HEALTH INSURANCE

I have a pre-existing condition. Can I get covered?

Absolutely! With health care reform, there are no denials and pre-existing is covered on all major medical health insurance plans.
To be able to sign up for major medical, it must be during an open enrollment period or you must qualify for an exception such as a qualifying life event

What are networks and are they different on health exchange plans?

Health insurance usually includes a network of hospitals and providers that have agreed to provide services at a particular rate to the insurance company. Even if you haven’t met your deductible, you will only be charged network-rates if you’re using an in-network provider. You will see significant savings.

 

Keep in mind, many of the health plans on the exchanges are cheaper because they have a much smaller network. The chances that your doctor or a provider you use would not be in your network would be greater.

What preventive care do I get for free?

With health reform, you can now get free preventive care including tests and vaccinations. However, you usually must use an in-network provider to qualify for free services.

Complete List

  • Abdominal Aortic Aneurysm one-time screening
  • Alcohol Misuse Screening and counseling
  • Aspirin use to prevent cardiovascular disease for men and women of certain ages.
  • Blood Pressure Screening for all adults
  • Cholesterol screening for adults of certain ages or at higher risk
  • Colorectal Cancer screening for adults over 50
  • Depression screening for adults
  • Diabetes (Type 2) screening for adults with high blood pressure
  • Diet counseling for adults at higher risk for chronic disease
  • HIV screening for everyone ages 15 to 65, and other ages at increased risk
  • Immunization vaccines for adults–doses, recommended ages, and recommended populations vary:
    • Hepatitis A
    • Hepatitis B
    • Herpes Zoster
    • Human Papillomavirus
    • Influenza (Flu Shot)
    • Measles, Mumps, Rubella
    • Meningococcal
    • Pneumococcal
    • Tetanus, Diphtheria, Pertussis
    • Varicella
  • Obesity screening and counseling for all adults
  • Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
  • Syphilis screening for all adults at higher risk
  • Tobacco Use screening for all adults and cessation interventions for tobacco users

If I don't have health insurance, do I pay a penalty?

Yes, health care reform introduced the individual mandate. All individuals must have health insurance or be subject to a penalty on their taxes.
If you do not have minimum essential coverage past the enrollment period and do not qualify for an exemption or have a qualifying life event, you may be subject to the penalty.
For 2014, the penalty is $95 er uninsured person or 1% of household income over the filing threshold. For 2015, penalty is $325 per uninsured person or 2% of household income over the filing threshold. In 2016, it will increase to $695 per uninsured person or 2.5% of houlsehold income over the filing threshold.

How can I avoid paying a penalty?

There are several ways to avoid a penalty:
  • Have a religious exemption.
  • Cannot afford coverage based on formulas contained in the law.
  • Have income below the federal income tax filing threshold.
  • Are a member of an Indian tribe.
  • Were uninsured for short coverage gaps of less than 90 days.
  • Have received a hardship waiver from the Secretary or are residing outside of the United States, or are bona fide resident of any possession of the UNited Stated.

What are qualifying life events?

If you missed open enrollment, you may still sign up for major medical health insurance if you have a qualifying life event:
  • Marriage or divorce
  • Having a baby, adopting a child or placing a child for adoption or foster care
  • Moving your residence, gaining citizenship, leaving incarceration
  • Losing other health coverage Voluntarily dropping coverage or losing coverage that doesn’t qualify as minimum essential coverage does not apply
  • Having a change in income or household status that affects eligibility for subsidies Only for those already enrolled in marketplace coverage
  • Gaining status as a member of an Indian tribe

Health reform plans are still too expensive for me. Are there any alternatives?

Yes, they are. We have been crunching the numbers and looking at the insurance market as a whole. There are many alternatives that will give you better value.
For example, if you’re healthy, sometimes paying the penalty and getting short-term insurance instead will be cheaper than an exchange plan.
There are many possibilities and every situation is different. Call us today at 1-800-257-1723 to discuss the best strategy to lower how much you pay out.

My insurance is up for renewal, what are my options?

Politics aside, it appears that “Obamacare” is here to stay. Most people are seeing about 20% increase in premiums. Overall, you have three options. Read our detailed PDF for more information:

Who qualifies for Special Enrollment Period?

You may qualify if you:

  • Lose health coverage due to a job change
  • Get married
  • Have a baby
  • Adopts a child or become a foster parent
  • Get divorced or legally separated and lose coverage
  • Move outside of a health plan’s service area
  • Have a change in income
  • Become a U.S. Citizen

The Affordable Care Act (ACA) requires most Americans to have health insurance starting in 2014. If I don't comply, what is the penalty I would have to pay?

People who don’t comply have to pay a penalty, the amount of which depends on several factors, including income and family size. This calculator lets you estimate the potential ACA penalty for individuals and married couples who don’t have health insurance coverage required by the ACA.

Why the Life Protection Pyramid –Not just the Medical?

The answer is simple… because you are purchasing coverage to protect you for events that happen—not what won’t happen.

If you thought nothing was going to happen, then you would not purchase coverage at all.  Here’s a brief explanation why you should purchase the other items included in the Life Protection Pyramid.

WHY LIVING BENEFITS: Purchasing the medical without the Living Benefits– exposes you to losing your medical coverage as well as losing your standard of living.  You see most of us don’t have large sums of money to fall back on.

Ask yourself a question: Could you survive without a paycheck for 6 months or a year?   Most of us would be destitute and foreclosed upon.  Certainly, even if you could financially survive the loss of income… why?  It is much easier to pass the burden of that onto an insurance company for a very reasonable premium.  For others, it simply makes sense to not put YOUR savings in jeopardy.  Use your savings for their original intention which for most people is retirement.

WHY Accident and Hospital Recovery: Simple mathematical logic and human nature.  As an agent of 27 years, the number 1 complaint I have heard is this “I have insurance, why am I having to come up with several thousand dollars for my deductible“?   Again, it just makes sense to plan that you ARE going to use the coverage.  There is an old saying “the unexpected happens”.  Having the Accident and Hospital Recovery coverage reduces or entirely eliminates your deductible for covered accidents and hospitalizations.  At an annual rate of about $1,000 a year for a family, just one accident or hospitalization for a single family member reimburses or exceeds the premium.  Point blank the math just makes sense.  For others, it is the peace of mind that comes from having the freedom to go have something looked into without having to worry about your deductibles.

Why Dental Coverage: The silent epidemic- Really there are only 2 types of people in this world, those who have regular visits to their dentist and those who don’t.  Protecting your smile and your health STARTS with ORAL Hygiene.  Quality dental plans provide you ACCESS to a dentist twice a year and protect you from unexpected future expensive dental work.  In addition, most of our plans provide up to $1,500 of treatment a year per insured for the unexpected.  Going to the dentist twice a year and paying out of pocket is approximately the cost of the premium.  The bonus to YOU is having the coverage for the $1,500 of unexpected per person.  If you going to pay the dentist about the same—might as well be insured.

What happens at the end of your Short Term Medical plan when you’re sick with a preexisting condition?

You transition back into Obamacare.

Our agents are recommending that you purchase your short term coverage to coincide with the open enrollment period of the ACA “Obamacare”.  This means syncing your coverage to cover you from January to January.  This way if a family member is seriously ill or has high medical expenses, you can OPT back into Obamacare and get guaranteed issue coverage with a pre- existing conditions.  In addition, since deductibles are calendar year anyway, this is the ideal time to make a change if necessary.  Remember that ONLY the person with a health condition needs to OPT back into the expensive Obamacare plan.   The balance of the family should re-enroll in the STM plan and continue to be covered at a lower rate.

Will you help me enroll on the Texas Health Insurance Marketplace?

We are available to help you register on the Texas Health Insurance Marketplace.  Our fee for doing so is $100, payable in advance.

OR you may apply through our website using self-service at no additional charge.

DENTAL INSURANCE

What's the difference between dental insurance and discount plans?

Discount plans work by convincing dentists to reduce their costs for members. Discount plans offer referrals to dentists and in exchange, dentists lower their costs for those patients.
More dentists are choosing not to be part of discount plans since it means they will get paid less. The less they get paid, the more patients they need, meaning waiting weeks for an appointment and being rushed to do the work.
Dental insurance on the other hand actually pays your dentist cash. The dental insurance you quote on our site can be used at any dentist. It pays you or your dentist a fixed-rate per procedure so you know how much it’ll cover ahead of time.

Can I use the dental insurance at any dentist?

Absolutely! We only recommend the best insurance that’s out there. The dental insurance you quote on our site can be used with any dentist; they do not have to be part of a network.
If your dentist does not want to deal with it, you can file the claim yourself and you will get the cash from the insurance company.

What does dental insurance cover?

Dental insurance pays benefits for preventive and basic services. Basic services includes fillings, simple extractions, and anesthesia. There’s also a plus major upgrade available to get benefits paid for crowns, inlays/onlays, endodontics, periodontics, and oral surgery.

How soon do dental benefits kick in?

Benefits usually begin the very next business day. If you apply for dental insurance during the 27th-31st of the month, it becomes effective on the 1st of the following month.
Plus Major upgrade benefits begin 6 months after your plan is effective.

Do I get benefits for preventive care?

Yes you do.. You get $100 for preventive care (cleanings, x-rays, exams) for up to 2 visits per year per insured.
The second visit must be at least 5 months (150 days) after the first visit.

ACCIDENT INSURANCE

Why should I get accident insurance?

Many unexpected medical expenses are related to accidents and usually bills are not high enough to go beyond your deductible. Having accident insurance is a great form of gap insurance for high deductible health insurance.
If you end up in the hospital due to an accident, you pay a small $250 deductible, and the insurance covers the rest of the covered charges up to your coverage amount.

Is there a deductible?

Yes, a small $250 deductible per accident. A lot better than the more traditional health insurance deductible of $2,500 to $5,000.

Am I covered while working?

Yes, unlike some other accident insurances, this one gives you coverage while you’re on-the-job. Coverage is 24hrs a day; while you are at home, on vacation, or at work.

Do I get a better price if I cover my entire family?

Yes, there’s one low-rate that covers your entire immediate family, no matter how many children you may have.

CRITICAL ILLNESS

Why should I have critical illness insurance?

Many financial strains related to an illness don’t just come from medical bills. Being out of work, finding child care, caring for a loved one, transportation, etc are not covered by health insurance.
Critical illnesses such as cancer or heart stroke are long-term illnesses in which expenses will pile up. This is where having critical illness insurance that pays you a fixed-set amount if you’re diagnosed with the covered illness will come in handy.
You can use the cash however you like. It’s your to use. Coverage amounts of $10,000 to $50,000 available.

Does Critical Illness insurance pay in addition to any other coverage?

Yes; so even if you have health insurance that will pay a portion of your medical bills, this does not matter. You will still receive the full lump-sum of the coverage you selected if you’re diagnosed with a covered critical illness such as cancer or heart stroke.

LIFE INSURANCE




Who needs life insurance?

Almost everyone needs life insurance. Do you have a mortgage? A spouse? Children or dependents? Enough in savings to cover funeral expenses?
Although you may think it won’t happen to you, the cost of life insurance is so minimal compared to the peace of mind you’ll get that in case something does happen, your loved ones will be taken care of.

Do you offer no-exam accident and illness life insurance?

Yes; full medical life insurance application processes can be long, daunting, and very intrusive. With no-exam life insurance, you only answer a few questions. There is no blood drawn.

 

Additionally, the application process for no-exam life insurance is a lot simpler and quicker.

What types of life insurance are there?

There are several types of life insurance. The two primary categories is “Accidental Death” and “Illness”. Some life insurance will cover both accidental deaths such as a car accident and illness such as a heart attack.

 

However, to save on costs, some only choose to have accidental death coverage. Premiums for accidental death only life insurance is substantially less but you also get less coverage.

What are living benefits and how do they work?