Health Insurance Plans

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Health Insurance Plans – Know The Difference

Finding and understanding today’s health insurance plans can be very confusing; there are so many options to choose from that it is often difficult to make sense of it all. You do not want to be stuck with a plan that is not only very expensive but also does not cover you for all your out-of-pocket expenses! It doesn’t have to be this way. Talk to our brokers about your current plan, your requirements, and needs – we will not only guide you through the process and ensure you have the most comprehensive coverage, we will also ensure that you have the most affordable coverage.

Major Medical

ACA major medical health insurance plans are commonly known as Obamacare cover hospitalization expenses. These plans usually have deductibles as well as co-pays or co-insurance that are paid by the patient before the remaining costs are covered by the insurer. In terms of the Affordable Care Act (ACA) you cannot be denied coverage for preexisting conditions. You can change ACA plans during Open Enrollment and after Open Enrollment if you have a Qualifying Event.  You may qualify for cost assistance, also called subsidy eligible depending on your income. ACA plans are guaranteed issue and do not have preexisting limitation conditions.

Short-Term Medical

Short-term medical insurance is typically seen as a temporary solution, rather than a replacement for an ACA compliant major medical plan that meets the minimum essential coverage requirements. This may be changing soon, however, as the Trump administration is moving forward with a proposal to extend short-term medical terms from the current limit of 3 months to 1 year. Under the new rule, short-term plans would be available in  90- day, 180- day and 364-day terms.  In the meantime, these plans provide temporary financial protection during unexpected coverage gaps for illness and injury, loss of coverage, in between jobs or waiting for an ACA plan to begin. To avoid the risk of penalty,  you can either apply for an ACA compliant plan as soon as you qualify, or you can add minimum essential coverage (MEC) to a short-term medical plan to be ACA complaint- at least until the tax penalty is no longer in force. You will need to qualify as medical underwriting is required. Coverage can last from 30 – 364 days as certain carriers will allow “blocks” of consecutive terms to be purchased.  Premiums are typically 30-40% lower than ACA plans if you qualify. No benefits are payable for preexisting conditions, and there are coverage limits when compared to ACA plans. These plans are available year-round but are not guaranteed issue.

Supplemental Insurance

Supplemental plans cover you and your family with the extra costs of hospitalization and serious illness. They can help fill coverage gaps created by deductibles and co-pays, and help pay for unexpected expenses. These plans pay for expenses not covered by your primary health insurance policy and are available year-round. Reimbursements are typically paid directly to you so you can spend the benefits as you see fit. You are covered as long as premiums are paid.

 

          Contact us today to learn more about what coverage is available for you and your family today