Frequently Asked Questions

FAQs : Learn More About Health Insurance

The ACA Marketplace offers private health insurance for individuals and families who don’t qualify for Medicare or Medicaid.

  • Medicare is a federal program for people 65+ or those with certain disabilities.
  • Medicaid is a state and federal program that provides coverage for low-income individuals and families. Eligibility varies by state.


Financial assistance, like premium tax credits, is based on income and household size.

  • If your income is between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for lower monthly premiums.
  • Medicaid eligibility depends on income and varies by state.
  • HMO (Health Maintenance Organization): Requires using a network of doctors and getting referrals for specialists.
  • PPO (Preferred Provider Organization): More flexibility to see out-of-network providers but at a higher cost.
  • EPO (Exclusive Provider Organization): No referrals needed for specialists, but you must stay in-network.
  • Deductible: The amount you pay before insurance covers costs.
  • Copay: A fixed fee you pay for doctor visits or prescriptions.
  • Coinsurance: A percentage of costs you pay after meeting your deductible (e.g., you cover 20%, insurance covers 80%).

 

  • ACA Open Enrollment: November – mid-January each year.
  • Medicare Open Enrollment: October 15 – December 7 annually.
  • Special Enrollment Periods (SEPs): Available for qualifying life events like job loss, marriage, or moving.

Frequently Asked Questions

FAQs : Learn More About Medicare Insurance

Medicare is divided into four parts:

  • Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facilities, hospice, and some home health care.
  • Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services, and medical supplies.
  • Part C (Medicare Advantage): A private insurance alternative to Original Medicare (Parts A & B) that often includes extra benefits like vision, dental, and prescription drug coverage.
  • Part D (Prescription Drug Coverage): Helps pay for prescription medications and is available as a standalone plan or included in Medicare Advantage.
  • Original Medicare (Parts A & B): Government-provided coverage with the option to add a standalone Part D plan and a Medicare Supplement (Medigap) policy.
  • Medicare Advantage (Part C): Offered by private insurers, these plans bundle Parts A, B, and often D, along with additional benefits like dental, vision, and hearing coverage.
  • Original Medicare (Parts A & B) does not cover routine dental, vision, or hearing services.
  • Medicare Advantage (Part C) plans often include coverage for dental checkups, eyeglasses, hearing aids, and more.
  • Standalone dental, vision, and hearing plans are available if you have Original Medicare and need additional coverage.

Frequently Asked Questions

FAQs : Learn More About Life Insurance

There are two main types of life insurance:

  • Term Life Insurance: Provides coverage for a specific period (e.g., 10, 20, or 30 years). It’s generally more affordable but does not build cash value.
  • Permanent Life Insurance: Includes Whole Life and Universal Life insurance, offering lifetime coverage and a cash value component that can grow over time.

The amount of coverage depends on factors like:

  • Your income and future earning potential.
  • Outstanding debts (mortgage, loans, credit cards).
  • Expenses for dependents, including education costs.
  • Funeral and end-of-life expenses.
    A common rule of thumb is to have 10–15 times your annual income in coverage.

It depends on the policy.

  • Traditional policies often require a medical exam to determine eligibility and pricing.
  • No-medical-exam policies, like simplified issue or guaranteed issue life insurance, do not require an exam but may have higher premiums.

Yes, in some cases:

  • Term policies can often be converted into permanent life insurance.
  • Some policies allow you to adjust coverage amounts or add riders (e.g., critical illness, disability waiver).
  • You may also cancel your policy at any time, but permanent policies may have cash value implications.

Frequently Asked Questions

FAQs : Learn More About Supplemental Insurance

Supplemental insurance is extra coverage that helps pay for expenses not fully covered by your primary health, Medicare, or life insurance policy. It can help with:

  • Deductibles, copays, and coinsurance
  • Lost income due to illness or injury
  • Out-of-pocket medical costs
  • Non-medical expenses like rent, groceries, and childcare during recovery
  • Accident Insurance: Pays a lump sum for injuries from accidents (e.g., fractures, burns, ER visits).
  • Critical Illness Insurance: Provides a cash payout for serious conditions like cancer, heart attack, or stroke.
  • Hospital Indemnity Insurance: Helps cover hospital stays, surgeries, and inpatient services.
  • Disability Insurance: Replaces a portion of your income if you’re unable to work due to injury or illness.
  • Medicare Supplement (Medigap): Covers out-of-pocket costs like deductibles and copays for Medicare beneficiaries.

Most supplemental policies pay benefits directly to you, not to doctors or hospitals. This means you can use the money however you need—whether it’s covering medical bills, rent, groceries, or other expenses during recovery.

Yes, dental and vision insurance are often considered supplemental insurance plans because they provide additional coverage beyond standard health insurance. Most health insurance plans, including ACA Marketplace and Medicare, do not include routine dental and vision care, so it’s beneficial to often purchase these plans separately.

  • Dental Insurance helps cover costs for preventive care (cleanings, exams, X-rays), basic procedures (fillings, extractions), and major procedures (crowns, root canals).
  • Vision Insurance helps pay for eye exams, prescription glasses, contact lenses, and sometimes discounts on LASIK surgery.

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