How HEALTH PLANS Works
Health Insurance Basics
Health insurance is a product that covers consumer medical expenses.
Most health insurance products generally cover medical costs due to illness, injury, and preventative care, e.g., wellness visits to a primary care doctor or vaccinations. Health insurance plans do not always cover 100% of medical expenses. Health insurance carriers share costs with consumers through components, such as, deductibles, copayments, coinsurance, and out-of-pocket limits.
Key Health Plans offers several types of health insurance coverage options including on-exchange and off-exchange products. All qualified (Obamacare-compliant) health insurance plans are required to cover 10 essential benefits to be included on a government-run exchange. Off-exchange plans are also required to meet the ten essential benefits.
Why is speaking with a licensed insurance agent that specializes in individual and family plan options necessary? We provide expert guidance on available Marketplace (ACA) and non-Marketplace plan options including Dental, Vision, Short-term and Life products. An agent will educate you on physician networks, formularies (prescription drugs), and cost analysis for the following: premiums, copays, deductibles, advanced premium tax credit (APTC), cost share reduction (CSR). Throughout the enrollment process and post-enrollment, you will have a personal contact to assist with questions, claims, or concerns, should any arise.
Call us today 1-855-745-5422 or use the form to the right to have a KHP licensed agent contact you, please include preferred time and method.
Explore Your Options
The 10 essential benefits include:
- Ambulatory patient services
- Maternity and newborn care
- Mental health and substance utilization of disorder services; inclusive of behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services
- Laboratory Services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Health insurance plans must also comply with:
- Affordability standards
- Other rules that may vary from state-to-state basis
- Certain federal standards to be considered qualifying health coverage
The Affordable Care Act (ACA) outlines that all American citizens must have qualifying health coverage. Without qualifying health coverage, consumers will face a designated tax fee on the following years tax return.
The tax fee is calculated by, 2.5 percent of household income or $695 per adult and $347.50 per child under 18. Any consumer will pay whichever option turns out to be higher. (Recent health care reform has changed this tax starting in 2019.)
Who Needs Qualifying Health Insurance
All American citizens are mandated to have health insurance coverage, unless they qualify for a hardship exemption.
Key Health Plans offers health insurance solutions for each consumer type including, but not limited to; individuals, families, and employer groups. Commonly, most US citizens are offered job-based options through their employers, which is accessible at a group-level rate. Self-employed and other uninsured types of consumers will need to find qualifying health insurance through on or off-exchange marketplaces.
Key Health Plans simplifies the search for qualifying health coverage by providing a one-stop shop for consumers to view and compare multiple health insurance options. Unlike going straight to the insurance carrier, Key Health Plans will provide you with unbiased advice and insurance solutions that best fit you.
A misconception most consumers have about health insurance; is that paying the tax penalty may be less expensive than an actual health insurance policy. However, the truth is that health insurance is less costly than the cost of the tax penalty, when considering that uninsured people receive less timely medical care and have worse health outcomes. Besides, the lack of insurance becomes a fiscal burden on uninsured and their families. Medical bills are one of the leading costs of consumer debt and other financial burdens. Overall, the benefits outweigh the costs of having health insurance.
To learn more about how health plans work, please contact us at 1-855-745-5422.