A deductible is the amount of money you have to spend on medical expenses in a calendar year before your coverage kicks in.

For example, if you have a $5,000 deductible, you have to spend the first $5,000 before your coverage starts giving you any benefits.

Copays are the fee you have to pay for specific services. For example, if you go to a primary care physician and you have a $50 copay, you have to pay $50 for the visit but may see additional charges if there are additional services not covered under the copay.

Some plans have copays that kick in before a deductible but some plans you have to pay full price until the deductible and then your copays will kick in.

Coinsurance is a cost-share with the insurance company that kicks in after you have met your deductible. For example, if you have a $10,000 bill and your plan comes with a $5,000 deductible and 50/50 coinsurance, then you will pay the first $5,000 and then only owe 50% of the remaining bill up to your out-of-pocket maximum.

Common coinsurances include 50/50, 60/40, 70/30, 80/20, and 90/10 where you will typically owe the lower percentage.

An out-of-pocket maximum is the most amount of money you will spend in a calendar year on medical expenses.

For example, let's say you have a plan the following plan:

Monthly Premium = $500

Deductible = $5,000

OOP Maximum = $8,000

Coinsurance = 70/30

Then let's say you have a major surgery and have a total bill of $50,000. You will be responsible for the first $5,000 and only be responsible for 30% of the remaining $45,000 which comes out to $13,500. Your OOP maximum is $8,000 so you will only pay $3,000 of the remaining bill and the insurance company will cover the rest! You will still have to pay your monthly premium of $500 though.

Exclusive Provider Organizations (EPO's) are the smallest and most limited networks and you have to be at a doctor or facility in the plan's network to have coverage. These are typically county-wide coverage.

Health Maintenance Organizations (HMO's) are networks where you're limited to doctors or facilities in the plan's network and you need a referral from a primary care physician to see a specialist. These are typically state-wide coverage.

Preferred Provider Organizations (PPO's) are networks where you can go to any doctor or facility you'd like but you will typically pay less if you're at an in-network doctor or facility. These are nationwide coverage.

Point of Service (POS) plans are a hybrid of HMO and PPO where you need to be established with an in-network primary care physician but you can go to out of network doctors or facilities at a higher cost.

It is much less expensive than you think! Since the rates for private health insurance are based on health and not income, you will generally see lower prices AND better benefits if you can qualify.

I personally save $2,400 every year by choosing private health insurance!

You don’t have to be an olympic athlete by any means, but if you are in relatively good health then you should be a strong candidate.

Of course individual considerations will be made, but if you don’t have any major pre-existing conditions such as cancer, heart attack, stroke, or diabetes then a private plan may be right for you!

Yes, there are no contracts for any health insurance plans through the public marketplace and private market. If you are on an employer plan, you may not be able to cancel at anytime without a qualifying life event.

No! We can also write policies for Dental, Vision, Life, Supplemental, Critical Illness, Accident Disability, etc. If we can't help you with our services, we have trusted referral partners we can get you set up with!