All that you need to know about Health Insurance to choose the right coverage for you and your family

What is Health Insurance?

When any member of the family falls ill there will be additional expenses.  Perhaps for treatment, medication, hospital care or surgery.  These expenses have to be paid for.  Health insurance is the security cover for you and your family when one of you needs medical care or treatment.  A monthly premium to an Insurance Company ensures that if these unexpected expenses arise there will be funds to meet them.

WHAT DOES THE AFFORDABLE CARE ACT (ACA) MEAN TO ME?

The ACA requires all American citizens and residents to have health care coverage, defined as the minimal essential coverage (MEC). The ACA also mandates that all insurance plans should, as a minimum, cover the same set of essential health benefits.

The ‘Act’ provides for subsidies and tax allowances which make insurance ‘affordable’ but also imposes penalties if you do not have the MEC.  These penalties could be higher than your insurance premiums and you would still be exposed to any medical costs.

HOW DO I GET THE COVERAGE I NEED?

There are three options:

Your Employer

More the half the American population is covered by health insurances included as part of their employment benefits package. Organizations employing more than 50 people are obliged to include health insurance as part of your employment package. Smaller enterprises, 50 employees or fewer, can also offer Small Business Health Options Program (SHOP) plans to their employees. Group plans, generally provide appropriate coverage at a lower cost to the employee.  Some companies also contribute to the group thereby increasing the value to their employees.

Group plans do not necessarily cover individual circumstances.  You can personalize your insurance by contacting TrueCoverage. We can fill the gaps!

Private Health Insurance

About one-tenth of the American population buys health insurance from the private health insurance marketplace. You can shop, compare and enroll in affordable plans through online portals like TrueCoverage. Apart from offering the widest choice of Insurers and plans benefits include free educational tools, customer support and guidance from qualified consultants able to advise on individual circumstances with full knowledge of state and federal law.

Government Funded Programs

The Federal government funds two major care plans.

MEDICARE

  Medicare, provides all senior citizens of America and some defined disability groups, with health coverage basically equivalent to the MEC without having to pay a monthly premium. Depending on individual circumstances, assistance may be given with the cost of chronic treatments, prosthetic devices and eye glasses. Separate provision is made for prescription drugs.

MEDICARE + CHOICE (Advantage Plans)

These plans enable users build on their Medicare coverage to design customized plans to suit their individual needs.

 Advantage plans do not automatically cover prescription drugs.

You can sign up for prescription drug coverage though a separate Medicare prescription drug plan (Medicare Part D) OR through the Medicare Advantage Prescription Drug plan.

MEDIGAP PLANS

There is a choice of 12 standard plans designed to complement (fill the gaps) in the original Medicare coverage. These plans are optional but they have been designed to meet the most frequently requested additional coverage and are approved by the Medicare and Medicaid agencies to be offered and administered by private companies.

Talk to one of our consultants.

MEDICAID

Medicaid is a joint Federal-State program that provides health coverage to certain categories of low-income citizens. These include children, pregnant women, parents of eligible children, people with certain disabilities and senior citizens needing nursing home care.

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