INDIVIDUAL HEALTH INSURANCE

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Generally speaking, if you want to purchase major medical insurance with no coverage limits including both doctor-visits and prescriptions, you must purchase a qualifying plan under the Affordable Care Act or ACA, also known as Obamacare. Generally, you can do that only one time per year between November 1 and December 15. Since only ACA coverage can provide those things, so if you received a quote that sounds too good to be true, it probably is. That’s not to say there are no other health insurance options, but alternative options will have some coverage limits.

DEFINED benefit plans

Defined benefit plans are the newest, latest and greatest in the health insurance world. Because of increasing rates in health insurance premiums, especially for those who don’t qualify for a subsidy, defined benefit plans are the answer. These plans not only provide network pricing and negotiated rate, but also include an element of indemnity coverage to pay for medical bills. These are sometimes confused with LIMITED BENEFIT PLANS, which are essentially nothing more than a discount plan. Most of the too-good-to-be-true plans that are out there fall into this category, but DEFINED BENEFIT PLANS are real, true health insurance. Check out the details or get in touch with a broker to determine if it’s right for you.

ACA COMPLIANT COVERAGE

This coverage, also called Obamacare, is full-benefit coverage including doctor-visits, prescriptions, and no policy limits. Generally, you will need to qualify for an SEP or Special Enrollment Period to buy one of these plans outside of the open-enrollment between Nov 1 and Dec 15 each year. If you think you qualify for an SEP, contact us and let’s find out.

Short term renewable health plans

These plans provide coverage in six-month increments and must be renewed every 6- months. In some states, these plans can auto-renew, and in others, you must renew them. Some of these plans have doctor-visits built in, but others don’t. All of these plans come with negotiated rate prescription coverage. These plans are not for everyone, so get in touch so we can discuss if you qualify and if it’s the right plan for you.

Negotiated rate plans

These plans provide no actual coverage, but instead provide you a negotiated rate when going to the doctor, hospital, or when picking up prescriptions. These plans should only be used by people who have enough money to pay their own medical bills, including hospitals stays, as even with the negotiated rate, the cost would be excessive for even the smallest things. Contact us so we can talk more about this option.