FAQs & Help

The Affordable Care Act made it easier for people without health insurance or looking to switch health insurance plans to find quality, affordable insurance. All health plans sold through Healthcare.gov are offered by private insurance companies and are required to meet minimum requirements.

These ACA-compliant plans are required to cover a comprehensive set of benefits including hospital care, doctor visits, emergency care, prescription drugs, lab services, preventive care and rehabilitative services. Insurers are not allowed to charge more or discriminate against people based on health status, health history or gender. The ACA also allowed children to stay on their parents’ insurance until age 26.

If you have health insurance through your employer, you can continue to get your health insurance through your job. However, if you are not satisfied you’re your job-based health insurance, you can shop for a plan on the ACA’s Health Insurance Marketplace. Generally, a quality health insurance plan will cost less through your employer than if you buy one on your own.

Out-of-network services are services provided by a doctor, hospital or other provider that does not have a contractual relationship with your health plan. Not all plans cover out-of-network services, but if they do, your share of the cost is usually significantly higher than if the service was provided in network. For example, an HMO plan may not provide any coverage for out-of-network services, except in an emergency. When possible, try to learn whether the doctor or hospital you are visiting is in-network before receiving services.

The No Surprises Act, which went into effect on January 1, 2022 with the American Heart Association’s strong support, provides federal protections for consumers from surprise medical bills. Surprise medical bills are costs incurred when you unknowingly receive care from a provider or facility that is outside your health care plan’s network. Prior to the No Surprises Act, the out-of-network provider or facility could bill you at higher rates for these costs, unless prohibited by state law. The new protections prohibit surprise bills for emergency care. In non-emergency situations, the law requires that patients receive a good-faith estimate of costs and provide advance consent before receiving out-of-network care. 

For more information on the No Surprises Act, visit https://www.cms.gov/nosurprises. A help desk for payment disputes is available from 8:00 am to 8:00 pm, 7 days a week. Call 800-985-3059 for assistance.

Yes. Federal law requires any health plan providing benefits for emergency services to cover them even if a particular health care provider or hospital is not in your insurance plan’s network. In addition, your plan can’t charge you a copayment or coinsurance on emergency services provided out-of-network that is greater than what it would charge if the services were provided in-network. However, in some states that allow balance or surprise billing, an out-of-network provider can charge you the difference between what the insurance company has paid and what the provider has charged. In this case, you may face higher out-of-pocket costs for emergency care.

You have the right to ask your plan to reconsider its decision. If your plan still denies payment after considering your appeal, the law permits you to have an independent review organization decide whether to uphold or overturn the plan’s decision. This final check is often referred to as an external review.

If you’re not satisfied with the way your insurance company addresses your appeal or if you need help, every state has an insurance department you can contact about your coverage. To find out more, contact your state insurance department. Your state may also have a consumer assistance program that can help you file an appeal. Ask your state insurance department if your state has such a program. Finally, contact the National Patient Advocate Foundation  on their website or (800) 532-5274, may also be able to help you file an appeal with your insurance company.

If you’re not satisfied with your health plan’s services or if your claim has been denied, call the member services phone number on your health plan member card. You may be able to resolve your concern over the phone, or you or your representative can file a complaint with the health plan.

If you decide to file a complaint, you may need to complete a form and submit it in writing so the health plan can investigate the facts, decide what to do and share any action being taken to address your complaint. You should receive a letter that explains how your complaint was resolved. It will include your appeal rights and how to submit an appeal if you want the health plan to reconsider its decision.

If you’re not satisfied with how your insurance company addresses your complaint, every state has an insurance department to help with questions or complaints. To find out more, contact your state insurance department. Ask if your state has a consumer assistance program that can help you file an appeal. The National Patient Advocate Foundation may be able to help you file an appeal or resolve billing or other complaints with your insurance company. You can also call them at (800) 532-5274.

According to the Federal Trade Commission, there is a direct relationship between credit score and an individual’s propensity to get into severe car accidents as well as cancel for non-payment. This has led 46 out of the 50 states in the US to allow insurance companies to use credit score when determining auto insurance and home insurance premiums.

Having a good handle on your credit score and keeping it as high as possible is important because a low credit score will result in higher insurance premiums in most states.

Talk to our insurance professionals about finding the best carrier for you.

Actual Cash Value is a method insurance companies usefor valuing property after an insurance loss.

It’s important to understand that depreciation is subtracted from the insurance company’s payment. For example, if your kitchen cabinets are twenty years old and you experience a kitchen fire, the company will compensate you based on the value of twenty-year-old cabinets, not the cost of replacing them today.

To protect your property adequately, many property owners prefer insuring it at replacement cost rather than actual cash value. 

The primary purpose of an additional interest on an insurance policy is to ensure that Insurances, Inc. stays organized and informed about the rights and responsibilities of various individuals and entities associated with the policy.

Notable items such as land, buildings, cars, boats, and more may require an additional interest. In addition, organizations like your mortgage company or auto loan company may also need to be included as additional interests.

Count on Insurances, Inc. to keep your policy well-managed and your interests protected.

Most insurance carriers offer multiple payment options such as EFT (Electronic funds transfer), monthly, quarterly, or paid in full. Opting for the pay-in-full option may even earn you a discount.

However, if you choose not to pay in full, every insurance company will charge you a per payment fee, the amount of which varies depending on the company.

At Insurances, Inc., we understand that how you pay for your insurance can affect your premiums.