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Health insurance is complicated, but you don't have to figure it out alone. Understanding terms and definitions is important when comparing health insurance plans. When you know more about health insurance, it can be much easier to make the right choice for you and your family. A common question when it comes to health insurance is, "Who pays for what?" Health insurance plans are very diverse and depending on your plan, you can have different types of cost-sharing: the cost of a medical visit or procedure an insured person shares with their insurance company. Two common examples of cost-sharing are copayments and coinsurance. You've likely heard both terms, but what are they and how are they different? Copayments Copayments (or copays) are typically a fixed dollar amount the insured person pays for their visit or procedure. They are a standard part of many health insurance plans and are usually collected for services like doctor visits or prescription drugs. For example: You go to the doctor because you are feeling sick. Your insurance policy states that you have a $20 copay for doctor office visits. You pay your $20 copay at the time of service and see the doctor. Coinsurance This is typically a percentage of the total cost of a visit or procedure. Like copays, coinsurance is a standard form of cost-sharing found in many insurance plans. For example: After a fall, you require crutches while you heal. Your coinsurance for durable medical equipment, like crutches, is 20% of the total cost. The crutches cost $50, so your insurance company will pay $40, or 80%, of the total cost. You will be billed $10 for your 20% coinsurance.

Read More About Copays vs. Coinsurance: Know the Difference

Did you know that members of Senior Care Plus, the largest Medicare Advantage Plan in northern Nevada, have access to an exclusive, senior-focused Renown Health primary care office right here in Reno? The facility – and the Medicare plan itself – are both designed with seniors in mind; this includes specialty staff, longer appointment times, on-site services, supportive furniture and more. 4 Benefits of an Exclusive Senior Care Plus Facility Centrally Located with Senior-Focused Staff The Senior Care Plus facility, located on Del Monte Lane, is only open to members of Senior Care Plus. This exclusive access means that the bilingual staff – including doctors, medical assistants, nurses and personal assistants – works daily with aging health needs. On-Site Services and Enrollment Specialists The Senior Care Plus providers understand that seniors often require complex care management and geriatric-focused services. That is why this location offers on-site lab draws, saving travel time and stress. Another essential service this location offers is longer appointment times, ensuring members don’t feel rushed when discussing their health needs with providers. Another perk of the Del Monte location – on-site enrollment specialists. Members, and potential members, can stop by this location on weekdays between 9 a.m. and 4 p.m. to have their SCP-related questions answered. Furniture Designed with Seniors in Mind Senior Care Plus makes a doctor visit as stress-free as possible. The office has furniture that makes each visit more comfortable for members. All of the office chairs have armrests, so seniors can easily get in and out of them. Also helpful are the exam room chairs with remote controls for reclining the chair and lifting the patient’s legs. This makes exams, such as a diabetic foot exam, less of a strain. Community Rooms Social connections are an important part of health. That is why the Del Monte Lane office has community rooms used for informative seminars and as a gathering place for members to mingle. The seminars focus on many interesting topics for older adults, such as diabetes, COPD, asthma, weight loss, nutrition, yoga and chair exercises.

Read More About A Facility Designed with Seniors in Mind

When it comes to purchasing a health insurance plan, you’ve probably heard of the two plan types, HMO and PPO, but what exactly do these terms mean, and what is an EPO? Let’s learn more about these plan types and how you can choose the plan that meets your needs. What is an HMO Plan? HMO stands for “Health Maintenance Organization.” HMO plans contract with doctors and hospitals creating a network to provide health services for members in a specific area at lower rates, while also meeting quality standards. HMO plans typically require you to select a primary care physician (PCP) and obtain a referral from your PCP to see a specialist or to have certain tests done. If you choose to see a provider outside of the HMO’s network, the plan will not cover those services and you will be responsible for all charges. What is an EPO Plan? An EPO stands for “Exclusive Provider Organization.” This plan provides members with the opportunity to choose in-network providers within a broader network and to visit specialists without a referral from their primary care doctor. EPO plans offer a larger network than an HMO plan but typically do not have the out-of-network benefits of PPO plans. EPO plans do not require you to select a primary care physician (PCP) giving you a broader network of providers. EPO options are a great cost-saving option with more flexibility than a standard HMO plan. What is a PPO Plan? PPO stands for “Preferred Provider Organization.” PPO plans are often more flexible when it comes to choosing a doctor or a hospital. These plans still include a network of providers, but there are fewer restrictions on the providers you choose. PPO plans do not require you to select a primary care physician (PCP), giving you a broader network of providers. So, which plan should you choose? Each plan type has different benefits, so it depends on your health needs when choosing the right plan type. If you are looking for flexibility when choosing providers and locations, a PPO plan may better fit your needs. An EPO plan may be a better option if you want the flexibility of a larger network, but don’t necessarily need out-of-network benefits. If you regularly seek care in a certain geographic area and are looking for a health insurance plan at a lower price point, consider an HMO plan. To keep costs low, insurance carriers contract with providers and partner in plan members’ health to ensure quality care at the lowest cost. Whether you choose an HMO, EPO or PPO option, partnering with your health insurance carrier and your healthcare provider will help you receive the best care while controlling your out-of-pocket costs. Keep in mind that most insurance carriers offer emergency care coverage for all three plan options (HMO, PPO, EPO). Get the most out of your health insurance benefits! Established in 1988, Hometown Health is the insurance division of Renown Health and is northern Nevada’s largest and only locally-owned, not-for-profit insurance company providing wide-ranging medical coverage and great customer service to members.

Read More About Health Insurance Terms Explained: HMO, EPO and PPO Plans

If you are approaching age 65, you may be starting to think about the government benefits you will soon qualify for. For example, your healthcare option to elect between Original Medicare or a Medicare Advantage plan. What’s the difference? Original Medicare comes in two parts: Part A and Part B. Part A covers a portion of hospitalization expenses, and Part B applies to doctor visits and medical expenses, such as lab tests and some preventative screenings. A Medicare Advantage plan, also known as Part C, is an “all-in-one” alternative to Original Medicare. These “bundled” plans include the benefits of Part A, Part B and Part D (prescription drugs). Some people choose a Medicare Advantage Plans over Original Medicare because these plans offer coverage like vision, hearing, dental and more. Saves You Money First and foremost, Medicare Advantage Plans save Medicare members money –and not just a little bit of money, but a lot of money. Original Medicare only pays 80% of the cost of medical care – the Medicare beneficiary is responsible for the other 20%. A Medicare Advantage Plan is different. The Medicare Beneficiary is only responsible for a small copay, typically less than 20% of a doctor visit or procedure. More importantly, Medicare Advantage Plans have a maximum out-of-pocket amount, meaning that once you reach the limit, the Plan pays 100% of all medical services. That alone can save thousands of dollars per year – particularly if there is a hospitalization involved. Dental, Vision and Hearing Coverage What sets Medicare Advantage plans apart is the additional benefits provided that Original Medicare doesn’t cover. These benefits include dental coverage, vision coverage, hearing exams and hearing aid coverage. None of these important health care benefits are included in Original Medicare. Also, most Medicare Advantage Plans include prescription drug coverage at no additional cost, while individuals with Original Medicare need to sign-up and pay extra for Part D prescription drug coverage. Medicare Advantage Plans offer more benefits than Original Medicare and they help members save on their health care costs. Focus on Accessibility, Wellness and Preventative Health Accessible healthcare coverage is key to staying on top of your health. To join a Medicare Advantage Plan you must have Part A and Part B coverage and live in the plan’s service area. It is important to remember that Original Medicare is only valid in the United States. Fortunately, many Medicare Advantage Plans offer worldwide emergency coverage. Another important healthcare consideration to keep in mind is Medicare Advantage Plans focus on your overall well-being. They offer preventative and wellness-related benefits at no cost to you. This includes important benefits like free over-the-counter medicines and free gym memberships. You won’t find those types of benefits with Original Medicare. Medicare Supplement Plans (Medigap) Some people confuse a Medicare Supplement Plan, also known as a Medigap Plan, with Medicare Advantage Plans. They are different and the biggest difference is Medicare Supplement plans come with ever-increasing premiums because they are based on your age. This means the cost of these plans increase every year. Plus, they don’t offer any supplemental benefit coverage like vision, dental or hearing. That’s not the case with a Medicare Advantage Plan. In many cases, there is no monthly premium and you receive all manner of supplemental benefits. These benefit-rich, zero-dollar premium Medicare Advantage plans are enticing people to say goodbye to pricy Medicare supplement plans and hello to Medicare Advantage Plans. Don’t worry, if you join a Medicare Advantage Plan for the first time and you aren’t happy with the plan, you’ll have special rights under federal law to buy a Medigap policy and a Medicare drug plan if you return to Original Medicare within 12 months of joining the Medicare Advantage Plan. The Flexibility to Change Your Mind A common misconception about Medicare Advantage Plans is that when you join, you are still on Medicare and are not giving up your Medicare coverage. Medicare Advantage Plans are considered “Medicare Part C.” This means they combine your Medicare Part A (hospital coverage), Part B (doctor’s coverage) and Part D (prescription drug coverage) into one convenient package that costs less and provides more. You can only join, switch or drop a Medicare Advantage Plan during the enrollment periods: Initial Enrollment Period: When you first become eligible for Medicare, you can sign up during your Initial Enrollment Period. For many, this is the seven-month period that begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. General Enrollment Period: If you have Part A coverage and you get Part B for the first time during this period (between January 1 - March 31 each year), you can also join a Medicare Advantage Plan. Your coverage may not start until July 1. Annual Election Period: Between October 15 and December 7, anyone with Medicare can join, switch or drop a Medicare Advantage Plan. Your coverage will begin on January 1 (as long as the plan receives your request by December 7). Medicare Advantage Plans have been around for more than 25 years and continue to grow in popularity. In some parts of the country, more than half of all Medicare beneficiaries are enrolled in a Medicare Advantage Plan. Only 40% are enrolled here in Nevada, but that number is growing every year.

Read More About 5 Benefits of Medicare Advantage Plans

Senior Care Plus was Nevada’s first Medicare Advantage Plan and is still providing healthcare coverage to qualifying members in Washoe, Carson City, Clark & Nye Counties. Senior Care Plus is administered by Hometown Health, the insurance division of Renown Health. That relationship means Senior Care Plus is the only Medicare Advantage Plan supported and accepted at Renown. This preferred access to Renown is a great benefit for northern Nevadans. When it comes to healthcare coverage, there are three key factors to keep in mind. Here’s why a Senior Care Plus Medicare Advantage Plan is your best choice. 1. Cost Cost matters when searching for the right insurance plan. Of the four Senior Care Plus plans available to residents of Washoe County and Carson City, three offer a zero-dollar monthly premium and all of them offer zero-dollar primary care office visits. That means no out-of-pocket costs for you. Additionally, all Senior Care Plus plans have an annual out-of-pocket maximum. This means when you reach this amount, that’s all you will pay. Senior Care Plus pays all other covered medical benefits for the rest of the year. That’s the beauty of a Senior Care Plus Medicare Advantage Plan. 2. Size of Provider Network and Accessibility Although saving money is important, it’s more important to be able to see a doctor when and where you need to. Senior Care Plus members enjoy the most comprehensive healthcare provider network in the region. Thousands of providers, including many hard-to-find specialists, are in the Senior Care Plus network. Since Senior Care Plus is part of the Renown Health family, you get priority access to all that Renown has to offer, which you won’t find with any other Medicare Advantage Plan. 3. Coverage Medical coverage needs are personal and unique to every member. Understanding a plan’s benefits is essential when picking the best coverage for you. Of course, the important benefits you associate with a healthcare plan are included in all Senior Care Plus plans: urgent care visits, specialists’ visits, lab services, imaging — all with reasonable copays. What sets Senior Care Plus apart from the rest are the additional benefits for preventive health. For example, Senior Care Plus offers plans with a comprehensive dental benefit with first-dollar coverage, meaning you pay nothing until the benefit limit is reached.  Senior Care Plus Medicare Advantage Plans also have a vision benefit allowing you to get a new pair of eyeglasses every year. In addition, these plans offer a fitness benefit, so you can join a local gym because Senior Care Plus wants to keep you healthy. Another interesting benefit is the over-the-counter benefit. If you choose the Renown Preferred Plan, you can select $50 worth of over-the-counter products such as: cold medicine, dental products, diabetic supplies, and digestive aides. Remember, that’s $50 worth of over-the-counter products four times per year. All on a plan that doesn’t cost a thing. Senior Care Plus Medicare Advantage Plans offer many added benefits tailored to Nevadans.

Read More About 3 Reasons to Choose a Senior Care Plus Health Plan

© AndreyPopov via Canva.com Becoming a Hometown Health plan member opens you up to the largest provider network in our region. As northern Nevada’s only not-for-profit health insurance company, the hometown advantage goes beyond your health coverage – and you may not be using all the perks available to you. Here are three benefits that Hometown Health is proud to offer all members to enhance wellbeing and connect the dots between healthcare and technology.  MyChart  MyChart is Renown Health's and Hometown Health’s secure online member portal that gives you direct access to your health and benefit information. From 24/7 access to your benefits and important documents to scheduling an appointment with your provider, this free tool is a great way to keep track of your family’s health. If you have a Renown primary care provider, you can use MyChart to:  Securely email your healthcare provider. Get your test results faster and view your After Visit Summaries. Request prescription refills. Schedule and check-in for appointments. Pay your bill. Request your medical records and review immunization records. Manage designated health care agents and upload end-of-life documents, such as advance directives and a living will. View or download your documents: Member ID Card, Summary of Care, Explanation of Benefits, Referrals and Authorizations. Get in touch with our Customer Engagement Center.  Telehealth  Virtual visits have never been easier thanks to Renown Telehealth and Teladoc. These two tools are convenient options that allow members to be seen by a qualified doctor via phone or video chat who can diagnose, recommend treatment and prescribe medication for many non-emergent medical conditions – no matter where you are. Some of the health issues your virtual provider can treat include:   Cold and flu Allergies Sore throat Sinus infection Respiratory infection Stomach bug Ear infection Urinary tract infection  Both Renown Telehealth and Teladoc are also staffed with specialists in behavioral health, where you can speak with a therapist or psychiatrist on a wide variety of issues, including:  Stress and anxiety Depression Trauma Grief Burnout Medication management  Renown is also proud to offer access to top-level specialty care to address your ongoing condition and help guide you through illness maintenance and education. Through Renown Telehealth, Hometown Health members have access to a variety of specialties, including (but not limited to):  Adolescent Medicine Cardiology Hematology, Oncology and Pediatric Oncology Nephrology Pediatric Endocrinology Pediatric Neurology Pulmonary and Pediatric Pulmonary Sleep Medicine  New in recent years, Teladoc is now proud to offer both dermatology and nutrition visits. Teladoc dermatologists can treat conditions like acne, rosacea and rashes, while their registered dieticians can help you manage your nutrition and weight goals.  Booking an appointment with Renown Telehealth is easy by heading over to MyChart and selecting “Schedule an Appointment.” To book an appointment with a Teladoc provider, visit teladoc.com or download the Teladoc app.  Renown Telehealth is available within the state of Nevada, and Teladoc is available in all 50 states. Your copay can be as low as $0 for each visit; check your plan documents for more information.  Doctoroo  The house call has returned – avoid long urgent care waits with Doctoroo. Through Doctoroo, Hometown Health members have access to in-home urgent care services at the same price as your regular urgent care copay. A call to Doctoroo will dispatch a fully equipped medical team consisting of an EMT and either a nurse practitioner or physician assistant to your home within a few hours. Whether you need treatment or testing, each team is ready to provide care in the comfort of your own home with their over 60 medications and antibiotics, EKGs, wound dressings, IVs, catheters and more.  Doctoroo care teams can address and treat many non-emergent care areas and conditions, including (but not limited to): Respiratory Ear, Nose, Throat Eye Wound Care Cardiac Care Musculoskeletal Gastroenterology  Doctoroo is open year-round from 7 a.m. to midnight. Book a house call in minutes in the Doctoroo app or by calling (888) 888-9930.

Read More About 3 Unexpected Perks of Choosing a Hometown Health Plan

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