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How Does Insurance Determine the Allowed Amount?

When you receive medical care and file a claim with your health insurance company, you may notice that the amount your provider charged doesn’t match what your insurance paid. This difference is due to the allowed amount set by your insurer. The allowed amount, sometimes called the eligible expense, is the maximum dollar amount an … Read more

Can My Employer Ask About My Spouse’s Health Insurance?

It’s becoming increasingly common for employers to inquire about a spouse’s access to health insurance. With rising healthcare costs, some companies are looking to trim expenses by limiting coverage for spouses who could get insurance through their own job. So can your employer actually ask about your spouse’s insurance when you enroll in workplace benefits? … Read more

What Are the Six Models of Managed Care?

Managed care refers to a variety of methods and systems that are intended to control healthcare costs and utilization. There are several different managed care models that organize provider networks, member services, and reimbursement approaches in order to manage the cost, quality, and access to healthcare. The six main types of managed care models include: … Read more

Can I Decline Health Insurance From My Employer?

Health insurance is commonly offered as an employee benefit by many companies. But in some cases, employees may want to opt out and decline coverage through their employer. So can you actually decline health insurance offered by your employer? The short answer is yes – employees can refuse employer health insurance coverage and waive participation … Read more

What Happens When You Pay Off Your Insurance Premium?

Paying off your insurance premium can seem like a great milestone. You no longer have a recurring payment to worry about every month or quarter. But what actually happens when you pay off your insurance early? Does your coverage stop? Do you still need insurance? Overview of Paying Off Insurance Early Let’s start with a … Read more

What is an Insurance Coverage Investigation?

Dealing with insurance companies after an accident, injury, or loss can be frustrating and confusing. You likely just want to get your claim settled and move on with your life. But often the insurance company says they need to do an “investigation” first. What exactly does this entail? Here’s an in-depth look at what an … Read more

Can a Single Member LLC Deduct Health Insurance Premiums?

Single member LLCs are increasingly popular business structures for freelancers, consultants, and solo entrepreneurs. A key question for many single member LLC owners is whether they can deduct health insurance premiums for themselves and their families. The answer depends on several factors related to the LLC’s tax status, who the premiums cover, and what type … Read more

Who Does Not Pay Medicare Premiums?

Medicare has different parts and options for coverage. Premium costs can vary based on the specific Medicare coverage you have. However, some people qualify to enroll in certain parts of Medicare without paying premiums. Understanding Medicare premium costs and eligibility for premium-free coverage can help you evaluate your options and budget for healthcare expenses in … Read more