Individual Health Insurance Plans in your area
Medical Coverage Overview
We are here to assist you with understanding your health policy. Simply click for a quote, or call 888.803.5917 and receive immediate, personalized attention from an expert. If you need a Summary of Benefits and Coverage (SBC) for the plans you’re interested in, browse options online or ask your representative for a copy to be emailed or mailed to you.
Metal Level Plans
Affordable plans with higher deductibles and lower monthly premiums to help you meet the requirements of the healthcare law, stay covered, and gain access to services. Plans may include copays (fixed rates, e.g. $20.00 for an in-network Primary Care Visit) to pay upfront for office visits, prescriptions and emergency or urgent care.
Coinsurance is typically 100% after deductible, meaning that once your deductible is met, the plan pays for the total cost of services.
You may be interested in opening a Health Savings Account (HSA) with your policy. Bronze HSA plans allow members to add up qualifying medical expenses for tax breaks.
Silver Plans make it easy to pay for quality care with convenient copays, coinsurance and moderate deductibles.
Coinsurance is 70/30, and the Plan pays 70 percent after your in-network deductible is met for eligible major medical care.
Most Silver-level policies include the option of paying a set cost for medications, doctor visits and exams you receive while using the Plan’s Network. Preventive services such as an annual physical or routine cancer screening are covered at 100 percent.
If you have medical conditions, are pregnant, or simply wish to secure excellent coverage for yourself and your family, Gold policies offer larger benefit amounts. Receive free care for regular check-ups, pay your doctors and pharmacies a flat rate, and don’t hesitate to use your hospital benefits if needed. Major Health Services such as inpatient care and surgery are more reasonable in cost due to a greater degree of available coverage.
Coinsurance is 80/20. Your Plan will cover at least 80 percent of your in-network medical bills after deductible.
Your deductible is substantially less than Bronze and Silver products, averaging $1,500 per year for an individual. Call us to review Gold Plan options in your State.
Offering the most insurance in the Obamacare metal tier lineup, Platinum Level plans are optimal for those who expect larger medical expenses than most. If you understand the value of paying a higher monthly premium for a plan that covers more services, you may wish to apply for a Platinum Plan.
Coinsurance is generally 90/10 or 100%, with copayments for services and medications before deductible. You pay 0-10 percent for in-network care once the deductible is reached.
Under the Affordable Care Act, all plans are required to include a Summary of Benefits & Coverage to detail exactly what is covered, how much coverage is offered and if any exclusions or limitations apply.
Note: While the law does protect insured members from being denied a health policy for pre-existing conditions, insurance companies are NOT required to cover all or any services related to a pre-existing condition.
Sample Bronze PPO Plan Summary:
Sample Silver HMO Plan Summary:
Sample Gold PPO Plan Summary:
Sample Platinum HMO Plan Summary: