Health insurance policies come in various forms. Two of the most common policies are major medical and short term (interim) major medical. These policies cover basically everything from doctor visits, prescriptions to hospitalizations and surgeries.
Major Medical Policies
These policies are offered by many insurance companies with various options and exclusions. The typical policy covers you for doctor visits, (well or sick), prescriptions (RX card), urgent care facilities, x-ray, imaging, surgeries and hospitalizations (inpatient and outpatient).
There are three basic types of major medical policies. They range from basic indemnity (go anywhere) plans; Preferred Provider Organization (PPO “network”) plans to Health Maintenance Organizations (HMO “must” stay in network) plans. They all protect you financially but how you are covered and what choices you have can vary greatly.
Preferred Providers Organizations (PPO’s)
PPO policies offer you the ability to choose providers, facilities and hospitals but give you incentives to choose within a “PPO” network of providers. The policy gives you more coverage when you choose providers within their designated networks. The PPO networks have arranged for significant (40% – 60%) discounts for all services.
Health Maintenance Organizations (HMO’s)
HMO’s allow you to choose your primary care physician from their limited physician list. Your primary care physician will direct your care within the HMO system. You DO NOT have the ability to go outside their system except for emergencies ONLY.
2017 Obamacare Health Plans (All HMO’s)
Every policy written since 1/1/2014 is compliant with the Affordable Care Act (Obamacare). It does not matter if it is written direct with a carrier or ON the exchange (healthcare.gov). To get a quote, click on the link below.
Obamacare Alternatives
SHORT TERM medical policies will still be available for purchase to those who can medically qualify (do not have pre-existing conditions). These plans cover you in the case of an illness or injury, but do NOT cover pre-existing conditions, well visits, preventative care, etc. They do NOT qualify as an approved plan to avoid the penalty for not having insurance.
United HealthCare Short Term (up to six months, one time renewal with re-qualification)
IHC Short Term (up to six months, one time renewal with re-qualification)
National General Short Term (up to 11 months)
Altrua
Altrua is a health insurance alternative that is exempt from the Affordable Care Act (no tax penalty). It is a faith-based solution that has been around for 30 years called Health Care Sharing Ministries (HCSM). It is very affordable but you MUST abide by a strict Statement of Standards. It is an underwritten policy, meaning you have to medically qualify and be accepted.
Self Employed/Small Group Insurance
If you are self-employed with at least 1 (non-spouse) W-2 employee, small group insurance may be available. Small group insurance is guaranteed issue, usually has cheaper premiums, and has a wide variety of PPO and HMO plans available. If you think you qualify as a small group, please contact our office.