I often get asked what are my options with health insurance. Despite what many people think there are many options.
Option 1- Group insurance. This is the kind of insurance you get from an employer. This is traditionally offered as a PPO (Preferred Provider Organization). Typically these plans offer benefits like Co-Pays for both doctors and prescriptions. They also have a smaller deductible for hospital based procedures. I do offer these services. I work with United, BCBS, Cigna, Aetna, Humana, Concordia and National General. Even if you are just a group of two, I can help!
Option 2- Affordable Care Act (Obamacare or Marketplace). This insurance often has a bad name. People have heard so many bad things about this option that they mere mention of it sends them off the edge. The ACA is (In Texas) either an HMO (Health Maintenance Organization) or EPO (Exclusive Provider Organization). As many people know these both offer smaller networks than a PPO. However, for those with pre-existing conditions ACA plans are often your best option if you do not work for a company with health insurance. These plans also have specific times to enroll and qualifiers if your are outside of this period.
Option 3- Short Term Insurance. This insurance is a great option for those that need insurance for a few months. They are deductible driven plans meaning that there are not a lot of benefits before you meet your deductible. These plans also work for those that are ok with a catastrophic style plan. These plans will allow enrollment year around. There are also options for 1 month to 36 months of continual coverage. So the term short term is a misnomer in those cases.
Option 4- Private health insurance. This insurance type is often an indemnity style plan. This simply means there is a fixed benefits paid for a particular service. These plans often work on either the Multi-plan or PHCS (Private health care systems) networks. While these are large national groups, there are many small groups under the bigger umbrella. These plans do not offer (usually) a out of pocket cap.
Option 5- Medical sharing. While this is not insurance, many Americans have these plans. This is simply of group of people (often faith based) who work together to share bills. This is often a cash pay system at the point of service and then a submission to the group for payment back to you.
Option 6- Medicare. This is only for those on disability or 65 years of age or older.