Eligibility for individual Affordable Care Act-compliant plans purchased on or off-exchange is based on where you…

Confusion continues years after the Affordable Care Act eliminated the practice of pre-existing conditions being…

Our featured video today addresses whether to elect COBRA, the temporary extension…..

Our featured video today is on COBRA. Our featured video today is on COBRA.

In A Dispute, Know How Your Plan Is Regulated What do you do when your insurance company makes a decision that adversely affects you? It may be time to file an appeal. To prepare for this process, you should find out how your plan is regulated. You can watch our video at healthcarenavigation.com/videos to listen to the information on this topic. This topic involves commercial plans, not Medicare. Individual Plans and small

The Out-of-Pocket Maximum The out-of-pocket maximum is just what you’d expect from the name. It is the maximum of what you spend out-of-YOUR-pocket on the deductible, coinsurance and copayments (but not premiums or premium contributions). Once you reach the out-of-pocket maximum, the insurer pays 100% for in-network services for the rest of the year or benefit period. For non-Medicare plans, the out-of-pocket maximum is a combination of what you spend at the pharmacy and on medical services. For Medicare, medical and

The Rules of Your Plan Today’s featured topic is about the rules of one’s Plan. Please watch the video at healthcarenavigation.com/videos and spread the word so that others learn about this important topic. All coverage has rules one must follow in order for claims to be paid. The more restrictive plans have more rules so be particularly mindful of them if you are enrolled in an HMO or EPO product. The following are rules to understand: Primary Care Physician (PCP): Know

Out-of-Network Benefits Today, we feature the Out-of-Network Benefits video found at healthcarenavigation.com/videos. The out-of-network benefit is sought after but poorly understood. This results in many individuals having substantial out-of-pocket exposure they didn’t expect because out-of-network providers do not have a participation agreement with their insurer. Of the U.S. healthcare system’s many disappointments, the administration of the out-of-network benefit is one of the most egregious. Most of the difficulty stems from consumers thinking their coinsurance amount (the percentage the patient

The Product Your health insurance benefits are provided through an insurance company that offers various products (watch our video at healthcarenavigation.com/videos) with different parameters (referred to as “Plan design”), packaged in an annoying array of abbreviations which are unintelligible to most consumers. Was it always this way? No, this is a modern phenomenon associated with the evolution of health insurance. Health insurance is a vital protection but the existence of health insurance also drives up healthcare