Health insurance can be a confusing topic, with many technical terms and jargon that can be difficult to understand. In this article, we will cover five basic health insurance terms to help you better understand your coverage. Premium: A premium is the amount of money you pay each month to your insurance company for your coverage. It is important to pay your premium on time to ensure that your coverage stays active.
APTC stands for Advanced Premium Tax Credit. It is available to apply for through MNSure, Minnesota’s Health Insurance Exchange. An APTC is used to lower your monthly premium costs. It must be applied to a private individual health plan through MNSure (catastrophic and dental plans are excluded).
If you or your spouse is still working when approaching age 65, the Medicare Part B Penalty is a common concern. Below we break down whether you need to sign up for Medicare Part A and/or Part B to avoid this penalty.
Whether you are signing up during the Open Enrollment Period or the Special Enrollment Period, it is important to know the deadlines and what is needed in order to get enrolled. A local agent can also help you navigate these enrollment periods to avoid a gap in coverage and get you enrolled.
Medicare fraud and abuse is a serious crime to report immediately. Medicare fraud can come in many forms but generally involves the illegal practice of falsifying Medicare claims to receive higher financial compensation. One other form of Medicare fraud involves identity theft. This can occur when a person’s Medicare information is stolen and used to submit fraudulent claims.
Health reinsurance is a way to curb the stark price increase in the individual health insurance market as a short-term solution. It was founded in 2017 by Minnesota lawmakers to combat the high individual private health rates after the Affordable Care Act. Reinsurance went into effect in 2018.
Although they sound similar, Original Medicare and Medicare Advantage are far from the same, yet they do share similarities. A few of the similarities are that they both provide medical coverage, you are eligible for both at 65, and both are regulated by the government. A few of the many differences between Original Medicare and Medicare Advantage are coverage, cost, travel, network, coinsurance vs. copay.
When looking into Health Savings Accounts, the question may arise, what can I use this on. This list shows what services are Qualified Expenses that your HSA can cover.
Early retirement is something we all dream of, but what happens when we are able to achieve that goal? In terms of health insurance, it could mean a lapse in coverage. If you do plan to retire before becoming Medicare eligible at the age of 65, you have plenty of health insurance options to ensure that you have coverage in case you get injured or become ill.
Medicare Part D is prescription drug coverage. It can be through two avenues: original Medicare, a stand alone Part D that is a separate plan that you have to enroll in through a private insurance company or a Medicare Advantage Plan (Part C). Most Advantage plans include a Medicare Advantage Prescription Drug plan.
Medicare Part C is the same thing as a Medicare Advantage Plan. They are just different names for the same thing. You will hear the terms Medicare Advantage, Part C, and MA plans used interchangeably. Medicare Advantage plans are provided by Medicare approved private companies. They can be thought of as a "bundle You need to have Medicare Part A and B to get an Advantage Plan. Your Advantage plan (Part C) essentially replaces Medicare Part A, Part B, and typically Part D too.
What does Medicare Part B cover? It covers treatments and supplies that are medically necessary to either treat or diagnose, preventative health care, and durable medical equipment. Things such as doctor visits, screenings, ambulance services, and wheelchairs are covered with Medicare Part B.
What is Medicare Part A? Medicare Part A is hospital insurance. Medicare Part A covers hospital inpatient services, skilled nursing facilities, hospice care, post-inpatient home health care.
Your financial assistance eligibility can be changed based on an increase or decrease in income. It is important to report these changes in household income because you could have the wrong level of financial aid or insurance plan. Examples of changes in income to report: • New Job • Lose a Job • Change in Current Income • Change to your Projected Annual Income
Governor Tim Walz signed the Alec Smith Insulin Affordability Act on April 15, 2020; this includes the Minnesota Insulin Safety Net Program. The MN Insulin Safety Net Program provides financial help to individuals who cannot afford their insulin.
The Social Security Administration (SSA) announced that all local Social Security offices will be closed to the public for in-person service starting Tuesday, March 17, 2020. However, their secure and convenient online services remain available at www.socialsecurity.gov . Local offices will also continue to provide critical services over the phone. What does this mean for people in need of applying for Medicare during this time? While the SSA offices are closed for in-person service there are still options for you to enroll in your Medicare coverage needs. People needing to apply for Medicare generally fall into one of three enrollment situations and below are instructions for each of those situations.
The Medicare Part D penalty is a late enrollment fee that is added to the monthly premium for your Part D plan. How do you know if you owe a Medicare Part D late enrollment penalty? After your initial enrollment period, if you go 63 consecutive days or longer without a Medicare Part D plan, a Medicare Advantage Plan, a different Medicare health plan that has prescription drug coverage, or any other valid prescription drug coverage you will owe a penalty. How do you avoid the Part D penalty? When you first become eligible for a Medicare prescription drug plan, join it. Have creditable prescription drug coverage, whether it is from the Department of Veterans Affairs, employers, unions, health insurance coverage, or other providers. Keep records that show you had credible drug coverage. Your plan will check if you had prescription drug coverage for 63 days or longer when you join a Medicare Part D plan. You may have to fill out a form if the plan does not think you had prescription drug coverage.
The type of health insurance plan you will need while traveling can be affected by a few different factors - How long will you be gone? Will you be traveling internationally or domestically? Does your plan offer a national network?
First, it is important to understand what affects life insurance rates. Your individual rate is determined by age, health, and policy type. The industry wide rates are majorly affected by business expenses, mortality rates, and the amount of interest a company can earn through investing. You can get online Term Life Insurance Quotes for Minnesota.
The Minnesota Department of Commerce recently released the proposed rate changes for 2019 for individual plans for people living in Minnesota and it looks like good news!
Starting in 2019, a popular Medicare insurance product known as a Medicare Cost plan will no longer be available to members in the vast majority of counties throughout Minnesota. Policyholders who are on this type of plan, which has been offered by three insurance companies here, Blue Cross and Blue Shield of Minnesota, HealthPartners, and Medica, will need to choose replacement coverage for January 1st. This impacts nearly 300,000 Minnesota residents.
MN Individual Health Insurance Open Enrollment Period runs from November 1 through December 15, 2017. This open enrollment period offers you the opportunity to shop and enroll in a plan that best fits the needs of you and your family. This means that if you don’t like your current policy, you may use this time to enroll in a different plan to replace it - one with different coverages, networks, and rates. The effective date of your new plan choice would be January 1, 2018. Once the annual open enrollment period is closed, you may only apply for an individual/family policy if you have a qualifying life event (i.e. baby, marriage, loss of employer coverage, etc.).
Minnesota legislators passed a law earlier this year called the Minnesota Premium Security Plan. This "reinsurance" plan was designed to help control the rise of health insurance premiums in the individual market for 2018. The law required approval by the federal government, which was granted recently by the Center for Medicare and Medicaid Services, or CMS, and the Department of Health Services.
The Medicare Annual Open Enrollment Period is the one time each year when you can switch your Medicare Advantage (MA), Medicare Advantage with Prescription Drug (MAPD), or Part D Prescription Drug (PDP) plan. This means that if you don’t like your current policy, you would use this time to enroll in a different plan to replace it, with an effective date of January 1. Medicare plans can change each year—things like the premium, coverages, and which providers and pharmacies are in their networks. You should compare the cost and coverages of your current MA, MAPD, or PDP plan to see if it is still the best fit. If needed, you can change Medicare health plans and prescription drug coverage for the following year to better suit you. If you're satisfied that your current plan will meet your needs for next year, and provided that it is still being offered, you don’t need to do anything. With a list of your current providers and medications, the licensed agents at MN Health Insurance Network can compare all of the Medicare plans that they represent in your area for free, and make suitable recommendations. Contact us at (952) 224-0123.
Medica will be the last and only health insurance carrier offering individual health insurance plans in Iowa for 2018. The Minnesota based health insurer will be the only option 72,000 Iowans who now buy their own insurance instead of obtaining in through an employer or government plan.
This year, for the first time, insurers were required to submit two sets of proposed rates: proposed rates that assume implementation of a new state reinsurance program in 2018, and proposed rates that assume no reinsurance program in 2018.
Unknown to many people, the solar eclipse on August 21 can cause permanent damage to your eyes if proper safety glasses are not used. Staring at the eclipse for 100 seconds will burn your retinas causing permanent damage to your eyes and even the top sunglasses won’t be able to help. These special eclipse glasses are a hot commodity as of late, but with that a multitude of knockoffs are popping up. Most of these knockoffs are being sold on Amazon and are hard to distinguish from the real ones.
Minnesota health insurers have proposed new rates for the upcoming enrollment period and for the second year in a row, people are seeing double digit increases in their health insurance premiums. According to Star Tribune, the five percent of Minnesotans (270,000 people) who obtain their health insurance coverage in the individual market will be asked to pay an average of 36 to 67 percent higher premium than what they were paying last year.
Since 2014, individual health insurance premiums have been increasing rapidly, usually around 50% per year. Even with those increases, however, from 2014 – 2016 many employers still thought it was financially beneficial to not offer group health insurance to employees. All of that will change for 2017.
Small Group Health Insurance Requirements
At around this time last year an important piece of the Affordable Care Act was ready to take effect in Minnesota – the transition of employers with 51-100 employees to the small group market instead of the large group market. This would have meant a substantial increase of people insured through the community rated small group risk pool, which would have substantially altered health insurance rates for thousands of people.
A major shift will be hitting the individual market in 2017, as Blue Cross Blue Shield will be dropping all individual market PPO plans. Blue Cross and Blue Shield of Minnesota is Minnesota’s largest health insurer, but have taken a loss of roughly $500 million over the last three years in the individual market according to BCBS. The insurer said that their claims for medical care greatly exceeded their revenue from premiums for those plans.
Sometimes small business owners ask the question: Why should I use a broker at all, much less you as a broker? There are several reasons, but here are a few:
The Internal Revenue Service (IRS) announced changes for 2016 contribution and rule changes to health savings accounts (HSAs) and for out-of-pocket spending under high-deductible health plans (HDHPs) linked to them. In Revenue Procedure 2015-30, issued May 5, 2015, the IRS provided the inflation-adjusted HSA contribution and HDHP minimum deductible and out-of-pocket limits, effective for calendar year 2016. The higher rates reflect a cost-of-living adjustment and rounding rules under Internal Revenue Code Section 223.
Many MN small businesses are wondering if they should offer an employer sponsored group plan or simply pay for employees’ individual plans. In light of recent IRS guidance, employers must be very careful when pay for employees’ individual health insurance plans. Not only do they have to treat any payment toward individual premiums as wage (and thus subject to FICA and taxed), but they also cannot associate those payments with any individual plan. That means any “reimbursement” or payment has to be a salary increase that is the same for every employee in the job class, even if the employee is on their spouse’s plan. If the payments are in any way tied to an individual health plan, the possible penalty is $100 per day per employee.
Many small employers believe the Employee Retirement Income Security Act (ERISA) only affects large businesses or retirement plans. That is, however, not the case. ERISA affects small businesses as well, and possible fines can be levied against small businesses not in compliance.
Retirement affords many seniors the opportunity to travel, which often includes trips abroad. These activities create certain challenges with regard to health insurance coverage for medical issues that may arise while these Medicare members are outside of our borders.
Minnesotans find themselves shopping for and comparing 2016 MN health care plans. The recently released rates have some people shocked as they are projected to see an over fifty-percent jump in their monthly health care coverage premium.
With the open enrollment period for individual healthcare plans quickly approaching, many Minnesotans find themselves concerned with the recent announcement of rate increases. Individual healthcare plans that are effective January 1st are expected to experience an increase anywhere between 14 and 49 percent in cost.
The Medicare Annual Open Enrollment Period is the one time each year when you can switch your Medicare Advantage (MA), Medicare Advantage with Prescription Drug (MAPD), or Part D Prescription Drug (PDP) plan. This means that if you don’t like your current plan, you can use this time to enroll in a different plan to replace it effective the first of the following year. You should compare the cost and coverages of your current MA, MAPD, or PDP plan to see if it is still the best fit for your needs. With a list of your current providers and medications, the licensed agents at MN Health Insurance Network can compare all of the Medicare plans that they represent in your area for free, and make suitable recommendations.
The Supreme Court backed President Barack Obama’s health care overhaul on Thursday. This prevented a major challenge for the millions of Americans tied to the health insurance under the law. The Affordable Care Act, or Obamacare, is here to stay.
Big savings for the government due to the new managed care contracts will come at the expense of UCare. UCare is currently the largest HMO in Minnesota’s public health insurance programs. Recently, the results from the latest round of competitive bidding on HMO contracts were revealed by Gov. Mark Dayton. He reported that there should be nearly $450 million in saving in 2016 from the process, dismissing UCare as an option for most enrollees. The state will also be receiving $200 million in repayments from HMOs and the county based purchasing organizations. This is due to the fact that enrollees didn’t use as much coverage as previously thought. The praises for the bidding process have been that it’s good for taxpayers and enrollees. State officials evaluated bids from health plans not only in terms of the cost, but also in the quality of the plan. The previous sets of bids resulted in more enrollees shifting to UCare, which currently manages care for around 360,000 people. This fall, these enrollees will need to switch plans for the upcoming year.
What is MN Medicare Part D Prescription Drug Donut Hole?
A big part of the Affordable Care Act is being implemented next year, and planning should begin soon for MN small businesses. Starting January 1, 2016, businesses with more than 50 full-time employees but less than 100 full-time employees are transitioning from the large group platform to the small group platform per Affordable Care Act requirements. What does this mean for those MN businesses offering group health insurance benefits?
Medicare is the federal health insurance program for people who are age 65 and older, and for certain individuals with disabilities. Medicare Part A covers inpatient hospital stays, while Part B covers doctor services. Medicare Part C refers to Medicare Advantage plans offered by private companies, and Medicare Part D offers prescription drug coverage. Medicare beneficiaries can stay in the traditional federal program, and purchase supplemental policies from insurance carriers. In some parts of the country, older adults have the option to enroll in Medicare Cost plans offered by private companies
If you are able to afford health insurance, but choose not to purchase it, you will receive a tax penalty unless you have a coverage exemption.
The IRS released the 2016 inflation-adjusted amounts for Health Savings Accounts (HSAs). For calendar year 2016, the annual limitation on deductions for an individual with self-only coverage under a high deductible health plan is $3,350 and for an individual with family coverage under a high deductible health plan is $6,750.
There are several types of Medicare products available in Minnesota including Medicare Advantage Plans, Medicare Supplement Plans, Medigap Plans, and stand-alone Prescription Drug plans. One other type is a Medicare Cost Plan. These plans are unique to this region and are very popular among Medicare members because they share the cost of claims with Medicare, while providing additional benefits not covered by Medicare. These benefits can include eyewear coverage, hearing aid coverage, dental coverage, health club memberships, as well as options to add prescription drug coverage. In addition, these plans travel well for members seeking coverage within the U.S., but outside of this area. Best of all the premiums are generally very competitive.
New IRS Guidance has been released that will dramatically change the way small businesses help their employees pay for health insurance. IRS Notice 2015-17 states that employers who offer employees reimbursements or pay premiums for employees' individual health insurance plans will be subject to a $100 per day per employee excise tax. The interpretation from the IRS is that any reimbursement or payment for employees' individual plans is actually a group health insurance plan, and because the payment is a group plan, it does not meet Affordable Care Act requirements for health insurance plans. Enforcement of this notice will go into effect July 1, 2015.
Scott Leitz, the CEO of Minnesota's state run health insurance exchange (MNSure) since 2013, resigned to accept a job with a health care think tank in Washington DC. His last day as MNSure CEO will be May 22, 2015. Allison O'Toole has been named as interim CEO. The MNSure board will address the issue of a permanent CEO at its upcoming May 19th meeting. O'toole is MNSure's third CEO in the past 2 years, and has worked with MNSure in it's marketing communications department.
In an effort to insure more people and lessen the tax consequences for some Minnesotans, MNSure has announced a special enrollment for those people that face a penalty for being uninsured in 2014, and would like to get coverage for 2015. The Special Enrollment period dates run from March 1, 2015 through April 30, 2015. Read here for more information on who qualifies and how to apply.
It’s that time again. Every year, Medicare has an open enrollment period when Medicare beneficiaries may apply for a new Medicare plan, or change the Medicare coverage that they currently have. This enrollment period is from October 15 through December 7, with plans becoming effective on January 1. Sorting through the different Medicare products like Medicare Supplement Plans, Medigap Plans, Medicare Select Plans, Medicare Advantage Plans, Medicare Cost Plans, or Medicare Prescription Drug Plans, can be a daunting task. Working with a broker like MN Health Insurance Network can be extremely beneficial in helping you choose the right Medicare plan for you based on your specific needs.
The IRS has recently released the information for the 2015 HSA health plans. A Health Savings Account is a tax-sheltered savings account that belongs to you and is linked with your high deductible health plan. You can make contributions for the tax year 2015 until April 15th, 2016. When comparing this years contribution limits to last years here are the major changes:
On April 1, 2014, President Obama signed into law the Protecting Access to Medicare Act of 2014. Among many other Medicare related issues, this act extended through 2015 the ability of insurance companies to offer contracts known as Medicare Cost plans. These popular plans allow Medicare members to purchase or leave them anytime during the year. They provide medical coverage, and in some cases, prescription drug coverage options, at an affordable premium. This is good news for the insurance companies in the states, like Minnesota, that sell this type of Medicare policy. BlueCross and BlueShield of Minnesota, HealthPartners and Medica all offer Medicare Cost Plans.
What is a Special Enrollment Period? You and your family may be eligible for a Special Enrollment Period (SEP), which is a time outside of open enrollment. This is a time when you would have the ability to change your insurance plan. You must have experienced a Qualifying Life Event (QLE). Generally, your SEP starts on the date that the Qualifying Life Event takes place, and ends 60 days later. You must choose a new plan and pay the premium before the SEP ends in order to guarantee coverage.
Minnesotans are now a just a couple of weeks into the introduction of MNSure open enrollment. Most individual and family health insurance policy owners are just now receiving letters from their insures showing the coverage changes due to the Affordable Care Act accompanied by large premium increases. Below is a step by step approach to navigating the complicated world of health insurance, MNSure, and shopping for new individual/family health insurance plan.
Medicare's annual open-enrollment period starts Today, October 15th, 2013. This is the time of year beneficiaries have to make changes to their Medicare supplement plans. You will have from Oct. 15 through Dec. 7 to choose your 2014 coverage, and you can contact a MN Health Insurance Network Medicare specials to assist you in evaluating you Medicare Supplement, Medicare Advantage, Medicare Cost, and Part D prescription-drug options. Important: Don't confuse Medicare open enrollment with the new health-insurance marketplaces that have just opened under the Affordable Care Act. If you are covered by Medicare, you don't need to visit the ACA marketplaces.
A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. These “gaps” are the health care costs that the Original Medicare Plan covers, but doesn't pay for. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will each pay its share of covered health care costs. Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to continue to pay the monthly Medicare Part B premium. In addition, you will have to pay a premium to the Medigap insurance company. As long as you pay your premium, your Medigap policy is guaranteed renewable, meaning that it is automatically renewed each year. However, if a Medigap policy was purchased before 1992, insurance companies in some states may refuse to renew it.
Effective October 1, 2013, employers must notify new and existing employees in writing about their state’s health benefit exchange and advance premium tax credits available through the exchange to help them purchase individual coverage. The requirement is contained in Section 218b of the federal Fair Labor Standards Act of 1938. The U.S. Department of Labor is charged with issuing regulations providing more specific guidance on the notice but has not yet done so. Section 218b requires the following information be included in the notice:
The Minnesota Health Insurance Exchange is opening its virtual doors to the public on October 1st, 2013 as a result of the Affordable Care Act. Health insurance professionals at MN Health Insurance Network will be helping individuals and families navigate this new online marketplace step-by-step in a variety of ways. First, we will help you determine if you are eligible for any type of subsidy or tax-credit within the MN Exchange. Government subsidies and tax credits
One of the most advantageous aspects of the Affordable Care Act is a premium tax credit for small businesses. This credit allows small businesses that meet certain conditions to qualify for a tax credit up to 50% of what they contribute toward their employees’ health insurance premiums. Below are the conditions that a small business must meet in order to qualify:
Effective October 1, 2013, employers must notify new and existing employees in writing about their state’s health benefit exchange and advance premium tax credits available through the exchange to help them purchase individual coverage. The requirement is contained in Section 218b of the federal Fair Labor Standards Act of 1938. The U.S. Department of Labor is charged with issuing regulations providing more specific guidance on the notice but has not yet done so. Section 218b requires the following information be included in the notice: 1.A description of the services provided by the exchange and the manner in which the employee may contact the exchange to request assistance. 2.If an employer provides employer-sponsored health coverage that does not provide minimum actuarial value (60 percent of expected costs for benefits provided under the plan), the employee may be eligible for a premium tax credit and reduced cost sharing (deductibles, copayments, and coinsurance) if the employee purchases individual coverage through the exchange. 3.If an employee purchases a qualified health plan through the exchange, the employee may lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for federal income tax purposes. Employer Model Notices: Employers that offer group health insurance: Click here Employers that do not offer group health insurance: Click here
Recent Blog Posts
Health Insurance Quotes
GET QUOTES NOW!