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Copyright 2005 Health Plan Finders All Rights Reserved. Terms | Login Steve Dixon agent/broker
Health Plan Finders is an
independent insurance agency. Our primary focus is to find the best health
insurance policy for our clients, and since we work with the top health
insurance companies we have many different options. If you need a policy for
yourself, your family or your business – we have worked in the health
insurance business since 1990 and we are ready to help find the policy that
works best for your needs and budget.
Health insurance in Texas,
Colorado and Michigan. Blue
Cross Blue Shield,
CIGNA,
Aetna,
Pacificare,
United Healthcare,
Golden Rule,
Humana,
SecureHorizons,
Assurant,
Fortis:
General Agent Steve Dixon - DFW,
Flower Mound TX,
Lewisville TX,
Highland Village TX,
Argyle TX,
Denton TX,
Southlake TX,
Grapevine TX,
Carrollton TX
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.
Delta Dental: Group Application Emp Application HIPAA
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