Individual Health Insurance

If you are an entrepreneur, retiring before you are eligible for Medicare, or simply do not get minimum essential health insurance coverage through your job, Blue Peak can help you find the right individual coverage for you.

DO YOU UNDERSTAND YOUR HEALTH INSURANCE COVERAGE?

Health insurance can be very confusing. There are several components, all with different terminology. In addition, changes have occurred due to health care reform. I will try to simplify some major factors related to health insurance.

If you don’t have health insurance, you need it.

There are many people who think that either they are healthy and don’t need insurance, or that if something happens to them the government will take care of them. Things happen, and little things can cost a lot of money. For example, a broken bone can cost over $10,000 in medical bills. An illness or accident can put you in debt for years.

Know your options.

Individual/family insurance can be obtained either by going directly through an insurance carrier, or by going through the Federal Health Insurance Marketplace. I can help people pursue both of these options. The reason to go through the Federal website is if you think you may qualify for a subsidy based on your income. All plans have to include the same benefits, referred to as Essential Health Benefits. They are divided by metallic levels of coverage, based on the actuarial value of the plans (Platinum-90%, Gold- 80%, Silver-70%, and Bronze-60%). In general, the higher the metal level, the more you pay (your monthly premium), in exchange for lower copays and out of pocket expenses. The health plan is not allowed to deny you coverage based on pre-existing conditions or ask you health related questions.

Understand your policy.

Too often when meeting individuals and families, they do not know what type of health coverage they have and how it works. It is important to know what is covered and how to utilize it to your advantage. First, is there a network of providers and hospitals that you need to use? If you go out of network, except in the case of emergencies, you may not be covered or your coinsurance may be significantly higher. I can help you review your provider network, your plan deductible, covered services, copays and more.

Perform a yearly checkup.

Things are constantly changing– always review what options are available to you. Make sure to meet with me during the annual enrollment period to determine if your current plan still meets your needs.