If you are like the millions of Americans who don’t have dental insurance provided by an employer, you may wonder why there aren’t more “reasonable” insurance products available in the individual market. There is no shortage of individual dental plans; all medical insurance companies offer them. But after looking more closely many people conclude correctly that it just doesn’t add up. So how come? The devil is in the details.
Let’s look at three major coverage restrictions typical of most PPO dental insurance:
- Coverage limits. Most PPO plans provide a maximum benefit of $1,000 or $1,500 annually.
- Waiting periods. Typical is a one year wait for major services – no coverage provided for services like crowns and root canals in the first year of coverage.
- Limited Provider networks. Dentists must accept a much lower fee for services than their going rate so most don’t participate.
Last month the Supreme Court ruled the ACA law (Obamacare) did not misstep in providing subsidies to residents of states with no state-run exchange (see June 29 blog entry, “Supreme Court decides to keep ACA subsidy”). A defeat could have led to a dismantling of the law. Continue reading
A big decision was made last week by the Supreme Court, which could have negatively impacted millions of Americans receiving health insurance subsidies in states where the federally run exchange is used.
Any one insured under CoveredCA, and receiving subsidies, should be aware of a recent development that may impact them. Continue reading
Many of us in individual health plans are unable to make a plan change outside of open enrollment. Unless you have a qualifying event, such as a change in family status, a move, or the loss of group health insurance, you may have to wait until open enrollment (November 1, 2015 – January 31, 2016) to make a plan change. While “locked-in” here are some tips on how to improve your health, stay informed and save money: Continue reading
Special Enrollment is a window of time outside of the annual open enrollment period during which you and your family can enroll in a healthcare plan. The next annual open enrollment period for the 2016 plan year is currently scheduled for November 1, 2015 – January 31, 2016. Continue reading
2015 started with a bang…actually with a cough. Like many in my circle of friends and acquaintances, I got the flu. After a few days of suffering, I found myself on a Saturday morning in mid-January with a choice to make. Do I continue with my Nyquil binge and wait till Monday to see my doctor or head out now to visit an Urgent Care center? Continue reading
It was touch and go there for a bit, but Blue Shield of California and Sutter Health resolved their differences and signed a new two-year agreement that will keep Sutter hospitals and medical centers in Blue Shield’s provider network. The public jousting was palpable and thankfully short-lived. Coming to an agreement before the end of the open enrollment (February 15) means many can check insurance off their to-do list, for a while anyway. Continue reading
There are just five days left to renew your health insurance for 2015 if you want it effective on January 1, 2015.
In both Covered CA and the private marketplace, you have through December 15, 2014 to explore your options and make any changes to your health insurance for a January 1, 2015 effective date. Please read the specifics below to understand your options based on the market in which you obtained your current health insurance. Continue reading
The first annual open enrollment period since the implementation of health care reform has started and it’s time to evaluate plan options for 2015. For those who have existing individual or family coverage and want to consider a change, are enrolled in group or COBRA insurance and want to compare their current plan with 2015 marketplace plans, or are without health insurance and entering the market for the first time, now is the time to consider a change. Continue reading