Let's Help You Get the Health Coverage You Need for You and Your Family's Needs
Choosing the right health coverage today really depends on you and your family's healthcare needs and financial situation. We have health plan solutions to fit almost every need and budget. If you qualify for financial help or have a pre-existing condition, you might want to look at a comprehensive health plan from one of our top carriers on or off the Marketplace(Healthcare.gov). Let's help you begin the process by considering your financial picture and anticipated healthcare needs.
How We Help
- You skip the headache of navigating the health insurance Marketplace alone.
- Assistance understanding confusing insurance terms.
- We help you find the best coverage for your unique needs.
- Access to more options and ongoing support year to year.
Don't need full health coverage?
We have low cost non-ACA options that will protect you and your finances should an unforeseen illness or accident occur.
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Types of Major Medical Health Plans
Today's comprehensive major medical plans are typically categorized as Bronze, Silver, Gold, and Platinum, which differ in their premium and cost-sharing amounts. Click the tabs below to learn more about these health insurance plans.
A Health Maintenance Organization plan (HMO) offers lower premiums and a significant savings on routine and preventative healthcare. However, this type of health plan requires you to appoint a primary care physician and to use doctors and facilities that are affiliated with the HMO. Thus, if you use healthcare service providers outside of the HMO, there is a good chance those charges won’t be covered by your policy. But, the great thing about an HMO is that the only charges you incur, outside of your premiums, are co-pays for doctor’s visits and other services such as procedures and prescriptions.
A Preferred Provider Plan (PPO) will save you money on services if you use the preferred providers within the network. Keep in mind that deductibles must be met on this plan before some services will be covered. The good thing about a PPO is they generally will allow a certain amount of services annually outside of the deductible with a small co-pay, and most often the PPO has a large network with quality care providers and excellent prescription drug coverage.
POS plans combine features of HMOs and PPOs. Most Point of Service Plans (POS) plans require members to choose a primary care physician from within the POS network, but allow them to use out-of-network specialists with a referral from a primary care physician. Co-payments will be higher for out-of-network services.
A Health Savings Account Plan (HSA) works by tying a tax-advantaged bank account to certain high-deductible health plans. It allows you to use tax free dollars to pay for allowable health expenses, such as copays, prescription drug costs and more.
Per rules of the Affordable Care Act, most insurers include wellness benefits in their comprehensive coverage, designed to improve lives and keep members healthy. Your plan from the Marketplace will generally include services like preventative screenings, free or discounted gym memberships, diet advice, disease management, telehealth, and much more.
A Health Maintenance Organization plan (HMO) offers lower premiums and a significant savings on routine and preventative healthcare. However, this type of health plan requires you to appoint a primary care physician and to use doctors and facilities that are affiliated with the HMO. Thus, if you use healthcare service providers outside of the HMO, there is a good chance those charges won’t be covered by your policy. But, the great thing about an HMO is that the only charges you incur, outside of your premiums, are co-pays for doctor’s visits and other services such as procedures and prescriptions.
A Preferred Provider Plan (PPO) will save you money on services if you use the preferred providers within the network. Keep in mind that deductibles must be met on this plan before some services will be covered. The good thing about a PPO is they generally will allow a certain amount of services annually outside of the deductible with a small co-pay, and most often the PPO has a large network with quality care providers and excellent prescription drug coverage.
POS plans combine features of HMOs and PPOs. Most Point of Service Plans (POS) plans require members to choose a primary care physician from within the POS network, but allow them to use out-of-network specialists with a referral from a primary care physician. Co-payments will be higher for out-of-network services.
A Health Savings Account Plan (HSA) works by tying a tax-advantaged bank account to certain high-deductible health plans. It allows you to use tax free dollars to pay for allowable health expenses, such as copays, prescription drug costs and more.
Per rules of the Affordable Care Act, most insurers include wellness benefits in their comprehensive coverage, designed to improve lives and keep members healthy. Your plan from the Marketplace will generally include services like preventative screenings, free or discounted gym memberships, diet advice, disease management, telehealth, and much more.
Frequently asked questions about Major Medical Health Insurance & the Marketplace
Marketplace plans and private health insurance plans are very similar. Both plans follow the rules of the Affordable Care Act (ACA), meaning they must contain essential standard coverage. This typically includes basic wellness and preventative benefits at low or no cost. The main differences are the subsidies that reduce your monthly premium, if you purchase your plan from the Marketplace (Government Exchange) and qualify based on your income. You are also guaranteed coverage, regardless of pre-existing conditions. Private plans, also known as "off-exchange" plans, are purchased directly from insurance companies. If you qualify for a subsidy, you must purchase your plan from the Marketplace. You can purchase your Marketplace plan through our platform at no additional cost.
CLICK HERE TO LEARN MORE ABOUT THE ESSENTIAL BENEFITS
For Healthcare.gov (the Federal Marketplace), and Pennie (PA's state health exchange) it’s important to know that you can only purchase your health insurance during the annual open enrollment which is November 1 to January 15th of each year, or unless you qualify for the special enrollment period. Missing this time frame means you’ll have to wait until the next year to buy your coverage.
There are special times when you can enroll in a health insurance plan outside of open enrollment. This is referred to as Special Open Enrollment. You can still sign up for health insurance after the deadline if you meet any of the following qualifying events:
-change in legal marital status
-a change in the number of dependents
-a change in place of residence and the -current carrier is not available
-significant cost or coverage change
a change in coverage of a spouse or dependant
-a COBRA qualifying event
-legal judgements, decrees and orders
-entitlement to Medicare or Medicaid
Currently, most people are not required to purchase health insurance. The ACA “shared responsibility payment” and the individual mandate has been eliminated by the Trump Administration for 2019 and beyond. However, some states have established their own individual mandates, so you still may be subject to your specific state tax penalty, if any. Pennsylvania has their own state run exchange which does not mandate insurance currently, meaning there is no penalty for not having a health plan. We also provide health insurance in Virginia which is part of the Federal program and there is not individual mandate for Virginia.
As healthcare costs continue to sky-rocket, why go without coverage and run the risk of financial ruin should you or a family member suffer an expected illness or accident. Most personal bankruptcies, (nearly 70%) are caused by illnesses and accidents leaving individuals unable to work and strapped with medical bills.
Non-ACA alternatives such as Short Term Health Insurance will cost you a lot less than an unsubsidized major medical plan and can protect your finances so you can focus on your health and getting better. However, keep in mind some of these plan have limitations and in some cases, do not cover certain and/or preexisting conditions.
CLICK HERE TO VISIT OUR PAGE ON SUPPLEMENTAL HEALTH AND NON-ACA PLANS
Marketplace plans and private health insurance plans are very similar. Both plans follow the rules of the Affordable Care Act (ACA), meaning they must contain essential standard coverage. This typically includes basic wellness and preventative benefits at low or no cost. The main differences are the subsidies that reduce your monthly premium, if you purchase your plan from the Marketplace (Government Exchange) and qualify based on your income. You are also guaranteed coverage, regardless of pre-existing conditions. Private plans, also known as "off-exchange" plans, are purchased directly from insurance companies. If you qualify for a subsidy, you must purchase your plan from the Marketplace. You can purchase your Marketplace plan through our platform at no additional cost.
CLICK HERE TO LEARN MORE ABOUT THE ESSENTIAL BENEFITS
For Healthcare.gov (the Federal Marketplace), and Pennie (PA's state health exchange) it’s important to know that you can only purchase your health insurance during the annual open enrollment which is November 1 to January 15th of each year, or unless you qualify for the special enrollment period. Missing this time frame means you’ll have to wait until the next year to buy your coverage.
There are special times when you can enroll in a health insurance plan outside of open enrollment. This is referred to as Special Open Enrollment. You can still sign up for health insurance after the deadline if you meet any of the following qualifying events:
-change in legal marital status
-a change in the number of dependents
-a change in place of residence and the -current carrier is not available
-significant cost or coverage change
a change in coverage of a spouse or dependant
-a COBRA qualifying event
-legal judgements, decrees and orders
-entitlement to Medicare or Medicaid
Currently, most people are not required to purchase health insurance. The ACA “shared responsibility payment” and the individual mandate has been eliminated by the Trump Administration for 2019 and beyond. However, some states have established their own individual mandates, so you still may be subject to your specific state tax penalty, if any. Pennsylvania has their own state run exchange which does not mandate insurance currently, meaning there is no penalty for not having a health plan. We also provide health insurance in Virginia which is part of the Federal program and there is not individual mandate for Virginia.
As healthcare costs continue to sky-rocket, why go without coverage and run the risk of financial ruin should you or a family member suffer an expected illness or accident. Most personal bankruptcies, (nearly 70%) are caused by illnesses and accidents leaving individuals unable to work and strapped with medical bills.
Non-ACA alternatives such as Short Term Health Insurance will cost you a lot less than an unsubsidized major medical plan and can protect your finances so you can focus on your health and getting better. However, keep in mind some of these plan have limitations and in some cases, do not cover certain and/or preexisting conditions.
CLICK HERE TO VISIT OUR PAGE ON SUPPLEMENTAL HEALTH AND NON-ACA PLANS
Individual Policies
Health Insurance Open Enrollment (On and off Exchange)
November 1st through January 15th
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