Find out how much you can save if you’re eligible to purchase your health insurance with tax credits available through the Affordable Care Act.
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Low premium plans available
Quotes on or off the exchange
Subsidy available if qualified
Continued support throughout the plan year
Always deal with friendly same staff and insurance advisors
What You Need To Know
With the implementation of the Affordable Care Act, following are important changes affecting how you may purchase your health benefits for you and your family.
There is an open enrollment period for the Individual insurance market, meaning you can only purchase health insurance during this enrollment period. Note: You can still purchase non-medical benefits, such as dental, life or disability year round.
Under the new rules of the ACA, you can now add your dependent children up to age 26 on your policy.
It is illegal to be turned down or quoted different rates than anyone else because of a pre-existing condition.
You may be fined a tax penalty for not complying with the requirements of the ACA.
The tax subsidy is only available through the Exchange. If you don’t qualify for a subsidy, then it is likely there is a less expense plan that is better suited to your needs through the private market.
Open Enrollment Begins Nov. 1st and Ends Dec. 15th!
Miss the deadline? If you miss the deadline, there are certain qualifying events in which to enroll for health insurance outside of the enrollment period. For more information, please call our office.
*If consumers do not purchase coverage for 2018, they may have to pay a fee when they file their 2018 income taxes.
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Individual and Family Major Medical Insurance
We offer a variety of individual and family major medical health insurance plans from some of the best carriers in the nation. Below are some of the most common insurance plans available to individuals on the open market that we may recommend, depending on needs.
A Health Maintenance Organization or HMO health plan requires you to appoint a primary care physician and to use doctors and facilities that are affiliated with the HMO. If you use healthcare service providers outside of the HMO, there is a good chance those charges won’t be covered by your policy. 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 Organization or 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.
Catastrophic Plans are great for those healthy individuals who do not expect to need medical care throughout the year, other than routine preventative care (generally available for under age 30). Note catastrophic plans may or may not contain the essential benefits required by the ACA to avoid penalty.
Individual and Family Dental and Vision Plans
Individual Dental Plans
Individual and family dental plans or policies are relatively inexpensive but can go a long way in promoting your overall health. Studies have shown that regular dental exams can not only optimize oral health to prevent cavities and bad breath, they also detect serious medical conditions such as heart disease and diabetes. Some studies have even shown that people who have dental insurance suffer less from depression, than those who do not have coverage.
Dental plans can range from a PPO or HMO to Pre-Paid, Fee-for-Service, and Discount on a variety of diagnostic and preventative care services including cleanings, exams, x-rays, fillings, orthodontia for children, and emergency care while traveling.
Individual Vision Plans
Take care of your eyes with an individual vision plan that can be purchased separately or combined with your major medical insurance. Similar to individual dental policies, vision plans are inexpensive and save money on routine exams, eyeglass frames and lenses, contacts, and even discounts on procedures like LASIK. Monitoring your eye health with regular exams also helps to prevent serious eye diseases like glaucoma and cataracts and also helps to detect early stages of diabetes, high blood pressure, and high cholesterol.
Individual and Family Life Insurance
Protect the people you love the most. When you can’t be there, life Insurance helps pay for your final expenses, your mortgage, your taxes, and the living expenses of your loved ones when they no longer have your income. It can also cover your children’s education and more.
BASIC TYPES OF LIFE INSURANCE
Cash Value: This type of life insurance policy builds up a cash value that has many benefits to the insured, such as borrowing against the policy or building a tax deferred investment income, in addition to paying a death benefit. Whole life, variable life and universal life are all types of cash value life insurance. Cash value insurance is also known as permanent life insurance because it provides coverage for the policyholder’s entire life.
Term Life Policy: This type of coverage does not build cash or investment value. Term life insurance covers you for a set period of time provided you pay the monthly premium, or in some instances, a lump sum in advance. The policy will pay to the named beneficiary the face amount of the policy (set benefit and/or lump sum) upon death of the insured within the stated term. Depending on the policy, it may also make payments upon terminal or critical illness.
Whole Life Policy: This type of coverage combines term life coverage with an investment fund, and as long as you pay your premiums you are covered for life. Part of your premium goes towards the term part that pays a fixed benefit upon your death, and part of your premium goes toward building taxed deferred cash value that you can borrow against. Some whole life policies offer plans in which you can pay a higher premium for a shorter, fixed period of time, such as 20 years, vs. your whole life.
Universal Life Policy: This type of policy combines term insurance with an interest earning money market account. It has flexible terms that let you adjust your payment or coverage amount. Because this account incurs expense charges, you will need to adjust accordingly to make sure your coverage stays active, in the event that the amount in your account becomes insufficient to meet premium payments. You also have the option of building more cash value by paying premiums even when your account has ample funds to cover them.
Variable Life Policy: With this type of coverage, the death benefits for the life insurance policy are based upon how well the investment account it is tied to is performing (stocks, bonds or mutual funds). Higher performance yields higher benefits, wherein poor performance will yield lower or no benefits at all. Some policies offer a separate or extra premium for a set amount to be paid upon death of the insured.
Life Insurance can be complex. We recommend you call us for more details.
Individual and Family Short and Long Term Disability
One of the most important coverages after health insurance to ensure your financial protection is Disability Income Insurance.
While you are in your working years, your most valuable asset is your ability to earn a living. However, statistics show that our chances are greater of becoming disabled than dying between the ages of 25 & 45.
During the time you are unable to work due to a qualifying disability (illness or injury), the replacement of your regular income through the monthly benefit provided by disability insurance helps to maintain your pre-disability lifestyle. Workplaces often provide standard short-term disability (STD) and long-term disability (LTD) insurance to meet federal guidelines. Individual disability income insurance can be customized to meet your needs and considers your occupation, age, income and other factors in determining your cost and monthly benefit payment amount.
Individuals not offered disability through their employer and self-employed individuals who desire disability coverage, can purchase policies.
Those who have disability insurance through their workplace, may wish to consider a “wrap around” disability policy to supplement their employer provided coverage.
STD generally allows for income payments to begin after about a two-week waiting period and will continue to pay until he/she recovers or maxes out the benefits–usually anywhere between one month to two years, depending on the policy.
LTD generally allows for income payments to begin after about a 90-day waiting period, although it could be much longer depending on the policy, but will continue to pay far longer than STD–for a few years, up to age 65, or even for life.
Supplemental Long Term Care Insurance
Long-Term Care (LTC) recipients are not “sick” in the traditional sense. Instead they are unable to perform some or all of the activities of daily living such as: dressing, bathing, eating, getting in/out of bed, toileting, walking or other basic activities. Long-term care encompasses a wide array of services that fall under two general categories – skilled care and personal care. Skilled care is provided when recovering from an illness or an injury.
Personal care helps maintain the daily activities and functions of life.
Long-term care is usually not medical care and generally does not require a doctor or a nurse. The need for LTC is not always age related. Although more than half of all individuals age 65 & over will need LTC at some point, it is important to note that roughly 40% of those receiving LTC today are between the ages of 18 and 64. It is never too early to plan for long-term care.
Long-Term Care services generally are not covered, or covered only minimally, by health insurance, Medicare or Medicaid. The cost of LTC can quickly drain even a large estate and burden those closest to you both financially and emotionally. Long-Term Care insurance can avoid those difficult situations, as well as enabling you to maintain control of your care and your choice of the facilities that best suit your needs, instead of allowing welfare or the government to make your LTC decisions for you. You should be aware that Disability Income Insurance is not designed to cover LTC expenses, but simply replaces part or all of your income during your working years should you become disabled. You need specific coverage to pay for long-term care needs.
Here are examples of what LTC policies may cover:
- Institutional Care: Nursing home, assisted living services residential care facility, hospice care, adult foster home, respite care and more.
- Home Care: Home health care, adult day care, personal care, homemaker services, hospice care, respite care and more.
Supplemental insurance benefits are extra protection (additional insurance products or plans) in which an individual can purchase through their insurance agent to supplement their health and life insurance.
Examples of some popular supplemental coverage individuals may choose to purchase are:
- Long-Term Care
- Dental or Vision Insurance
- Accident & Dismemberment
- Critical Illness
Medicare doesn’t cover all your healthcare costs. Original Medicare (Part A) covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. We offer affordable Medicare Advantage Plans and Medicare Supplement Plans that provide more coverage and/or help fill in that gap between your out-of-pocket healthcare expenses and your wallet.
Here’s how Advantage Plans and Supplement Plans work to offset your costs:
MEDICARE ADVANTAGE PLANS
Medicare Part C: Also known as Medicare Advantage, Part C is a more cost effective Medicare health insurance plan that acts like an HMO or PPO and combines Original Medicare Part A and B together. It is provided through a private carrier and typically provides better coverage than just A and B alone. This policy may have co-pays and deductibles.
People who elect to purchase Medicare Advantage over original Medicare Parts A and B do not need to buy a Medicare Supplement Plan. However, they may find that original Medicare along with a good Medicare Supplement plan may save them more money on their overall healthcare costs. Every situation is unique, therefore it is always a good idea to consult a professional insurance advisor who can assist you in exploring and comparing all of your options.
MEDICARE SUPPLEMENT PLANS
Medicare Supplement Insurance complements your original Medicare plan and will pay some, if not all, of the expenses that Original Medicare Part A and B do not cover. These expenses could be co-pays, coinsurance, deductibles and other excess charges. There are many different types of Medicare Supplement policies available today, offered by many different carriers. Medicare Supplements are standardized by the federal government, meaning that the benefits for these policies, known as Medigap Plan A through N, are all the same regardless of the carrier; the only difference is in the premium. Premiums vary depending on how the carrier prices the policy, which is dependent on different factors such as age or geographical location. Ultimately, the best supplement plan is one that is purchased from a quality carrier, has a low premium and leaves you with the least or no out of pocket expenses. Note: Most of our carriers offer multiple standardized flexible plan designs with a Medicare Part D (prescription drug) coverage option.