Brought to you by Alison Gordon Insurance Services, Inc. CA license #0780178
Used by insurance companies, a pre-approved list of preferred, commonly prescribed prescription drugs. These drugs are chosen by a team of doctors and pharmacists because of the drugs’ clinical superiority, safety, ease of use and cost (but mostly costs!).
Used by insurance companies, it is a pre-approved list of preferred, commonly prescribed prescription drugs. These drugs are chosen by a team of doctors and pharmacists because of the drugs’ clinical superiority, safety, ease of use and cost (but mostly costs!).
COBRA is short for the Consolidated Omnibus Budget Reconciliation Act. It is a federal law that allows people to continue benefits for a period of time after group health coverage ends. COBRA applies after a job loss, reduction in hours, death or divorce. The person usually pays the entire premium plus two percent.
If you bought your health insurance after 3/23/10 or made any changes at all to a plan you bought before 3/23/10, you have a Non-Grandfathered Plan. It must meet the requirements of the federal reform laws known as the Patient Protection and Affordable Care Act (PPACA).
If you bought your health insurance before 3/23/10 and haven’t made any changes to it since, you have a Grandfathered Plan. It does not have to meet the requirements of the federal reform laws known as the Patient Protection and Affordable Care Act (PPACA).
An Explanation of Benefits (sometimes called a Claims Summary), is a document the health insurance company sends you and your medical providers telling you how your medical claims (expenses) have been processed. For you it is simply an FYI. The EOB lists the treatments that took place, the portion of the cost that is covered… Continue reading EOB – Explanation of Benefits
With a PPO, you can see any doctor you like, or visit any hospital usually within a preferred network of providers. You always have the option of seeing doctors or visiting hospitals that are “out-of-network,” but you will spend more of your own money on medical expenses. In a PPO, you do not have to… Continue reading PPO – Preferred Provider Organization
A Health Maintenance Organization (it used to be called Managed Care, but The Insurance Mom now refers to it as Mangled Care!). An HMO requires that you see only doctors or hospitals on their list of providers, and sometimes at a specific facility. An HMO also requires that you choose a Primary Care Physician (often sight unseen), who will… Continue reading HMO – Health Maintenance Organization
State licensed institutional setting which provides nursing and rehabilitative care provided by or under the direction of skilled medical personnel – available 24-hours a day & ordered by a physician under a treatment plan.
In Long Term Care insurance, nursing home or home care that temporarily replaces the existing level of support received from an informal, non paid caregiver for the purpose of providing care and supervision to the patient while relieving the caregiver