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Understanding Health Insurance
What Are The Advantages Of Individual Health Insurance?
The advantage to having an individual plan is you can tailor it to meet your needs and you can make changes as needed. We help you select a plan that has your doctors in the network and your prescriptions covered. No worries if you are self-employed, in between jobs, or unemployed. Individual plans cover individuals and families from birth and up.
Types Of Individual Plans We Can Help With
Marketplace Plans
(ACA, Obamacare, Healthcare.gov)
It is a service offered by the federal government to help individuals and families secure health insurance that is not offered group coverage. Individuals with incomes that fall between 100% and 400% of the federal poverty level may qualify for premium tax credits to lower their premiums.
Marketplace plans provide coverage for preexisting conditions and offer essential healthy benefits. Call us today to see if you qualify for lower costs.
Short-Term Plans
Temporary Health Coverage
Short-term plans are designed to help you when you don't need coverage for an entire year. We represent PPO plans that provide nationwide coverage.
Short Term plans are medically underwritten and do not cover the essential healthy benefits that marketplace plans cover. These plans can be tailored with a deductible and co-insurance that meets your needs and your budget. Some plans provide copays for office visits, urgent care, and generic prescriptions. Allow us to provide you a quote for those in-between moments.
Understanding The Types Of Insurance Plans
HMO
What is an HMO (Health Maintenance Organization) plan?
An HMO plan requires you to use in-network providers and to coordinate your care through your primary care physician. Referrals are required to see a specialist. Out-of-network benefits are only available in an emergency. HMOs are less expensive, have lower deductibles, and coinsurance.
PPO
What is a PPO (Preferred Provider Organization) plan?
A PPO plan does not require a primary care physician and referrals to specialists are not needed. PPO plans typically have a nationwide network and offer out-of-network benefits. Out-of-network providers are subject to an out-of-network deductible. You generally pay more for your services when seeing an out-of-network provider and may have to file your claim with the insurance company. PPO plans cost more, offer the most flexibility, and are ideal for those who like to travel.
EPO
What is an EPO (Exclusive Provider Organization) plan?
An EPO plan does not require a primary care physician or referrals to see a specialist. In-network providers are required and out-of-network benefits are only available in an emergency. EPOs are less expensive than PPO plans and offer flexibility with seeing in-network providers.
Not Enrolled?
When Can I Enroll Into A Marketplace Plan?
Open enrollment starts on November 1st and ends on January 15th of every year. What happens if you need coverage outside of open enrollment? Marketplace plans can be added or changed with a certain life event such as losing coverage, getting married, having a baby, adopting a child, moving, or if your household income is below a certain amount. This is called a special enrollment period. We love helping with life's transitions.
Avail Makes It Easier
Don't Navigate Healthcare.gov On Your Own?
We are certified to help calculate subsidies and have the experience you need to help you compare all the plans available on Healthcare.gov. Best of all our services will not cost you any additional premium. Give us a call now we are ready to help.
Commonly Asked Questions
Find answers to generally asked questions
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What is a PCP?A PCP is a primary care physician that you see to maintain your health. By seeing a PCP regularly you can maintain better health and lower your healthcare costs.
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What is maximum out of pocket?The maximum out of pocket is the cap that you have to pay in covered health services before the plan pays 100% of covered services for the year.
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What is a deductible?A deductible is the amount that you pay for covered health services before the plan starts to pay.
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What is co-insurance?A percentage that you pay for covered health services after your deductible has been met.
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What is a co-pay?A fixed amount you pay for covered health services after your deductible has been met.
Call Us To Speak To An Agent Today
We are here to help you understand how the plans work, so feel free to ask us as many questions as you like. There is never a fee for our services.
(813) 450-8084
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