Frequently Asked Questions About Insurance
Learn About Health Coverage
- What is the difference between major medical and fixed-benefit plans?
Major Medical Fixed Benefits Overview Unlimited comprehensive coverage once deductible, coinsurance, and access fees are met. Pays a set dollar amount per covered procedure.
- Child-only or young people seeking basic coverage
- Anyone needing easy 4-question qualification
- Tobacco users over age 40
Deductible $2,000 to $25,000. No deductible Coverage
- Pays 100% of covered expenses after deductible, coinsurance, and access fees have been met.
- Includes free checkups and preventive services per the PPACA.
- Pays a set $ amount per covered item.
- May pay a portion for checkups/preventive.
- Other money saving features: see sample benefit guide
Doc Copay (Optional) Example: You pay $35, plan pays the rest.
Example: Plan pays $50-$75, you pay the rest. PPO Networks Several PPO networks to choose from based upon your area.
See Recommended Major Plan.
Medication Drugs may be included or a drug card with copays.
* Not available on all plans
Example: Plan pays $15-$35, you pay the rest. Lifetime Max Unlimited Up to $1,000,000.
- What does coinsurance and out-of-pocket (OOP) mean on major medical plans?
The insurance company will pay a portion of the bill up to a maximum out-of-pocket after you meet your deductible. Once you pay up to the maximum out-of-pocket, the insurance company will pay 100% of covered expenses for the rest of the calendar year.
- Why do drug and doctor copay plans actually cost you more?
You ultimately spend more out-of-pocket
Co-pay plans are more expensive and copays do not contribute to your major deductible.
When drugs/doctor visits contribute to your deductible, you reach the point where your plan will pay 100% of all covered expenses quicker.
You still receive network-discounted prices when visiting the doctor, keeping it affordable.
Doctor Visits Are Still Affordable
Even if you haven't met your deductible, a major medical health plan will still make visiting a doctor affordable.
- You still get network discounted visits
- What you pay will contributes to your deductible
- In-network visits can be as low as $50 (without a copay)
- What are HSA (Health Savings Accounts) plans?
- Health Savings Accounts provide individuals covered by high-deductible health plans to receive tax-savings on money saved for medical expenses. Watch HSA Video | Shop HSA Plans
- Why buy insurance if I can just go to a hospital when I'm really sick and they have to take care of me?
- If you walk-in to an ER, all they have to do is "stabilize you" - nothing more. If you're a cancer patient and go to the ER with great pain, you may be admitted and hospitalized until you either pass away or are well enough to walk out the door; this is what stabilizing means. Unless you can pay for treatment, you won't be offered surgery or treatment that might save your life.
- What are the top 10 most common reasons for an ER visit and how does a bundle protect me?
Supplemental insurance gives you extra needed coverage. According to the CDC, the top 10 reasons that most people go to the ER are:
Chest paints can be attributed to heart strokes. Your coverage is extended in a bundle with a supplemental Critical Illness policy. Learn more about Critical Illness
Emergency rooms are expensive for dental care. Avoid a trip to the ER by maintaining your teeth with the dental insurance included in our bundles. Learn more about Dental Coverage
Sprains and Broken Bones
Sprains and broken bones can happen to anyone, regardless of health or age. Learn more about Accidental Coverage
Upper Respiratory Infections
Cuts and Contusions
Cuts usually result from an accident with a knife or glass. Having accident insurance will enhance your coverage. Learn more about Accidental Coverage
Back pain may result from an accident or faulty movement to a point where you strain a back muscle or injure one of the bones in the spinal column. Learn more about Accidental Coverage
Skin infections may result from a cut or accidental injury in which case it Accident Insurance may provide coverage. Learn more about Accidental Coverage
Foreign Objects in the Body
A foreign object usually enters the body via an unintentional accident. Learn more about Accidental Coverage
Headaches / Migraines
Although unlikely, migraines can be a sign of a serious illness such as meningitis or cerebral hemorrhaging which may be additionally covered with Critical Illness insurance. Learn more about Critical Illness
- If I don't qualify for the Easy Qualify Bundle, is there still an option?
Although our Easy Qualify Bundle is a good fit for many, some might still get denied due to existing health conditions. For those, we have plan available, 24hr-eDoc:
- Unlimited phone, email, chat medical consultations
- Free Yearly Lab Tests
- Drug Discount Card / Premium RX Co-Pay Card Upgrade
- No Denial Enrollments
- Fast and Quick Enrollment
- See All Benefits & Enroll Online
- How will the Health Reform Subsidies Work?
Learn About Accident Coverage
- What is covered by accident insurance?
Protect yourself and family from high out of pocket costs.
- Slips and falls
- Mis-step while running
- Falling off bike
- At-home handyman accidents
- Accidents at work
- Sporting accident (Great for kids)
- Cooking accidents
- ... and other accidents
*Not all accidents may be covered by all policies. Always check the policy's conditions and limitations.
- Why do I need accident insurance?
- An accident can easily become very medically expensive.
Learn About Critical Illness Coverage
- Why do I need Critical Illness Insurance?
According to the CDC, heart disease is the leading cause of death in the United States. Additionally, cancer is the leading cause of death for persons age 45-64 and the second leading cause of death for 25-44 year-olds.
- How much critical illness coverage do I need?
We recommend 2x your health insurance out-of-pocket and deductible.
With deductible and max out-of-pocket, most insurance will have a minimum expense of $10k-$15k per year. Critical illness treatment can take a couple of years. You should have enough critical illness coverage to pay your out-of-pocket for at least two years, so in this case 20k-30k of coverage.
- What critical illnesses are covered?
- Invasive Cancer
- Heart Attack
- Kidney Failure
- Heart Valve Surgery
- Major Organ Transplant
- Loss of limb
- Major burns
Partial benefits paid:
- Advanced Alzheimer's disease*
- Coronary artery bypass graft*
- Non-invasive cancer*
Not all conditions may be covered by all critical illness plans. See Assurant Plan
- Is there a Life / Critical Illness Combo?
- Yes, critical Illness coverage may be included with an Assurity Life Plan.
(view life insurance brochure) | (view critical illness brochure).
Get life insurance without a physical
Learn About Life Coverage
- What additional benefits are included in these plans?
Terminal Illness Living Benefit
- If you're diagnosed with a terminal illness with 12 months or less to live, you can get a partial advance on your death benefit that you can use to get your bucketlist done.
Nursing Home Benefit
- Some life insurance policies now give you an advance on your death benefits to pay for your nursing home.
* Not all benefits available on all policies
- Why do I need life insurance? [video]
- What is the difference between medical vs non-medical life insurance?
Also known as no-exam life insurance, you may get coverage without an extensive medical exam. Great if you're afraid of needles or bloodwork.
- New policies now make no-exam life insurance more affordable than ever. No exam makes the approval process fast and simple.
- Also known as no-exam life insurance, you may get coverage without an extensive medical exam. Great if you're afraid of needles or bloodwork.
Learn About Dental Coverage
- What is the difference between a discount plan and dental insurance?
Dental Insurance Discount Plan Overview Pays cash to your dentist or you. In-network and out-of-network benefits. No out-of-network benefits. Only discounts services, does not pay cash to your dentist or you. Coverage Pays a % or set amount per procedure. Covers most, if not all, of wellness (exams, cleanings, x-rays). Most don't cover cosmetic (ie. braces or implants). Provides 5%-60% discount on dental services with specific dentists in-network. Usually cosmetic discounts are available (braces, veneers, etc). Waiting Periods Ranges from next-day to 1 year depending on plan, procedure, and state. Our bundle dental plan has next-day benefits* for wellness and basic with only a 6 month wait for major.* May not be available in some cases Usually receive membership materials in 7-10 business days. Dentist Availability Usually can use at any dentist. Limited to a certain number of dentists.
- Why do I need dental insurance?
- Gum disease can lead to blood clots or even contribute to diabetes, pneumonia, or low birth weight.
- Early symptoms of osteoporosis, most oral cancers, anorexia, or bulimia may be found during a routine dental exam.