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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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Parents often struggle with installing and choosing car seats for their children. Picking out a car seat for your child is a never-ending battle. Safe Kids Washoe County has made it simple for you to understand the types of car seats that will work for your child. Types of Car Seats Rear-Facing Only Seat. Your baby's first car seat is often used from 5 to 40 pounds. People usually buy this type of seat because it is portable. Convertible Car Seat. This seat is larger and stays in the car; it may be rear-facing until your child is two years or more. After that, it can change to a forward-facing seat. Forward-facing-only car seat. This type of seat is used in one direction and has a 5-point harness and top tether.  Combination seat. This is a forward-facing seat with a 5-point harness and top tether and can change into a booster seat when you remove the harness.  3-in-1 car seat. This seat also stays in the car. You can use it rear-facing, forward-facing, and then later, as a booster seat. Booster seat.  It boosts the child for a safer and more comfortable fit of the adult seat belt. Make sure your child has outgrown the weight or height limits allowed in the forward-facing car seat. The seat belt must lie flat across your child's chest, on the bony part of the shoulder, and low on the hips or upper thighs. Most children will be between the ages of 8 to 12 years old before they are ready for the seat belt alone. Have a trained car seat technician check your installation Why: 3 out of 4 car seats are installed improperly, with some studies show that the misuse rate is 90%, with the average car seat having three mistakes. Solution: Ensuring that your child's car seat is installed correctly by a certified car seat technician will ensure your child's safety.

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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.

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Car seat technicians often find parents are moving their child to their next car seat stage too soon, as they get older. Here are a few reminders of when to transition your child from their booster seat to a seat belt. Moving to a booster seat too soon According to Safe Kids Worldwide, nearly 9 in 10 parents remove children from their booster before they’ve reached the recommended height, weight, or age of their car seat recommendations, which leaves the seat belt in a position on the child that could injure them. If the child is not the proper height, the seat belt can rise up on the belly, instead of the hips where it’s supposed to sit, which can lead to spinal cord damage or whiplash in the event of a car crash. Solution: You can switch from a car seat to a booster seat when your child has topped the weight allowed by the car seat manufacturer; typically 40 to 80 pounds (18 to 36 kilograms). Remember, however, that your child is safest remaining in a car seat with a harness for as long as possible. Booster seats must always be used with a lap and shoulder belt — never a lap-only belt.  Transitioning to a safety belt too soon Older children need booster seats to help ensure the seat belt stays properly positioned on their body. The lap belt should lie low across the child's hips and pelvis with the shoulder belt crosses the middle of the child's chest and shoulder, so that in the event of a crash, the forces are applied to the hip bones and not the abdomen. If the lap belt is not positioned properly then it could lead to injuries to the spinal cord and abdominal organs.  Solution: Most kids can safely use an adult seat belt sometime between ages 8 and 12. Always use a booster seat until the child passes the 6-step test Your child reaches a height of 4 feet, 9 inches (nearly 1.5 meters) Their back is flat against the seat back. Knees bend over the edge of the seat and feet are flat on the floor. The shoulder belt sits on their shoulder and chest (not face or neck.) The lap belt sits low on their hips and touches their upper thighs (not on their stomach.) Your child can sit comfortably this way for the entire trip.   The American Academy of Pediatrics reminds us that the back seat is the safest place for children younger than age 13.

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The warm weather is here and pools are open. Swimming is a great way to keep your kids cool, occupied and exercised throughout summer, however pools come with their fair share of risks. Before you take your children swimming, check out these pool safety tips. Pool safety is something every parent needs to take more seriously. Why? Because drownings of young children ages one to four have increased in recent years. Unfortunately, drownings are the number one cause of death in this age group - we lose the equivalent of 10 school buses full of children to fatal drownings in the U.S. each year. With warmer temps and hopes of cooling off in a local pool, you can’t be too careful when it comes to protecting your children from the risk of drowning. Children are naturally drawn to water, so parents must be extra aware in order to protect their kids from diving in headfirst. Kris Deeter, MD, pediatric intensive care physician at Renown Children’s Hospital, offers tips to keep your littles safe in the water. Preparing Your Child for the Pool People aren’t born knowing how to swim. This means parents must teach their children about swimming and pool safety if they want them to be safe and confident around water. It can take years to develop these skills, so the key is to start when your children are very young. Here are some ground rules: Teach your child to swim starting at age one. We recommend enrolling your toddler in swim classes; there are several organizations in the Reno-Tahoe area that offer baby and toddler swim classes. Keep your kids away from plastic and inflatable pools - they’re easy for children to fall or climb into and drown. They’re also a breeding ground for bacteria. Floaties and water wings are not safe! They are not a safe substitute or “crutch” for learning how to swim and they can lead to drowning if the child is using them incorrectly or while unsupervised. Stay within arm’s reach of babies and toddlers when at the pool. Supervision alone is not enough – you must be within arm’s reach in case they fall in and need to be rescued quickly. Learn child and infant CPR. If a drowning does occur, the best course of action is to call 911, get the child onto dry land and conduct CPR until breathing is restored or the EMTs arrive.   Pool Parties: A Risk for Drowning? Surprisingly, pool parties, a common summer pastime, actually increase the risk of drowning incidents. Although responsible adults are usually at pool parties, distractions ranging from alcohol to pool toys can actually make it easier for drownings to occur unnoticed. Does this mean you should RSVP “no” to the next pool party your child is invited to? Not if you follow the pool safety tips below: Attend the party with your child so you can supervise them while they swim. Remove unused floaties and toys from the pool. They can obscure visibility, making it difficult to see a child in the pool. Don’t drink alcohol while supervising a pool party. Assign an adult “water watcher” to pay constant attention to children in the pool.   Pool Safety Precautions for Homeowners If you own a pool, there are several more precautions to ensure the safety of your children. Even if your kids are strong swimmers who have mastered the rules of pool safety, there may be neighbors or friends who are younger and more vulnerable to drowning. You must undertake precautions for these children too. Some of these may seem time-consuming or expensive, but they are worth it to prevent a child from a fatal drowning. To keep your pool or spa safe, please: Cover your pool or spa when not in use. Choose a pool or spa cover with safety features like locks, safety sensors or alarms. Fence in your pool or spa area. The fence should be locked and at least four feet tall. Do not leave toys in the pool area as these may attract children.

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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.

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Car seat mistakes can have very serious consequences. Misuse of a car seat can injure your child, or fail to keep them safe in the event of a crash. A lot goes into finding the right car seat for your child. With so many factors to consider (including age, weight and height of the child, type and brand of a car seat, cost of the car seat, etc.) it can be easy to forget critical factors. Here are two common mistakes that certified technicians often find when speaking with parents. Mistake #1: Getting a used car seat without knowing its history Why: A used or secondhand car seat can pose several factors that can compromise its safety in a crash. First, car seats expire six to ten years after their date of manufacture, so refer to the car seat's manual for recommended car seat longevity. The safety mechanisms can be compromised if a car seat has been in a crash. So it's crucial to replace your car seat following a collision. Solution: Only use a car seat if you know its history. A new car seat is your best bet, as they are up to date on the latest safety guidelines, and safety mechanisms are up to standard. However, if you are considering a used car seat for your child, please ensure the following: The car seat has never been in a car crash. The car seat isn't expired or outside the manufacturer's recommended longevity. It comes with the car seat manual and has all safety labels, including manufacture date, model number, and use instructions and restrictions. The car seat or any of its parts have not been recalled. The overall state and integrity of the car seat and its parts are undamaged. The carseat or any of its parts have not been recalled and are present and in working order.

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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

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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.

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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.

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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.

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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.

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