Affordable Health Insurance Quotes

Why will individual and family health insurance work for me?

What types of individual and family insurance plans does Benepath offer?

Indemnity and Managed-Care are the two main types of individual and family health insurance plans. Generally speaking, the most important differences between the two categories are the number of healthcare providers from which to choose, the amount of out-of-pocket expense, and the bill-paying process. Normally, indemnity plans offer more choices of healthcare providers than managed care plans, but it is important to note that indemnity plans will not begin to make payments on your claims until they have received a bill from the provider. This usually results in required payment at the time services are rendered and then subsequent reimbursement by the insurance company.

Healthcare provider networks are the main structures utilized by managed-care plans. Insurance companies and healthcare providers within a network develop predetermined rates for specific services, and the providers agree to perform those services for managed-care plan patients as well as submit the claim to the insurance company. There are three main types of managed-care health insurance plans. These include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Point of Service (POS) plans.

To summarize the two categories of plans, an indemnity plan offers a wider selection of healthcare providers and utilizes a reimbursement system; a managed care plan provides the options of lower out-of-pocket costs and very little paperwork along with a reduction in healthcare provider choices.

What is a Preferred Provider Organization (PPO) plan?

Although it is not required that you do so, when you use the insurance company's network of preferred doctors and hospitals, a PPO plan will have lower costs. If you choose an out-of-network provider, the cost will be much higher. In-network healthcare providers have predetermined rates, usually nominal, for the provision of each service to the health insurance plan's members. Consider the following example: Let's assume that the out-of-network coverage rate is sixty percent. This means that the insurance company will pay sixty percent of what that service would have cost had you gone to an in-network provider. If you received $500 worth of services from an out-of-network provider and those same services were available from an in-network provider for $250, the insurance company will only pay sixty percent of $250, which is $150, leaving you responsible for the remaining $350. Another consideration is that not only may up-front payment be required, but the out-of-network provider will not submit your claim for reimbursement.

It is generally not required to pick a primary care physician which allows plan members to seek medical services from any doctor or specialist within the network. While one of the most popular qualities of PPO plans is the flexibility in choosing providers, it is essential to confirm that your preferred doctor or neighborhood hospital belongs to the network. Additionally, if you will be including children in your plan, preventive and well-child care benefits will be of special importance to you. An annual deductible typically must be met before the insurance company starts covering your medical bills. A co-payment may be required for certain services or it may be necessary for the plan member to cover a certain percentage, or coinsurance, of the total charges.

What is a Health Maintenance Organization (HMO)?

The biggest benefits of a standard HMO plan are the lower out-of-pocket healthcare expenses, the strong focus on preventative medicine, and nominal co pays that are independent of a deductible. However, more often than not, these features are paired with more limited options as far as freedom to choose specific physicians or hospitals. Unlike a PPO, the selection of a primary care physician (PCP), who will handle the majority of your healthcare needs, is required. With an HMO plan, your insurance claims are submitted for you by the provider. It is important to note that should you decide to receive services out-of-network, an HMO will most likely cover none of the cost. In addition, even in-network providers are not covered for services rendered without being referred by your PCP. In order for the insurance company to cover specialist visits, it is up to the discretion of the PCP to make a referral.

What is a Point of Service (POS) plan?

A POS plan is a cross between an HMO plan and a PPO plan. Similar to an HMO, it is required to select a primary care physician (PCP) whose services will usually be provided independently of a deductible. POS plans also share the HMOs concentration on preventive medicine. The highest percentage of coverage will almost always be for services rendered or referred by your PCP. As with PPOs, visits to out-of-network providers generally require payment of the deductible and less of the costs will be absorbed by the insurance company. Another consideration is that not only may up-front payment be required, but the out-of-network provider will not submit your claim for reimbursement.

What is an Indemnity plan?

An Indemnity plan is one of the most flexible health insurance plans on the market. It allows you to freely choose any doctor or hospital you wish with no difference in the levels of coverage. Selection of a primary care physician is not required, nor is it necessary to get a referral to see a specialist. However, Indemnity plans are considerably more expensive than managed care plans because a deductible, usually ranging from $500 to $1500, must be met annually before the insurance company begins to absorb any of the cost. When the deductible is met, claims will be paid at a certain percentage of the usual, customary, and reasonable rate (UCR), which is determined by examining the standard costs of healthcare in your area. Additionally, since the insurance company does not have managed care agreements with providers, the responsibility for filing claims for reimbursement is left to you.

What is a Health Savings Account (HSA)?

The freedoms offered by HSAs have been available since the January 1, 2004 legislation. An HSA is the most progressive alternative to traditional health insurance, allowing you to set aside money specifically for healthcare in an investment savings account without any tax penalties whatsoever. HSAs facilitate the payment of current health expenses while simultaneously saving for future medical and retiree health expenses. Not only is the money in your account solely controlled by you independently of any third party or health insurer, but only you have the authority to determine what types of investments will be made to grow your funds. In order to be eligible for an HSA, you must first be covered by a High Deductible Health Plan (HDHP). Standard HDHP costs are usually lower than those of traditional health care, so the money saved on insurance expenses can be put directly into the Health Savings Account. Please see our HSA examples of significant savings with HSAs.

The popularity of HSAs and HSA-eligible health insurance plans is rapidly spreading. This is why:

• When used in combination with an HSA-eligible high deductible health insurance plan, HSAs allow you save for retirement while paying for current medical expenses.
• The standard annual premium on an HSA-eligible high deductible plan is much less expensive, usually around $1,000 less, than the annual premium for a lower-deductible health insurance plan.
• Not only are contributions to an HSA 100% deductible, but they may also be made with no income tax penalties, up to set limits per year.
• You control and invest the funds in your HAS with the option of simply allowing unused funds to remain in the account and accrue interest year-to-year, tax-free.
• Money in your HSA can be withdrawn to pay for qualified medical expenses with no tax penalties and funds can also conveniently be used for purposes other than healthcare, although there are taxes and fees associated with non-medical withdrawals.

Before choosing an HDHP for use with an HSA, it is important to be sure that your selected high-deductible plan is HSA-eligible. Read more information about HSAs.

What is a co-payment?

A co-payment or "co-pay" is a specific dollar amount that plan members are required to pay for a specific service. The most common examples of co-payments are for office visit or prescription drugs, after which the insurance company will absorb the remainder of the cost. Co-pays frequently range from $10 to $50, although all plans vary in their specific charges.

What is a deductible?

Although there are exceptions, most Indemnity and PPO plans have a required deductible that must be met while HMO plans usually do not. A deductible is a set dollar amount that plan members must pay annually before the health insurance company will begin absorb any medical costs.

What is coinsurance?

Coinsurance is the percentage of coverage provided by health insurance companies, after co-payments or deductibles have been met. For example, a 25% coinsurance rate means that you are responsible for paying 25% of any medical costs incurred. Specifically, $75 of a $100 medical bill would be covered by the insurance company, and your out-of-pocket cost would be $25. It is important to note that each insurance company has its own combination of co-payments, deductibles, and coinsurance.

How is a network used by insurance companies?

A network is a group of providers with whom the insurance company has negotiated specific rates for specific services for plan members. These providers are called in-network providers. Any provider who has not contracted with the health insurance company is considered out-of-network. Services rendered out-of-network will either be covered at a much lower percentage or, as frequently occurs with HMOs, not covered at all. By and large, provider networks are generally utilized by PPOs, POS plans, and HMOs while Indemnity plans allow their policy holders to visit any provider at their discretion at the same level of coverage.

How do I pick the best health insurance plan for me?

At Benepath, we know that finding the best health insurance plan for you can be complicated since there is no such thing as a one-size-fits-all plan. We understand that the best plan for you and your family will be individualized to your specific needs and circumstances. It is because we appreciate the diversity of our customers that we have created the following list of questions to help you find the perfect plan that fits you like a glove.

1) Are you seeking coverage for a transitional period or are you looking for a plan that will cover you indefinitely?
Many people who are between jobs for a period of 1-6 months may not need to look any further than our short-term coverage options. On the other hand, if you are not planning to participate in health insurance coverage through an employer, the reliability and more extensive benefits offered through an individual and family health insurance plan might be a valuable investment for you.

2) How comprehensive would you like your coverage to be?
Basic coverage generally includes emergency features such as inpatient hospitalization and outpatient surgery rather than coverage for preventative medicine and check-ups. The monthly premium for basic coverage plans is usually much lower than plans with more comprehensive coverage. Depending upon your circumstances and the frequency with which you plan to use your insurance, basic coverage may be the best choice if your primary concern is protection in the event of a serious accident or major illness.

Although plans with more comprehensive coverage have a higher monthly premium, they frequently include features such as office visits, prescription drug coverage, and preventative care in addition to covering outpatient surgery and hospitalization. Comprehensive care plans are usually the best choice for people who will be using their insurance coverage frequently. For example, if you are on a regular prescription medication or if you have a current health condition, comprehensive coverage will most likely be the best choice to meet your needs.

3) Would you prefer to have a lower premium with higher co-payments or a higher premium with lower co-payments?
Almost always, a choice must be made between a higher monthly premium with lower deductibles and co-payments or a lower monthly premium with higher deductibles and co-payments. The best way to approach this question is to determine how frequently you will be using your insurance. If you won't be utilizing your health insurance all that often, your insurance costs will most likely be less if you choose a higher-deductible plan with a lower monthly premium. If you are on a regular prescription medication or have frequent doctor's visits, your insurance costs will most likely be less if you choose a plan with a higher monthly premium with a lower deductible and co-payments.

4) How important is it for you to see specialists right away?
A health insurance plan, such as an HMO, that requires the selection of a primary care physician (PCP) will generally not cover specialist visits without a referral. This can be very inconvenient in the event that you are unable to get in to see your PCP and you have a pressing medical need to see a specialist. If direct access to specialists at your discretion is an important feature, you may wish to choose a plan that does not restrict your selection of providers.

5) Do you currently have a specific doctor or hospital from which you would like to continue receiving care?
A large number of insurance plans utilize provider networks. Before choosing a plan, confirm that your current doctor or hospital is a contracted provider with the health insurance plan you select. Additionally, it is important to note that insurance companies sometimes change the providers on their network lists, so you might want to pay special attention to updated lists to be sure your selected providers are still available to you.

6) In the event of an accident or sudden illness, what is the maximum amount of money you would be able to pay out-of-pocket?
Usually there is a certain limit that a policyholder is required to pay out-of-pocket annually. This dollar amount is often referred to as an out-of-pocket maximum. Once this dollar amount is met, the health insurance company will begin to absorb 100% of all other costs for the remainder of the year. If you anticipate using your insurance coverage frequently in the near future, or if you are concerned about what may happen to you in the event of an injury or a sudden illness, the out-of-pocket maximums will be important features for you to review when choosing a plan.

How do I start my coverage?

The best way to expedite the coverage begin date is to "eSign" your application, which allows underwriters to start working on it right away. Individual and family health insurance plan start dates can range from 1 to 90 days in the future. An important consideration is that your selected insurance company will need some time to process your application, and much of it depends upon the underwriting process and the availability of your medical records.

What if I only want to insure my children?

Many insurance companies will not insure more than one child on a single policy. Although Benepath does provide you the options of performing quote searches for one or multiple children, the broadest selection of plans will be shown if you search one child at a time. When getting quotes for your child only, enter the child's information in the "Applicant" or first row as you would your own. When searching for policies for multiple children, you will want to be sure that a childýs information is not entered in the "Spouse" row. You are, of course, free to apply for each child separately or together, whichever best suits your needs.

Why Benepath?

Through Benepath, you will receive your own Personal Health Insurance Advisor who is knowledgeable about your regional health insurance options as well as critical issues like knowing the top hospitals and if they are in the recommend health plans. We also assist you by answering questions, explaining benefit options, helping with plan comparisons and assisting with the application process.

Our customers receive:

• Extensive Choices. Since Benepath is not a health insurance company, we have no investment in which company you choose. As a health insurance agency, our primary objective is to provide you with the broadest selection of plans available in your area so that you can make the most informed decision possible. Because of this, small businesses, families, and individuals look to Benepath for health insurance solutions more than any other online agency.
• Most Affordable Rates. Each state's Department of Insurance has all health insurance rates on file. Regardless of whether you purchase a plan through a local insurance agent, Benepath, or directly from the insurance company, you will still pay the same monthly premium. Why not allow Benepath to do the work for you to ensure that you get the lowest price possible?
• Express Processing. Using online technology, Benepath offers the fastest possible means of applying for and obtaining the right health insurance plan for you.
• Excellent Customer Attention. With Benepath, you'll enjoy the best health insurance experience available in the industry. Our licensed health insurance advisors will help you along every step of the process to ensure you buy the right health insurance plan for your needs and budget.

If I provide my personal information to Benepath, how do I know it is safe?

In addition to utilizing state-of-the-art privacy technologies, Benepath will sell, trade, or give away your information to anyone, for any reason, except the items directly relevant to the processing of your application with the insurance company. Our Privacy Policy, which ensures the confidentiality of all of your information, is available for viewing at your convenience. If you would like us to answer any questions or address any concerns please contact us at 1-888-423-6437.

Do I make payments directly to the insurance company?

Upon completion of most health insurance applications, a credit card number or a check written to the health insurance company will be required for the first premium payment. Generally, the insurance company will not charge your credit card or cash your check until they have confirmed your approval for coverage. If you are not granted coverage, or if you cancel your application, your check will be returned to you or your card will be credited. Usually, health insurance premium payments are paid either quarterly or monthly directly to the insurance company. There are many different options for payment and billing such as automatic withdrawal or standard paper bills. It is important to not that coverage can be obtained without utilizing credit card billing.

Is there any obligation for me to buy an insurance plan once I have applied?

Absolutely not. Using Benepath is a safe, easy method of finding the best health insurance plan for your individualized needs. You may cancel your plan at any time, even during the underwriting process and up to ten days after you actually receive your policy. Although you will provide payment information while completing your application, most insurance companies won't charge your account until you are approved. Some insurance companies may charge a minimal application fee, usually $25 or less, but you will be notified during the application process if this is the case. Due to insurance company policy, these fees are generally non-refundable.

How do I know you are finding me the lowest premiums?

Each state's Department of Insurance has all health insurance rates on file. Regardless of whether you purchase a plan through a local insurance agent, Benepath, or directly from the insurance company, you will still pay the same monthly premium. Why not allow Benepath to do the work for you to ensure that you get the lowest price possible?

Who do I contact if I need help?

Your personal health insurance advisor is able to walk you through this process from beginning to end. At Benepath, we believe in providing you with stellar customer service to address all of your health insurance needs.

• Call Us

Just call 888-423-6437 anytime to speak to a health insurance advisor.

• Email Us

Send us an email at info@benepath.com and we will get back to you as soon as possible.