Selecting the right health insurance can be confusing, stressful, not to mention expensive in today’s health insurance landscape. Determining the right health coverage really depends on your situation. We are here to help. We consider your anticipated healthcare needs and if you qualify for financial help (tax subsidies), or if you have a pre-existing condition, we may recommend a comprehensive health plan from one of our top carriers on or off the Marketplace(Healthcare.gov). No matter your situation, our experienced health insurance agents are here to help you find affordable healthcare coverage.
Today’s comprehensive major medical plans are typically categorized as Bronze, Silver, Gold, and Platinum, which differ in their premium and cost-sharing amounts, with Bronze being the most affordable with low premiums, but higher deductibles, and Platinum offering the highest level of coverage and the lowest out-of-pocket costs for users, but also the highest monthly premiums. Click the tabs below to learn more.
A Health Maintenance Organization plan (HMO) offers lower premiums and a significant savings on routine and preventative healthcare. However, this type of health plan requires you to appoint a primary care physician and to use doctors and facilities that are affiliated with the HMO. Thus, if you use healthcare service providers outside of the HMO, there is a good chance those charges won’t be covered by your policy. But, the great thing about an HMO is that the only charges you incur, outside of your premiums, are co-pays for doctor’s visits and other services such as procedures and prescriptions.
A Preferred Provider Plan (PPO) will save you money on services if you use the preferred providers within the network. Keep in mind that deductibles must be met on this plan before some services will be covered. The good thing about a PPO is they generally will allow a certain amount of services annually outside of the deductible with a small co-pay, and most often the PPO has a large network with quality care providers and excellent prescription drug coverage.
POS plans combine features of HMOs and PPOs. Most Point of Service Plans (POS) plans require members to choose a primary care physician from within the POS network, but allow them to use out-of-network specialists with a referral from a primary care physician. Co-payments will be higher for out-of-network services.
A Health Savings Account Plan (HSA) works by tying a tax-advantaged bank account to certain high-deductible health plans. It allows you to use tax free dollars to pay for allowable health expenses, such as copays, prescription drug costs and more.
Per rules of the Affordable Care Act, most insurers include wellness benefits in their comprehensive coverage, designed to improve lives and keep members healthy. Your plan from the Marketplace will generally include services like preventative screenings, free or discounted gym memberships, diet advice, disease management, telehealth, and much more.
We work with many of the top Health Insurance carriers to offer plans that suit different healthcare needs and budgets. Our guidance is completely free, and your premiums are never higher when working with one of our experienced Health Insurance agents.
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I/We do not offer every plan available in your area. Any information I/we provide is limited to the plans I/we do offer in your area. Please contact Medicare.gov or 1-800-Medicare to get information on all of your options. Doyle-Crow & Associates, or it’s Agents, are not part of the Federal Government Medicare System. The content in on this website has not been reviewed or approved by Medicare.
The public health insurance Marketplace (also referred to as an “Exchange”) is where you can purchase health insurance (also known as Obama Care) for you and your family. A plan from the marketplace is considered a comprehensive major medical plan and also contains the essential health benefits (see below) as established under the Affordable Care Act (ACA) law.
The essential health benefits are as follows:
-Ambulatory patient services
-Emergency services
-Hospitalization-Maternity and newborn care
-Prescription Drugs
-Mental health and Substance Abuse disorder services
-Rehabilitative and habilitative services and devices
-Pediatric services, including oral and vision care
-Preventive and wellness services, and chronic disease management