HEALTH INSURANCE
NAVIGATING HEALTH INSURANCE
Understanding health insurance can be a minefield. If you’re not sure what is important to look out for it can become infinitely more difficult to pick a plan with the appropriate coverage. Essential Health Solutions is here to help you make an informed decision and ensure your family’s health and wellness.
Which Health Plan is
THE RIGHT FIT FOR MY FAMILY
Finding the right health plan for your family doesn’t have to be stressful. There are many coverage options available to ensure your family’s healthcare. Depending on your family’s size and age, you will want to look at several things while comparing health insurance and family plans, including:
- Premium amount
- Coverage percentage and benefits
- Access to doctors, hospitals, and other providers
- Access to after-hours and emergency care
- Out-of-pocket costs (coinsurance, copays, and
- deductibles)
- Exclusions and limitations
Need help finding a plan?
Different Types of
HEALTH INSURANCE PLANS
There are several different types of health insurance plans. Healthcare coverage varies by the plan which is offered through small businesses to their employees, through the state or federal government, or through another non-profit agency.
Generally, health insurance plans offered through a small business or an employer are considered group insurance. While insurance policies purchased directly from the insurance company or the marketplace are considered individual plans.
Different types of health insurance plans include:
- Medicare/Medicaid: these are both federal insurance plans designed for individuals 65 or older, younger people with disabilities, and those with end-stage renal cancer.
- HMOs: Health Maintenance Organization.
- PPOs: Preferred Provider Organization.
- EPOs: Exclusive Provider Organization.
- POS: Point of Service.
- Catastrophic Plans: high deductible coinsurance.
- High-deductible health plans with or without a health savings account (HSA)
The main differences between these health insurance options include:
- The size of the network offered: Some plans will have a more extensive list of providers (doctors and hospitals) available to their members.
- Out-of-Network Services: Some plans will cover out-of-network services, while others will not.
- Health Care Costs: Plans will differ in premiums (your monthly/annual cost for coverage)
- Access to different provider types: For some plans, you will need a referral from your primary care provider to see a specialist, whereas in other plans you can see whomever you wish without a referral.
Frequently Asked Questions About
HEALTH INSURANCE
Q: Will I be able to find affordable health coverage?
A: Low-cost health insurance is available. Options can include various Medicaid and Medicare plans and Medicare advantage for qualifying individuals and ACA alternative plans for those who don’t.
Q: When can I enroll in a health insurance plan?
A: Open enrollment typically happens once a year around the renewal date of the policy. Typically this is a 1-month window when you can select your plan coverage from an employer or the marketplace.
Special enrollment periods occur when you qualify for a major life event, including:
• Starting or stopping a job
• Having a child
• Getting married
Q: What services will my health plan cover?
A: Health benefits will vary by plan. However, most major health concerns are covered by group health plans and individual health plans. The one care service that may not be covered by your insurance is mental health. If this is an important service to your well-being, be sure to ask about coverage options while comparing plans.
Q: Will Coronavirus treatments be covered?
A: COVID treatment coverage will vary by plan and will depend on the existence of comorbidity or pre-existing condition.
Q: What will all be covered by my health insurance?
A: Health benefits will vary by location and insurance plan. Quality care is available for a variety of services including preventative care and prescription drugs.
Speak to an Agent
Our agents can give you more information on many different options for health, dental, vision, and hearing insurance plans.
