Major Medical Insurance in Monticello, GA

Traditional or individual insurance are plans offered by private insurance companies.  The premiums are usually paid by an individual directly to the insurance company.  Group insurance offers an employee health insurance at a reduced rate for the employee.  Bear in mind that group policies may not offer the family members of the employee the same reduced rates.  Usually, an employee has to pay the normal price to include dependent children or their spouse on an employer-sponsored health plan.

Any “credible” health plan has to cover pre-existing conditions per the Affordable Care Act. A credible health plan is a health plan that does not exclude pre-existing conditions or imposes a maximum amount of coverage (i.e. $1 million of health care coverage).  Credible plans must also cover preventive screenings, such as annual physical exams, mammograms, vaccinations, etc.

A copay (copayment) is a fixed fee that is paid by the insurance provider.  Copays help reduce medical costs for those who are insured, like the cost of a doctor’s visit or medication.  Copays are paid at the time of the medical service, like during a doctor visit or when you get your medicine.  Some plans don’t provide copays, while others use copays in addition to deductibles and coinsurance.

Coinsurance is a percentage of medical cost that you pay after you’ve met your deductible.  The general concept of coinsurance is that the insured individual and the insurance carrier shares the cost of the service or medication.  Typically, If one hasn’t paid his deductible yet, he would pay the full cost until his deductible has been reached.  When reading one’s coinsurance percentage, a higher coinsurance percentage means a higher share of the service cost that one must pay.  The insured individual is also responsible for any additional charges that the insurance company’s plan doesn’t cover or share.

A deductible is a yearly total amount that an insured individual must pay before the insurance company shares the cost for covered services or medications. The amount you pay depends on the type of plan that you choose, but in-network services typically have lower deductibles than out-of-network services.

When choosing a deductible amount, it is best to consider the chances of your needing to use the insurance plan.  If the plan is more likely to be used, a lower deductible and a higher premium might be best.  On the other hand, if the plan is not expected to be used, a higher deductible and lower premium might be best.

Health insurance offered through the Health Insurance Marketplace is also called Obamacare. The “Marketplace” offers health coverage to individuals and families, often at a reduced rate, typically lower than buying a plan directly from an insurer. The difference is that eligibility for financial assistance may depend on various factors such as age, income, and geographic location. Insurance is usually offered until an individual turns 65 years old.  After age 65, in most cases, an individual is no longer eligible for an individual health insurance plan. There are certain circumstances where an individual 65 or older may be able to stay with an individual plan, such as employer or group insurance.  Click here if you’d like to visit our Healthcare Marketplace page.