FAQ
What is an Insurance Premium?
A premium is your monthly bill. Every month a premium is paid to a health insurance company; to access the health insurance plan. However, it is not equal to the amount you pay for the health care services.
What is a deductible?
Deductibles are the out-of-pocket costs you pay to utilize health care services before the health insurance takes effect. Once the deductible is paid, the health insurance company will use the copayments and coinsurance to split costs with you (up to the out of pocket maximum, after which the plan pays for 100 percent of the services).
What is a Copayment?
A copayment is a fixed amount paid for a specific service or prescribed medication. Copayments are one of the ways that health insurers will split costs with you after you achieve the plan deductible. In addition, you may have copayments on specific services before you reach your deductible.
*For example, many health insurance plans will have copayments for doctor’s visits and prescription drugs before you reach your targeted deductible. You will pay copayments until you arrive at your maximum out-of-pocket limit.
What does Coinsurance mean?
Coinsurance is another way that health insurers will split costs with you. Unlike a copayment, coinsurance isn’t a fixed cost (it’s a percentage of the cost that you pay for covered services.)
*For example, if you have a coinsurance of 20 percent, you’ll pay 20 percent of the cost of covered services until you reach your out-of-pocket limit.
What does Coinsurance mean?
Coinsurance is another way that health insurers will split costs with you. Unlike a copayment, coinsurance isn’t a fixed cost (it’s a percentage of the cost that you pay for covered services.)
*For example, if you have a coinsurance of 20 percent, you’ll pay 20 percent of the cost of covered services until you reach your out-of-pocket limit.
Affordable Care Act
What is difference between Obamacare, Health Insurance Marketplace and Affordable Care Act (ACA)?
The federal Health Insurance Marketplace, which is also called the “Marketplace” or “Exchange,” is the website where individuals can browse various health care plans available under the Affordable Care Act, commonly known as “Obamacare,” as well as compare them, and purchase health insurance. Obamacare and Affordable Care Act are the same thing.
When can I enroll in ACA/Obamacare?
Open enrollment is the one time of the year when employees can sign up for health insurance or change their health insurance plans. If you choose not to enroll during the open enrollment period, your options to purchase coverage become limited. Why? You cannot purchase ACA-compliant coverage unless a qualifying event occurs.
Qualifying events include:
- Loss of a job
- Move to a new coverage area
- Birth of a child
- Loss of existing coverage
- Family event (i.e. marriage, divorce, or death)
What is difference between Obamacare, Health Insurance Marketplace and Affordable Care Act (ACA)?
Open enrollment is the one time of the year when employees can sign up for health insurance or change their health insurance plans. If you choose not to enroll during the open enrollment period, your options to purchase coverage become limited. Why? You cannot purchase ACA-compliant coverage unless a qualifying event occurs.
Qualifying events include:
- Loss of a job
- Move to a new coverage area
- Birth of a child
- Loss of existing coverage
- Family event (i.e. marriage, divorce, or death)
Can immigrants buy health insurance through the health insurance Marketplaces?
Most lawfully present immigrants can buy health insurance through the Health Insurance Marketplaces. This group includes lawfully present immigrants who cannot enroll in Medicaid based on immigration status, for example, because they are in the five-year waiting period for Medicaid or CHIP coverage. As of November 1, 2024, Deferred Action for Childhood Arrivals (DACA) recipients will be newly eligible to purchase Marketplace coverage.
Certain lawfully present non-immigrants, such as people with work (H1) and student visas, are also eligible to purchase Marketplace plans.
Undocumented immigrants may not purchase coverage through the health insurance Marketplaces.
Medicare
There are so many parts to Medicare, can you explain what they mean?
We understand that health insurance can be overwhelming with all the abbreviations and terms. Here are some key parts of Medicare and the letters you might come across.
- Part A: Hospital Insurance – Covers hospital stays, nursing care, hospice, and some home health services.
- Part B: Medical Insurance – Covers doctor visits, outpatient care, and preventive services.
- Part C: Medicare Advantage – A plan that includes Parts A, B, and often D, offered by private companies.
- Part D: Prescription Drug Coverage – Helps with the cost of prescription medications through private plans.
Who is eligible for Medicare?
Generally, Medicare is for people 65 or older. You may be able to get Medicare earlier if you have a disability, End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant), or ALS (also called Lou Gehrig’s disease).
What is the difference between Medicare and Medicaid?
Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that gives health coverage to some people with limited income and resources.
Keystone Advisors
Is Keystone Advisors a reputable company?
Yes, Keystone Advisors is a highly reputable company. With over 10 years of experience, we have built a strong reputation for putting people before sales and always prioritizing our clients’ best interests. Our team undergoes extensive training to ensure we provide the highest level of expertise and service.
We are proud to have been recognized as a 2024 Houston Chronicle Best of the Best Finalist, a testament to our dedication to excellence. Additionally, with more than 300 five-star ratings on Google, our clients consistently trust us to deliver outstanding results and personalized solutions.
At Keystone Advisors, we’re committed to maintaining the trust of our clients and continuously improving the services we offer.
I prefer to work with someone in person rather than over the phone. Is that possible?
Absolutely! We understand that some clients prefer face-to-face interactions. Our office at, 10900 Corporate Centre Drive Ste 150 Houston TX 77041, is always open during business hours, and you’re welcome to either schedule an appointment through our website or walk in at your convenience. Our team is always available and ready to assist you in person.
What if I don’t speak English?
That’s not a problem at all! We have a diverse team of agents who are fluent in English, Spanish, Vietnamese, Arabic, and more. We’re committed to ensuring clear communication and making sure you feel comfortable throughout your experience with us.
Will Keystone Advisors charge me?
No, we do not charge for our services. Whether you have questions, need help finding the right health plan, or require assistance with enrollment, we’re here to support you at no cost.