The term "vision insurance" is commonly used to describe health and wellness plans designed to reduce your costs for routine preventive eye care and prescription eyewear such as eyeglasses and contact lenses. Some vision plans also offer discounts on elective vision correction surgery, such as LASIK and PRK.
You can get vision insurance in one of two ways: as a standalone plan or as combined with your dental plan.
Going to the doctor, going to the dentist—all part of taking care of your health. But going to the eye doctor? Also important! Eye exams at every age and life stage can help keep your vision strong. Many people think their eyesight is just fine, but then they get that first pair of glasses or contact lenses and the world comes into clearer view—everything from fine print to street signs.
Only Your Eye Doctor Knows for Sure
Eye diseases are common and can go unnoticed for a long time—some have no symptoms at first. A comprehensive dilated eye exam by an optometrist or ophthalmologist (eye doctor) is necessary to find eye diseases in the early stages when treatment to prevent vision loss is most effective.
During the exam, visual acuity, depth perception, eye alignment, and eye movement are tested. Eye drops are used to make your pupils larger so your eye doctor can see inside your eyes and check for signs of health problems. Your eye doctor may even spot other conditions such as high blood pressure or diabetes, sometimes before your primary care doctor does.
Vision Care Can Change Lives
Early treatment is critically important to prevent some common eye diseases from causing permanent vision loss or blindness:
-Cataracts (clouding of the lens), the leading cause of vision loss in the United States
-Diabetic retinopathy (causes damage to blood vessels in the back of the eye), the leading cause of blindness in American adults
-Glaucoma (a group of diseases that damages the optic nerve)
-Age-related macular degeneration (gradual breakdown of light-sensitive tissue in the eye)
Why get a vision insurance plan?
-Protect your eye health. Routine vision care may not be covered by your health plan.
-Save money. A vision insurance plan may reduce your out-of-pocket costs for eye care.
-Maximize benefits. Receive discounts on vision expenses like glasses or even LASIK.
-Get personalized service.
The two popular Vision Insurance Carriers in California are VSP and Humana.
If you want to discuss options about your vision insurance, we recommend speaking with an independent insurance agent like George Beach Insurance Services. We work for you the client, and not a particular big company.
HMO - Health Maintenance Organization
An HMO is a type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. You will usually need a referral from your Primary Care Physician to see a Specialist, resulting in multiple co-pays. All healthcare services are managed in-network through your Primary Care Physician.
In California, the popular HMOs are Kaiser Permanente, Sutter Health Plus, Western Health Advantage, Health Net of California, Sharp Health Plan, LA Care, Molina Healthcare, and Valley Health Plan.
PPO - Preferred Provider Organization
A PPO is a type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network. You can use doctors, hospitals, and providers outside of the network for an additional cost. PPOs do not require you to select a Primary Care Physician. One of the benefits of a PPO is you usually can self-refer to a Specialist.
In California, the popular PPOs are Blue Shield of California, Health Net Life Insurance Company, and Oscar.
EPO - Exclusive Provider Organization
A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan’s network (except in an emergency). Under an EPO plan you do not choose a Primary Care Physician. You can receive care from any of the in-network doctors and self-refer to in-network specialists.
In California, the popular EPOs are Anthem Blue Cross, Health Net Life Insurance Company, and Oscar.
If you want to discuss options about your health insurance, we recommend speaking with an independent insurance agent like George Beach Insurance Services. We work for you the client, and not a particular big company.
Since the 2019 Open Enrollment Period is over, you can now enroll in or change a Health Insurance Marketplace plan only if you have a life event that qualifies you for a Special Enrollment Period.
A change in your situation — like getting married, having a baby, or losing health coverage — that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment Period.
There are 4 basic types of qualifying life events. (The following are examples, not a full list.)
Loss of health coverage
Changes in household
Changes in residence
Other qualifying events
Opioid use, whether for a short or long period of time, can make you susceptible to addiction and possible overdose. There are many factors that can play a role in prescription drug addiction, including your personal background and length of use, but there really is no sure way of knowing who will fall victim to opioid abuse. Whether a person acquires them legally or illegally, these drugs are to blame for the vast majority of overdose deaths in the United States. Over 115 people in the United States die daily from opioid abuse. This has turned into a national crisis affecting public health as well as social and economic welfare. The United States loses over $78.5 billion a year fighting this crisis. Unfortunately, this negative trend is showing no signs of slowing down.
How it Started
Drug companies originally assured the medical community and government that opioids would not be addictive. This contributed to physicians prescribing these drugs more often. Eventually, this led to widespread abuse of these medications before medical professionals realized they were very addictive. In the meantime, opioid misuse and overdose rates continued to steadily climb. By 2015, over 33,000 Americans died of opioid-related overdoses. In that same year, nearly 2 million Americans suffered from opioid pain reliever substance abuse, and nearly 600,000 suffered from heroin addiction. It is important to be considerate toward addicts because it is a difficult situation to deal with, and many factors are beyond the user’s control.
Medical Coverage for Addiction
You may be wondering if medical insurance covers opioid addiction treatment. Generally speaking, yes. The Mental Health Parity and Addiction Equity Act, which was passed in 2008, mandates that insurance companies provide coverage for opioid addiction that is comparable to regular medical and surgical care. The types of drugs that are covered and other specifics will vary based on your insurer and plan type. Prior to the Affordable Care Act, many people did not have health care insurance, and their addiction problems went untreated. Today, nearly 85 percent of adults have medical insurance coverage.
The United States has over 14,500 facilities that specialize in drug addiction. It is important to remember that your insurance plan may not cover every facility. Most insurance plans also cover maintenance programs for people who are recovering from addiction. These programs are designed for individuals who had severe addictions and are unable to survive without drugs even after rehabilitation. Typically, maintenance programs will prescribe medications to help these people live a drug-free life. In most cases, these drugs are very expensive, so medical coverage is essential.
Opioid addiction is a very serious problem in the United States that costs billions of dollars each year to confront. The problem started with a misunderstanding of the addictive potential of the drugs. On the bright side, the majority of people in the United States do have medical insurance to treat addiction and improve their lifestyle.
At your first appointment, you’re required to have:
The following lists will help the doctor get to know you and learn about your health care needs. While sharing personal health issues can be embarrassing, the more information you give, the better equipped the doctor will be to keep you healthy.
Before the day of your appointment, write down this information to bring with you:
With your written permission, your doctor can get a copy of your medical records from your previous doctor. The physician’s office will provide the forms for you to sign.
It’s often hard to remember what you want to ask the doctor. Here’s a list of questions to get you started:
Want to know what your health plan covers before your appointment? Send me an email (email@example.com) and I will review your policy with you. You can even text me at 209-353-2330.
If you are dealing with addiction problems, then you know how difficult an addiction can be to beat. When a person does not find the correct resources to help with his addiction, he can find himself in a constant cycle of addiction and pain. Unfortunately, there is a stigma attached to addiction and addiction recovery, so some people may want to try to quit on their own without telling anyone about their struggle. Although there have been individuals who have been able to get clean on their own, most people do need to go to some type of treatment center. Many leading doctors agree, “coupling medication with psychotherapy and support creates a solid foundation and results in a longer lasting recovery." Treatment centers can offer a person relief from the lifestyle that is keeping them in the prison of addiction.
Do Insurance Companies Cover Treatment Centers?
Since the majority of people who suffer from addiction will need some type of help from a treatment center, you may wonder how it is possible to cover the cost. These recovery experts explain, “there are many approaches to successful treatment such as: behavioral therapy, 12 step programs, motivational interviewing, contingency management, medication treatments, and even alternative methods.” Treatment centers can keep a person for weeks or even months. These centers have to be able to fund the professional staff that works at the center and the facility itself. For that reason, the cost of staying at a treatment center can be high. Instead of worrying about payment, you'd do well to get in contact with your insurance company.
The good news is that most insurance companies will cover treatment centers; there may be some stipulations on the coverage. It is possible that the insurance company will want you to only go to a treatment center that is in their network, or they won't cover the expenses. On the other hand, the insurance company may only cover you for a certain amount of days, or for a percentage of the total cost. There are still some insurances that will ask you to pay a certain amount towards the deductible and copay before they offer coverage.
Don’t Hesitate To Get Help
Regardless of the issues that may come up with insurance, the most important thing is that you get the help that you need in order to stop the addiction rollercoaster. This government agency reinforces, “You suffering is real, and it is possible to overcome it. Don’t give up on hope. It may not be simple or easy, but it will be worth it.”
It is worth the time and effort that you may have to spend when working with your insurance company to find the right treatment center. There is no price on your happiness and your livelihood, so do the initial work so that you can live a better life. Various treatment centers can give you the tools that you need to break the cycle of addiction.
If you find yourself in need of insurance, whether it be health insurance or some other kind, keep George Beach Insurance in mind! We want our clients to be happy, healthy, and safe. Get in contact with us for a free quote!
There are many advocacy groups for addiction recovery that are claiming some addictions are diseases. Therefore, they believe that it's critical for insurance coverage to be available. However, if addiction isn't understood as a disease, these insurers will not make payments for treatments. These groups are insisting that we continue making the case that addiction is a disease and that insurance companies cover the fees for treatments.
Insurers are Already Making Payments
Many insurance companies are already making payments for many conditions they don't consider diseases. For example, pregnancies and broken bones receive coverage, and they don't fall under the category of diseases or disorders. Therefore, it's vital that those who have an insurance policy to review the details regarding the inclusions and exclusions of their coverage.
Because treatment plans aren’t cheap, it’s vital that you contact your insurance provider if you have any questions regarding your insurance coverage. This medical website also advises, “if your insurance company denies your claim, you have the right to appeal (challenge) the decision. Ask your doctor for his or her opinion. If your doctor thinks it’s right to make an appeal, he or she may be able to help you through the process.”
Understand Your Options
There are a significant amount of insurance companies recognizing the fact that addiction is a condition that's treatable. This treatment center explains, “medically supervised drug and alcohol detox eases symptoms of withdrawal for individuals recovering from drug abuse and addiction.” The assistance these centers can provide should be recognized. Thankfully, many drug and alcohol dependencies are seen as medical conditions that could be covered under a public, private, or group insurance plan. If you have a private or public insurance plan, they'll frequently compensate a portion of the inpatient or outpatient treatment expenses for just about every kind of addiction treatment program.
Recognition of Mental Disorders
These mental health experts defines it as, “addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with a substance use disorder have distorted thinking, behavior and body functions. Changes in the brain’s wiring are what cause people to have intense cravings for the drug and make it hard to stop using the drug.” Because our culture as a whole has begun to recognize it, insurance companies are also recognizing addiction more and more as a mental condition.
As such, they're providing the same coverage as they would for health and behavioral conditions. These insurance companies understand that substance abuse can lead to physical or psychiatric consequences in the future. They also recognize that other health conditions including diabetes and heart disease could be the result of addiction. Therefore, it's favorable for those who are insured to receive coverage.
What Coverages Can I Expect?
Coverages will depend on the insurance provider with which you're doing business and your plan. Look for plan coverage that will include detoxification. This drug abuse hotline explains, “in many cases, private insurance will cover some or all of your addiction treatment. Payment options like financing, loans, and sliding scales often help to offset the remaining cost.” So no matter what situation people may find themselves in, there’s always hope.
Medically supervised drug and alcohol detox is a serious situation and, when patients are undergoing this treatment program, insurance companies understand that withdrawal symptoms could be fatal. Therefore, many insurance companies understand that it's critical for coverage to be in place for the health and safety of the patient. When patients are surrounded by experienced healthcare professionals, they have a better chance of experiencing a positive outcome that involves less potential for risk or fatalities.
If you’re looking for health insurance and need some additional support, spend some time examining our Health Insurance options!
There are many insurance products out there that you can benefit from. Some of the most common that people are aware of are health insurance, car insurance, and life insurance. But there are other valuable insurance policies that you may not think about or be aware of. Here are five insurance products that you didn't know you needed.
Every year, everyone has to update their health insurance. It is inevitable and many people dread having to decide which plan they should go with for the following year. There are so many variables, and cost is one of those variables. The cost of the health insurance plan can vary depending on the size of the deductible.
Because the insured will be responsible for a larger amount of their initial care at the beginning, a high deductible plan will have a lower premium each month. The deductible can range from $1,000 or more depending on the size of the insured’s family. The money paid out for the deductible will end as soon as the limit is reached for the plan.
If the insured decides on a high deductible plan, they maybe be eligible for a Health Savings Account. This account allows the insured to set aside a certain amount of pre-tax dollars for medical expenses. Sometimes an employer will also contribute to an employee’s Health Savings Account.
A low deductible plan means that the insured will pay less for medical care when they visit a doctor, but their premiums will be much higher every month. Most of the time with a low deductible plan, the insured is paying a co-pay for each visit to the doctor and these co-pays will need to be paid throughout the year.
It is usually best to estimate the medical costs for the following year before signing up for a plan. A person should make a list of all of the routine and necessary appointments plus prescriptions and then add on a few extras just in case. Next, add up all of the expenses including the premium for a high deductible plan and then for the low deductible plan and compare them. A low deductible plan has the potential to cost twice as much per month than a high deductible plan, depending on how often the medical insurance is used.
A high deductible plan is usually best for people who are healthy and do not have children. Low deductible plans are always best for people with chronic medical issues and children.
Health insurance is necessary and it is not something that can be ignored. Every person needs to look at the information carefully and make the best decision for themselves and their family.