HEALTH INSURANCE
FOR THOSE AGE 64
AND UNDER
Health insurance coverage can be categorized into 2 major categories:
-Indemnity plans
-managed care plans
Indemnity plans
An indemnity plan reimburses you for your medical expenses, regardless of who provides the service. In some situations/types of coverage, this amount may be limited. The coverage offered by most insurers is in the form of an indemnity plan.
Different plans use different methods for determining how much you will be reimbursed for your medical expenses. Below are some common methods of reimbursement:
Reimbursement--percentage of actual charges
Under this plan, the insurer pays a percentage of the actual charges for covered procedures and services, regardless of how much they cost. A common reimbursement percentage is 80%. This has the same effect as a 20% co-payment.
Reimbursement--actual charges
Under this type of plan, the insurer will reimburse you for the actual cost of specified procedures or services, regardless of how much that cost may be.
Indemnity
Under this type of plan, the insurer pays a specified amount per day for a specified maximum number of days. Although your reimbursement amount does not depend on the actual cost of your care, your reimbursement will never exceed your expenses.
Managed care plans fall into 3 basic types of plans:
HMO
PPO
POS
A common trait among managed care plans is the incentive (usually, a lower premium) for the insured to stay within a specified network of health care providers.
Health Maintenance Organizations (HMOs)
HMOs provide medical treatment on a prepaid basis, which means that HMO members pay a fixed monthly fee, regardless of how much medical care is needed in a time period (usually a monthly basis). In return for this fee, most HMOs provide a wide variety of medical services, from office visits to hospitalization and surgery. There are exceptions but most HMO members must receive their medical treatment from those within the network.
Preferred Provider Organizations (PPOs)
A PPO is made up of doctors and or hospitals that provide medical service only to a specific group. Rather than prepaying for medical care, PPO members pay for services as they are provided. The PPO sponsor (usually an employer or insurance company) usually reimburses the member for the cost of the treatment, minus any co-payment fee. In some cases, the doctor may submit the bill directly to the insurance company for payment. The insurer then pays the covered amount directly to the health care provider, and the member pays his or her co-payment amount. The price for each type of service is negotiated in advance by the health care providers and the PPO sponsor(s).
Point Of Service (POS) plans
A point of service plan is a type of system where you pay no deductible and usually only a small co-payment when you use a health care provider within your network. You also must choose a primary care physician who is responsible for all referrals within the POS network. If you choose to go outside of the network for health care, you will likely be subject to a deductible, and your co-payment will be a percentage of the physicians charges.
COMPARE PLANS
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TO PICK THE PLAN
THAT BES SUITS YOU
click on highlighted areas
for websites with details of plans
| 1 | Do not have adequate health insurance |
| 2 | Have health insurance with high deductibles or out-of-pocket expenses |
| 3 | Want to supplement the coverage you may have |
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Membership in Med Sense Guaranteed Association offers these outstanding features:
| Insurance Benefits | |||
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Guaranteed Issue for members & their spouse's ages 18 through 64, and dependent children to age 19 or age 25 if attending an accredited school full-time | ||
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$1,000,000 Lifetime Maximum per Covered Person | ||
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U.S. Citizenship not required, only U.S. residency for 12 consecutive months | ||
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In-Hospital Daily Indemnity - Choice of $500, $750, $1,000 or $1,500 per day | ||
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Surgery, Anesthesia, Lab, X-Ray, Wellness, Emergency Room and Ambulance benefits | ||
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Doctor office visits - Choice of $25, $50 or $75 per visit benefit | ||
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$2,000 Accidental Injury Medical Benefit | ||
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$10,000 Accidental Death and Dismemberment | ||
| Non-insurance Benefits | |||
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Access to Beech Street PPO Network Savings | ||
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Rx Prescription Drug 4 Tier Card & Vision Discounts | ||
United States Fire Insurance Company , part of Crum & Forster group
Rated "A" by A.M. Best Reports
_________CLICK HERE TO QUOTE & APPLY_______
apply right here above
ESSENTIAL PLUS SHORT TERM MEDICAL (STM)
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Between jobs or laid off |
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Waiting for employer benefits |
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Part-time or Temporary employees |
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Recently graduated |
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Without adequate health insurance |
Legal Disclaimer: This web site provides a brief description of the plan. You must be 18 years old to apply. The policy will contain reductions, limitations,exclusions, and termination provisions. Full details of the coverage are contained in policy form number AH-60001. If there are any conflicts between this document and the Policy, the Policy shall govern.
_____________CLICK HERE TO QUOTE & APPLY___________
apply right above online
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AIM |
- High Hospital & Surgical Benefit
- Preventive Coverage
- Diagnostic Lab & Imaging Benefit
- HIPAA Compliant
- Prescription Drug Coverage
(click here to get to website with details of plans and you can enroll here)
Comprehensive Guaranteed Issue Limited Medical Plans for Aim Members and Your Family
Whether you have been declined due to health conditions or just cannot afford the high costs of traditional medical plans, AIM has you covered. There are NO HEALTH QUESTIONS and NO MEDICAL UNDERWRITING.
NOTE: Preexisting conditions are not covered until the policy has been in effect for more than 12 months. A preexisting condition is any condition you have now or had within a six month period prior to the effective date of coverage for each covered person. The plan is HIPPA compliant - if you have current coverage for a pre-existing condition, AIM will cover that condition as long as there is NO GAP in time between that coverage and picking up AIM coverage.
Guaranteed Health Insurance HIPAA Compliant makes it easy for you to access health insurance coverage by offering you a benefit program that combines low monthly premiums, nationwide coverage, and ease of enrollment.
The following groups have benefited from our insurance:
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• Small business owners
• Sole proprietors
• Independent contractors
• 1099 workers
• Part-time and temporarily employed workers
• Unemployed and those laid-off
• Individuals between health insurance plans
• Recent college graduates
• Those who can't qualify for traditional coverage
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IFOCUS CO-PAY BALANCE
by AVALON HEALTH CARE
(a Florida-based company)
Managed Care Plan
Choose from a large variety of deductible and coinsurance options and more than a dozen
pharmacy plan choices
balancing between affordability and benefits
Deductible choices range from $1,000 to $5,000
Coinsurance choices range from 100%/80% to 80%/60% or 50%/30%
Out-of-Pocket Choices range from $0 to $5000
Copay Choices range from
$25 for PCP (primary care physician) to $50 for specialist
to $50 for PCP, $75 for specialist, $90 for urgent care
MATERNITY HAS A 15 MONTH WAITING PERIOD
COVERED:
Diagnostic X-Ray and Lab
Complex Imaging (MRI, MRA, CAT, PET)
2nd Surgical Opinions
Allergy Testing & Treatment
Chiropractic Care (15 visits/calendar year)
Out-Patient Rehab Srvices (60 visits/calendar year)
Emergency Room
Surgery, Surgical Assistant, Anesthesia
Skilled Nursing Facility (30 days/calendar year)
Ambulance Services/Emergency Transportation ($2000 max./calendar year)
Home Health Care (30 visits/calendar year)
Durable Medical Equipment ($2000 max/calendar year)
Orthotics and Prosetheics ($2000/calendar year)
PHARMACY BENEFITS (OPTIONAL)
DENTAL PLAN (OPTIONAL)
OPTIONAL BENEFIT RIDERS
BASIC VISION PLAN INCLUDED
and other benefits included
ASK ABOUT OUR IFOCUS HSA HEALTHSAVER PLAN
CONTACT MARILYN FOR QUOTES THAT
FIT YOUR BUDGET AND NEEDS
CALL 561-302-3388
EMAIL: marilynfjacobs@gmail.com
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FLEX GUARD PLUS |
Major Medical Plan
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Issue Ages 0-63
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Freedom of Choice: United American policyholders are free to visit any doctor or hospital they wish to
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Guaranteed Renewable: UA policies cannot be canceled or non-renewed as long as premiums are paid on time
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Flexible Benefits: You design the policy with the coverage required to meet your needs. UA policies are designed to provide protection for individuals and families with no coverage, or serve as a supplement to existing coverage
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Portability: US´a policies are all individually written, so insurance coverage goes where you go. Though you may move to a different state or change jobs, UA´s benefits remain the same
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24 hour coverage: No matter where you go in the United States, you are covered 24/7
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Return of premium: in the event of an insured´s accidental death while the policy is in force, UA will refund double the premiums paid
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30-day free look: if you´re not satisfied with your FLEXguard® Plus policy for any reason, return it to your Agent within 30 days for a premium refund
SOME CHOICES OFFERED:
Hospital Expense Maximum: $50,000 / $75,000 / $100,000
Hospital Expense Benefits:
80% up to $1,000/day for next 30 days or up to $2000/day for days 1-10
80% up to $1,500/day for next 30 days or $3,000/day for days 1-10
80% up to $2,000/day for next 30 days or $4,000/day for days 1-10
Surgical Expense Benefit: 100% up to $7500 for first two plans; up to $10,000 for 3rd plan
Anesthesiologist up to 25% of Surgical Expense Benefit for Anesthesiologist
There are inpatient and outpatient benefits that your agent can go over with you and optional additional coverages, e.g., cancer benefit rider, critical illness benefit rider, accident benefit rider and policy add-ons for whole or term life to $20,000, and child term life rider for $5000 or $10,000 coverage.
Maternity is not covered.
Ask your agent (Marilyn Jacobs - 561-988-0070 or
marilynfjacobs@gmail.com) for quotes
and limitations and exclusions.
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FREEDOM Signature Series |
another AFFORDABLE COVERAGE PLAN
DESIGNED BY YOU!
Sliding Scale of Benefits and Premiums
(not major medical coverge- it's portable!)
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Daily Hospital Room & Board Benefit from $100 to $800
Intensive Care Benefit from $200 to $1,600
Miscellaneous Hospital Expense Benefit with Deductibles ranging from $500 to $2,500 and from $7,500 to $25,000
Surgical Procedure Benefits ranging from $3,000 to $7,500
Outpatient Expense Benefit Ranging from $500 to $1,000
Doctor Office Visit Benefit ranging from $25/vist to $35 copay
with annual maximum ranging from $250 to $1000
Monthly premiums are age-based and include
a marriage discount
For information on Riders including Cancer, Accident and Critical Illness Benefits, ask Agent Marilyn Jacobs
(561-302-3388 or marilynfjacobs@gmail.com) for details
Have you heard about Consumer Driven Health Care? (CDHC)
These are plans with Health Savings Accounts (HSAs) and Health Reimbursement Arrangements (HRAs).
Medical Payments can be made for qualified medical expenses from HSAs or HRAs when you have a high-deductible health insurance policy protecting you from catastrophic medical expenses. Your pre-funded spending account pays routine medical claims. Your high deductible policy costs less than more traditional plans. If you balance runs out, you pay your medical bills yourself up to the deductible amount. Any balance left in the pre-funded account rolls over to invest for future expenses.
Patients have direct control over their health budgets. Some feel that this fosters competition and lowers prices and therefore stimulates improvements in services. Others worry that some may avoid health care because of the burden of the cost.
Health Savings Account (HSA)
For those enrolled in a High Deductible Health Plan (HDHP) this is a tax-advantaged medical savings account available to taxpayers in the United States). The funds contributed to the account, which is owned by the individual, are not subject to federal income tax at the time of deposit. funds roll over and accumulate year over year if not spent. Funds may be used to pay for qualified medical expenses at any time without federal tax liability. Withdrawals for non-medical expenses are treated very similarly to those in an IRA account in that they may provide tax advantages if taken after retirement age, and they incur penalties if taken earlier.
To qualify for an HSA account, your deductible must be between $1,100 - $5,600 for an individual and $2,200 - $11,200 for a family. For 2008 you can contribute up to $2,900 for an individual and $5,800 for a family. Email marilynfjacobs@gmail.com for a copy of the brochure about HSA accounts from the Department of the United States Treasury. There are other details you should know in the brochure. Marilyn can also supply you with a list of HSA/HRA Qualified Medical Expenses and a copy of the IRS Publication 502 re Medical and Dental expenses.
Health
Reimbursement
Accounts
These are Internal Revenue Service (IRS)-sanctioned programs that allow an employer to reimburse medical expenses paid by participating employees, thus yielding "tax advantages to offset health care costs". HRAs are initiated by the employer and serviced by a third-party administrator or plan service provider. HRAs are initiated by the employer and serviced by a third-party administrator or plan service provider. The employer decides if the funds are rolled from year to year and how much rolls over (which can be either a flat amount or a percentage).
MORE PLANS
ARE AVAILABLE
including supplemental plans:
accident, hospital, cancer, disability with affordable premiums and you get cash to spend however you need/want to e.g., when you are in the hospital so that if you are a 1099 and your income stops
YOU NOW HAVE AN INCOME STREAM
to pay the mortgage, car payment, or whatever you want!
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CALL MARILYN JACOBS AT 561-988-0070
OR EMAIL marilynfjacobs@gmail.com
what your needs are
and include your date of birth.
For questions and more information, email marilynfjacobs@gmail.com or call
561-988-0070.
Marilyn Farber Jacobs is
a Licensed Advisor / Independent
Health Insurance Agent
licensed to sell Health Plans in Florida
as well as Life Insurance
(ask about our low cost term insurance
to cover your assets)
Medicare Supplements
and Advantage Plans
(ask about our PPO plan)
Long Term Care
Annuities
If we take care of today,
tomorrow will take care of itself!
Marilyn Farber Jacobs
561-302-3388
marilynfjacobs@gmail.com