individual/family health insurance
Health Insurance seems to have changed a lot over the years, but what remains the same is the vital importance of reducing financial risks.
There are several affordable health insurance plans available that are emerging and gaining in popularity in the market for individuals and families. We will help you understand the coverage and cost differences between the different plans. We specialize in consulting with you to find just the right plan. Often times it might be more affordable to carry different coverages for different family members based on how each member uses their plan. Family coverage can help save on bundled deductibles and max out-of-pocket costs.
Child-only insurance policies have gained popularity with less and less being covered by employers and with rising health care costs. Child-only policies can help cover your most important loved one either while away at school or for additional coverage when they play accident-prone sports.
Below are a few common terms used when picking a plan.
- Indemnity (Fee-for-Service, or FFS) Plans: These medical plans offer the greatest flexibility in choosing your doctors and have the best overall value built into their plans. The limitation with Indemnity plans exists in the amount of the reimbursement that an insured party can receive to cover medical expenses. The medical expense reimbursement amount can range from a per-day cost and set percentage to the actual costs of the medical expenses. Many of these are hybrids and are adjusting PPO and POS components.
- Short Term Plans: Short term plans tend to fall under the PPO umbrella but closely resemble a medical major plan in that they will have a deductible option and copay. They will have a limited time frame depending on your state that you will have to requalify for to renew.
- ACA/Marketplace plans - was signed into law in March 2010. It was designed to extend health insurance coverage to millions of uninsured Americans. ... It prevents insurance companies from denying coverage due to pre-existing conditions and requires plans to cover a list of essential health benefits. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level.
- Preferred Provider Organizations (PPOs): These plans contract with a network of hospitals and doctors who provide services at a negotiated rate. This means you have access to any PPO provider in the network, whether a primary care physician or specialist. PPO members can go to doctors or hospitals that are not in the network but may have to pay a higher cost for doing so. This is a great option if you are looking for insurance that is both affordable and flexible.
- Point of Service (POS) Plans: These medical plans are a combination of the PPO and HMO models. Like an HMO, there is a PCP providing referrals to in-network doctors. Like a PPO, you can see providers outside the network and pay more of the cost.
- Health Maintenance Organization: Typically require a copayment fee of non-preventative visits. Must see your primary care provider (PCP) for a referral to a specialist. Networks are more limited.
- Exclusive Provider Organiztion (EPO): It is a new plan option with the mass exit of many PPO's in various states, allowing you to see a specialist without a referral.
A Family Health Insurance plan will cover the financial needs of an entire family under the sum insured defined in the policy. This requires every family member to be on the same plan, regardless of individual usage or need. This complete coverage amount can be easily availed by any one or more members in a situation where medical aid is needed via finances.
Additional Financial Risk Helpers - Add-on Options:
- Critical Illness (Heart attack / stroke / cancer) Coverage: These plans can provide you with a fixed amount of money for your living expenses or a benefit for your medical expenses.
- Accident Insurance: These plans cover you if you are in an accident and can have coverage for on or off-the-job events. They typically also carry a benefit for accidental death or dismemberment.
- Accident Disability: These plans will give you income if you are disabled due to an accident. There are many riders that can be added to these policies that have different exclusion periods and have different periods of time that they would provide coverage.
- Gap Insurance -These plans can greatly reduce your major medical deductibles and co-pays.