Deductible - The amount an insured must pay before the insurer pays for certain services.
Co-pay - A dollar amount for certain services like doctors visits and prescriptions. Usually co-pay payments are paid before deductibles are met and the deductible does not apply to co-payed services.
Co-insurance - A percentage of funds the insured is responsible for after the deductible is met and before the max out of pocket is met.
Max out of pocket - The amount of money the insured pays before the health insurance plan pays 100% of eligible expenses.
Critical Illness Insurance - Coverage that pays the insured a specified dollar amount upon the occurrence of a specific illness or illnesses.
Accident Insurance - Coverage that pays the insured a specified amount upon the occurrence of an accident.
Vision Insurance - A policy that pay for vision screenings, eye-wear and contacts.
Life Insurance - A policy that pays a specified amount upon the death of the insured. Whole life is a permanent policy that last the lifetime of the insured. Term life insurance is a temporary policy that only pays if the insured dies during a specified time frame. Whole life insurance policies typically accumulate a cash value the insured can borrow from. Term life insurance usually does not accumulate a cash balance (in most cases).
Short Term Disability Insurance - A policy that pays a monthly cash payment for a period of usually 12-24 months while the insured is sick or injured and cannot work.
Long Term Disability Insurance - A policy that pays a monthly cash payment for a long period (usually until retirement age) while the insured is sick or injured and cannot work.
Association - A non-insurance group that offers members benefits such as discounts, group life insurance, patient advocates, telemedicine and other products and services.
Small Business Health Insurance: A health insurance policy designed for business with less than 50 full time employees.
A: The first thing I recommend is to work with a local agent, someone who has experience in your area. With the ACA (Obamacare) buying health insurance and the options have never been more confusing to the average consumer.
A few ideas... If you have no major pre-existing conditions consider a short-term policy for now (while Washington is sorting out the future of healthcare). Most states are now allowing 1-year terms on short-term plans. Because these plans do not cover pre-existing conditions and tend to not approve of unhealthy individuals, they are usually a fraction of the cost.
Design your plan so that you're up for renewal (the end of the one year term) at ACA open enrollment (November 1to December 15th). This way if your health takes a turn for the worst you can easily transition into an ACA plan that covers pre-existing conditions. If you're still in good health you can renew another year to take you to the next ACA open enrollment.
Pro- low cost
Cons - term plans are not considered ACA compliant. So you'll want to compare any savings against the possibility of paying the individual mandate penalty (2.5% of income). Even with the penalty, however many people end up saving money going this route.
Consider a high deductible plan with a supplement. It's no secret that higher deductible plans are less expensive. Most people cringe at the thought of having a $7,500 deductible though. However, when we add a supplement to that high deductible plan you now receive money to pay the deductible if you have an illness or accident. Also, you want to pay your medical bills but most people that have a major illness or a bad accident are out of work for a while.
The hospitals will work with you, but utility companies usually aren't as nice. So by taking out a supplement that is more than your plans out of pocket cost you provide your family with a way to "keep the food on the table" and pay the everyday bills that most of us would get behind on if we had a bad accident or illness. The overall cost of buying a high deductible plan is typically a lot less than a low deductible plan.
Pro- Low cost
Cons- depending on the supplement you choose it may not cover everything. So minor procedures and treatments may still come out of pocket. It's important to choose the right supplement.
What about a health share? Health shares are non-profit organizations usually offered by religious organizations. While they are not insurance they provide a lot of the same benefits as health insurance. As long as a health share has been around since 1999 it is Affordable Care Act (ACA) exempt meaning you shouldn't have to pay the government's individual mandate (2.5% income) come tax time. Many have low out of pocket cost at a fraction of the cost of an ACA (Obamacare) plan.
Pros- Low cost, no ACA penaltyCons- Not health insurance. Need to do research and choose a financially strong health share.
A: HSA's or Health Savings Accounts allow the account holder to add funds to a savings or investment account on a pre-tax basis. Those funds can then be used to pay for qualified medical expenses. In order to open and add funds to an HSA, you must have an HSA qualified health insurance policy. These are high deductible policies that do not have copays and do not start paying until the deductible is met (except for annual checkups). Once you have money in an HSA account you no longer need a qualified health insurance policy to use those funds. So these funds can be spent down the road, even if you do not currently have a high deductible health plan.
When searching for an HSA compliant policy look for higher deductible policies. For 2018 the minimum deductible for an individual must be $1350 and a family must be $2700. Most states have at least one Affordable Care Act policy (aka Obamacare) that is HSA compliant, although the deductibles tend to be in the 4k to 7k range. The name of the policy will almost always have HSA in it. If you're still having trouble finding an HSA policy call or text us (indyhealthagent.com).
Once you have an HSA policy you'll need to open a Health Savings Account. Most local banks offer these. You'll typically need your government-issued ID and your policy binder showing you have an eligible HSA policy. There are also banks that specialize in HSA's, like HSA bank and those found on our HSA account page. If you think you'll likely just add money to the account as needed, make sure that the bank makes it easy to deposit money and provides a debit card. At the end of the year, they get a statement showing how much they transferred so they can file it with their taxes. Limits that you can contribute generally increase over time. In 2018 the contribution limit for an individual is $3450 and a family is $6900. However, if you're 55 or older you can contribute an extra $1000 a year.