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Health insurance jargon can be the hardest to understand for consumers. That’s why you have a broker who goes to work for you and explains your policy options with clarity. However, not all brokers work ethically. You may not have an insurance broker who values you and may not elaborate on your policy limitations. The omission of these limits is illegal and should result in the termination of that broker. In contrast, the insured typically doesn’t take legal action, and the broker makes his or her desired commission.
This is not to say that all health insurance brokers operate in this zone of immorality. Just as with any profession, there are good and rotten eggs. Your moral compass and ability to judge a person’s intention is a significant factor – people can typically smell a sleazy salesperson. Below, are the most common limitations obscurely mentioned in health insurance policies. This information should adequately equip you for when you are asking questions of your broker.
Here’s a screenshot from the summary of the benefits of an insurance carrier’s product:
*Note – these limitations do not exist in all policies. Ask your broker.
The list of benefits above is towards the end of the policy summary. Most people are interested in seven factors when it comes to their health insurance:
Deductible/coinsurance/max out of pocket, doctor visits/specialists/urgent care, the network, prescription coverage, preventative/wellness coverage, emergency room fees, and ambulatory services. If your insurance broker goes over those seven things, this is how the policy would look and sound:
Most people would agree that those seven things sound fantastic for health coverage. You have all your daily doctor needs taken care of and one million dollars in coverage, right? Wrong, let me show you a scary breakdown if you had an appendectomy while being covered by this policy.
On average, the “Fair Price” for an Appendectomy lies somewhere between $7,000 and $25,000 (may vary due to zip code). If there are complications, it could be upwards of $35,000 or more. Here’s a breakdown of the services and their estimated costs. You can always check on any surgery, and it’s price by visiting Healthcare Bluebook.
This cost adds up to the lower end of about $11,000 for an appendectomy. If you look above at the example policy, you’ll see that for the entire coverage term an appendectomy will be given a $2,500 coverage benefit. Even though your plan has a deductible, coinsurance, and max out of pocket; there’s a specific limitation for appendicitis. With this knowledge, the insured will be left an $8,500 bill as an out of pocket expense! Keep in mind; these numbers are on the low end with no complications.
Of course, it’s always better to have health insurance instead of going uninsured. With insurance, that remaining $8,500 for the appendectomy may negotiate to a lower bill. Policygenius.com does a great job explaining the functionality of network negotiated rates. Without insurance, you would be paying the almost full retail price for your medical surgery, which is a terrifying thought!
Rehabilitation Services Provided in Skilled Nursing FacilitiesRehabilitation services are a cornerstone of skilled nursing facilities (SNFs), designed to help individuals recover from illnesses, injuries, or surgeries and regain their independence. Heres a closer look at the rehabilitation services offered in skilled nursing facilities and their benefits.1. Physical TherapyPhysical therapy is a critical component of rehabilitation in skilled nursing facilities. It focuses on helping residents restore strength, mobility, and physical function after surgery, injury, or a medical event such as a stroke. Key aspects of physical therapy include: Strength Training: Exercises to rebuild muscle strength and endurance. Balance and Coordination: Techniques to prevent falls and improve stability. Mobility Exercises: Activities designed to improve range of motion, walking ability, and the use of mobility aids such as walkers or wheelchairs. By working closely with licensed physical therapists, residents can achieve improved independence and a better quality of life.2. Occupational TherapyOccupational therapy in SNFs is designed to help residents regain the skills needed for daily living. This therapy focuses on enhancing a persons ability to perform activities of daily living (ADLs) such as dressing, grooming, eating, and bathing. Specific interventions include: Adaptive Techniques: Teaching residents how to use assistive devices or modify tasks to suit their abilities. Fine Motor Skills Training: Improving dexterity for tasks like buttoning clothes or holding utensils. Energy Conservation Strategies: Helping residents manage fatigue and perform tasks more efficiently. Occupational therapists work with residents to restore independence and adapt to new physical or cognitive limitations.3. Speech TherapySpeech therapy addresses communication and swallowing difficulties that may result from strokes, neurological disorders, or other medical conditions. Speech-language pathologists (SLPs) in skilled nursing facilities focus on: Swallowing Therapy: Treating dysphagia (difficulty swallowing) to prevent complications like choking or aspiration pneumonia. Communication Training: Helping residents regain or improve their ability to speak, understand language, or use alternative communication methods. Cognitive Therapy: Assisting residents with memory, problem-solving, and organizational skills. Speech therapy improves both safety and quality of life by enabling residents to eat, communicate, and engage with others effectively.4. Specialized Rehabilitation ProgramsSkilled nursing facilities often provide rehabilitation programs tailored to specific conditions, including: Post-Stroke Rehabilitation: Combining physical, occupational, and speech therapies to address the multifaceted challenges of stroke recovery. Orthopedic Recovery: Rehabilitation for individuals recovering from joint replacement surgeries, fractures, or other musculoskeletal injuries. Cardiac Rehabilitation: Programs focused on improving heart health and endurance following heart attacks or surgeries. Neurological Rehabilitation: Care for residents with conditions such as Parkinsons disease, multiple sclerosis, or traumatic brain injuries. These specialized programs ensure that residents receive targeted care to address their unique recovery goals.5. Benefits of Rehabilitation Services in Skilled Nursing FacilitiesRehabilitation services in skilled nursing facilities offer numerous benefits, including: Faster Recovery: Access to expert care and tailored therapies helps residents recover more quickly. Enhanced Mobility and Independence: Therapy restores physical function and confidence, enabling residents to perform tasks on their own. Improved Quality of Life: Rehabilitation helps residents regain their abilities, reducing frustration and fostering a sense of accomplishment. Preventing Complications: Therapies such as swallowing training and balance exercises minimize risks like choking, falls, and re-hospitalization.
Our eyes are incredibly precious, yet its easy to take our vision for granted until problems arise. Lets focus on proactive steps to maintain and improve our eye health. Here are some tips to keep your vision in top shape:Schedule Regular Eye Exams:One of the best ways to safeguard your vision is by scheduling regular eye exams. Comprehensive eye exams can detect vision problems early on, allowing for prompt treatment and prevention of further complications. Make it a priority to see your eye doctor at least once a year, even if you dont currently wear glasses or contact lenses.Protect Your Eyes from UV Rays: Just like your skin, your eyes can be damaged by the suns harmful UV rays. Whenever youre outdoors, especially on bright, sunny days, wear sunglasses that offer UV protection. Look for sunglasses that block 100% of UVA and UVB rays to shield your eyes from potential damage. Give Your Eyes a Break from Screens: In todays digital age, many of us spend a significant amount of time staring at screens, whether its for work, leisure, or staying connected. Prolonged screen time can lead to digital eye strain, characterized by symptoms like dry eyes, blurred vision, and headaches. To reduce eye strain, follow the 20-20-20 rule: every 20 minutes, take a 20-second break and look at something 20 feet away.Eat a Balanced Diet:Nutrition plays a crucial role in maintaining eye health. Incorporate foods rich in vitamins and antioxidants, such as leafy greens, colorful fruits and vegetables, fish high in omega-3 fatty acids, and nuts and seeds. These nutrients can help protect against age-related vision problems like macular degeneration and cataracts.Practice Good Eye Hygiene:Proper eye hygiene is essential for preventing eye infections and irritation. Wash your hands frequently, especially before touching your eyes or handling contact lenses. Follow your eye doctors recommendations for contact lens care, including proper cleaning, disinfecting, and storage.Stay Hydrated: Dehydration can contribute to dry eyes, so be sure to drink an adequate amount of water throughout the day. Aim for at least eight glasses of water daily to keep your eyes and body hydrated.Get Plenty of Sleep:Adequate sleep is crucial for overall health, including eye health. During sleep, your eyes receive much-needed rest and replenishment. Aim for 7-9 hours of quality sleep each night to help reduce eye fatigue and maintain optimal visual function.By incorporating these simple yet effective tips into your daily routine, you can help protect and preserve your precious eyesight for years to come.Your eyesight is irreplaceable, so take care of your eyes today for a brighter tomorrow!
Moving to a new home can be scary and stressful, especially for older people. But don't worry! Here are some easy ways to make moving day less scary and more fun.1. Pick the Right HomeFirst, choose a new home that feels good. Think about what you like. Do you want a garden view? Do you need help with cooking? Make sure your new home has what you need to be happy.2. Make ListsWrite down everything you need to do. This helps you remember important things. Start early and take your time. Don't rush!3. Choose Special ThingsWhen you move to a smaller home, you can't take everything. Pick the things that mean the most to you. It's okay to feel sad about leaving some things behind.4. Get Help from MoversHiring people to help you move can make things much easier. They know how to pack and move your stuff safely.5. Use Good BoxesUse boxes that stack well. Plastic boxes with lids are great because they're easy to pack and unpack.6. Say Goodbye to Your Old HomeHave a party to say goodbye to your old home. Take lots of pictures to remember it. This can help you feel better about moving.7. Think Happy ThoughtsMoving can be exciting! Think about all the fun new things you'll do in your new home. You might make new friends or try new activities.8. Pack a Special BagPack a bag with things you'll need right away in your new home. Put in things like:MedicineToothbrush and toothpastePajamasSnacks and waterThis way, you won't have to search through all your boxes on the first night.9. Make a Moving Day PlanPlan out your moving day. Know when you'll leave and when you should arrive at your new home. Don't forget to plan for breaks along the way.Remember, moving can be a big change, but it can also be the start of a great new adventure in your life!
We offer coverage for all situations: Individual, family, small business, and large group. With Healthcare Reform and the industry's ever-changing landscape, Baker Consulting still has options to choose from. Whether you are looking for better coverage, recently uninsured or its your first time purchasing health insurance, we will help you find a high-quality, affordable plan. Depending on your budget and your need, we will custom design a plan for you. Whichever fits you best, Major Medical-ACA Compliant, Short Term, Fixed Benefit, and Guaranteed Issue plans are all available to you. Even if your employer offers you coverage, an individual plan could still be the best option for you. Additionally, dependent coverage through your employer may not always be the most affordable option either. Customizing your coverage is essential as health insurance is not a one size fits all type of product. Therefore, a BCS agent will assist you in determining what will work best for your situation. With all the different deductibles options and product designs, choosing the right plan could be difficult and our mission is to simplify this process. Licensed States: UH, SD, PA, OH, KY, NC, SC, VA, WV, GA, TN, TX, FL, AL, AZ, IN
We offer coverage for all situations: Individual, family, small business, and large group.With Healthcare Reform and the industrys ever-changing landscape, Baker Consulting still has options to choose from. Whether you are looking for better coverage, recently uninsured or its your first time purchasing health insurance, we will help you find a high-quality, affordable plan. Depending on your budget and your need, we will custom design a plan for you. Whichever fits you best, Major Medical-ACA Compliant, Short Term, Fixed Benefit, and Guaranteed Issue plans are all available to you.Even if your employer offers you coverage, an individual plan could still be the best option for you. Additionally, dependent coverage through your employer may not always be the most affordable option either.Customizing your coverage is essential as health insurance is not a one size fits all type of product. Therefore, a BCS agent will assist you in determining what will work best for your situation. With all the different deductibles options and product designs, choosing the right plan could be difficult and our mission is to simplify this process.