Frequently Asked Questions

Here is a list of some the most frequetnly asked questions. If you have other questions, please call us toll free at 877-477-4602. We are here to answer you questions and offer your the best in service in determining you insurance needs.

What kind of individual and family plans are available?

A variety of insurance companies offer HMO (Health Maintenance Organization) s called as well as PPO (Preferred Provider Organization) plans.

What is the difference between an HMO and a PPO health plan?

There are many differences between an HMO and a PPO plan, but the most significant is how you access care. With an HMO plan, you and all eligible family members must live or work in an area served by the HMO facility and access ail your care through a designated Personal Physician that you are allowed to choose as long as that physician is part of HMO plan you have subscribed to. Depending upon the coverage with a PPO plan you may visit any licensed doctor without a referral from a Personal Physician.

With an HMO plan, you:

Generally pay higher monthly dues so that your costs are lower whenever you access care throughout the year

Receive many covered services at no charge or for a fixed co-payment

Choose a designated Personal Physician within the HMO network who provides, refers and coordinates all your medical care.

Receive all medical services from providers in your Personal Physician's medical group or IPA (Independent Practice Association)

You may be able to go directly to a specialist without a referral who is part of the HMO network

With a PPO plan, you:

Choose your own provider(s) each time you seek medical care.

Generally pay lower monthly dues/premiums in exchange for higher out of-pocket costs when you access care throughout the year.

Generally pay lower monthly dues/premiums in exchange for higher out of-pocket costs when you access care throughout the year. Receive some preventive care benefits even before you meet your plan deductible

Pay a percentage of charges for most covered services after you meet any applicable plan deductible

Reduce your out-of-pocket costs when you use doctor of hospital who is part of the preferred provider network.

What are the differences among PPO plans'?

There are many choices of PPO plans. Some have a different calendar-year deductible and different benefit levels. As a general rule, the higher the calendar-year deductible, the lower the monthly premiums. Plans with lower deductibles tend to have higher monthly premiums, more generous prescription drug benefits and lower office visit co-payments.

Is preventive care covered?

Yes. To help our members stay healthy many plans cover preventive care such as routine physical exams, immunizations, well-baby care and annual gynecological exams before meeting any deductible,

Will my doctor be included in the provider network?

Contact us and we can find out if your physician is part of the HMO or PPO network for the insurance carrier you are interested in. Many insurance networks include major hospitals, local dentists, optometrists, dermatologists, mental healt providers, chiropractors and acupuncturists.

Can individual family members have different plans?

Yes. It may better suit some families' health coverage needs or budget to place family members on different types of plans. We can help guide you and discuss which plan may be right for each of your family members. Putting your child on his or her own plan with special Youth Coverage rates may also save you money. This can reduce your monthly dues/premiums compared to having a single family plan. Ask us about Youth Care plans.

Can I get dental coverage through my health insurance company?

Can I get dental coverage through my health insurance company? Yes. Many health insurance companies offer Dental PPO or Dental HMO plans at an additional cost.

Can I get life insurance through my health insurance company?

Can I get life insurance through my health insurance company? Yes. If you are approved for a health plan many insurance companies can also offer you life insurance, such as term life insurance. Many times this insurance can be added to your overall package without a separate approval process. Please contact us for more details

For further information and for all your health insurance needs, please call us at our toll free number 877-477-4602 and talk to an actual person and learn the difference personalized service can mean when learning about and purchasing health insurance.