Health Insurance Plan in Surprise Arizona
Health Insurance Plans in Surprise, AZ
What type of Health Insurance Plan is right for you?
With health insurance, there are many types of plans available. Those include, but not limited to, short term health plans, major medical plans, Affordable Care Act plans, employer-based group plans, catastrophic healthcare plans, and hospital/healthcare indemnity plans. Each of these insurance plans address a specific need.
What To Expect From A Health Insurance Broker
What Does a Health Care Broker Do?
A health care broker can help you sift through all of the health insurance quotes in order to find the health insurance plan that meets your needs and is compatible with your budget.
The Benefits of a Health Insurance Broker
When you buy a health insurance policy through a health care broker, you gain peace of mind because you know that your plan provides the best coverage at the most affordable price.
Working with a health insurance broker from American Insurance Benefits to purchase a health insurance policy can be incredibly valuable. You will have fast access to support when you need it. In addition, you will receive personalized recommendations as we explain the advantages and drawbacks of each package.
Here are some examples.
Short Term Healthcare Plans are great for individuals or families that are looking to fill a gap in coverage. Maybe you are starting a new job in a few months and are leaving a current employer. Maybe you are going back to school for a couple semesters and losing your group healthcare plan.
Major medical plans are healthcare plans offered by the major healthcare insurance companies like Blue Cross Blue Shield, Aetna, Cigna, and more. These plans are what most people associate with your traditional health insurance plans. They come in all shapes, sizes, coverage options, and price points. This is why we encourage our clients to sit down with us so we can develop a personalized insurance profile to find the right coverage for you. Time and time again, we see families selecting plans based on what they perceive or because a friend told them it was a great plan that “covered everything!” Sadly, this can put you in a really bad place long term and cost you in the long run.
Affordable Care Act plans are also referred to as marketplace plans. These plans or plan types were developed in 2010 under President Obama to combat the rising cost of healthcare and prescription drug coverage. These plans are all administered by private insurance companies and regulated by the federal government. These plans are required to include basic coverage like routine exams, prescription drug coverage, hospital care, and more designed to provide access to healthcare for more Americans.
Employer-based group plans are health insurance plans provided by your employer. In the Federal and State laws require employers with a certain number of staff to provide coverage at certain levels. Typically, most employers will cover a certain amount of the monthly premium and you, the employee, picks up the balance. All employer sponsored group plans are different, providing various levels of coverage, deductibles, and more. Believe it or not, employer sponsored group plans are not always the best option for an individual. To understand what your out-of-pocket risk is, we encourage you to meet with us so we can review your coverage options.
Catastrophic healthcare plans typically provide coverage for major issues such as extended hospital stays, emergency surgeries, and more. Just as the name implies, they are for catastrophic incidents. Most people use these plans to provide an additional level of coverage when a major medical plan or other health insurance plan provides certain coverage limitations.
Next up, we have healthcare or hospital indemnity plans. These plans provide specific coverage levels for specific services. Some individuals really like these plans because they know exactly what is covered and what isn’t, and exactly how much is covered. These let you really take charge of your healthcare and shop around for more affordable healthcare options. Most indemnity plans are on a reimbursement basis, however some plans do provide some in-network benefits that are paid directly to the provider. These plans are becoming increasingly popular with consumers as they are typically more affordable than traditional major medical plans.
The Affordable Care Act (ACA) has made it possible for Arizona residents to buy health insurance in the private market. This is known as Obamacare, and it enacts a number of new rights for consumers and policyholders. Health insurance plans under the ACA must cover essential health benefits, including hospitalization, emergency care, prescription drugs, and maternity care. In order to buy one of these plans, residents of Arizona must enroll during the open enrollment period, which runs from November 1 to December 15 each year. If they don’t qualify, however, they must wait until the next special enrollment period, which is triggered by a qualifying life event, such as marriage, birth, or death.
The Medicaid program is Arizona’s indigent-care program, known as AHCCCS, which was previously administered by county governments, and their eligibility criteria and services varied significantly. Legislation to participate in the Federal Medicaid program was routinely defeated, as Arizona’s legislature had limited the use of local property taxes to fund public health care. Today, county revenue is no longer sufficient to meet the rising cost of indigent health care. State legislators were skeptical about the benefits of joining the federal program, and their fears about costs led to a number of failed attempts.
For state-sponsored exchanges, despite the constitutionality of this law, Arizona’s governor has vetoed a state-sponsored exchange for government health insurance. The governor argues that the state should still have some control over its residents’ health plans even if the federal government does the same. While the federal government will pay for the initial startup costs of an exchange, the costs will ultimately be passed on to the policyholders.
For in-network deductibles, the first step in determining the deductible for government health insurance in Arizona is to check if the plan offers any in-network providers. If so, the deductible is set by the health plan and is determined by the type of provider you visit. If the plan offers an in-network deductible, it should be set at a lower amount than the corresponding out-of-network deductible.
In a recent meeting, the Arizona Department of Insurance and federal HHS officials discussed the importance of freedom of choice in health care. They concluded that a government-run health care system would be unaccountable to the patients but would instead be controlled by special interest groups that fund political campaigns. By allowing such a system to operate, Arizona would be denying patients their right to choose the health care providers they want and forcing them to pay for their coverage through the government.
Government Health Insurance—What You Should Know
There are many different types of government health insurance in Arizona. You can apply for it through the state-sponsored exchange, Medicaid, or directly from the government’s website. You can find out if you qualify through the application process. Regardless of your financial situation, you should learn about all of your options so you can make the best decision for your individual needs. Here are a few things to consider. Some of these government health insurance options are the Affordable Care Act, Medicaid, state-sponsored exchanges, in-network deductibles, freedom of choice, and more, as mentioned above. If you’re looking for a more detailed explanation regarding your health insurance, contact us at (623) 742-3878 today.
While there are several other types of healthcare insurance plans available, as a consumer or business, it is always in your best interest to work with an independent insurance agent to help you find the best coverage, at the best price, that addresses all your individual and family needs. Give us a call today and schedule your meeting today!
Health Insurance FAQ
A monthly payment you make to have health insurance. Like a gym membership, you pay the premium each month, even if you don’t use it, or else lose coverage. If you’re fortunate enough to have employer-provided insurance, the company typically picks up part of the premium.
A predetermined rate you pay for health care services at the time of care. For example, you may have a $25 copay every time you see your primary care physician, a $10 copay for each monthly medication and a $250 copay for an emergency room visit.
The deductible is how much you pay before your health insurance starts to cover a larger portion of your bills. In general, if you have a $1,000 deductible, you must pay $1,000 for your own care out-of-pocket before your insurer starts covering a higher portion of costs. The deductible resets yearly.
Coinsurance is a percentage of a medical charge that you pay, with the rest paid by your health insurance plan, that typically applies after your deductible has been met. For example, if you have a 20% coinsurance, you pay 20% of each medical bill, and your health insurance will cover 80%.
The most you could have to pay in one year, out of pocket, for your health care before your insurance covers 100% of the bill.
How they all work together
Health insurance policies can have a variety of cost-sharing options. Some policies have low premiums and high deductibles and out-of-pocket maximum limits, while others have high monthly rates and lower deductibles and out-of-pocket limits.
In general, it works like this: You pay a monthly premium just to have health insurance. When you go to the doctor or the hospital, you pay either full cost for the services, or copays as outlined in your policy. Once the total amount you pay for services, not including copays, adds up to your deductible amount in a year, your insurer starts paying a larger chunk of your medical bills, typically 60% to 90%. The remaining percentage that you pay is called coinsurance.
You’ll continue to pay copays or coinsurance until you’ve reached the out-of-pocket maximum for your policy. At that time, your insurer will start paying 100% of your medical bills until the policy year ends or you switch insurance plans, whichever is first.