Health insurance agent, Michelle Bungo, explains doctor networks and finding the right care.
A doctor network, or provider network, is a catalog of hospitals, doctors, and other healthcare professionals that are covered with your health insurance. Each office has a contract with health insurance companies to offer care at a discounted rate. Michelle Bungo explains that the providers on the list are considered to be “in-network” and are your best chance at landing affordable care. If you choose to go “out-of-network,” your bill may be partially covered or not covered at all.
When choosing your health insurance plan, consider the four types of networks available:
HMOs only cover healthcare costs from in-network providers and require referrals for seeing specialists.
If you are looking for something with more flexibility, consider choosing a PPO. The PPO plans typically have higher monthly premiums, but pay for partial coverage if you want a doctor outside of your network. Additionally, PPO accounts allow you to see a specialist on your account.
EPO plans are a mix of the two mentioned above. People with EPO plans will only receive coverage from in-network providers, but they can go to specialists without a referral.
Finally, POS plans offer partial out-of-network coverage but require referrals for specialists. POS plans are also considered to be a hybrid of HMO and PPO.
Although this seems pretty straightforward, Michelle Bungo notes that it can be quite challenging to find an in-network doctor. When you start looking, make sure you have our insurance card in hand. It will tell you the plan name, tier, and network type.
- Call the Office
Always contact the potential provider’s office to make sure they take your insurance plan. Michelle Bungo notes that not all doctors at the same medical practice even take the same insurance plans. When you make the call, have your health insurance card in front of you so that you can quickly answer their questions. Make sure you are as specific as possible to avoid any mix-ups! Sometimes, doctors practice at multiple locations. Not all locations are equally covered, so make sure you choose the right one.
- Contact Your Insurance Provider
If you are having trouble reaching busy doctors’ offices, this option may be the most helpful to you. Michelle Bungo recommends this step because insurance carriers can use tax ID numbers to check for in-network providers for you. Make sure you know the potential healthcare providers’ tax ID number and your specific plan for a smooth process.
- Search Online
Finally, you can check to see if your health insurance provider offers a “find your doctor” search on their website. This is a relatively new feature that shows which doctors in your area are covered under all their plans. If you have an idea of which office you’d like to visit, Michelle Bungo recommends searching by the doctor’s name. If you are looking for a new doctor, the online directory can help you start in the right direction.
If you still need help, consider contacting your health insurance agent so they can go over your plan and its options.
Florida Health Care Plans (FHCP) is the second oldest HMO in the nation, providing innovative and affordable plans that Michelle Bungo can help you make the most of.
There are many ways to get health insurance, whether that be through your employer, the government, or privately. If you choose to get coverage through FHCP, a small business health insurance provider in Florida, there are a few ways to maximize the use of your benefits. Experienced health insurance agent, Michelle Bungo, explains.
- Use In-Network Providers
Members will have access to a large network of providers that offer quality care. Staying in-network with authorized healthcare providers will keep costs low. It will also make sure that your family is with professionals who are familiar with your PHCP plans. Michelle Bungo explains that going out of network for routine care may make your claim unclaimable.
- Use Wellness Programs
All members have access to special classes and programs that are focused on improving their health. Some employers take it a step further by including extra wellness services in their plans. Michelle Bungo recommends using these additional tools for preventative care. They could consist of biometric screenings, physical activity programs, and health assessments.
Many FHCP networks also include the use of fitness centers in your area. Michelle Bungo recommends checking to see if your plan has a gym network, which will allow you to use excellent facilities for free. There is no cap on how many times you can go or how many locations you can use. Michelle Bungo stresses the importance of physical fitness and activity for staying healthy.
- Shop Around
Even though you can go to any provider in your network, you should still shop around for pricing on elective procedures. Michelle Bungo explains that some procedures are cheaper at FHCP clinics, doctor’s offices, or imaging centers compared to a hospital or outpatient surgery center. By choosing your provider carefully, you can save money and nowhere to go time and time again.
Michelle Bungo is a licensed health insurance agent in Coral Springs, FL, with years of experience working with all major insurance carriers. Physical fitness is important to Michelle Bungo, which is why she works out regularly. You can catch her at the gym every week! When she’s not at the gym or office, Michelle Bungo spends her free time socializing with friends and neighbors or hanging out with her kids. She also has an avid love for music and frequently attends local concerts.
Open enrollment may be over, but health insurance agent, Michelle Bungo, explains qualifying life events that may help you stay covered
The Open Enrollment Period (OEP) for health insurance typically lasts between November 1st and December 15th. This small window of time is the only opportunity to switch or find new coverage. However, due to various circumstances, many individuals find themselves needing coverage at other times in the year. Licensed health insurance agent, Michelle Bungo, explains which qualifying events will allow you to enroll outside of OEP.
There are a handful of specific life events that can make someone qualified for a Special Enrollment Period (SEP). Michelle Bungo notes that most qualifications require you to have had health insurance previously, although there are a few instances for exceptions. The most common qualifying life events are as follows.
Loss of Job-Based Coverage: Most people receive health insurance through their employer or their spouse’s employer. However, if the job is lost, you may qualify for SEP. Michelle Bungo notes that this option is available even when someone decides to quit their job or leave on their terms.
Turning 26: Staying on your parent’s insurance plan is an excellent option for many. However, Michelle Bungo explains that due to the Affordable Care Act, young adults are only allowed to stay on their parent’s plans until they reach 26.
Having Children: Whether you have a baby or choose to adopt, adding members to your family is considered a change in the household. Michelle Bungo notes that those who already have coverage can add dependents to their plan. Additionally, you can switch to a new plan or enroll your child in their own.
Marriage or Divorce: Once you’re married, you have the option to join your spouse’s health insurance plan. Michelle Bungo notes that you can use this time to your advantage if either of you are ready to change coverage or find a new plan. Adversely, separating also means that you are eligible for SEP if that is the reason for your loss of coverage.
Moving: If you make a permanent move to a new state, you’re automatically qualified for SEP. Michelle Bungo notes that to be qualified for SEP after moving in-state, the new region must not support your current plan, or must have plans that weren’t previously available to you.
Other qualifying life events include: losing COBRA coverage, losing eligibility for Medicaid, CHIP, or Medicare, significant changes in income, death in the family, gaining US citizenship, leaving incarceration, or gaining status as American Indian or Alaskan Native.
About Michelle Bungo:
Michelle Bungo is a licensed health insurance agent in Coral Springs, FL, with years of experience working with all major insurance carriers. Physical fitness is important to Michelle Bungo, which is why she works out regularly. You can catch her at the gym every week. When she’s not at the gym or office, Michelle Bungo spends her free time socializing with friends and neighbors or hanging out with her kids. She also has an avid love for music and frequently attends local concerts.
It can be tempting to avoid another monthly bill; however, Michelle Bungo explains three reasons why you should keep your health coverage.
In 2019, individuals no longer feared a tax penalty for not having adequate health insurance in the United States. The end of that Obamacare mandate seemed like good news for some, but in reality, every person should still have health insurance. Even those who are young and healthy greatly benefit from coverage in the event of a catastrophe or illness. Health insurance agent, Michelle Bungo, explains three major reasons why people should have health insurance.
In the United States, medical care is costly without insurance. Even care for small injuries can come with a hefty price tag. A broken bone alone can cost around $8,000. More significant injuries that require a hospital stay can run your bill upwards of tens of thousands of dollars.
Michelle Bungo notes that something serious such as cancer or an organ transplant can cause you to go bankrupt. Additionally, two-thirds of bankruptcies are related to medical bills and taking time off work. Although some out of pocket maximums may seem high on insurance plans, it’s nowhere near the amount that you may face without coverage.
To avoid paying high costs, people without insurance tend to visit the doctor less often. Children are also delayed urgent care due to fears of treatment costs. Additionally, Michelle Bungo explains that non-insured people are more likely to receive a late diagnosis of potentially life-threatening illnesses. When a disease is not caught in the early stages, it can be more expensive to treat and more difficult to cure.
Early detection is proven to save lives and provide less invasive treatment options. Michelle Bungo notes that health insurance policies are now required to include preventative care. When you’re covered, you’re more likely to stay healthy.
Although you won’t be denied for pre-existing conditions, Michelle Bungo explains that it is not wise to wait until you’re sick to sign up for a policy. People are only allowed to register during open enrollment periods each year. Open enrollment typically happens for a few short months in the winter. The only exception to enrolling outside of that period is if you have had a qualifying life event. Because life is unpredictable, it’s wise to have continuous coverage. Visit your local health insurance agent to find a plan that best suits you and your family’s needs.
Find out what Open Enrollment means with insight from health insurance agent Michelle Bungo.
Open Enrollment announcements are everywhere. You’ve probably heard about it on TV commercials, radio announcements, and on the internet. But what is Open Enrollment, and how can it impact you? Health insurance agent Michelle Bungo answers common questions about Open Enrollment to help you prepare for 2020.
For most states, the Open Enrollment Period (OEP) starts November 1st and ends December 15th. This six week period is the only time of year that people can register for health insurance plans. Michelle Bungo explains that the only exception to this rule is if you experience a qualifying life event. People with existing plans may change coverage providers during this time as well.
The government created the OEP so that insurance companies can function correctly. Healthy individuals pay for insurance regularly in case of illness. They are contributing to the money pool by paying monthly premiums while sick people pull money out of the pool through claims. If people only purchased insurance when they got ill, there would never be claim money available. The OEP helps maintain the balance so that people can have care when they need it.
Any American between the ages of 18 – 64 may find Open Enrollment beneficial. Those who purchased health insurance last year will be automatically re-enrolled if no action is taken. While it may seem convenient to keep the same plan year after year, Michelle Bungo notes that it can be risky. It’s common for plan premiums to increase while benefits change.
Research health insurance plans during the Open Enrollment periods to make sure you have the best coverage for your needs. Insurance companies are offering more plans than ever before, expanding reach into new zip codes. Michelle Bungo explains that this means it’s possible to choose from more plan options this upcoming year! Additionally, premium prices are going down by an average of 4% in 2020.
There may be an abundance of plans to choose from, but that doesn’t mean you need to enroll in all coverage options! Michelle Bungo notes that many people choose to enroll in dental, vision, life, disability, and accident insurance for additional protection. However, if you feel that you won’t use a specific service, there is no need to enroll.
Health Insurance is available through both federal and state exchanges. Low-income individuals and families who need assistance paying for standard premiums may qualify for subsidies. For help finding a plan, Michelle Bungo recommends visiting a local health insurance agent.
Health insurance agent, Michelle Bungo, explains short and long-term healthcare options for the self-employed.
When people are looking for a job, they are also looking into the benefits it offers. Being your own boss means having a flexible schedule and pursuing passionate work. It also leaves you to figure out things like health insurance all on your own. Health insurance agent, Michelle Bungo, walks you through different ways to get good coverage while being self-employed.
For those who are only planning to be self-employed for a short period, there are still health insurance options available to you. It’s essential to avoid gaps in coverage in the event of a serious catastrophe or emergency.
If you would like to continue the health insurance plan you had with your employer, Michelle Bungo recommends using COBRA health insurance. The cost per month will increase since the employer is no longer paying for a percentage of the bill. However, this route can be used for up to 18 months.
For those who are interested in saving money over convenience, Michelle Bungo suggests looking into short-term insurance. This option is suitable for a three month period of time and offers low monthly premiums. A short-term policy may not cover pre-existing conditions and could have high out of pocket costs.
Another option is to look into industry-specific insurance plans that can be found through things like unions of alumni groups. Group plans can sometimes provide better coverage at a lower rate. However, always read the fine print to avoid any surprises.
Many people are self-employed permanently and need options that will provide coverage long-term. In this case, Michelle Bungo recommends checking out the Health Insurance Marketplace. This government-run program offers tax credits to reduce monthly health insurance premiums for those who have a low income. If qualified, children can be added to the plan.
Another option for long-term coverage is looking into private health insurance plans. Some providers have plans designed specifically for self-employed people. There are great options out there that provide a wide range of benefits at affordable prices.
Searching through the seemingly endless amount of options is often the most overwhelming and challenging part of the process. Always check with a health insurance agent before signing up to make sure you are choosing the right plan for you.
Health insurance plans for each stage of a young adult’s life as explained by health insurance agent Michelle Bungo.
College is meant to prepare young adults for entrance into the workforce, but it usually doesn’t educate students on how or when to buy health insurance. Millennials may be young and healthy, but they still need a health plan that fits their budget and needs. Health insurance agent, Michelle Bungo, reveals four adult phases and the popular insurance options for each.
At this age, millennials can stay on their parent’s family plan until they turn 26 years old. Staying on the family plan is the cheapest and easiest option of staying covered. Additionally, they usually have better coverage that reaches beyond just catastrophic events. Michelle Bungo notes that even if you’re married, you can stay on your parent’s plan if you’re under 26.
Student benefits are usually available to those who do not have access to a family plan. Most universities offer affordable health care plans to enrolled students. College plans are also a good choice for out of states students. Michelle Bungo recommends talking to the admissions office for more information on school health care plans.
After college, most millennials will have healthcare available through their jobs. Michelle Bungo recommends choosing a catastrophic plan. It is a low-premium, high-deductible plan which offers coverage minimum benefits. It is designed for healthy people but will cover emergencies.
In some states, providers will allow extensions on health insurance after the age of 16. To see if you are qualified for the rider option, Michelle Bungo suggests contacting your parent’s plan provider.
If you had a catastrophic plan in your twenties, Michelle Bungo notes that the insurance provider will most likely keep you in a similar plan into your thirties. At this age, however, it would be a good idea to shop around for new quotes. It is common for couples to begin having children as well, which means a good family plan will most likely meet your needs better.
For those who are struggling with employment or have a low income, Medicaid may be the best option. These plans are administered by the state and offer plans at a reduced cost. Additionally, Michelle Bungo recommends looking into Marketplace, which offers financial assistance for a variety of plans once qualified.
The best health insurance options are usually available through employers or a spousal plan. Employers have access to group health insurance benefits, and will typically subsidize or completely cover the cost of monthly premiums.
Healthcare insurance agent, Michelle Bungo, covers five topics that will help you choose the right insurance plan for your needs.
Shopping for the best healthcare insurance policy is a daunting task for the majority of Americans. There is an abundance of different plans and options to choose from. Finding the right one for your budget and needs, however, can feel like searching for a needle in a haystack. Healthcare insurance agent Michelle Bungo, goes over the top 5 things to look for when shopping for health insurance.
- The Premium
The premium is the fixed monthly cost you will pay for a health insurance policy. Typically, insurance policies with minimal coverage will have lower premiums. More inclusive policies will have higher premiums. When deciding on the premium to pay, Michelle Bungo suggests choosing the premium that covers the healthcare services you need.
- The Deductible
A deductible is an amount you must spend on healthcare services in one year before your insurance provider will start covering them. Some policies, however, cover specific services before your deductible is hit. In this situation, healthcare insurance agent, Michelle Bungo, explains that lower deductibles will have higher premiums and vice versa.
- Range of Network Of Doctors
Most health insurance companies do not cover visits to all health providers. Michelle Bungo explains that when insurance companies make deals with care providers, they create a “network.” Look for plans that include your preferred doctors or clinics in its network. If you don’t have a specific place in mind, consider the size of the network for how many options you’ll have.
- Out-of-Network Care
There are instances when out-of-network care might be needed to see specialists. Some policies will cover 100% of an out-of-network bill; others will cover a small portion. Additionally, some plans will pay 100% if it’s an emergency, and others will pay none at all.
Michelle Bungo recommends choosing a plan that includes some out-of-network assistance to protect you from unexpected situations. It is not unheard of for a patient to be stuck with a massive bill after visiting an in-network hospital. Some team members or specialists may not be included in a patient’s care network.
- Max Out-of-Pocket Cost
The maximum amount that you can pay for services for one year is called the out-of-pocket maximum. Michelle Bungo notes that this is different from your deductible. A low out-of-pocket maximum is recommended for people who do not want to worry about surprise expenses. If you know the maximum for the year, it’s much easier to budget accordingly. A low out-of-pocket maximum is also recommended for people who need a lot of care.
Healthcare insurance agent, Michelle Bungo, provides insight on the benefits of Marketplace plans before your next enrollment period.
Healthcare enrollment is right around the corner, which means you may be shopping around for new or improved coverage. The Health Insurance Marketplace is a government program that provides affordable options to those who may not have benefits available through their employer. It offers premium tax credits and a wide variety of plans to fit your needs.
Michelle Bungo notes that Marketplace plans are often very popular because they include essential health benefits, pre-existing conditions, and preventative care. These benefits are available for all plan categories and types. The new enrollment period will begin on November 1, 2019.
Doctors’ visits, prescriptions, hospitalizations, and pregnancy are all categorized under essential health benefits. Specific services will vary depending on your state’s requirements. Michelle Bungo recommends meeting with a healthcare insurance agent for a full list of benefits in your plan.
People who have a pre-existing condition may find Marketplace plans to be extremely beneficial. Michelle Bungo explains that no Marketplace plan can reject you, charge more, or refuse benefits for any condition that existed before enrollment. This rule also applies to pregnant women who need coverage.
Everyone knows that preventative measures are essential to good health. Finding an issue early often means less invasive measures are needed down the road. Many tests can even catch a disease before it starts. Catching issues early helps patients recover quickly while keeping overall medical expenses down.
Michelle Bungo always recommends using all preventative healthcare services included with Marketplace Insurance plans. Services include shots and screenings, which are free when visiting a healthcare provider within the network. For a more detailed explanation of available preventative services, click here.
In addition to the three standard benefits listed above, Michelle Bungo explains that some plans can offer additional benefits. Many people will choose to include vision, dental, or medical management plan options to treat specific conditions. It’s easy to compare plans side by side on HealthCare.gov.
If you are unsure about choosing a plan that’s best for your needs and budget, visit a local healthcare insurance agent. Michelle Bungo recommends making an appointment with a local agent that you can turn to for advice every year. They will be able to compare your past plans and make recommendations during enrollment periods.
Healthcare agents are also beneficial when questions arise about coverage or policy changes outside of the enrollment periods. Coverage for 2020 will open on November 1, 2019. Michelle Bungo recommends finding an agent today!