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when to change your plan

When to change our plan

Its July now, and for many of us, we have had our current health insurance plans for seven months out of the year. This timeline has walked us through flu season, allergy season and an extended enough period to get a good read on whether or not your current health insurance plan is a good fit. At this time of year, we always recommend going back over your year and checking off your health needs.How many times did you need to go to Urgent Care?

How many times did you go to the Emergency Room?

How many times did you need to visit a specialist?

How many times did you need to visit your doctor?

Was there any unexpected change to your health this year?

Were there any diagnoses that would potentially need extended lasting care?

All of these questions can have a significant impact on the type of insurance that is best for you and your family. For example, let’s say that you have a Bronze level plan which is known for their low monthly premiums but high costs when you need care. In this last year, you have gone to urgent care more than expected and required more time with your family’s doctor. This plan would not be very affordable for you as you are continuing to pay more out of pocket with each doctor’s visit and care that was provided.

If you have seen significant changes in your health or your family’s health, now is an excellent time to make a note of it. You cannot make changes to your health insurance plan unless there is a qualifying life experience (lose current coverage, changes in household…). But you can make a note of how many times you paid out of pocket for care. If this number is significant enough, we recommend talking to us during open enrollment to change your plan. With information like this written down, we can help you find the best health insurance plans for your needs and finances. Please feel free to call us at any time of the year for any guidance on your health insurance needs.

Pros and Cons of Kaiser
Kaiser Permanente is one of the staples of our local health providers.

They have recently built a facility in Redlands and continue to provide health services to our community. But bringing up the name Kaiser Permanente can come with some very mixed results. You’ll find people who love Kaiser and feel that they have never experienced better or more organized care. You’ll also find people with vitriol and fury in their descriptions of the healthcare company. This may be because of the unique type of business model that Kaiser holds to, which is different than any other health provider.

Kaiser not only provides health care through doctors, nurses and specialists; they also provide the health insurance to help pay for that care.

Medical health insurance that is purchased through them makes all of their doctors and facilities available to you. However, you will not have access to anyone outside of their care. If it is an emergency situation, they will cover attention that was received at another hospital.

It is this system that makes people have such polarizing opinions on Kaiser.

For many, they experience a system with a lot of ease. All of your medical records are accessible and ready at any time to any doctor that you may see. The costs are usually lower than other health insurance and care providers. They are dedicated to providing your excellent, whole health care. Their website states “Kaiser Permanente was founded on the radically simple idea that everyone deserves the chance to live a healthy life. That’s why you can find high-quality care and coverage in one place.” But on the rare case that you become ill with something that their specialists cannot find an answer to, and if there is another specialist outside of their system who could better treat you, it is not likely that it would be approved.

We hope that this light perusal of Kaiser Permanente has been helpful. If you ever have questions about your health insurance and what it covers, please always feel free to call us at Bernardini and Donovan.

As the time comes for open enrollment or to renew your health insurance, here are some helpful hints to look at before your purchase a plan.

Look before you renew
As the landscape for health insurance continues to change it is important that you make sure that your fully check out your options before opting to renew. Not only do the options available in your plan change from year to year but your personal circumstances change. You may have moved, found a new job, or had a child and all of these can change what you need from your provider. Also, if your plan is being replaced make sure you fully look over what it is being replaced with so you are not surprised later down the road and find that what you need is not covered.

Doctors and prescriptions, oh my…
You will want to make sure that your preferred doctor accepts that coverage before you enroll. And going to a doctor outside of your coverage can cost you substantially more that going in your plan. Also, you will want to know what your prescription medication is going to cost you. Most companies will assign medications to a different level or tier so that between different companies the medication you need may be covered but it may be on a different tier and therefore would cost you much more.

Consult an insurance broker
When the Affordable Care Act come into effect its purpose was to let people comparison shop relatively easily for different health care options. However, the health care market is wide and varied and you can very easily not see a special savings or find out that what you need is not covered when it is too late. Health Insurance brokers are working hard to stay ahead of the changes in the law, know all the different nuances of plans being offered and want to help you find your best fit. Contact us at Bernardini & Donovan and let us help you look beyond the bare essentials to finding a package that fits you and your family perfectly.

There are so many benefits to having health insurance. From the simple fact that when you are feeling not at your best you have a place to go to get some care. Even having the peace of mind of knowing that when your baby won’t stop coughing you have an expert at hand who will give you everything you need to take care of your little one. But did you know that there are many additional benefits to your health insurance besides your basic doctor visits, prescription drugs and hospital care.

  • Online access – How many times have you lost your ID card and need to call to get a new one mailed to you. With online access you can print out a new ID card immediately. You can also see your claims, changed doctors, and never be on hold for over an hour again. You can do all of these and more online.
  • Gym Membership – Many insurance companies are now offering gym memberships, discounts on gym membership or even reimbursement on a gym membership if you check in a certain number of times at the gym per month. They may also offer discounts on gym equipment. So if you are looking to invest in an elliptical or a treadmill check to see if you get a discount.

  • Diet plans – You may find a discount on certain weight loss and diet plans such as Weight Watchers, Jenny Craig or Nutrisystem.

  • Homeopathic Medicine – more insurance programs are covering homeopathic remedies such as acupuncture or chiropractic care. If they don’t completely cover it they may also offer to add it on for a small fee.
  • 24 hours nurse care – small children always seem to get every cold that is out there. And with this service you can call a nurse hotline and get advice if it is enough of an emergency situation to go to urgent care or emergency room.

  • Employee Assistance Program – get financial advice for today or for your future financial planning.

  • Mental Health – Talk to someone via telephone as well as in person visits if needed.

Health insurance costs are continuing to go up but there are other benefits available to you that adds to the value to your health insurance plans.

Health Insurance for Children

With the recent twists and turns of the Affordable Care Act, there have been many changes to health insurance. While most people talk about how this will affect the health insurance needs of adults, not many people think about how it can help children. The Affordable Care Act has made it easier than ever for children to be covered with the right health insurance policy.

In order to sign up for health insurance, adults have to wait for an open enrollment period or have a qualifying life event. However, children are able to get covered with the right health insurance plan at any point in the year through Medicaid and the Children’s Health Insurance Program, also known as CHIP. Both federal and state programs offer low cost or free health care to children, which help to bring the number of uninsured children to record lows.

Many private health insurance providers are now offering the same services that CHIP and Medicaid are offering, including various preventive care services that come at no cost. These preventive services include immunizations, autism screenings, depressions screening, obesity screenings, and more to help ensure the health of children across the country.

All health insurance plans are now required to offer 10 services, including vision and dental care for children, as well as maternity and newborn care. It is important to keep in mind that insurance companies do not have to offer dental and vision care to children who are over the age of 19, so look carefully when deciding on the right policy to fit your needs.

Contact the insurance experts at Bernardini & Donovan Insurance Services in Redlands, California for all of your child health insurance needs. We will work with you to ensure that you have the right amount of coverage for everyone in your family, all at the right price.

If you are one of the many Americans who missed Obamacare’s first open enrollment period, it is important that you start preparing so that you can be ready when the second open enrollment period arrives. If you miss this second period, you will be forced to pay a penalty for each month that you do not have health insurance. Unless you qualify for the special enrollment period, you could be paying hefty penalties for several months until the third open enrollment period arrives.

The second Covered California open enrollment period starts on November 15, 2014 and will end on February 15, 2015. During this time, you must obtain health insurance in order to avoid the penalty. During the weeks leading up to the second open enrollment period, you will want to gather all important documents such as birth certificates, proof of citizenship, etc. If you find the market exchange confusing, an insurance broker can guide you through this complicated process.

We understand how confusing the laws and regulations surrounding Obamacare can be, especially if you have never purchased health insurance before. Many individuals who are inexperienced in purchasing health insurance benefit immensely by using a broker. Insurance brokers such as the experienced brokers at Bernardini & Donovan Insurance Services guide you through each step of the health insurance process, free of charge. Our experience makes us the perfect candidates to sit down and compare varying plans and policies with you, to ensure that you obtain the most affordable policy possible.

Contact Bernardini & Donovan Insurance Services in Redlands for all of your California health insurance needs. We are extremely knowledgeable in all regulations and laws surrounding the Affordable Care Act, which is why we are the perfect team to guide you in your health insurance endeavors. We can help ensure that your health insurance complies will all new rules and regulations.

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As the next open enrollment period fast approaches, many state insurance exchanges are preparing for the overflow of traffic. Most state insurance exchanges have begun preparing for the second Obamacare enrollment period by adding new carriers. However, Covered California did not follow the trend, rather they chose to decrease in size. Yes, you heard right!

As one of the largest states in America, many were surprised to hear that Covered California only had 13 carriers at the start of the first open enrollment period. This year, Covered California will only have 10 carriers. For any other state, 10 carriers would suffice. Of the 10 Covered California carriers, only 4 of them are major insurers with Kaiser Permanente, Blue Shield of California, Health Net, and Anthem Blue Cross.

As if your freedom of choice was not taken with the implementation of Obamacare in the first place, forcing all Americans to obtain health insurance, you now have even less choice. Many regions throughout California are forced to depend on the only insurance carrier available to them, eliminating choice altogether.

Many insurance experts are fearful of the lack of choice Covered California has provided. Since the lack of varying insurance carriers eliminates competition fears continue to rise about the success of Covered California. One main concern that many insurance experts have brought to everyone’s attention is the insurance carrier’s ability to raise prices for insurance. The purpose of Obamacare is to provide Americans with affordable health care, however, the lack of multiple participating carriers gives contributing carriers the ability to raise prices, because there is a lack of many other health insurance options.

We understand that the various implications surrounding Covered California may have you confused, and that is why we are available to dispel any myths and reveal only the truth. Contact Bernardini & Donovan Insurance Services for all of your California health insurance needs.

Despite common initial reaction to recent health care reform, health insurance brokers are still important, if not more important when it comes to the health care industry. With the majority of California residents still wondering how the Affordable Care Act will affect their lives, insurance brokers are able to help individuals and small businesses navigate through the various health insurance regulations. Gathered are 5 reasons why your insurance broker will become even more vital of an asset to you:

  1. If you are one of the many individuals who will be purchasing health insurance for the first time, your insurance broker will be able to answer any questions you may have, and guide you through the process of successfully enrolling in health care.
  2. Your insurance agent will be able to tell you whether or not your existing health insurance plan can become a grandfathered plan where you can keep it. You can even ask your insurance agent to help you determine which plan is the most cost effective and which provides the most benefits to you.
  3. As a small business owner, you may be able to purchase SHOP coverage through your insurance broker. Likewise, your insurance agent can help make sure that you are following all new rules and regulations under Obamacare, and help you assess the various health insurance options.
  4. As a small business owner, you can utilize the various benefits of having an employee benefits broker by your side. Your insurance broker will be able to manage your health care costs while ensuring that your organization complies with all rules and regulations.
  5. Most importantly to note, your insurance agent has been in the industry far longer than any health care reform navigator, therefore, they will best be able to assist you.

We understand that the various implications surrounding Covered California may have you confused, and that is why we are available to dispel any myths and reveal only the truth. Contact Bernardini & Donovan Insurance Services for all of your California health insurance needs.

With the introduction of Covered California, better known as Obamacare, many individuals and businesses are left wondering how the implications will affect their lives. Health exchanges have been put in place, providing individuals and businesses with a specific place where they can purchase health insurance through Covered California.

Although these health exchanges have been put in place, many Californians will continue purchasing health insurance from insurance companies, brokers, and private health exchanges. Since the majority of California residents who purchase health insurance will not qualify for government tax subsidies, many individuals would prefer to avoid purchasing health insurance from the state exchange service.

If you choose to purchase health insurance on an off-exchange plan, you will still be receiving top quality care. This is because the off-exchange plans are required to follow the 10 essential health benefits, offering the following 10 necessities:

  • Services during emergencies
  • Outpatient care without hospital admittance
  • Hospitalization
  • Maternity care and newborn care
  • Care for those with mental health and substance abuse problems
  • Prescription medications
  • Rehab and rehabilitative services
  • Laboratory facilities
  • Pediatric care
  • Preventative care

While there are still options for health insurance, it is now required by law that you obtain health insurance. Under the recent health care reform, all individuals must have health insurance. Likewise, there are a variety of legal requirements businesses must abide by now. If you have more than 50 full-time employees, you are now required by law to offer those employees health insurance. The next open enrollment period is fast approaching, so be sure to get informed so that you can make the appropriate health insurance decision based on your unique needs.

We understand that the various implications surrounding the Affordable Care Act may have you confused, and that is why we are available to dispel any myths and reveal only the truth. Contact Bernardini & Donovan Insurance Services for all of your California health insurance needs.

If you missed the health insurance deadline on March 31, you may still qualify for one of the Special Enrollment Periods to access the Healthcare Marketplace. These are 60-day windows to enroll after certain “life events” that change your individual or family status from the open enrollment time frames.

Special Enrollment Periods

Along with some specified life events, should you qualify for Medicaid or the Children’s Health Insurance Program (CHIP), you are able to apply for coverage at any time. Otherwise, you need to meet guidelines for special enrollment periods with “qualifying life events.” Examples of these events include the following items.

  • Marriage,
  • Divorce,
  • Birth of a child,
  • Loss of employment, and
  • Moving to a new state.

All of these events change your status, qualifying you for special enrollment periods that allow you to access the Healthcare Marketplace after open enrollment dates. Additional qualification limitations apply, including —

  • The state in which you live or to which you move,
  • Your household size, and
  • Evidence of new disability.

You should check with your state to learn how it interprets qualification rules for special enrollment periods. State requirements can also differ for application to Medicaid or CHIP, so investigate or get expert advice.

If you want some valuable advice, contact Bernardini & Donovan Insurance Services. The professionals at Bernardini & Donovan Insurance Services can answer your questions about special enrollment periods, details of different health insurance coverage, give you quotes and advise you on how to protect yourself, your family and/or your business.