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	<title>SmartChoiceMD &#187; insurance</title>
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		<title>Diet Labs &#8211; Diet Testing for Your Best Body</title>
		<link>http://blog.smartchoicemd.com/diet-labs/</link>
		<comments>http://blog.smartchoicemd.com/diet-labs/#comments</comments>
		<pubDate>Wed, 27 Jan 2016 14:10:41 +0000</pubDate>
		<dc:creator><![CDATA[SmartChoiceMD]]></dc:creator>
				<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[Lab Testing]]></category>
		<category><![CDATA[Wellness]]></category>
		<category><![CDATA[clean eating]]></category>
		<category><![CDATA[diet]]></category>
		<category><![CDATA[exercise]]></category>
		<category><![CDATA[fitness]]></category>
		<category><![CDATA[health]]></category>
		<category><![CDATA[insurance]]></category>
		<category><![CDATA[labs]]></category>
		<category><![CDATA[weight]]></category>

		<guid isPermaLink="false">http://blog.smartchoicemd.com/?p=477</guid>
		<description><![CDATA[<p>Lately, scientific breakthroughs in understanding the unique differences in a person&#8217;s genetic makeup and metabolism have made visiting diet labs increasingly popular. In a <a href="http://onlinelibrary.wiley.com/doi/10.1002/oby.21381/abstract">recent paper</a> published by researchers at the University of Tennessee in the journal <i>Obesity</i>, a number of genetic markers that influence weight loss were identified. It is believed that, in the near future, DNA samples and sensors similar to today&#8217;s FitBit and other lifestyle tracking devices will allow doctors to customize a special diet plan unique for the individual.</p>
<p class="more-link-wrap"><a href="http://blog.smartchoicemd.com/diet-labs/">Continue reading &#160;&#187;</a></p>
<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/diet-labs/">Diet Labs &#8211; Diet Testing for Your Best Body</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
]]></description>
				<content:encoded><![CDATA[<p>Lately, scientific breakthroughs in understanding the unique differences in a person&#8217;s genetic makeup and metabolism have made visiting diet labs increasingly popular. In a <a href="http://onlinelibrary.wiley.com/doi/10.1002/oby.21381/abstract">recent paper</a> published by researchers at the University of Tennessee in the journal <i>Obesity</i>, a number of genetic markers that influence weight loss were identified. It is believed that, in the near future, DNA samples and sensors similar to today&#8217;s FitBit and other lifestyle tracking devices will allow doctors to customize a special diet plan unique for the individual.</p>
<p>For now though, diet labs offer a number of tests to help people understand their current health condition and be better informed about what proactive steps can be followed to lose weight and become healthier.</p>
<p><strong>What Tests do Diet Labs Offer?</strong></p>
<p>Right now, there is no standardized legal description of a &#8220;diet lab&#8221;, so every facility offers different diet testing. Some of the tests currently available from diet labs include:</p>
<ul>
<li><strong>CBC</strong> &#8211; Otherwise known as a &#8220;Complete Blood Count,&#8221; this common test will measure the functioning of your immune system, as well as the oxygen levels in your body. The test can reveal certain forms of malnutrition, including anemia, as well as the presence of inflammation in cell tissues, which can be linked to the consumption of certain types of food and drinks.</li>
<li><strong>Comprehensive Metabolic Panel</strong> &#8211; This full-spectrum test of your blood will reveal important insights into how your kidneys and liver are functioning. Your blood glucose levels will also be measured, which can reveal the presence of diabetes or an elevated risk of contracting Type II diabetes. Thyroid and other metabolic disorders can also be identified with this test, as well as abnormally low Vitamin D and/or calcium levels.</li>
<li><strong>Ketones</strong> &#8211; This test will measure the number of ketones in your urine. High levels can indicate the presence of diabetes or an excess of high glycemic index foods in your diet.</li>
<li><strong>Liver Panel</strong> &#8211; When people are obese, there is a strong correlation between high enzyme levels produced by the kidney. This test can also identify long-term damage to the kidneys.</li>
<li><strong>Serum Iron</strong> &#8211; This test measures the level of iron in your blood. Low levels may indicate anemia, iron deficiency due to dietary or other causes, as well as other forms of malnutrition.</li>
<li><strong>Lipid Profile</strong> &#8211; This is the test that measures the various forms of cholesterol in your blood, an important marker for tracking and monitoring your overall health.</li>
<li><strong>Serum Magnesium</strong> &#8211; This test can identify problems related to a loss of magnesium which can occur due to malnutrition, the consumption of diuretics (which include &#8220;water pills&#8221;), and excessive use of laxatives.</li>
<li><strong>Serum Phosphorous</strong> &#8211; Consuming too many diuretic drinks (which includes soft drinks, coffee, and tea) can lead to low calcium levels. High levels of phosphorous in the bloodstream can result from overusing common antacid products.</li>
<li><strong>Amylase Test</strong> &#8211; Performed on urine samples, the amylase test can reveal damage to the pancreas and/or salivary glands.</li>
<li><strong>Thyroid Panel</strong> &#8211; This test can reveal problems with the thyroid gland, including hypothyroidism (low levels of hormones produced by the thyroid glands). The thyroid is the &#8220;control center&#8221; of the body&#8217;s metabolic function, and can play a key role in difficulty losing weight.</li>
<li><strong>Transthyretin</strong> &#8211; Also referred to sometimes as prealbumin test, this can reveal certain deficiencies in the liver and the thyroid glands, as well as some forms of malnutrition.</li>
</ul>
<p>It is also recommended that anyone visiting a diet lab get a standard check-up where vital signs are measured. These include blood pressure, pulse rate, and your temperature. Abnormal vital signs may indicate a fever, inflammation, dehydration and issues relating to blood pressure .</p>
<p><strong>How Much Do Tests at a Diet Lab Cost?</strong></p>
<p>Every diet lab charges different prices for their services. The tests listed above require just a small blood sample and/or urine sample but many diet labs send their blood work and/or urinalysis work to a third-party laboratory. In some cases, these tests may be covered by existing health insurance. Always check with your insurance provider for the exact details about which tests have partial or complete coverage.</p>
<p><strong>Interpreting Your Diet Lab Results</strong></p>
<p>The internet is replete with advice about how to interpret the results of your diet lab work but only a medical professional or nutritionist can give you an accurate diagnosis of the current state of your health. Working with the results of your diet lab tests, you and your nutritionist or healthcare professional can then develop a diet and exercise routine to help you succeed in losing weight and enjoying a healthier life.</p>
<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/diet-labs/">Diet Labs &#8211; Diet Testing for Your Best Body</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
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		<title>Commercial and Government Health Insurance</title>
		<link>http://blog.smartchoicemd.com/commercial-and-government-health-insurance/</link>
		<comments>http://blog.smartchoicemd.com/commercial-and-government-health-insurance/#comments</comments>
		<pubDate>Fri, 13 Nov 2015 13:34:48 +0000</pubDate>
		<dc:creator><![CDATA[SmartChoiceMD]]></dc:creator>
				<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[Wellness]]></category>
		<category><![CDATA[affordable care act]]></category>
		<category><![CDATA[EPO]]></category>
		<category><![CDATA[government insurance]]></category>
		<category><![CDATA[health insurance]]></category>
		<category><![CDATA[healthcare]]></category>
		<category><![CDATA[HMO]]></category>
		<category><![CDATA[insurance]]></category>
		<category><![CDATA[medicaid]]></category>
		<category><![CDATA[medicare]]></category>
		<category><![CDATA[obamacare]]></category>
		<category><![CDATA[PPO]]></category>

		<guid isPermaLink="false">http://blog.smartchoicemd.com/?p=337</guid>
		<description><![CDATA[<p>With all the recent changes in the law, it can sometimes be difficult understanding the exact difference between government insurance and commercial insurance. In short, government insurance usually refers to a variety of different plans (including those that are regulated by the government in a kind of market, while commercial insurance refers to plans that are sold by for-profit companies that are free from such regulations.</p>
<p class="more-link-wrap"><a href="http://blog.smartchoicemd.com/commercial-and-government-health-insurance/">Continue reading &#160;&#187;</a></p>
<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/commercial-and-government-health-insurance/">Commercial and Government Health Insurance</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
]]></description>
				<content:encoded><![CDATA[<p>With all the recent changes in the law, it can sometimes be difficult understanding the exact difference between government insurance and commercial insurance. In short, government insurance usually refers to a variety of different plans (including those that are regulated by the government in a kind of market, while commercial insurance refers to plans that are sold by for-profit companies that are free from such regulations.</p>
<p><strong>Government Insurance</strong></p>
<p>Depending on who you are, where you live, your status, and income, you may be eligible for government insurance. <a href="http://blog.smartchoicemd.com/obamacare-2016-what-you-need-to-know-about-the-affordable-care-act/" target="_blank">The Patient Protection and Affordable Care Act</a>, commonly referred to as <a href="http://blog.smartchoicemd.com/obamacare-2016-what-you-need-to-know-about-the-affordable-care-act/" target="_blank">Obamacare</a>, refers to a kind of regulated marketplace where insurance plans are sold to the general public. For most people today, insurance coverage is now mandatory, and the Obamacare plans are what people must choose if they are not otherwise covered by another plan.</p>
<p>The federal government also offers three other insurance-type plans for eligible people: Medicare, Medicaid, and CHIP.</p>
<p>Medicare has been around since 1966, and is a form of insurance offered to anyone over the age of 65. Although Medicare is administered through the government, the actual coverage is provided through a network of about 30 private companies. Medicare is further subdivided into four categories: A, B, C, and D, which refer to which kinds of healthcare are provided.</p>
<p>Medicaid is a form of government health insurance that is available for people with very low incomes, or who qualify due to other circumstances like disabilities or being a pregnant woman. Unlike Medicare, Medicaid is jointly administered and funded by both the federal government and the state government where the person resides.</p>
<p>CHIP (Children&#8217;s Health Insurance Plan) is a form of insurance coverage offered to otherwise uninsured children, and to families with otherwise uninsured children. Formerly administered at the state level, since 1997, CHIP is now a jointly operated federal and state program similar to Medicaid.</p>
<p>There are strict rules about when, and for how long, a person can enroll in or be eligible for government insurance plans.</p>
<p><strong>Commercial Insurance</strong></p>
<p>Any kind of insurance coverage not offered or administered by the government is a form of commercial insurance. Private, for-profit companies sell these plans to eligible customers for a monthly fee known as a premium. Generally speaking, most commercial insurance plans fall into the <a href="http://blog.smartchoicemd.com/understanding-hmo-ppo-and-epo/" target="_blank">following categories</a>:</p>
<ul>
<li><strong>HMO</strong> &#8211; Healthcare is coordinated through a primary care physician, and treatment centers and providers are grouped into a network.</li>
<li><strong>PPO</strong> &#8211; The customer chooses where to get treatment, with treatment inside the network being significantly cheaper than treatment received outside the network.</li>
<li><strong>EPO</strong> &#8211; The customer chooses where to get treatment, but usually has to pay full price (out of pocket) for any treatment received outside the coverage network.</li>
</ul>
<p>Most commercial insurance plans can be bought at any time, and a person can opt out of continuing coverage whenever they want.</p>
<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/commercial-and-government-health-insurance/">Commercial and Government Health Insurance</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
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		<title>Understanding Health Insurance Coinsurance</title>
		<link>http://blog.smartchoicemd.com/understanding-health-insurance-coinsurance/</link>
		<comments>http://blog.smartchoicemd.com/understanding-health-insurance-coinsurance/#comments</comments>
		<pubDate>Wed, 11 Nov 2015 21:19:39 +0000</pubDate>
		<dc:creator><![CDATA[SmartChoiceMD]]></dc:creator>
				<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[Wellness]]></category>
		<category><![CDATA[coinsurance]]></category>
		<category><![CDATA[copay]]></category>
		<category><![CDATA[deductibles]]></category>
		<category><![CDATA[insurance]]></category>

		<guid isPermaLink="false">http://blog.smartchoicemd.com/?p=339</guid>
		<description><![CDATA[<p>If buying and comprehending health insurance weren&#8217;t complicated enough, many people today are also tasked with paying for and understanding coinsurance. Because the term can be confusing, we have prepared the following guide.</p>
<p class="more-link-wrap"><a href="http://blog.smartchoicemd.com/understanding-health-insurance-coinsurance/">Continue reading &#160;&#187;</a></p>
<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/understanding-health-insurance-coinsurance/">Understanding Health Insurance Coinsurance</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
]]></description>
				<content:encoded><![CDATA[<p>If buying and comprehending health insurance weren&#8217;t complicated enough, many people today are also tasked with paying for and understanding coinsurance. Because the term can be confusing, we have prepared the following guide.</p>
<p><strong>What is Health Insurance Coinsurance?</strong></p>
<p>Depending on your health insurance, you may be required to pay <i>some</i> of the costs of any treatment you receive. Depending on how you pay, and when, there are different terms:</p>
<ul>
<li><strong>Deductible</strong> &#8211; This is how much you have to pay before your insurance &#8220;kicks in&#8221;. If your deductible is $500, and the cost of treatment is $800, you would pay $500 while your insurance company would pay $300. But if the cost of your treatment is $300, you&#8217;d have to pay for all of that yourself.</li>
<li><strong>Copay</strong> &#8211; This is when you have to pay a set fee for certain services. If your copay for medication is $20, and your medication costs $100, you&#8217;d pay $20 and your insurance company would pay $80. If your medication costs $22, you&#8217;d pay $20 and your insurance company would pay $2.</li>
<li><strong>Coinsurance</strong> &#8211; After the threshold for the deductible has been met, coinsurance is what <i>percentage</i> you have to pay of the rest of the costs for treatment.</li>
</ul>
<p>Imagine a plan like this: your deductible is $500, and your coinsurance plan is 10%. You go see a doctor and the total bill is $1000.</p>
<p>$500 &#8211; you pay as the deductible, leaving a remainder of $500. Since your coinsurance plan is set at 10%, you pay 10% of the remaining costs ($500), which is $50. Therefore, in this example, your total cost would be $550 while your insurance company would pay the remaining $450.</p>
<p>The easiest way to think of coinsurance is that you are responsible for paying a percentage of the total costs, in effectively &#8220;insuring yourself&#8221; together with (co-) the insurance company.</p>
<p>Many insurance plans have different coinsurance rules depending on whether you receive treatment inside the coverage network or outside. Therefore, a doctor&#8217;s visit inside your network might have a coinsurance percentage at the lower rate, while a visit to a specialist outside the network carries a higher coinsurance percentage.</p>
<p><strong>Pros and Cons of Coinsurance</strong></p>
<p>The overwhelming benefit of coinsurance plans is that they usually carry lower monthly premiums. The downside is that you will always be responsible for a percentage of your treatments, which can sometimes be exorbitantly expensive.</p>
<p>Benefits:</p>
<ul>
<li>Lower monthly premiums</li>
<li>Lower deductibles (sometimes)</li>
<li>Sometimes more treatment options and specialist care is offered</li>
</ul>
<p>Risks:</p>
<ul>
<li>Coverage outside the network has a higher coinsurance percentage rate</li>
<li>You will have to pay a percentage of potentially very expensive treatment</li>
<li>In some circumstances, you may be paying more of the total costs than your insurance company</li>
</ul>
<p>It&#8217;s important to always carefully read and understand the details of any insurance plan before enrolling.</p>
<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/understanding-health-insurance-coinsurance/">Understanding Health Insurance Coinsurance</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
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		<title>The Pros and Cons of a High Health Insurance Deductible Plan</title>
		<link>http://blog.smartchoicemd.com/the-pros-and-cons-of-a-high-health-insurance-deductible-plan/</link>
		<comments>http://blog.smartchoicemd.com/the-pros-and-cons-of-a-high-health-insurance-deductible-plan/#comments</comments>
		<pubDate>Mon, 09 Nov 2015 17:21:21 +0000</pubDate>
		<dc:creator><![CDATA[SmartChoiceMD]]></dc:creator>
				<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[Wellness]]></category>
		<category><![CDATA[affordable care act]]></category>
		<category><![CDATA[deductibles]]></category>
		<category><![CDATA[insurance]]></category>
		<category><![CDATA[obamacare]]></category>

		<guid isPermaLink="false">http://blog.smartchoicemd.com/?p=324</guid>
		<description><![CDATA[<h1></h1>
<p>When it comes to choosing health insurance plans, one of the most important things to consider is the deductible. With any insurance policy, a deductible is the amount you must pay out of pocket before the insurance provider will pay for anything. While not every insurance plan includes deductibles, more than 80% of them do, so knowing which one is right for you is important. Many insurance plans are categorized by having a low deductible, meaning you only pay a little before the insurer begins to play, or a high deductible, which can be quite substantial. But because the premiums (costs) of high deductible insurance plans are lower, it can be a wise choice for some people.</p>
<p class="more-link-wrap"><a href="http://blog.smartchoicemd.com/the-pros-and-cons-of-a-high-health-insurance-deductible-plan/">Continue reading &#160;&#187;</a></p>
<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/the-pros-and-cons-of-a-high-health-insurance-deductible-plan/">The Pros and Cons of a High Health Insurance Deductible Plan</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
]]></description>
				<content:encoded><![CDATA[<h1></h1>
<p>When it comes to choosing health insurance plans, one of the most important things to consider is the deductible. With any insurance policy, a deductible is the amount you must pay out of pocket before the insurance provider will pay for anything. While not every insurance plan includes deductibles, more than 80% of them do, so knowing which one is right for you is important. Many insurance plans are categorized by having a low deductible, meaning you only pay a little before the insurer begins to play, or a high deductible, which can be quite substantial. But because the premiums (costs) of high deductible insurance plans are lower, it can be a wise choice for some people.</p>
<h2><strong>The Benefits of a High Deductible Plan</strong></h2>
<div class="text-content">
<p>Commonly called HDHPs (High Deductible Health Plans), insurance coverage featuring high deductibles (a maximum of $6,450 for an individual in 2015 with an Obamacare plan) are becoming increasingly popular with both individuals and employers alike. Some people like knowing that their monthly premiums will be lower, and employers generally see lower costs when providing HDHPs for their workers.</p>
<p>The main thing to understand when choosing a health plan is estimating just how much health coverage you think you&#8217;ll need in the immediate future. A high-deductible plan has far lower monthly premiums, so if you&#8217;re willing to gamble that you won&#8217;t need a lot of expensive medical treatment, these plans might be best for you.</p>
<p>For Americans covered by the Affordable Care Act (Obamacare), the most popular type of plan is the silver level, and the majority of silver plans are HDHPs.</p>
<p>An HDHP might be best for you if:</p>
<ul>
<li>You don&#8217;t expect to incur costly healthcare treatment in the near future</li>
<li>You have the resources to pay for your deductible should anything happen</li>
<li>You are generally healthy but on a restricted budget</li>
<li>A substantial portion of your net assets are illiquid</li>
<li>You do not suffer from a chronic illness</li>
<li>You don&#8217;t have young children</li>
<li>The most affordable insurance plan available to you is an HDHP offered by your employer</li>
<li>You have enough funds in a health savings account to cover most or all of your deductible</li>
</ul>
<p>Another factor to consider are co-pays, in which you&#8217;re required to pay some of the costs for certain treatment, as well as medications. Some insurance plans apply all care and medication costs towards the deductible, while other plans treat co-payments separately from the deductible.</p>
</div>
<div class="text-content">
<h2><strong>The Downside of a High Deductible Plan</strong></h2>
<div class="text-content">
<p>No matter how carefully described, a high-deductible plan is always going to be a calculated gamble. If an emergency arises, or you develop an illness that requires costly treatment, you could find yourself having to pay the full amount of a high deductible.</p>
<p>A plan with a lower deductible may be better for you if:</p>
<ul>
<li>You have young children, or are expecting children in the near future</li>
<li>You have a chronic condition</li>
<li>You saw your doctor four times or more in the past year</li>
<li>You plan on undergoing an expensive medical procedure or receiving specialist medical care in the near future</li>
<li>Your budget can accommodate the higher monthly premiums</li>
</ul>
<p>As you can see, there are pros and cons of a high health insurance deductible plan and you have to carefully weigh the importance of each one to decide which plan is best for your and your family.</p>
</div>
</div>
<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/the-pros-and-cons-of-a-high-health-insurance-deductible-plan/">The Pros and Cons of a High Health Insurance Deductible Plan</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
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		<title>Understanding HMO, PPO and EPO</title>
		<link>http://blog.smartchoicemd.com/understanding-hmo-ppo-and-epo/</link>
		<comments>http://blog.smartchoicemd.com/understanding-hmo-ppo-and-epo/#comments</comments>
		<pubDate>Thu, 05 Nov 2015 21:41:05 +0000</pubDate>
		<dc:creator><![CDATA[SmartChoiceMD]]></dc:creator>
				<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[Wellness]]></category>
		<category><![CDATA[affordable care act]]></category>
		<category><![CDATA[EPO]]></category>
		<category><![CDATA[HMO]]></category>
		<category><![CDATA[insurance]]></category>
		<category><![CDATA[obamacare]]></category>
		<category><![CDATA[PPO]]></category>

		<guid isPermaLink="false">http://blog.smartchoicemd.com/?p=319</guid>
		<description><![CDATA[<p>With so many acronyms flying around when it comes to describing health insurance, it&#8217;s easy to get confused. Below is a simple guide to what these acronyms stand for, and how you can better understand which type of plan is best for you.</p>
<p class="more-link-wrap"><a href="http://blog.smartchoicemd.com/understanding-hmo-ppo-and-epo/">Continue reading &#160;&#187;</a></p>
<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/understanding-hmo-ppo-and-epo/">Understanding HMO, PPO and EPO</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
]]></description>
				<content:encoded><![CDATA[<p>With so many acronyms flying around when it comes to describing health insurance, it&#8217;s easy to get confused. Below is a simple guide to what these acronyms stand for, and how you can better understand which type of plan is best for you.</p>
<h2><strong>What is HMO insurance?</strong></h2>
<p>Starting in the 1970s, the Health Maintenance Organization (HMO) began offering health coverage based on an in-house network of providers.</p>
<p>Essentially, what makes an HMO unique is that you start by choosing a primary care physician (PCP), usually a general practitioner. Everything else, outside of emergencies, goes through that doctor. For instance, if you develop a rash, first you visit your PCP and then get a referral to an in-network dermatologist.</p>
<p>With most HMO plans, health services for women such as a visit to the obstetrician or gynecologist is also provided without first needing to get a referral from your PCP.</p>
<p>HMO plans are usually the most comprehensive insurance plans today, as your doctor has a wider range of care specialists to which you can be referred for treatment. In general, HMO plans have a higher premium than EPO or PPO plans, but are quite popular because all of your healthcare is coordinated through a single individual.</p>
<p><strong>Approximately 40% of insurance plans today are HMOs.</strong></p>
<div class="text-content"></div>
<div class="text-content">
<h2><strong>What is PPO insurance?</strong></h2>
<p>The acronym PPO stands for Preferred Provider Organization. Essentially, you choose a network of healthcare providers, usually a combination of general practitioners, hospitals, clinics, and specialists. Instead of having to go see your primary doctor first, instead you select the medical specialists you need directly. Therefore, if you develop a skin rash, you&#8217;d go visit an in-network dermatologist.</p>
<p>PPO plans often have a slightly higher premium than HMO plans, but are becoming increasingly popular because of the increased flexibility offered to participants. While there is certainly some cost savings that come with a PPO plan, it can be challenging to coordinate all of your healthcare needs through the insurance company rather than via your personal care physician.</p>
<p><strong> Approximately 40% of insurance plans today are PPOs.</strong></p>
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<h2><strong>What is EPO insurance?</strong></h2>
<p>An Exclusive Provider Organization (EPO) is very similar to a PPO. You do not need to choose a primary care physician, and can go directly to the healthcare provider to suit your needs. Therefore, if you developed a skin rash, you could go directly to a dermatologist. What makes an EPO different than a PPO is that the network is far more restricted, but the out of pocket expenses for in-network treatment is usually far lower. Anything outside of an emergency won&#8217;t be covered, so you&#8217;ll have to pay full price for any treatment received by a doctor or hospital out of your EPO network. EPO plans often come with lower premiums than HMO or PPO plans, but this is offset by being restricted to a smaller network.</p>
<p><strong>Partly because they are relatively new, only approximately 7% of insurance plans today are EPOs.</strong></p>
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<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/understanding-hmo-ppo-and-epo/">Understanding HMO, PPO and EPO</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
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		<title>Obamacare 2016: What you need to know about the Affordable Care Act</title>
		<link>http://blog.smartchoicemd.com/obamacare-2016-what-you-need-to-know-about-the-affordable-care-act/</link>
		<comments>http://blog.smartchoicemd.com/obamacare-2016-what-you-need-to-know-about-the-affordable-care-act/#comments</comments>
		<pubDate>Fri, 30 Oct 2015 19:10:40 +0000</pubDate>
		<dc:creator><![CDATA[SmartChoiceMD]]></dc:creator>
				<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[Wellness]]></category>
		<category><![CDATA[affordable care act]]></category>
		<category><![CDATA[insurance]]></category>
		<category><![CDATA[obamacare]]></category>

		<guid isPermaLink="false">http://blog.smartchoicemd.com/?p=311</guid>
		<description><![CDATA[<p>The Affordable Care Act, most commonly known as &#8220;Obamacare,&#8221; has a number of changes that will take place for the year 2016. Below is a complete guide to everything you will need to know about enrollment in the program:</p>
<p class="more-link-wrap"><a href="http://blog.smartchoicemd.com/obamacare-2016-what-you-need-to-know-about-the-affordable-care-act/">Continue reading &#160;&#187;</a></p>
<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/obamacare-2016-what-you-need-to-know-about-the-affordable-care-act/">Obamacare 2016: What you need to know about the Affordable Care Act</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
]]></description>
				<content:encoded><![CDATA[<p>The Affordable Care Act, most commonly known as &#8220;Obamacare,&#8221; has a number of changes that will take place for the year 2016. Below is a complete guide to everything you will need to know about enrollment in the program:</p>
<hr />
<p style="text-align: center;"><strong>Dates</strong></p>
<hr />
<p>Although the changes will take place effective for 2016, there are a number of important dates that start in 2015.</p>
<ul>
<li style="font-weight: 400;"><b>November 1, 2015</b><span style="font-weight: 400;"> &#8211; The beginning of Open Enrollment for 2016. Coverage will begin on January 1, 2016.</span></li>
<li style="font-weight: 400;"><b>December 15, 2015</b><span style="font-weight: 400;"> &#8211; The last day to enroll or change your plan for coverage beginning on January 1, 2016.</span></li>
<li style="font-weight: 400;"><b>January 1, 2016</b><span style="font-weight: 400;"> &#8211; Coverage begins for people who enrolled or changed their plans between Nov 1 and Dec 15, 2015</span></li>
<li style="font-weight: 400;"><b>December 16, 2015</b><span style="font-weight: 400;"> &#8211; Any enrollment or changes will take effect February 1, 2016</span></li>
<li style="font-weight: 400;"><b>January 15, 2016</b><span style="font-weight: 400;"> &#8211; The last day to enroll or change a plan, with coverage beginning on February 1, 2016</span></li>
<li style="font-weight: 400;"><b>January 16-January 31, 2016</b><span style="font-weight: 400;"> &#8211; Enrollments or changes in this period will take effect beginning on March 1, 2016</span></li>
<li style="font-weight: 400;"><b>January 31, 2016</b><span style="font-weight: 400;"> &#8211; The last day of Open Enrollment for coverage in the year 2016.</span></li>
</ul>
<p><span style="font-weight: 400;">Anyone who fails to enroll by January 31 will be ineligible for coverage unless they qualify for a Special Enrollment Period.</span><span style="font-weight: 400;"><br />
</span><span style="font-weight: 400;"><br />
</span><span style="font-weight: 400;">Note: There are no restrictions as to when you can enroll in Medicaid or CHIP (Children&#8217;s Health Insurance Program). Applications are accepted at any time.</span><span style="font-weight: 400;"><br />
</span></p>
<hr />
<p style="text-align: center;"><b>Special Enrollment Period</b></p>
<hr />
<p>People who have undergone certain major life changes may be eligible to enroll in Obamacare outside of the normal enrollment periods. A Special Enrollment Period gives you 60 days from the event in which to enroll or change your plan.</p>
<p>You may qualify for a Special Enrollment Period:</p>
<ul>
<li style="font-weight: 400;"><span style="font-weight: 400;">If you get married</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">When you have a baby</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">If you lose a member of your household</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">If you gain a member in your household</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">You lost your health coverage</span></li>
</ul>
<p><span style="font-weight: 400;"><br />
</span><em><span style="font-weight: 400;">Note: you must report these life changes to the Marketplace to qualify for a Special Enrollment Period</span></em><span style="font-weight: 400;"><br />
</span><span style="font-weight: 400;"><br />
</span><em><span style="font-weight: 400;">Note: if you get hired on at a new job, you have 30 days to enroll in a plan.</span></em><span style="font-weight: 400;"><br />
</span></p>
<hr />
<p style="text-align: center;"><strong>Non-Enrollment Penalties</strong></p>
<hr />
<p><span style="font-weight: 400;">If you do not have any health coverage for 2016, you will be required to pay a fee to the government. This is determined by whichever of the following is the </span><i><span style="font-weight: 400;">highest</span></i><span style="font-weight: 400;">:</span><span style="font-weight: 400;"><br />
</span><span style="font-weight: 400;"><br />
</span><strong>Either:</strong></p>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">2.5% of your yearly household income (as long as you exceed the filing threshold, which is about $10,000 per individual adult); OR</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">$695 per adult, or $347.50 per child under the age of 18.</span></li>
</ol>
<p><span style="font-weight: 400;"><br />
</span><strong>The maximum fine assessed will be:</strong></p>
<ol>
<li style="font-weight: 400;"><span style="font-weight: 400;">The national average premium for a Bronze plan; OR</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">$2,085 per family</span></li>
</ol>
<p><span style="font-weight: 400;"><br />
</span><em><span style="font-weight: 400;">Note: certain hardship exemptions exist for people who don&#8217;t have health insurance. These include: </span></em></p>
<ul>
<li style="font-weight: 400;"><span style="font-weight: 400;">Being homeless</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Being evicted from your home in the past 6 months</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Receiving a shut-off notice from a utility company</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Being the victim of domestic violence</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">The death of a close family member</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Surviving a fire, flood, or disaster that caused substantial damage to your property</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">A bankruptcy in the past 6 months</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Unpaid medical expenses from the previous 24 months that resulted in substantial debt</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Increased necessary expenses for providing care for a family member</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Your state failed to expand eligibility for Medicaid, and you were determined ineligible for Medicaid</span></li>
<li style="font-weight: 400;"><span style="font-weight: 400;">Your individual insurance plan was cancelled</span></li>
</ul>
<p><em><span style="font-weight: 400;">Note: hardship exemptions are temporary, and usually only cover the month previous to, the month after, and the duration of the hardship. You must contact the Marketplace in order to qualify for a hardship exemption.</span></em></p>
<hr />
<p style="text-align: center;"><strong>Being Unemployed</strong></p>
<hr />
<p>No one is automatically exempted from the requirement to obtain health insurance just because they are unemployed. If you are unemployed but do not obtain health insurance, you will be fined.</p>
<p>However, certain people with low (or no) income may qualify for an exemption.</p>
<hr />
<p style="text-align: center;"><strong>Catastrophic Coverage</strong></p>
<hr />
<p>If you successfully qualify for a hardship exemption, you will be able to obtain a catastrophic coverage plan regardless of your age or income. This will protect you from certain medical costs. If you qualify for a hardship exemption, you&#8217;ll be given an Exemption Certificate Number (ECN) to use when buying the plan from an insurance company.</p>
<hr />
<p style="text-align: center;"><strong>Premium Prices</strong></p>
<hr />
<p>Currently, 37 states are participating in the federal Obamacare Marketplace. While prices vary from state to state, the latest figures estimate that premium prices will rise 7.5% across the board for the year 2016.</p>
<p>The changes, however, vary widely from certain states and metropolitan areas. Recently published figures show that residents and Oklahoma and Montana will see their premiums rise as much as 35%, while residents of Indiana will benefit from a 13% drop in prices.</p>
<p>Many of the other 13 states rely on separate ACA insurance marketplaces, with premiums expected to rise a modest 2% on average.</p>
<p>Government press releases emphasize that approximately 90% of people enrolling in an Obamacare plan are eligible for tax credits, which will reduce their total cost.</p>
<hr />
<p style="text-align: center;"><strong>Mandatory Employer Participation in Obamacare</strong></p>
<hr />
<p>After being delayed for years, the Employer Shared Responsibility provision of Obamacare will finally take effect in 2016. The regulations require that any company with 50 or more full-time employees must offer their workers and dependent children affordable insurance coverage or face substantial financial penalties.</p>
<p>&nbsp;</p>
<p>The post <a rel="nofollow" href="http://blog.smartchoicemd.com/obamacare-2016-what-you-need-to-know-about-the-affordable-care-act/">Obamacare 2016: What you need to know about the Affordable Care Act</a> appeared first on <a rel="nofollow" href="http://blog.smartchoicemd.com">SmartChoiceMD</a>.</p>
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