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Category: health

What does health insurance cover?

Prior to the Affordable Care Act’s (ACA) passage, this question would have been substantially more difficult to answer. Up until its passage, each health insurance plan could include or exclude whatever they choose. The ACA brought clarity and regulatory standards with regard to the required types of coverage offered to members. It requires that all permanent health insurance plans provide coverage for the following ten “essential benefits”:  

Ambulatory Patient Services: When you receive non-hospital outpatient medical care, which may include advanced procedures and technological services. This includes such services as diagnosis, observation, consultation, treatment, intervention, and rehabilitation services.


Emergency Services: Your provider can’t require that you contact a hospital prior to an emergency to see if they are an approved hospital. If you’re experiencing a medical emergency, proceed to the closest hospital available. Health insurance coverage must include emergency services provided from any hospital, regardless of whether they are in-network or not. 


Hospitalization: If you are required to stay overnight in a hospital, or find yourself in need of a surgery, or prescription drugs while in the hospital, then your health provider is required to provide coverage. 


Pregnancy, Maternity and Newborn Care: Yes, pregnancy is a required coverage by the ACA mandate and that includes before birth and after birth care. It also includes labor and pregnancy complications.


Mental Health and Substance Abuse Treatments: Health insurance providers now must provide coverage for substance abuse and behavioral therapy, as well as inpatient mental health services.  There is also protection that prevents insurance companies from placing lifetime limits for any specific disorder or substance abuse issue.

Prescription Drugs: Health insurance providers can’t exclude coverage for prescription drugs. They do have an option referred to as “step therapy”, which allows them to require patients to try comparable medications which cost less before agreeing to cover more expensive or potentially habit forming prescription drugs. 


Rehabilitative Services and Devices: These include therapies such as physical therapy, occupational therapy and mobility devices.


Laboratory Services: Health insurance providers must provide coverage for outpatient bloodwork and imaging that you receive in a hospital or medical facility such as an upper GI scan or x-rays.


Preventive Services and Wellness Screenings: Many health insurance plan providers offer these services for free and they include services such as annual physicals, vaccinations and booster shots. 


Pediatric Services: Insurance providers are required to include health, vision and dental services to children covered on your plan. It’s important to note that this only applies to children and the ACA does not provide a mandate on these coverages for adults. You may find them offered separately as an add-on service to include adult coverage for an additional cost. 


Your plan must also include the following benefits for women:

  • Breastfeeding Support: This includes counseling and equipment for nursing mothers.
  • Birth Control: ACA-compliant plans must include prescribed FDA-approved contraceptive methods. This includes emergency contraceptives but does not include drugs intended to terminate an already viable pregnancy.

Your employer may be exempt from covering certain contraceptives if you work for a house of worship or a religious non-profit.

What Does Health Insurance Not Cover?

Illustration of married couple being surprised by not having health insurance coverage.

Most health insurance plans don’t cover the following benefits:


Male Birth Control: Vasectomies and barrier methods for men are not covered under most plans. While female birth control is considered an essential benefit, male birth control is not. 


Travel Vaccinations: Travel vaccinations are viewed as elective prevention and not covered under most plans.


Vision and Dental Coverages: These coverages are required to be provided for children but not adults. You may want to check to see if your provider offers this as an add-on service. 


Weight Loss Surgery: Bariatric surgery is not required by the federal mandate but many insurance providers do elect to include this coverage. Be sure to contact your health provider to confirm if it’s covered before enrolling, if you or a loved one is considering this procedure. 


Cosmetic Surgery: Since cosmetic surgeries are not medically necessary and are based on elective selection, cosmetic procedures are not covered by health insurance mandate.  


As you can see by reviewing the above list, the benefits which are mandated and required to be included by coverage providers are each based on the concept of essential services and/or essential benefits. If a procedure or service is not deemed essential or necessary, it generally is not going to make the list and be covered by most insurance providers. Keep in mind, the above non-covered medical procedures and services is simply a partial list of medical treatments which are not covered. It’s by no means a comprehensive list and only to be used as a basic list of common areas not covered. If you find yourself in any doubt, it’s always best to contact your health insurance provider and inquire with them about specific plan coverages.

Speak with a licensed agent today. We're here to answer all of your questions.

Choosing the right life & health insurance coverage for your family is a great way to protect your loved ones. Our licensed agents are here to help. Contact us today to get answers to your important life & health insurance questions. 

By Samantha Devanehealth
Open Enrollment

Why Can’t You Purchase Health Insurance All Year Long?

What's the point of open enrollment periods?

If you’ve ever been told you can’t purchase health insurance because it’s not the open enrollment period, you may be wondering why would anyone design a business with such bizarre limitations.

Illustration of businesses only opening between certain months of the year.

Imagine only being able to order a pizza between certain months of the year…that’s kind of weird, right? Sure, we like pizza in November but we also like pizza in July, and March and…well, come to think of it, I can’t think of any month out of the year that I would not like pizza. How about you? 

As strange as this may sound, when it comes to signing up or enrolling for Health Insurance, there really are specific weeks of the year when we are permitted to enroll. And if you attempt to enroll outside of this open period, you may just find yourself feeling locked out, and peeking through the windows and wondering, what’s up with this strange industry that doesn’t want to accept my money?

Most recently, our previous open enrollment dates began on Nov 1, 2020 and ended on Dec 15, 2020. You may find there were a few states which extended their open enrollment period and provided some avenues for those who missed the deadline, most did not.

And this is not just limited to enrolling into the Affordable Care Act offered through your state’s exchange, it’s true for most all types of health insurance, including Medicare.

It also includes other situations like, let’s say you choose to not enroll with your company’s health insurance when you were hired, but then later in the year or maybe the next year you decide to change your mind. Depending on what time of the year it is, and the terms of your company’s policy, you’ll likely find that you can only enroll during a very specific time period each year.

Of course, you could get lucky and end up looking into health insurance just at the right time of the year when the open enrollment period is available, but either way, you’ll likely find out that if you miss the cut off date, you’ll be waiting until the next year’s enrollment period.


ADVERSE SELECTION
What’s the point of these restrictive enrollment periods anyway? In theory the restrictions are the insurance companies way of protecting itself from a concept known as, adverse selection.

In plain English, this means the insurance company would have too many sick people and not enough healthy people.

 

An illustration showing a large group and a small group or people along with an explanation of adverse selection that reads: Adverse selection occurs in health insurance when those who are more likely to need or use health insurance enroll but those who are less likely to need health insurance decide not to enroll.


If given the chance to enroll any time of the year they wanted, the idea is that many healthy people would likely take the risk of not enrolling. That would leave health insurance companies with a disproportionate number of sick and unhealthy people (who would most certainly enroll).

Under this scenario, the average cost of coverage would go up and possibly be unaffordable for those who choose to enroll.

Having a limited enrollment period is the way insurance companies “compress” the decision making process into a “limited time offer” situation.

Sort of like the buy one pizza, get a second pizza free offer you get in the mail, but it’s only good on a certain night of the week. This is usually their slowest pizza sales night. Which may be a Tuesday but definitely not on Friday. Who doesn’t like a good pizza on Friday night?

So, just like the pizza shop that needs sales on Tuesday to help keep them open and to pay the bills, insurance companies need healthy people who pay the same premiums as sick people to offset the cost of paying the medical expenses of all of the unhealthy individuals.

Below is an example using a fictitious story to help with the concept. Bear in mind, this is a hypothetical story, but it may help you to get the general idea.


EXAMPLE of Health Insurance Concept:
ABC Health Insurance Company charges $8000/year for each plan member who enrolls into their health insurance plan.

Let’s agree there are 100 members. If each member is paying $8,000 per year, that’s a total of $800,000 collected for the year.

Now, let’s say ABC Health Insurance needs to pay some of their members medical bills.


MEMBER EXPENSES:

• 5 members need an open heart bypass surgery

• 5 members need dialysis treatment

We’ll need some amount to represent the cost of these services, so for now we will assume the cost for an open heart surgery is $75,000, and the annual cost of dialysis care for a single patient is $90,000.

$75,000 X 5 = $375,000

$90,000 X 5 = $450,000

The total cost to cover the member’s medical care is $825,000.

In the real world, there would be additional factors such as deductibles, and other considerations, but for our illustration and to keep things very basic and simple, we will work with broad numbers.

If the company receives $800,000 throughout the year from their members in the form of monthly premiums, but they spend $825,000 paying medical expenses to hospitals and doctors, they will have a major financial problem, right?

We all understand that making a profit in business is key to a businesses long term survival, and insurance companies are no exception.

As we can clearly see in the example above, health insurance companies require a large amount of healthy customers to cover the sick customers.

In our example, it takes 90 completely healthy customers who have absolutely no medical needs for the year, in order to get close to covering the expense of just 10 sick clients. And while our estimated costs of medical expenses are not exact, we based our cost estimates on numbers published by reputable sources.

Let’s take a look at one example as reported in the LA Times.

Heart bypass surgery costs an average of $75,345 in the United States, compared with $15,742 in the Netherlands and $16,492 in Argentina.  – www.latimes.com

What can we take away from the above example?
We can clearly see that having a high number of healthy people enroll is very important to the insurance companies bottom line and survival.

By requiring that all customers choose whether or not to purchase health insurance within a limited time period each year, it substantially increases the financial risk for individuals who do not enroll.

We all know that medical emergencies are expensive, and a simple medical procedure could easily cost tens of thousands of dollars out of our own pocket, if we are uninsured. It’s this financial risk that works to motivate millions of healthy individuals to enroll into a health insurance plan. The peace of mind that comes from knowing health insurance will decrease their financial risk and possibly save their life, makes signing up during the open enrollment period a strong incentive.

Maximizing the number of people who do enroll helps the insurance company by increasing their ratio of healthy to sick members.  

It’s not a perfect system, but for now, it’s the best option we have going. There are many controversial debates over the best and most optimal way to proceed with respect to health insurance in our country, but no matter how it works out, you can count on our agents to be here to help answer your questions and assist you through the enrollment into a health insurance coverage plan that will work for you.

Speak with a licensed agent today. We're here to answer all of your questions.

Choosing the right life & health insurance coverage for your family is a great way to protect your loved ones. Our licensed agents are here to help. Contact us today to get answers to your important life & health insurance questions. 

By Samantha Devanehealth

Best Cheap Health Insurance California

Cheap Health Insurance in California:

What is Health Insurance?

The purpose of health insurance is to cover the majority of costs related to medical care and treatment of illnesses and injuries; this includes surgical, medical, prescription medication, and some dental expenditure.

If you are unable to work because of an illness or injury, health insurance may reimburse you and/or directly pay your healthcare provider.

Most individuals acquire health insurance through their employer, but you can also receive health insurance privately or through a State exchange. You are likely to encounter different terms that describe your financial responsibility for coverage and payments; these are:

 

Premium:
The monthly payment amount which you pay for health insurance is called a premium. It’s normal to have extra insurance related costs in addition to your monthly premium, such as your deductible, copayments, and coinsurance. 

Because of these additional costs, it’s a good idea to keep in mind when you’re shopping around for your health insurance that the policy with the lowest monthly premium may not end up being the least expensive for you or your family, before the year is over. If you’re anticipating frequent medical visits, it may be to your advantage to pay a slightly higher monthly premium with a lower deductible, than to pay a lower monthly payment with higher deductible. 

 

Deductible:
This is the amount you pay for covered health care services before your insurance plan starts to pay. With a $5,000 deductible, for example, you would pay the first $5,000 of covered services for the year, out of your own pocket. After you pay an amount equal to your deductible amount (deductible amounts do vary depending on your policy), you will then usually pay for a portion of the covered services, this is called a copayment or coinsurance for your covered services.


Copay:
A set amount (for example, $25) that you pay for a covered health care service after you’ve paid your deductible. Let’s say your allowable cost for a doctor’s office visit is $100. Your copayment for a doctor visit is $25.


Coinsurance:
The percentage of costs of a covered health care service that you pay out of pocket. Let’s use an example of 30% and a $2,000 annual deductible. Let’s assume that you’ve paid $2,000 out of pocket towards your health insurance cost for the year. Let’s also assume that your health insurance plan’s allowed amount for an office visit cost is $100 and your coinsurance percentage is 30%. Since you’ve paid your $2,000 deductible: You pay 30% of $100, or $30. In this scenario, if you have not paid your deductible for the year, let’s say you’ve only paid $1200 towards your yearly covered medical expenses, then you would pay the full $100 and that would increase your deductible expense from $1200 out of pocket to $1300 for the year.

By Samantha Devanehealth

Best Cheap Health Insurance Wyoming

Healthcare is changing, but we’re adapting to meet your needs. Our company provides Wyoming with excellent health coverage and affordable plans. Our commitment as a trusted leader in providing health insurance to Wyomingites, will always be to offer excellent customer experiences and to offer value-based products for all of your health insurance needs.

We can help you address crucial medical concerns by providing access to affordable medical coverage for individuals and families. All healthcare inquiries are of course addressed through a network of qualified Health Insurance Providers. By having the proper health insurance, you’ll never have to worry about having access to clinical experts who specialize and practice medicine in the areas that you need, when you need it.

Most health insurance companies that we work with offer access to telemedicine, which means you’ll have 24/7 access to healthcare professionals, online prescription services, and home testing kits. If you do have questions, we invite you to contact us today. Our licensed agents are available to help answer your questions regarding health insurance coverages offered.

Health Insurance Cost in Wyoming

If you’re asking yourself, how much will it cost to purchase a health insurance policy, for myself or my family in Wyoming, let’s take a look at what Wyomans are currently paying. The average individual health insurance premium in Wyoming (for a benchmark plan) is about $881 in 2020 and projected to be $791 in 2021. These estimates are from the Kaiser Family Foundation Health Insurance Marketplace Calculator.

The average premium for a family plan is around $1,020/month. However, it’s important to keep in mind that the monthly premium will vary based on a variety of factors. According to healthcare.gov there are five main factors which can affect a plan’s monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents.

Why Choose Us?

What makes Life & Health Now stand out in today’s market, is our professional and friendly team. Our focus is on delivering value and positive health care shopping experiences to each and every client.

As a team, we don’t settle, and we are all in it together; we apply this thinking to help our customers thrive and live better lives by eliminating their concerns over choosing the right insurance provider.

Cheap Health Insurance in Wyoming:

What is Health Insurance?

The purpose of health insurance is to cover the majority of costs related to medical care and treatment of illnesses and injuries; this includes surgical, medical, prescription medication, and some dental expenditure.

If you are unable to work because of an illness or injury, health insurance may reimburse you and/or directly pay your healthcare provider.

Most individuals acquire health insurance through their employer, but you can also receive health insurance privately or through a State exchange. You are likely to encounter different terms that describe your financial responsibility for coverage and payments; these are:

 

Premium:
The monthly payment amount which you pay for health insurance is called a premium. It’s normal to have extra insurance related costs in addition to your monthly premium, such as your deductible, copayments, and coinsurance. 

Because of these additional costs, it’s a good idea to keep in mind when you’re shopping around for your health insurance that the policy with the lowest monthly premium may not end up being the least expensive for you or your family, before the year is over. If you’re anticipating frequent medical visits, it may be to your advantage to pay a slightly higher monthly premium with a lower deductible, than to pay a lower monthly payment with higher deductible. 

 

Deductible:
This is the amount you pay for covered health care services before your insurance plan starts to pay. With a $5,000 deductible, for example, you would pay the first $5,000 of covered services for the year, out of your own pocket. After you pay an amount equal to your deductible amount (deductible amounts do vary depending on your policy), you will then usually pay for a portion of the covered services, this is called a copayment or coinsurance for your covered services.


Copay:
A set amount (for example, $25) that you pay for a covered health care service after you’ve paid your deductible. Let’s say your allowable cost for a doctor’s office visit is $100. Your copayment for a doctor visit is $25.


Coinsurance:
The percentage of costs of a covered health care service that you pay out of pocket. Let’s use an example of 30% and a $2,000 annual deductible. Let’s assume that you’ve paid $2,000 out of pocket towards your health insurance cost for the year. Let’s also assume that your health insurance plan’s allowed amount for an office visit cost of $100 and your coinsurance percentage is 30%. Since you’ve paid your $2,000 deductible: You pay 30% of $100, or $30. In this scenario, if you had not not paid your deductible for the year, let’s say you’ve only paid $1200 towards your yearly covered medical expenses, then you would pay the full $100 and that would increase your deductible expense from $1200 out of pocket to $1300 for the year.

Types of Health Coverage

Health insurance is offered in a variety of health plan types. Your monthly cost will be determined by the plan that you choose. There are plans where seeing a specialist or other health care providers will require a referral from your primary care physician. 

Below we will review the differences between HMOs, PPOs, EPOs and POS health plans. When shopping for health insurance, you’ll find these are the most common health insurance plans offered today.

  • Health Maintenance Organization (HMO) plans: An HMO is the most affordable option of the three plans. If you’re looking for the best value, this could be the plan for you. The main drawback of an HMO is it also comes with limitations regarding your choice of doctors and healthcare providers. You’ll be assigned to a network of doctors, specialists and health care providers in your area. Should you need or want to see a specialist outside of this network, you’ll need a referral. If you like the idea of trading flexibility in choice for savings, then this may be the plan for you.
  • Preferred Provider Organization (PPO) plans: If it’s the freedom of choosing your own doctor and health care providers that you desire most (and you don’t mind higher monthly premiums), then a PPO plan may be suited for you. You will still have a network of doctors and specialists, and using them can save you money, but should you desire to see a specialist (or any doctor of your own choosing), you can and do not need a referral to do so. You’ll pay a little more for your out of network office visits, but for those who want the most freedom to choose their health care providers, going with a PPO is well worth the additional cost. 
  • Point-of-service (POS) plans:  If you’re looking for a mix of the two plans outlined above (HMO & PPO) then choosing a Point of Service plan could be the ideal plan for you.  As in the PPO plan, with a POS plan, you will be able to see the specialists and/or general practice doctors that you desire, even if they are not part of your plans network. However, similar to a HMO, you will need a doctor’s referral to do so. In short, POS plans cost less than PPO’s, yet they still offer patients the flexibility of seeing the doctors they truly desire. 
  • Exclusive Provider Organization (EPO) plans: An EPO is an exclusive provider organization, and is similar to an HMO but it often does not require a referral to see a specialist.

It’s important to keep in mind that while insurance companies are required by health laws to identify their health insurance products by type, in their plan coverage summaries, one PPO plan may have very different out of pocket expenses for you or your family as well as coverage limits than another plan. Since no two plans are likely to be identical, it’s important when shopping that we don’t just lump all PPO’s or HMO’s (or any other type of health insurance plan) into one generic “bucket”.

As the lines between the various plans (for the purpose of this article we’re referring to, HMO, PPO, EPO and POS plans), it’s becoming increasingly difficult to tell one type from another.

One expert, Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms, had this to say, “You have PPOs with really high cost sharing for out-of-network services, which from a consumer perspective seem a lot like HMOs”.

The “idea” behind using recognizable plan type labels and acronyms was (in general) to provide the public with a fast and easy way to distinguish the level of access it’s members would have to the various providers that are outside of a plan’s network, how much it would cost to see those providers – if desired, and whether or not a referral would be required. However due to a lack of uniformity and regulations with respect to the industry-wide-definitions, and standards that vary from state to state, this leaves insurance companies with a great deal of latitude when it comes to marketing similar plans under different names.

While the above examples are generally true, some experts say, there are PPO plans which don’t offer any out-of-network services at all. While at the same time, there are HMO’s which do in fact offer out-of-network options, which makes it very hard to differentiate from a PPO plan.

Confused yet? We understand, with all of the similarities and minor differences between the most common health plan types, it’s easy to get lost and overwhelmed.

With a lack of clarity and standardization between states in the industry it’s easy to get lost.

A few Important Questions to Ask When Shopping for Health Insurance:

(1) Is there out-of-network coverage?

(2) Will you need a referral to see out-of-network doctors or specialists? 

(3) Does that out-of-network spending count (accrue) toward your out-of-pocket maximum? (Not a requirement but some plans do include it).

What Problems Does Health Insurance Solve?

Having private health insurance provides peace of mind. It assures you and your loved ones, that if health crisis should arise, the insured can be seen by a private care physician or surgeon. Without it, you may find yourself waiting weeks or even months for a referral or operation through federal and/or state health insurance programs such as Medicaid.  Medicaid is a health insurance plan offered by the Federal Government for people with a low income.

Additionally, in these times of COVID-19, your insurance company can help you with telehealth services, testing, outpatient visitation, and inpatient hospital stays. Your insurance provider will monitor the spread of COVID-19 to help keep you informed with updates and safety information at this time.

If you have made it to retirement age without any severe health issues, consider yourself fortunate; however, as we age, the inevitability of declining health becomes a reality. As you plan for retirement, you must consider how you would manage financially having to contend with serious conditions such as diabetes, cancer, or heart disease. When facing a health crisis, you don’t want to add the payment for treatments to the list of things to worry about.


Having health insurance can lower your worries, especially during these difficult times; your health insurance will cover many of the services that would be too costly otherwise. Knowing that you or your family member will have the benefit of choosing a private or semi-private hospital room with doctors and healthcare providers who can look after you, is a peace of mind that health insurance is uniquely designed to provide. 

Speak with a licensed agent today. We're here to answer all of your questions.

Choosing the right health insurance coverage for your family in Wyoming is a big decision. Our licensed agents are here to help. Contact us today to get answers to your important Wyoming health insurance questions. 

By Samantha Devanehealth

Best Cheap Health Insurance Pennsylvania

Healthcare is changing, but we’re adapting to meet your needs. Our company provides Pennsylvania with excellent health coverage and affordable plans. Our commitment as a trusted leader in providing health insurance to Pennsylvanians, will always be to offer excellent customer experiences and to offer value-based products for all of your health insurance needs.

Content Covered On This Page: Find exactly what you're looking for by using any of our direct links.

In a hurry? We understand, if you prefer to just receive a quote right away, you can use our  request and find the lowest cost, cheapest health insurance premium with the coverage that fits you or your family today.

We can help you address crucial medical concerns by providing access to affordable medical coverage for individuals and families. All healthcare inquiries are of course addressed through a network of qualified Health Insurance Providers. By having the proper health insurance, you’ll never have to worry about having access to clinical experts who specialize and practice medicine in the areas that you need, when you need it.

Most health insurance companies that we work with offer access to telemedicine, which means you’ll have 24/7 access to healthcare professionals, online prescription services, and home testing kits. If you do have questions, we invite you to contact us today. Our licensed agents are available to help answer your questions regarding health insurance coverages offered.

Health Insurance Cost in Pennsylvania

If you’re asking yourself, how much will it cost to purchase a health insurance policy, for myself or my family in Pennsylvania, let’s take a look at what Pennsylvanians are currently paying. The average individual health insurance premium in Pennsylvania (for a benchmark plan) is about $459 in 2020 and projected to be $455 in 2021. These estimates are from the Kaiser Family Foundation Health Insurance Marketplace Calculator.

The average premium for a family plan is around $1,020/month. However, it’s important to keep in mind that the monthly premium will vary based on a variety of factors. According to healthcare.gov there are five main factors which can affect a plan’s monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents.

Why Choose Us?

What makes Life & Health Now stand out in today’s market, is our professional and friendly team. Our focus is on delivering value and positive health care shopping experiences to each and every client.

As a team, we don’t settle, and we are all in it together; we apply this thinking to help our customers thrive and live better lives by eliminating their concerns over choosing the right insurance provider.

Cheap Health Insurance in Pennsylvania:

What is Health Insurance?

The purpose of health insurance is to cover the majority of costs related to medical care and treatment of illnesses and injuries; this includes surgical, medical, prescription medication, and some dental expenditure.

If you are unable to work because of an illness or injury, health insurance may reimburse you and/or directly pay your healthcare provider.

Most individuals acquire health insurance through their employer, but you can also receive health insurance privately or through a State exchange. You are likely to encounter different terms that describe your financial responsibility for coverage and payments; these are:

 

Premium:
The monthly payment amount which you pay for health insurance is called a premium. It’s normal to have extra insurance related costs in addition to your monthly premium, such as your deductible, copayments, and coinsurance. 

Because of these additional costs, it’s a good idea to keep in mind when you’re shopping around for your health insurance that the policy with the lowest monthly premium may not end up being the least expensive for you or your family, before the year is over. If you’re anticipating frequent medical visits, it may be to your advantage to pay a slightly higher monthly premium with a lower deductible, than to pay a lower monthly payment with higher deductible. 

 

Deductible:
This is the amount you pay for covered health care services before your insurance plan starts to pay. With a $5,000 deductible, for example, you would pay the first $5,000 of covered services for the year, out of your own pocket. After you pay an amount equal to your deductible amount (deductible amounts do vary depending on your policy), you will then usually pay for a portion of the covered services, this is called a copayment or coinsurance for your covered services.


Copay:
A set amount (for example, $25) that you pay for a covered health care service after you’ve paid your deductible. Let’s say your allowable cost for a doctor’s office visit is $100. Your copayment for a doctor visit is $25.


Coinsurance:
The percentage of costs of a covered health care service that you pay out of pocket. Let’s use an example of 30% and a $2,000 annual deductible. Let’s assume that you’ve paid $2,000 out of pocket towards your health insurance cost for the year. Let’s also assume that your health insurance plan’s allowed amount for an office visit cost is $100 and your coinsurance percentage is 30%. Since you’ve paid your $2,000 deductible: You pay 30% of $100, or $30. In this scenario, if you have not paid your deductible for the year, let’s say you’ve only paid $1200 towards your yearly covered medical expenses, then you would pay the full $100 and that would increase your deductible expense from $1200 out of pocket to $1300 for the year.

Types of Health Coverage

Health insurance is offered in a variety of health plan types. Your monthly cost will be determined by the plan that you choose. There are plans where seeing a specialist or other health care providers will require a referral from your primary care physician. 

Below we will review the differences between HMOs, PPOs, EPOs and POS health plans. When shopping for health insurance, you’ll find these are the most common health insurance plans offered today.

  • Health Maintenance Organization (HMO) plans: An HMO is the most affordable option of the three plans. If you’re looking for the best value, this could be the plan for you. The main drawback of an HMO is it also comes with limitations regarding your choice of doctors and healthcare providers. You’ll be assigned to a network of doctors, specialists and health care providers in your area. Should you need or want to see a specialist outside of this network, you’ll need a referral. If you like the idea of trading flexibility in choice for savings, then this may be the plan for you.
  • Preferred Provider Organization (PPO) plans: If it’s the freedom of choosing your own doctor and health care providers that you desire most (and you don’t mind higher monthly premiums), then a PPO plan may be suited for you. You will still have a network of doctors and specialists, and using them can save you money, but should you desire to see a specialist (or any doctor of your own choosing), you can and do not need a referral to do so. You’ll pay a little more for your out of network office visits, but for those who want the most freedom to choose their health care providers, going with a PPO is well worth the additional cost. 
  • Point-of-service (POS) plans:  If you’re looking for a mix of the two plans outlined above (HMO & PPO) then choosing a Point of Service plan could be the ideal plan for you.  As in the PPO plan, with a POS plan, you will be able to see the specialists and/or general practice doctors that you desire, even if they are not part of your plans network. However, similar to a HMO, you will need a doctor’s referral to do so. In short, POS plans cost less than PPO’s, yet they still offer patients the flexibility of seeing the doctors they truly desire. 
  • Exclusive Provider Organization (EPO) plans: An EPO is an exclusive provider organization, and is similar to an HMO but it often does not require a referral to see a specialist.

It’s important to keep in mind that while insurance companies are required by health laws to identify their health insurance products by type, in their plan coverage summaries, one PPO plan may have very different out of pocket expenses for you or your family as well as coverage limits than another plan. Since no two plans are likely to be identical, it’s important when shopping that we don’t just lump all PPO’s or HMO’s (or any other type of health insurance plan) into one generic “bucket”.

As the lines between the various plans (for the purpose of this article we’re referring to, HMO, PPO, EPO and POS plans), it’s becoming increasingly difficult to tell one type from another.

One expert, Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms, had this to say, “You have PPOs with really high cost sharing for out-of-network services, which from a consumer perspective seem a lot like HMOs”.

The “idea” behind using recognizable plan type labels and acronyms was (in general) to provide the public with a fast and easy way to distinguish the level of access it’s members would have to the various providers that are outside of a plan’s network, how much it would cost to see those providers – if desired, and whether or not a referral would be required. However due to a lack of uniformity and regulations with respect to the industry-wide-definitions, and standards that vary from state to state, this leaves insurance companies with a great deal of latitude when it comes to marketing similar plans under different names.

While the above examples are generally true, some experts say, there are PPO plans which don’t offer any out-of-network services at all. While at the same time, there are HMO’s which do in fact offer out-of-network options, which makes it very hard to differentiate from a PPO plan.

Confused yet? We understand, with all of the similarities and minor differences between the most common health plan types, it’s easy to get lost and overwhelmed.

With a lack of clarity and standardization between states in the industry it’s easy to get lost.

A few Important Questions to Ask When Shopping for Health Insurance:

(1) Is there out-of-network coverage?

(2) Will you need a referral to see out-of-network doctors or specialists? 

(3) Does that out-of-network spending count (accrue) toward your out-of-pocket maximum? (Not a requirement but some plans do include it).

What Problems Does Health Insurance Solve?

Having private health insurance provides peace of mind. It assures you and your loved ones, that if a health crisis should arise, the insured can be seen by a private care physician or surgeon. Without it, you may find yourself waiting weeks or even months for a referral or operation through federal and/or state health insurance programs such as Medicaid.  Medicaid is a health insurance plan offered by the Federal Government for people with a low income.

Additionally, in these times of COVID-19, your insurance company can help you with telehealth services, testing, outpatient visitation, and inpatient hospital stays. Your insurance provider will monitor the spread of COVID-19 to help keep you informed with updates and safety information at this time.

If you have made it to retirement age without any severe health issues, consider yourself fortunate; however, as we age, the inevitability of declining health becomes a reality. As you plan for retirement, you must consider how you would manage financially having to contend with serious conditions such as diabetes, cancer, or heart disease. When facing a health crisis, you don’t want to add the payment for treatments to the list of things to worry about.


Having health insurance can lower your worries, especially during these difficult times; your health insurance will cover many of the services that would be too costly otherwise. Knowing that you or your family member will have the benefit of choosing a private or semi-private hospital room with doctors and healthcare providers who can look after you, is a peace of mind that health insurance is uniquely designed to provide. 

Speak with a licensed agent today. We're here to answer all of your questions.

Choosing the right health insurance coverage for your family in Pennsylvania is a big decision. Our licensed agents are here to help. Contact us today to get answers to your important Pennsylvania health insurance questions. 

By Samantha Devanehealth

Best Cheap Health Insurance Florida

Healthcare is changing, but we’re adapting to meet your needs. Our company provides Florida with excellent health coverage and affordable plans. Our commitment as a trusted leader in providing health insurance to Floridians, will always be to offer excellent customer experiences and to offer value-based products for all of your health insurance needs.

Topics Covered On This Page: Find exactly what you're looking for by using any of our direct links.

In a hurry? We understand, if you prefer to just receive a quote right away, you can use our  request and find the lowest cost, cheapest health insurance premium with the coverage that fits you or your family today.

We can help you address crucial medical concerns by providing access to affordable medical coverage for individuals and families. All healthcare inquiries are of course addressed through a network of qualified Health Insurance Providers. By having the proper health insurance, you’ll never have to worry about having access to clinical experts who specialize and practice medicine in the areas that you need, when you need it.

Most health insurance companies that we work with offer access to telemedicine, which means you’ll have 24/7 access to healthcare professionals, online prescription services, and home testing kits. If you do have questions, we invite you to contact us today. Our licensed agents are available to help answer your questions regarding health insurance coverages offered.

Health Insurance Cost in Florida

If you’re asking yourself, how much will it cost to purchase a health insurance policy, for myself or my family in Florida, let’s take a look at what Floridians are currently paying. The average individual health insurance premium in Florida (for a benchmark plan) is about $468 in 2020 and projected to be $457 in 2021. These estimates are from the Kaiser Family Foundation Health Insurance Marketplace Calculator.

The average premium for a family plan is around $1,020/month. However, it’s important to keep in mind that the monthly premium will vary based on a variety of factors. According to healthcare.gov there are five main factors which can affect a plan’s monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents.

Why Choose Us?

What makes Life & Health Now stand out in today’s market, is our professional and friendly team. Our focus is on delivering value and positive health care shopping experiences to each and every client.

As a team, we don’t settle, and we are all in it together; we apply this thinking to help our customers thrive and live better lives by eliminating their concerns over choosing the right insurance provider.

Cheap Health Insurance in Florida:

What is Health Insurance?

The purpose of health insurance is to cover the majority of costs related to medical care and treatment of illnesses and injuries; this includes surgical, medical, prescription medication, and some dental expenditure.

If you are unable to work because of an illness or injury, health insurance may reimburse you and/or directly pay your healthcare provider.

Most individuals acquire health insurance through their employer, but you can also receive health insurance privately or through a State exchange. You are likely to encounter different terms that describe your financial responsibility for coverage and payments; these are:

 

Premium:
The monthly payment amount which you pay for health insurance is called a premium. It’s normal to have extra insurance related costs in addition to your monthly premium, such as your deductible, copayments, and coinsurance. 

Because of these additional costs, it’s a good idea to keep in mind when you’re shopping around for your health insurance that the policy with the lowest monthly premium may not end up being the least expensive for you or your family, before the year is over. If you’re anticipating frequent medical visits, it may be to your advantage to pay a slightly higher monthly premium with a lower deductible, than to pay a lower monthly payment with higher deductible. 

 

Deductible:
This is the amount you pay for covered health care services before your insurance plan starts to pay. With a $5,000 deductible, for example, you would pay the first $5,000 of covered services for the year, out of your own pocket. After you pay an amount equal to your deductible amount (deductible amounts do vary depending on your policy), you will then usually pay for a portion of the covered services, this is called a copayment or coinsurance for your covered services.


Copay:
A set amount (for example, $25) that you pay for a covered health care service after you’ve paid your deductible. Let’s say your allowable cost for a doctor’s office visit is $100. Your copayment for a doctor visit is $25.


Coinsurance:
The percentage of costs of a covered health care service that you pay out of pocket. Let’s use an example of 30% and a $2,000 annual deductible. Let’s assume that you’ve paid $2,000 out of pocket towards your health insurance cost for the year. Let’s also assume that your health insurance plan’s allowed amount for an office visit cost is $100 and your coinsurance percentage is 30%. Since you’ve paid your $2,000 deductible: You pay 30% of $100, or $30. In this scenario, if you have not paid your deductible for the year, let’s say you’ve only paid $1200 towards your yearly covered medical expenses, then you would pay the full $100 and that would increase your deductible expense from $1200 out of pocket to $1300 for the year.

Types of Health Coverage

Health insurance is offered in a variety of health plan types. Your monthly cost will be determined by the plan that you choose. There are plans where seeing a specialist or other health care providers will require a referral from your primary care physician. 

Below we will review the differences between HMOs, PPOs, EPOs and POS health plans. When shopping for health insurance, you’ll find these are the most common health insurance plans offered today.

 

  • Health Maintenance Organization (HMO) plans: An HMO is the most affordable option of the three plans. If you’re looking for the best value, this could be the plan for you. The main drawback of an HMO is it also comes with limitations regarding your choice of doctors and healthcare providers. You’ll be assigned to a network of doctors, specialists and health care providers in your area. Should you need or want to see a specialist outside of this network, you’ll need a referral. If you like the idea of trading flexibility in choice for savings, then this may be the plan for you.

 

  • Preferred Provider Organization (PPO) plans: If it’s the freedom of choosing your own doctor and health care providers that you desire most (and you don’t mind higher monthly premiums), then a PPO plan may be suited for you. You will still have a network of doctors and specialists, and using them can save you money, but should you desire to see a specialist (or any doctor of your own choosing), you can and do not need a referral to do so. You’ll pay a little more for your out of network office visits, but for those who want the most freedom to choose their health care providers, going with a PPO is well worth the additional cost. 

 

  • Point-of-service (POS) plans:  If you’re looking for a mix of the two plans outlined above (HMO & PPO) then choosing a Point of Service plan could be the ideal plan for you.  As in the PPO plan, with a POS plan, you will be able to see the specialists and/or general practice doctors that you desire, even if they are not part of your plans network. However, similar to a HMO, you will need a doctor’s referral to do so. In short, POS plans cost less than PPO’s, yet they still offer patients the flexibility of seeing the doctors they truly desire. 

 

  • Exclusive Provider Organization (EPO) plans: An EPO is an exclusive provider organization, and is similar to an HMO but it often does not require a referral to see a specialist.

It’s important to keep in mind that while insurance companies are required by health laws to identify their health insurance products by type, in their plan coverage summaries, one PPO plan may have very different out of pocket expenses for you or your family as well as coverage limits than another plan. Since no two plans are likely to be identical, it’s important when shopping that we don’t just lump all PPO’s or HMO’s (or any other type of health insurance plan) into one generic “bucket”.

As the lines between the various plans (for the purpose of this article we’re referring to, HMO, PPO, EPO and POS plans), it’s becoming increasingly difficult to tell one type from another.

One expert, Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms, had this to say, “You have PPOs with really high cost sharing for out-of-network services, which from a consumer perspective seem a lot like HMOs”.

The “idea” behind using recognizable plan type labels and acronyms was (in general) to provide the public with a fast and easy way to distinguish the level of access it’s members would have to the various providers that are outside of a plan’s network, how much it would cost to see those providers – if desired, and whether or not a referral would be required. However due to a lack of uniformity and regulations with respect to the industry-wide-definitions, and standards that vary from state to state, this leaves insurance companies with a great deal of latitude when it comes to marketing similar plans under different names.

While the above examples are generally true, some experts say, there are PPO plans which don’t offer any out-of-network services at all. While at the same time, there are HMO’s which do in fact offer out-of-network options, which makes it very hard to differentiate from a PPO plan.

Confused yet? We understand, with all of the similarities and minor differences between the most common health plan types, it’s easy to get lost and overwhelmed.

With a lack of clarity and standardization between states in the industry it’s easy to get lost.

A few Important Questions to Ask When Shopping for Health Insurance:

(1) Is there out-of-network coverage?

(2) Will you need a referral to see out-of-network doctors or specialists? 

(3) Does that out-of-network spending count (accrue) toward your out-of-pocket maximum? (Not a requirement but some plans do include it).

 

What Problems Does Health Insurance Solve?

Having private health insurance provides peace of mind. It assures you and your loved ones, that if a health crisis should arise, the insured can be seen by a private care physician or surgeon. Without it, you may find yourself waiting weeks or even months for a referral or operation through federal and/or state health insurance programs such as Medicaid.  Medicaid is a health insurance plan offered by the Federal Government for people with a low income.

Additionally, in these times of COVID-19, your insurance company can help you with telehealth services, testing, outpatient visitation, and inpatient hospital stays. Your insurance provider will monitor the spread of COVID-19 to help keep you informed with updates and safety information at this time.

If you have made it to retirement age without any severe health issues, consider yourself fortunate; however, as we age, the inevitability of declining health becomes a reality. As you plan for retirement, you must consider how you would manage financially having to contend with serious conditions such as diabetes, cancer, or heart disease. When facing a health crisis, you don’t want to add the payment for treatments to the list of things to worry about.


Having health insurance can lower your worries, especially during these difficult times; your health insurance will cover many of the services that would be too costly otherwise. Knowing that you or your family member will have the benefit of choosing a private or semi-private hospital room with doctors and healthcare providers who can look after you, is a peace of mind that health insurance is uniquely designed to provide. 

Speak with a licensed agent today. We're here to answer all of your questions.

Choosing the right health insurance coverage for your family in Florida is a big decision. Our licensed agents are here to help. Contact us today to get answers to your important Florida health insurance questions. 

By Samantha Devanehealth

Best Cheap Health Insurance Maine

Cheap Health Insurance in Maine:

What is Health Insurance?

The purpose of health insurance is to cover the majority of costs related to medical care and treatment of illnesses and injuries; this includes surgical, medical, prescription medication, and some dental expenditure.

If you are unable to work because of an illness or injury, health insurance may reimburse you and/or directly pay your healthcare provider.

Most individuals acquire health insurance through their employer, but you can also receive health insurance privately or through a State exchange. You are likely to encounter different terms that describe your financial responsibility for coverage and payments; these are:

 

Premium:
The monthly payment amount which you pay for health insurance is called a premium. It’s normal to have extra insurance related costs in addition to your monthly premium, such as your deductible, copayments, and coinsurance. 

Because of these additional costs, it’s a good idea to keep in mind when you’re shopping around for your health insurance that the policy with the lowest monthly premium may not end up being the least expensive for you or your family, before the year is over. If you’re anticipating frequent medical visits, it may be to your advantage to pay a slightly higher monthly premium with a lower deductible, than to pay a lower monthly payment with higher deductible. 

 

Deductible:
This is the amount you pay for covered health care services before your insurance plan starts to pay. With a $5,000 deductible, for example, you would pay the first $5,000 of covered services for the year, out of your own pocket. After you pay an amount equal to your deductible amount (deductible amounts do vary depending on your policy), you will then usually pay for a portion of the covered services, this is called a copayment or coinsurance for your covered services.


Copay:
A set amount (for example, $25) that you pay for a covered health care service after you’ve paid your deductible. Let’s say your allowable cost for a doctor’s office visit is $100. Your copayment for a doctor visit is $25.


Coinsurance:
The percentage of costs of a covered health care service that you pay out of pocket. Let’s use an example of 30% and a $2,000 annual deductible. Let’s assume that you’ve paid $2,000 out of pocket towards your health insurance cost for the year. Let’s also assume that your health insurance plan’s allowed amount for an office visit cost is $100 and your coinsurance percentage is 30%. Since you’ve paid your $2,000 deductible: You pay 30% of $100, or $30. In this scenario, if you have not paid your deductible for the year, let’s say you’ve only paid $1200 towards your yearly covered medical expenses, then you would pay the full $100 and that would increase your deductible expense from $1200 out of pocket to $1300 for the year.

Types of Health Coverage

Health insurance is offered in a variety of health plan types. Your monthly cost will be determined by the plan that you choose. There are plans where seeing a specialist or other health care providers will require a referral from your primary care physician. 

Below we will review the differences between HMOs, PPOs, EPOs and POS health plans. When shopping for health insurance, you’ll find these are the most common health insurance plans offered today.

  • Health Maintenance Organization (HMO) plans: An HMO is the most affordable option of the three plans. If you’re looking for the best value, this could be the plan for you. The main drawback of an HMO is it also comes with limitations regarding your choice of doctors and healthcare providers. You’ll be assigned to a network of doctors, specialists and health care providers in your area. Should you need or want to see a specialist outside of this network, you’ll need a referral. If you like the idea of trading flexibility in choice for savings, then this may be the plan for you.
  • Preferred Provider Organization (PPO) plans: If it’s the freedom of choosing your own doctor and health care providers that you desire most (and you don’t mind higher monthly premiums), then a PPO plan may be suited for you. You will still have a network of doctors and specialists, and using them can save you money, but should you desire to see a specialist (or any doctor of your own choosing), you can and do not need a referral to do so. You’ll pay a little more for your out of network office visits, but for those who want the most freedom to choose their health care providers, going with a PPO is well worth the additional cost. 
  • Point-of-service (POS) plans:  If you’re looking for a mix of the two plans outlined above (HMO & PPO) then choosing a Point of Service plan could be the ideal plan for you.  As in the PPO plan, with a POS plan, you will be able to see the specialists and/or general practice doctors that you desire, even if they are not part of your plans network. However, similar to a HMO, you will need a doctor’s referral to do so. In short, POS plans cost less than PPO’s, yet they still offer patients the flexibility of seeing the doctors they truly desire. 
  • Exclusive Provider Organization (EPO) plans: An EPO is an exclusive provider organization, and is similar to an HMO but it often does not require a referral to see a specialist.

It’s important to keep in mind that while insurance companies are required by health laws to identify their health insurance products by type, in their plan coverage summaries, one PPO plan may have very different out of pocket expenses for you or your family as well as coverage limits than another plan. Since no two plans are likely to be identical, it’s important when shopping that we don’t just lump all PPO’s or HMO’s (or any other type of health insurance plan) into one generic “bucket”.

As the lines between the various plans (for the purpose of this article we’re referring to, HMO, PPO, EPO and POS plans), it’s becoming increasingly difficult to tell one type from another.

One expert, Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms, had this to say, “You have PPOs with really high cost sharing for out-of-network services, which from a consumer perspective seem a lot like HMOs”.

The “idea” behind using recognizable plan type labels and acronyms was (in general) to provide the public with a fast and easy way to distinguish the level of access it’s members would have to the various providers that are outside of a plan’s network, how much it would cost to see those providers – if desired, and whether or not a referral would be required. However due to a lack of uniformity and regulations with respect to the industry-wide-definitions, and standards that vary from state to state, this leaves insurance companies with a great deal of latitude when it comes to marketing similar plans under different names.

While the above examples are generally true, some experts say, there are PPO plans which don’t offer any out-of-network services at all. While at the same time, there are HMO’s which do in fact offer out-of-network options, which makes it very hard to differentiate from a PPO plan.

Confused yet? We understand, with all of the similarities and minor differences between the most common health plan types, it’s easy to get lost and overwhelmed.

With a lack of clarity and standardization between states in the industry it’s easy to get lost.

A few Important Questions to Ask When Shopping for Health Insurance:

(1) Is there out-of-network coverage?

(2) Will you need a referral to see out-of-network doctors or specialists? 

(3) Does that out-of-network spending count (accrue) toward your out-of-pocket maximum? (Not a requirement but some plans do include it).

By Samantha Devanehealth

Best Cheap Health Insurance Wisconsin

Healthcare is changing, but we’re adapting to meet your needs. Our company provides Wisconsin with excellent health coverage and affordable plans. Our commitment as a trusted leader in providing health insurance to Wisconsonites, will always be to offer excellent customer experiences and to offer value-based products for all of your health insurance needs.

Topics Covered On This Page: Click on any of the links below and proceed directly to the section.

In a hurry? We understand, if you prefer to just receive a quote right away, you can use our  request and find the lowest cost, cheapest health insurance premium with the coverage that fits you or your family today.

We can help you address crucial medical concerns by providing access to affordable medical coverage for individuals and families. All healthcare inquiries are of course addressed through a network of qualified Health Insurance Providers. By having the proper health insurance, you’ll never have to worry about having access to clinical experts who specialize and practice medicine in the areas that you need, when you need it.

Most health insurance companies that we work with offer access to telemedicine, which means you’ll have 24/7 access to healthcare professionals, online prescription services, and home testing kits. If you do have questions, we invite you to contact us today. Our licensed agents are available to help answer your questions regarding health insurance coverages offered.

Health Insurance Cost in Wisconsin

If you’re asking yourself, how much will it cost to purchase a health insurance policy, for myself or my family in Wisconsin, let’s take a look at what Wisconsinites are currently paying. The average individual health insurance premium in Wisconsin (for a benchmark plan) is about $491 in 2020 and projected to be $457 in 2021. These estimates are from the Kaiser Family Foundation Health Insurance Marketplace Calculator.

The average premium for a family plan is around $1,020/month. However, it’s important to keep in mind that the monthly premium will vary based on a variety of factors. According to healthcare.gov there are five main factors which can affect a plan’s monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents.

Why Choose Us?

What makes Life & Health Now stand out in today’s market, is our professional and friendly team. Our focus is on delivering value and positive health care shopping experiences to each and every client.

As a team, we don’t settle, and we are all in it together; we apply this thinking to help our customers thrive and live better lives by eliminating their concerns over choosing the right insurance provider.

Cheap Health Insurance in Wisconsin:

What is Health Insurance?

The purpose of health insurance is to cover the majority of costs related to medical care and treatment of illnesses and injuries; this includes surgical, medical, prescription medication, and some dental expenditure.

If you are unable to work because of an illness or injury, health insurance may reimburse you and/or directly pay your healthcare provider.

Most individuals acquire health insurance through their employer, but you can also receive health insurance privately or through a State exchange. You are likely to encounter different terms that describe your financial responsibility for coverage and payments; these are:

 

Premium:
The monthly payment amount which you pay for health insurance is called a premium. It’s normal to have extra insurance related costs in addition to your monthly premium, such as your deductible, copayments, and coinsurance. 

Because of these additional costs, it’s a good idea to keep in mind when you’re shopping around for your health insurance that the policy with the lowest monthly premium may not end up being the least expensive for you or your family, before the year is over. If you’re anticipating frequent medical visits, it may be to your advantage to pay a slightly higher monthly premium with a lower deductible, than to pay a lower monthly payment with higher deductible. 

 

Deductible:
This is the amount you pay for covered health care services before your insurance plan starts to pay. With a $5,000 deductible, for example, you would pay the first $5,000 of covered services for the year, out of your own pocket. After you pay an amount equal to your deductible amount (deductible amounts do vary depending on your policy), you will then usually pay for a portion of the covered services, this is called a copayment or coinsurance for your covered services.


Copay:
A set amount (for example, $25) that you pay for a covered health care service after you’ve paid your deductible. Let’s say your allowable cost for a doctor’s office visit is $100. Your copayment for a doctor visit is $25.


Coinsurance:
The percentage of costs of a covered health care service that you pay out of pocket. Let’s use an example of 30% and a $2,000 annual deductible. Let’s assume that you’ve paid $2,000 out of pocket towards your health insurance cost for the year. Let’s also assume that your health insurance plan’s allowed amount for an office visit cost is $100 and your coinsurance percentage is 30%. Since you’ve paid your $2,000 deductible: You pay 30% of $100, or $30. In this scenario, if you have not paid your deductible for the year, let’s say you’ve only paid $1200 towards your yearly covered medical expenses, then you would pay the full $100 and that would increase your deductible expense from $1200 out of pocket to $1300 for the year.

Types of Health Coverage

Health insurance is offered in a variety of health plan types. Your monthly cost will be determined by the plan that you choose. There are plans where seeing a specialist or other health care providers will require a referral from your primary care physician. 

Below we will review the differences between HMOs, PPOs, EPOs and POS health plans. When shopping for health insurance, you’ll find these are the most common health insurance plans offered today.

  • Health Maintenance Organization (HMO) plans: An HMO is the most affordable option of the three plans. If you’re looking for the best value, this could be the plan for you. The main drawback of an HMO is it also comes with limitations regarding your choice of doctors and healthcare providers. You’ll be assigned to a network of doctors, specialists and health care providers in your area. Should you need or want to see a specialist outside of this network, you’ll need a referral. If you like the idea of trading flexibility in choice for savings, then this may be the plan for you.
  • Preferred Provider Organization (PPO) plans: If it’s the freedom of choosing your own doctor and health care providers that you desire most (and you don’t mind higher monthly premiums), then a PPO plan may be suited for you. You will still have a network of doctors and specialists, and using them can save you money, but should you desire to see a specialist (or any doctor of your own choosing), you can and do not need a referral to do so. You’ll pay a little more for your out of network office visits, but for those who want the most freedom to choose their health care providers, going with a PPO is well worth the additional cost. 
  • Point-of-service (POS) plans:  If you’re looking for a mix of the two plans outlined above (HMO & PPO) then choosing a Point of Service plan could be the ideal plan for you.  As in the PPO plan, with a POS plan, you will be able to see the specialists and/or general practice doctors that you desire, even if they are not part of your plans network. However, similar to a HMO, you will need a doctor’s referral to do so. In short, POS plans cost less than PPO’s, yet they still offer patients the flexibility of seeing the doctors they truly desire. 
  • Exclusive Provider Organization (EPO) plans: An EPO is an exclusive provider organization, and is similar to an HMO but it often does not require a referral to see a specialist.

It’s important to keep in mind that while insurance companies are required by health laws to identify their health insurance products by type, in their plan coverage summaries, one PPO plan may have very different out of pocket expenses for you or your family as well as coverage limits than another plan. Since no two plans are likely to be identical, it’s important when shopping that we don’t just lump all PPO’s or HMO’s (or any other type of health insurance plan) into one generic “bucket”.

As the lines between the various plans (for the purpose of this article we’re referring to, HMO, PPO, EPO and POS plans), it’s becoming increasingly difficult to tell one type from another.

One expert, Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms, had this to say, “You have PPOs with really high cost sharing for out-of-network services, which from a consumer perspective seem a lot like HMOs”.

The “idea” behind using recognizable plan type labels and acronyms was (in general) to provide the public with a fast and easy way to distinguish the level of access it’s members would have to the various providers that are outside of a plan’s network, how much it would cost to see those providers – if desired, and whether or not a referral would be required. However due to a lack of uniformity and regulations with respect to the industry-wide-definitions, and standards that vary from state to state, this leaves insurance companies with a great deal of latitude when it comes to marketing similar plans under different names.

While the above examples are generally true, some experts say, there are PPO plans which don’t offer any out-of-network services at all. While at the same time, there are HMO’s which do in fact offer out-of-network options, which makes it very hard to differentiate from a PPO plan.

Confused yet? We understand, with all of the similarities and minor differences between the most common health plan types, it’s easy to get lost and overwhelmed.

With a lack of clarity and standardization between states in the industry it’s easy to get lost.

A few Important Questions to Ask When Shopping for Health Insurance:

(1) Is there out-of-network coverage?

(2) Will you need a referral to see out-of-network doctors or specialists? 

(3) Does that out-of-network spending count (accrue) toward your out-of-pocket maximum? (Not a requirement but some plans do include it).

What Problems Does Health Insurance Solve?

Having private health insurance provides peace of mind. It assures you and your loved ones, that if a health crisis should arise, the insured can be seen by a private care physician or surgeon. Without it, you may find yourself waiting weeks or even months for a referral or operation through federal and/or state health insurance programs such as Medicaid.  Medicaid is a health insurance plan offered by the Federal Government for people with a low income.

Additionally, in these times of COVID-19, your insurance company can help you with telehealth services, testing, outpatient visitation, and inpatient hospital stays. Your insurance provider will monitor the spread of COVID-19 to help keep you informed with updates and safety information at this time.

If you have made it to retirement age without any severe health issues, consider yourself fortunate; however, as we age, the inevitability of declining health becomes a reality. As you plan for retirement, you must consider how you would manage financially having to contend with serious conditions such as diabetes, cancer, or heart disease. When facing a health crisis, you don’t want to add the payment for treatments to the list of things to worry about.


Having health insurance can lower your worries, especially during these difficult times; your health insurance will cover many of the services that would be too costly otherwise. Knowing that you or your family member will have the benefit of choosing a private or semi-private hospital room with doctors and healthcare providers who can look after you, is a peace of mind that health insurance is uniquely designed to provide. 

Speak with a licensed agent today. We're here to answer all of your questions.

Choosing the right health insurance coverage for your family in Wisconsin is a big decision. Our licensed agents are here to help. Contact us today to get answers to your important Wisconsin health insurance questions. 

By Samantha Devanehealth

Best Cheap Health Insurance West Virginia

Healthcare is changing, but we’re adapting to meet your needs. Our company provides West Virginia with excellent health coverage and affordable plans. Our commitment as a trusted leader in providing health insurance to West Virginians, will always be to offer excellent customer experiences and to offer value-based products for all of your health insurance needs.

Topics Covered On This Page: Click on any of the links below and proceed directly to the section.

In a hurry? We understand, if you prefer to just receive a quote right away, you can use our  request and find the lowest cost, cheapest health insurance premium with the coverage that fits you or your family today.

West Virginia health insurance

We can help you address crucial medical concerns by providing access to affordable medical coverage for individuals and families. All healthcare inquiries are of course addressed through a network of qualified Health Insurance Providers. By having the proper health insurance, you’ll never have to worry about having access to clinical experts who specialize and practice medicine in the areas that you need, when you need it.

Most health insurance companies that we work with offer access to telemedicine, which means you’ll have 24/7 access to healthcare professionals, online prescription services, and home testing kits. If you do have questions, we invite you to contact us today. Our licensed agents are available to help answer your questions regarding health insurance coverages offered.

Health Insurance Cost in West Virginia

If you’re asking yourself, how much will it cost to purchase a health insurance policy, for myself or my family in West Virginia, let’s take a look at what West Virginians are currently paying. The average individual health insurance premium in West Virginia (for a benchmark plan) is about $628 in 2020 and projected to be $654 in 2021. These estimates are from the Kaiser Family Foundation Health Insurance Marketplace Calculator.

The average premium for a family plan is around $1,020/month. However, it’s important to keep in mind that the monthly premium will vary based on a variety of factors. According to healthcare.gov there are five main factors which can affect a plan’s monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents.

Why Choose Us?

What makes Life & Health Now stand out in today’s market, is our professional and friendly team. Our focus is on delivering value and positive health care shopping experiences to each and every client.

As a team, we don’t settle, and we are all in it together; we apply this thinking to help our customers thrive and live better lives by eliminating their concerns over choosing the right insurance provider.

Cheap Health Insurance in West Virginia:

What is Health Insurance?

The purpose of health insurance is to cover the majority of costs related to medical care and treatment of illnesses and injuries; this includes surgical, medical, prescription medication, and some dental expenditure.

If you are unable to work because of an illness or injury, health insurance may reimburse you and/or directly pay your healthcare provider.

Most individuals acquire health insurance through their employer, but you can also receive health insurance privately or through a State exchange. You are likely to encounter different terms that describe your financial responsibility for coverage and payments; these are:

 

Premium:
The monthly payment amount which you pay for health insurance is called a premium. It’s normal to have extra insurance related costs in addition to your monthly premium, such as your deductible, copayments, and coinsurance. 

Because of these additional costs, it’s a good idea to keep in mind when you’re shopping around for your health insurance that the policy with the lowest monthly premium may not end up being the least expensive for you or your family, before the year is over. If you’re anticipating frequent medical visits, it may be to your advantage to pay a slightly higher monthly premium with a lower deductible, than to pay a lower monthly payment with higher deductible. 

 

Deductible:
This is the amount you pay for covered health care services before your insurance plan starts to pay. With a $5,000 deductible, for example, you would pay the first $5,000 of covered services for the year, out of your own pocket. After you pay an amount equal to your deductible amount (deductible amounts do vary depending on your policy), you will then usually pay for a portion of the covered services, this is called a copayment or coinsurance for your covered services.


Copay:
A set amount (for example, $25) that you pay for a covered health care service after you’ve paid your deductible. Let’s say your allowable cost for a doctor’s office visit is $100. Your copayment for a doctor visit is $25.


Coinsurance:
The percentage of costs of a covered health care service that you pay out of pocket. Let’s use an example of 30% and a $2,000 annual deductible. Let’s assume that you’ve paid $2,000 out of pocket towards your health insurance cost for the year. Let’s also assume that your health insurance plan’s allowed amount for an office visit cost is $100 and your coinsurance percentage is 30%. Since you’ve paid your $2,000 deductible: You pay 30% of $100, or $30. In this scenario, if you have not paid your deductible for the year, let’s say you’ve only paid $1200 towards your yearly covered medical expenses, then you would pay the full $100 and that would increase your deductible expense from $1200 out of pocket to $1300 for the year.

Types of Health Coverage

Health insurance is offered in a variety of health plan types. Your monthly cost will be determined by the plan that you choose. There are plans where seeing a specialist or other health care providers will require a referral from your primary care physician. 

Below we will review the differences between HMOs, PPOs, EPOs and POS health plans. When shopping for health insurance, you’ll find these are the most common health insurance plans offered today.

  • Health Maintenance Organization (HMO) plans: An HMO is the most affordable option of the three plans. If you’re looking for the best value, this could be the plan for you. The main drawback of an HMO is it also comes with limitations regarding your choice of doctors and healthcare providers. You’ll be assigned to a network of doctors, specialists and health care providers in your area. Should you need or want to see a specialist outside of this network, you’ll need a referral. If you like the idea of trading flexibility in choice for savings, then this may be the plan for you.
  • Preferred Provider Organization (PPO) plans: If it’s the freedom of choosing your own doctor and health care providers that you desire most (and you don’t mind higher monthly premiums), then a PPO plan may be suited for you. You will still have a network of doctors and specialists, and using them can save you money, but should you desire to see a specialist (or any doctor of your own choosing), you can and do not need a referral to do so. You’ll pay a little more for your out of network office visits, but for those who want the most freedom to choose their health care providers, going with a PPO is well worth the additional cost. 
  • Point-of-service (POS) plans:  If you’re looking for a mix of the two plans outlined above (HMO & PPO) then choosing a Point of Service plan could be the ideal plan for you.  As in the PPO plan, with a POS plan, you will be able to see the specialists and/or general practice doctors that you desire, even if they are not part of your plans network. However, similar to a HMO, you will need a doctor’s referral to do so. In short, POS plans cost less than PPO’s, yet they still offer patients the flexibility of seeing the doctors they truly desire. 
  • Exclusive Provider Organization (EPO) plans: An EPO is an exclusive provider organization, and is similar to an HMO but it often does not require a referral to see a specialist.

It’s important to keep in mind that while insurance companies are required by health laws to identify their health insurance products by type, in their plan coverage summaries, one PPO plan may have very different out of pocket expenses for you or your family as well as coverage limits than another plan. Since no two plans are likely to be identical, it’s important when shopping that we don’t just lump all PPO’s or HMO’s (or any other type of health insurance plan) into one generic “bucket”.

As the lines between the various plans (for the purpose of this article we’re referring to, HMO, PPO, EPO and POS plans), it’s becoming increasingly difficult to tell one type from another.

One expert, Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms, had this to say, “You have PPOs with really high cost sharing for out-of-network services, which from a consumer perspective seem a lot like HMOs”.

The “idea” behind using recognizable plan type labels and acronyms was (in general) to provide the public with a fast and easy way to distinguish the level of access it’s members would have to the various providers that are outside of a plan’s network, how much it would cost to see those providers – if desired, and whether or not a referral would be required. However due to a lack of uniformity and regulations with respect to the industry-wide-definitions, and standards that vary from state to state, this leaves insurance companies with a great deal of latitude when it comes to marketing similar plans under different names.

While the above examples are generally true, some experts say, there are PPO plans which don’t offer any out-of-network services at all. While at the same time, there are HMO’s which do in fact offer out-of-network options, which makes it very hard to differentiate from a PPO plan.

Confused yet? We understand, with all of the similarities and minor differences between the most common health plan types, it’s easy to get lost and overwhelmed.

With a lack of clarity and standardization between states in the industry it’s easy to get lost.

A few Important Questions to Ask When Shopping for Health Insurance:

(1) Is there out-of-network coverage?

(2) Will you need a referral to see out-of-network doctors or specialists? 

(3) Does that out-of-network spending count (accrue) toward your out-of-pocket maximum? (Not a requirement but some plans do include it).

What Problems Does Health Insurance Solve?

Having private health insurance provides peace of mind. It assures you and your loved ones, that if a health crisis should arise, the insured can be seen by a private care physician or surgeon. Without it, you may find yourself waiting weeks or even months for a referral or operation through federal and/or state health insurance programs such as Medicaid.  Medicaid is a health insurance plan offered by the Federal Government for people with a low income.

Additionally, in these times of COVID-19, your insurance company can help you with telehealth services, testing, outpatient visitation, and inpatient hospital stays. Your insurance provider will monitor the spread of COVID-19 to help keep you informed with updates and safety information at this time.

If you have made it to retirement age without any severe health issues, consider yourself fortunate; however, as we age, the inevitability of declining health becomes a reality. As you plan for retirement, you must consider how you would manage financially having to contend with serious conditions such as diabetes, cancer, or heart disease. When facing a health crisis, you don’t want to add the payment for treatments to the list of things to worry about.


Having health insurance can lower your worries, especially during these difficult times; your health insurance will cover many of the services that would be too costly otherwise. Knowing that you or your family member will have the benefit of choosing a private or semi-private hospital room with doctors and healthcare providers who can look after you, is a peace of mind that health insurance is uniquely designed to provide. 

Speak with a licensed agent today. We're here to answer all of your questions.

Choosing the right health insurance coverage for your family in West Virginia is a big decision. Our licensed agents are here to help. Contact us today to get answers to your important health insurance questions. 

By Samantha Devanehealth

Best Cheap Health Insurance Washington

Cheap Health Insurance in Washington:

What is Health Insurance?

The purpose of health insurance is to cover the majority of costs related to medical care and treatment of illnesses and injuries; this includes surgical, medical, prescription medication, and some dental expenditure.

If you are unable to work because of an illness or injury, health insurance may reimburse you and/or directly pay your healthcare provider.

Most individuals acquire health insurance through their employer, but you can also receive health insurance privately or through a State exchange. You are likely to encounter different terms that describe your financial responsibility for coverage and payments; these are:

 

Premium:
The monthly payment amount which you pay for health insurance is called a premium. It’s normal to have extra insurance related costs in addition to your monthly premium, such as your deductible, copayments, and coinsurance. 

Because of these additional costs, it’s a good idea to keep in mind when you’re shopping around for your health insurance that the policy with the lowest monthly premium may not end up being the least expensive for you or your family, before the year is over. If you’re anticipating frequent medical visits, it may be to your advantage to pay a slightly higher monthly premium with a lower deductible, than to pay a lower monthly payment with higher deductible. 

 

Deductible:
This is the amount you pay for covered health care services before your insurance plan starts to pay. With a $5,000 deductible, for example, you would pay the first $5,000 of covered services for the year, out of your own pocket. After you pay an amount equal to your deductible amount (deductible amounts do vary depending on your policy), you will then usually pay for a portion of the covered services, this is called a copayment or coinsurance for your covered services.


Copay:
A set amount (for example, $25) that you pay for a covered health care service after you’ve paid your deductible. Let’s say your allowable cost for a doctor’s office visit is $100. Your copayment for a doctor visit is $25.


Coinsurance:
The percentage of costs of a covered health care service that you pay out of pocket. Let’s use an example of 30% and a $2,000 annual deductible. Let’s assume that you’ve paid $2,000 out of pocket towards your health insurance cost for the year. Let’s also assume that your health insurance plan’s allowed amount for an office visit cost is $100 and your coinsurance percentage is 30%. Since you’ve paid your $2,000 deductible: You pay 30% of $100, or $30. In this scenario, if you have not paid your deductible for the year, let’s say you’ve only paid $1200 towards your yearly covered medical expenses, then you would pay the full $100 and that would increase your deductible expense from $1200 out of pocket to $1300 for the year.

Types of Health Coverage

Health insurance is offered in a variety of health plan types. Your monthly cost will be determined by the plan that you choose. There are plans where seeing a specialist or other health care providers will require a referral from your primary care physician. 

Below we will review the differences between HMOs, PPOs, EPOs and POS health plans. When shopping for health insurance, you’ll find these are the most common health insurance plans offered today.

  • Health Maintenance Organization (HMO) plans: An HMO is the most affordable option of the three plans. If you’re looking for the best value, this could be the plan for you. The main drawback of an HMO is it also comes with limitations regarding your choice of doctors and healthcare providers. You’ll be assigned to a network of doctors, specialists and health care providers in your area. Should you need or want to see a specialist outside of this network, you’ll need a referral. If you like the idea of trading flexibility in choice for savings, then this may be the plan for you.
  • Preferred Provider Organization (PPO) plans: If it’s the freedom of choosing your own doctor and health care providers that you desire most (and you don’t mind higher monthly premiums), then a PPO plan may be suited for you. You will still have a network of doctors and specialists, and using them can save you money, but should you desire to see a specialist (or any doctor of your own choosing), you can and do not need a referral to do so. You’ll pay a little more for your out of network office visits, but for those who want the most freedom to choose their health care providers, going with a PPO is well worth the additional cost. 
  • Point-of-service (POS) plans:  If you’re looking for a mix of the two plans outlined above (HMO & PPO) then choosing a Point of Service plan could be the ideal plan for you.  As in the PPO plan, with a POS plan, you will be able to see the specialists and/or general practice doctors that you desire, even if they are not part of your plans network. However, similar to a HMO, you will need a doctor’s referral to do so. In short, POS plans cost less than PPO’s, yet they still offer patients the flexibility of seeing the doctors they truly desire. 
  • Exclusive Provider Organization (EPO) plans: An EPO is an exclusive provider organization, and is similar to an HMO but it often does not require a referral to see a specialist.

It’s important to keep in mind that while insurance companies are required by health laws to identify their health insurance products by type, in their plan coverage summaries, one PPO plan may have very different out of pocket expenses for you or your family as well as coverage limits than another plan. Since no two plans are likely to be identical, it’s important when shopping that we don’t just lump all PPO’s or HMO’s (or any other type of health insurance plan) into one generic “bucket”.

As the lines between the various plans (for the purpose of this article we’re referring to, HMO, PPO, EPO and POS plans), it’s becoming increasingly difficult to tell one type from another.

One expert, Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms, had this to say, “You have PPOs with really high cost sharing for out-of-network services, which from a consumer perspective seem a lot like HMOs”.

The “idea” behind using recognizable plan type labels and acronyms was (in general) to provide the public with a fast and easy way to distinguish the level of access it’s members would have to the various providers that are outside of a plan’s network, how much it would cost to see those providers – if desired, and whether or not a referral would be required. However due to a lack of uniformity and regulations with respect to the industry-wide-definitions, and standards that vary from state to state, this leaves insurance companies with a great deal of latitude when it comes to marketing similar plans under different names.

While the above examples are generally true, some experts say, there are PPO plans which don’t offer any out-of-network services at all. While at the same time, there are HMO’s which do in fact offer out-of-network options, which makes it very hard to differentiate from a PPO plan.

Confused yet? We understand, with all of the similarities and minor differences between the most common health plan types, it’s easy to get lost and overwhelmed.

With a lack of clarity and standardization between states in the industry it’s easy to get lost.

A few Important Questions to Ask When Shopping for Health Insurance:

(1) Is there out-of-network coverage?

(2) Will you need a referral to see out-of-network doctors or specialists? 

(3) Does that out-of-network spending count (accrue) toward your out-of-pocket maximum? (Not a requirement but some plans do include it).

By Samantha Devanehealth