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Showing posts from November 17, 2019

I notice short-term policies are for sale outside of the Marketplace and they are cheaper than many other policies. What is a short-term policy?

I notice short-term policies are for sale outside of the Marketplace and they are cheaper than many other policies. What is a short-term policy? As the name implies, a short-term health insurance policy offers coverage for a period of less than 12 months.  Many offer coverage for just 3 to 6 months.  Beyond that term, coverage generally can only be continued if the insurance company agrees.  This is sometimes called a non-guaranteed-renewable policy.  If you've made claims since you bought the short-term policy, the insurer can, and likely will refuse to continue coverage once the policy term ends. In addition, short-term policies do not offer other protections found in Marketplace plans.  For example, short-term policies can exclude coverage of pre-existing conditions.  Short-term policies also typically do not cover essential health benefits such as prescription drugs, mental health care, substance abuse treatment, or maternity care.

I’m buying coverage on the Marketplace for my family. I notice many health plans don’t cover pediatric dental care, but there are also stand-alone dental plans for sale. Is that allowed?

I’m buying coverage on the Marketplace for my family. I notice many health plans don’t cover pediatric dental care, but there are also stand-alone dental plans for sale. Is that allowed? Each health insurance Marketplace can decide whether to require all insurers to cover pediatric dental benefits or whether to allow the sale of stand-alone dental policies. When stand-alone dental policies are allowed, health insurers in the Marketplace might not be required to cover pediatric dental benefits. If your health plan covers dental benefits, you will pay one premium for everything. If you get dental benefits through a stand-alone plan, you will have to pay a separate premium for the dental benefits.

Transparency in Coverage Rule

Trump Administration Announces Historic Price Transparency Requirements to Increase Competition and Lower Healthcare Costs for All Americans (CMS press release, 11/15/19): If finalized, the proposed Transparency in Coverage rule would require health plans to: Give consumers real-time, personalized access to cost-sharing information, including an estimate of their cost-sharing liability for all covered healthcare items and services, through an online tool that most group health plans and health insurance issuers would be required to make available to all of their members, and in paper form, at the consumer's request. This requirement would empower consumers to shop and compare costs between specific providers before receiving care.Disclose on a public website their negotiated rates for in-network providers and allowed amounts paid for out-of-network providers. Making this information available to the public is intended to drive innovation, support informed, price-conscious decision-…

Introducing the Transition IEP Miniseries

We are excited to announce the release of the Indiana Transition IEP Miniseries. The seven-course miniseries is a free online training from the Indiana Secondary Transition Resource Center. Each course (they’re brief!) is designed to help you become more familiar with the components of the cyclical planning process and support you as you create quality Transition IEPs with your students.

Courses in the Transition IEP Miniseries are:

•    Introduction
•    Student Involvement
•    Present Levels of Functional Performance
•    Transition Assessments and Postsecondary Goals
•    Transition Services and Activities
•    Annual Goals
•    Conclusion

You can complete the entire series or individual courses. The miniseries is designed both for teachers new to the field and for teachers and administrators who just want a refresher. Upon completing courses, you can receive contact hours used toward Professional Growth Points, up to a total of 10.5 contact hours for completing the entire miniseries.

The T…

How can I find out if an ACA health plan covers the prescription drugs that I take?

How can I find out if a health plan covers the prescription drugs that I take? Health plans in the Marketplace must include a link to their prescription drug “formulary” with other on-line information about the plan. The “formulary” is a list of prescription drugs the plan will cover. If you don’t find your drug on the formulary but your doctor says it’s medically necessary for you to take that specific drug, you can appeal for an exception to the plan formulary. If there is a Consumer Assistance Program in your state, staff in this program can help you file your appeal.