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Health Insurance Plans in Surprise, AZ

Find the best health plans for you and your family

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Health Insurance Plans

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Today’s healthcare insurance market is flooded with plans and options that make it confusing to the average consumer. You really have to be careful about what each affordable health plan covers, what are the plan limitations, what is your out-of-pocket exposure, and so much more. The fortunate thing is there are dozens of options so finding a plan that fits your needs shouldn’t be tough as long as you have the support and experience provided by an independent insurance agent. At American Insurance Benefits, we pride ourselves in providing our clients with a detailed insurance plan review, discussing things like general health, medical conditions, prescription drugs, and so much more. Our clients at American Insurance Benefits – Andy Orlikoff thank us constantly for helping them understand exactly where they stand and what risk factors may influence their financial future when it comes to 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.

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Health Insurance Plans
Health Insurance Plans

What To Expect From A Health Insurance Broker

Regardless of whether you already have health insurance or you are a first-time buyer, you need to review a number of health insurance quotes in order to find the best policy options. A health care broker or health care agent can save you both money and time. A health insurance broker can simplify the entire process of buying insurance, much better than healthcare insurance agents. If you have decided to seek help from a medical insurance broker, you should know what to expect.

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What Does a Health Care Broker Do?

A medical insurance broker is a licensed professional who can assist you in the process of purchasing health insurance from beginning to end. Some people choose to find healthcare insurance agents on their own, but others find the process somewhat overwhelming. If this sounds familiar, you will likely benefit from consulting a professional health insurance broker.

A health care broker in Surprise, AZ can help you sift through all of the health insurance quotes in order to find the comprehensive health coverage that meets your needs and is compatible with your budget.

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Health Insurance Plans
Health Insurance Plans

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 American Insurance Benefits – Andy Orlikoff explains the advantages and drawbacks of each package.

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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 in Surprise, AZ, 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. Contact us today and schedule your meeting with American Insurance Benefits – Andy Orlikoff today!

Health Insurance FAQ

Premium

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.

Copay

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.

Deductible

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

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%.

Out-of-pocket maximum

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.

What is health insurance and how does it work?

It helps protect you from paying full cost for medical services if you are injured or sick.

What are the benefits of having health insurance?

Protects you from unexpected medical costs.

How much does health insurance cost?

Costs vary and some can be customized based on your needs.

What is the difference between an HMO and a PPO?

PPO plans have more flexibility for insureds to see their provider of choice.

How do I choose a health insurance plan?

It is dependent upon your health needs and how often you will have medical visits.

What does a health insurance policy cover?

It will depend on the plan you purchase but most plans cover doctors visits, wellness care and medical devices.

How can I get health insurance if I’m unemployed?

Several private and public options may be available to you based on income, previous insurance, and current health.

What is the Affordable Care Act (ACA) and how does it affect health insurance?

It’s a comprehensive reform law, enacted in 2010, that increases health insurance coverage for the uninsured and implements reforms to the health insurance market.

How can I compare different health insurance plans?

First you’ll need to determine how much health care you use. From their review plan options that fit your needs and compare estimated yearly costs. A good health insurance broker can provide you with several choices to compare.

What are pre-existing conditions and how do they affect my health insurance coverage?

A pre-existing condition For which medical advice, consultation, diagnosis, care, or treatment (includes receipt of services, supplies,
or diagnostic tests) was received or recommended from a provider or prescription drugs were prescribed typically during the 1 year period immediately prior to the covered person’s effective date, regardless of whether the condition was diagnosed, misdiagnosed or not diagnosed Asthma, Diabetes, Cancer, Heart disease, Pregnancy

What is health insurance and how does it work?

Health insurance is a form of insurance that pays for medical expenses. It is a contract between an insurance company and an individual or his/her sponsor (such as an employer) where the insurer agrees to pay for medical expenses and the insured person agrees to pay a premium. A health insurance policy is an example of a managed health care plan, where the insurer gives a group of providers access to its customers in order to reduce costs and improve quality of care.

What are the benefits of having health insurance?

Health insurance can help protect you from unexpected, high medical costs. If you have health insurance, the cost of a doctor visit or prescription drug may be lower than what you would pay out of your own pocket. In addition, if you have a serious illness or injury that requires hospitalization, your insurance may pay for the co-payments and deductibles necessary to get the care you need.

What is a health insurance deductible?

The deductible is usually a set amount of money that you must pay out-of-pocket before your insurance plan begins to pay. If a service or prescription does not meet your deductible, you will be responsible for the full cost of that service or prescription. These costs are typically discounted with network contracted rates. In some plans, there’s also a coinsurance requirement. For example, if your plan has a 20% coinsurance requirement and your prescription costs $100, you’ll pay $20 and your insurance company will cover the remaining $80.

Is a health insurance premium?

The amount you pay for your health insurance every month.

What is a copay in health insurance?

A fixed amount ($50, for example) you pay for a covered health care service. Often these are first dollar benefits where you dont need to meet a deductible.

What is a coinsurance in health insurance?

The portion of the bill shared between the insurance company and the insured. Often seen as 80/20, 70/30 and 60/40. The first number is the percentage paid by insurance.

Can I keep my doctor with my health insurance plan?

Based on your health insurance carrier and plan name, your provider will be able to tell you if they take your insurance.

How do I enroll in health insurance?

A qualified health insurance broker will be able to assist you with that. We provide this service at no cost to you.

What is open enrollment for health insurance?

Open enrollment is the time of year when people who need health insurance coverage can sign up or renew health care plans.

What is a health savings account (HSA)?

A health savings account (HSA) is a type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses.

What is a flexible spending account (FSA)?

A flexible spending account (FSA) is a special account you put money into that you use to pay for certain out-of-pocket health care costs. FSAs are typically offered through your employer.

What is a health reimbursement arrangement (HRA)?

A Health Reimbursement Arrangement (HRA) isn’t traditional health coverage through a job. Your employer contributes a certain amount to the HRA. You use the money to pay for qualifying medical expenses. For some types of HRA, you can also use the money to pay monthly premiums for a health plan you buy yourself.