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Individual Insurance

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What you need to know to help you choose

  • Access your health and family health history before you choose.
  • What type of doctors do we see (specialists/ primary care)
  • Do I/we anticipate large medical expenses in the next 12 months (i.e. pregnancy, surgery, cancer).
  • What types of prescriptions do I/ we take?
  • Are benefits per policy or per person?
  • Do I need extras covered?
  • What are the health insurance policy costs?
  • Do I qualify for a rebate or subsidy?
  • Consider the extra perks.
  • Do I/we look at traditional major medical or non-traditional plans
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Understanding Health Coverage

Buying individual health insurance is a big decision. And big decisions require information, choices, and someone to turn to when you have questions.You can be sure you will be well-taken care from Zinn Insurance Agency. Our goal is to provide fast, friendly service every time you need answers on claims, benefits, or payments.

We take you through our 5-step process

Insurance plans come in all shapes and sizes. That’s why it’s important to assess your needs before you choose an insurance plan.

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Obtaining Health Coverage

Many people get health coverage through their employer. This is called group coverage. Employers may offer several plans to choose from, and employees get a chance to change their plan once a year during open enrollment.

Some people purchase their own coverage because it is not available through their employer. This is called individual health insurance coverage. Individual health insurance coverage is a good option for people who are:

  • In between jobs
  • Self-employed
  • Early retirees
  • Recent college graduates
  • Part-time workers

Some Americans receive health coverage through government programs. Some examples of government health programs are Medicare, Medicaid and other programs run by individual states.

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Types of Health Coverage

Health insurance plans come in all shapes and sizes. That’s why it’s important to assess your needs before you choose an insurance plan.

  • Traditional major medical
  • Short Term
  • Health Share
  • Health Reimbursement
  • Medical Travel

We take our clients though a 5 step process.

Insurance plans come in all shapes and sizes. That’s why it’s important to assess your needs before you choose an insurance plan.

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Types of Insurance Networks

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HMOs

HMOs, available through participating employers, are a type of health plan that gives you access to certain doctors and hospitals, often called network or contracting doctors and hospitals (sometimes called “providers”).

 

HMO Basics: When you sign up, you select a primary care physician (PCP) from a network of doctors. Your PCP is your first point of contact for most of your basic health care needs. Women can also select an OB/GYN for obstetrical and gynecological care. If you need special tests or need to see a specialist, your PCP will give you a referral to see another doctor. Learn more from Blue Cross Blue Shield: HMO Rights and Responsibilities 

 

The Bottom Line: HMO plans generally have lower up-front costs, or premiums, than other types of plans. HMOs usually feature copayments as well. Copayments are set amounts (usually a dollar amount or a percentage) that you pay for care. An example of a copayment is $20 for each office visit. HMO plans generally provide coverage only when you use doctors, hospitals and specialists that are in the network. If you seek care outside the network, other than in an emergency or with authorization from your HMO, your care typically will not be covered at all.

PPOs

Like HMOs, PPOs often feature a network of doctors, specialists and hospitals; however, there are some key differences between the two types of plans.

 

PPO Basics: With a PPO insurance plan, you don’t have to choose a primary care physician. You have the option of receiving care from doctors, hospitals and specialists in the network or outside the network, and you don’t always need a referral to see a specialist.

 

Key Features: PPO insurance plan premiums are generally higher than HMO plans, which means you’ll have to pay more up front. When you receive care from a doctor or hospital that is in the network, your costs tend to be lower. When you receive care from a doctor or hospital outside the network your costs are likely to be higher, and you may be responsible for the difference between the amount your insurance plan pays and the provider’s billed charges. PPO insurance plans usually have a deductible. So, for example, if your PPO insurance plan has a $500 deductible, your coverage doesn’t begin until you’ve paid out-of-pocket for the first $500 of your own medical expenses. Preventive care services are not subject to the deductible.

Consumer Driven Health Plans (CDHPs)

Consumer Driven Health Plans (CDHPs) often involve pairing a high deductible PPO insurance plan with a tax-advantaged account, such as a Health Savings Account (HSA)1. For an individual to establish an HSA and contribute money to the account each year, he or she must be considered an HSA-eligible individual. Eligibility includes enrollment in an HSA-qualified high deductible health insurance plan. Learn more from Blue Cross Blue Shield – Guidance on choosing a health insurance plan: U.S. Agency for Healthcare Research and Quality (AHRQ) 

 

Key Features: If the insurance plan uses a PPO network, you don’t have to choose a primary care physician You have the option of receiving care from doctors, hospitals and specialists in the network or outside the network, and you don’t always need a referral to see a specialist.

 

The Bottom Line: When a CDHP includes a high deductible health insurance plan, premiums are often lower than other types of health plans because you are responsible for a greater share of your health care costs.

Health Savings Account-HSAs

HSAs are type of savings account that allows you set aside money on a pre-tax basis to pay for qualified medical expenses. The untaxed dollars in a Health Savings Account (HSA) can be used to pay for deductibles, copayments, coinsurance, and some other expenses, however, generally may not be used to pay health insurance premiums.

  • Plan year 2019, the minimum deductible is $1,350 for an individual and $2,700 for a family.
  • Plan year 2020, the minimum deductible for an HDHP is $1,400 for an individual and $2,800 for a family.

When you view plans in the Marketplace, you can see if they’re “HSA-eligible.”

 

 

HSA Contributions:

  • 2019 – up to $3,500 for self-only coverage and up to $7,000 for family coverage into an HSA.
  • 2020 – up to $3,550 for self-only coverage and up to $7,100 for family coverage into an HSA.
  • 2021 – up to $3,600 for self-only coverage and up to $7,200 for family coverage into an HSA.

HSA funds roll over year to year if you don’t spend them. An HSA may earn interest or other earnings, which are not taxable.

Frequently Asked Questions

Are rates higher if I use an Agent/Broker?

No. Rates are regulated by the department of insurance in each state. The rates are the same if you purchase from a broker or directly from the company. When you have a broker, you have someone who is knowledgeable in the industry, stays abreast of the changes within the industry, will provide service and will have annual reviews of your insurance programs. We are a full-service agency who provides all of the above services!

Is coverage guaranteed & automatic?

No. All applications are subject to underwriting.

What consists of "underwriting"?

First an application is taken. Generally, the insurance company will conduct a telephone interview for the member and any eligible dependents. The telephone interviews are random. It is up to underwriting if additional information such ordering medical records, or a paramedical exam is needed.

How do I submit an application?

Applications can be submitted on paper via fax or online applications. You may obtain all information thought our office. We will provide the links to online applications

How long is the underwriting process?

Underwriting can take anywhere from 48 hours to 3 weeks for health insurance. If underwriting is for life insurance, it can take 6-8 weeks.

Is maternity covered?

Typically, no, but varies by state.

What happens to my personal info if I no longer want insurance?

The information is kept on file for 6 weeks and then destroyed.

Am I locked into a contract?

No. The rates are locked in for 6 or 12 months depending on state you reside, and plan/company chosen. You may cancel your insurance at any time. Most companies require 30 days notice in written form.

We understand healthcare.

We are a full-service insurance agency. We offer a professional approach to meet the insurance needs of businesses, individuals, and seniors. We offer a FREE, no obligation consultation to review the current policies of your business and personal needs.

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Client Review

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Why would anyone get insurance any other way? This was an amazing experience.

We went to see Monique (The Owner) and was floored by the incredible customer service, her thorough walkthrough of all the plans to make choosing easier and the speed in which we signed up for all insurance. We were literally in and out of the office (a beautiful residential area by the way), within 1 hour and 10 minutes. Thats not bad for being a first time business owner, 26 years old and having my brother with me looking at vision, dental and health at the same time.

She was courteous, polite, caring and gave us options that she had already prepared before we arrived. It was such a great luxurious service that I started to worry about how much this would cost, I was prepared to invest because she absolutely deserved it, but numbers started to fly around.

When she told me that it was free because she gets a commission from any packages she recommends our jaws dropped. Not only that but we can call her if we have any questions at all, change our primary through her and change policies on the fly making everything super easy and insurance a lot more fun to deal with, instead of dreading it.

Her character was bright, sunny and fun making the entire transition a wonderful experience. I highly highly recommend her and you’d honestly would have to be crazy not go with Zinn Insurance!

Louis B.
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