Understanding Your Health Insurance Options (click image below)
Generally, there are 2 costs associated with health insurance:
1. What you pay, in the form of your monthly premium, to have the insurance and;
2. What you will pay out-of-pocket when you use your insurance.
Finding the right Health Insurance plan is all about balancing these 2 things. Our goal is to help you find that "Happy Spot" in your budget. The more out-of-pocket financial risk you are willing to accept, (like deductibles, copays & coinsurance), associated with an injury, an illness, prescriptions & doctors visits, the less you will pay to an insurance company to have the insurance coverage.
5 possible types of health insurance protection for you to consider:
1. An Affordable Care Act (ACA)/Obamacare plan, like a Blue Cross Blue Shield, through Access Health CT or the Federal Health Insurance Marketplace. ACA plans are the most comprehensive plans available, covering all pre-existing conditions. Enrollees may qualify for premium assistance (subsidies) to help offset their high cost. Otherwise, ACA plan prices are very expensive for those in the higher income range.
2. IHA Health that offers 12 comprehensive ACA-like plans designed specifically for the self employed & independent contractors. If you are in good or reasonably good health, these plans may be a better fit than a Marketplace plan mentioned above. Rates are based on answers on the Personal Health Questionnaire. Go here for details and plan pricing.
3. A Short-Term Major Medical Plan that usually come with cost sharing in the form of deductibles and co-insurance; just like an ACA plan. In most states you have to medically qualify for STM plans. Terms range from 3 to 12 months depending on state regulations. Some allow you to "piggy-back" additional 12-month terms to extend coverage beyond a year. By definition, they will terminate and subject the insured party to re-apply, which may be risky if a medical condition pops up. Short-Term Medical plans are not offered in every state.
4. An Indemnity Health Plan. Also known as a Defined Benefit Health Plan that pays a specific dollar amount for a covered medical service, like hospitalization, emergency & urgent care, doctors visits, etc. You know ahead of time, how it will pay for medical services. Typically no deductible is involved (unless hospitalized with New Era/Philadelphia America). Leading carriers in this space are New Era/Philadelphia America , Manhattan Life & United Healthcare
5. A Healthcare Sharing Plan These are not actually insurance as they are not subject to insurance regulations like health insurance, but they look very similar in the way medical costs are covered. These organizations facilitate the sharing of healthcare costs among it's members who have common religious or ethical beliefs. Essentially, they involve people helping people. They have a 1-2 year waiting period before pre-existing conditions are covered. They're typically 40-60% less expensive than ACA plans. OneShare Health and Medi-Share are 2 popular choices. Call or email for a brochure and a quote.
Regardless of which way you go, financial consequences are likely to occur when treated for an injury or an illness. These financial consequences may be in the form of :
- Deductibles, coinsurance and copays;
- Loss of income resulting from not working while sick or injured;
- Travelling to and from a healthcare facility;
- Medical services not covered due to using out-of-network healthcare providers, etc.
That's where supplemental coverage can play a part, like:
- Critical Illness insurance;
- Lump Sum Cancer, Heart Attack & Stroke Insurance and;
- Accidental Injury plans.
When you have a medical event covered by one of these supplements, cash benefits are paid directly to you, for you to use however you see fit to offset any financial consequences.
Kevlar, as you may know, is a bullet proof fabric uses by law enforcement operations and the armed services to protect those in harms way. Kevlar vests have steel plating for additional protection of vital organs, like your heart or lungs. If one of the 5 healthcare options above is your "Kevlar" protection, then the supplement coverage, like Critical Illness Insurance, is the "steel plating" for additional protection.
Ask me how you can get insurance protection that is most suitable for you!