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Understanding Individual & Family Health Insurance

Health insurance is a good way to help you manage your health care costs. You pay health care companies premiums – a set amount of money each month – and you get benefits to pay for your eligible health care expenses. This can include regular doctor checkups or injuries to treatment for long-term illnesses.
Because health care can be expensive, it’s a smart idea to have health insurance so you’re prepared for when you or your family have medical needs.
Health insurance can be broken down to Medical insurance, Dental insurance, and Vision insurance based on what it covers. It also can be broken down to Individual & Family Health Insurance, Group Health Insurance, and Senior Health Insurance based on who it is for. Typically, Medical insurance is provided through various plan types such as HMO, PPO, or EPO.
Whether you need Individual & Family Health Insurance or Group Health Insurance or Senior Health Insurance, we are here for you and do our best to help you find the perfect health insurance solution.

Health Insurance Products:

 

Individual & Family Health Insurance

Individual & Family health insurance is purchased by individuals as opposed to groups such as companies or other kinds of organizations.
Under the Affordable Care Act, also known as Obamacare, there are two kinds of Individual & Family Health Insurance. One is called Off-exchange Individual & Family Health Insurance and the other is called On-exchange Individual & Family Health Insurance. The latter refers to the health insurance plans sold through the marketplace such as Covered CA. If you purchase your Individual & Family Health Insurance through Covered CA, you may qualify for government’s assistance which is also called advanced premium tax credit.
No matter which plan you choose, you’ll pay a monthly payment (premium) to keep your health insurance coverage. You may also pay each time you receive medical care (co-payment or co-insurance). Generally, the more you pay per month (premium), the lower your deductibles and out-of-pocket costs.
When you’re looking at health insurance plans, the biggest differences are in the services they cover and how much they’ll pay for those services. With some plans, you’ll pay a certain amount when you have a service – that can be called a co-payment or coinsurance, depending on your plan.

Covered Califonia

Click to learn more about Covered California

Group Health Insurance

Your employees are your greatest investment. And health insurance can be one of the most critical and effective factor in recruiting and retaining talented and dedicated employees, as well as in maintaining productivity and employee satisfaction.
Offering the “right” health insurance plans to your employees is one of the most important decisions you can make as a business owner – keeping employees happy and healthy benefits you in the long run.
Group Health Insurance is typically purchased by an employer and offered to eligible employees and their dependents. Group Health Insurance products are available for both small groups and large groups. Regulations can be different by the state and the group size as well. In most states, small group means up to 50 employees. However, a few states including California and New York define “small group” as up to 100 employees.
Monthly premiums are paid by employers because they are the policy holders, but employers can have employees pay part of their premium.
Once the employer purchases Group Health Insurance and enrolls its employees and/or dependents, those employees and dependents can use the coverage just like Individual & Family Insurance enrollees would.

Senior Health Insurance

There are many Senior Health Insurance options available for those living in California. Whether you choose a Medicare Supplement Plan and Prescription Drug Plan to supplement your basic Medicare or you choose a Medicare Advantage Plan as your primary insurance- you should understand all of your options.

Medicare Advantage Plan:
A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.

Medicare Supplement Plan (Medigap):
Medicare Supplement Plan (Medigap), a plan offered by private insurance companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like co-payments, coinsurance, and deductibles. 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.

Medicare Prescription Drug Plan (Part D):
Medicare Prescription Drug Plan is an add-on plan to the Original Medicare Plan. Access to prescription drugs is the only benefit to Medicare Prescription Drug Plan.

 

For more information:  Tel: (213) 387-5000