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You Should Think About Using Your Health Insurance’s Mental Health Services

Mental health is no longer the taboo topic that it once was, and thanks to changes in health insurance law, mental health care is now more accessible than ever.

If one thing has changed in American healthcare over the last 10 years, aside from the emergence and acceptance of the Affordable Care Act, it has been our society’s increased acceptance of mental health services as an important part of healthcare.

Health Insurance For Mental Health

In decades past, mental health support was seen as something taboo, and was probably joked about in movies and tv shows more than it was taken seriously. Many people saw mental health services as something for “rich people” and “crazy people”, and in reality, these services were out of reach for most people. Mental health professionals were hard to find, and many health insurance plans did not support mental health services, so people had to pay out-of-pocket to access these services, making them unaffordable to much of the population.

The Laws That Changed Everything
Biden Signs Executive Order for ACA
President Obama and then-Vice President Biden in office in the early 2010’s. “Obamacare” marked a major national shift in access to mental health services.

In 1996, access to mental health coverage began to shift with the introduction of the Mental Health Parity Act. The Mental Health Parity Act, or MHPA for short, and its later relative, the Mental Health Parity and Addiction Equity Act of 2008, stated that employer-sponsored health insurance had to include mental health coverage, and insinuated that health insurance companies should treat mental health coverage as equal to other parts of medical coverage.

These laws proved to be a double-edged sword. On the positive end, they did help provide mental health benefits for people who did not have access to it before. The drawbacks were that there was no protection for those who had mental health issues as a pre-existing condition, so insurance companies could use mental health screenings as a reason to deny people. Also these laws did nothing to cover the millions of low-income people who didn’t have health plans, who (statistically speaking) were likely to be more in need of mental health services.

The Affordable Care Act

When the Affordable Care Act was introduced in 2010, it marked an even greater shift in the way Americans could access mental health care. At the time, the opioid crisis was peaking in America, and treatment was now seen as the morally correct way to address the issue (as opposed to jail time). A wide-ranging solution was needed.

The introduction of the Affordable Care Act provided a worthwhile solution. Mental health support was one of Obamacare’s original “10 essential services“, meaning that all health plans on the public healthcare marketplace had to include coverage for mental health services, and people could not be denied for pre-existing mental health issues. In addition, Medicaid and Medicare began covering mental health services as well. This was important because it set a precedent for health plans outside of the public marketplace to do the same in order to remain competitive. That being said, even 10 years later, mental health support is one of the most underused parts of health insurance.

What Type of Mental Health Services Does Health Insurance Cover?

Although the cost and extent of support available varies by plan, there are certain services that must be offered by every plan under the Affordable Care Act standard. They are as follows:

  • Behavioral Treatment (for example psychotherapy and counseling):
    • Outpatient individual counseling or group therapy sessions
    • Diagnostic services such as psychological evaluation and testing services
    • Ongoing outpatient treatment, including medication management and psychiatric treatment programs
  • Substance abuse (also known as substance use disorder) treatment:
    • Outpatient diagnostic and treatment services for chemical or alcohol dependency
    • Medical services for withdrawal symptoms, such as inpatient detoxification services
    • Substance use disorder recovery services, including counseling and educational resources
  • Mental and behavioral health inpatient services
    • Mental health care if you’re admitted to a psychiatric facility.
  • Additional provisions for preventative care
    • There are preventative care services in the ACA that pertain to mental health, such as depression and alcohol abuse screenings.

Once again, this is just a baseline; it is best to check with your health insurance provider to see exactly what services are provided via your plan.

Do You Need A Health Insurance Plan That Covers Mental Health Services?

If you think you need mental health services and don’t have health insurance, don’t fret. HealthPlanOptionsToday can help you find a plan that will get you started on the road toward wellness. Call us at 888-375-8879 for more information, or click the button below and we’ll get in touch with you.

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New Law Brings Online Shopping To Hospital Visits

A law that went into effect on January 1, 2021 seeks to make hospital visits less of a guessing game and more of a shopping experience.

Every January 1st, new laws go into effect across the United States. Usually by this time, the debate has been long over on most of these laws and the media attention on the passage of these laws has died down. As a result, the majority of these new regulations go unnoticed by most people. Some of these laws make changes that we happen to notice in passing, such as a highway being renamed or the expansion of a national park. Occasionally, one of these “unknown laws” ends up making major changes to the way regular people approach their lives, and the American public doesn’t notice until much later.

This was the case on January 1st, 2021, when a law that encourages price transparency for hospital visits officially went into effect. This law, which is known popularly as (you guessed it) the Price Transparency Rule may have the most impact on American healthcare since the passage of the Affordable Care Act, “Obamacare”, in 2010.

This new transparency law was originally passed in 2019, but has very modern implications. Under the new law, hospitals must publicly disclose the price of every item and service they provide to patients via an “easy to understand” page on their website. The aim of this law is to increase competition, which will, in the words of the law, “ultimately drive down the cost of healthcare services, making them more affordable for all patients” (see the actual law here).

How Might This Law Change Hospital Prices?

Most people will agree that the price of many hospital services is simply out of hand. The reason for this is a topic of a debate that has no single right answer.

For example, consumer advocates say that the high prices are the result of secret collaboration between hospitals and insurance companies. They believe that large health insurance networks and hospital networks have collaborated to keep costs high for non-insured people but low for insurance companies. This is totally feasible, considering that it’s no secret that major hospital networks make their money by treating hospital visits as commodities and patients as numbers.

On another hand, economists say that the price issue has emerged because in the world’s biggest free-market economy, one of our nation’s biggest businesses- medicine- does not operate in a truly free-market way. They say if people can’t shop around for the best deal, then prices can’t drop to attract new clients, and each hospital can more or less act as a monopoly to itself.

The Price Transparency Rule seeks to remove the “guessing game” factor from hospital visits.

While both those explanations and others all have some truth to them, the bottom line is that most people go into the hospital with no idea how much the stay will cost. This keeps people from visiting the hospital in the first place, as they are afraid to be saddled with a massive bill that may have a worse impact than whatever they’re visiting the hospital for in the first place. If this law does serve to increase competition and lower prices in the long-term, society will be better off for it, simply for quality-of-life reasons.

How Will Everyday People Benefit From Price Transparency?

For those in the know, there was an earlier law that made hospitals make their “chargemasters” public (a chargemaster is a list of a hospital’s services that isn’t quite a good example of the actual price of care). This law goes several steps further than that law did.

Every hospital must now post the prices for everything they charge patients for, and must list the “cash” price as well as the “insurance” price, which is likely to be much lower than the cash price. They also must post a list of costs for services that are most commonly needed at hospitals, like having a baby or getting an MRI. The new law provides a list of 300 of these services, but only 70 of these 300 are mandated to be listed by each hospital. In addition, the prices the hospitals provide must include all costs from admission to release, so there’s less room for surprise, although at the end of the day, the prices given are still estimates.

While this law may not help people who are rushing to fix emergency-room situations, this will help people comparison shop for the services we use most often, such as mammograms, X-Rays, or even psychotherapy. It makes sense that people without insurance or with high insurance deductibles will likely benefit the most from these lists.

Who Could Possibly Not Like This Law?

As you may have already guessed, the hospital industry isn’t too pleased with the passage of this law. Even before the law went into effect, the American Hospital Association (AHA) took to the courts to attempt to have the law removed from the books, saying that the law violates their First Amendment rights. This challenge was struck down by the court system, as was a later appeal by AHA lawyers in December 2020. The AHA has publicly stated that they’re not done yet, and they’ll attempt to communicate directly to the Biden administration to try to make a change.

There is one other group that is involved in the price struggles that haven’t been mentioned yet: health insurance companies. Rest assured, health insurers aren’t being left off the hook- their version of this law will be coming into effect in 2022.

If you’re in need of health insurance, don’t wait until you see a hospital bill to take action . Our plans start as low as $160/ month. Get in touch with our hotline at 888-375-8879 or click the button below and we’ll help you get a health insurance quote in 3 easy steps.

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Moderate Increase In Health Care Costs Coming 2021

With so many Americans suffering with the coronavirus (whether directly as a victim or if merely among us as a bearer of the bad times we are in), how does the country expect to handle all of these piling-up medical bills with authenticity? In accordance with Kimberly Lankford, a Contributing author for US News, we are now seeing that though the price of health insurance will rise, it will not be much.

Whether this is a good thing or a bad thing, we have yet to figure out.

An example would be larger employers of over 50 employees. Their finalized health care plans for 2021 expect to see an average health care cost of $15,500 per employee, which is actually only a mere 5.3 percent increase since the 2020 fiscal year. Smaller companies, of which seem to abide by less stringent health care rules, have not yet reported their figures. However, the main bulk of the issue seems to be the more than it really is. “With this recent open enrollment for some employers this summer, there were more people enrolling who didn’t elect coverage in the past,” states W. Sakamoto.

So, what can we expect to see?

  • Increases in premiums for families and higher-income workers
  • Tons and tons of additional telehealth and virtual care visits
  • An expansion of mental health services throughout
  • Tons of new tools to assist navigating health care options

Let us examine something really important here: the massive expansion of mental health. We do not realize who we are walking among, as one in five adults in the U.S. are struggling with some form of mental illness. Schizophrenia, as an example, tops itself as 1 percent of the population; clinical depression tops that at 17 percent. In all, the U.S. has spent over $200 billion on mental health spending.

Now, since the time of the pandemic, this is slowly but surely creeping into our awareness. The ACA increased adamant amounts of health coverage to those with a mental or emotional illness, and before that point (and before that law), this was without causation. Though the point of this article is not to examine mental health coverage, it is surely a means to an end: with that much spent on mental health alone, can we really handle an increase in a time where mental health is being affected the most?

Remember that open enrollment for HealthCare.gov begins on November 1st,, and coverage begins January 1st, 2021. If you need help picking a premium, contact us.

A twist comes into the midst: the fact that though one website does justice by showing us that health care coverage increases (i.e. the need of actual health care). Rather, what are the costs? We are actually seeing quite the opposite between actual needs for health care coverage, versus the costs. The U.S. alone reports that 2021 will bring the price from a 2020 12 percent decrease to a 31.9 percent increase.

Just when you thought there was good news, it is quote the opposite, and that is why we urge you to contact us if you need assistance in deciding which plan to use.

Still, many experts continue to say that even these estimates are higher or lower than they actually will be. In turn, it can be hard to predict the future, and we can only base our results on facts. The pandemic has caused crisis and chaos, leading many to turn to free testing. However, what we do not realize is that this is only free for us. An actual COVID-19 test (whether offered to the public as free or not) can range from $23 to as high as $2,315. This means that the government may be spending as much as $200,000 per 10,000 tests! That is insane, when you think about it, but it is a necessity we truly require. In times like this, we often find ourselves facing political backlash: we blame our choice parties based on what they say, not what they do.

This, again, meshes quite well into the midst of healthcare premiums.

When the government loses that much (and believe us, the government is not in such a high state-of-worth as we may think), we find ourselves lost in the world of health insurance costs. When the government poses that much income toward preventing a pandemic, or rectifying it, they will slowly but surely require additional government funds. This will come from Social Security, Health Care, and the Armed Guards.

So, what do we expect?

There will be a massive increase in health care costs, which is why you need to reach out to us for your benefit. We can choose the right premiums and health care plans for you, just hit that “Contact Us” button and get to work! In the meantime, we end with a discussion: where you may be right now. Like most of the world, we are carrying the weight of many others. Our families, friends and loved ones are at stake, and so is our health care coverage. As businesses open up, they are finding it is harder and harder to appease to government regulations about health insurance.

This is because not many can afford such a luxury, as over 99 percent of companies in the United States are small businesses. These are not ones who can afford high deductibles or offer benefits. Rather, they are restaurants, coffee shops, and so on. With this many people losing insurance, it is time to rally up the troops and see how we can do all of this together as a functioning unit!

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President Trump Tries to Bypass Obamacare

Never in my life did I ever think I would hear the following words: “The president’s support for killing Obamacare during the coronavirus pandemic shows a callous disregard for communities in crisis” (Jonathan Metzl, 2020). To catch up, the Affordable Health Care Act has been around for about a decade under President Obama’s decision to make it mandatory for Americans to all have health insurance. Though half of uninsured Americans denied themselves of potential coverage, the other half embraced it! It was a breath of fresh air to many who were without affordable health insurance.

But things change, and politics rule.

Now, in the midst of crisis and a pandemic we cannot seem to stop, President Trump has decided to call Obamacare a “disaster,” and said he wished to “terminate it.” This is not completely in context. Many Americans were (and still are) upset about being forced to pay a fine given they did not have the right coverage (Kaiser, 2020). It is a dual-edged sword: Americans did not embrace the ACA, but now that we need it the most it makes the most sense to use it. You would think this would lead to better health coverage, but that is not the case. Obamacare enrollment skyrocketed since Trump became President. But Trump has decided that now, of all times, is a good place to end the system.

Backing up to May 2020, Trump began the process of getting rid of the necessity of Obamacare, but in a time when Americans can barely afford the premiums, it seems as if the Affordable Healthcare Act is, as of now, quite useless. But the time and place to cancel this ethereal part of our history, in my opinion, is where the “wrong” begins. Aside from personal opinions and political orientations, let us examine this factually.

First, some statistics. 33 percent of White Americans (as of 2010) were without proper health coverage; 33 percent of Hispanics; and 20 percent for Black Americans. This accounts for a tremendous 46.5 million people who currently do not have the proper health coverage. This is ironically 18 percent of the nonelderly population.

 Then, the ACA began.

By 2016, 90 percent of Black Americans had health care, as one example, and many people claimed to have paid much less for prescriptions, to have less medical debt, and in turn, more security when something goes wrong. However, despite this progress, the Trump administration has spent three long years trying to eliminate it. Speculations are amidst. Many claim that it is a way of ridding us of the Obama era; others feel it is simply Trump’s way of cutting funds to a crucial problem.

Click here to see how we can help you with your insurance needs!

However, despite political boundaries, the main issue is not “why” we are cutting it. Rather, it is a question of: “what happens when it is cut?” The main issue seemed to be the cutting of advertising the program. Since Trump’s induction, there has been a 79 percent drop in community outreach, according to the Kaiser Family Foundation. In other words, though the ACA still exists, and most likely will continue to exist (one can only amend so much), the fact is many Americans have forgotten – especially in the midst of a pandemic – that Obamacare is an option. So, what happened last week?

The Trump administration “urged the Supreme Court to overturn the Affordable Care Act.” Ironically, it was the same day that half a million Americans lost health insurance due to the economic shutdown, of which was meant to slow the COVID-19 spread. 20 million Americans can and have lost their health coverage, and according to House Speaker Nancy Pelosi: “If President Trump gets his way, 130 million Americans with pre-existing conditions will lose the ACA’s lifesaving protections and 23 million Americans will lose their health coverage entirely.”

Sound bad? Well, it really is.

When this case approached the Supreme Court, many conservative-led states did make their point that the ACA was “unconstitutional,” where fines are issued for not having proper health insurance. What many do not realize is, that was not meant to harm the American public. Rather, it was a way to incentivize the notion that without health insurance, one is subjected to potentially thousands of dollars during a routine visit. In turn, it was not meant to “punish” us, but rather to motivate us!

With due respect, Trump is not the monster they are making him out to be. However, he certainly is not making the health insurance game any easier. With so many Americans affected by the coronavirus, the loss of millions of jobs, and God knows what else, it seems the last thing we should be doing is cutting down on affordable care. Despite this, Trump has made sure we all know that those with preexisting conditions (i.e. an illness or a health issue that was made prior to the actual insurance policy) will still be protected, but how? That is the question many are currently asking, as though it was announced that Obamacare would be seeing changes, no mention of how to redeem its loss have come into earshot, leaving many stressed and without help.

Denied health coverage? Contact us for some assistance!

Now, the good news is since the loss of millions of jobs, around 487,000 people have been wise enough to sign up with HealthCare.gov, after the loss of workplace overage. It is a drastic increase of 46 percent since last year, and all we can do at this point is hope that an appeal is missed, or an executive order is ignored. Otherwise, the realm of health insurance will never quite be the same – if we allow it, that is. We can only hope…

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The Future of Healthcare May Be Going Virtual

We all thought quietly to ourselves: “COVID is going to destroy the world.” I disagree. I feel that after this is all over, we will feel as if we are more in touch with technology. And the health care industry agrees with me. With what was once called “telehealth,” or when you consult with your doctor about a pressing issue, we all felt weirded out about it. Now, ask yourself: have you attended a doctor’s appointment remotely? If so, you have engaged in telehealth! And that is the future of health care, and health insurance.

“We’ve seen a dramatic increase in the foundation we are building for telehealth literally within the last two and a half months,” said James Roxburgh, of whom is CEO for Banner Telehealth (link). It seems that now, the game is all about online visits, but what comes with this is a change in healthcare infrastructure. The insurance market is going to have to adapt accordingly, and that seems to be where the trouble is.

Will insurance cover telemedicine?

The good news is yes! Though this was not once the case, and may not be a factor at the present moment, the Federal Government has passed on telehealth coverage to Medicare, Medicaid, and most private insurance companies. However, because this new way of doing things is so new, it may take a few months for people to adapt. According to an August 2020 discussion panel, many are still in flux with telehealth. It is amazing to see that many are actually cancelling their policies in an effort to avoid being exposed.

But we have to learn to embrace change.

 Telemedicine or “telehealth” is basically what we have all been doing for the past six months: visiting with doctors or physicians virtually via FaceTime, Zoom, Skype, or any other means where there is a camera and a microphone involved. However, studies show that 76 percent would much rather risk obtaining the coronavirus than use technology to their advantage. Another source pointed out that many of the elderly cannot quite grasp the technological requirements to engage in this manner of working.

My mother was one such case. She had me tell her how to see her doctor virtually. Turns out it was rather chaotic: a website that exists provides telehealth, yes, but they did not use Zoom or a phone visit. Rather, they required a separate website that required a registration, almost as if this telehealth movement – specifically since the pandemic – has become a monopoly. Doc.me, ZoomDoc.com, and others are doing nothing different than utilizing a platform such as Zoom and, instead, requiring a much more corporate outlook on things. In other words, they are there for no reason other than that of the doctor, as many choose FaceTime or Zoom (of which even my mom could not use, either).

What do we do from here?

Well, the first step seems to be less focalized around learning to adapt to telehealth, as that was already done for us. Instead, it is about educating Americans how to use these various methods of online visitations without having to rely on me to do it! In other words, we need to be focusing around educating the masses two fundamental challenges: 1) that telehealth is not going away, even after the pandemic ends, and 2) that it is time to embrace this new method of things, as it is a much better alternative.

When you think about it, since telehealth truly formed around 2016, it has had a slow gain in progress. Now, it is everything we have! We cannot go to the doctor because we will infect the patients; we will be exposed to the virus in closed quarters…so on, so forth. Okay, well that is inevitable. Let us focus on the positive: telehealth is ten times less expensive than paying overhead on an office, meaning the doctors in question can actually charge you less each visit because they are sitting in a living room!

Health insurance plans will develop for this new methodology, but we have to be patient and accept that healthcare has changed and, just like how the pacemaker used technology to keep us alive in the event of a heart problem, telehealth is doing a similar thing here. We just need to accept that our lives – from now and until the next pandemic – will be virtualized. It leaves me wondering if we are even ready for this.

Either way, it is time to start educating individuals on how to use the right platforms, and how it benefits more than it hinders. A lot of people feel it is impersonable, and that is okay. Doctors are still helping as much as they can, despite the circumstances. It is time to adapt to the future, and hopefully health insurance plans will begin to do so as well. In fact, we may be adopting a merger with a local company dedicated to teaching us about the benefits of telehealth, as well as how to use it properly (contact me).

Also, considering state laws require insurers to accommodate during the pandemic, we can use this time with telehealth to practice, adapt, and adjust. Soon it will be just as expensive as it was with in-office visits, and yes, you may have to pay a higher premium to go through telehealth platforms at present, but make note that this is not the doctor overcharging you. Rather, it is insurance plans that are trying to keep up so you can only pay a copay and thus, they would inevitably cover you if they had the upcoming policies. Stay strong, stay safe, and remain vigilant. This is not going anywhere soon!