Health
What's Medicare?
Medicare is the federal health insurance program for:
- People who are 65 or older
- Certain younger people with disabilities
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
What are the parts of Medicare?
The different parts of Medicare help cover specific services:
- Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. - Medicare Part B (Medical Insurance)
Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. - Medicare Part D (prescription drug coverage)
Helps cover the cost of prescription drugs (including many recommended shots or vaccines).
Medicare Advantage Plans
Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). In most cases, you’ll need to use health care providers who participate in the plan’s network. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services. Some plans offer non-emergency coverage out of network, but typically at a higher cost. Remember, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services.
What is Medicare Supplement Insurance?
Medicare supplement (Medigap) insurance can help pay some of the health care costs that original Medicare does not cover, like copayments, coinsurance, and deductibles.
Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medicare supplement insurance policy pays its share.
A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.
Important Things to Know About Medicare Supplement Coverage
- If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
- You pay the private insurance carrier a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.
- A Medigap policy covers one person. If you and your spouse both want Medigap coverage, we'll work with you to setup two separate policies.
- Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.
Medicaid
Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.
To learn more about Medicare Medicaid or Supplement Insurance coverage that is right for you.
What is Critical Illness Insurance?
Critical illness insurance or critical illness coverage is an insurance product, where the insurer is contracted to typically make a lump sum cash payment if the policyholder is diagnosed with one of the critical illnesses listed in the insurance policy.
The policy may also be structured to pay out regular income and the payout may also be on the policyholder undergoing a surgical procedure, for example, having a heart bypass operation.
Conditions That May be Covered:
- Alzheimer's disease
- blindness
- deafness
- kidney failure
- A major organ transplant
- multiple sclerosis
- HIV/AIDS contracted by blood transfusion or during an operation
- Parkinson's disease
- paralysis of limb
- terminal illness
To learn more about the right critical illness coverage for you.
What is Hospital Indemnity Insurance?
Hospital indemnity insurance is an insurance plan you can purchase separate or in addition to your health insurance plan. In this plan, there will be a monthly premium, just like any other, and if you end up in the hospital, you receive a fixed benefit amount directly to you to help cover the expenses. Depending on the plan you purchase, you could use the benefits for anythig you ma need like medications, coinsurance, transportation, deductibles, rehabilitation or cost that you may have at home, or even costs incurred as you recover.
What Does Hospital Indemnity Insurance Cover?
Hospital indemnity insurance provides a payout to you based on circumstances related to hospitalization. this is different than typical health insurance, which have specifications on covered services. Hospital indemnity insurance can be distributed in whatever way you need so you can prioritize your health.
Hospital Indemnity plans, do not have deductibles, coinsurance or network restrictions. Generally, they payout on circumstance like:
- Intensive care unit (ICU)
- Critical care unit (CCU) confinement.
- Outpatient procedures
- Emergency room,
- Ambulance transport
It all depends on the added benefits purchased more could be covered. It's also family-friendly, meaning plans can cover you, your spouse and your children.
To Learn More about Hospital Indemnity Insurance
What is Dental Insurance?
Dental insurance is designed to pay a portion of the costs associated with dental care. Generally dental offices have a fee schedule, or a list of prices for the dental services or procedures they offer.
Typical Types of Dental Insurance
Indemnity Dental Insurance Plan:
This plan may be helpful when you want to stay with your dentist and he/she does not participate in a dental network. By the very nature of this plan the insurance company generally pays the dentist a percentage of your services according to the policy you purchased. In addition you will want to review the co-payment requirements, waiting periods, stated deductible, annual limitations, graduated percentage scales based on the type of procedure and/or length of time you have owned the policy prior to starting your dental work.
Dental Health Managed Organization (DHMO):
When a dentist signs a contract with a dental insurance company that provider agrees to accept an insurance fee schedule and give their customers a reduced cost for services as an In-Network Provider. Many DHMO insurance plans have little or no waiting periods, no annual maximum benefit limitations, while covering major dental work near the start of the policy period. This plan is sometimes purchased to help defray the high cost of the dental procedures. Some dental insurance plans offer free semi-annual preventative treatment. Fillings, crowns, implants and dentures may have various limitations.
Participating Provider Network (PPO):
Depending on your specific plan, the PPO works similar to a DHMO while using an In-Network facility. However, it allows you to use an Out-of-Network or Non-Participating Provider. Any difference of fees will become the financial responsibility of the patient unless otherwise specified in your dental policy. As noted, some dental insurance plans may have an annual maximum benefit limit. Thus, once the annual maximum benefit is exhausted any additional treatments may become the patient's responsibility. Each year that annual maximum is reissued. The reissued date may vary as a calendar year, company fiscal year, or date of enrollment based on your specific plan.
To learn more about the right dental insurance for you.
What is Vision Insurance?
Vision insurance is a form of insurance that provides coverage for the services rendered by eye care professionals such as ophthalmologists and optometrists.
The typical vision insurance plan provides yearly coverage for eye examinations and partial or full coverage eyeglasses, sunglasses, and contact lenses, with or without copays, depending on the plan chosen.
If you see the big picture, you know how important eye health is to overall well-being. A little attention to those baby blues, browns, greens, or hazels can make all the difference.
We can help you obtain affordable vision coverage including an annual routine eye exam for a low copayment. Plus you get coverage for contact lenses or eyeglass lenses and frames - including designer names.
To Learn More about Vision Insuranc
What is the Affordable Care Act?
The “Affordable Care Act” (ACA) is the name for the comprehensive health care reform law and its amendments. The law addresses health insurance coverage, health care costs, and preventive care. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 and was amended by the Health Care and Education Reconciliation Act on March 30, 2010.
To Learn More about Affordable Care Act
What Is a Group Health Insurance Plan?
Group Insurance health plans provide coverage to a group of members, usually comprised of company employees or members of an organization. Group health members usually receive insurance at a reduced cost because the insurer’s risk is spread across a group of policyholders. There are plans such as these in both the US and Canada.
- Group members receive insurance at a reduced cost because the insurer’s risk is spread across a group of policyholders.
- Plans usually require at least 70% participation in the plan to be valid.
- Premiums are split between the organization and its members, and coverage may be extended to members' families and/or other dependents for an extra cost.
- Employers can enjoy favorable tax benefits for offering group health insurance to their employees.
How Group Health Insurance Works
Group health insurance plans are purchased by companies and organizations and then offered to their members or employees. Plans can only be purchased by groups, which means individuals cannot purchase coverage through these plans. Plans usually require at least 70% participation in the plan to be valid. Because of the many differences—insurers, plan types, costs, and terms and conditions—between plans, no two are ever the same.
Group plans cannot be purchased by individuals and require at least 70% participation by group members.
Once the organization chooses a plan, group members are given the option to accept or decline coverage. In certain areas, plans may come in tiers, where insured parties have the option of taking basic coverage or advanced insurance with add-ons. The premiums are split between the organization and its members based on the plan. Health insurance coverage may also be extended to the immediate family and/or other dependents of group members for an extra cost.
The cost of group health insurance is usually much lower than individual plans because the risk is spread across a higher number of people. Simply put, this type of insurance is cheaper and more affordable than individual plans available on the market because more people buy into the plan.
Group Health Insurance Definition (investopedia.com)
To Learn More about Group Health Insurance