It’s a guy thing: Staying Fit & Healthy with the ACA.

Men's Health photo basketball players
Catch health problems early with health screenings covered by the Affordable Care Act (ACA)

Guys, the Affordable Care Act (ACA) has you covered.

ACA healthcare policies aren’t designed just to treat you when you’re sick, but to catch problems early – when they can best be treated –  through regular health screenings. These can help you stay fit and healthy, and can even save your life.

While men are significantly more likely to put off doctor’s visits and get screened for illnesses than women, they are much more likely to be hospitalized for diabetes complications heart failure and pneumonia.

Screenings for diabetes (high blood sugar), for example, are particularly important to catch early, when treatment is most effective. Your doctor can also check for high cholesterol and high blood pressure. ACA health policies cover screenings for depression, HIV, Hepatitis C and can help you with weight loss, which can lead to many of the diseases already mentioned.

Some screenings are tied to age. For example, did you know if you’re 50 or older, you are covered for colon cancer screening (or earlier if you have a family history)? If you are between 65 and 75 (or have smoked more than 100 cigarettes in your lifetime), you can receive an Abdominal Aortic Aneurism ultrasound test. This can detect whether the largest artery in your body is bulging, which could prevent it bursting leading to internal bleeding or death. Those between the age of 55 and 80 (or those who have smoked extensively or quit in the past 15 years) can receive a lung cancer test.

 

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Quick guide to Men’s Health Screenings

 

For more information on men’s health, go to: healthfinder.gov – Men: Take Charge of Your Health:

Learn more about ACA essential health benefits: https://www.healthcare.gov/coverage/what-marketplace-plans-cover/

Do you  have more questions about what your healthcare policy covers? The Epilepsy Foundation of Florida’s federally licensed healthcare navigators are here to help! You can call our toll-free statewide number at 877-553-7453 to schedule an appointment with a navigator.  More information is also available at www.efof.org/acanavigation.

Women’s Well-Care Essential to ACA healthcare policies

 

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Well-women check-ups include preventive screenings for diabetes, cancer and depression

Improvements to health coverage have been one of the hallmarks of the Affordable Care Act (ACA), which mandates that all insurance plans cover certain health benefits.

 

This has been especially important for women. For example, contraception and maternity care are covered in ACA plans at no additional charge. Well-women annual exams are covered with no co-pays or co-insurance costs when provided by an in-network provider. And deductibles don’t apply for these services either.

Other required benefits include breastfeeding equipment, HPV testing and domestic violence screenings.

In addition, all ACA healthcare policies and Medicaid plans cover pregnancy and childbirth, which are considered “essential health benefits.”  In fact, all qualified health plans both inside and outside the health marketplace must cover them.

 

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Practicing good health is a life-long pursuit

 

What exactly is a well-woman yearly check-up? It’s where you can talk to your health provider about your health and get preventive screenings, including for:

  • Certain types of cancer
  • HPV (human papillomavirus), which can lead to cervical cancer`
  • HIV and other sexually transmitted diseases (STDS) DYK? Regular Pap tests lower the number of new cervical cancers and deaths by more than 80%.
  • High blood pressure and cholesterol. DYK? More than 75% of women 40-60 years of age have at least one risk factor for heart disease.
  • Diabetes Osteoporosis (weak bones)
  • Depression
  • Domestic violence

For a complete list of all #PreventiveCare offered women, go to: https://www.healthcare.gov/preventive-care-women/

In between visits, check out these “Healthtips” for a healthier you all year and all life long: http://go.usa.gov/x9JSz

Do you still have questions about what your healthcare policy covers? The Epilepsy Foundation of Florida’s federally licensed healthcare navigators are here to help! You can call our toll-free statewide number at 877-553-7453 to schedule an appointment with a navigator. More information is also available at www.efof.org/acanavigation.

 

Make the Most of Summer Fun with Preventive Care

 

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Whether you’re on a healing hike or hitting the beach, make the most out of your summer by staying healthy with preventive care.

Get the most out of your health coverage this summer by getting the preventive care you need.

Did you know? Most health plans cover shots and screening tests — at no cost to you. This means your plan can’t charge you a co-pay or coinsurance – a share of costs – for preventive services. This is true even if you haven’t met your deductible.

What is preventive care?

Screenings, check-ups, and counseling that prevent illnesses, disease, and other health problems, or other healthcare services designed to detect illness at an early stage – it’s all considered  preventive care.

Why is preventive care important?

It helps you stay healthy and happy throughout your life and can detect illness at earlier stages, when treatment is most likely to work best.  Preventive care counseling can help you make healthier lifestyle choices – better diet, no smoking, curbing excessive drinking – that lead to good health and well-being.

Preventive services for all adults include: blood pressure, cholesterol and diabetes (Type 2) screenings. For adults over age 50, preventive care includes colorectal cancer screenings. Lung cancer screenings for adults at higher risk because they are heavy smokers or have quite within the last 15 years are also covered for ages 55-80. Immunizations and flu shots are always  included.

Women have their own set of covered preventive care services, including annual “well-women” visits and mammograms every 1-2 years for women over 40. Beginning at age 60, osteoporosis screening for good bone health is included. Contraception and STD screenings are both considered preventive care for women.

There are extensive preventive care services for children, each suited to the appropriate life stage, from autism and developmental screenings beginning in infancy to lead and vision screenings and even obesity and diet counseling as they get older. Immunizations are always covered as preventive services for children.

No matter where your summer takes you – to the beach or to the woods for healing hikes – stay healthy with preventive care.

Learn more about preventive care and all the services included: https://www.healthcare.gov/preventive-care-adults/

#Coverage2Care #PreventiveServices #Immunizations

Have questions about how to best use your #HealthCare coverage? EFOF’s licensed & certified navigators are here to help. Call 877-553-7453 for answers.

Essential Health Benefits under the ACA

Dental visit photo fr kidsGetting health coverage is just the first step to healthy and happy. Knowing how to use your health coverage effectively is what comes next.

Every health insurance plan purchased on the health marketplace comes with “Essential Health Benefits (EHBs).”

Under the Affordable Care Act (ACA), every health plan sold on the health marketplace and in small group markets must carry a set of 10 categories of services, including doctors’ services, inpatient and outpatient hospital care. These also include: prescription services, pregnancy and childbirth, and mental health. Some plans cover even more than is minimally required. Children covered under the ACA also receive dental benefits.

These are a given, no matter how much your deductible is, co-pays or co-insurance.  Make sure you know your EHB’s:  

·         Emergency services

·         Ambulatory patient services (outpatient care you get without being admitted to a hospital)

·         Hospitalization (like surgery and overnight stays)

·         Pregnancy, maternity and newborn care (both before and after birth)

·         Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)

·         Prescription drugs

·         Rehabilitative and rehabilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)

·         Laboratory services

·         Preventive and wellness services and chronic disease management

·         Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

Including these benefits in every policy has made health insurance coverage more comprehensive for consumers. This also protects them from unforeseen medical bills for essential services, including maternity and prescription drugs. Those consumers with pre-existing conditions benefit, too because insurers can’t “opt out” of certain expensive services, like diabetes or asthma coverage.

Learn more: https://www.healthcare.gov/coverage/what-marketplace-plans-cover/

Have more questions on how to use your health coverage? Contact the Epilepsy Foundation of Florida navigation services at 877-553-7453. We’re here to help!

#EssentialHealthBenefits #Coverage2Care #CoverageMatters #AffordableCareAct

Keeping the “Affordable” in the ACA

To keep the “affordable” in the Affordable Care Act, Silver Plans purchased through the Healthcare Marketplace come with financial assistance for low and moderate-income consumers.

These “extra savings” help consumers afford their monthly premiums. They also reduce the co-pay amounts paid to healthcare providers and for prescription drugs. Annual deductibles and co-insurance costs are also lower.  

You may qualify for these savings if your household income is between 12,000 to $30,000 for an individual, or about $24,000 to $60,750 for a family of four.

The savings can be substantial if you have substantial healthcare needs or require many medications.

 

An analysis by the Commonwealth Fund gives this example: “Someone earning $17,000 who is also a high user of care, projected out-of-pocket spending would be no higher than $650—a savings of nearly $6,000 compared to the average silver plan. In other words, instead of potentially spending more than a third of his income on health care expenses, he spends no more than 3.8 percent of his income…”

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Without premium subsidies and share-of-costs savings, many consumers would not be able to afford their health insurance. In 2017, 7 million people qualified for this assistance -—58 percent of all marketplace enrollees.

If these savings were eliminated, as proposed in some reform plans being considered, insurance costs would rise, as insurance companies would be forced to increase premiums. Some Silver Plan premiums could increase by 9 to 27 percent, according to some reports. And out-of-pocket costs would also increase. In Florida, the  Kaiser Family Foundation predicts premiums could increase 25 percent if the share-of-costs savings are eliminated.

You  find out if you qualify for premium tax credits and these extra savings when you fill out your marketplace application through healthcare.gov.  More information is available here: https://www.healthcare.gov/lower-costs/save-on-out-of-pocket-costs/

·         Frequently asked questions:

What is a copayment or coinsurance?  Payments you make each time you get care – like $30 for a doctor visit. The extra savings could mean you pay $20 or $15 instead.

Do these extra savings apply to my “out-of-pocket maximum?” Yes. If you incur high costs in one year because you become seriously ill or had an accident, you are protected with a maximum amount. The extra savings also help lower this amount.  

Source: Essential Facts About Health Reform Alternatives: Eliminating Cost-Sharing Reductions, The Commonwealth Fund, April 2017

Empower yourself to be healthy

Womens Health week photo

Can we talk?

Empower yourself to be healthy. #WomensHealth week is the perfect time to schedule that annual exam you’ve been putting off. Did you know that Pap tests lower the number of new cervical cancers and deaths by more than 80%. Regular screenings and check-ups save lives.

Well-woman visits include a full checkup, separate from any other visit for sickness or injury. These visits focus on preventive care for women, which may include:

  • Services, like shots, that improve your health by preventing diseases and other health problems
  • Screenings, which are medical tests to check for diseases early when they may be easier to treat
  • Education and counseling to help you make informed health decisions

Staying healthy is more than well-women care. More than  75% of women 40 to 60 have at least one risk factor for heart disease, the most common cause of death in women in the United States. That’s why it’s a good idea to also have your blood pressure and cholesterol levels checked regularly.

Besides visiting a doctor for a checkup and preventive screenings, here are some other steps to stay healthy and happy:

  • Get active
  • Eat healthy
  • Pay attention to mental health, including getting enough sleep and managing stress
  • Avoid unhealthy behaviors, such as smoking or excessive drinking
  • Stay safe while on the road: wear a bicycle helmet, fasten your seatbelt and never text while driving.

Under the Affordable Care Act, the health care reform law passed in 2010, many insurance plans now cover at least one well-woman visit per year at no cost to you. Plans must also cover some screenings and types of counseling.

For more information about preventive services covered by the Affordable Care Act, visit HealthCare.gov. Contact your insurance provider to find out what’s covered by your plan.

EFOF navigators are here to help you understand your health insurance coverage and make the most of your benefits. Call 877-553-7453 to make an appointment with a health care navigator to find out more.

Wellness Wednesday: Get Moving to Stay Healthy

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Everyone benefits from regular physical activity, which can be anything that gets you moving. A good goal is 2 hours and 30 minutes of moderate activity each week but studies have shown that even less can bring mental and physical health benefits.

Start at a comfortable level. If you haven’t been active before and are concerned, ask your health provider what’s right for you.

What kinds of activity is good?

Try a combination of aerobic activities which make you breathe harder, causing your heart to beat faster, and muscle-strengthening activities like lifting weights, using resistance bands and push-ups.

In addition to getting physical, here are a few other things you can do to #GetHealthy: Eat healthy, manage stress, quit smoking and watch your weight.

Find more tips here: https://healthfinder.gov/HealthTopics/Category/everyday-healthy-living/physical-activity

NY times workout photoOnly have 9 minutes? The New York Times has a full-body strength workout for you. Find out how: http://nyti.ms/2qmtkT2

 

Need affordable health insurance? DYK? You can enroll year-round in a health marketplace plan through healthcare.gov if you qualify for a Special Enrollment Period. EFOF navigators are here to help. Call 877-553-7453 to find out more  or go to http://www.efof.org/navigation.