Frequently asked Question

Researching health insurance on your own can leave you with more questions than when you started. Here is some information that will help clarify some things.

What is the difference between a deductible, co-insurance, and max-out-of-pocket?

Deductible is the amount you have to pay before the insurance begins to pay. Co-Insurance is the percentage of each bill you have to pay until you reach your max-out-of-pocket. Max-Out-Of-Pocket is the maximum amount that you will have to pay before the insurance begins to cover you at 100%.

What are the biggest differences between ACA/Obamacare, Employer plans, and Private insurance?

ACA/Obamacare is guaranteed major medical coverage that cannot denied you for any reason. It is most affordable option for people with major pre-existing conditions and/or are receiving government subsidy on the monthly premiums. For those who aren’t getting that discount, it is way more expensive than most plans out there. Employer plans are great for the employee, but the minute you add a family member (spouse and/or children) on to the plan, that premium skyrocket. This is because employers usually pay at least 50% of the employee’s premium, but pay nothing towards the family’s premium. Now, the family will be paying full price. Private insurance is health-based, therefore, there is an application process because not everyone qualifies. Because you're relatively healthy, you're getting a preferred rate so it is cheaper than most plans with better coverage.

What are insurance prices based on?

Public Marketplace (aka ACA/Obamacare plans) are based on income and age. Private plans are based on health and age.

Will I be locked into a contract?

Insurance rates can be locked in for a year, meaning the rate will not change for one year. You are not obligated to stay on the same insurance for any length of time. All insurance is month to month.

What kind of insurance do you offer?

I offer Medical/Health, Dental, Vision, Life, Supplemental, Critical Illness, Income Protection. I am here to guide you in the right direction.

What is the fee for your services?

NO FEE! Just schedule an appointment for a consultation.

What is the difference between HMO, EPO, and PPO?

HMO limits coverage to medical care provided through doctors and other providers who are under contract with the HMO and requires a referral to see a specialist. EPO offers a local network of doctors and hospitals for you to choose from and requires a referral to see a specialist. PPO provides maximum benefits if you visit an in-network physician or provider and some coverage for out-of-network providers. Referral aren't needed to see a specialist.

Do I only have the "open enrollment" time period to be able to set up private insurance?

That is only for ACA/Obamacare and government plans. Private insurance is available year-round.