AFFORDABLE CARE ACT
Obama Care is the unofficial name for The Patient Protection and Affordable Care Act, a health reform law signed on March 23, 2010, by President Barack Obama. ObamaCare (the Affordable Care Act) is a US healthcare reform law that expands and improves access to care and curbs spending through regulations and taxes.
The Affordable Care Act’s primary focus is on providing more Americans with access to affordable health insurance, improving the quality of health care and health insurance, regulating the health insurance industry, and reducing health care spending in the US.
Frequently asked questions
Obamacare doesn’t create health insurance – it regulates the health insurance industry and helps to increase the quality, affordability, and availability of private insurance.
Most people who currently have health insurance can keep it.
You can obtain Private Health Insurance during each year’s annual open enrollment period by contacting us at 407-807-0835.
If you don’t obtain coverage and maintain coverage throughout each year or get an exemption, you must pay a per-month fee on your federal income tax return for every month you are without health insurance.
Due to a coverage gap exemption that applies to all Americans, you can go without insurance for up to 3 months in a row without coverage.
Beyond the coverage gap exemption, there are around 20 other exemptions that you can qualify for. Please contact us for more details about these exemptions.
If you purchase your insurance by the 15th, then your insurance will begin the first of the following month.
The cost of your marketplace health insurance works on a sliding scale. Those who make less, pay
less.
MEDICARE
WHAT IS MEDICARE
Medicare is a federal health insurance program that pays for a variety of health care expenses. The Center administers Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health & Human Services (HHS).
Medicare benefits people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
Similar to Social Security, Medicare is an entitlement program.
Most U.S. citizens earn the right to enroll in Medicare by working and paying their taxes for a minimum required period. Even if you didn’t work long enough to be entitled to Medicare benefits, you might still be eligible to enroll, but you might have to pay more.
Medicare Part A or Hospital Insurance (HI) helps pay for hospital stays, which includes meals, supplies, testing, and a semi-private room. This part also pays for home health care such as physical, occupational, and speech therapy that is provided on a part-time basis and deemed medically necessary.
Care in a skilled nursing facility as well as certain medical equipment for the aged and disabled such as walkers and wheelchairs are also covered by Part A.
Part A is generally available without having to pay a monthly premium since payroll taxes are used to cover these costs.
Medicare Part B or Medical Insurance (MI) helps pay for doctors’ services, outpatient care, medical supplies, and preventive services. For example, Medicare Part B covers:
Durable medical equipment (canes, walkers, wheelchairs, etc.)
Physician and nursing services
X-rays, laboratory and diagnostic tests
Certain vaccinations
Blood transfusions
Renal dialysis
Outpatient hospital procedures
Some ambulance transportation
Immunosuppressive drugs after organ transplants
Chemotherapy
Certain hormonal treatments
Prosthetic devices and eyeglasses
You pay a monthly premium for this part of Original Medicare. The fee can be higher for people with high incomes. A different government program, Medicaid, can help cover Medicare Part B premiums for low-income beneficiaries.
Part B beneficiaries are usually responsible for a portion of their health care costs. You’ll have to pay a deductible each year before your Medicare Part B benefits kick in, and then you’ll generally pay 20% of the bill when you go to a participating Medicare doctor. Medicare pays the full cost of many lab tests and services requested by your doctor.
A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.
If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.
If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
DENTAL PLAN
WHAT IS DENTAL PLAN?
Taking good care of your health means worrying about your oral health, no matter how old you are. Our Dental
insurance policies are just an easier way to help you stay healthy.
THE IMPORTANCE OF SEEING YOUR DENTIST
Going to the dentist isn’t something that most people look forward to. It isn’t always a pleasant experience, and it can cause anxiety for some. But your dentist is your partner in preventing oral health issues, which is well worth the effort! Here are six ways you will benefit from visiting your dentist on a regular basis.
Catch problems before they become painful or expensive
Build a relationship with your dental care team
Make informed decisions. Leave the dentist feeling better!
Stay on top of your dental—and overall—health Take advantage of preventive services
Take advantage of preventive services
A strong relationship exists between oral health and overall health. When you get your health and dental coverage, you may benefit from integrated health and dental programs that can improve your total well-being.
Accidental plans
Accidental plans coverage refers to insurance policies that provide financial protection against accidents. These plans typically offer coverage for medical expenses, disability benefits, and sometimes even death benefits resulting from accidental injuries. The specific coverage and benefits vary depending on the insurance provider and the terms of the policy.
Its important to note that accidental plans coverage may have limitations, exclusions, and specific conditions outlined in the policy. Itis crucial to review the policy terms and conditions to understand the coverage provided, any deductibles or copayments, and any restrictions that may apply.
Insurance providers typically offer accidental plans as standalone policies or as add-on coverage to existing health insurance or life insurance policies.
Critical lllness plan
A Critical lllness plan is an insurance policy that provides coverage for specific serious illnesses or medical conditions. The coverage is designed to offer financial protection by paying a lump sum or periodic benefit upon the diagnosis of a covered critical illness. The specific coverage and conditions covered can vary depending on the insurance provider and the terms of the policy.
Hospital indemnity
Hospital indemnity coverage is an insurance policy that provides a fixed cash benefit for each day or a predetermined lump sum amount if you are hospitalized due to illness or injury. It is designed to supplement other health insurance coverage by providing additional financial support to cover out-of-pocket expenses or other costs associated with a hospital stay.
407-807-0835
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