Health & Medicare Insurance FAQ
What's the difference between a Primary Care Physician (PCP) and a specialist?
A Primary Care Physician, or PCP, is the doctor you would go to on a regular basis, such as when you're simply not feeling well, or have an ear ache or the flu. A specialist is a doctor that your PCP might refer you to if the problem you have requires a doctor with more experience in a certain area.
What is "Out-of-Pocket-Maximum"?
This is the amount of money one would pay out of their own pocket towards your medical expenses in any given year. An out of pocket expense can refer to how much the co-payment, coinsurance, or deductible is. Also, when the term annual out-of-pocket maximum is used, that is referring to how much the insured would have to pay for the whole year out of their pocket, excluding premiums. Usually, your maximum out-of-pocket is never more than a couple of thousand dollars over and above your chosen deductible.
What is a network?
A network is a list of doctors, hospitals and other providers that have contracted, or agreed, with an insurance company to do business with the insurance company. The provider's fees have been pre-negotiated, which means that the insurance company will not necessarily pay the doctor or hospital what your actual medical bills are, but will pay a lower amount.
What is a pre-existing condition?
A pre-existing condition is any health condition you have or have had prior to applying for a health insurance policy.
Can I get health insurance if I'm currently pregnant?
Unfortunately No. You certainly may obtain insurance prior becoming pregnant and if you have other children, they may be insured through us at any time.
What is HIPAA?
HIPAA stands for the Health Insurance Portability and Accountability Act, which is a law mandating that anyone belonging to a group health insurance plan must be allowed to purchase health insurance within an interval of time beginning when the previous coverage is lost regardless of current health status.
What is a Medicare Supplement plan?
A Medicare Supplement insurance plan helps cover the "gaps" in coverage that are left unpaid after Original Medicare pays its portion of your health care expenses.
Can you help me compare Original Medicare to the Medicare Advantage plans?
Yes. Visit our Medicare Advantage Plans section.
Why should someone buy Medicare Supplement Insurance?
There are out-of-pocket costs not covered by Medicare and Medicare Supplement Insurance policy may fill these gaps.
Will a Medicare Supplement plan cover me if I have a preexisting condition?
Possibly. Insurance companies will usually ask for proof of prior coverage before offering coverage for conditions. However, there some instances where this is not necessary to provide coverage from pre-existing conditions. Give us a call at (800) 559-7593 so when can help you find coverage to cover your health conditions.