Consumer Tips

Rules Prohibiting Schools’ Use of Mandatory Arbitration Agreements

By: Amy

On October 28, the Department of Education issued final regulations intended to protect student loan borrowers against school closures and fraud.  To that end, the rules include significant provisions restricting school arbitration agreements; clarifying student rights to raise school fraud as a defense to loan repayment; providing automatic closed school loan discharges to certain eligible borrowers; and providing new rights for students to obtain false certification loan discharges.  See https://www.gpo.gov/fdsys/pkg/FR-2016-11-01/pdf/2016-25448.pdf.  Although some provisions are likely to face legal challenge, the rules generally will be effective July 1, 2017.

For those in the dispute resolution community, the  provisions that may be of most interest are those limiting school arbitration and class-waiver requirements.  This came in the wake of some institutions, such as Corinthian Colleges, using class action waivers and arbitration clauses to thwart actions by students for fraudulent and abusive conduct that largely pushed students into financial peril.  The new rules prohibit schools participating in the federal student loan program from entering into pre-dispute arbitration agreements with students or agreements that purport to waive students’ rights to bring class actions.  These limitations apply to agreements with students who have obtained Federal Direct Loans or benefited from Direct Parent PLUS Loans, and apply to claims regarding the making of the Federal Direct Loan or the provision of educational services for which the loan was obtained.  This bars schools from using contract clauses or stand-alone pre-dispute agreements with students that waive students’ right to go to court or to pursue a class action over any claims that could also give rise to a “borrower defense” claim (described more fully in the new rules).  The provisions also bar a school from relying on an existing pre-dispute arbitration agreement or other agreement to force an individual or class action out of court.  This includes agreements entered into prior to the rule’s effective date.  The school must either amend the agreement or notify the students that they will not enforce the agreement.

The rules also aim to increase transparency regarding such “borrower defense” related arbitration and litigation.  If schools do engage in arbitration proceedings in a manner that is consistent with the regulations and applicable law, the rules require that these schools notify the Secretary of Education and provide disclosures.  The rules similarly require that schools disclose such judicial filings and dispositions.

The complete provisions are lengthy, and can be reviewed in the PDF linked above from 75926 Federal Register/Vol. 81, No. 211/Tuesday, November 1, 2016/Rules and Regulations.

Meanwhile, we wait for the Consumer Financial Protection Bureau (CFPB) to issue final regulations regarding its proposal to prohibit companies from including pre-dispute arbitration clauses in agreements regarding financial products or services that prevent class action lawsuits. The proposal would open up the legal system to consumers so they could file a class action or join a class action when someone else files it. Although the proposal would allow companies to include arbitration clauses in their contracts, it would require that the clauses would have to say explicitly that they cannot be used to stop consumers from being part of a class action in court.

A Basic Guide to Understanding Missouri Payday Loans for the Missouri Consumer

 

In 2003, Elliot Clark took out five short-term loans of $500 from payday lenders in Kansas City so he could keep up with the bills his security job simply could not cover. Clark juggled the five loans for five years, paying off a $500 loan and interest using loans he took from another payday lender. Clark ultimately received disability payments from Veterans Affairs and Social Security, and he was able to repay the debt. The interest Clark paid on the original $2500: more than $50,000.

Clark is not alone. Twelve million American adults use payday loans annually. In Missouri, borrowers received 1.87 million payday loans between October 2013 and September 2014. The average loan in Missouri during this time period was $309.64, with an interest/fee of $53.67 for a 14-day loan. The resulting average interest rate was approximately 452%.

So, how do we as Missouri consumers navigate the world of payday loans and short-term lending? This post answers: (1) how does Missouri define payday loans and (2) what traps should I avoid as a consumer of such loans?

What is a payday loan?

A payday loan is an unsecured small dollar, short-term loan. The name of the loan derives from the loan period; the typical duration of a payday loan matches the borrower’s payment schedule. In Missouri, a borrower can obtain a loan for up to $500. An initial interest rate can be set for up to 75%. The loan must be repaid 14 to 31 daysafter the borrower receives the loan.

A borrower may “renew,” or rollover the loan for an additional 14 to 31 days. To renew a loan, a borrower must:

  • Make a written request to the lender
  • Pay 5% of the principal amount of the loan
  • Make a payment on interest and fees due at the time of renewal

The lender can also charge up to 75% in interest rate for each renewal. A borrower in Missouri can renew the loan up to 6 times.

What traps should I, the consumer, avoid?

  • Do not underestimate the extremely high interest rate: A lender can charge an interest rate of 75% on the initial loan. During each renewal period, that interest rate stays the same. As mentioned above, the average annual percentage rate for a payday loan in Missouri is 452%, and with high annual percentage rates reaching 800%.
  • Do not take the full amount offered: Payday lenders will frequently attempt to persuade consumers to take the full $500 loan, when a borrower only needs a fraction of that amount. Take only the amount you need to cover the immediate expenses. The extra $100 you borrow can become over $1000 that you must pay back.
  • Do not be embarrassed to ask for help in understanding the contract terms: Loan language can be confusing, especially as special terms used in loan contracts are not used in everyday language. If you do not understand what annual percentage rate, renewal, or principal are, ask the employee. Make the employee explain exactly how the loan will work – go through how much you will owe at the end of the term, how much money will be owed if renew the loan, and how much interest will be paid on each loan. It is better to understand what you contract into before you sign then to be surprised in two weeks with a larger debt than you expected.
  • Do not renew a payday loan: Lenders make money by collecting on interest on renewal loans. Because Missouri allows interest rates up to 75% per renewal, your interest owed will quickly become larger than the amount you originally took out. As mentioned earlier, only take out the amount you need and can afford to pay back!
  • Do not take out loans from multiple locations: While it is tempting to take out a second loan from a second lender to pay the interest off a second loan, this leads to further debt. While law does not allow this type of lending, it still occurs in Missouri payday loan practice. Like Clark, borrowers become stuck juggling multiple loans and increasing interest.

Alarmingly, the Missouri laws regulating payday loans are confusing and unclear. More terrifying is the lack of guidance Missouri consumers face in navigating the maze of payday statutes. The Missouri Attorney General’s office currently does not produce a guide to short-term loans (like it does in other areas of law, such as Landlord/Tenant). The Missouri Department of Finance provides an explanation as murky and bewildering as the statute it attempts to interpret.

Ultimately, Missouri consumers must be extremely careful when taking out payday loans. The best policy individual consumers regarding payday loans may be to simply avoid at all costs.

**I would like to recognize Michael Carney, staff attorney at Mid-Missouri Legal Services, for his help in researching and understanding the Missouri statutes applicable to payday loans.

How to Avoid Defaulting on your Federal Student Loans

By: Mercedes Pineda 

Recent reports by the Wall Street Journal estimate more than 40% of federal student loan borrowers are not making payments or are behind on their payments. Defaulting on a loan can carry serious consequences, such as: lowering your credit rating, preventing you from buying a house or car, making it difficult rent an apartment, or even getting a cell phone contract. Additionally, the cost of your loan increases because of additional fees and it becomes payable immediately. All of the institutions can take measures to against you to recover the debt, including your school, lender, and federal government. This post aims to help you avoid the pains of default.

First, a few definitions are helpful to understand the default process. A loan is “delinquent” when loan payments are not received by the due dates. Your loan becomes delinquent the first day after you miss a payment and will continue until all payments are made to bring the loan current. (Source: Studentaid.ed.gov). Loan servicers report all delinquencies of at least 90 days to credit bureaus. “Default” happens when you fail to make a monthly payment for 270 days.

So, what steps can you take to avoid defaulting on your federal student loans?

1) Take the time to understand your loan agreement and the loans you receive. This includes reading your promissory note, which is a legal document where you agree to repay the loan according to its terms. This also includes learning the costs of getting your loan, the interest rate, and the repayment terms. You must repay all the loans you receive, even if you do not complete the educational program. A helpful guide in understanding your loans can be found on the Consumer Financial Protection Bureau site: http://www.consumerfinance.gov/students/knowbeforeyouowe/.

2) Manage your borrowing. Students often accept the full amount of loans offered in their school’s financial aid package. However, students should create a budget before accepting their loans in order to figure out how much money they actually need to borrow. Students can then request a lower loan amount via their school’s financial aid office. The student can always increase this amount later if they decide they need the additional funds. Students should also complete financial awareness counseling: https://studentloans.gov/myDirectLoan/counselingInstructions.action.

3) Track your loans online. Keep track of all your loans via: https://studentaid.ed.gov.

4) Keep good records. It is really easy to misplace important loan documents (especially when you don’t need to look at them for years). You should keep the following documents in easy to find file:

  • Financial aid award letters;
  • Loan counseling materials;
  • Promissory notes;
  • Amount of all student loans you borrow;
  • Loan servicer contact information;
  • Loan disclosures;
  • Payment schedules;
  • Record of your monthly payments;
  • Any communications you have with your servicer;
  • Deferment or forbearance paperwork; and
  • Documentation that you paid your loan in full.

Although it is possible to track down this information several years after receiving loans, it is a difficult, time-consuming process and not always successful.

5) Notify your loan servicer. Your loan servicer manages your loan and processes payments. It is really important to talk to your loan servicers whenever any of the following situations happen:

  • You need help making your monthly payments;
  • You graduate;
  • You withdraw from school;
  • You drop below half-time enrollment status at school;
  • You change your name, address, or social security number;
  • You transfer to another school; or
  • You experience a change in your life that might impact your loan payments.

You can work with your loan servicer to pick the best repayment plan for you when any of these events happen. If you do not contact your loan servicer, you run the risk of missing payments and ultimately default. Never ignore delinquency or default notices from your loan servicer! You are much better off working with your servicer to out the best plan of action.

When is a Landlord Allowed to Enter Your Home?

By: jjrbennett 

When is a Landlord Allowed to Enter Your Home?

What Does the Law Say?

Unfortunately in Colorado there is not many protections for a tenant’s privacy in relation to their landlord. Boulder County and City, along with the State of Colorado, have no statutory language for tenant privacy. However there is an implied covenant of quiet enjoyment that is written into every lease.

The Duty of Quiet Enjoyment

Colorado case law provides that a landlord cannot violate the duty of quiet enjoyment. This duty is defined generally to be “a covenant that promises that the grantee or tenant of an estate in real property will be able to possess the premises in peace, without disturbance by hostile claimants.” This covenant protects tenants rights in principle, yet enforcement is difficult. There are also many legitimate reasons for landlords to come in and inspect the premises.

When Can a Landlord Enter the Premises? 

A tenant’s right to privacy is almost entirely subject to the lease. Whatever protections you wish to have relating to your privacy must be negotiated with your landlord at signing.

According to the standard Boulder Housing Lease, a landlord may enter their tenant’s premises, without notice, to:

  • Inspect the residence
  • Repair damage
  • Or show the premises to prospective buyers

The specific language in the Boulder Model Lease is laid out below

“Resident shall permit owner/agent to enter the premises at reasonable times and upon reasonable notice for the purpose of making necessary or convenient repairs or reasonable inspections, or to show the premises to prospective residents, purchasers, or lenders. Entry may be made without prior notice only if owner/agent reasonably believes that an emergency exists, such as a fire or broken water pipe, or that the premises have been abandoned.”

Link: http://ocss.colorado.edu/sites/default/files/imce/BoulderModelLease.pdf

What about the Boulder Housing Code?

The Boulder Housing Code does require that entry be permitted for reasonable repairs which relate to the Code. Therefore, whatever language you negotiate with your landlord for privacy cannot violate this code.

Link: https://bouldercolorado.gov/plan-develop/codes-and-regulations

What Else Can I Do If a Landlord Continues to Invade My Privacy? 

First and foremost, you should attempt to resolve the problem by negotiating with your landlord. This is the easiest and most hassle-free way to resolve all landlord-tenant disputes. Perhaps starting with a tactful letter may be the best way to go.

If negotiations break down, then it is time to consult an attorney or request mediation. Mediation services in the City of Boulder can be found here:

https://bouldercolorado.gov/community-relations/mediation-program

Finally, DO NOT deny entry of your home to your landlord. If your landlord has similar language in your lease as in the Boulder Model Lease above, then your landlord can immediately start eviction proceedings against you.

Conclusion

I hope this is helpful! Best of luck with your future landlord relationships!

-Joshua JR Bennett

Consumer Choice Legislation And You

By: Dylan Sheji 

Third party data collection is a scary topic, and though you might know what it is and various means to minimize its effects it seems like there is no legal way to stop it. Under current U.S. laws consumers have no right to know which data brokers have their data and what data they have. Some laws and agencies exist that could regulate some behavior, such as the Federal Trade Commission (FTC), but only if companies fail to follow their privacy policies or use fraudulent data collection practices. Is there any reprieve for consumers suffering from run-of-the-mill invasive data collection? Three bills and efforts in the past five years seek to resolve these issues in favor of consumers.

 

“Reclaim Your Name”

At a privacy conference in June of 2013, FTC Commissioner Julie Brown called for an initiative she named “Reclaim Your Name.” The program would make data brokers accountable to consumers by providing a user-friendly online portal where consumers could edit and update their information. This program mirrors the Do Not Call Registry available for consumers to avoid telemarketers. The program is a follow up to the “Do Not Track” option implemented in most browsers. This option allows consumers to opt out of tracking by some third parties who have agreed to the initiative. This program would greatly help consumers manage their data, but has not gained much traction by itself since 2013.

 

“Consumer Bill of Rights”

In 2012 the White House first introduced the Consumer Privacy Bill of Rights, draft legislation that would give consumers more control over their data. The Bill was reintroduced in 2015. The Bill contains broad definitions for personal data and entities covered by the bill. The Bill requires covered entities to give notice to consumers about what data they use and how they use it, and requires covered entities to give consumers options to edit their data for accuracy. The Bill still has flaws, namely weak enforcement fines that are calculated by the number of days during which a violation occurs rather than number of violations. It is still a step forward and brings consumer choice issues to the forefront of legislation.

 

Data Broker Accountability and Transparency Act

In February of 2015 two democratic senators introduced the Data Broker Accountability and Transparency Act to the Senate. This bill would require data brokers to establish procedures to ensure accuracy of personal information and to provide cost free means for individuals to review their data. It would also require data brokers to provide individuals with reasonable means to exclude their information from being used by marketers. There are still many ambiguous definitions in the bill, and many sections aren’t clear in how those provisions should be enforced. The bill was sent to committee in 2014 and forgotten, and met a similar fate in 2015.

 

While there are many legislative initiatives to bring consumer choice back to consumers, many of these bills are gridlocked in a partisan Congress, and are unlikely to become law soon. Consumers must remain vigilant about how their data is used on the Internet.

Tips for Preventing Medicare Fraud

By: Greg Garcia

As the cost of care rises in the United States, so does the occurrence of health care fraud across the country. In fact, some estimates place the amount of money lost to healthcare fraud in the United States in the tens of MILLIONS of dollars each year. While all health care and health insurance fraud is a problem, scams targeting Medicare are especially pervasive since one major hurdle is often removed for fraudsters. Unlike the with population at large, if an American is over 65, a potential scammer can assume that they have access to Medicare and therefore doesn’t need to do any research or steal any data to perpetrate their crime. Fortunately, there are some simple things we can all do to help avoid being victims of Medicare fraud.

  1. NEVER GIVE OUT YOUR MEDICARE INFORMATION OVER THE PHONE OR TO SOMEONE YOU DON’T KNOW

Medicare is a largely centralized system. Any legitimate Medicare provider will have access to your information already and will never ask for it over the phone. One helpful way to think about this is to treat your Medicare number like your Social Security Number. Protect it and only share it with people or agencies you trust.

  1. NEVER SIGN A MEDICARE OR INSURANCE FORM WITHOUT REVIEWING CAREFULLY

Because fraudsters are able to rely on the widespread use of Medicare, they often try to convince people to sign off on procedures that are either unnecessary, or that were never performed at all. This is something to be ESPECIALLY skeptical of if you are receiving care somewhere other than your regular doctor’s office. Fraudsters often take advantage of mobile medical facilities set up in malls, shopping centers, church parking lots or other public places to try to commit these false claim crimes.

  1. ALWAYS FEEL FREE TO CONTACT MEDICARE

Another advantage to Medicare being a centralized system is that you have a single point of contact to report suspicious behavior and investigate the legitimacy of a service offering. Medicare can be reached by either calling 1-800-MEDICARE or through www.medicare.gov. Medicare also operates their own fraud prevention website in collaboration with the Department of Health and Human Services, the Department of Justice, and the HHS Office of Inspector General. The site can be found at www.stopmedicarefraud.gov and contains a host of helpful tips and reporting tools for preventing and fighting Medicare fraud.

 

Buying a house in Colorado? Here are 5 Tips for your Home Inspection!

By: Aaron Fransua 

Purchasing a house is often the largest purchase a consumer can make in their lifetime, so it’s little wonder why it’s highly recommended that before closing on the deal that a property inspector reviews the property and tries to find any problems for the buyer. But what happens if the property inspector misses something big, something that will cost the buyer several thousand dollars to fix?

I found myself recently in a situation where the property inspector missed several large problems that were very costly to repair. As a first-time homebuyer, I had no idea what to look for as possible problems with a potential property and relied heavily on the property inspector’s opinion. Sure the inspector found some obvious problems such as broken electrical sockets, questionable window locks, and missing smoke alarms. But two significant problems went undetected; that should have been discovered. The first issue was found immediately after closing on the property, and I started moving in. Underneath the sink in the basement bathroom was a tremendous amount of water damage and a thriving colony of black mold. Immediately  I thought back to the property inspection- how did this get missed?! Then it hit me; I remembered how cluttered the cabinet under the sink was at the time of the inspection, and neither the inspector or I wanted to remove all the items the seller stored under there. Simply taking the time to remove a few items, or asking the seller to move them, to inspect the floor board of the cabinet could have saved me quite a bit of money in repairs and mold mitigation.

The second problem, like many household issues, didn’t surface until much later. At the time of inspection, I vividly recall having a lot of questions about the Boiler system. The property was built in the late ’70s and used baseboard heating for the winter, which is something I never used before. The inspector glanced over the boiler system and told me everything looks good, boiler systems last 50-70 years on average, and informed me to have the seller do a tune-up as a condition of the sale. Seemed fair enough and the seller had no qualms with doing a tune-up. It wasn’t until the end of this winter when I brought a contractor out to do another tune-up that I discovered that not only was this boiler system in such bad condition that a tune-up could not be performed, but that it should have never passed inspection since the setup was done backwards, highly corroded, and is in violation of numerous building codes. The cost to replace the system and put it up to code: $14,000! Ouch! This piece of information would have been great to know during the inspection and could have been negotiated during the sale of the property. Needless to say, I felt a bit slighted by my property inspector- how could he have missed this, and could he potentially be liable for such a huge oversight?

Unfortunately, in Colorado, property inspectors are not regulated by any state agencies and usually limit their liability through their contracts. In my particular circumstance, the property inspector had a clause that limits his liability to the purchase price of his services- a measly $200. While there may be some ways to pierce this clause, such as fraud, the likelihood of success is quite small and would cost significantly more in legal fees to do so.

Although I am unlikely to hold the property inspector responsible for his huge oversights, I did come out of this experience with a few lessons that I can pass along:

  1. Be there at the inspection! Don’t just trust that the inspector will look at everything and get back to you. Now is your chance to ask questions about the property, so take advantage of it.
  2. Don’t be afraid to request the seller to move things around to get a better visual. This is where I failed. I noticed there was a huge mess of stuff inside the cabinet underneath the sink, but did not move any of the items to get a proper visual on the condition of the inside cabinet. Moving just a few items would have exposed significant water damage and black mold at the bottom of the cabinet.
  3. Don’t be afraid to ask questions. Unless you’re a contractor, you probably don’t know much about the “guts” of the house: the electrical, plumbing, and HVAC systems. So ask plenty of questions. A good inspector will answer all of your questions thoroughly and will explain what he’s doing and looking at all along the way.
  4. Get a specialist. A home inspector is like a doctor who’s a general practitioner. They both can diagnose problems, and they both know when to refer you to a specialist. If your housing inspector recommends a specialist, you should get one. In my case, bringing in a specialist to review my boiler system would have saved me $14,000 in repairs.
  5. Inspect your inspector. Your real estate agent might suggest a home inspector, and that inspector could turn out to be wonderful. But you’re the one buying the house, so make sure you choose well. Besides asking your friends and neighbors, use the American Society of Home Inspectors to vet their recommendations and make sure you hire someone who’s qualified.

Payday Loan Alternatives and Resources

By: Edison
Payday loans can be useful for those who have an immediate need for cash to meet short-term obligations.  Be sure to exhaust these alternatives prior to seeking a payday loan:
  • —Borrow from a credit union or other small loan lender. Be sure you understand all the fees and terms before you sign.
  • Put off the expense until you have the money. For example, if you need money to repair your car, find other transportation until you have the funds to fix the car.
  • —Request overtime or secure a part-time job to cover the unexpected expense.
  • Contact your creditor and ask for more time to pay or a repayment plan.
  • —Use your credit card or obtain one if you do not currently have one. Even if you have to get a cash advance, it will be much less expensive than a payday loan.

If none of those options are available, a payday loan may be appropriate.  Prior to seeking a payday loan, you should always educate yourself regarding what it means to have a payday loan and what your obligations will be.  The resources below are a great starting point.

Resources:

  • Consumer Federation of America – Payday Loans
  • Consumer Financial Protection Bureau
    • Government agency that provides information and complaint service for consumers
    • consumerfinance.gov
  • National Consumer Law Center

Reverse Mortgage Scams: How to Protect Yourself

By: Greg Garcia

As more American’s move into retirement, more and more people are taking advantage of a reverse mortgage to access the equity in their home. However, this also means that scams involving reverse mortgages are on the rise. These scams can take many forms, including:

  • Contractor Fraud: This scam involves someone convincing you that you need home improvements or repairs that you can pay for by letting them help you take out a reverse mortgage.
  • Flipping Fraud: This type of reverse mortgage fraud involves convincing someone to use a reverse mortgage to move into a smaller, less expensive home. Often these homes have been made to look nice but are actually of very poor quality.
  • Theft: This is the most simple reverse mortgage scam but also the most destructive. In this scam, a trusted advisor or relative convinces someone to take out a reverse mortgage in order to pay off their existing mortgage but instead simply walks away with the funds.

For more information on types of reverse mortgage scams see http://www.investopedia.com/articles/personal-finance/071715/beware-these-reverse-mortgage-scams.asp

Fortunately, there are some simple steps you can take to protect yourself if you are considering a reverse mortgage. First, it is good to know a little bit about how reverse mortgages work. Reverse Mortgage are actually called Home Equity Conversion Mortgages (HECMs) and are insured by the Federal Housing Authority. In order to qualify for an HECM, a borrower must meet the following qualifications:

  • 62 years of age or older
  • Occupy their property as a primary residence
  • Own (at least mostly) their property

Any product that doesn’t meet the above criteria is something you should be skeptical of. Also, there is an excellent network of advisers across the country who specialize in assisting people who are interested in a reverse mortgage. These counselors are generally FHA housing specialists who can offer their services to you for free or at a very low cost and can help you determine if a reverse mortgage is right for you. In addition, these counselors can help you make sure that the product you are looking at is a legitimate HECM. The U.S. Department of Housing and Urban Development maintains a database of HECM counselors across the country that you can use to find help in your area. This database can be found at: http://portal.hud.gov/hudportal/HUD?src=/program_offices/housing/sfh/hecm/hecmlist

Just like any other financial product, you should never feel rushed in entering into a reverse mortgage. Get help from the network of HUD advisers and help your community by reporting any suspicious reverse mortgage activity to HUD at 1-800-347-3735.

Choosing the Right Insurance Plan and Coverage Under the ACA

By: Ian Marable

There have been many changes to the insurance arrangement under the Affordable Care Act. Whether  you’ve been unaffected by the changes, have been forced to select a new insurance plan as a result of the ACA, or are among the 15 million remaining uninsured individuals, currently looking for insurance, this guide is designed to help you with the basic steps towards getting the right plan for you.

Grandfathered Plans

If you were previously insured before the ACA and are satisfied with your coverage and the price of your premium, you may not have to do anything in regards to getting new insurance. Many plans were “grandfathered” in under the ACA, meaning as long as the changes did not significantly violate any ACA provisions, the policy stays intact. All plans that were grandfathered in must disclose that they were, so there’s no secret of whether not your policy was grandfathered in. If, on the other hand, you wish to cancel your previous plan to seek a new one https://www.healthcare.gov/reporting-changes/cancel-plan/ has a handy guide to help you do just that.

Government Assistance

However, if you don’t have a current plan or are looking for a new one, the first step is to check whether you and your family qualify for Medicaid, the Children’s Health Insurance Program (CHIP), or subsidies to help you pay for your insurance.

Medicaid

Under the ACA, Medicaid was expanded to 133% of the federal poverty level (currently up to about $30,000 for a family of four). Although Medicaid coverage varies by state, in each state you will be covered for most: ambulatory services, visits to doctors, urgent care clinics, hospitalization, maternity, newborn care, family planning, and pediatric services. And while, a downside to Medicaid is that many doctors decide not to accept it because they get paid less than they get from other insurance plans, it can nonetheless generally provide for most of your medical needs. To see if you qualify for Medicaid or assistance go to https://www.healthcare.gov/medicaid-chip/getting-medicaid-chip/#howtoapply.

CHIP

If your income is too high to qualify for Medicaid, your children may still qualify for the Children’s Health Insurance Program (CHIP) or other related state plans. Coverage includes, among other things, prescriptions, visits to doctors, hospitalization, x-rays, ambulatory services, and dental care. If you’d like to see if your child or children qualify for CHIP choose your state and fill in the information at http://www.insurekidsnow.gov/state/index.html.

Subsidies

Even if you and your family don’t qualify for Medicaid or CHIP, you may still qualify for government subsidies to help pay for coverage. Check https://www.healthcare.gov/lower-costs/ to see if you do.

Coverage and Types of Plans

 If you don’t qualify for government assistance and you and your family are not adequately insured by your employer’s health insurance plan, then the two things you need to consider when choosing your health plan are, the amount of coverage and the type of plan that interests you. Many states such as Colorado offer free in-person and online help to help you choose what insurance plan is best for you http://connectforhealthco.com/person-help/. A simple engine search for your state may turn up similar programs too.

Coverage

In cases where no help is available in your state or if you choose to go at it alone, in general, when considering the amount of coverage, consider: what premium you can afford, how often you and your family go to the doctor, and how much you have to lose. There are four “metal categories,” with concern to coverage: bronze, silver, gold and platinum. If you and your family have a lot to lose and often go to the doctor’s office or hospital, you may want to consider a gold or platinum plan, as copayments will be lower for the many visits, but if you can’t pay as high of a premium or you and your family don’t go to the doctor’s office as much, you may want to consider a different plan. For more information about the metal categories and amount of coverage, visit https://www.healthcare.gov/choose-a-plan/plans-categories/.

Types of Plans

Types of plans too differ depending on you and your family’s specific needs. Among these plans are Health Maintenance Organizations, Exclusive Provider Organizations, Point of Service plans, and Preferred Provider Organizations. While EPOs and HMOs are generally cheaper, consumers are usually confined to providers exclusively within their network, which may create difficulties if you want to see a different doctor for a medical issue or a specialist in another area, outside the network. PPOs and POS plans, on the other hand, while more expensive, generally provide at least some coverage for doctors and medical treatment outside the network. As with anything, you’ll have to weigh the costs and benefits for your family in choosing the right type of plan. For more information on types of plans visit: https://marketplace.cms.gov/outreach-and-education/what-you-should-know-provider-networks.pdf.

Your Insurance

Each individual’s needs is different and it’s important to consider all information relevant to you and your family’s needs when deciding on your plan, and of course seek help when necessary.