Finding Health Insurance That Covers Medication Assisted Treatment

Covers Medication Assisted Treatment

If you're on MAT or have family in treatment, you know the high cost of care and the dangers of skipping doses. But unfortunately, there are many times that patients come up short on paying their daily treatment cost. With the passage of the Affordable Care Act (ACA), the problem of paying for treatment may no longer be an issue for some.

Whitehuouse.gov states that "The ACA includes substance use disorders as one of the ten elements of essential health benefits. This means that all health insurance sold on Health Insurance Exchanges or provided by Medicaid to certain newly eligible adults starting in 2014 must include services for substance use disorders." Although not all health insurance providers cover the same treatment options, it is expected that they now cover some medications for opiate treatment and programs to treat substance abuse.

Depending on the insurance company, either a combination of Suboxone, Subutex or Methadone or all three will typically be covered under a health insurance plan in a post ACA world. Not only are the medications covered by the plans, but many of the consumers purchasing the plans will qualify for tax credits to help pay the plans monthly premiums and co-insurance deductions to help pay plan deductibles and prescription copays. The tax credits are available to those whose incomes are below 400 percent of the federal poverty line and the co-insurance deductions are available to consumers who have incomes under 250 percent of the federal poverty line. So as an example, an individual with an income in 2015 of less than $46,680 would qualify for a tax credit and an income of less than $29,175 would qualify for a co-insurance deduction.

Customers can apply for these plans at healthcare.gov, by working with a health insurance agent or by calling insurance companies directly that participate in the federal exchange. One source for those looking to work with an agent to find insurance that covers their MAT is saveonmethadone.com. The site (and sites like it) look to match consumers with insurers that cover their medications and treatment providers. No matter what channel you use to obtain your ACA insurance coverage the monthly premium cost should be the same. This is because each plan that a carrier offers must have the plan cost approved by the individual states Department Of Insurance. This allows consumers that would like to use the services of a licenced health insurance agent to have peace of mind in knowing that they will not be charged any additional fees for seeking the advice of an agent.

Larry Medcalf is a licensed insurance agent. His main focus is on serving the life, health, medicare and long-term care insurance needs of small businesses and middle-income families and individuals.

More about → Finding Health Insurance That Covers Medication Assisted Treatment

Controlling Health Insurance Costs for Employees

Health Insurance Costs for Employees

Health insurance costs have gone through the roof in recent years, especially since the Affordable Care Act has been signed into law. Many are looking for ways to control the costs. Some are left empty-handed. You almost need an insider to give you the best tips. However, many do not know where to look. In the meantime, they are forced to pay higher premiums and out-of-pocket costs. Where does the bleeding stop?

The bleeding stops with the employer strategies. Employers need to have good expert consultant or advisor to make sure their moves are not only in the favor of themselves, the employer, but also the employees. At times there is a disconnect from the employers to the employees because the employer is more concerned about their pocketbook. Rightly so. However, there just has to be a good mix between benefits and the cost for everyone.

Employers should start off with finding a team of experts. These are the specialist in the trenches everyday making things work. They may have published their own material on the subject, have a team of advisors and are willing to take the time with you.

Employers should also offer multiple options for employees to choose from. You may have high standards based on your current standard of living, but your employees do not. There definitely has to be a low-cost, high deductible option as well as the rich, low deductible option. Let the employee take control on their health care by starting out with making their own plan selection.

Employers should also offer a series of voluntary benefits. This does a few things.

Retention of great talent is hard, but can be done. This is one way to hook those key employees.

Some employees just love little things such as dental and vision. So give it to them. The good news, the employer does not have to pay for these benefits. They can to add value by contributing, but not required to do so. This will increase employee production in the workplace.

Offering voluntary benefits, such as dental and vision, will increase the enrollment percentages in the group health plan. Some employers maybe opposed to this. However, in some situations, this can help lower the over all cost for some small to mid-sized employers. This could be the key to making or breaking a benefits program.

For smaller employers, 49 employees and fewer, have different strategies to work with since they are exempt from the employer mandate requirements. Small employers have the option listed above to help control costs and provide value to their employees. Since the market with 49 employees and fewer are on the community rating platform for premiums, the premiums will not necessarily decrease as a result of increasing the membership.

Another option for smaller employers is dissolving the traditional group plans and allowing the employees to be guided with an insurance professional on the exchange/marketplace for options and the possibility of receiving a tax credit to reduce premiums.

Employers will lose the pre-tax benefit of group health insurance by allowing employees to purchase their own health insurance. So we need to do the math to see which side has a greater advantage.

Employers also have to be careful when allowing their employees to purchase an individual plan. Depending on how you do it, there could be some tax consequences to worry about.

The best thing an employer needs to do is bring in their health insurance expert or consultant. I encourage to at least bring in one other person in addition to your current benefits insurance agent/consultant. This will allow you to see a couple different ideas as well as making sure your current consultant is acting in your best interests. You would be surprised how many insurance agents get complacent in what they do and use their own interests for the strategies they use.

Arthur "Butch" Zemar is a 2014 Broker of the Year Finalist, an insurance specialist, author and President at Elite Benefits of America. Butch Zemar is actively developing informative resources, such as articles and videos that deliver vital information on healthcare reform and employer options. Elite Benefits of America has consultative packages for employers, as well as insurance solutions, to keep employers compliant with healthcare reform and keep skyrocketing premiums under control.

More about → Controlling Health Insurance Costs for Employees

Choosing the Right Health Insurance for Your Needs

Making sure your body is in the best shape possible is important to your longevity. However, preventative care can also have a big impact on your wallet. Yearly exams for your teeth, eyes, and body can be expensive when you pay out of pocket, which is why health insurance can be very beneficial. The right plan can offset your costs with deductibles that are lower than paying for everything yourself. Having this kind of coverage can also help you choose a doctor based on skill rather than how cheap they are. Learn how to pick the best plan for your needs, so you can get the care you deserve.

What Are Your Needs?

The first thing you should think about is what kind of coverage you want. For example, if you wear glasses, you should probably choose health insurance that has a vision care package. If you are worried about dental costs, consider adding dental to your premium.

Many people choose to pay a small monthly premium that covers major medical expenses but doesn't cover everyday prescription costs or doctors visits. This is often referred to as hazard coverage. Having this type of coverage is not true protection; instead, it provides peace of mind in case you are faced with a large medical expense unexpectedly.

If you have medical needs that require you to visit a doctor frequently, a plan with a cheap deductible (the portion you pay when you use your coverage) may be the best choice for you. The cheaper your deductible, the more expensive your premium will be. However, over the course of a year, you may end up paying less out of pocket with this type of plan.

How Much Have You Already Paid Out of Pocket?

Gather your receipts from the past year and add up how much it has cost you to pay for your dental work, annual exams, and glasses out of pocket. Without health insurance, these dollars add up. Try to find a plan that fits within the budget you have already spent over the last year that also meets the medical requirements you have. This will help you save money and get a decent idea of what you can realistically afford.

Getting health insurance lets you rest easy knowing that you can get quality care whenever you require dental, vision, or general doctor visits. Before choosing just any plan, you need to determine your needs and how much you can afford.

More about → Choosing the Right Health Insurance for Your Needs