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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.

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Health insurance might be one of the most complicated purchases you will make throughout your life, so it is important to understand the terms and definitions insurance companies use. Keep these in mind as you are comparing health insurance plan options to choose the right plan for you and make the most of your health insurance benefits. One area of health insurance that can cause confusion is the difference between a plan's deductible and out-of-pocket maximum. They both represent points at which the insurance company starts paying for covered services, but what are they and how do they work? What is a deductible? A deductible is the dollar amount you pay to healthcare providers for covered services each year before insurance pays for services, other than preventive care. After you pay your deductible, you usually pay only a copayment (copay) or coinsurance for covered services. Your insurance company pays the rest. Generally, plans with lower monthly premiums have higher deductibles. Plans with higher monthly premiums usually have lower deductibles. What is the out-of-pocket maximum? An out-of-pocket maximum is the most you or your family will pay for covered services in a calendar year. It combines deductibles and cost-sharing costs (coinsurance and copays). The out-of-pocket maximum does not include costs you paid for insurance premiums, costs for not-covered services or services received out-of-network.  Here's an example: You get into an accident and go to the emergency room. Your insurance policy has a $1,000 deductible and an out-of-pocket maximum of $4,500. You pay the $1,000 deductible to the hospital before your insurance company will pay for any of the covered services you need. If you received services at the hospital that exceed $1,000, the insurance company will pay the covered charges because you have met your deductible for the year. The $1,000 you paid goes toward your out-of-pocket maximum, leaving you with $3,500 left to pay on copays and coinsurance for the rest of the calendar year. If you need services at the emergency room or any other covered services in the future, you will still have to pay the copay or coinsurance amount included in your policy, which goes toward your out-of-pocket maximum. If you reach your out-of-pocket maximum, you will no longer pay copays or coinsurance and your insurance will pay for all of the covered services you require for the rest of the calendar year.

Read More About Health Insurance Terms Explained: Deductible and Out-of-Pocket Maximum

Hygiene in healthcare is an essential backbone to providing the safest, most optimal care to every patient. From everyday handwashing techniques and getting all necessary vaccinations to surveilling our health system before the onset of outbreaks, at Renown Health, creating and maintaining a low-infection environment is a group effort. From ensuring fundamental infection prevention practices are carried out to identifying process improvement opportunities, Renown’s Infection Prevention (IP) department is here to help care teams be successful in their role. This effort is led by members who are devoted in sharing evidence-based best practices to our patients, employees, healthcare organization partners and community. Making “Zero” A Reality Reducing healthcare-associated infections is possible when core infection prevention practices are incorporated into the daily care of our patients. These team members are dedicated to Renown’s commitment to creating a culture of Excellence, caring for our healthcare environment, and our care teams. “Often times, when asked what we do in our work it can be a challenge to answer because unpredictability is built into almost every day; and in that, we as a team must divide and conquer,” said Susanne James, Manager of Infection Prevention. Every day, each team member is assigned a day to perform required surveillance activities. Whether they are reviewing patients’ infections and isolation and evaluating lab orders for possible infectious processes or reporting communicable diseases to the local health authorities and the CDC, every Infection Preventionist participates in improvement projects and address issues as they arise. The Infection Prevention team plans, organizes, manages and evaluates the Infection Prevention Program and ensures IP policies reflect current best practice. They work closely with all departments at Renown in order to achieve high levels of standards that are implemented to reduce transmission of infection. “As a team, we perform ‘Infection Prevention Environment of Care Rounding’ on all units and departments to ensure our environment complies with regulatory requirements,” said Erika Clark, Operations Analyst at Renown Health. "We work together with Facilities and Site Practice Leaders to ensure a safe environment.” The pandemic challenged all Renown teams to find creative solutions for issues no one ever imagined. Our Infection Prevention department worked tirelessly alongside Renown's Hospital Incident Command Structure (HICS) and care teams in creating several lines of defense against COVID-19, including: Launching Renown's Alternate Care Site to meet the need for critical patients. Bringing on the new lab tests and specimen collection criteria. Managing demand for personal protective equipment (PPE). Bringing vaccines to staff and then to the community. Managing ill employees and our visitors. Keeping all locations informed on pandemic status and changes (which were occurring at breakneck speed). These initiatives enabled Renown's care teams to focus on providing the safest care possible to patients saving countless lives. This solidified the fact that together, the team can accomplish anything. “Infection Prevention is proud to be a valued and respected member of the care team,” said Susanne James. “We appreciate being a trusted resource and take this responsibility seriously as this enables us to provide staff the best possible tools to be successful.” Fight the Good Fight Against the Spread of Disease Educating patients and providers plays a huge part on the Infection Prevention stage. This team provides educational materials on a range of topics, some of the most important are, proper hand hygiene and the use of PPE. All these materials can be found throughout our health system and serve as an important reminder – infection prevention starts with all of us. “We partner with every aspect of the health system – environmental services, nutrition services, lab services, facilities, pharmacy, physical therapy and occupational therapy, respiratory care, patient access, security, nurses, providers and quality...just to name a few!” said Susanne James. Our Infection Prevention team also partners with Washoe County Health District and other public health agencies to report – and in turn, stop the spread of – diseases and exposures. These close partnerships poise our team to do what we do best: Fight the Good Fight. “I greatly appreciate everyone in the IP department for sharing their expertise as I learned a new position,” said Erika Clark. “I love working with my team and how closely we work with other departments to ensure excellence in all we do.” Our health system is ever-changing. But according to the experts in our Infection Prevention department, the three main ways to prevent illness and disease that remain the same time and time again are to: Clean your hands. Hand hygiene is the most effective way of preventing the spread of infections. The CDC recommends washing your hands with warm soap and water for 15-20 seconds or using an alcohol-based hand sanitizer. Clean your hands often and assist our patients to do the same. Learn expert hand-washing advice here. Get vaccinated. Immunizations are one of the top methods you can embrace the fight against preventable diseases, such as COVID-19, flu, measles, tetanus and more. Discover how you can get vaccinated with Renown. Keep germs from spreading. Practice good hygiene by covering your cough or sneeze or wearing a mask and sanitizing frequently touched spaces. Stay home if you feel ill to prevent the spread of illness and infection. Be sure to bring up any illness concerns with your primary care provider. “Every aspect of our health system has an infection prevention component, and we work daily to ensure our staff, patients and visitors are providing and receiving care free from potential harm or infections,” said Susanne James. “We are often the first call staff make when they have questions, concerns or just need someone to help improve process or outcomes.” Reveling with Renown Proudly defining themselves as a “small but mighty” team, the six-person Infection Prevention department moves mountains to ensure the safety of anyone who walks through Renown’s doors. The tight-knit nature of this team can be felt from miles away, and to them, being “small but mighty” is not a hindrance, as they have the support of the IP Champions and the entire health system.   “I originally came to Renown in 2018 as a nurse traveler, the facility and people I worked with immediately made an impact on me,” said Brian Stroud, Infection Preventionist at Renown Health. “My wife and I chose Renown and Reno due to the positive impact the people had on us. Everyone is welcoming, helpful and caring. Now, I am a full-time employee, and the team has made my transition into infection prevention trouble-free." Renown’s mission of providing a genuine difference for the health and wellbeing of the community is heightened and echoed by the Infection Prevention team. “I chose Renown because of the reputation Renown has earned in the community because of the excellent care and level of services provided,” said Shannon Oriola, Infection Preventionist at Renown Health. “I absolutely love this team and my Renown family!” “What brought me to Renown was the opportunity to acquire diverse skills which then motivated me to pursue my master’s degree,” added Paul DeLeon, Infection Preventionist at Renown Health. “What keeps me here is the people – Renown attracts hard working, ethical and caring people.” "My wife and I loved coming out to the Nevada mountains on vacations," added Russ Laarman, Infection Preventionist at Renown Health. "After being in Michigan for 47 years, we took the plunge and made NV our home. The experience has been great! I work with a great team that is very knowledgeable and works hard to ensure positive outcomes for our patients and colleagues at Renown.” Their pride shines through with their own individual accolades, both inside and outside of work. This past year: Shannon Oriola received a scholarship from the Association for Professionals in Infection Control and Epidemiology (APIC) for “improving outcomes through knowledge and practice,” which provided her with a $1,000 scholarship to attend the annual APIC conference in Indianapolis. Paul DeLeon earned his Certification in Infection Control and Prevention from APIC. Erika Clark completed Renown’s High Potential program, a six-month program that gives employees hands-on learning experience with several competencies, including emotional intelligence, effective communication, building successful relationships and organizational knowledge. Brian Stroud and his wife Charla became official Nevada residents. Russ Laarman scaled Mount Whitney. ...And the list keeps growing! Charged with the goal of keeping disease spread at bay, our Infection Prevention team remains vigilant and dedicated to their mission. Their commitment to Renown and to keeping our health system clean and healthy proves the age-old saying true: not all heroes wear capes. “I’m so very proud of the work Infection Prevention does every day, working with the vast teams throughout the health system to improve lives,” said Susanne James. “We would like to thank all of you for protecting the health and safety of your colleagues, our patients and the community.”

Read More About Department Spotlight: Infection Prevention

When finding a provider to receive your health services, you've probably heard the terms "in-network" and "out-of-network" when it comes to your health plan. But what do these terms mean for a patient? And why should you be aware if a provider is out-of-network? What does it mean when a provider is "in-network" with a health plan? A provider is a person or facility that provides healthcare. When a provider is in-network it means there is a contractual agreement with that health plan regarding the rates for services. The provider will accept negotiated rates for services from the insurance. This means a patient will typically pay less for medical services received and is less likely to receive surprise bills. What does it mean when a provider is "out-of-network" with a health plan? Providers that are out-of-network are those that do not participate in that health plan's network. The provider is not contracted with the health insurance plan to accepted negotiated rates. This mean that patients will typically pay more or the full amount for the service they receive. Why should patients see in-network providers? Seeing an in-network provider for medical services can significantly reduce your medical expenses. Remember that in-network providers have a contractual agreement for negotiated rates with the health plan, so they cannot charge you more than that negotiated rate for a service. Seeing an in-network provider will always ensure any costs you do incur (copays or co-insurance) are applied to your health plan's deductible and out-of-pocket maximum (out-of-network costs don't apply to these amounts). To find the amounts you will pay for specific services, you can check your health insurance plan's Summary of Benefits. What is the best way to find which providers are in-network with a patient's health plan? Most health insurance companies offer multiple ways to find if a provider is in-network. To find the most accurate benefit information from your health plan, you can: Call their Customer Service department Check their website for their online provider directories If offered, check your online member portal.

Read More About Understanding "In-Network" and "Out-of-Network" Providers

Medicaid plays a significant role in our health care system and is the nation’s public health insurance program. In addition, this program is the predominant source of long-term care coverage for Americans. Renown Health is contracted with two Medicaid plans: Molina and Anthem. If you currently have a different plan but want to change to one that Renown accepts, you can request to change plans during the open enrollment period from January 1 to March 31. Request to change your Medicaid plan in one of three ways: Request a change to your plan, or managed care organization (MCO), by reviewing the available MCO plans online at bit.ly/MCOPlansNV and filling out the form on the webpage. Email Nevada Medicaid to ask for a plan change and include your name, Medicaid ID and the names and Medicaid IDs of any dependents in your home: MCORedistribution@dhcfp.nv.gov. Call your local Medicaid district office at 775-687-1900 (northern Nevada) or 702-668-4200 (southern Nevada) to ask about changing your plan.  For more information about the Medicaid plans accepted at Renown Health, please visit: Anthem Molina Healthcare   Renown Health accepts most insurances, but please visit the link below for the full list. Click here for all accepted plans

Read More About 3 Ways to Switch to a Medicaid Plan Accepted at Renown

A slobbery kiss, a wagging tail, a judgement-free smile. There are few things better than the love and attention of a canine companion. At Renown Health, we have a loyal and playful group of pet therapy teams. This volunteer program uses animal-assisted interactions (AAI) and animal-assisted therapy (AAT) to provide comfort, reduce boredom, increase social interactions, improve mood, boost general well-being and – perhaps most importantly – bring smiles to our patients’ faces. Benefits of AAT & AAI: Lowers blood pressure and heart rate by relieving anxiety Helps in pain management Eases feelings of depression, loneliness, boredom and isolation Stimulates communication Encourages physical activity For more information about the program, a complete list of our teams or to get involved, click here. Meet Keno and Linda Linda, Keno’s human, has volunteered as one-half of a therapy dog team for more than 14 years. Keno is her third Newfoundland, and he is a sweet and cuddly 2-year-old pup, who, according to Linds, thinks is a lap dog. “My mother was in assisted living for almost 10 years, and I saw what an impact a therapy dog can have,” Linda said. When she moved to Reno from Portland six years ago, she immediately contacted Renown. A Memory the Stands Out: A patient in the ICU was not responsive because of oxygen deprivation due to almost drowning. Linda and Keno went into the patient’s room at his physical therapist’s request, and the therapist asked the patient to reach out and pet the dog. After the third request, he moved his hand toward the dog, and his mother burst into tears. It was the first time the patient had moved since his accident. Linda and Keno went back several days in a row, and soon the patient was talking, sitting up and eating on his own.   Meet Madi and Clark Madi, Clark’s human, is an employee at Renown, and Clark made it a family affair by joining the team in Sept. 2021. Clark is a unique pup with an amazing demeanor who adores everyone as much as they adore him. He is a hardworking Goldendoodle who loves to be a goofball at home when he’s off the clock. Why They Became a Therapy Dog Team: Madi was inspired to get Clark trained as a therapy dog because, as an employee at Renown, she was always so happy to see dogs walking around, and she knew that I wanted to provide that same relief to others. Her favorite thing about being a Renown volunteer is the joy it spreads to those working and the patients they are caring for.   Meet Richard and Raven Raven is a four old Belgian Malinois who has been working as a therapy dog for two and a half years. She is calm, friendly and loves having her tummy rubbed. “The therapy dog teams are just one little part of Fighting the Good Fight,” Raven’s human Richard said. A Memory that Stands Out: Raven and Richard were assigned to the Sierra oncology ward one shift and visited a woman who had a picture of her dog displayed next to her bed. Raven immediately went to the bedside and the patient started petting her. As she spent more time petting Raven, Richard could see the stress disappearing from her face. He later learned that it was the patient’s first chemotherapy infusion, and Raven gave her the peace and the strength she needed to face the chemotherapy head-on.   Meet Savannah and Hallie Hallie and Savannah’s journey as a therapy dog team began in 2017 at the Morgan Stanley Children’s Hospital in New York and has also taken them to San Francisco General Hospital and Stanford Hospital. The duo moved to Reno in 2020 and immediately joined the Renown Pet Therapy Program. A friend, energetic and cuddly American Cocker Spaniel, Hallie especially loves spending time with the young children at the hospital. A Memory That Stands Out: Savannah remembers one visit to a patient in the Children’s Emergency Room who was struggling with suicidal thoughts. Having struggled with mental health herself, Savannah felt a deep connection to the patient and a need to help. She recalls placing Hallie on the patient’s bed a seeing a “very small hint of a smile.” Savannah later learned that the Renown nurses hadn’t seen the patient smile in days. It was that moment that made Savannah realize what a profound impact Hallie can have on patients.   Meet Chivas and Donna Chivas was a McNab/Border Collie mix who volunteered at Renown with her human Donna for two years. With help from Donna, Chivas was a master at reading situations in the hospital and reacting accordingly. For example, if a patient was afraid of dogs, she would sit with her back to the person so she didn’t come off as threatening. Contrarily, she would lie down on the floor when playing with young children to let them pet her on their level. Why They Became a Pet Therapy Team: This dynamic duo started out as a member of a local pet therapy group. During the height of the COVID-19 shutdown, they participated in outdoor pet therapy parades for various hospitals in the area. Donna and Chivas met Renown Volunteer Coordinator Wendy Peuket at one of the parades and she inspired Donna to pursue becoming a registered therapy dog team for Renown's Therapy Dog Program. Chivas sadly passed away unexpectedly in early December 2021, and the world is a whole lot dimmer place without Chivas’ light shining brightly.

Read More About Getting to Know Renown's Canine Companions

This holiday season, don't forget about your favorite furry friends by baking these easy, AKC-approved dog treats. Simple ingredients and quick baking times make this the ideal last-minute surprise. Make it a gift by picking up affordable canisters (usually abundant at dollar and thrift stores) and filling them with homemade treats. It makes the merriest, pet-friendly gift of the season!

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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 require you to select a primary care physician (PCP) and usually require 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 means “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 and typically do not have the out-of-network benefits of PPO plans. Generally, EPO plans cost more than an HMO, but less than a PPO. 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 travel often and 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.   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

Cost-saving isn’t the only reason to enroll in a Medicare Advantage Plan. One of the main reasons Medicare beneficiaries in Nevada join a Senior Care Plus Medicare Advantage Plan is for the care coordination services. The Senior Care Plus Care Coordination team helps members navigate what can be a complex healthcare system. Care coordination is a popular and extremely important service for members because keeping members healthy is the number one goal. One way they help reach this goal is to encourage members to participate in a no-cost, comprehensive health assessment. At this Quick Start Health Assessment, members meet with a geriatric specialist – a provider who specializes in the care of seniors – to discuss the 4 Ms: Mentation – Thinking, memory and mental health Medications – Understanding your medication Mobility – Staying physically active What Matters to You – Let your provider know what is important to you – examples could be family, health and independence The results of this detailed visit are then shared with the member’s primary care provider, so a customized care plan can be developed. This is a free service for Senior Care Plus members, along with an annual wellness visit and an annual physical exam. Care Team Approach – Laying the Foundation to Improve Health Health assessments and annual visits are offered so Renown Health providers can build relationships to improve care. This approach, also known as the Building Relationships to Improve Care or BRIC Model, is the care model used across Renown Health. “What’s special about this care model is that it really puts our patients at the center of their care,” says Savannah Gonsalves, a registered nurse with Senior Care Plus. “Members have their providers and nurses, Senior Care Plus personal assistants, case managers, and within the BRIC Model, they’re all talking to one another and putting the focus on the patient to meet needs.” Personal Assistants – A Unique Connection to Each Member A team of personal assistants is available to help members coordinate care by: Scheduling a member’s appointments Answering a member’s benefits questions Helping navigate care – these are experts in both health insurance and healthcare Answering questions about medications Working with providers to coordinate a member’s care The Senior Care Plus personal assistants are one of the most popular services that the Medicare Advantage plan offers. Each personal assistant has a direct phone line so members can call them to ask questions. “After my hip surgery my personal assistant, Megan checked in on me every day,” recalls Janelle, a Senior Care Plus member. “She made sure that I was doing alright and that I didn’t need anything. She just let me know that she was there for me.” To Learn More Senior Care Plus is the largest Medicare Advantage Plan in northern Nevada. They offer $0 plans with low co-pays with access to Renown Health and Teladoc Virtual Visits that cover you nationwide. To learn more about Medicare Advantage plans and to see if you qualify, visit SeniorCarePlus.com or call 775-982-3158 to speak to an enrollment specialist.

Read More About What is Care Coordination for Senior Care Plus Members?