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Health insurance covers medical expenses for illnesses, injuries and conditions. But, unlike a plan through an employer, individual health insurance is something you select and pay for on your own.
In essence, health insurance provides a safety net, mitigating the financial burden associated with unexpected medical expenses. It empowers individuals to access necessary healthcare services without worrying excessively about the cost.
Accidents or illnesses can strike at any time, and covering medical expenses out-of-pocket can be overwhelming—medical costs are the leading cause of bankruptcy. Health insurance provides you with access to a network of physicians, hospitals, and other providers who offer reduced rates through your plan. It’s a crucial safeguard for both your physical health and financial well-being.
A Harvard University study found that 62 percent of personal bankruptcies were due to medical expenses. Many of those affected faced rare or serious injuries, with high medical bills depleting their savings, including retirement funds. Health insurance can help cover these costs, protecting policyholders from financial distress. Beyond financial protection, health insurance also ensures access to timely care, helping you recover and maintain your quality of life. This is why having health insurance is so crucial.
Health Insurance is not the only means of keeping you healthy but it is definitely important and beneficial in keeping us healthy and as a preventive tool we can utilize for our healthcare.
Preventive care helps detect or prevent serious diseases and medical problems before they can become major. Annual check-ups, immunizations, and flu shots, as well as certain tests and screenings, are a few examples of preventive care. Health insurance allows us to pay zero to less out of pocket for these check-ups based on your insurance plan.
Take charge of your well-being with wellness services that promote preventive care! Save on services through discount plans that offer reduced rates on fitness, nutrition, and holistic care. Whether you’re looking to maintain a healthy lifestyle, improve your nutrition, or explore holistic treatments like acupuncture and chiropractic care, these wellness plans help you access a wide range of services at a fraction of the cost. Prioritize your health with proactive solutions that keep you feeling your best!
Affordable Care Act (ACA) compliant refers to a major medical health insurance policy that conforms to the regulations set forth in the Affordable Care Act also referred to as (Obamacare).
ACA compliant plans are major medical, comprehensive coverage, that meets all the requirements of the ACA and are the most comprehensive on the market. If you have a chronic illness or face a medical emergency, these plans can help prevent high expenses.
ACA plans provide benefits for inpatient and outpatient, routine doctor visits, prescription drugs, preventative care, and more. These plans are available to almost everyone, and you can’t be denied based on preexisting conditions.
These plans are available on and off the marketplace. Enrollment on these plans ar offered once a year during the Open Enrollment Period or through a Special Enrollment Period. Get health insurance coverage for you or your family.
The Affordable Care Act makes it possible for more people to get inexpensive or free insurance through subsidies.
You can enroll online or schedule your free personalized advising Let’s Talk!
You may qualify for zero to low premium and cost sharing on your health insurance plan. Many people qualify. The factors considered in helping you lower your premium payment and or health insurance cost savings include household income and the number of people in your family.
An example of those who could qualify for premium cost savings:
Individuals with an annual income below $51,520
Couples with a combined annual income below $69,680
Families of four with a combined annual income below $106,000
Need help understanding your options, enrolling, or managing your plan, I am available to assist you. Additional Information available at healthcare.gov
Licensed in: FL; GA, AL, TX; SC; NC; VA; OH, MI; OR; WA; OR
Private health insurance, available for individuals and families, encompasses plans offered by the private sector, distinct from government-run programs.
While some private plans entail medical underwriting and may incorporate pre-existing condition clauses, many employer-sponsored and individual/family private plans align with Affordable Care Act (ACA) standards. These ACA-compliant plans fulfill minimum essential coverage requirements.
In contrast, alternative options like short-term, fixed indemnity, and critical illness policies offer cost-effective benefits but lack the comprehensive coverage of ACA plans and do not qualify as ACA-approved health plans.
On a budget but still need coverage? I can help you find a plan that fits your needs! Preventive care is key—taking care of yourself is the first step in healthcare. Interested in a preventive care plan? Let’s chat!
Short-term plans are not Affordable Care Act (ACA) compliant plans; they do not meet the requirements of ACA and may not cover some of your medical needs, those considered pre-existing medical conditions.
If you are in between jobs and need coverage in the interim (three months).
Having short-term medical insurance can offset medical costs due to illness and emergencies that are unrelated to a preexisting condition. Some of these plans may cover wellness care with a fee for service.
Short-term plans are often significantly less expensive, which can be a major advantage. However, this lower cost comes with some important limitations.
Unlike ACA plans, short-term health insurance is not required to cover the “minimum essential” benefits, such as pre-existing conditions, mental health services, pregnancy, preventive care, and prescription drugs. As a result, these plans typically provide coverage for sudden, unexpected injuries and illnesses, such as a broken bone or hospitalization due to influenza.
It’s important to note that coverage varies by plan, so it’s crucial to thoroughly review the plan’s official documentation, including notices and disclaimers, before applying. Need Personalized advising? Let’s Talk! Schedule your advising.
Indemnity plans are also known as fee-for-service plans. An indemnity policy plan outlines a specific percentage of total charges that the insurance company will pay you for a particular service or type of care but may not cover the full amount. You’ll be responsible for paying the rest.
Medical indemnity health insurance pays a fixed amount for services such as $100 for a doctor visit regardless of the bill for the actual visit.
These plans work exceptionally well when combined with other insurance helping you cover out-of-pocket medical expenses like deductibles, copays, and coinsurance.
Just like short-term health insurance, medical indemnity plans do not meet the requirements of the Affordable Care Act (ACA), they both can be used as stand-alone but do not typically cover preexisting conditions.
Disability insurance provides income protection if you’re unable to work due to illness or injury. It replaces a portion of your lost income, helping you cover essential expenses like rent, bills, and medical costs while you recover. This insurance ensures that you maintain financial stability during difficult times when you can’t earn your regular income.
Disability insurance safeguards your financial well-being by providing a steady income when you’re unable to work due to illness or injury. It helps you maintain your standard of living, cover essential expenses, and avoid depleting your savings. By ensuring you have a reliable income stream during periods of disability, this insurance protects you from financial hardship and supports your long-term financial stability.
Accident health insurance, is a type of coverage that provides financial protection in the event of accidental injuries. It typically covers costs related to unexpected injuries, such as broken bones, burns, concussions, and other injuries resulting from accidents. This insurance can help cover medical expenses, hospitalization, emergency treatment, and sometimes even rehabilitation costs.
Unlike traditional health insurance, accident health insurance focuses specifically on injuries caused by accidents rather than illnesses or general medical care. Some policies also provide lump-sum payouts or daily cash benefits if you are hospitalized or unable to work due to an accident.
Accident health insurance can be a valuable supplement to regular health insurance, especially for individuals with active lifestyles, high-risk jobs, or those seeking additional financial protection for unexpected injuries.
Need more information about Affordable Accident Plans. Let’s Talk!
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Licensed in: FL; GA, AL, TX; SC; NC; VA; OH, MI; OR; WA; OR
Telehealth, provide consultations with healthcare providers, including doctors and specialists, through video or phone calls. It allows patients to consult with healthcare professionals without the need for in-person visits, offering convenience and flexibility.
Here are some common types of care provided through telehealth:
1. Virtual Primary Care: such as routine check-ups, prescription refills, and management of chronic conditions, conducted virtually.
2). Virtual Talk Therapy: Therapeutic sessions and counseling are seamlessly delivered through video or phone calls, promoting accessible mental health support.
3. Digital Prescriptions: Electronic prescribing of medications based on online consultations.
4). Specialist Consultations: Access to specialized care from experts in various fields, through virtual consultations.
5. Virtual Urgent Care: services for minor illnesses, injuries, and common medical concerns.
*Interested in telehealth? Click the links to learn more. There are plans available to fit your needs and budget. Let’s Talk!
This is the amount you pay your health insurance company to keep your coverage active. Most people pay their premium monthly.
Your copayment, or copay, is the flat fee you pay every time you go to the doctor or fill a prescription. It’s usually a relatively small dollar amount. Most plans don’t count your copays toward your health insurance deductible but there are some plans that do. It is important to verify your summary of benefits.
This is a set amount you have to pay toward your medical bills every year before your insurance company starts paying. It varies by plan and some plans have no deductible
This is the percentage of your medical bill you share with your insurance company after you’ve paid your deductible. Unless you have a policy with 100 percent coverage for everything, you have to pay a coinsurance amount. For example, if you have a $100 doctor’s bill and your plan covers 80 percent of it, your coinsurance amount due to the doctor’s office is 20 percent, or $20.
Life events that allow you to obtain or change coverage at any time such as a change in household (marriage, divorce, a new baby, and adopting a child), losing coverage through your employer, moving out of your current coverage area or even gaining citizenship. Qualifying events provide 60 days to buy health insurance coverage from the date of change.
There are special situations that allow you to enroll outside of the Open Enrollment Period and select coverage for the current year or upcoming year. When you experience a qualifying life event, the special enrollment period is a short window of time for you to sign up for health insurance. From the date of the event, you generally have 60 days in which you can buy health coverage that fits your changing needs.
Health insurance is typically only available during the open enrollment window established by the Affordable Care Act (ACA). Generally, November 1 – December 15th to begin January 1, 2022.
If you miss the deadline, you may have to wait until the next open enrollment period to get insurance coverage.
A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts. If the insurance has a pre-existing clause any health condition that already exists will not be covered through your plan. They will only cover medical conditions that are new while on the plan.
A Health Maintenance Organization Plan (HMO) more restrictive managed care with a focus on prevention. These plans usually require you to select a primary care physician (PCP). PCP referral required to see a specialist. No out of network benefits except for emergency room care. In network care only.
An Exclusive Provider Organization (EPO) plan, a broader managed care plan that requires you to use a in network providers but you do not have to select a Primary Care Physician (PCP) and no referral to a specialist is required. No out of network benefits unless for emergency care.
A Preferred Provider Organization (PPO) plan, a less managed care with access to providers in and out of the network. Not required to have a Primary Care Physician (PCP) and no referrals to specialist.
A Point of service plan is combines the benefits of a HMO and PPO plan. It provides care through a specific network of doctors to provide in and out of network coverage. A primary care doctor is required.
Critical illness insurance helps cover costs that traditional insurance might not, such as expenses related to Cancer, Heart Attack, or Stroke. If you’re diagnosed, you’ll receive a lump sum payment directly to use as you see fit. For instance, a stroke could leave you unable to work while you recover—do you have funds set aside for this? If not, a critical illness plan can provide essential support for you and your family.
Supplement your health insurance with a plan that pays you cash in the event of a illness. Critical illness insurance pays a lump sum benefit if you are diagnosed with a condition listed in the policy terms. You choose how you spend the money.
Dental insurance makes dental care affordable, covering costs for preventive care and procedures like crowns, bridges, and fillings.
Vision insurance enhances affordability for eye care, encompassing routine exams, eyeglasses, and contact lenses within your budget.
Travel Medical Insurance provides peace of mind to world travelers and expats living a global lifestyle by providing access to an elite network of providers.
Your current health insurance likely doesn’t cover medical care while traveling abroad. If it does, coverage is typically limited to emergencies, requiring you to pay out-of-pocket first and then submit a claim for potential reimbursement—which may not cover all of your expenses.
Licensed in: FL; GA, AL, TX; SC; NC; VA; OH, MI; OR; WA; OR
As your virtual insurance advisor, I’m eager to support you with your health insurance requirements. While our interactions are virtual, expect a personal and professional experience throughout.
I offer professional, client service-driven insurance advising.