Medical
Coverage Options

 All plans meet the Affordable Care Act guidelines with annual maximums up to $6,000,000 per person per year and deductibles as low as $1,000.

Everyone has different needs, as a result there is no one size fit's all. However we do have a perfect solution and plan for everyone regardless of health or budget.

 

Super Preferred Medical

Super Preferred Medical health insurance plans are an excellent way to get catastrophic levels of coverage with deductibles as low as $1,000 per person.  They are designed for people in good health and aren't currently experiencing serious medical conditions.  As a result plans are typically much more affordable since they are reserved for a healthier client.

Once you qualify you can keep the plan on a month to month contract or you can keep it for a rolling 12 month period (364 days) with the ability to renew and change your deductible anytime throughout the year.  Your price can't be increased due to claims, declining or negative health during this period. 

Plans will cover everything from annual check-ups,  sick visits, urgent care to catastrophic events like cancer and heart problems.  This plan meets the Affordable Care Act requirement for minimal essential coverage (also known as qualifying health coverage).  This allows for individuals and families enrolled in the plan to avoid the penalty for not having insurance.  This plan is available to individuals, small businesses and large companies of any size.

table-office-bed-hospital-clinic-doctor-1203833-pxhere.com.jpg

Perks

  • Very affordable pricing.

  • Deductibles from $1,000 to $10,000.

  • Pays 100% of covered expenses after the deductible is met to $6 Million per year

  • Choose ANY hospital, doctor, medical provider of your choice.

  • Next month coverage.

  • 364 day duration from the first date of enrollment and ability to renew each year.

Drawbacks

  • Health questions but NO lab or blood work needed to qualify.

  • People who have serious medical conditions that require ongoing care that were diagnosed before the plan was applied for would not be covered.

 


Traditional Major Medical

Major medical insurance can be used from everything from annual check-ups to catastrophic events.  They will pay for all past and present medical conditions and in some cases surgeries deemed "cosmetic" such as gastric bypass if deemed medically necessary. Most of our plans will cover the majority of prescription drugs as well as outside benefits like physical and mental health, physical therapy, and rehab.  These plans are ACA compliant which means you will not pay a tax penalty.  In many cases we can help you qualify for a subsidy to lower your cost based on family size and income. Network options include choice of HMO, PPO, and EPO plans.

traditional-major-medical

Perks

  • No health questions, no lab work, no height or weight restrictions.

  • Pre-existing conditions are allowed and covered from day one.

  • Deductibles from $1,000 to $7,500.

  • Pays 100% of covered expenses after the deductible and max out of pocket is met.

  • Ongoing coverage with no contract.

Drawbacks

  • Limits on network especially with HMOs and EPOs. If out of network, there is either a very high deductible or in many cases no coverage at all.

  • Usually a 30-90 waiting period for coverage from the application date.

  • Sometimes significantly more expensive than other medical plans since everyone is accepted.

  • Prices may drastically increase year to year.

  • Can only enroll during the open enrollment period (Nov 1st- Dec 15th) or because of a qualifying life event.

 
 

Short Term Medical

Short term medical insurance plans are typically used to cover a gap or lapse of coverage.  Common examples include, switching or between jobs, missing the open enrollment for ACA, having a waiting period before benefits of your major medical plan become effective, turning 26 and getting off your parent's insurance, and waiting for your medicare beneifts to begin.

They are typically the most affordable plans you can buy but are only designed for a short duration (90 days or less).  They come with no contract so you only pay for what you need and can switch to another plan at anytime.

headache-1540220_640.jpg

Perks

  • Extremely affordable

  • Only pay for the months you need coverage for

  • Excellent for those in between jobs or waiting for your ACA compliant insurance to start.

  • No lab work and simple Y/N questions to apply

  • Open network with ability to choose doctor of your choice

  • Next day effective coverage

  • Deductibles from $1,000 to $20,000

  • Pays 100% of covered expenses after the deductible is met

Drawbacks

  • Health Questions are required to be approved

  • Pre-existing conditions are not allowed and and will either declined or excluded

  • Plan term lengths range from 1 month to 90 days

  • After each term you must apply again, if you contract a serious health condition during your term it may limit your ability to reapply.

  • Not ACA compliant and doesn't cover preventive wellness benefits such as annual check ups and exams.


 

Definitions

  • Health maintenance organizations (HMOs)

  • Preferred provider organizations (PPOs)

  • Exclusive provider organizations (EPOs)

  • Point-of-service (POS) plans.

  • High-deductible health plans (HDHPs), which may be linked to health savings accounts (HSAs)