4 Common Misconceptions to Clear Up for Your Clients About Health Benefit Insurance

Your clients come to you with a broad range of health concerns and ask for a personalized approach to help them manage those concerns.  It’s crucial to your success that you listen to and understand those needs and that you have a variety of coverage options to offer them.

One of those options often prompts questions and discussions of myths and misconceptions: health benefit insurance plans – also known as limited benefit medical plans or fixed cash plans. HBI plans provide a fixed benefit payment for specific covered services. They can provide a range of benefits to help meet your clients’ needs, but they have distinct differences from the major medical policies.

Healthcare costs are undoubtedly rising. Your assistance in providing your clients coverage that fits their needs can impact how they are able to manage their healthcare spending. This type of coverage can often be misunderstood, prompting your clients to ask questions about how the plans work and how they can benefit from such a plan. HBI coverage can be a viable option, but it’s imperative to understand your clients’ needs and to make sure they understand how the coverage works before enrolling them.

Let’s take a look at some common misconceptions about health benefit insurance coverage:

Misconception #1: Health benefit insurance plans work the same way as major medical or short-term medical insurance.

HBI insurance plans have some significant differences from major medical policies. Helping your clients understand these differences can allow them to decide if this type of coverage will be helpful as they consider their healthcare realities.

These plans pay fixed indemnity benefits towards covered procedures as well as offer discounted rates for using in-network providers. They can provide flexibility for those who need to supplement their major medical coverage.

When discussing health benefit insurance plans with your clients, remind them that they have no deductibles or copays to satisfy, and let them know that their fixed cash benefits and in-network discounts can combine to bring them additional savings. Clients must also understand the plans are not a replacement for major medical insurance. Policies do have limitations, restrictions, and exclusions to consider.

Misconception #2: Health benefit insurance plans don’t provide quality benefits and have a small network of doctors.

HBI insurance plans often have lower premiums than major medical plans since they are not providing comprehensive coverage. That said, they may still provide members with a host of benefits to help with their medical needs.

The core benefits offered by health benefit insurance plans can include fixed benefit payments for the following services:

  • Hospitalization*
  • Emergency care*
  • Doctor’s office visits
  • Surgery*
  • Diagnostics and labs
  • Wellness

*Typically not covered for pre-existing conditions

This level of coverage can also come with a wide network of doctors nationwide. If the doctor your client chooses does not accept the insurance, your client can opt to pay upfront and then submit her own claims for reimbursement. Remind her though she may be subject to higher out-of-pocket costs if she goes this route.

When your clients enroll in HBI plans, they may also have the option to take advantage of other non-insurance healthcare features as well.

These may include:

  • Prescription savings program on generic and brand-name medications
  • Ability to speak to a licensed doctor over the phone or mobile app to diagnose common illnesses
  • Patient advocacy service that can help your clients find procedures for the lowest cost and can negotiate medical bills

Keep in mind that there are often exclusions with health benefit insurance plans that are important for your clients to consider before they enroll.

Exclusions may include:

  • Pre-existing conditions (12-month waiting period)
  • Prescription benefits
  • Maternity benefits

Make sure your clients are aware of how to leverage our online Member Portal. This includes knowing how to log into the portal, where to access their ID cards, and how to reach out to the different parties who can help them with questions about benefits, billing, claims, etc.

Misconception #3: Health benefit insurance plans are only beneficial for young people or as supplementary insurance.

HBI insurance plans can benefit clients of all ages with varying medical needs.

While this level of coverage is designed to be supplementary to major medical policies, members can use them in a variety of circumstances.

This type of coverage may fit the needs of those who:

  • Are priced out of major medical coverage, but seek a limited level of coverage for basic healthcare needs
  • Want additional benefits to help cover deductibles and copays of a major medical policy
  • Are seeking limited coverage until they are eligible for a major medical policy during Open Enrollment or through their employer

Note: Health benefit insurance plans are not intended to be a replacement or alternative to ACA or other major medical plans nor does it provide the minimum essential health benefits that are required, and it won’t help to avoid the fee for not carrying health insurance. These plans can have exclusions and limitations, which may not make them a valid option for some clients.

Misconception #4: Health benefit insurance plans can satisfy ACA requirements.

Fixed benefit insurance plans do not meet the minimum essential coverage required under the Affordable Care Act, so your clients would likely be subject to a tax penalty. Because they do not have to follow the guidelines for the ACA, premiums tend to be lower as more limited and/or restricted benefits are being offered. Still, these plans can be useful solutions for some who may need to supplement a high-deductible plan or who may otherwise go completely uninsured.

 

Are you ready to help your clients learn more about health benefit insurance plans?

Learn more by:

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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.

Source:

“The Rising Cost of Health Care by Year and Its Causes.” The Balance. https://www.thebalance.com/causes-of-rising-healthcare-costs-4064878

 

Tips to Help You Talk to Your Clients About Cervical Health Awareness

Tips to Help You Talk to Your Clients About Cervical Health Awareness

The new year is here, and so is a clean slate for many of your clients as they set new goals for their health and wellness. You’re in the position to guide those clients to coverage options with features and benefits that fit their lifestyle and health needs.

You also have the opportunity to raise awareness among your clients about important health observances such as Cervical Health Awareness Month during January. It’s the ideal time to make sure your clients’ coverage addresses any concerns they or their dependents may have about cervical health and to direct them and/or their loved ones to resources related to cervical health.

The Centers for Disease Control (CDC), the National Cervical Cancer Coalition (NCCC), and the American Cancer Society (ACS) have many resources detailing how pervasive HPV and cervical cancer are.

Consider these stats:  

  • At any time, there are approximately 79 million people in the United States with HPV1.
  • There are 14 million new HPV infections in the United States each year1.
  • HPV is so common that most people get it at some time in their lives and usually causes no symptoms2.
  • If HPV does not go away on its own, there is a chance that over time it may cause cervical cancer2.
  • While the cervical cancer death rate has gone down by more than 50% thanks to the increased use of the Pap test, nearly 13,000 new cases of invasive cervical cancer are estimated to have been diagnosed in 20173.

Benefits offered by short-term medical and limited medical coverage that may be helpful to your clients worried about their cervical health include:

  • Open network of physicians, specialists, and hospitals
  • Variety of deductible and coinsurance options
  • Low copay options for in-network benefits
  • Paid benefits similar to traditional major medical plans
  • Next day coverage
  • Deductibles as low as $250
  • Relatively inexpensive premiums, but may result in lower and more restricted benefits
  • Guaranteed acceptance for some products, if eligibility is met and available in state

Short-term medical coverage or limited medical coverage may be the best fit for some of your clients. However, it’s important for you and your clients to understand these products do not replace major medical insurance, and they do not count as minimum essential coverage required by the Affordable Care Act. These products are not intended to serve as sole medical coverage. Limitations, restrictions, and exclusions may apply.

As an agent, your clients rely on your expertise to make sure they have access to affordable, quality coverage with benefits that help them face specific concerns. Take your expertise one step further by promoting awareness resources about specific health concerns such as cervical health throughout the year.

Learn more about expanding your portfolio with short-term medical and limited medical plans by:

Click here to like us on Facebook for important industry updates, tips, and articles!

Sources:

1: “Ten Things to Know About HPV and Cervical Cancer.” National Cervical Cancer Coalition. http://www.nccc-online.org/images/pdfs/10ThingsHPV_CCAM.pdf

2: “What Are the Risk Factors for Cervical Cancer?” Centers for Disease Control. https://www.cdc.gov/cancer/cervical/basic_info/risk_factors.htm

3: “What Are the Key Statistics About Cervical Cancer?” American Cancer Society. https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html

 

This blog is for agent use only – not for public distribution.

Help Your Clients Make Safe Toys and Gifts Part of Their Holidays

Help Your Clients Make Safe Toys and Gifts Part of Their Holidays

The holiday season shopping season is upon us as we prepare to celebrate, share laughs and good times with loved ones, and exchange gifts. Prevent Blindness America, a non-profit group dedicated to advocating for eye care and healthy vision, has declared December as Safe Toys and Gifts Awareness Month to help adults make the best decisions on how to keep this holiday season joyful for everyone.

Consider these statistics:
  • Hospital emergency rooms treated an estimated 265,000 toy-related injuries in 2012 throughout the United States1.
  • 72% were people less than 15 years of age1.
  • Close to 90,000 were people less than 5 years of age1.
  • Each year, thousands of children aged 14 and younger suffer from eye injuries and even blindness from toys2.

Many of your clients may be understandably excited to indulge their own children as well as children in their families, but they may not consider important safety concerns or the age range for toys they purchase.

Encourage your clients to follow the guidelines below when choosing toys and gifts2:
  • Read all warnings and instructions on the box.
  • Consider if the toy is appropriate for the child’s ability and age.
  • Avoid purchasing toys with sharp or rigid points, spikes, rods, or dangerous edges.
  • Check the lenses and frames of children’s sunglasses; many can break and cause injuries.
  • Buy toys that will withstand impact and not break into dangerous shards.
  • Look for the letters “ASTM.” This designation means the product meets the national safety standards set by ASTM International.
  • Avoid toys that shoot or include parts that fly off.
  • Inspect toys for safe, sturdy construction.
  • Fix or throw away broken toys.
  • Keep young children away from toys meant for older children.
  • Make sure children store toys properly after play to avoid risks or falls.
  • Supervise children’s craft projects (scissors and glue can be extremely dangerous to a child’s eyesight).
  • Have children wear the right eye protection for sports (face shields, helmets, eyeguards).

Your members deserve coverage options that provide convenient and affordable access to healthcare all year long, especially in case of an emergency. If a loved one becomes injured this holiday season, your clients may end up relying on their health insurance coverage.

Short-term medical coverage and limited medical coverage can provide options that include valuable features such as:
  • Open network of physicians, specialists, and hospitals
  • Access to urgent care centers
  • Flexibility in length of coverage and in cost (coverage duration varies by state, may not be renewable)
  • Variety of deductible and coinsurance options
  • Low copay options for in-network benefits
  • Paid benefits similar to traditional major medical plans
  • Next day coverage
  • Little to no waiting periods
  • Deductibles as low as $250
  • Relatively inexpensive premiums, but may result in lower and more restricted benefits
  • Guaranteed acceptance for some products, if eligibility is met and available in state
  • Unlimited low-cost doctor and specialist copays

Short-term medical coverage or limited medical coverage may be the best fit for some of your clients. However, it’s important for you and your clients to understand these products do not replace major medical insurance, and they do not count as minimum essential coverage required by the Affordable Care Act. These products are not intended to serve as sole medical coverage. Limitations, restrictions, and exclusions may apply.

Learn more about the features above as well as how they can help clients with a variety of health concerns, lifestyle needs, and budget needs by:

Click here to like us on Facebook for important industry updates, tips, and articles!

Sources:

1: “Safe Toys and Gifts Awareness Month.” Prevent Blindness America. https://www.preventblindness.org/safe-toys-and-gifts-awareness-month

2: “Safe Toy Checklist.” Prevent Blindness America. https://www.preventblindness.org/safe-toy-checklist

 

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

 

 

Breast Cancer Awareness Month Help Your Clients Protect Themselves

Breast Cancer Awareness Month: Help Your Clients Protect Themselves

Approximately 1 in 8 women born today in the United States will get breast cancer at some point, the second most common kind of cancer in women1. While most women can survive breast cancer if it’s detected and treated early 1, there are several lifestyle factors that your clients should consider when assessing risk, including:

  • Consuming dairy (with risk of death increasing for those who continue to consumer dairy after diagnosis)2
  • Being overweight or obese3
  • Not being physically active3
  • Regularly drinking alcohol4
  • Taking hormone replacement therapy4
  • Taking hormonal birth control3

 

The month of October is Breast Cancer Awareness Month, an opportunity to raise awareness about steps women can take to decrease their risk and to detect and treat this disease. It’s also an opportunity to help your clients protect themselves from potential financial challenges that can come with breast cancer treatment. When faced with high deductibles, high copays, and high premiums, it can be difficult for your clients to afford medical coverage.

Limited medical plans can offer economical options that can help do just that for your clients who are:
  • Anticipating rising medical expenses
  • Unable to afford major medical coverage
  • Not eligible for short-term medical coverage
  • Looking for supplemental coverage to their major medical plans
 With these products, you can offer your clients many features, including:
  • The freedom to choose any doctor or hospital of their choice
  • Guaranteed issue coverage with $50-$100 paid toward doctor and specialist visits
  • Offer preventative care for $50, $75, $80, $100
  • Next day coverage or little to no waiting periods for accidental injuries or sickness
  • 12 month waiting period for pre-existing conditions
What are the limitations of limited medical coverage?

This type of plan does not count as minimum essential coverage required by the Affordable Care Act and is not suitable to serve as your clients’ only medical coverage. Although the premiums may be lower than a major medical plan, the benefits are also lower and more restricted.

You may have clients who need to supplement their existing coverage, but who are worried about affordability and value. With limited medical coverage, they have the option to take advantage of low premium rates, discounted network rates, and even access to non-insurance benefits such as a prescription savings program, 24/7/365 video and phone access to quality physicians, and a patient advocacy service.

Learn more about how limited medical options may be ideal for your clients 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.

Sources:

1: “October: National Breast Cancer Awareness Month.” U.S. Department of Health and Human Services. https://healthfinder.gov/NHO/OctoberToolkit.aspx

2: “High – and Low-Fat Dairy Intake, Recurrence, and Mortality After Breast Cancer Diagnosis.” Candyce H. Kroenke Marilyn L. Kwan Carol Sweeney Adrienne Castillo Bette J. Caan. https://academic.oup.com/jnci/article/105/9/616/986948/High-and-Low-Fat-Dairy-Intake-Recurrence-and

3: “Lifestyle-Related Breast Cancer Risk Factors.” American Cancer Society. https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/lifestyle-related-breast-cancer-risk-factors.html

4: “Lifestyle: How Our Lifestyle and Choices Affect Breast Cancer Risk.” Breast Cancer Now. http://breastcancernow.org/about-breast-cancer/what-can-cause-breast-cancer/lifestyle