Are you under age 65 and needing medical coverage for you or your family? I can help in this area of planning as well. These plans are known as Affordable Care Act (ACA) or Marketplace plans. There are no medical questions to obtain these plans, so pre-existing conditions wont prevent you from obtaining. Depending on your income, you may be eligible for tax credits and subsidies to reduce premiums.
I simplify the comparison of Marketplace plans by ensuring your providers are accepted, checking medication costs, and locating the plan that would suit you well.
Main Types of Health Insurance Plans
- HMO (Health Maintenance Organization) is a type of plan where you can use only doctors and hospitals that are a part of the plan’s network. A referral is needed to see a specialist on most HMO plans.
- PPO (Preferred Provider Organization) is a type of plan that allows you to use doctors and hospitals in and out-of-network. A referral is not needed to see a specialist on a PPO plan.
- EPO (Exclusive Provider Organization) is a type of plan that is similar to an HMO where you must stay in network but no referrals are needed to see a specialist.
- POS (Point-of-Service) is a type of plan that allows you to go in network or out-of-network, however you pay less for going in network. With most POS plans you need a referral to see a specialist.
Other Tips to Know:
- When considering a marketplace plan be sure to review the costs for items including, but not limited to inpatient hospital costs, outpatient surgical costs, emergency room visit, cancer radiation and chemotherapy treatments.
- Consider complementing a marketplace plan with a Hospital Indemnity Plan to protect your savings.
Enrollment Periods for Individual & Family Marketplace Plans
- Open Enrollment Period is November 1 thru January 15th. You can enroll into or change to a different plan during this period of time.
- Special Enrollment Period is is another option and covers several situations that are unique. Some of these include a major move, having a baby, marriage/divorce, or denied or losing Medicaid. There are many other special election periods, contact to learn more.