In the United States, health insurance plans are traditionally provided and chosen for us. As a child and young adult, we are covered under a parent’s plan. As we enter the workforce, our employer selects the plan options that are available to us. But what happens when these fallbacks aren’t available to you… when you retire, aren’t employed, or temporarily unemployed?
An individual health insurance plan can be confusing and difficult to secure. The terminology and nuances that you once relied on others to understand and package together for you can seem daunting to navigate.
Our experienced health insurance team can help you get the best coverage, quality, and value from the products and services available to you.
Are you eligible for a tax credit?
Do you need coverage for preventive care?
Do you have and need coverage for any preexisting conditions?
Do you anticipate experiencing a “life event” this year (marriage, divorce, birth of a child, or loss of coverage)?
These are just some of the many factors used to determine the best policy for your individual health insurance needs.
Individual Health Insurance Coverages
Medicare is a federally funded health insurance program for US citizens or individuals who have been a resident for at least 5 continuous years and are either 65 or over, have end-stage renal disease, or others who are under 65 but with certain disabilities.
The Medicare program consists of three different Parts: Part A covers hospital visits, Part B covers doctor visits and outpatient care, and Part D is the prescription drug program. It also includes Part C, an option that is known as the Medicare Advantage Program.
Similar to a traditional employer-based plan, but purchased through the health insurance marketplace or directly from an insurance carrier.
ACA Compliant plans include coverage for essential health benefits such as prescription drugs, preventive care, and mental health services. They also provide coverage for pre-existing conditions and limit the amount of cost-sharing for patients.
Short-term medical is a good option for individuals who only need limited coverage for a short amount of time, typically one month to one year (sometimes longer).
These plans are also known as “catastrophic” medical plans and usually only offer basic coverage for essential healthcare services, such as doctor visits, emergency medical care, and prescription drugs.
However, short-term health plans can be a less expensive option for those who are in between health plans or need temporary coverage.
No matter what type of policy you secure, it is helpful to understand the meaning of these common health insurance terms.
The amount of money you pay toward medical bills before your insurance coverage begins.
A specified amount of money you pay upfront for doctor visits and prescription refills.
The percentage of medical bills you pay after meeting the deductible.