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Today's Health Insurance Note:
Medical Services that are covered by a health insurance policy are typically subject to the deductible or a copayment


The deductible is the amount the patient is responsible for when covered medical services are received unless the medical services are subject to the copayment. Medical services that are usually subject to the deductible are hospitalizations, surgery, ER visits, laboratory tests and x-rays. Keep in mind that the insurance company will pay their portion of the bill regardless if the patient has paid their deductible to the hospital or not. Policies vary greatly, ask us about the differences.

The copayment is the set dollar amount the patient pays usually for a doctor's office visit. Keep in mind the copayment amount is usually not applied toward the deductible and lab test and x-rays in a doctor's office may be subject to the deductible. Make sure you visit a doctor who is "in-network" (this means the doctor has signed a contract with the PPO). Policies vary greatly, ask us about the differences.

On covered medical expenses that are subject to the deductible, once your deductible is satisfied, most policies have a co-sharing or coinsurance percentage. Most people recognize the term 80/20 plan, this is coinsurance; the insurance company pays the first percentage (80% in this example) and the patient pays the second percentage (20% in this example). Most medical insurance policies also have a coinsurance maximum. The coinsurance maximum is the maximum amount of coinsurance the patient is responsible to pay during that calendar year. Once the coinsurance maximum is met, usually additional covered medical expenses are paid by the insurance company at 100% for the remainder of the calendar year. One important note – make sure you always stay in-network since in-network covered medical expenses have a negotiated lower price and most medical policies have a higher coinsurance maximum for out-of-network covered medical expenses. These examples are basic summaries of terms used in insurance policies. A written summary of benefits with terms, benefits and exclusions and limitations are available for each medical insurance policy. A copy will be provided upon request.

Employer sponsored group policies usually have more medical services subject to the copayment than individual medical policies. Call and we can talk about the specific differences.

Affordable Health Insurance is something we all want; reliable health insurance is what we all need. Health Insurance is our specialty, no matter

what your situation, we can help. If you are self employed or not a part of a large company we can help you find affordable health insurance that you can count on. If you own a small business we can help you find affordable group health insurance that will help you keep quality employees. We understand that your budget is important, that is why we don't search for cheap health insurance, we will find the right plan at the right price for you. This site gives you access to many health insurance plans offered by the best health insurance companies in America. AMG provides a free service to consumers and does not add any fees to the carrier's rates and fees. No one else can offer a lower premium for the same insurance plans. We are your advocate to quality insurance. Plans also available in Colorado and Michigan.         fm                Links

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Health Plan Finders is the best website to get health insurance quotes in Texas. Go to the website at www.healthplanfinders.com and click on get quotes and you will see several quotes from the best health insurance companies in Texas.

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Today's Health Insurance Note:
Don't wait until after you get pregnant try to get health insurance. If you have access to a group plan through your employer (or your spouses employer), but you waived off the plan - you might not be able to join the plan until open enrollment. If you don't have access to health insurance at work, you will have very little chance to get coverage once you are pregnant. So get coverage before you need coverage and have coverage "in-force" when you need it. Call and we can talk about your situation.   nfl

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