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George Beach Insurance Services LLC Blog

Insurance News Roundup for 10/11/2021

10/11/2021

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1. Medicare open enrollment starts soon. Here’s why you should pay attention: https://www.cnbc.com/2021/10/09/medicare-open-enrollment-starts-soon-why-you-should-pay-attention.html
Medicare open enrollments starts October 15th and runs through December 7th. This is your chance to make changes to your Medicare coverage for the upcoming year. If you’re happy with your current plan and coverages, you do not need to do anything but it is still recommended that you at least look at the changes and review your Part D (prescriptions) to see if there are any formulary changes.

2. Some California parents can now join their kid's health insurance plan: https://www.abc10.com/article/money/some-california-parents-can-now-join-their-kids-health-insurance-plan/103-3fccf935-f54c-42a7-9e89-b92187101d9b
The ACA allowed children up to age 26 to remain on their parents’ health insurance plan. Now Governor Newsom signed a law allowing some parents to join their kids’ health insurance. The new law only applies to plans purchased on the individual markets, such as direct buys or through Covered California and not plans available through an employer.

3. Covered California Opens Special Enrollment Period: https://www.escalontimes.com/news/covered-california-opens-special-enrollment-period/
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Covered California has announced a new special enrollment period for individuals who lost federal financial assistance towards their COBRA coverage. It is estimated there are 138,000 California eligible for the new special enrollment period. Coverage can start as soon at November 1st 2021.

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Covered California Welcomes New Carrier - Bright HealthCare!

10/4/2021

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Covered California members in Contra Costa County will have a new carrier to choose from when picking their 2022 health insurance. 

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​Bright HealthCare, while not new to health insurance, is new to Covered California and Contra Costa County. Members who pick Bright Healthcare will have full access to the John Muir Health and Hill Physicians Networks.

Bright HealthCare is offering 7 plans in 2022: Bronze 60, Silver 70, Gold 80, and Platinum 90. There will also be 3 Cost Sharing Reduction plans available for those who qualify: Silver 73, Silver 87, and Silver 94.

Bright HealthCare is an HMO (Health Maintenance Organization) that truly puts the members' needs first. Bright HealthCare uses smart tools and technology to simplify health insurance for all of those involved. Their goal is to take the confusion and chaos out of the process and build benefit-packed plans that still deliver surprisingly low rates, so the member can focus on staying happy and healthy…and paying less for their healthcare.

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Can Covered California Be Retroactive?

9/27/2021

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​No, coverage bought through Covered California will start the first of the following month. Individuals who sign up for Medi-Cal (California’s Medicaid program) can have coverage that is effective retroactively to the first day of the month from when they submitted their application.

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Does Dental Insurance Cover Wisdom Tooth Removal?

11/14/2019

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Does Dental Insurance Cover Wisdom Tooth Removal?
Few people get excited at the thought of going to the dentist, especially if tooth removal is on the menu. Fortunately, many procedures are covered by dental insurance. When it comes to wisdom teeth, whether dental insurance will cover your procedure is dependent on a few different factors.

Average Cost of Wisdom Tooth Removal in the US

Wisdom tooth removal cost varies depending on a few factors. Whether your teeth or impacted or have erupted through the gums makes a huge difference in price, since the latter typically results in a relatively easy removal. If your teeth are impacted, meaning trapped underneath the gums, the price tends to be much higher. The average cost of wisdom tooth removal for all four teeth after insurance tends to be around $1,000. Remember that the price is entirely dependent on the severity of your wisdom teeth situation, meaning the more impacted they are, the more work that will go into removing them, so the price will be much higher than a simple extraction. The Oral Health Foundation suggests always getting an estimate before you start treatment to make sure you can get the actual price you will be paying.

If It's Medically Necessary, You're in Luck

Wisdom tooth removal when it comes to impaction is typically considered medically necessary. According to Murfreesboro Family Dentistry, impacted wisdom teeth can be very painful and lead to infection, so this condition generally qualifies removal as “medically necessary.” Be sure to speak with your insurance provider prior to the procedure, however, just to be sure that the wisdom teeth removal is actually covered.

If It's Preventative, You Might Have a Hard Time

Dental insurance companies will be less likely to want to cover a procedure that is not deemed medically necessary. In turn, if you are trying to get your wisdom teeth removed as a preventative measure, dental insurance will not be as willing to cover your procedure. Work with your dentist's billing department prior to undergoing the procedure to see if they need to bill it a certain way in order to obtain dental coverage for wisdom teeth removal. Otherwise, you may be responsible for a hefty portion, if not the entirety, of the bill.
More often than not, insurance is a good idea. Especially when it comes to dental work, it is worth looking into insurance. Even if your wisdom teeth removal is deemed unnecessary from a medical standpoint, you can always call your dental insurance provider to see if they will cover a portion of the procedure at the very least.
​It’s important to have insurance to protect your health. Contact us to get a quote!
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Anthem Blue Cross Is Expanding!

9/23/2019

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​Anthem Blue Cross of California
 
Anthem Blue Cross is one of the largest managed health care companies in California. It is an independent licensee of the Blue Cross Blue Shield Association based in Thousand Oaks, California. Anthem and its affiliates serve over 8 million Californians and have offered Covered California plans since 2014.
 
2020 Expansion
Anthem is pleased to announce that we are expanding our participation in an additional six regions for 2020. In addition to currently offering plans in regions 1 (Northern California counties), 7 (Santa Clara County), and 10 (San Joaquin, Stanislaus, Merced, Mariposa and Tulare counties), Anthem will also offer plans in regions 9 (Santa Cruz, San Benito and Monterey counties), 11 (Fresno, King and Madera counties,) 12 (San Luis Obispo, Santa Barbara, and Ventura counties), 15 (Los Angeles County East), 16 (Los Angeles County West), and 17 (Inland Empire).
 
Innovative Programs
Anthem is working with doctors and hospitals that share responsibility for increasing access to appointments, improving the member experience, and providing a more coordinated treatment plan to patients.
 
We also want to help our members spend more time focused on their health and less time managing the ins and outs of health care. That’s why Anthem is driving meaningful change through technology to deliver an easier to use, more complete web and mobile health care experience.
 
Introducing IngenioRx
Anthem’s new pharmacy benefits manager, IngenioRx, not only manages Anthem drug plans, it also offers better support to our members. This means members will have around-the-clock access to teams of specialists, online tools that can be used at home or on the go, and the ease of managing health and drug plans in one place.
 
Mobile and Online options Meet Sydney, Anthem’s new mobile app designed to provide members a more personal, simplified experience. Along with quick access to their Digital ID card, Find a Doctor, and a Personal Goal Setting tool, members can also use the new ChatBot to help guide them on the app, and try the new Care Team set up feature, too. And at anthem.com/ca, members can find all the same features built with easy access and personalization in mind as the mobile app and much more.
 
24/7 Access with Telehealth Anthem’s LiveHealth Online telehealth program gives members access to real-time, face-to-face visits with a choice of doctors across a range of specialties via computer, tablet or mobile phone 24 hours a day. Available in both English and Spanish, doctors can answer questions, diagnose common problems, and even prescribe some medications.
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ACA Metal Tiers

9/18/2019

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Health plans are classified under four categories to make comparing them easier. The categories are divided according to the percentage of health care costs they pay, and they include the following:
  • Platinum – Plan pays 90% of the costs. You pay 10%.
  • Gold – Plan pays 80% of the costs. You pay 20%.
  • Silver – Plan pays 70% of the costs. You pay 30%.
  • Bronze – Plan pays 60% of the costs. You pay 40%.
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How Divorce Affects Your Family Health Insurance

9/9/2019

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The breakup of families is very common in the United States with 40 to 50% of marriages ending in divorce. Of course, this has serious economic impacts on the individuals involved. One such area is health insurance, the coverage of which can be significantly altered by a divorce. With so many other important factors involve, this may be the last one you consider, but when you do, you'll realize that it is one of the most significant. Here are three things you should know about how divorce affects your family's health insurance.

Your Coverage May Go Through Drastic Changes
If you divorce and your health insurance was provided by your spouse's employer, changes in the coverage will probably ensue. In this scenario, it is entirely possible that you will lose your health insurance when you also lose your status as a qualified dependent. Once that happens, you must find your own or pay for COBRA Insurance, which can cover you and the rest of your family for up to 36 months, though often at increased premiums. Investigate your health insurance options. Potential alternatives include checking what your own employer offers or signing up for the Affordable Care Act.

Your Kids Should Still Be Covered
One of the most important things in a divorce that involves children is to work out which spouse will pay to ensure that those children have health insurance. This decision will be based on various of factors, including which spouse can purchase the most comprehensive coverage and what the cost of the coverage may be.

It's also important to keep in mind that the spouse who covers health insurance may have child support payments altered in compensation. According to Laurence J Brock, child support payments are calculated based on several factors, including health insurance costs. As such, payment of health insurance often lowers child support payments.

Your Coverage Might Not Change
There are numerous scenarios under which your health insurance may not change. The first is the most obvious, the one in which you are the person who obtained the coverage in the first place. Indeed, in this scenario, your costs may actually drop when you remove your spouse. Some states, however, allow a person to keep an ex-spouse on a health insurance plan. In certain cases, it might even be required.​

Divorce leads to myriad changes in life, and one of the most important could be health insurance coverage. Before a divorce, you should make sure that you know your options and how the legal severance may impact your life. Talk with professionals and make sure your decisions are informed.

If you are worried about your coverage, let us give you some peace of mind!
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Insurance Questions: What is the Advance Premium Tax Credit (APTC)?

8/25/2019

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​The Advance Premium Tax Credit is a Federal Tax Credit for individuals that reduces the amount that they pay monthly for their health insurance premiums when they buy their health insurance on the marketplace.
 
The Advanced Premium Tax Credit is calculated by the federal government and sent directly to the health insurance carrier. The individual gets a monthly discount on the premium they pay each month.
 
Anyone eligible for this tax credit is determined by income. Those who make more will receive a smaller credit and smaller discount, while those with a lower income will receive a larger discount and larger credit. Because this tax credit is a direct payment the individual is not responsible for the entire amount, only the discounted amount.
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What are the Essential Health Benefits?

8/21/2019

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All health insurance plans share some common characteristics. The Affordable Care Act also known as Obamacare requires that all health insurance plans offered in the individual and small group markets must provide a comprehensive package of items and services. These are known as the Essential Health Benefits.
 
These benefits fit into the following 10 categories:
  • Outpatient Services
  • Emergency Services
  • Hospitalization
  • Maternity and Newborn Care
  • Mental Health and Substance Abuse Disorders
  • Prescription Drugs,
  • Rehabilitative and Habilitative Services and Devices
  • Laboratory Services
  • Preventive and Wellness Services
  • Pediatric Services including Dental and Vision care
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How do you pick the right insurance plan?

8/19/2019

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To make the best health insurance choice for you and your family, you can't just look at the premium. Usually a lower premium means a higher deductible and a higher premium means a lower deductible.
 
The main choice is do you want to pay less per month for your premium but then risk having higher costs when you use your services or do you want to pay a little bit more per month and then pay less when you need to use your services?
 
Some plans also have separate deductibles, one for medical services and one for prescriptions. Some plans have co-insurance some plants have co-payments. Co-insurance is where you're responsible for a set percentage of the services received, a co-payment is when you have a set dollar amount for the services received.
 
Don't just assume the deductibles and co-payments are the only differences between the plans we really need to dive into it to see which services are available and covered. Be sure to check that the plan covers the prescription drugs that you take and at what cost. If you have a doctor that you would like to keep seeing make sure that they're a provider for that network, if they're not you're going to end up paying a lot more.
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George Beach Insurance Services LLC​
Modesto, CA 95355
(209) 353-2330​
Click Here to Email Us
CA License: 0K34688 & 0K82780
AZ License: 17640886
CO License: 630662
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