Fixed Benefit Plans 

  • Pay a fixed amount of money for a specified event regardless of actual costs 
  • Non Qualified plan


Lifetime Maximum​

  • Total amount that a policy will pay
  • Not allowed on Qualifying plans


Monthly premiums 

  • Premium is your monthly payment for the insurance
  • Employer plans can be deducted from each paycheck 


Non-Qualified Plan

  • Must answer Health questions
  • Dollar Cap on medical coverage
  • Not eligible for Tax Credits
  • Does not cover minimum essential benefits
  • ex.  Short-term plans, Fixed benefit plan


Out-of-pocket maximum

  • Absolute maximum of out of pocket expenses
  • Normally per calendar year
  • Includes deductible 
  • Applies to individual and family


Qualified Plan

  • No Health questions (Guaranteed acceptance)
  • No Cap
  • Eligible for Tax Credits
  • Covers the required minimum essential benefits 


Short Term Plan

  • Medical plan of less than 364 days
  • Non-Qualified plan

Terms to know:



 Co-insurance

  • Percentage of the medical cost you pay after deductible is paid 
  • Expressed as percentage rather than fixed dollar amount (80/20, 70/30 or other combinations).  First number is the amount the insurance company pays.


 Co-Insurance Maximum

  • Maximum amount of Co-insurance that will be paid after Deductible


 Co-pay

  • Cost for routine services to which deductible does not apply 
  • Payment is same regardless of extent of visit or cost.


 Deductible

  • How much you pay before insurance starts paying 
  • Does not apply to all service. of deductible

We do not offer every plan available in your area.  Any information we provide is limited to those plans we do offer in your area.  Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Deductible (Aggregate)

  • The total family deductible must be paid out-of-pocket before health insurance starts paying for the health care services incurred by any family member.


Deductible (Embedded)

  • A single member of a family doesn't have to meet the full family deductible for after-deductible benefits to kick in.


60% of all bankruptcies are from medical bills. 77% had major medical insurance​​

 Health Insurance: is used to help people pay their medical bills.  Health insurance is divided into three areas.


1.  Major Medical:  Can be provided by an employer or privately purchased.  Major Medical insurance varies extensively in premiums, deductibles, co-pays, and co-insurance.


2.  Medicare:  A federally funded medical insurance program that provides assistance for people over age 65 or Disabled.  Medicare part A and B together are designed to pay 80% of a beneficiaries medical costs.  There are various products available to assist Medicare beneficiaries in controlling their costs. 



Medicare is broken down into four parts:

  • Part A; Hospital Coverage
  • Part B; Out patient Coverage
  • Part C; Medicare Advantage or Private Medicare plans
  • Part D; Prescription drug coverage


3.  Supplemental:   A type of medical insurance used to meet needs. Not covered by Major Medical or Medicare. 

  • Can cover a narrow or broad spectrum
  • Can be fixed benefits or percentage based
  • ex. Medicare Supplement, Dental, Vision, Cancer, Accident, Critical illness, Short/Long Term Disability etc...



Factoid

​​​$9,788 is the average hospital expense, adjusted per inpatient stay.

Downloadable Forms

​Health Insurance

Phone: 501-259-5535

​Confused?​

​We can help

Fax: 501-377-9880

Factoid

Factoid


​$39.4 million, number of visits to hospital emergency departments due to injuries in 2007