INDIVIDUAL/FAMILY HEALTH INSURANCE
There are several affordable health plans available that are emerging and gaining in popularity in the market for Individuals and families. We will help you understand the coverage and cost differences between the different plans. We specialize in consulting with you to find just the right plan. Below are a few common terms used when picking a plan.
- Indemnity (Fee-for-Service, or FFS) Plans: These medical plans offer the greatest flexibility in choosing your doctors and have the best overall value built into their plans. The limitation with Indemnity plans exists in the amount of the reimbursement that an insured party can receive to cover medical expenses. The medical expense reimbursement amount can range from a per-day cost and set percentage to the actual costs of the medical expenses. Many of these are hybrids and are adjusting PPO and POS components.
- Short Term Plans: Short term plans tend to fall under the PPO umbrella but closely resemble a medical major plan in that they will have a deductible option and copay. They will have a limited time frame depending on your state that you will have to requalify for to renew.
- ACA/Obamacare plans - was signed into law in March 2010. It was designed to extend health insurance coverage to millions of uninsured Americans. ... It prevents insurance companies from denying coverage due to pre-existing conditions and requires plans to cover a list of essential health benefits. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level.
- Preferred Provider Organizations (PPOs): These plans contract with a network of hospitals and doctors who provide services at a negotiated rate. This means you have access to any PPO provider in the network, whether a primary care physician or specialist. PPO members can go to doctors or hospitals that are not in the network but may have to pay a higher cost for doing so. This is a great option if you are looking for insurance that is both affordable and flexible.
- Point of Service (POS) Plans: These medical plans are a combination of the PPO and HMO models. Like an HMO, there is a PCP providing referrals to in-network doctors. Like a PPO, you can see providers outside the network and pay more of the cost.
- Health Maintenance Organization: Typically require a copayment fee of non-preventative visits. Must see your primary care provider (PCP) for a referral to a specialist. Networks are more limited.