Wellness In Now.

Individual Health Insurance

Individual health insurance is coverage that you purchase on your own, on an individual or family basis, as opposed to obtaining through an employer or from a government-run program like Medicare, Medicaid, or CHIP.

Individual health insurance is for anyone who doesn’t have access to employer-sponsored or government-run health coverage. This includes people who are employed by a small business that doesn’t provide health benefits, people who are self-employed, and people who retire before they’re eligible for Medicare and have to get their own personal health coverage until they reach age 65.

Short-term Health Insurance

Short-term health insurance is a type of health plan that can provide you with temporary medical coverage when you are between health plans, outside enrollment periods, and need some coverage in case of an emergency. However, to get the most out of a short term health plan, you need to understand how they work, what they cost, and what they cover.

Short-term health insurance coverage varies greatly depending on the plan and the insurance company you buy from. These types of plans are not required to comply with Affordable Care Act (ACA) guidelines. ACA plans are required to provide certain levels of coverage—called minimum essential coverage. Short-term health plans are not required to meet the same standards.

Short-term medical insurance typically provides some level of coverage for preventive care, doctor visits, urgent care, and emergency care. There may also be coverage for prescriptions. Some plans also offer cost savings for seeing in-network providers. Make sure to read the “exclusions and limitations” information before buying any plan. This will tell you what’s covered and not covered by a certain plan.

Limited-duration Insurance

Short-term, limited duration (STLD) health insurance has long been offered to individuals through the non-group market and through associations. The product was designed for people who experience a temporary gap in health coverage.1 Unlike other products that are considered “limited benefit” or “excepted benefit” policies – such as cancer-only policies or hospital indemnity policies that pay a fixed dollar benefit per inpatient stay – short-term policies are generally considered to be “major medical” coverage; however, short-term policies are distinguished from other comprehensive major medical policies because they only provide coverage for a limited term, typically less than 365 days. Short-term policies are also characterized by other significant limitations, including the types of services covered, often with a dollar maximum.

Late last year, Congress repealed the Affordable Care Act’s individual mandate penalty, the requirement that individuals have minimum essential health coverage or face a tax penalty. Starting in 2019, the tax penalty will be reduced to $0. It is possible this change could lead more consumers to consider purchasing short-term policies. In addition, late last year, President Trump issued an executive order directing the Secretary of Health and Human Services to take steps to expand the availability of short-term health insurance policies, and a proposed regulation to increase the maximum coverage term under such policies was published in February. This brief provides background information on short-term policies and how they differ from ACA-compliant health plans

Fixed Indemnity Health Insurance

Fixed indemnity health insurance is a type of medical insurance that pays a pre-determined amount on a per-period or per-incident basis, regardless of the total charges incurred. Plans might pay $200 upon hospital admission, for example, or $100 per day while a person is hospitalized.

Fixed indemnity health plans are not regulated by the ACA, do not provide coverage for the essential health benefits, can exclude pre-existing conditions, and have annual and lifetime benefit limits (as well as defined benefit limits for all services, as that’s their service model). People who have fixed indemnity plans without additional minimum essential coverage are subject to an individual mandate penalty if they’re in a state that imposes a penalty for going without health coverage (unless they qualify for an exemption), as a fixed indemnity plan does not count as having insurance.

Medicare Advantage

Medicare Advantage (MA) plans, also known as Part C plans, are private health plans that provide an alternative to Original Medicare for health and drug coverage. MA plans are offered by private companies that contract with Medicare and must follow Medicare rules. They typically include Part A, Part B, and Part D coverage, and may also offer additional benefits like dental, hearing, and vision services. MA plans may have lower out-of-pocket costs than Original Medicare, but most require you to use doctors in their network.

Contact