Health Insurance in Evansville & Newburgh, IN
The purpose of health insurance is to provide peace of mind to you and your family that you will not be financially ruined in case of illness, accident, or injury. Health insurance coverage will help pay for medical care you or a member of your family may require.
Although you may be young and healthy, you should have health insurance in case of unexpected illness or serious accidental injury; without insurance, regardless of your age, you’re responsible for paying for treatment once a medical event happens.
Beginning in 2014, the Affordable Care Act (ACA) requires everyone to have health insurance that meets minimum standards as defined by the act. If you don’t have health insurance, you may be subject to tax penalties—and the penalties increase in coming years.
The ACA can be confusing for many people, but the Certified Application Counselors at Schultheis Insurance are trained to explain the program and certified to help you complete an application for coverage.
Are you a business owner? Schultheis has four agents who are certified in writing ACA policies for businesses.
Where Can I Get Affordable Health Insurance?
Many employers offer group health insurance to their employees. This insurance will cover medical expenses for the employee and eligible family members and will most likely be the most cost-effective coverage available because premiums are based on the power of group insurability and because the employer may pay part or all of the insurance premium.
If, however, your employer does not offer health insurance coverage, you should obtain individual family health insurance. You may be insurable through a group such as an organization of which you are a member; or, if you’re over 50 years old, you may qualify for insurance through membership in the American Association of Retired Persons (AARP).
The Affordable Care Act (ACA)
Under the Affordable Care Act, individual and family healthcare policies are available through various online insurance exchanges. The policies offered, and the costs for each, vary widely; however, income-based subsidies are available to help lower-income individuals offset the cost. The Certified Application Counselors at Schultheis Insurance are trained to explain the program and certified to help you complete an application for coverage.
While all healthcare policies are now required to meet certain minimum standards, you may also make insurance decisions that will affect the amount of your premiums. For example, you may choose a higher deductible amount that you would pay before the insurance coverage begins. Your Schultheis Insurance Agent can help you make the decisions about the type of coverage you need and can advise you about the companies whose plans best suit your needs.
What Types Of Coverage Are Available?
Health insurance coverage is basically divided into two types: Fee-for-Service and Managed Care.
Fee-for-Service, or traditional health insurance, is based on the medical professional being paid a certain fee for service provided to the patient. In this type of policy, the insured or the health professional presents a claim to the insurance company, and the health care provider is paid by the insurance company. The amount paid will depend on factors such as the amount of deductible paid by the insured before the insurance pays, the co-pay made by the insured, and company limits on the amount to be paid for a specific service or treatment (usually defined as “usual & customary” and based on the company’s database of charges usually charged in a certain region). Many people choose this type of insurance plan because it allows them to use the doctors and medical facilities they prefer.
Managed Care includes several types of plans, such as HMOs (health maintenance organizations), PPOs (preferred provider organizations), and POS (point of service plans). Each of these plans is slightly different, but the common factor is that they provide comprehensive health care services to their members, and they require members to use specific in-network providers or pay a larger fee for using healthcare professionals or facilities that are not part of the specific organization.
There are several other types of specialized health care insurance. You may wish to consider a Medicare Supplement policy if you are over 65 and depend on Medicare as your primary health insurance. You may want to look into special dental or vision insurance coverage if these costs are not addressed by your healthcare insurance. In addition, you may wish to add coverage against certain catastrophic health conditions, such as cancer, with a specialty insurance policy.
Your Schultheis Insurance Agent can help you evaluate your health insurance needs and select the policy that will provide you with the coverage you require.
What should I know about additional insurance coverage for seniors?
As you plan for your retirement, you should consider the amount of income you’ll need to maintain your lifestyle. In addition, you’ll want to consider healthcare coverage for those expenses not covered by Medicare Part A (hospitalization) and Part B (doctors’ expenses and other related medical fees). Finally, since you will no longer be covered by your employer’s group policy, you may wish to consider additional life insurance, disability insurance, nursing home insurance, and long-term care insurance.
What types of coverage are available and why do I need them?
Medicare Supplement, or Medigap, insurance, is health insurance sold by private insurance companies to fill gaps in the Original Medicare Plan coverage. This type of medical insurance helps pay for costs such as coinsurance, co-payments, or deductibles not covered by Medicare Parts A or B. There is a wide variety of Medigap policies offered for different types of costs (labeled Parts C – J), but all insurance companies are required to offer the same type of coverage for each plan. Your Schultheis Insurance Agent can help you determine which of the Medigap plans is most appropriate for your needs and locate a policy provider offering the most cost-effective coverage.
Long-Term Care Insurance (also known as Nursing Home Insurance)
Medicare and most health insurance policies provide only limited long-term care coverage. If you should have an illness or condition which would require you to stay in an extended care facility or nursing home, or to have nursing care in your home, your financial resources could be quickly depleted. Long-Term Care Insurance provides coverage for health-related care—either in a healthcare facility or in your own home, if appropriate. The best time to buy this type of coverage is in your middle-age years, before you actually need the care. However, if you are not currently disabled, you would still qualify for long-term care coverage, and having this coverage protects your family’s financial resources in the event of long-term illness or disability. Your Schultheis Insurance Agent can help you sort through the options and decide on long-term insurance that provides you the best coverage options at the lowest cost.
Guaranteed Issue Life Insurance
If you have been turned down for life insurance coverage because of pre-existing conditions or other risk factors, it may still be possible for you to have life insurance with a guaranteed issue life insurance policy. You are usually asked few questions about your current health and not required to have a health check-up before you receive your insurance coverage. However, guaranteed issue life insurance usually has limits on face value and term, and the premiums may be comparatively high. Ask your Schultheis Insurance Agent to help you locate the life insurance coverage that will protect your family from devastating financial situations.
Annuity accounts can be established to provide a regular income to supplement your pension and Social Security income. This type of account allows you to invest in your future with the possible addition of a life insurance feature. Your Schultheis Insurance Agent can help you determine the type of annuity that best fits your financial planning situation.
How much coverage should I plan for?
Your decisions about the types and amounts of insurance coverages will depend on many factors. As a general rule, you should review your financial situation and the amount of income and insurance coverages you have and what you are likely to need in addition. Then you should purchase the coverages you will need. Your Schultheis Insurance Agent will spend the time with you to help you determine your needs and then will review what is offered by a number of insurance companies to get you the coverages you need at the most cost-effective rates.