how-to-manage-health-care-expenses

How to Talk to Your Clients About Out of Pocket Expenses

As a health insurance agent, you are likely faced with one overarching concern every day: how to make insurance less complicated for your clients. There’s no doubt that healthcare coverage is challenging and multi-faceted; consumers likely feel overwhelmed with the laundry list of aspects they need to consider before selecting the coverage that effectively fits their needs and budgets. They depend on agents’ guidance and expertise when they’re deciding how to best protect their health (and the health of their loved ones) as well as their wallets.

Such responsibility can feel daunting, especially considering all there is to know about healthcare coverage. If you’re a new health insurance agent, you’re probably still grasping the ins and the outs and tailoring your sales approach to this ever-evolving and highly regulated industry.

Let’s take a look at some industry terminology that will help you talk to your clients about out of pocket expenses and consider how those expenses relate to short-term medical and health benefit insurance plans.

Deductible

This refers to the amount your clients pay for themselves before their insurance carrier pays benefits.

If your clients are concerned about the cost of deductibles when facing common illnesses such as a cold, an ear infection, pink eye, or strep throat, they may be interested in coverage that includes a telemedicine as a feature.

Telemedicine meets patients where they are by allowing them to connect with doctors via phone, video, smartphone, or computer and reducing travel time, anxiety, and time away from family and responsibilities. This feature is available with many short-term medical and health benefit insurance plans as well as traditional healthcare coverage.

Copay

This refers to the amount your clients pay to their providers at the time of their visit. The amount may vary depending on the type of service they receive and typically does not count toward deductibles.

Affordability is certainly one of your clients’ primary concerns when choosing healthcare coverage. Many short-term medical plans offer low out of pocket copays for doctor’s office visits and wellness care. That said, clients must understand that benefits may be more restricted as well since these plans do not need to meet the 10 essential health benefits. They also do not cover preexisting conditions.

Clients who need another type of coverage and/or who may need to supplement their major medical coverage may benefit from health benefit insurance, as this type of policy may be cost effective and provides cash benefits to pay for a variety of expenses, including copays. Keep in mind that there may be limitations and/or restrictions, so be sure to fully review the circumstances under which payment can be received with your clients.

Coinsurance

This refers to the amount your clients pay to their providers for services rendered after they pay their deductible and after their carrier covers its portion. This amount is a form of cost sharing and is in addition to the copay that is paid at the time of the visit.

Short-term medical plans offer a variety of coinsurance options, including a 100%/0% option. This can allow your clients to circumvent a coinsurance payment and would task the carrier with paying 100% of the fees.

Keep in mind that short term insurance plans do not cover preexisting conditions and are not required to cover 10 essential health benefits, including maternity and newborn care, mental health and substance abuse disorder services. Encourage clients to check any plan details carefully to understand what is covered. Health benefit insurance plans do not offer coinsurance options, as they provide fixed cash benefits for specific covered expenses.

Note: It is important to keep in mind, that while short-term and health benefit insurance coverage can provide valuable benefits, neither one is intended to be a replacement nor an alternative to ACA or other major medical plans. These types of coverage do not provide the minimum essential health benefits that are required and will not help to avoid the fee for not carrying health insurance.

Are you ready to talk to your clients about affordable coverage and features of short-term medical and health benefit insurance plans?

Learn more today by:

Health Insurance Innovations, Inc. is a leading developer and administrator of affordable, web-based individual health insurance plans and ancillary products. We help consumers address their health insurance needs by offering access to a number of products offered by various insurance carriers.

For agent use only – not for use with the general public

Effective Ways to Help Your Clients Manage Their Stress

Few things in life are certain. Stress is one of those certainties, a detail you are indubitably aware of when working with clients to find the coverage that best fits their health and lifestyle realities.

Chances are that you are also keenly aware how important it is for your clients to hit the refresh button on their worries and overall state of mind. April is National Stress Awareness Month, the perfect time to remind them (and yourself) to use that button more liberally and to recognize how stress impacts overall health.

It’s crucial to be able to recognize stress symptoms to be able to manage it1. Stress is a natural reaction and is a way to protect ourselves from danger. According to the Centers for Disease Control and Prevention2, it can prompt us to develop skills needed to manage potentially threatening situations. But it’s best to be aware of stress and find ways to manage it through self-care.

Some of the common effects of stress are1:
  • Headache
  • Muscle tension or pain
  • Chest pain
  • Fatigue
  • Sleep problems
  • Anxiety
  • Restlessness
  • Lack of motivation or focus
  • Feeling overwhelmed
  • Irritability or anger
  • Sadness or depression
  • Overeating or undereating
  • Angry outbursts
  • Social withdrawal

When the natural fight or flight response is left unchecked, it can contribute to a variety of health problems such as high blood pressure, heart disease, obesity, and diabetes1.

Talk to your clients about managing their stress by3:
  • Recognizing when they don’t have control and letting it go
  • Avoiding anxiety about situations they can’t change
  • Focusing their minds on something that makes them feel calm and in control
  • Developing a vision for healthy living, wellness, and personal growth
  • Setting realistic goals to help them realize their vision

Carving out even just a few moments each day to relax can help your clients manage their stress. Everyone has their favorite activities that help them unwind and manage their stress.

Here are a few ideas they may want to explore1:
  • Engaging in regular physical activity
  • Partaking in relaxation techniques, such as deep breathing, yoga, or getting a massage
  • Socializing with family and friends
  • Setting aside time for hobbies, such as reading a book or listening to music
Let’s take a look at a few available insurance benefits to pique the interest of those clients as it relates to stress management:

Wellness care

When your clients begin thinking about improving their stress management techniques, they’re likely to also begin thinking about how to make healthier choices going forward. Short-term medical and health benefit insurance coverage are options that may be able to help them maintain access to quality healthcare all while including wellness care benefits. While they’re not intended to replace major medical insurance, they can be used to continue access to health benefits.

Preventive care 

Beyond learning more about healthier choices, your clients may also be interested in learning more about their general health as well as screenings and shots. If traditional insurance coverage is not an option, short-term medical and health benefit insurance coverage can include preventive benefits that give them access to quality physicians who can provide such care.

Routine doctor visits

Maintaining general health is likely to become a priority as your clients become more aware of their stress and management exercises that work for them. With short-term medical coverage, they can take advantage of benefits that allow for access to physicians who can provide routine care and consultations. With health benefit insurance coverage, they can take advantage of cash benefits that subsidize the costs of such visits. Both types of coverage can provide access to a network of providers and facilities. It’s important to review any plans carefully to understand what is covered, if preexisting conditions are included or not, and what services will qualify for any cash benefits. While major medical insurance will provide access to routine care, your clients may find themselves in a situation where they cannot obtain coverage, and these plans may provide an alternative to help them stay on track with wellness and health goals.

Note: It is important to keep in mind, that while short-term and health benefit insurance coverage do provide these benefits, neither one is intended to be a replacement nor an alternative to ACA or other major medical plans. These types of coverage do not provide the minimum essential health benefits that are required and will not help to avoid the fee for not carrying health insurance.

Are you ready to help your clients unwind this National Stress Awareness Month with quality coverage that addresses their concerns?

Learn more today by:

Health Insurance Innovations, Inc. is a leading developer and administrator of affordable, web-based individual health insurance plans and ancillary products. We help consumers address their health insurance needs by offering access to a number of products offered by various insurance carriers.