNA Tests

In March of this year, ancestry DNA testing giant, 23andMe, announced that they would begin testing user DNA for Breast Cancer genes, more specifically identified as the BRCA1 and BRCA2 genes. While technically able to test for these genes for years, it wasn’t until this past March that the FDA officially signed off on it, therefore, making the 23andMe at-home DNA test, the first FDA-approved direct-to-consumer test to evaluate one’s potential risk for cancer.

What Can Your DNA Reveal

The test is offered as an add-on to 23andMe’s standard ancestry report for a total of $199 and is delivered alongside a variety of other reports designed to tell you if you possess certain genetic markers which may suggest a predisposition to things such as:

  • Macular Degeneration
  • Lung and/or Liver Disease
  • Celiac Disease
  • Hemochromatosis
  • Hereditary Thrombophilia
  • Alzheimer’s Disease
  • Parkinson’s, and many more
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Last Chance to Enroll

Last Chance to Enroll in Individual Health Insurance for 2017

Don’t wait until it’s too late to get your individual health coverage for 2017. Open Enrollment for Individual Health Insurance ends on January 31st. If you haven’t enrolled in a plan by this date, you may be stuck with your current coverage or no coverage for the remainder of the year unless you have a qualifying life event. Schedule an appointment with a licensed benefits counselor or start shopping today to make sure you are covered.

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