Medicare Insurance

Hospital Plans

Unlike a traditional major medical plan that reimburses you or pays directly to a provider for approved hospital stays and medical care, a Hospital Indemnity Plan is a limited benefit plans that pays a lump-sum payment directly to the insured.

When paid directly to the insured, cash payments help you, your family or your employees with out-of-pocket expenses and covers you when you are off work due to a hospital stay. There are no plan maximums, however the coverage is usually a set amount per day, per week, per month, or per visit depending on the benefit level selected.

Critical Care Plans

Surviving cancer and other critical illness is becoming increasingly common with the advances in modern medical technology.  Critical Illness Insurance can help you, your family or your employees reduce the personal financial impact of the cost of fighting these illnesses or keeping up with everyday bills through that process.  If you have a health insurance plan and/or disability insurance, Critical Illness Insurance will provide benefits in addition to your other coverage.

Some key features:

• -Lump-sum cash benefit paid directly to you.
• -You decide how best to spend your payment.
• -No network restrictions.
• -Benefit level choices to fit your needs and budget.
• -Simple plan options for your needs and budget.

The benefits and riders offered are supplemental and are not intended to cover all medical expenses.  Certain terms, exclusions and limitations may apply.

Accident Plans

Accidents can happen anytime and bring unexpected costs not fully covered by medical insurance.  Accident Insurance is very affordable and complements your major medical policy, in the case of an accidental injury.

Accident insurance helps to protect you, your family, or your employees from suffering through financial hardship due to a great deal of medical and out-of-pocket expenses that follow accidental injuries. Emergency treatment, hospital stays, medical exams, transportation and lodging needs are just a few of the expenses that accident insurance can help cover. Some policies can even pay benefits in as little as one day, based on time of claim submission.

Dental Plans
Regular dental exams help employees stay healthier and more productive in the work place. And, studies show that simple routine visits to the dentist (which are usually covered 100% by insurers), help to detect serious underlying conditions such as heart disease and diabetes. The National Association of Dental Plans and the Centers for Disease Control have performed studies that show that employees with Dental Insurance plans have better attitudes and are less likely to suffer from depression, a common condition in today’s fast-paced world.

Dental Plans offer a variety of diagnostic, preventative care and corrective services including cleanings, exams, x-rays, fillings, root canals, orthodontia for children, and emergency care while traveling.

Vision Plans
Similar to dental policies, vision plans are inexpensive and save money on routine exams, eyeglass frames and lenses, contacts, and even discounts on procedures like LASIK. Monitoring your eye health with regular exams also helps to prevent serious eye diseases like glaucoma and cataracts and also helps to detect early stages of diabetes, high blood pressure, and high cholesterol.

A Preferred Provider Organization or PPO

A PPO will save you money on services if you use the preferred providers within the network. Keep in mind that deductibles must be met on this plan before some services will be covered. The good thing about a PPO is they generally will allow a certain amount of services annually outside of the deductible with a small co-pay, and most often the PPO has a large network with quality care providers and excellent prescription drug coverage.

A Health Savings Account or HSA

Many small group health plans benefit by having a Health Savings Account (HSA) feature that combines a high deductible/lower premium health insurance plan (PPO) with a savings account. Both employer and employee can contribute, tax-free to the savings account, which can help fund the deductible and other qualified medical expenses. Then, the insurance will begin paying claims, once the deductible is satisfied.

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Term Life Insurance

Term Life is the most cost-effective type of life insurance.  This simple, budget friendly life insurance solution is good for young people, families on a budget, and for people who may want to convert their term policy to a more permanent solution later down the road. You may also want to supplement a permanent life insurance policy.  Generally, it provides the largest immediate amount of protection for the lowest cost and pays a death benefit upon your death.

How it works
Term Life covers you for a set period of time, provided you pay the monthly premium, or in some instances, a lump sum in advance. The policy will pay to the named beneficiary the face amount of the policy (set benefit and/or lump sum) upon death of the insured within the stated term. Depending on the policy, it may also make payments upon terminal or critical illness.

Travel Medical Insurance

Medical travel insurance is typically very affordable and provides valuable medical coverage when traveling in the US or abroad, much like a regular health insurance policy. Most often these types of policies will cover care and services that are not typically covered by your regular health policy or Medicare.

Drug RX Plans

Plan includes generic and brand drugs, 70% of generics are $10 or less.  Preview plan list to see if you prescription needs will be covered.  No maximums or deductibles.

Gap Insurance

Gap insurance provides benefits that supplement a low premium, high deductible major medical health plan. It works by paying a significant amount of the deductible.  More specifically, the additional benefits help to cover out-of-pocket expenses related to coinsurance, co-pays and deductibles for inpatient and outpatient services. For example, if you have a $5,000 deductible on your major medical plan, gap coverage could pay up to $4,000 of that deductible.  You may find you save more money with a low premium high deductible health plan, along with the additional premium for gap insurance, when compared to one low deductible, high premium plan.

MEC Plans

MEC plans generally cover preventive and wellness-related services and screenings, as well as treatments. They do meet the requirements as outlined under the Affordable Care Act (ACA), however, they are not considered traditional major medical coverage plans.  MEC Plans are a more affordable alternative to an expensive Marketplace Health Plan that is not subsidized.  MEC99 Plus adds additional wellness and financial protection benefits to the plan.

Lifestyle  Plans

While these type of affordable plans do not meet the requirements of the ACA, they help you, your family or business and it’s employees control your healthcare costs by addressing the underlying chronic health and lifestyle issues that drive up healthcare.  Improve overall health and wellness with the following benefits:

• -RX Discounts
• -Telehealth
• -Travel benefits
• -Nurse Hotline
• -Online Fitness and Nutrition Help
• -Online Mental Health Services
• -Online Substance Abuse Help
• -Vet Services & Discounts
• -Credit Monitoring and Identity Theft Protection
• -Cell and Computer Protection and Tech Support
• -And MORE!

What if you miss the annual open enrollment deadline or your circumstances have changed?

You can still sign up for health insurance after the deadline if you meet any of the following qualifying events:

• -change in legal marital status
• -a change in the number of dependents
• -a change in place of residence and the current carrier is not available
• -significant cost or coverage change
• -a change in coverage of a spouse or dependant
• -a COBRA qualifying event
• -legal judgements, decrees and orders
• -entitlement to Medicare or Medicaid

Why you should have health insurance.

With today’s high cost of medical care, it is just no longer an option to go without healthcare insurance. One accident or illness can be financially devastating. You need to protect yourself and protect your family. In fact, according to a new study 66.5% of all personal bankruptcies that were filed were due to illnesses and accidents leaving individuals unable to work and strapped with medical bills.  Whether you qualify for a subsidy or not, a comprehensive health plan can help you avoid financial ruin.

Additionally, Non-ACA alternatives such as Short Term Health Insurance, and/or Critical Care or Hospital Indemnity Plans will cost you about a third of what an unsubsidized major medical plan costs, and will protect your finances so you can focus on your health and getting better, should you have an accident or unexpected illness.  Click here to learn more about NON-ACA Plans.  Note that Non-ACA options, however, have limitations and in some cases, do not cover certain and/or preexisting conditions.

You can avoid the hassle of trying to find a plan on your own by letting our agent, Jeanne Clark, as a FREE resource to you, help you find a plan that meets your exact requirements.

What is the Marketplace?

In Connecticut, Access Health CT is the public health insurance Marketplace (also referred to as an “Exchange”) and is where you can purchase health insurance (also known as Obama Care) for you and your family.  A plan from the marketplace is considered a comprehensive major medical plan and also contains the essential health benefits (see below) as established under the Affordable Care Act (ACA) law.  When you purchase your health insurance through the marketplace, you are guaranteed issue regardless of any pre-existing condition and you may be eligible for a subsidy (premium tax credit) to help off-set high premiums.  Our agent, Jeanne Clark, can help you determine if you qualify for a subsidy.

The essential health benefits are as follows:

• Ambulatory patient services
• Emergency services
• Hospitalization
• Maternity and newborn care
• Prescription Drugs
• Mental health and Substance Abuse disorder services
• Rehabilitative and habilitative services and devices
• Pediatric services, including oral and vision care
• Preventive and wellness services, and chronic disease management