Lucid Health

Health insurance agency, providing transparent consulting for solopreneurs, businesses, families, an NPN # 19458132

Licensed in Texas, Arkansas, Florida, Indiana, North Carolina, Ohio, Oklahoma, Tennesse, and Utah.

03/18/2024

“One of the differences between some successful and unsuccessful people is that one group is full of doers, while the other is full of wishers.”
- Edmond Mbiaka

Do you find yourself in the wrong group?
Perhaps it's time to stop wishing, even planning, and start doing.

12/28/2023

Understanding Health Insurance Terminology - Copayment:

According to HealthCare-dot-gov, this is defined as:

"A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service."

A copayment (or "copay") is a more reliable price point when you go to the same provider. These range in price - depending on your plan.

Fixed indemnity plans do not offer copays. These types of plans pay a specific amount for each service provided by a provider. This creates a more variable cost point for patients that go to multiple providers. However, many times the fixed indemnity plan will create less cost for the patient for routine services. Specialties, hospitalizations, or more complex and uncommon services could create a much larger risk profile for these types of plans.

Share any questions or concerns with us in the comments, or connect with us directly for more personal service.

12/27/2023

What starts with an "O", edns with "nions" and sometimes makes you cry?..

Opinions...
especially the ones posted on social media!

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Sticks and stones can break your bones, but words can also hurt you. It is estimated that over 20% of Americans between the ages of 18 and 64 received mental health treatment in the past 12 months. It is also estimated that over 70% of Americans would benefit from treatment.

The two main reasons people do not seek mental health treatment is because of the negative stigma around it and the cost to receive it.

Not all health insurance plans provide mental health treatment, although many do. It is important to find the plan that best suits you by choosing the one with the benefits that you are most likely to use.

If you do not know the total cost of ownership (cost to have and cost to use) of your current plan, then you may be doing yourself, your family, and possibly your employees a disservice. Contact us today to learn more about what variables you should be focusing on and/or guidance toward the plan that would serve you and your loved ones best.

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12/26/2023

Understanding Health Insurance Terminology - Marketplace:

According to HealthCare-dot-gov, this is defined as:

"A marketplace for health insurance where individuals, families and small businesses can learn about their plan options; compare plans based on costs, benefits and other important features; apply for and receive financial help with premiums and cost sharing based on income; and choose a plan and enroll in coverage. Also known as an "Exchange". The Marketplace is run by the state in some states and by the federal government in others. In some states, the Marketplace also helps eligible consumers enroll in other programs, including Medicaid and the Children’s Health Insurance Program (CHIP). Available online, by phone, and in-person."

The Marketplace is available during Open Enrollment (November 1 through December 15 for those under 65) for the following calendar year or during a Special Enrollment Period that is caused by very specific circumstances throughout the remainder of the year.

An approved Marketplace is accessible by the public. However, it literally does not cost a penny more to use an agent to navigate this with you. Using an agent typically provides peace of mind and helps you better pick a plan to fit your needs.

Note that private plans and group plans are not available on these Marketplaces. Therefore, better solutions may be accessible only through agents or brokers.

Have any questions or concerns? Share with us in the comments or connect directly for more personal service.

12/25/2023

Understanding Health Insurance Terminology - Coinsurance:

According to HealthCare-dot-gov, this is defined as:

"Your share of the costs of a covered health care service, calculated as a percentage (for example, 20%) of the allowed amount for the service. You generally pay coinsurance plus any deductibles you owe. (For example, if the health insurance or plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your coinsurance payment of 20% would be $20. The health insurance or plan pays the rest of the allowed amount.)"

Share any questions or concerns with us in the comments, or connect with us directly for more personal service.

12/23/2023

Your friends at Lucid Pros and Lucid Health Insurance Specialists Wish you a Merry Christmas filled with joy, peace and light. May your holiday season reignite hope and stirs passion that will build a better future for us all.

The creator of the universe humbled himself and came to us as a baby, born in a barnyard. The incarnation of the uncreated one is worth celebrating. And don't forget, he is coming again.

12/21/2023

Understanding Health Insurance Terminology - Claim:

According to HealthCare-dot-gov, this is defined as:

"A request for a benefit (including reimbursement of a health care expense) made by you or your health care provider to your health insurer or plan for items or services you think are covered."

Too often we see clients believe once they have health coverage in place, everything is covered 100%. However, the premium only covers the cost to HAVE coverage. Whenever you have any service performed by a provider, a claim is submitted to the insurance company to pay their portion of that service. Any remaining cost will be the responsibility of the patient receiving the service.

Share any questions or concerns with us in the comments, or connect with us directly for more personal service.

12/19/2023

Understanding Health Insurance Terminology - Appeal:

According to HealthCare-dot-gov, this is defined as:

"A request that your health insurer or plan review a decision that denies a benefit or payment (either in whole or in part)."

Whenever you have a claim denied, you have the right to appeal - especially if you believe it should be covered. Many times the insurance carrier will help you take a look at how the claim was coded and submitted by the provider to determine whether or not to ask the provider to correct the claim and resubmit to the insurance carrier for correction.

Share any questions or concerns with us in the comments, or connect with us directly for more personal service.

12/18/2023

Understanding Health Insurance Terminology - Prescription Drug Coverage:

According to HealthCare-dot-gov, this is defined as:

"Coverage under a plan that helps pay for prescription drugs. If the plan’s formulary uses “tiers” (levels), prescription drugs are grouped together by type or cost. The amount you'll pay in cost sharing will be different for each "tier" of covered prescription drugs."

There are alternative solutions to prescriptions than going through your health insurance plan that can be more cost-effective. Examples include CleverRX, GoodRX, Cost Plus Drugs, and more.

We suggest checking multiple sources with high-cost prescriptions before filling through your insurance at your local pharmacy.

Share any questions or concerns with us in the comments, or connect with us directly for more personal service.

12/14/2023

Understanding Health Insurance Terminology - Complications of Pregnancy:

According to HealthCare-dot-gov, this is defined as:

"Conditions due to pregnancy, labor, and delivery that require medical care to prevent serious harm to the health of the mother or the fetus. Morning sickness and a non-emergency Caesarean-section generally are not complications of pregnancy."

A few examples of complications of pregnancy include (but not limited to) high blood pressure, gestational diabetes, preeclampsia, preterm labor, depression, anxiety, miscarriage, stillbirth, and more.

Some complications can be minimized, but mothers-to-be are not able to avoid all of them. These are why a good prenatal plan and proper service are necessary to protect the health of the mother and fetus.

Have any questions or concerns? Share with us in the comments or connect directly for more personal service.

12/13/2023

What do you call Santa when he's wearing earmuffs?..

Anything you want. He can't hear you!

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Over 40 million people (15% of Americans aged 18 and over) experience hearing loss. With proper health coverage, this can not only be diagnosed, but it can also be treated for much less than you might think.

Give yourself or your loved ones the gift of hearing over the Holiday Season. It is one of our most important senses, and more often than not, something can be done about it.

There are 2 days left in the ACA Open Enrollment period. If they are a good fit, make sure to take advantage of these plans while you still can.

Follow this link to shop without fear of sharing your personal information: https://www.healthsherpa.com/?_agent_id=travis-lamnek

12/12/2023

Understanding Health Insurance Terminology - Excluded Services:

According to HealthCare-dot-gov, this is defined as:

"Health care services that your plan doesn’t pay for or cover."

Many patients are not clear on whether a service is going to be excluded or not before proceeding. We suggest contacting the service provider prior to the service and double-checking with them against your health plan to see what the resulting financial impact should be. Most will not guarantee the rates but will provide an estimate so that you can see what is included and what is not - thereby generating a total expected cost.

Do you have any questions or concerns? Share them with us in the comments, or connect with us directly for more personal service.

Address

Houston, TX

Telephone

+17138281642

Website

http://www.lucidhealthinsurance.com/

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