Do you get scared of visiting the hospital due to the billings that follow? Are you tired of paying heavy medical bills? Have you tried subsidizing your medical billings? Are you looking for how to go about it? You’re in luck because this article is set to guide you through the possible ways of subsidizing your medical billings.
Health care is an essential part of living and we cannot overemphasize the importance of medical insurance. Health is wealth, they say. Individuals need to learn the act of prioritizing their health. If you’re one of those who worry about the cost of health care, it would interest you to know that medical insurance covers a good part of your medical billings.
As you plan for your household weekly or monthly expenses through budgeting, endeavor to include the cost of health insurance. We understand that the cost of medical bills can be expensive and adding it to your budget will eat into your monthly finances, hence, the subsidy.
A medical subsidy can be gotten in different ways but the most common way of subsidizing your medical billing is through insurance. Asides from the normal billing services available, there are behavioral health medical billing services as well. They specialize in billing, collections, benefits verification, claim audits, appeals, and lots more. Here are ways of subsidizing medical billings.
Many individuals fail to see the need for health insurance. They give excuses such as “I would not fall sick” “It is a waste of money” and “I can self-medicate”. These excuses are a result of ignorance as those who have been sensitized know the importance of health insurance. This insurance helps individuals improve their health and encourages them to always stay healthy.
Health insurance can be gotten if you do not have health coverage offered by an employer. For health insurance, there are two groups based on the amount of money spent on health care. The first group spends well over $10,000 per person while the other spends less than $1,000 on health care/insurance. These groups buy health insurance for different purposes and gains. Check out the functions of health insurance below.
Health Insurance Subsidies
Here are two types of health insurance subsidies:
1. Advanced Premium Tax Credit (APTC): It is best for lower monthly premiums and the tax credit is based on the size of your household and estimated income. Your household size may include you, your spouse, and any other person you claim as a tax dependent. This insurance considers what it would cost to cover health care in your state. If you qualify for this insurance, your premium tax credit can be an advanced premium tax credit when added to your monthly insurance premium. It goes to say that you will not pay the complete amount of your monthly premium. However, if you take more than you qualify for, the excesses have to be paid back at the end of the year when filing your federal tax return.
2. Cost-Sharing Reductions (CSRs): These are the extra savings that help to reduce the cost taken out of your pocket. It is done by lowering your copays/coinsurance, deductible, and out-of-pocket maximum. To get the extra savings on the out-of-pocket cost plan in the Silver category will be best if your income qualifies you for the CSRs. The Bronze plans are okay; they have the lowest premium but the highest deductibles as well as cost-sharing. The enrollee is left to pay more out-of-pocket when covered health care services are received.
When signing up for your insurance, bear in mind that there is a possibility for you to be eligible for both APTC and CSRs plans. It’s a good thing because you get to save a lot on your annual health plan costs.
Functions of health insurance
1. Financial protection for individuals with serious health conditions
Like car and housing insurance, health insurance is meant to protect individuals from unforeseeable and financially draining situations. Harmful health events like car crashes and pandemics are not common but they are hard to predict. The worst part of these catastrophic events is the cost; it goes as far above people’s means. Treating illnesses like sclerosis or cancer can amount to over $10,000 and only a few can afford it. Organ transplants and other related situations most times amount to hundreds of thousands.
2. Improving the quality of hospitals and clinicians
Buying health insurance helps in improving the quality of hospitals and monitoring their activities as well. Insurers are responsible for providing ratings and exclude some hospitals from providing certain kinds of services to people based on their quality. Your insurers offer top-notch ratings to help you choose right the hospital to engage with. The policies are centered on quality and comprehensive measurement.
3. Encouraging individuals to stay healthy
One of the essential benefits of insurance is healthy living. Health insurers have not stopped designing new methods of encouraging healthy behavior. Health clubs are created for individuals who stop drinking and smoking. Value-based insurance design(VBID) is another method; here individuals pay very little for health services. It offers services like preventive measures and medications that prevent complicated health issues.
Negotiation of Medical Services and Bills
Subsidizing medical care is most times easier than you think. You have the power to negotiate with the health care systems, clinicians, and hospitals. You can screen out the high-cost services and go for affordable ones. If you’re under an insurance agency, negotiating health services will be simple and stress-free. Insurers have policies responsible for the negotiation of the leverage hospitals and clinicians have.
Medical billings can be taken care of by the medical billing service you subscribe to. For normal health care, there are various billing services you can choose from. There are small-scale medical billing services, professional medical billing services, and physician practice management companies. For behavioral health, there are several behavioral health medical billing services that offer great services that would benefit you in the long run.
However, in the absence of insurance, you have the right to request an itemized bill for review. Mistakes are bound to happen; errors such as incorrect patient info, insurance or provider information, duplicate billing, and incorrect codes are clerical information you should review. It was discovered that about 15% of billings given at the hospital are not billable; so review and negotiation are important.
Still on this, you can ask your provider if discounts are offered to uninsured patients. For nonprofit hospitals, there are financial assistance programs offered to low-income patients. Note that the aid given varies with institutions and states.
Another way to negotiate is by asking for a lower bill. Reach out to the providers, be nice and tell them the bill is too much for you to pay. Kindly ask for a reduction and do not force anything as you might be successful on your first try. Request that you be charged the Medicare rate that providers are familiar with. Once the negotiation is over and you have the bill, you can request a payment plan. Ensure that the plan you come up with is very realistic and affordable.
This is another form of subsidized coverage that is available to individuals at a reduced or no cost at all. It is also meant for people with incomes that go below specific levels. The Children’s Health Insurance Program (CHIP) and Medicaid are examples of subsidized health coverage. Note that there are various requirements necessary to qualify for this health coverage. One of the requirements states that your household income must be below 138% of the federal poverty level.
Health Insurance Subsidy Eligibility
How do you know if you’re qualified for a medical billing subsidy? Primarily, the subsidies are dependent on your earnings. Your earnings are compared to the yearly updated guidelines of the federal poverty level. Things to be considered:
Cost of insurance
Before you’re placed on insurance, health coverage, or allow negotiation, the cost of insurance is considered. Knowing the cost of insurance will help you make better decisions on what plan you should enroll in. Do not forget that there is insurance for every income level, so your earnings will determine the type of insurance you get.
Your household size is important if you’re looking toward getting a subsidy on medical billings. According to the federal poverty guidelines for 2022, the number of household members determines the percentage of subsidy coverage you get.
If your household income level is within the range of 100% and 250% of the FPL, you may be eligible for the APTC and CSRs health insurance subsidies. But if it is above 250%, you may be eligible for just the APTC and pay around 8.5% of your expected annual income to the premiums.
Now you have a good guide towards subsidizing medical billings. There is no end to the health insurance coverage options you can get. Anyone can get a medical billing subsidy so long as you have a stable income from which you would pay up. Low-income earners have nothing to fear as there is health coverage available as well. For children, subsidized health coverage includes vision and dental care; but adults may not get the service.
A very large number of people in the world are without health insurance and they have no means of getting subsidies on health bills. With the information above, it is expected that you update your insurance plan if you have one or get an insurance provider and enroll. I hope you found this article helpful!
TIME BUSINESS NEWS
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