A.C.A Quote
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40 yr Male, 40 yr female, 2 children
- Deductible: $0
- PCP Copay: $8
- Specialist Copay: $15
- RX copay: $8
Plan Premium with tax credit = $145.77
Get a QuoteShort Term Medical
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40 yr Male, 40 yr female, 2 children
- Deductible: $2000
- Doctor Co-pays $30/$60
- RX: $10 Co-pay
- Up to 36 months of Coverage
- Teledoc Included
Short Term Silver Plan $369.80
Get a QuoteIndemnity
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40 yr Male, 40 yr female, 2 children
- Hospitalization = $3000 per day
- Surgery 100% *restrictions apply
- Emergency Room = $125 per/day
- Doctors Office Visit = $ 100 per visit
- Teledoc Included
Plan Premium $268.00
Get a Quote
About Amerus Financial Group
At Amerus Financial we are serious about putting the needs and desires of our clients before anything else. We take the time to carefully conside your individual circumstances before making any reccomendations. Our experienced planners take pride in searching out solutions to complex needs and making sure that we offer sound financial advise.
With over 4,000 satisfied clients at Amerus Financial Group we strive to go above and beyond your expectations.
Call us +1 (888) 441-7891Marketplace Health Insurance ('Obama Care')
The Affordable Care Act (ACA), otherwise known as Obamacare, is designed to make guaranteed issue health insurance plans available to everyone. These plans cover preexisting conditions along with a list of essential health benefits that don't change from plan to plan, known as preventative care.
The ACA has established a yearly Open Enrollment period (Nov. 1st-Dec 15th) for enrolling in a qualified health plan. In most cases, if you want ACA coverage, you must enroll in an ACA-compliant medical plan within that period. However, if you experience a qualifying event or major life change outside of that Open Enrollment window, you may be able to enroll during a Special Enrollment period. Contact an agent to see if you qualify. .
Pros:
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Dependant Coverage
- Dependants can stay on your policies until age 26.
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Subsidies & Tax Credits
- For those that qualify, Subsidies and tax credits not only bring down the monthly premium (Cost) of your health insurance but also bring down things such as Deductibles and copayments on silver plans. Based on your FPL (Federal Poverty Level.
- No pre-existing condition limitations.
- Insurance companies cannot cancel your health plan due to an error on your application nor can they deny you coverage due to a pre-existing health condition that you may have.
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No waiting periods
- There is no more waiting period to be met before you or your dependent can see a physician. Once your policy is effective you can begin using the benefits immediately.
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Free Preventative Care
- All qualified marketplace plans must provide preventative care, free of charge to you. That means no deductibles, copayments, or coinsurance.
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No Caps
- All qualified health plans must cover according to the policy contract without a maximum benefit.
Cons:
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Limited Companies
- Due to the fact that Marketplace health plans have lost the majority of their risk stops, such as pre-existing condition waivers, many insurance companies simply cannot afford to offer plans on the health exchange. Therefore you are limited to certain companies and networks. Some counties only have one option.
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High Deductibles and High premiums
- For those that do not qualify for the subsidies and tax credits marketplace plans may be unaffordable. Customers may end up paying high premiums while also being stuck with a high deductible plan.
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Tax Penalties
- Prior to 2019, you could face large tax penalties for being uninsured. While this has been done away with on a federal level many states have begun to enforce similar mandates of their own.
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Annual Open Enrollment
- Once the enrollment period is closed it becomes next to impossible to purchase a plan on the exchange. Those looking for coverage outside of OEP (Open Enrollment Period - November 1, 2020 – December 15, 2020.) must have a qualifying life event to open up an SEP (special Enrollment Period).
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Loss of Employment Coverage
- Due to the ACA there has been a major increase in premiums making group insurance coverage unaffordable for many small businesses.
Short Term Health Insurance
Short-term health plans are low-cost, low-coverage plans. Short term health insurance plans offer major medical benefits in the case of unexpected accidents and illnesses. These plans are not regulated by the ACA law and typically do not cover Preventative Care or ACA Essential Benefits such as Pregnancy.
These plans are for individuals and families and last for a defined term of up to 364 days and renewable for up to 36 months depending on your state, unlike traditional health plans which don't have time limits.
What short-term plans cover varies widely. Federal regulations allow short-term plans to create their own coverage plans without any required mandates from the ACA.. So, you may find substance abuse treatment coverage in one short-term plan, while another might cover barely anything. Short Term Health insurance plans are Great for those that are just wanting coverage in the case of an unexpected medical event.
Pros:
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No Enrollment Periods
- With Short term plans you can shop anytime of year and even have coverage effective the next day.
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Economical Premiums
- Premiums are not based on household size and income such as a marketplace plan. Therefore these plans can be a fraction of the cost of the plans on the marketplace
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Broad Networks
- Oftentimes have large networks of Doctors and Hospitals for you to choose from.
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Customizable
- Short Term Health plans can be customized to meet your individual needs.
Cons:
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Pre-existing coverage limitations
- You may be denied coverage if you have any pre-existing conditions. If you are accepted for coverage you may have claims related to your condition denied
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Policy maximum coverage
- Policies may have annual limits and lifetime maximums on coverage benefits.
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Not ACA Compliant
- Do not cover preventative care free of charge as an exchange plan.
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ACA Subsidies don’t apply
- There are no government subsidies that apply to premiums and tax credits.
Indemnity
A fixed indemnity plan is one that pays a set amount of money for any medical services you receive. So, for example, if your plan specifies a $5000 per day benefit for a Hospital Stay then your plan will pay the specified amount outlined in the policy whether the bill is more or less. If the bill is more, then you would be responsible for the excess charges if it is less then the remaining monies would be yours to keep.
Because the benefit is preset and paid out regardless of what the total bill for the qualified service might be, fixed indemnity insurance is sometimes called fixed benefit insurance or fee for service insurance. Flexed Indemnity plans are good for those who want affordable coverage that they can customize to meet their individual needs.
Pros:
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Affordable Premiums
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First Dollar Coverage
- You get First Dollar Coverage that covers various procedures while not requiring you to meet a deductible.
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No Enrollment Period
- Enrollment is not limited to an enrollment period but can applied for anytime during the year.
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Customizable
- You can customize your plan benefits to cover the things that are most important to you.
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Direct Payments
- Pays directly to a member upon a qualifying incident. Payment is based upon a predetermined schedule of qualifying events.
Cons:
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Preset Fees
- Indemnity plans cover medical procedures at a specific dollar amount. If the medical practitioner charges more than the amount allotted you will be responsible for the difference.
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Pre-existing condition exclusions
- Indemnity plans are subject to underwriting and do not cover Pre-existing conditions. Some plans will cover certain pre-existing conditions after a waiting period.
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Waiting Periods
- Some indemnity plans have waiting periods that must be satisfied before specific conditions such as cancer is covered.
Frequently Asked Questions
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What Is Health Insurance?
Health insurance is a type of coverage that can protect you from the full expense of regular health care, as well as the costs of medical and surgical procedures. In exchange for paying a premium, your insurance company will cover the costs of your healthcare and certain types of medical procedures.
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What Does Health Insurance Cover?
Health insurance can cover a variety of things, from your regular checkups and family care to your major medical expenses. The types of services that are covered will vary with different healthcare providers and plan types.
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Am I eligible for a subsidy?
You may qualify for a tax credit if your income is less than 400% of FPL. If your income is between 100% and 200% of FPL you may qualify for a subsidy to help cover your deductible and out of pocket expenses.
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Will a Short Term Insurance plan cover my Pregnancy?
There are Short term plan options that will cover a pregnancy. That being said, most short term plans will have an exclusion for pregnancy.
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How do I Apply for Medicaid?
You can apply in one of two ways :
- 1. You can go through the health insurance marketplace and let th em send your application to your state medicaid office.
- 2. You can also apply directly through your state agency.
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What is the Affordable care act:
he comprehensive health care reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”).
- Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level.
- Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level. (Not all states have expanded their Medicaid programs.)
- Support innovative medical care delivery methods designed to lower the costs of health care generally.
- Additional Information Can be obtained from Healthcare.gov
- Is health insurance required by law?
Individuals are no longer subject to tax penalties if they choose not to carry Health Insurance but businesses with 50 or more full time employees are still required to provide coverage to their employees.