Let’s discuss Health Insurance

What is Health Insurance? Health insurance is a type of coverage that pays for medical and surgical expenses incurred by the insured due to sickness or injury. It includes protection against losses from accidents, medical expenses, disabilities, or accidental death and dismemberment.

Types of Health Insurance

1. Health Maintenance Organizations (HMOs) and Exclusive Provider Organizations (EPOs): HMOs and EPOs typically limit coverage to providers within their networks. A network consists of doctors, hospitals, and other healthcare providers who have agreed to offer medical care to members of a specific health plan. If you use a doctor or facility outside the HMO’s network, you may be responsible for the full cost of the services provided. HMO members usually have a primary care doctor and need referrals to see specialists, while this is not generally the case for EPOs.
2. Preferred Provider Organizations (PPOs) and Point-of-Service (POS) plans: PPO and POS plans offer the flexibility of receiving care within or outside a provider network. With these plans, you may use out-of-network providers and facilities, but you will pay more than if you use in-network providers. PPO plan members can visit any doctor without a referral, while POS plan members need a referral to visit out-of-network providers.
3. High Deductible Health Plan (HDHP): HDHPs typically feature lower premiums and higher deductibles than traditional insurance plans. If you have an HDHP, you can use a health savings account (HSA) or a health reimbursement arrangement (HRA) to pay for qualified out-of-pocket medical costs, which can lower your federal tax liability.
4. Catastrophic Health Insurance Plan: A catastrophic health insurance plan covers essential health benefits but comes with a very high deductible. This means it provides a “safety net” coverage in case of an accident or severe illness. Catastrophic plans usually do not cover services like prescription drugs or vaccinations. Premiums for catastrophic plans may be lower than traditional health insurance plans, but deductibles are generally much higher.

What is Dental Insurance?

Dental insurance is a type of coverage designed to help pay for a portion of the costs associated with dental care. Dental offices generally have a fee schedule or a list of prices for their dental services or procedures.

Typical Types of Dental Insurance

Indemnity Dental Insurance Plan:

This plan can be beneficial if you want to stay with your dentist who does not participate in a dental network. The insurance company usually pays the dentist a percentage of your services according to the policy you purchased. You should review the co-payment requirements, waiting periods, stated deductible, annual limitations, and graduated percentage scales based on the type of procedure and/or length of time you have owned the policy before starting your dental work.

Dental Health Managed Organization (DHMO):

When a dentist signs a contract with a dental insurance company, the provider agrees to accept an insurance fee schedule and offer their customers a reduced cost for services as an In-Network Provider. Many DHMO insurance plans have little or no waiting periods, no annual maximum benefit limitations, and cover major dental work near the start of the policy period. This plan is sometimes purchased to help offset the high cost of dental procedures. Some dental insurance plans offer free semi-annual preventive treatment. Fillings, crowns, implants, and dentures may have various limitations.

Participating Provider Network (PPO):

Depending on your specific plan, a PPO works similarly to a DHMO when using an In-Network facility. However, it allows you to use an Out-of-Network or Non-Participating Provider. Any difference in fees will become the financial responsibility of the patient unless otherwise specified in your dental policy. As noted, some dental insurance plans may have an annual maximum benefit limit. Once the annual maximum benefit is exhausted, any additional treatments may become the patient’s responsibility. Each year the annual maximum is reissued. The reissued date may vary as a calendar year, company fiscal year, or date of enrollment based on your specific plan.

What is Vision Insurance?

Vision insurance is a type of insurance that offers coverage for services provided by eye care professionals, such as ophthalmologists and optometrists.

A typical vision insurance plan offers annual coverage for eye examinations and partial or full coverage for eyeglasses, sunglasses, and contact lenses, with or without copays, depending on the specific plan chosen.

Understanding the importance of eye health in relation to overall well-being is crucial. Taking care of your eyes, regardless of color, can significantly affect your quality of life.

We can assist you in obtaining affordable vision coverage, which includes an annual routine eye exam for a low copayment. Additionally, you will receive coverage for contact lenses or eyeglass lenses and frames, including designer options.