This type of insurance provides coverage for a defined period of time and generally has a much lower monthly premium than other forms of major medical health insurance. These types of plans do not usually require an enrollment event and they last from 30 days to 90 days. You do need to re-apply for these plans each time your coverage term expires. These plans are helpful to add to help supplement your full coverage benefits.
If you have a qualifying life event, you have the availability to choose from ACA/Obamacare Plans. ACA policies are guaranteed issued, great for those who have significant health issues such as heart attack, stroke, cancer, etc. because they can still obtain coverage without worrying about their pre-existing conditions . These plans are going to normally cost much more if you don't qualify for a subsidy because these plans are priced based on income and the geographical location.
Approval-based or underwritten plans provide an option to lower rates and increase benefits since the insurance company is taking a much smaller risk on the individual that has been underwritten. With this type of policy, the insurance company can be selective on their applications which means you must be medically underwritten and approved before you're eligible for the policy. Beneficial for the low risk individual.
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A deductible is an amount you must pay (besides your monthly premium) before any medical benefits kick in.
The out of pocket maximum is the amount you are liable for in the year for your individual/family medical bills. This is also called a stop loss.
HMO's or Health Maintenance Organizations usually limit coverage to care from doctors who work for or contract exclusively with the HMO. Most do not cover any out-of-network expenses except for emergencies.
EPO's or Exclusive Provider Organization are a managed care plan where the only coverage you have is within it's network of doctors or hospitals. These are typically smaller networks of coverage.
PPO's or Preferred Provider Organizations are a type of plan this the most flexible of the major four types of plans. Normally you can use doctors, hospitals and providers within and outside the network. You may receive additional savings for staying within the network.
POS's or Point of Service is a type of plan where you save money by staying in the network you are in but you can get referred outside of the network for a larger fee.
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