04 Jun 2019

Inpatient vs Outpatient Coverage

Inpatient vs Outpatient Coverage

When looking for proper health care plans for your needs, you may have wondered what the difference between inpatient and outpatient care was and how it would concern you as a patient or insurance policyholder. For one, you’ll need to know how the two terms refer to the way your healthcare assistance is being provided to you.

What is Inpatient Care?

What is Outpatient Care?

What is the Difference between Inpatient vs Outpatient Care

Inpatient vs. Outpatient Rehab

How Much Does Inpatient Care Cost?

What is Inpatient Care?

Simply put, inpatient care refers to any type of medical service that a person needs to be admitted to the hospital to receive. Health insurance plans consider inpatient care as a stay due to severe illness or trauma that needs attention for at least one or more nights at the hospital. Policies typically require you to be formally admitted for it to be considered “inpatient care,” which means a doctor has to write a note to admit you. So, for example, if you were in the emergency room and were asked to stay overnight for medical observation, you will not be viewed as an inpatient in the insurer’s eyes.

Though you shouldn’t be discouraged – over half of all inpatient hospital admissions come from the emergency room and health insurance plans have some form of coverage that will help with emergency room vs. inpatient facility care costs. Case in point, some policies have copays for the services received in the emergency room waived if the health insurance policyholder is admitted to the hospital for further care.

Another important thing to note is that inpatient care has two components: the facility fee and those costs associated with the surgeon or physician. Copays for inpatient services are commonly on a per stay or per day basis.

outpatient care

What is Outpatient Care?

Outpatient care is medical assistance that does not need an extended stay at a hospital. This can include services such as checkups, visits to clinics or more complex procedures like same day surgery. There are also many other outpatient care services available, such as rehab therapies and mental health services. Because it is less involved and does not need around the clock medical care, it tends to be less expensive.

Outpatient care is mostly broken down into what type of care you receive; for example,  Primary Care Physician, Specialist, or Mental Health programs would all have different costs. It will then describe your share of cost within that type of procedure.

Outpatient care also has two components: the facility fee and those costs associated with the surgeon or physician. Copays for inpatient services are commonly on a per stay or per day basis.

outpatient care

What is the Difference between Inpatient vs Outpatient Care

Now that you know the primary differences between the two types of care, here’s the reason why it is essential for you as a policyholder.

As you now know, outpatient and inpatient care are determined by a doctor who writes an order to confirm patients in-hospital supervision. This has a significant impact on how much a health insurance policyholder will pay after receiving their medical care.

Most of the time, the doctor’s choice between inpatient and outpatient care comes down to how intense medical care will be and is not a choice you can help decide.

Those who are admitted as inpatients will typically have more severe conditions that need around the clock care and monitoring from medical staff. Because of this, the cost of inpatient care is naturally higher due to the number of medical professionals needed to take care of you. These costs are then incurred by both the insurance company and the policyholder.

Though there are a few exemptions where patients have a choice in whether their care is administered inside or outside of a hospital. Some surgeries may allow you to choose between inpatient vs. outpatient, though it’s rare. For example, some types of knee surgery can be handled either or and can be helpful for those who have time constraints such as work days or not enough coverage to pay for the additional price of overnight facility care.

Inpatient and Outpatient Rehab

Policyholders can choose inpatient or outpatient care when it comes to rehabilitation. This applies to physical therapy as well as drug recovery. This is not restricted to only hospitals; it can include specialized physical rehab facilities too.

All types of rehab services have a separate breakdown of benefits and coverage that vary between insurance plans. The categorization deals with the cost-sharing involved with the services along with the different copays and coinsurances, both inpatient and outpatient rehab has. This is a significant difference to discuss with your family as policyholders who need this type of care as plans with copays can opt to charge on a per admission/stay basis or a per day basis. This could have a major effect on your finances, so be sure you read the small print carefully!

Like other forms of outpatient care, rehab normally to has much cheaper copays since these instances are similar to checkups. Copays and coinsurance for outpatient rehab are like those that you would find for a visit to a primary care physician or a specialist. This cost is roughly around $10-$50 per visit depending on your healthcare plan. On the flip side, inpatient rehab costs can majorly differ depending on the facility and health insurance plan.

How Much Does Inpatient Care Cost?

To give you an idea of how costly inpatient care tends to be for policyholders, here is a breakdown of inpatient costs per day at hospitals in states across America in 2017.

LocationState/Local Government HospitalsNon-Profit HospitalsFor-Profit Hospitals
United States$2,129$2,574$1,996
Alabama$1,455$1,723$1,621
Alaska$1,874$3,042$3,280
Arizona$2,209$2,812$2,225
Arkansas$2,032$1,751$1,619
California$3,217$3,800$2,255
Colorado$2,263$3,319$2,781
Connecticut$3,979$2,655N/A
DelawareN/A$3,039$1,707
District of ColumbiaN/A$3,166$2,433
Florida$2,079$2,358$1,681
Georgia$917$2,005$1,861
Hawaii$1,049$2,706N/A
Idaho$1,662$4,208$2,434
Illinois$2,725$2,557$1,649
Indiana$1,671$2,777$2,500
Iowa$1,547$1,564$1,558
Kansas$1,609$1,872$1,997
Kentucky$1,966$1,954$1,882
Louisiana$1,828$1,981$2,024
Maine$1,585$2,396$1,055
MarylandN/A$2,759$1,207
Massachusetts$1,870$3,221$1,881
Michigan$1,224$2,383$2,227
Minnesota$1,482$2,518$1,771
Mississippi$1,239$1,365$1,762
Missouri$1,686$2,452$1,963
Montana$52$1,627$2,614
Nebraska$906$2,148$3,031
Nevada$2,357$2,194$1,794
New HampshireN/A$2,654$2,059
New JerseyN/A$2,717$1,826
New Mexico$2,617$2,782$2,330
New York$2,775$2,719N/A
North Carolina$2,056$2,157$1,620
North DakotaN/A$1,780$4,701
Ohio$2,884$2,736$2,391
Oklahoma$1,324$2,034$2,262
Oregon$4,062$3,546$2,731
Pennsylvania$787$2,448$1,937
Rhode IslandN/A$2,843$2,028
South CarolinaN/A$2,159$1,729
South Dakota$442$1,519$3,956
Tennessee$1,537$2,193$1,836
Texas$2,926$2,675$2,078
Utah$3,038$3,291$2,478
VermontN/A$2,440N/A
Virginia$2,994$1,888$1,895
Washington$3,312$3,540$2,451
West Virginia$2,461$1,965$1,362
Wisconsin$2,778$2,490$2,830
Wyoming$1,269$2,225$2,219

Via: KFF.org

15 Mar 2019

3 Ways Technology is Improving Healthcare

3 Ways Technology is Improving Healthcare

 

Modern advancements in technology are changing how Americans work and spend their free-time. It’s also hugely transforming the health industry both in the offices of health practitioners and in our homes.

Electronic Health Records (EHRs)

Electronic Health Records (EHR) facilitate countless advances in medical diagnostics and treatments making it easier to share and transfer patient records. The goal of using EHR is to deliver high-quality care for all. Many systems have been connected and data can be transferred quickly. Using data from patient records can also be used to improve quality outcomes through their care management programs.  

Telemedicine / Telehealth

Telemedicine refers to methods of advancing healthcare based on telecommunications technologies. Not only is this advancement incredibly convenient, but it’s also a way for rural areas and those with limited mobility to meet virtually with their doctor. Another added benefit is the cost benefits for both providers and patients. According to the Alliance for Connected Care, telehealth services can save up to $100 per visit.

Wearable Technology & Remote Monitoring Tools

Remote monitoring tools are an incredible advancement for those who suffer from chronic illnesses or heart diseases. These products can help patients monitor their health from home saving them both time and money. Advancements in items like pacemakers also send data to health centers so they can be monitored from a distance. There are also very popular with those who want to take an active role in their health. Huffington Post projects that by 2018 130 million wearable devices will be sent to consumers.

Find out how you can better protect yourself with extended Medicare coverage by contacting the professionals of healthquoteinfo.com at 1-855-614-5057.

3 Ways Technology is Improving Healthcare

04 Dec 2018

Health insurance a key concern for American voters

Health insurance a key concern for American voters

The recent midterm elections have shown that American voters are more concerned with the health care system than ever before. In CNN’s 2018 exit polling, 41% of the population ranked health care as the most important issue, compared with only 25% in 2015 and a mere 18% in 2012. A Kaiser Family Foundation tracking poll further demonstrated that 71% of voters considered health care “very important” in determining which Congressional candidate to vote for in the midterms. Similarly, data from CBS News/YouGov revealed that 70% of voters in Congressional swing districts considered health care to have more of an impact on voting decisions than gun laws, the Supreme Court, immigration and even the economy.

Democratic vs. Republican Campaign Ads

In the run-up to the midterm elections, Democratic candidates seemed to have their fingers more firmly on the pulse of the people. According to the Wesleyan Media Project, Democratic ads were laser-focused on constituents’ highest priority: 44% of ads touched on health insurance with an additional 18% mentioning Medicare. Advertising information compiled by Kantar Media/CMAG found that only 21% of Republican ads mentioned health care at all.

While Republican politicians have generally been on a mission to destroy Obamacare since its inception, prior to the midterm elections they seemed to have changed their tune. Many GOP candidates tried distancing themselves from the repeated GOP attempts to “repeal and replace” Obamacare, a mantra that became further popularized in the Trump administration. But the tide seemed to have turned during the midterms: Democratic candidates urged that a vote for them was a vote to save affordable health care. They began centring their campaigns on the many attempts by their opponents to exclude patients with preexisting conditions from health coverage. And they won.

Nearly all of the votes have been counted in the midterm elections and the Democrats have netted almost 40 seats in the House of Representatives. This has undoubtedly shown just how important health care is for the average American voter and family. In some traditionally red states, like Idaho, Nebraska and Utah, voters opted for some inherently blue policies; namely, the adoption of the ACA’s expansion of the Medicaid program.

In choosing Democratic candidates, American voters have expressed one of their most fundamental concerns: for lower cost, higher quality health coverage that enables everyone to gain access to the health care that they need.

01 Nov 2018

Open Enrollment Changes for 2019

Open Enrollment Changes for 2019

Medicare provides health insurance coverage for most Americans over 65 years old or suffering from a disability.  According to the NCPSSM, over 56 million Americans are currently on Medicare receiving an average benefit of $12,829 each.

The Open Enrollment Period (OEP) gives Americans the chance to purchase or make changes to their health insurance plans.  It’s been happening every year since President Obama passed the Affordable Care Act in 2010.

While President Trump and other government officials have been pushing for changes to the American health insurance system, there is nothing concrete yet for 2019.  But there are still some changes you need to be aware of as a consumer.

What are the changes to Open Enrollment?

Open Enrollment Period start date

The Trump administration shortened the Open Enrollment Period from 90 days to 45 days last year and changes will carry over to this year. Open Enrollment for 2019 takes place between November 1st and December 15th, 2018.

Changes to “Essential Health Benefits” benchmark plans

Previously, the Affordable Care Act required 10 basic coverages that marketplace plans had to have.  But now, states will be able to build their own benchmark plans.  This new rule will give health insurance companies more flexibility and hopefully more choice to consumers.

Be sure to review your plan as it may have changed.

No penalties for those without health insurance

Prior to this change, people who did not have health insurance would have to pay a tax penalty.  This new rule will give exemptions to people living in counties with no health insurance companies or where there is only one insurer offering coverage.

People in counties where the only health insurer covers abortions are also exempt if abortions go against their religious beliefs.

Get help with your 2019 Open Enrollment

There are a lot of changes coming down the pipe for 2019.  You can read the full CMS rules if you’re curious.

And as a bonus tip, you should also update your application with new expected income and household information.  Plans and prices change every year and there will be different plans available in 2019.  You should review your coverage and all of the plans available.  There might be one that better fits your needs.

For more information or help navigating the changes to health insurance, get in touch with the experts at healthquoteinfo.com or call us at 855-614-5057.  Our licensed health insurance advisors would be happy to assist.

01 Nov 2018

Open Enrollment Checklist for Employees

Open Enrollment Checklist for Employees

While open enrollment can often be a stressful and even confusing time for employees, your employee benefits package is an invaluable part of your total compensation package. In fact, in financial terms, the benefits you receive through an employer-sponsored group health plan can boost your compensation from work up to 30%!

Open enrollment gives employees the opportunity to reassess their benefits from the current year and make changes that will benefit them for the year to come. While it is sometimes tempting to just enroll in the same plan as last year without giving it a second thought, you could be cheating yourself out of a significant portion of your compensation structure.

Selecting your healthcare coverage is arguably the most important decision that you have to make during the open enrollment period. But, that doesn’t mean that it’s a simple one to make. In fact, it can be pretty complicated since your optimal coverage depends on personal factors related to your health. To make the best choice for coverage in the coming year, employees must take into consideration whether they take prescription medication, how often they visit medical facilities, how many dependents they have and how much they will pay out of their own pockets.

  • Review your medical and financial situation from the previous year. Before choosing your health plan for the coming year, it’s important to take stock of last year’s healthcare plan. Choosing the least expensive plan may seem like the best short-term option for your wallet, but depending on your individual health needs, it can be a very short-sighted choice that can end up costing you more in the end. To help you decide which plan is best, make a list of all your medical costs for the previous year, including copays, deductibles, premiums and coinsurance. Some employers may allow you to maintain your current coverage, so it is important to carefully scrutinize how your plan held up the previous year.
  • Consider any voluntary benefits. Review any supplemental offers, such as dental and vision coverage, financial counseling, disability protection and even pet insurance. Some employers are offering more supplemental coverage now and prices are lower in a job-based plan than on the open marketplace. Choose the coverage that is adequate for your personal needs, depending on whether you anticipate needing any major work done as opposed to basic cleanings and checkups.
  • Remember to take possible tax breaks into account. Flexible Savings Accounts (FSA) and Health Savings Accounts (HAS) enable employees to put money aside to help defray healthcare costs, or “qualified expenses,” such as copays, deductibles, coinsurance and monthly prescription drug costs. Both FSAs and HSAs work as personal savings accounts and help employees reduce their tax liability by depositing funds into the account on a pre-tax basis. To qualify for an HSA, you must have an HDHPs (High-Deductible Health Plans), which is defined as health coverage with a deductible of $1300 or more for an individual or $2600 or more for a family. If you qualify, an HSA is generally preferable due to the fact that limits are higher and contributions can be carried over from the previous year. In addition, Dependent Care Flexible Savings Account (DCFSA) is another form of pre-tax benefit account that can be used to pay for eligible services for dependents, such as summer camp, after-school programs, and daycare.

To learn more about the open enrollment period for employees, contact the experts at HealthQuoteInfo.com at 1-855-614-5057. Our licensed insurance professionals are standing by to answer any questions you may have.

 

15 Oct 2018

Dates And Deadlines For 2019 Open Enrollment Coverage

Dates And Deadlines For 2019 Open Enrollment Coverage

What’s all this talk about the Open Enrollment Period and how will it affect your family? We’re going to break down all the facts and talk about the important dates to save on your calendar.

What is the Open Enrollment Period?

This refers to the time period when Americans can either purchase or modify a health insurance plan for the upcoming year. This time frame was officially established by the Obama administration with the creation of the Affordable Care Act.

While the future of the ACA remains uncertain as the current White House attempts to undermine the program, the Open Enrollment Period remains an annual event.

When Is The 2019 Open Enrollment Period?

It officially begins on November 1st, 2018, and ends on December 15th, 2018, providing exactly 45 days for Americans to make an informed decision. If you have any questions or concerns regarding enrollment, we encourage you to call one of our agent at 1-855-614-5057. We can help you navigate through the confusion and find a plan that’s suited for you.

Other Enrollment Dates

Each state either uses the federal exchange (otherwise known as healthcare.gov) or their own state-based exchange. For this reason, approximately a dozen states have slightly different enrollment dates outlined below.

HQI Enrollment Graphic 2019

What If You Miss The Open Enrollment Period?

If you missed the 2019 Open Enrollment Period, you’ll unfortunately have to wait until next year. It’s not all bad news though, as you do have a few options. Firstly, if you’ve experienced a Qualifying Life Event, you can apply for special enrollment. Examples of a Qualifying Life Event include the following:

  • Marriage, divorce or legal separation
  • Birth or adoption of a child
  • Death of a spouse or child
  • Change in residence or work location, which impacts the eligibility
  • Your child fails to meet the plan’s eligibility rules (for example, the student status changes)
  • You or your covered dependents gain or lose other coverage because of a change in employment status (for example, beginning or ending a job) 

For more information regarding this topic, you can always visit our resource page.

Short-Term Health Insurance

Those without an annual plan can also purchase a short-term health insurance plan, which can now last up to a few months. In most cases, short-term health insurance plans are more expensive compared to the competition, but these policies can serve as a lifeline for this who missed the Open Enrollment Period. For more information, you can visit our page dedicated to short-term health insurance.

If you have any outstanding questions, we recommend contacting one of our agents at 1-855-614-5057 or visit HealthQuoteInfo.com.