Before going further, let us have a good overview of Kaiser Permanente.

What Is Kaiser Permanente?

Kaiser Permanente is one of the largest nonprofit healthcare plans in the United States, and it was founded on July 21^st, 1945. Its mission is to provide high-quality, affordable health care services and to improve its members’ health and the communities they serve.

This organization operates 39 hospitals and more than 700 medical offices, with over 300,000 personnel, including more than 80,000 physicians and nurses. Therefore, it is safe to say that you can only access Kaiser’s services at its hospitals and medical offices. 

Understandably, people always want to get the best when it concerns health. So, many people would desire to indulge in Kaiser’s services. But sadly, we see that not everyone can afford them. Therefore, we see that some people depend on insurance services to access healthcare.

It should not be surprising that people depend on insurance services to access quality health care. After all, that is the aim of health insurance. But, it would also come in handy to know the insurance that Kaiser Permanente accepts. 

Understandably, there are numerous insurance services in the United States. So, one begins to wonder if they can use any of these insurance services at Kaiser’s facilities. 

Can I Use Any Insurance At Kaiser Permanente?

Sadly, we see that there are restrictions, and there are specific insurance services you can use at Kaiser Permanente hospitals. So, you cannot expect to walk into any of their facilities with a random insurance plan and expect them to attend to you. 

Yes, we know that you are curious about the insurance that Kaiser Permanente accepts, and we will talk about it in this article. 

Kaiser Permanente only accepts two insurance services; Medicare and Medi-Cal insurance services. If you are a member of any of these insurance services, you can sure to receive treatments from any Kaiser’s hospital. But if you do not own a plan under any of these insurance services, you will have to pay your full bill if you want to use Kaiser Permanente. 

It depends on individuals to choose what works best for them. 

Medicare 

Medicare is a national health insurance service in the United States and mostly carters to older adults from age 65. However, we see that this service also covers younger people who have disabilities. 

Medicare comes with different insurance plans, and what you choose is what you get when you visit any medical facility like Kaiser Permanente. 

Some of Medicare’s insurance plans are:

1. Part A: The part A plan covers hospital insurance as it caters to people who are formal inpatients in hospitals. With this plan, you are covered for 90 days when admitted at the hospital. Medicare covers the full bills for the first 60 days; then, you co-pay the bill for the remaining 30 days until it gets to 90 days. To enjoy this plan, the care must be medically necessary, and it has to be ascertained by a doctor. In addition, your stay in the hospital must be at least three days. It means that once you have stayed up to three days and three midnights, your plan can start counting. Also, you can enjoy a semi-private room with this plan. 

2. Part B: It is safe to say that this plan covers outpatient services while Plan A covers inpatient services. Such services could be blood transfusions, x-rays, lab tests, etc. it also covers medical equipment like wheelchairs and other essentials. Depending on what you choose and your records, the insurance can cover everything or 80% of the bills. 

3. Part C: This plan is a combination of part A and part B. The plan allows people to choose health plans with at least the same service coverage as Parts A and B. Therefore, you can say that this plan is customized and based on the patient’s preference. 

4. Part D: It is a plan that covers self-administered drugs, and you are eligible for it if you have either part A or part B plan. 

Medicare has been helpful to many United States citizens, and you can use it at any Kaiser Permanente hospital. 

Medi-Cal

First, it is important to note that another name for this insurance plan is Medicaid. It is a California insurance program for low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of the federal poverty level. One can enjoy both inpatient and outpatients services with this insurance plan. In addition, you can also get dental and eye services and more. 

As already stated, you can become a part of this insurance program through your income or based on programs. In this case, programs mean household type or pregnancies. 

According to Medicaid, you must report any household changes to your local county social services office within ten days.

Below Is A Table Highlighting The Difference Between Medicare And Medi-Cal Insurance Programs.

So, you can now see how they differ, but they are the insurance programs that Kaiser Permanente accepts.

FAQs 

Some frequently asked questions about Kaiser Permanente and its insurance programs are:

We usually get this question from people who benefit from either of the acceptable Kaiser’s insurance programs, but they are currently not within the United States. In such cases, you will have to pay your bill. But, you can request reimbursement when you get back to the United States. 

Do Kaiser Doctors Only Accept Kaiser Insurance?

Yes, Kaiser Doctors only accept Kaiser insurance from Medicare and Medi-Cal insurance programs. 

Does Kaiser Accept United Healthcare PPO?

No, Kaiser does not accept United insurance, and vice-versa. To access Kaiser’s facilities, you must use its acceptable insurance programs, Medicare and Medi-Cal.

Conclusion 

Kaiser has a reputation for providing top quality healthcare services, and its acceptable insurance programs are Medi-Cal and Medicare. So, you can register under any of them to accept Kaiser’s facilities if you are eligible. 

Sources

Medi-Cal through Kaiser Permanente in California

Understanding Health Insurance | Kaiser Permanente

Kaiser Permanente: Custom Care & Coverage Just For You

Kaiser Permanente – Wikipedia

Medicare (United States)

Medi-Cal | Covered California

The post What Insurance Does Kaiser Permanente Accept? appeared first on Insurance BlogX.

Coinsurance is a form of cost-sharing between the insurance company and a client. It is the amount you pay as a patient toward your claim. 

Coinsurance is typically paid after meeting your annual deductible. To paint a clearer picture of how coinsurance works, let’s use 10% and 0% as examples.

How Does It Work?

Scenario One

A 10% coinsurance means that you cover 10% of your health provider’s total cost of service while your insurance company will cover the remaining 90%. Coinsurance applies to office visits, operations, and medications.

If you visit your dentist and your bill is $50, you will pay $5 and your insurance company will pay the remaining $45.

Scenario Two

0% coinsurance means that you don’t have to share the cost of your medical bills with your insurances company and they will cover the total cost. 

If you go to a clinic and the cost of your prescription is $30, your insurance company will cover the full amount.

Other Health Insurance Terminologies 

Coinsurance and copays in health insurance are referred to as out-of-pocket costs; these are expenses that you incur for receiving health services in addition to your monthly premium. 

To fully understand out-of-pocket costs, there are other health insurance terminologies you should be familiar with.

Deductibles

A deductible is an amount you pay before you can start enjoying your coinsurance or copay. That is to say, it is the cost of medical bills you must cover before your insurance company begins to split cost with you.

If your deductible is $500, you would have to pay up the $500 before your insurance provider chips in on your medical cost.

High deductible plans usually have lower monthly premiums to balance out the cost. However, these plans will force you to spend a lot of money on your healthcare before they start contributing.

Lower deductible plans typically come with higher monthly premiums. However, because your deductible amount is smaller, your insurance company begins their contribution sooner.

Annual Limit

Annual limits are like deductibles for insurance companies; it is the highest amount they can incur on the healthcare cost within a policy year.

Once this amount is reached, the client is forced to pay out-of-pocket bills.

Luckily, the Affordable Care Act has prohibited insurance providers from setting annual dollar limits on most plans, though there are exceptions. 

Out-of-Pocket Maximum

From the name you can guess what this means. The out-of-pocket maximum is the highest amount you can spend on healthcare within a policy year. If you reach this amount, your insurance company will bear any remaining costs throughout your policy year.

Coinsurance Vs Copay- Are They the Same?

Coinsurance and copays are two terms you will encounter often once you are within the health insurance scheme. The two are similar in terms of function but there is a key difference between the two.

Coinsurance is computed as a percentage, whereas copay is a flat fee. Let’s give you an example to understand it better.

Let’s say your insurance provider has set $30 copay on doctor visits, and $10 copay on prescribed medication.

In this scenario, whatever your bill is at a doctor’s appointment, you are expected to pay $30, and anytime you have prescribed medication, you are to pay $10 as part of the cost.

An advantage of copay over coinsurance is the certainty attached to how much you are expected to pay. Even if your consultation fee is summed up at an expensive rate, you would not have to pay more than your copay requires.

Unlike coinsurances where the higher the bill, the higher you would have to pay.  Because of this, copays are usually more affordable than coinsurances.

That is not to say that all coinsurance plans are bad. However, it would be best to consult with a licensed professional on what plan best suits you.

How To Lower Your Coinsurance Rate

Keep in mind that your coinsurance rate does not have to be high for your out-of-pocket payment to start becoming expensive. 10% of a $100 is $10, and 10% of $400 is $40. 

The same percentage but a higher out-of-pocket cost, hence the more expensive your bill, the higher you would have to pay out of it.

Fortunately, there is a way for coinsurance rates to be lowered. You can lower your coinsurance rate through cost-sharing reduction (CSR) subsidies. 

Once you meet certain criteria set out by these subsidies will reduce your coinsurance, copayments, deductibles, etc by increasing the actuarial value of your plan.

The actuarial value of a plan is the set percentage for the total average cost of covered benefits under that plan. 

If you register under a plan with an actuarial value of 60%, it means you can expect your insurance plan to cover 60% of the average costs and you will be expected to cover the remaining 40% .

In essence, the higher the actuarial value of the plan you are registered under the lesser you would have to pay.

Some plans offer 0% coinsurance meaning that once you have reached your deductible, the insurance company will cover 100% of your bill without any further payment on your end.

Conclusion

Your coinsurance on a health plan can make or break your experience throughout your policy year. A high rate could lead to spending large amounts on out-of-pocket costs for the medical care you receive, defeating the objective of getting health insurance- to minimize or possibly eliminate cost. And a rate on the low side is usually followed by costly monthly premium payments. Luckily, you have a chance of reducing your coinsurance rate if it is on the high side through Cost Sharing Reduction subsidies. 

The post What Does 0 Coinsurance Mean In Health Insurance? appeared first on Insurance BlogX.

Statistics show that the number of married couples in the US has reduced from 58% to 53%, while the percentage of couples who are not married but cohabiting has increased from 3% – 7%.  One reason for the rise in domestic partnerships could be that employers recognize them more, hence; people no longer have to wait for marriage before enjoying health benefits with their partner.

Domestic Partnership

There is no definition for who counts as a domestic partner or domestic partnership. A domestic partnership is a term used to describe a couple who live together and share their interpersonal life as married. However, the reality is they are not married or joined in any form of union civilly, religiously, and otherwise. 

A domestic partner could be of any gender, there are limitations. Employers who offer domestic partnership may require you to sign an affidavit confirming:

1. How long you have lived together 

2. Your age

3. Neither of you is married 

4. You are responsible for each other’s welfare

5. You both are eligible for marriage in the state you reside in

6. Both of you are jointly responsible for your living expenses

It is advisable to check your employers’ terms and conditions and what their plan covers. This way nothing will take you by surprise.

Some people believe that domestic partnerships created an avenue to treat same-sex couples fairly since their marriages are not considered/recognized in many states. 

However, as more states legalize same-sex marriages, the popularity of domestic partnership insurance has declined. In addition, there are no federal laws that mandate employers to have domestic partnership insurance as part of their benefit plan. 

Domestic Partner Insurance – What is it?

Domestic partner insurance offers benefits to domestic partners like they would marry couples. 

The objective of this insurance type is to allow you to share your health benefits with your partner and even your children as dependents without getting married. 

Registered Domestic Partnership

There is a difference between merely living with your partner as a couple and being in a registered domestic partnership.

When you are in a registered domestic partnership, it means that the state legally recognizes your union as one where two people share their lives but are not married. 

Same-sex couples and heterosexual couples are eligible for registering their domestic partnership based on the state they reside in.

Domestic partnerships confer similar benefits associated with marriage, such as adding your partner to your health insurance policy or adopting their child.

How To Certify Your Domestic Partnership

The rules for securing a domestic partnership certificate vary based on your location. In some states like Nevada, you may have to file a Declaration of Domestic Partnership form and have it notarized either physically or electronically. Then you will have to pay a registration fee. 

In other states such as New Jersey, you will be requested to produce an Affidavit of Domestic Partnership form to register as a domestic partner. 

After you have filed and registered your affidavit with relevant authorities, you will be issued an informational copy of your Certificate of Domestic Partnership.

No matter what state you live in, it is necessary to obtain proof of evidence for your domestic partnership, usually a certificate. 

If you live in a state where the law recognizes domestic partnerships check in with the relevant authorities on how to get your certificate. 

Domestic Partnership Vs Marriage – What’s The Difference?

Frequently Asked Questions

Are There Tax Implications For Domestic Partnerships?

A clear difference between marriage and domestic partnership comes to the limelight on the issue of taxation. Federal law dictates that the premiums of health insurance spouses and dependents can’t be taxed. Meaning the premiums for these individuals are tax-free. 

How Do I Select A Domestic Partnership Insurance?

Selecting an insurance plan for your domestic partnership is no different from selecting a regular health insurance plan. 

You have to research what insurances offer domestic partnership coverage, their premiums, deductibles, waiting periods, and the like.

Paying special attention to your needs during this research stage will ensure you get the best out of your plan.

What Do I Do If My Employer Doesn’t Offer Domestic Partnership Insurance?

There is a possibility that your employer does not offer coverage that can accommodate you and your partner. First, try checking if your partner’s employer offers coverage for both of you. 

If neither employer provides domestic partner insurance you can get private insurance from somewhere else. If you are going for a private source aim for somewhere that offers better benefits than your workplace.

You can also bring up the idea with top management in your organization to adopt domestic partnership insurance.

Does Domestic Partner Insurance Cover Children In These Relationships?

Yes, children of domestic partners receive health coverage under their parent’s health plans. In marriage, children are recognized as dependents and thus receive coverage from their parents. The same is applicable to domestic partners.

We strongly advise you to review your employer’s policy to ensure that your children are covered under your insurance plan. Feel free to discuss anything you don’t understand with the insurance agent or the provider’s contact center.

What States Recognize Domestic Partnerships?

Conclusion

A domestic partnership is a perfect alternative for regular health insurance if you are looking for how you and your partner can enjoy benefits under the same plan. Some plans even allow you to cover your children as dependents under your plan. 

To register for domestic insurance check in with your state of residence for eligibility and follow their guidelines.

Sources

Civil Unions and Domestic Partnerships

Health Insurance Benefits for Domestic Partners

Domestic Partnership Vs. Marriage: What’s the Difference?

Understanding Domestic Partnerships and Domestic Partnership Insurance

The post Can A Boyfriend And Girlfriend Be On The Same Health Insurance? appeared first on Insurance BlogX.

High Costs

America has some of the most skilled professionals in the health sector; it is no surprise that their services will be costlier compared to what you will get will, junior professionals. 

Dental procedures are generally expensive whether conducted by a highly trained professional or not. Now imagine getting a bill worth thousands of dollars and discovering that your insurance company won’t take up the cost.

You may be surprised to find out that many people turn down recommended dental procedures and trips to the dentist due to cost concerns, including people who have dental coverage.

If you repeatedly experience such a situation, you may wonder why you have dental insurance at all and thus avoid getting dental care.

The sad thing about this is poor oral hygiene can lead to other health issues. Skipping preventive and routine dental visits reduces your chances of spotting potential health threats. 

Another issue is that most people don’t know how to differentiate between an issue that requires immediate attention and something that can be postponed or even ignored. Unfortunately, some dentists won’t tell you. 

They will bombard you with a list of issues relating to your teeth which truthfully may not be much of an issue. However, since you don’t know what needs to be done and what can be put off for later, you may end up spending more than you need to on your dental visits. 

Poor Coverage

A staggering 38% of baby boomers do not have dental insurance, and they say this is because their insurance does not cover it. Most citizens in this age group use Medicare as it is one of the oldest and most reputable insurance providers of their time. 

Medicare provides limited coverage where dental health is concerned. They may provide coverage for some emergency procedures during inpatient stays. However, most dental procedures like cleanings or extractions are not covered.

Low Income

Unfortunately, dental insurance does not fall under the Obamacare Act, but it is available under some health care plans or offered as a standalone policy. 

Most individuals who do not have dental coverage wish they did and even admitted they wished they took better care of their teeth. 

Three in ten Americans will regret not making better oral hygiene choices, which is common with low-income earners. In households that make less than $5000 a year pretax, ValuePenguin discovered that an average of 34% experience oral care-related sadness. 

This percentage is for people who do not have dental insurance. For the people who are fortunate to have some dental coverage but are still unhappy with their teeth, the percentage is lesser- 17%.

No need for Insurance 

Let’s look at the other side of the story; not everyone is unhappy with the state of their teeth. On the contrary, some people love their teeth, and it’s not just for cosmetic reasons but because their teeth are genuinely healthy. 

Because their teeth are healthy, they don’t have any reason to visit a dentist more than twice a year, talk less of signing up for dental insurance. These people would save more money paying out of pocket for their occasional dental visits than paying premiums on dental insurance. 

This brings us to the next point on why dental insurance in the US is awful- there are cheaper alternatives. 

Not anyone can perform a root canal; you need to visit a trained dental professional. However, not all your dental needs require the services of a dentist, and even they do, there are affordable places to get such services. 

A quick search on google can yield results for clinics that charge less than what you will spend on premiums for “free” routine and preventive care procedures.

The table below contains dental-related regrets of American citizens. 

Now that we have analyzed the problem, the next step is to proffer some solutions. Dental Insurance in the US might be bad, but can it be improved? The answer is yes, it can.

We think the first and most important step is to create to tackle the current state of dental coverage in Medicaid. Medicaid is a key player in the insurance industry, and its user population is over 24 million. 

This means that over 24 million people in the US population have no dental coverage. Those who do get it from other sources such as Medicaid or Medicare Advantage plans. 

To create a dental benefit program under Part B of Medicare’s insurance plans, efforts have been made. A second option is to offer dental services under a new voluntary part of the program. 

The US is in a dental health crisis, and it is negatively affecting its residents’ lives. Unfortunately, most people avoid dental routines due to costs, even when they have insurance.

It is even more saddening that a key player such as Medicare has no defined dental coverage plan for its users, leaving them to get this service from other sources. Fortunately, efforts are being made to provide dental coverage for their users.

Sources

9 Secrets Dental Insurance Companies don’t Want you to Know

Why Dental Insurance is so Unspeakably Awful

Luxury Vs. Necessity: The US Dental Care Dilemma

Reasons to Ditch Dental Insurance

Policy Options for Improving Dental Coverage for People on Medicare

ValuePenguin Dental Survey

The post Why Is Dental Insurance So Bad In The US? appeared first on Insurance BlogX.