Like the average person, you know next to nothing about your health insurance. Whether provided by your employer, through your state’s Heath Insurance Marketplace or an independent provider, health insurance is there to protect you from paying the full costs of your medical bills when you are sick or injured. A typical plan will cover:
- Emergency services
- Laboratory tests
- Maternity and newborn care
- Mental health and substance-abuse treatment
- Outpatient care (doctors and other services received outside a hospital)
- Pediatric services, including dental and vision care
- Prescription drugs
- Preventive services (immunizations and mammograms) and management of chronic diseases (diabetes and asthma)
- Rehabilitation services
First, you should consider when you will be buying a health plan. Most people buy during the annual open enrollment period, which lasts from November 1st to January 31st. You can also buy a health plan during other times of the year during a special enrollment period, but you must have a qualifying life event. Remember, you must purchase a health plan to avoid paying a penalty. The next step you should take is to determine if you qualify for a subsidy, which can help you pay for health insurance. Based on when you are shopping and if you qualify for a subsidy, we can help you find a policy that meets your needs and fits your budget.
Today, many people covered by health insurance are enrolled in organized health care plans, such as a health maintenance organization (HMO) or a preferred provider organization (PPO) and point-of-service (POS). POS and PPO plans offer more flexibility by combining features from HMOs and fee-for-service plans. Premiums may be higher, but do not require a primary care physician to coordinate patient care.
Generally, HMOs strive for you to receive most of your health care from a primary care physician (PCP), from an approved network provider, except in an emergency, in order to receive coverage. After enrolling in an HMO, you select a primary care physician who will coordinate all of your patient care. Most do not require you to use a network provider, however you will pay a higher out-of-pocket expense. When you are considering an HMO policy, it is important to compare the conditions and features amidst the various HMO plans available.
The Affordable Care Act provides healthcare to many people who have never had health insurance by putting in place a comprehensive health insurance reform that will:
- Broaden Coverage
- Lower health care premiums and out-of-pocket expenses
- Give access to more choices
- Improve the quality of care for everyone
Stahler & Associates will work to not only provide you with the coverage you want, but also to help educate you on the coverage you may need. We work with numerous senior’s 65+ to help them learn about their options and coverage while applying for Medicare. We work with Medicaid to help provide free or low-cost benefits to low-income people with no or insufficient medical insurance. We also offer supplemental insurance to provide additional protection from additional healthcare costs. Here at Stahler & Associates, we can obtain insurance from any agency and also give you a quote from each of those agencies.
Stahler & Associates Insurance Services is an independent, licensed insurance agency servicing Bettendorf and Davenport, the Iowa-Illinois Quad Cities and surrounding areas. Whether you are looking to sign-up , get a quote or just need some information, contact us today to learn more 563-326-6423. Stahler & Associates, your leading Quad Cities individual and group health insurance provider.