Individual & Family Care Health Insurance |  |
What do I need to consider when choosing a health plan? |
Choosing a health plan that is right for you is a matter of weighing your needs. Cost, benefits, and access to service are the key elements you should consider when making your selection. You will arrive at the right plan if you carefully identify your most important needs by answering the following questions. Cost - What are the monthly premiums of each plan?
- What price is within my budget?
- Do I need to pay a deductible before the insurance starts to cover my medical expenses?
- What percentage of the cost will the insurance company cover after my deductible has been met?
- Can I afford to pay for the maximum out-of-pocket expense for the chosen plan?
- How much do I need to pay for each doctor visit?
| |
|
Benefits - What health care services does each plan cover?
- What are the limitations on the amount of coverage if I choose a lower premium plan?
- Does the plan cover prescription medication? Preventive care? Maternity?
- Do I need a plan that covers only basic or most of my medical expenses?
- Do I need health insurance for my whole family or just for myself?
|
Access of Care - What doctors and hospitals are part of the plan?
- Are the health care facilities at a convenient and accessible location?
- Will I need to obtain a referral before I see a specialist?
- Do I have the freedom to choose any health provider?
Which plan is right for me?Most insurance companies offer HMOs and PPOs to individuals and families. Typically, HMO plans are chosen by people who go to the doctor often. HMOs provide more comprehensive coverage. The monthly premiums of either plan are determined by your age, area of residence, and individual needs. However, HMOs limit the doctors and facilities you can use. PPOs are often chosen by people who go to the doctor infrequently or by those who want to use any provider they choose. | |
|
PPO Health Insurance may be the right choice for you if:
- … you want more flexibility in choosing your health care provider and you are willing to share more of the cost .
- … you do not visit the doctor often.
- … you want the ability to get treatment from specialists without the hassle of obtaining pre-authorization from a primary care doctor.
- … you are willing to pay a higher share of the cost when you receive care.
|
HMO Health Insurance may be the right choice for you if:- … you see the doctor frequently and want to pay as little as possible for those visits.
- … you need a more comprehensive health coverage (such as maternity care, prescription drugs and preventive care).
- … you are willing to trade the flexibility to see any doctor that you want.
- … you prefer to pay a lower share of the cost each time you receive health care services.
| | How can I lower my monthly premium? |
|
Move to a higher deductible.
If you are a young, healthy individual who doesn’t anticipate any major health problems, you may want to switch to a higher deductible. Your premium will become significantly lower! However, if you are certain of high medical expenses, then the opposite would apply. You may want to switch to a plan with both a lowest possible deductible and lowest out-of-pocket expenses. |
What is the difference between an in-network and an out-of-network medical provider?In-network providers are physicians, hospitals, or other health care providers that join a health insurance carrier and provide services based on negotiated fees. You will find a list of in-network providers in your insurance carrier plan directory. Out-of-network providers are those who are not members of the carrier’s plan and therefore are not included on the directory. In general, you will save money by using an in-network provider. What is it that the brochures don’t tell you? | |
|
Brochures are helpful in determining rates and benefits. However, with the brochures alone, you will not find information on other important issues such as how quickly a company handles claims or how difficult it is to get a specialist. Therefore, it is especially important to find an experienced agent who can guide you through the process every step of the way. With almost 20 years of experience, KCAL Insurance Agency can provide you the highest quality personal assistance to satisfy your insurance needs. To learn more about us, please click here. |
Why do I need health insurance?
|
- Most people cannot individually afford the cost of even simple medical emergencies.
- Health insurance helps protect you from financial catastrophe in the event of illness.
|
What is long term health care insurance?- Long term care insurance pays for nursing home care, assisted living, and at home extended care.
- This type of policy is intended to aid persons who are not eligible for Medicaid and those who do not have sufficient funds to personally pay large medical bills.
- Certain restrictive medical conditions must be present before benefits become available.
| |
|
What is disability insurance? |
- Disability insurance helps replace income lost due to extended illness or accident.
- Employer group policies typically cover only up to 60% of a worker’s base pay.
- Group policies usually have a cap, so higher paid employees cannot replace all their earnings.
|
What do the terms cancellation and non-renewal mean? |
- After 60 days, a company may cancel a policy only for your failure to pay a premium or if you committed fraud or misrepresentation on your application.
- Non-renewal is a decision made by either you or the company not to renew the policy when it expires. In some states, the company must provide you a certain number of days advance notice and explain the reason before it drops your policy.
|
