Open Enrollment – What Does That Mean For You?

Open EnrollmentIt is open enrollment time which is the yearly time when people can enroll in a health insurance plan. Open enrollment is also the time you can change your plan or disenroll. Employers often times have open enrollment times as well as ACA plans and Medicare. If you have your own health insurance you do have to wait for open enrollment to make changes.

Whether you are seeking health insurance through your employer or on your own you will be offered a variety of plans. In order to make the proper decision about which plan is right for you it is important to know the basic characteristics of the most popular types of health insurance.

Fee for service

For many years the fee for service plan was very popular and widely used type of health insurance. The insured pays a monthly fee. A deductible is applied to the cost of the services. Some services related to healthy living or emergency services may be exempted from the deductible. Once the deductible has been met the insured and the insurance company share the cost of services. For most companies, the split may be 80/20 or 70/30. The company pays eighty or seventy percent, the insured pays twenty or thirty percent. There will be a cap on the total amount of money the insurance company will pay in a lifetime.

Health Maintenance Organization (HMO)

HMOs have become increasingly more common in the last decade. Again, the insured pays a premium which makes him/her a member of the HMO. As a member of the group the member is entitled to visit any of the doctors who are part of the group. These doctors may all work together in an HMO facility or may work in individual clinics as part of a group of doctors under contract to the HMO. Members may have to pay what is called co-pay when they visit the doctor. No paperwork is necessary to validate the claims of an HMO member; however, members may wait longer for non-emergency appointments than they would with a fee for service insurance program. An HMO generally requires its members to have a primary care physician who then refers the member to a specialist if needed.

Preferred Provider Organizations (PPO)

The PPO, a blend of the fee for service model and the HMO model, is a fast-growing sector of health insurance. As with an HMO there is a network of doctors from which the insured chooses his/her physician. This physician is responsible for designating the need for specialized care. A co-payment will be required when an office or hospital visit is made. There will also be a deductible and medical expenses will be divided at an agreed upon scale between the insured and the insurance company operating the PPO. A person may choose to use a doctor who is outside of the network. Expenses incurred for medical care outside the network will make the patient’s share higher.

It is best to collect as many quotes as possible in order to compare services and rates. One way to get a quote is to probably search for one on the Internet.

When you search for affordable family and individual health insurance on the Internet, you will to be required to answer several questions before you can get your family and individual health insurance quote. Those questions include, but are not limited to:

  • Your location. This helps determine whether the insurance company offers family and individual health insurance plans in your area.
  • The gender and date of birth of the applicant, as well as the spouse and any children who are going to be included on the family and individual health insurance plan.
  • The tobacco use of everyone who is going to be included on the family and individual health insurance plan. You shouldn’t provide false information about your tobacco use; in the end, if you need health care related to illnesses caused by smoking, your family and individual health insurance plan may not provide coverage if your false information is discovered.
  • Whether or not the applicant, or anyone who is going to be included on the family and individual health insurance plan, is a full-time student. Many family and individual health insurance plans are purchased by full time college or university students who have dependents.
  • Your contact information. If you qualify for an affordable family and individual health insurance plan, the company is going to want to contact you with a quote and further steps.

Once you have done your research, schedule an appointment with us and we can help guide on what are the best options for you, your family needs and budget. We will work with you to find you the best coverage for your budget. We strive to save you money and provide you with all the information you need to make the best decision for you and your family.

You can leverage our experience in designing plans that meet the unique needs of different individuals and families. We will help you find a plan that meets your needs and gives you peace of mind. We look forward to providing a competitive health insurance plan for you and your family.

Make an appointment to have your plan reviewed and recommendations as to your best options today

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8359 Beacon Blvd #213
Fort Myers Fl 33907