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How to Prevent Your Health Insurance Provider from Denying Your Claim
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You need pre-authorization or a referral 

Did you need to undergo a medical procedure such as an MRI or a CT scan? If so, your insurance provider may require a referral or pre-authorization from your physician.

Even if the facility agrees to provide the procedure without a referral or pre-authorization, your insurance provider may not agree to cover the cost. To rectify the situation, see if your doctor can reach out to your insurance carrier and let them know about ordering the procedure for you. (Physicians and other healthcare specialists using services like Fortis Medical Billing may have an easier time working with your insurance carrier.)

Your policy does not cover the procedure

Even with proper pre-authorization or a referral, you must check with your insurance provider or look over your policy to ensure your plan includes the procedure. Even if your carrier previously covered the procedure, your latest plan may not include it. 

You used an out-of-network provider

Something else to double-check on your insurance plan is whether the provider you want to see is in your current provider network.

Provider networks are common for exclusive provider organizations and health maintenance organizations. If you do not use an approved provider who agrees to your carrier's payment terms, your insurance carrier may deny your claim. Occasionally, insurance companies will accept a claim from an out-of-network provider, but you may have to pay a higher percentage of the costs than you normally would.

If you want to have the option of using out-of-network providers, ask your current carrier if you can include out-of-network benefits on your current health insurance plan. That way, you receive non-emergency and/or elective treatment. 

Your claim contains typos

A clerical error on your part may be the reason for your denial. Check to see whether you listed your birth date, name, address, and all other personal information correctly on your claim. If you notice a typo, reach out to your provider's customer service department to correct it.

Your physician billed the wrong provider

Perhaps the mistake was your doctor's and the wrong insurance carrier received your claim. This sometimes happens if you go to a doctor or another healthcare provider you have not been to in a while. They may have outdated or inaccurate policy information on file. 

Do you have multiple health insurance policies? Maybe you and your spouse have separate plans through your employers but see the same physician. If so, your doctor may have sent the bill to your spouse's carrier rather than yours.

If your physician billed the wrong provider, see that the office sends the bill to the right company as soon as possible. Waiting too long could result in a denial because the bill did not arrive on time to qualify for approval.  

Your service was not considered medically necessary

Another reason insurance companies deny claims is that they do not feel the requested service qualifies as medically necessary. Even though you may need a procedure, treatment, or service, you may have to make your policy provider understand why you need it.

Team up with your doctor to supply your carrier with adequate evidence of your medical need. Also, ask yourself if you truly need the service to improve your health or if you only want the service for vanity or nonessential reasons.

You did not choose the less-expensive option

Insurance companies are a business, which means they want more money coming in than they do funneling out. If you opt for a more expensive medical option when a less expensive one achieves the desired result, your carrier may deny your claim based on cost-efficiency.

Always choose the less-expensive procedure or treatment first. If results do not work the way your physician would like, then you can see if your provider would cover the more expensive option.

Do not lose hope if your carrier denies your claim. A phone call and the right information could change everything for the better.

What to Do When You Lose Your Health Insurance
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Losing your job is stressful. Losing your health insurance on top of that is even worse. And whether you have health concerns now or want to safeguard yourself and family for the future, you might be worried about how to cover medical expenses if you’re out of work. Find out what to do when you... Read More

The post What to Do When You Lose Your Health Insurance appeared first on Credit.com.

These Will Be the Top Home Decor Trends of 2021, According to the Experts – Real Simple
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These Will Be the Top Home Decor Trends of 2021, According to the Experts  Real Simple
7 Big Insurance Mistakes to Avoid During the COVID Crisis
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The coronavirus has upset lives and livelihoods all over the globe. While insurance can’t keep you from getting COVIID-19, having the right types of insurance can reduce your financial risk as the virus spreads.

There’s never been a better time to protect your health, life, property, and business with the right insurance. Let's take a look at seven insurance mistakes you might be making during the pandemic. You’ll learn how to face new risks and challenges with the help of different types of affordable insurance.

Coronavirus insurance mistakes

Here’s the detail on each mistake you should avoid to make sure you and your family stay safe during the pandemic.

1. Skipping health insurance

The coronavirus has changed the health insurance landscape in drastic ways. If you’ve become unemployed or have your work hours cut and lost employer-sponsored health insurance, don’t go without coverage when you may need it most.

Here are several ways to get health insurance:

Medicaid and Children’s Health Insurance Program (CHIP) may be options for free or low-cost coverage if you can’t afford health insurance. These programs allow you to get coverage at any time of year, depending on your income, family size, and where you live. You can learn more at the Medicaid website at Medicaid.gov.

Your parent’s health plan may be an option if they have coverage, you’re under age 26, and they’re willing to insure you. Even if you’re married, not living with a parent, and not financially dependent on them, they can cover you until your 26th birthday.

COBRA coverage is typically available when you leave a job with group health insurance. Whether you quit, are laid-off, or get fired, COBRA is a federal regulation that gives you the option to continue your employer-sponsored health, dental, and vision insurance for a certain period, such as 18 months. However, if you have funds in a health savings account or HSA, you can use them to pay your COBRA premiums.

Affordable Care Act (ACA) coverage is available through federal or state health online marketplaces, insurance brokers, and insurance websites. If your income is below certain limits based on your family size, you qualify for a federal subsidy, which reduces your healthcare premiums. No matter where you live, you can begin shopping at the federal exchange at Healthcare.gov.

2. Not using telehealth services

If you have a high-deductible health plan (HDHP), it typically only covers certain preventive care costs, such as an annual physical or vaccinations, before you meet the yearly deductible.

The CARES Act makes it easier to use telehealth services because your plan must cover it cost-free before your HDHP deductible is satisfied.

However, the CARES Act makes it easier to use telehealth services because your plan must also cover it cost-free before your deductible is satisfied. For other types of health plans, such as HMOs and PPOs, they must also waive any cost-sharing or co-pays for remote health services.

The telehealth relief is only temporary for 2020 and 2021. However, it can give you significant savings if you have a non-emergency or medical question that you want to address with a doctor online.

3. Only getting minimum car insurance coverage

During tough financial times, it can be tempting to cut your auto insurance coverage or drive uninsured. Remember that it’s against the law to drive without having the minimum liability coverage for your home state.

Since many drivers are uninsured, you should never go without uninsured motorist coverage.

However, since many drivers are uninsured, you should never go without uninsured motorist coverage. This insurance protects you from a driver who hits-and-runs or is uninsured or underinsured for the damage they cause you, your passengers, and your car.

According to the Insurance Information Institute (III), 13 percent of drivers are uninsured nationwide. My home state, Florida, has the highest number—almost 27 percent! This data from 2015 is the most recent. Due to coronavirus-related financial hardships, I’d bet those numbers are much higher now.

If you drop any auto insurance coverage, make it collision or comprehensive, which repair or replace your vehicle if it’s damaged or stolen (after paying your deductible). Reducing or eliminating these coverages could make sense if your car isn’t worth much, such as less than $1,000. A good rule of thumb is to drop these coverages if their annual cost is 10% or more of your car’s cash value.

Another way to save on auto insurance is to increase your deductibles or bundle it with other coverage, such as your home or renters policy.

4. Not purchasing a non-owners auto insurance policy

If you’ve sold your car or you tend to borrow or rent cars when needed, don’t forget that you still need the protection of a non-owner auto insurance policy. This coverage gives you liability protection when you drive a car you don’t own or are a passenger in someone else’s car.

Here are some situations when you need non-owner car insurance:

  • You rent a car and don’t already have insurance on a vehicle you own.
  • You use ride-sharing services, such as Uber and Lyft.
  • You borrow cars from family, friends, or neighbors for short or long trips.

5. Overlooking a renters insurance policy

According to the III, a surprisingly low number of renters, 35 percent have renters insurance. Whether you mistakenly believe that your landlord is responsible for your personal belongings (they’re not) or that you don’t have enough to insure (you probably do), you should have a policy.

Landlords only have insurance to protect the structure of a home or apartment you rent, not for a tenant’s personal property. Nor do they protect your liability if someone gets injured accidentally injured in your rental place.

Landlords only have insurance to protect the structure of a home or apartment you rent, not for a tenant’s personal property. Nor do they protect your liability if someone gets injured accidentally injured in your rental place.

Standard renters insurance offers a lot more protection than many people think. It covers your possessions if they’re stolen or damaged from a covered event, such as a water leak, fire, or natural disaster. A renters policy also pays living expenses if you have to move out while repairs get made after an insured disaster, such as a tornado or fire.

Even more important is the liability protection I mentioned. If you get involved in a lawsuit related to property damage or medical injuries, you’ll be covered up to your policy limit.

Renters insurance gives you a lot of protection for the money. It’s probably more affordable than you might think, costing only an average of $188 per year across the nation. Bundling it with your auto insurance could even reduce the cost.

6. Working from home without commercial coverage

Due to stay-at-home mandates during the pandemic, most people who can work from home are doing so. If you’re self-employed as a solopreneur or operate a small business from home, be aware that your home or renters insurance excludes most home-based business activities.

For instance, if you keep inventory at home or have special business equipment, they aren’t covered under a standard homeowner or renter policy. Make sure your business assets and liability are protected by having a separate commercial policy or adding a home-business rider or endorsement to your existing insurance.

The type of business coverage you need varies depending on your industry, whether you drive for business purposes, if you see clients at your home, the value of your business assets, and how much potential risk you have. But it could cost as little as $150 per year. Check with your existing insurance company or a trade association for your industry about getting coverage.

RELATED: How to Qualify for the Coronavirus Economic Relief Package

7. Thinking you can’t get life insurance

It’s not fun to think about death or what would happen to your family if you weren’t alive. If your surviving spouse, partner, children, parents, other dependents, or business partners would be hurt financially after your death, you need life insurance to protect them.

Think about how your survivors would care for your children and meet financial obligations without additional income. Consider how your children would survive if you and your spouse or partner died at the same time. If you’re procrastinating getting life insurance or increasing your current coverage, think about the legacy you want to leave.

The good news is that term life insurance is affordable and still readily available during the pandemic. For example, a $500,000 payout for your family could cost about $200 a year if you’re middle-aged and reasonably good health. Bankrate.com is a good site to learn more and get free life insurance quotes.

3 Tips for Finding an Affordable Health Insurance Plan
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The discounts and cost-sharing offered by health insurance plans are well worth the premium payments. However, premiums can be tricky to work into your budget. It’s important to find an affordable health insurance plan that offers good coverage. Whether it’s open enrollment and you’re trying to find a better plan or you qualify for a special... Read More

The post 3 Tips for Finding an Affordable Health Insurance Plan appeared first on Credit.com.

The Basics of Medicare Eligibility
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Medicare is a federal health insurance program widely used by U.S. citizens and permanent residents age 65 and older. The program also applies to those younger than age 65 who have disabilities, end-stage renal disease (ESRD) or other diseases. But … Continue reading →

The post The Basics of Medicare Eligibility appeared first on SmartAsset Blog.

Dallas Market Center Announces Visual Presentation Awards Winners – Furniture Lighting & Decor
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Dallas Market Center Announces Visual Presentation Awards Winners  Furniture Lighting & Decor
6 Tips to Find Affordable Health Insurance When You Become Self-Employed
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If you're dreaming about leaving a corporate job to work for yourself, getting affordable health insurance is probably one of your top concerns. Fortunately, there are more protections now than ever for those who leave the safety of a group health plan.

This post will cover six tips to find affordable health insurance when you become self-employed or leave a job for any reason, so you and your family get the coverage you need.

Major benefits of the Affordable Care Act (ACA)

The Affordable Care Act (ACA), known as Obamacare, became law in 2010, with significant provisions taking effect in 2014. One critical ACA benefit is that you can't be denied coverage or charged sky-high premiums when you have a preexisting medical condition. However, insurers can charge different rates based on where you live, your age, tobacco use, and family size.

One critical ACA benefit is that you can't be denied coverage or charged sky-high premiums when you have a preexisting medical condition.

The ACA also removes annual and lifetime caps on your health coverage. And no matter how much care you receive, the law caps how much you have to pay for it.

Out-of-pocket annual maximums vary depending on your health plan, but if you get in-network care, you'll never have to pay more than $8,150 as an individual, or $16,300 as a family, for the 2020 plan year. For 2021, these amounts increase to $8,550 and $17,100. Note that these limits don't include your monthly premiums.

What is the Affordable Care Act (ACA) Subsidy?

The ACA also offers many low- and middle-income Americans a health subsidy, which cuts the cost of premiums depending on your income and family size. It's a tax credit paid to your health insurance provider every month, which allows you to pay a lower premium.

For 2020, an individual earning approximately less than $51,000 or a family of four making under $104,000 per year may qualify for an insurance subsidy.

The ACA subsidy applies when your household income is between 100% and 400% of your state's federal poverty level. For 2020, an individual earning approximately less than $51,000 or a family of four making under $104,000 per year may qualify for an insurance subsidy. 

One challenge to using a subsidy is that it's based on your estimated earnings in the year when you'll get coverage, not on your last year's income. Since self-employment incomes can vary dramatically from month to month, the chances of knowing exactly how much you'll earn in the current or future year may be difficult. 

If you underestimate your income for a health subsidy, you may have to return a portion of the tax credit already spent on your insurance during the previous year. In other words, you may owe additional taxes that you weren't expecting.

When you enroll in an ACA plan, you'll have access to a marketplace account. That's where you can update changes to your expected income or family size that affect your tax credit so you can correct it as quickly as possible.

What is the Affordable Care Act (ACA) Mandate?

The ACA mandated that individuals be covered by a qualified health plan or pay a tax penalty if you're uninsured for more than two consecutive months. The mandate applies no matter if you're employed, self-employed, unemployed, a child, an adult, or where you live. 

Technically, it's still illegal to be uninsured, but the federal government won't penalize you for it.

However, starting in 2019, due to the Tax Cuts and Jobs Act, the mandate penalty for not having health insurance no longer applies. Technically, it's still illegal to be uninsured, but the federal government won't penalize you for it. 

But several states have their own insurance mandates, requiring you to have a qualifying health plan. You may have to pay the penalty for being uninsured if you live in:

  • California
  • District of Columbia
  • Massachusetts
  • New Jersey
  • Rhode Island
  • Vermont

For example, California residents without ACA coverage in 2020 face a penalty up to 2.5% of household income, or $696 per adult, and $375.50 per child, whichever is greater. So, even if the federal government won't penalize you for being uninsured, you could have to pay a hefty state penalty, depending on where you live. More states will likely adopt penalties to keep the cost of coverage for residents as low as possible.

The ACA established health insurance exchanges, primarily as online marketplaces, administered by either federal or state governments. That's where individuals, the self-employed, and small businesses can shop and purchase qualified insurance plans and find other options, depending on your income.

How to get affordable health insurance

When you go out on your own, the cost of a health plan can be shocking—especially if you just left a company that paid a big chunk of the insurance bill on your behalf.

Remember that the high cost of health insurance pales when compared to the alternative. Having a medical emergency or being diagnosed with a severe illness that you can't afford to treat could be devastating. 

Remember that the high cost of health insurance pales when compared to the alternative.

Here are six tips for finding affordable health insurance when you become self-employed or no longer have job-based coverage for any reason:

1. Join a spouse or partner's plan

If your spouse or partner has employer-sponsored health insurance, joining their plan could be your most affordable option. Group insurance generally costs much less than individual coverage. Plus, some employers subsidize a portion of your premium as a benefit. 

However, some employer plans may not offer domestic partner benefits to unmarried couples. So, find out from the benefits administrator what's allowed. 

If you're under age 26, another option is to join or remain on a parent's health plan if they're willing to have you. Even if you're married, not living with your parents, and not financially dependent on them, the ACA allows you to get health insurance using a parent's plan. However, once you're over age 26, you'll have to use another option covered here.

2. Enroll in a federal or state marketplace plan

As I mentioned, the ACA established federal and state marketplaces for consumers who don't have access to employer-sponsored health insurance. The following states have health insurance exchanges:

  • California
  • Colorado 
  • Connecticut 
  • District of Columbia
  • Idaho 
  • Maryland 
  • Massachusetts
  • Minnesota
  • Nevada
  • New York 
  • Rhode Island
  • Vermont
  • Washington

No matter where you live, you can begin shopping for an ACA-qualified health plan at healthcare.gov. However, you can only apply for a policy during the annual open enrollment period—November 1 to December 15, for coverage that will begin on January 1 of the following year. Some states with healthcare exchanges have an extended enrollment period

In general, if you miss the enrollment window, you can't get an ACA health plan until the following year unless you qualify for a special enrollment. That allows you to purchase or change coverage any time of the year if you have a major qualifying life event, such as losing insurance at work, getting married or divorced, having a child, or relocating. However, you typically only have 60 days after the event occurs to enroll.

If your income is too high to qualify for a healthcare subsidy, you can still buy health insurance through the federal or your state's exchange. You can also get an ACA-qualified health plan directly from an insurance company, a health insurance agent or broker, or an online insurance aggregator.

3. Consider a high-deductible health plan (HDHP)

One way to reduce the cost of health insurance premiums is to choose a high-deductible health plan (HDHP). You enjoy lower monthly premiums but have higher out-of-pocket costs. If you're in relatively good health, an HDHP can make sense; however, if you get sick, it can end up costing you more. 

Paying for a broad range of HSA-eligible medical, dental, mental, and vision costs on a tax-free basis can add up to massive savings!

Another benefit of having an HDHP is that you qualify for a health savings account (HSA). Contributions to an HSA are tax-deductible and can be withdrawn at any time to pay for qualified medical expenses, such as doctor co-pays, prescription drugs, dental care, chiropractic, prescription eyeglasses, and mental health care. 

Paying for a broad range of HSA-eligible medical, dental, mental, and vision costs on a tax-free basis can add up to massive savings!

4. Get a short-term plan

If you miss the deadline to enroll in an ACA health plan and don't qualify for special enrollment, are you simply out of luck? Fortunately, no. You can purchase a short-term health plan until the next enrollment period comes around.

The problem is, short-term plans don't have to meet ACA standards and only offer temporary coverage, such as for a few months or up to a year. You may be eligible to renew a plan for up to three years in some states, depending on the insurer. 

You won't find short-term plans on the federal or state exchange, and therefore can't get a subsidy when you purchase one. However, they can be less expensive than an ACA-qualified plan.

Short-term plans can charge more if you have preexisting conditions, put caps on benefits, or not cover essential services like prescriptions and preventive care. Because they fall short of ACA requirements, you can have one and still be subject to a state-mandated health penalty. 

You won't find short-term plans on the federal or state exchange, and therefore can't get a subsidy when you purchase one. However, they can be less expensive than an ACA-qualified plan. 

Having short-term coverage is certainly better than being uninsured, but I recommend replacing it with qualified health coverage as soon as possible. That's the best way to have the protection you need against the enormous financial risk of medical costs. 

5. Enroll in Medicaid and CHIP (Children's Health Insurance Program)

If you can't afford health insurance, you may be eligible for free or low-cost coverage through Medicaid or CHIP at any time of year, depending on your income, family size, and the state where you live. In general, if you earn less than the poverty level, which is currently $12,760 for an individual or $26,200 for a family of four, you may qualify for these programs. They may have different names depending on where you live. 

Unlike ACA health plans, state-run health programs don't have set open enrollment periods, so if you qualify, coverage can begin any time of year. 

When you complete an application at the federal or state health insurance exchange, you can also determine if you qualify for coverage through Medicaid and CHIP programs. You can learn more about both programs at medicaid.gov

6. Get COBRA coverage

If you leave a job with group health insurance, you can enroll in COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage. It isn't an insurance company or a health plan, but a regulation that gives you the option to continue your employer-sponsored health insurance after you're no longer employed. 

Instead of having your plan canceled the month you leave a job, you can use COBRA to continue getting the same benefits and choices you had before you left the company. In most cases, you can get COBRA benefits for up to 18 months.

The problem with COBRA coverage is that it's temporary and can be expensive. Unlike other federal benefits, such as the Family and Medical Leave Act (FMLA), employers don't have to pay for COBRA. You typically have to pay the full cost of premiums, plus a 2 percent administrative charge, to the insurer. 

If you're not eligible for regular, federal COBRA, many states offer similar programs, called Mini COBRA. To learn more, check with your state's department of insurance.

Health insurance shopping tips

After you become self-employed and purchase health insurance, it's crucial to shop for plans every open enrollment period. Your or your family's medical needs or income may change.

Additionally, new health insurers come in and go out of the health insurance marketplace. Carriers that offered plans in your ZIP code last year may not be the same set of players this year. In other words, a competitor could offer a similar or better plan than yours, for a lower price. So, if you don't shop annually, you could leave money on the table.

5 Things to Consider When Changing Car Insurance
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Insurance is defined as a form of protection against loss. But in today’s insurance industry, insurance can be purchased to mitigate against all forms of loss. It is a type of risk management used by people to protect against uncertain loss or the risk of failure. Insurance companies or carriers or underwriters sell premiums to... Read More

The post 5 Things to Consider When Changing Car Insurance appeared first on Credit.com.

What Is Gap Insurance, and What Does It Cover?
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When purchasing or leasing a new car, you have several insurance coverage options. When selecting coverage, you will likely know if you want to have collision coverage or not, but will you know what gap insurance and whether to select that … Continue reading →

The post What Is Gap Insurance, and What Does It Cover? appeared first on SmartAsset Blog.

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