Shopping the marketplace: The #1 benefit to researching health coverage

main benefit to researching health coverage options

Overview: This main benefit to researching health coverage options will help you choose the ideal plan.

Choosing the right health coverage plan requires conducting personal and professional research if you want to experience the full benefits. We don’t recommend that you choose the first health coverage plan that comes your way — as rushing and picking the wrong health insurance plan could be costly in more than one way.

It’s important that you prioritize your needs — whether that involves others (families) or not. As such, the main reason you should do research on health coverage plans is because you’ll be able to compare plans across the marketplace and essentially curate what you need based on the different options in the marketplace that you’ve come across. Granted, there aren’t too many options, but there are enough variations for you to pick-and-choose certain factors.

Do research to specialize your health coverage plan to your needs

Let’s say your employer offers health coverage plans but you’d rather shop the marketplace, this is when research and time come in. Conducting your own health coverage research is beneficial even if your employer does offer plans because you get to compare the different types of health insurance plans.

You might come across one plan that offers one thing that you like and another plan that offers another thing that you like. You’ll ultimately be able to curate an “ideal” list of factors you would like to have in a health coverage plan and start to tailor your research to that.

This isn’t to say that you’ll get exactly what you want, but the more specific you could get when doing research, the easier it’ll be to sift out what you don’t want. The reality is that there might be some aspects of certain plans that you don’t need and aspects of other plans that you consider to be a must-have. Factors such as cost, in-network options, referrals, and provider choice all play a role in what health coverage plan you ultimately decide on.

main benefit to researching health coverage options

The main benefit of going through your employer for health insurance plans

If your employer offers health insurance, this already cuts the research aspect in half. While you can always search for alternative plans available in the marketplace, receiving health coverage through your employer means that you’re likely to have lower premiums since your employer pays a portion.

For the best decision, be aware of past treatment trends

Regardless of whether you choose to go through your employer or not, doing the right research should also take into consideration (1) the amount of treatment you’ve received in the past and (2) the type of treatment you’ve received in the past.

To help you narrow down choices, think about the following factors:

  • You see a primary physician or a specialist frequently.

  • You frequently need emergency care.

  • You take expensive or brand-name medications on a regular basis.

  • You are expecting a baby, plan to have a baby or have small children.

  • You have a planned surgery coming up.

  • You’ve been diagnosed with a chronic condition such as diabetes or cancer. Or, on the contrary:

  • You can’t afford the higher monthly premiums for a plan with lower out-of-pocket costs.

  • You are in good health and rarely see a doctor.

Comparing common plans to start

Though it’s impossible to predict every medical expense, being aware of trends can help you make an informed decision. Let’s compare two common health coverage plans and see how they may or may not benefit you based on your needs.

HMO: HEALTH MAINTENANCE ORGANIZATION

If cost is your biggest determining factor, HMOs might be your best option. Choosing this plan means that you typically must see a primary care physician before scheduling a procedure or visiting a specialist. Due to this restriction, HMOs tend to be the cheapest type of health plan, overall.

  • You have to stay in network to get coverage except for an emergency

  • Procedures and specialists typically require a referral

  • There are lower out-of-pocket costs

  • You get a primary doctor who coordinates your care for you

  • Less freedom to choose providers

At the same time, another benefit with choosing HMO is that there is technically less work on your end, since your doctor’s staff coordinates visits and handles medical records.

PPO: PREFERRED PROVIDER ORGANIZATION

If being able to choose your specialist is your main interest when doing health coverage research, a PPO might prove ideal.

  • You do not have to stay in network to get coverage

  • In-network care is less expensive

  • Procedures and specialists do not require a referral

  • You have more provider options and no required referrals

  • There are higher out-of-pocket costs

This might be better for individuals who live in a remote or rural area and have limited access to doctors and care since you may be forced to go out of the network.

Related article(s): Your Step-by-Step Guide to Choosing a Health Insurance Plan

7 Important Women’s Health Screenings You Should Prioritize

Women's Health Screenings

Maintaining one’s good health takes commitment to a few critical habits.

While you may be well aware of the benefits of eating nutritious foods, getting regular exercise, and making time for rest, be sure not to overlook regular visits to your doctor as well. With routine screenings and checkups, you can detect problems early on to receive proper treatment. In this article, we’ll discuss seven critical health screenings that women should prioritize for the benefit of their good health.

Women’s Health Screenings

Seven health screenings to prioritize:

  1. Blood pressure screening. According to the American Heart Association, the ideal blood pressure measuring is 120/80 or below. So, if you maintain this healthy blood pressure, it is recommended that you have it checked at least once every two years, beginning at the age of 20. However, if you are at a higher risk of hypertension, you are 40 or older, African American, or suffer from a chronic condition like obesity, then an annual screening is encouraged.
  2. Cholesterol check. A cholesterol check is an assessment of your risk for heart disease or stroke. It is recommended that adults older than 20 to have this measured at least once every five years. However, if you pose a higher risk for these conditions, be sure to ask your doctor about the frequency at which you should have this checked.
  3. Pap smears. This critical exam takes cells from your cervix to check for cervical cancer. It is recommended that women get a pap smear exam every three years after the age of 21. And after 30 years of age, you can get this done just once every five years if it’s combined with a screening for HPV– an STD that can lead to cervical cancer.
  4. Mammograms. These take an x-ray image of the breast to screen for cancer. And while these are exceptionally important, there is debate over the frequency at which a woman should undergo a mammogram. That’s because while the risk for breast cancer increases with age, false positives are common with frequent screenings. However, the most recent guidelines suggest women begin at 50 years old to have a mammogram screening every two years. If you have a family history of breast cancer, though, talk to your physician about more frequent screenings.
  5. Bone density screenings. Women are especially prone to suffering from osteoporosis. And so, they should receive a bone density test at age 65. If you display risk factors, including fractures and low body weight, then you might consider getting screened earlier. The frequency of tests should be determined by your doctor, depending on your bone density and risk factors.
  6. Blood glucose test. After age 45, women should receive a blood glucose test every three years. This checks for diabetes and prediabetes. You might consider getting these tests done at an earlier age if you are at a particular risk for these diseases. If you are obese, have a family history of diabetes, or are a race or ethnicity that is at higher risk, you may need to have more concern for your blood glucose level. Speak with your doctor to help you plan.
  7. Skin examination. No matter your age, the American Cancer Society recommends that women should examine their skin every month at home. Each month, be sure to check for moles or changes to existing moles. These could be early signs of skin cancer. If you have a family history of skin cancer or you are at an increased risk, it may be necessary to talk with a dermatologist about routine office visits.

We at Bernardini and Donovan aim to help you and your family members stay healthy. That’s why we encourage your routine doctor’s visits and physical exams. These will help you stay healthy and promptly get the medical attention you require. And in the instance that you need more than routine checkups, make sure that you’re adequately insured. Reach out today for assistance with your health insurance needs.

4 Things You Need to Know About The 2019 Measles Outbreak

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One of the most interesting health issues to resurface this year has been the Measles. Which is interesting because, in the year 2000, the United States was able to declare that the Measles had been eliminated. However, in these last six months, we have seen 1077 cases. A number that is still growing. The last time we saw these kinds of numbers was in 1992. Here is what you need to know about these recent outbreaks:

1. Over 26 states have reported a Measles breakout

These states include: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, New Mexico, Nevada, New Hampshire, New Jersey, New York, Oklahoma, Oregon, Pennsylvania, Texas, Tennessee, and Washington.

2. Small Community Centered

Most of the reported breakouts include a small number of people affected; only a couple at a time. But the most significant reported amounts are in an Orthodox Jewish Community in New York City, specifically in Rockland County. This group has been vaccine skeptic, and the measles virus has spread wildly. So much so that the mayor of New York City, Bill de Blasio, declared a public health emergency on April 9th. He said that anyone who has not been vaccinated within a specific zip code must get the vaccine. If they refused, they would be fined $1,000.

3. It’s an aggressive virus.

You may have the virus and not show any symptoms. A person can have it up to four days before they ever show signs, and they can easily infect another person during that time if a person who has contracted the measles were to walk into a room, cough and then leave. Hours later, an unvaccinated person could get the virus from the droplets in the air from the infected person. No other virus can do that.

4. It’s making its way into the US from tourists

Many of the outbreaks that stemmed from people that have traveled to countries where measles still is a significant problem. Outbreaks in California have originated from strains of measles found in Vietnam or Thailand. New York’s epidemic seems to come from Jerusalem. If you are traveling to another country this summer, the CDC recommends that you are up on your vaccines so that you do not contract this aggressive virus.

If more people are vaccinated, it creates what is called the herd effect. It helps the people who cannot get vaccines like small children or people or autoimmune diseases from getting the disease. If you need to check up on your vaccines, make sure to call your doctor. If you have already been vaccinated for measles, most people do not need a have the vaccine again, but if you got it before 1967, you might. Your doctor will be able to help you determine what you need as far as vaccines go.

5 Tips For Your Healthiest Summer

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With Summer here, its time to go out and have an adventure. It’s time to take a vacation! It’s time to live your best life!! And having that best life means not only being happy but being healthy. Here are five tips for your healthiest Summer.

  • Its all about that water

    Our bodies need water to function! Keep your body happy and make sure that you are drinking plenty of water. If you are starting to feel a little bit hungry, that may be your first sign that you are dehydrated! Pick up a glass of water before your pick up a snack and see how you feel. Most likely, you’ll be more full and will feel better.

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health insurance
  • Eat all the colors of the rainbow

    When eating its essential that your plate has a full spectrum of color to ensure that you are getting all of the vitamins, minerals, and antioxidants that you need. This can look like a colorful salad with tomatoes, yellow peppers, carrots, and berries. Or it could be a kabob with mushrooms, red onion, bell peppers and pineapple on it. Be creative and see how many colors you can get into your meals.

  • Be social while you eat

    It is easy to want to overeat when delicious foods surround you at parties, bbqs, and gatherings. Here are a few tips to keep your intake in check. Sit down while you eat. You’re less likely to keep eating if you’ve moved to a seated position over standing by the food. Then talk to someone while you eat. If you are talking to someone, you are eating slower and filling up more between eat a bite. If you are going out to eat, try sharing a meal. Restaurants typically have more substantial portions than what we require. Not only will you be full, but you will also save on a meal!

healthy eating
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  • Smart snacking

    Have a mid-morning or mid-afternoon snack can help you feel fuller longer. But what you snack on matters! We suggest nuts. They are full of healthy unsaturated fats! If you want to take your snack on the go, try getting snack sized baggies. You can portion out your snacks ahead of time, and you won’t overeat so that your snack turns into a meal. If you are about to head out to a party that you know will be full of unhealthy foods, you should eat before you eat! Grabbing some fruit before a party can help fill you up before you go and gorge yourself on your mom’s potato salad.

  • Play outside

    Use the warm summer weather to get out of the gym during your workouts. Hiking, biking, running, swimming is all an excellent way to get in exercise while outdoors. You could also choose a family-friendly activity and bring the whole family along. Nothing beats bonding with your loved ones over a shared activity. If you are on vacation, try walking to your destinations. Many places outside of the US are more walking friendly, and you will experience your vacation spot in a whole new way. You’ll be like one of the locals!

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Know Before You Go: Quick Tips to Take Before You Travel

Tips to Take Before You Travel

As you plan your summer vacation, the last thing that you plan for is to get sick. However, studies have shown that around 15% of travelers experience some medical need during their travels. It can range from accidents or injuries surrounding their exciting plans or could be that they fall sick from some foreign bug. Either way, travelers that experience these type of medical needs often have some questions about how their medical needs will be paid for. So before you go on vacation, here are a few tips to make sure that your health has a priority.

health insurance
  • Call Your Health Provider

    One of the easiest ways to find out if your health provider will pay for out of the country health benefits is to ask them! Some health policies will provide a certain amount of health coverage, but many will make you pay out of pocket and then submit for reimbursement. And if you have original Medicare, there is not international coverage. You will want to make sure that you are asking the following questions:

    • Will my policy cover me while I travel abroad?
    • Will I have to submit for a reimbursement
    • Will my coverage include preexisting conditions
    • Ask about injuries that are due to circumstances outside of your control, such as acts of war, natural disaster, or acts of terror?
    • Will preauthorization be needed for treatment in a hospital?
  • Get a Quote for Travel Medical Insurance

    This type of insurance is different than travel insurance because it focuses on your medical care or you need for evacuation instead of trip cancellation. If you should get injured or sick while on a trip, it helps to pay for your medical needs, and if you were to get injured in a remote area where you could not receive proper medical care, it would cover the cost of the evacuation to get to an appropriate hospital. Many types of travel insurance also include this aspect, so make sure that you are looking at precisely what is covered when you purchase it. It will usually cost you to 4-8% of what you have paid to go on your trip.

  • Don’t take unnecessary risks

    While we understand that for some, going on an adventure is part of their vacation, it is important that you are not signing up for an unsafe situation. Many times accidents that happen while on vacation are simply that, accidents. A person trips while walking on cobblestones or one may be involved in a car accident. These are all very normal if not unfortunate circumstances. But if you are signing up for an experience, make sure you are working with a reputable company that complies with basic safety standards.

    We hope that your summer vacations are full of fun and excitement and that sickness and injury stay far away. But if you should get ill, we hope that you’ve taken these tips to heart and covered yourself for any travel mishaps that you may encounter.

Summer Sun Skin: 5 Ways to Protect Your Skin This Summer

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Summer brings so many good things for us! Time off from school, family vacations, beach trips, warm weather and lots and lots of sunshine! But while you are partaking in soaking up these rays, it is essential to think about how to protect your skin. Your skin can go through some severe damage during this season. So here are fives ways to protect your skin this summer!

  • Drink Water

    When the temperatures rise your body sweats and lose hydration. On top of that, your skin is made up of 64% water. So when you are not drinking enough water, it can show! It can also lead to headaches and itchy patches on your skin. So it is essential that you are keeping your body well hydrated with eight glasses of water a day.

  • Sun protection is key

    One of the most significant issues with too much sun exposure is skin cancer, and one of the easiest ways to avoid this is to wear sunscreen. Anything over SPF 30 will block out about 97% of the UV rays. You will want to make sure that you are covering any part of your skin that will be in the sun and then reapply every two hours. If you are swimming or sweating you may want to apply more often. But sunscreen is not the only way to protect yourself from the sun. You can also cover up with clothing. Light long sleeves and pants and a wide-brimmed hat can do wonders to keep you from getting sunburned. You may also want to seek out shade. Some choose to carry an umbrella with them for a little extra protection against the sun.

  • Exfoliate

    During the summer months, your skin experiences a lot and needs to be exfoliated. Between sweat, sunscreen, and other elements, your skin can be easily clogged and can lead to acne and breakouts. Regular exfoliation and washing allows your pores to breath and makes for happier skin.

  • Feed your skin

    The saying you are what you eat holds some weight here. Your skin reacts to what you are eating, and if you are not feeding yourself good, nutritious foods, your skin is one of the first telltale signs. But eating foods that vary in all the colors of the rainbow can help your skin can help protect your skin from outside elements while also giving you a healthy glow.

  • Quit Smoking

    Smoking has many adverse side effects, but on top of those havoc-wreaking consequences, it also hurts your complexion.
    There are plenty of reasons other than your skin health to give cigarettes the boot—like an increased risk of lung cancer—but all those packs also wreak havoc on your complexion. Smoking causes the small elastic fibers and collagen in your skin to be damaged and over a period that leads to wrinkles in your skin. Smoking makes you age much faster than the average person would. So this summer, put down your tobacco use for good.

    We hope that this list has given you a few helpful tips and tricks to keep your skin happy this summer. We know that it is easy to be excited for beach days and warm vacation spots, but taking care of your skin today will have lasting benefits for the rest of your life.

There are plenty of reasons other than your skin health to give cigarettes the boot—like an increased risk of lung cancer—but all those packs also wreak havoc on your complexion. Smoking causes the small elastic fibers and collagen in your skin to be damaged and over a period that leads to wrinkles in your skin. Smoking makes you age much faster than the average person would. So this summer, put down your tobacco use for good.

family health insurance

We hope that this list has given you a few helpful tips and tricks to keep your skin happy this summer. We know that it is easy to be excited for beach days and warm vacation spots, but taking care of your skin today will have lasting benefits for the rest of your life.

Your Healthcare Options Part 1

Healthcare Options

What Are Your Healthcare Options?

If you are over or close to the age of 65, Medicare is something that you might be utilizing or thinking about using. If you are in that boat, then it is essential to know your open enrollment times. If you are looking to go with the Medicare Advantage Plan, open enrollment is upon us.

Recipients of Medicare have a choice between the Medicare Advantage Plan or the Medicare Supplement Plan which is like a PPO plan. The difference between the two is that in the Advantage plan you will pick a primary care physician who will direct your care. They are known as the gatekeeper. If you need to see any specialist, they will provide a referral for that. Under a PPO contract, you have the flexibility to direct your care. You do not have a primary care physician, and you have a choice of any doctor in your provider network. This option does have a higher cost in comparison to the Medicare Advantage Plan so we often see people in this area choose the Advantage Plan and it works well for them. Many doctors prefer this plan over the PPO option, as well, because there are Medicare Reporting standards that they are held to and it is easier to capture that data on this particular plan.

The Medicare Advantage plans and Part D have open enrollment starting on October 15 and ending on December 7. So if someone has original Medicare and purchases a drug plan without any other supplemental coverage that is the time that they can change their drug plan because Medicare by itself does not cover medication.

At Bernardini & Donovan, we work very closely with a majority of our clients who utilize the Medicare Advantage Plan. If that is something that you know that you want to look into, there is no one better for you talk to than us. Our years of experience allow us to help you plan and see how you can have the low cost of the Advantage Plan while having the best possible health care available to you. Please feel free to call us today to set up an appointment if you have questions.

The Power of Giving

The Power of Giving

The Power of Giving

One can find many quotes about giving:
“The best way to find yourself is to lose yourself in the service of other.” – Mahatma Gandhi

 

Or maybe you’ve heard this one:
“We make a living by what we get; we make a life by what we give.” – Winston Churchill

 

The fact of the matter is that giving changes something inside of us and changes the world around us. But how can this one simple act create that much change?

 

Scientists have started to study the biological changes in humans through the act of giving. Darwin’s survival of the fittest would initially lead one to believe that as humans we are not intrinsically designed to give or nurture. But that is not the case. Studies have shown that when a person gives their money willingly that the prefrontal cortex of the brain lights up. It is the same region that is engaged when we experience pleasure from food or relationship. Their studies showed that our brains are hardwired to respond to this very basic concept.

 

There are also examples and bountiful testimonies of people who experIenced emotional changes in their lives when they started giving financially. They describe it as before they started giving they were reinforcing the idea that they never had enough, that they must continue to strive for more. But in the act of giving they not only found peace in their circumstances, but they also had a better view of money and were able to grow their wealth as well as their physical health.

 

At Bernardini & Donovan, we are always looking for ways to grow in our appreciation of all that we have been given. We know that looking beyond ourselves is vital to be a greater service to others. We hope to help our community not only through our service but by giving back to the countless others who have helped us and giving to those who are in need.