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What is the Affordable Care Act (ACA)?
The comprehensive health care reform law enacted in March 2010 by the Obama Administration. (sometimes known as ACA, Affordable Care Act or “Obamacare”).
- The Affordable Care Act - also known as Obamacare. It was designed to extend health insurance coverage to millions of uninsured Americans.
- The Act created a Health Insurance Marketplace.
- It prevents insurance companies from denying coverage due to pre-existing conditions and requires plans to cover a list of essential health benefits.
- Lower-income families can qualify for extra savings on health insurance plans through premium tax credits and cost-sharing reductions.
The Affordable Care Act (ACA) has been successful in bringing affordable health and has expanded health insurance to more than 20 million people, and consumers receive more coverage for their dollar.
What is the Health Insurance Marketplace?
The Health Insurance Marketplace is a resource where individuals, families, and small businesses can find out if you are eligible for tax credits for private insurance or health programs like Medicaid or the Children’s Health Insurance Program (CHIP).
What we do for you?
We compare health insurance plans for coverage and affordability. We also get answers to questions about your health care insurance and enroll you in a health insurance plan that meets your needs. We are open year-round. That means, we are available to help you at any time during the year. This includes also with payments, finding a doctor, discovering if meditations are covered under your policy. We work for you, our client!
Health Insurance sometimes is difficult to understand. Lets quickly explain what the most common and possibly most confusing words in a health insurance policy.
Deductible
- The amount you pay for covered health care services before your insurance plan starts to pay. For example: if you have a $1,500 deductible and undergo three $1,000 procedures in 2021, you will have to pay the FULL BILL AMOUNT for the first procedure and $500 of the second … your insurance will cover the remainder of the second procedure and third procedure in its entirety.
Co-pay
- A co-pay is a fixed fee you pay when you receive covered care like an office visit or pick up prescription drugs. Although some co-pays do vary from plan to plan. For example, a plan may require co-pays of $10 for office visits, $100 for emergency room visits, $5 for generic prescriptions, or $25 for name-brand drugs.
Premium
- The amount you pay into the insurance plan on a monthly basis. In some cases you have the option to make to pay your premium annually, quarterly, or monthly. You must pay your premium to keep your coverage active, regardless of whether you use it or not. For example if the health plan you’ve chosen costs $27 per month, which is your premium. In order to keep your benefits active and the plan in force, you’ll need to pay your premium on time every month.
Coinsurance
- The percentage of your medical bill you share with your insurance company after you’ve paid your deductible. There are some plans with 100 percent coverage for everything, these plan may have a higher deductible and premiums. For example a plan that is referred to as “80/20” plan. Your insurance company pays for 80% of your costs after you have met your deductible and you pay for 20% coinsurance.
Maximum Out of pocket
- The amount a policyholder must spend on eligible healthcare expenses through coinsurance, or deductibles before the insurance starts covering all covered expenses, not including the cost of the plan premium. Due to this, a deductible will be lower than the out-of-pocket maximum. Once you reach your annual out-of-pocket maximum, your health insurance company will cover all covered costs for the rest of the year.
In-Network & Out of Network
- When you see a doctor or facility who is in-network, you are using a provider who participates in the insurance carrier's agreement and that saves you money.
- If a doctor or facility has no agreement with your health plan, they're considered out-of-network and can charge you full price for the visit and other services. It's usually much higher than the in-network discounted rate.
What is Private Health Insurance?
Private health insurance simply refers to any health insurance coverage that is not offered by a state or federal government.
What type of private insurance coverage is right for me?
One benefit of private health insurance is that certain types of coverage may be available any time of the year, instead of only during open enrollment periods. Marketplace plans are typically only available during Open Enrollment unless you qualify for a Special Enrollment Period. If you do not have coverage and don’t qualify for a Special Enrollment Period, some types of private health insurance (such as short-term plans) may help bridge the gap in the meantime.
What we do for you?
Just like any ACA plan, we compare health insurance plans for coverage and affordability. Provide answers to questions about your health care insurance and enroll in a health insurance plan that meets your needs.