Fambuli is for

Family

Fambuli is for

Family

Learn About Health Insurance

If you're confused about the state of health insurance in the US, we don't blame you. Fortunately, we're here to help make it a little easier to understand. Essentially there are three ways to get health insurance in the US today and we're going to break those down for you and then some.

Your first option for health insurance is through your employer. Generally your employer will choose a plan to offer to their employees and will cover most of the expense as a benefit. But not all employers offer coverage, so that leaves some people trying to figure it out on their own.

So what do you do when you don't have employer coverage? That's where the market place and private insurance come in.

The marketplace (or the exchange) is run by the government. Depending on your state, it may be a state marketplace or a federal marketplace. Either way, the insurance companies offering coverage on the marketplace must offer minimum benefits and must accept anyone who applies. Also, depending on your income, you may qualify for subsidies on your premiums to help make the costs more affordable.

What if you don't qualify for subsidies or you don't like your options? Private health insurance can be an option. With private health insurance, premiums can be much lower than the marketplace, but the insurance companies may deny coverage if you don't meet underwriting criteria.

That's a lot right? And we've barely just scratched the surface.

Private Health Insurance

When an employer doesn't offer coverage, or you're self employed, a lot of people don't know where to look. If your income is too high to qualify for subsidies on the health exchange, but not high enough to pay for the premiums, private health insurance should be considered.

With private health insurance, premiums can be much lower than the marketplace, but the insurance companies reserve the right to deny coverage if you don't meet underwriting criteria. The good news is that since the insurance companies have underwriting guidelines for these plans, the overall costs are lower, and the savings get passed to you.

Another benefit to private insurance is that it is almost always a nationwide PPO, meaning you have coverage anywhere in the US.

Types of Plans Available

Co-Pay Plans: These types of plans have co-pays, deductibles, and co-insurance. What this means is that you are responsible for a portion of your medical bills in addition to your premium payment. You're probably used to having a plan like this if you ever had a PPO or HMO through an employer or the marketplace.

First Dollar (Indemnity) Plans: These plans payout a fixed dollar amount for services rendered and do not have co-pay, deductibles, or co-insurance. The amounts paid and types of benefits will vary based on the insurance company and the plan selected. For example, the insurance company may pay a fixed dollar amount for you to see the doctor, or pay a daily rate if you're hospitalized. If there is a surplus paid out, you get to keep the difference.

Supplement Plans: Since there is no perfect health insurance plan, supplements help fill the gaps. They can help you meet deductibles and co-insurance, or they can pay out a lump sum for certain diagnoses. Supplements can be added to compliment any plan you already have and can payout regardless of the network you use.

Consider If

You are healthy
You make too much to qualify for subsidies
You want nationwide coverage

Don't Consider If

You have a major diagnosis
Take several medications
Require ongoing care from a specialist

To find out if private health insurance is right for you

Learn About Health Insurance

If you're confused about the state of health insurance in the US, we don't blame you. Fortunately, we're here to help make it a little easier to understand. Essentially there are three ways to get health insurance in the US today and we're going to break those down for you and then some.

Your first option for health insurance is through your employer. Generally your employer will choose a plan to offer to their employees and will cover most of the expense as a benefit. But not all employers offer coverage, so that leaves some people trying to figure it out on their own.

So what do you do when you don't have employer coverage? That's where the market place and private insurance come in.

The marketplace (or the exchange) is run by the government. Depending on your state, it may be a state marketplace or a federal marketplace. Either way, the insurance companies offering coverage on the marketplace must offer minimum benefits and must accept anyone who applies. Also, depending on your income, you may qualify for subsidies on your premiums to help make the costs more affordable.

What if you don't qualify for subsidies or you don't like your options? Private health insurance can be an option. With private health insurance, premiums can be much lower than the marketplace, but the insurance companies may deny coverage if you don't meet underwriting criteria.

That's a lot right? And we've barely just scratched the surface.

Private Health Insurance

When an employer doesn't offer coverage, or you're self employed, a lot of people don't know where to look. If your income is too high to qualify for subsidies on the health exchange, but not high enough to pay for the premiums, private health insurance should be considered.

With private health insurance, premiums can be much lower than the marketplace, but the insurance companies reserve the right to deny coverage if you don't meet underwriting criteria. The good news is that since the insurance companies have underwriting guidelines for these plans, the overall costs are lower, and the savings get passed to you.

Another benefit to private insurance is that it is almost always a nationwide PPO, meaning you have coverage anywhere in the US.

Types of Plans Available

Co-Pay Plans

These types of plans have co-pays, deductibles, and co-insurance. What this means is that you are responsible for a portion of your medical bills in addition to your premium payment. You're probably used to having a plan like this if you ever had a PPO or HMO through an employer or the marketplace.

First Dollar (Indemnity) Plans

These plans payout a fixed dollar amount for services rendered and do not have co-pay, deductibles, or co-insurance. The amounts paid and types of benefits will vary based on the insurance company and the plan selected. For example, the insurance company may pay a fixed dollar amount for you to see the doctor, or pay a daily rate if you're hospitalized. If there is a surplus paid out, you get to keep the difference.

Supplement Plans

Since there is no perfect health insurance plan, supplements help fill the gaps. They can help you meet deductibles and co-insurance, or they can pay out a lump sum for certain diagnoses. Supplements can be added to compliment any plan you already have and can payout regardless of the network you use.

Consider If

You are healthy
You make too much to qualify for subsidies
You want nationwide coverage

Don't Consider If

You have a major diagnosis
Take several medications
Require ongoing care from a specialist

To find out if private health insurance is right for you

Explore How Fambuli Protects Your Family

Whether you're single, married with kids, divorced, or in a situationship, we partner with several major insurance companies to build customized solutions based on your needs and budget.

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Explore How Fambuli

Protects Your Family

Whether you're single, married with kids, divorced, or in a situationship, we partner with several major insurance companies to build customized solutions based on your needs and budget.