Under the Affordable Care Act every plan must offer 10 Essential Health Benefits at no dollar limit. Essential Health Benefits consist of 10 categories of items and services required on all plans starting in 2014. In general, Essential Health Benefits are the types of care you need to prevent and treat sickness and do not include elective and “non-essential treatments”
Co-insurance is the term used by health insurance companies to refer to the amount that you are required to pay for a medical claim, apart from any co-payments or deductible. For example, if your health insurance plan has a 20% co-insurance requirement (and does not have any additional co-payment or deductible requirements), then a $100 medical bill would cost you $20, and the insurance company would pay the remaining $80.
Every insurance company has different rate guarantees. Depending on which plan you take your rates could be locked in anywhere from 1 year to the lifetime of the plan.
Your plan contracts with a wide range of doctors, as well as specialists, hospitals, labs, radiology facilities and pharmacies. These are the providers in your “network.” Each of these providers has agreed to accept your plan’s contracted rate as payment in full for services. Before picking a plan, we will first determine if your preferred doctor or clinic is “In-Network”. This will help us decide which company to go with. Keep in mind that Subsidized Affordable Care Act plans that are “On The Exchange” have VERY limited networks.
Just give us a call at 920.243.4100 or send us a request to get started. We will review your situation and budget and help you pick the plan that best fits YOU!
Starting in 2014, there will no longer be any “Application Fees” on Major Medical plans. You may be required to pay a small application fee if you choose to take out a plan that is not Major Medical – depending on which company you choose. These fees usually range from $20-$95