You Have Questions. We have Answers.
Is there an additional cost to use an agent?
No. An independent agent can help you find the best plan to fit your budget. Our agents are fully up-to-date on healthcare reform, available subsidies and navigating the marketplace.
How does insurance work?
Health insurance policies are a contract between an insurance company and an individual. The type and amount of healthcare costs that will be covered by each party are specified in advance, in the member contract.
How is my insurance premium determined?
Many variables affect the amount you will pay for insurance, such as your age, income, etc. An independent agent can identify the most affordable plans in your area.
Common Terms for Insurance
The amount the policy holder or his sponsor (e.g., an employer) pays to the health plan provider each month to purchase health coverage.
The amount the insured must pay before the insurer takes over payment. For example, a policy holder might be responsible to pay for services like doctors’ visits and prescription refills until a total deductible of $500 has been met in one year. After this total is met, the insurance company will begin to pay for the insured’s care.
A fixed amount that the insured must pay out-of-pocket at the time of each visit or service. For example, an insured person might pay a $45 copay for a doctor’s visit or to obtain a prescription. For most plans, this amount must be paid until the deductible is met.
As opposed to a copayment, coinsurance is a percentage of the total cost that the insured may also pay. For example, the insured could be responsible to pay 20 percent of the cost of a surgery, while the insurance company pays the other 80 percent.
Much like a deductible, an out-of-pocket max is a cap on the total the insured will be responsible to pay annually. What counts toward this amount and the amount itself varies widely from plan to plan.
Exchanges & Marketplaces:
Both the federal government and some individual states have established health insurance marketplaces, sometimes called exchanges, where consumers can purchase plans that align with the new standards put in place by the Patient Protection and Affordable Care Act (PPACA). These health insurance elections can be made on-exchange, meaning using these marketplaces, or off-exchange through a private insurance agency.