Health Insurance Plans

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 don’t want to choose a plan that does not cover you for what could be a huge out-of -pocket expense. many different types of health plans can work for you, but you need to know what  a plan covers, and more importantly, what it does not cover..

Major Medical

ACA major medical health insurance plans , also known known as Obamacare, or Marketplace insurance 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.  Depending on your income,you may also qualify for a subsidy. ACA plans are the only form of insurance that covers pre-existing conditions from day one.

Short-Term Medical

Short-term medical insurance is typically seen as a temporary solution, as these plans do not have the minimum essential coverage requirements of  ACA health plans. As of October of 2018, short-term plans are now available in  90- day, 180- day and 364-day terms and in some cases, are renewable for up to 3 years.  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. .You will need to qualify as medical underwriting is required.  Premiums are typically 20-40% lower than ACA plans depending on your age bracket. Pre-existing conditions are not covered as these plans are not guaranteed issue .Coverage limits are typically $600,000 to $2,000,000 per term.

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 but are not meant to be a stand- alone policy, . Reimbursements are typically paid directly to you so you can spend the benefits as you see fit.

Cancer Plans

Cancer plans are cash benefit plans paid directly to the covered person for a first diagnosis of an  internal Cancer or malignant melanoma (this excludes all other skin Cancer); provided the diagnosis is made in the U.S. and  occurs after the waiting period, which is usually 30 days. Premiums will not increase with age and policies are guaranteed renewable until covered person’s one-time cash benefit is paid Benefit paid upon written satisfactory proof of first-time diagnosis of cancer while policy is in force.

Critical Illness Plans

A critical illness protection policy that pays a lump sum benefit directly to you upon first diagnosis of a critical illness including:

Major Organ Transplant

Heart Attack

Total Loss of Eyesight

Stroke

Total Loss of Hearing

End Stage Renal Failure

Critical Illness policies doe not cover any disease or injury involving the cardiovascular system except heart attack and stroke.  The following are not covered:

Transient Ischemic Attack (TIA)
Attacks of Vertebrobasilar Ischemia
Cerebral Symptoms Due to Migraine
Cerebral Injury Resulting from Trauma or Hypoxia
Vascular disease affecting the eye or optic nerve

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

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Contact Info

PBC Insurance Group

9010 Alister Blvd. East
Palm Beach Gardens, FL 33418
Phone: (561) 633-9248

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