YES! Even if you're young and healthy, basic health coverage is a must! Unfortunate health circumstances and accidents often happen unexpectedly! “Medical bills can be shocking,” warns Dr. Jordan Hollsten, a practicing surgeon in San Antonio, Texas. “Everything from medications to hospital fees to surgical center fees to medical equipment must be covered. And accidents and unexpected illness happen, which require care whether insurance is available or not.”

There are several options available! We have access to health insurance plans for individuals, families, businesses, self-employed individuals and more! Depending on your individual circumstance, we may review a variety of plans, such as ACA plans or the private plans.

Absolutely! We would love to help you find the best coverage that fits you, your needs, and your budget!

We will review what you currently have, what you need, and what's out there and then evaluate if your current plan is the best affordable option for YOU! 

There may be options to get covered with health insurance now. Book an appointment today to discuss your individual circumstances, and we would be happy to provide unbiased and personalized options that are available!

Depending on your circumstance, and which health insurance plan is best, you may be eligible to enroll in a plan now or have to wait until open enrollment. Open Enrollment usually takes place November through January 16 each year. Some states do have longer enrollment periods. Be sure to book an appointment today to see what your options are!

ACA stands for Affordable Care Act and refers health insurance plan options that are available on the Federal Marketplace, also known as Obamacare or Marketplace coverage. Depending on your zip code, the available options might be overwhelming! Rest assured, we have been awarded the "Marketplace Circle of Champions" for our exemplary guidance and support for our clients and will provide the unbiased and personalized guidance needed to navigate the complex world of health insurance to find the right plan for YOU!

Initially, under the ACA, a federal tax penalty was imposed on individuals who didn't have health insurance that met the ACA’s minimum essential coverage criteria. This federal penalty has since been eliminated, but some states continue to enforce their penalties for lack of coverage. At Core Legacy Group LLC, we'll review the guidelines of ACA coverage and what that may mean for you. As always, we recommend consulting with a tax advisor within your state is advisable.

A deductible is the amount of money you agree to pay for treatment before your health insurance policy begins to pay.

Typically, a higher deductible means a lower monthly premium. So, if your deductible is $1000, you’ll pay 100% of your healthcare expenses until you’ve hit $100. After you meet your deductible, you’ll be responsible for any cost-sharing, such as copayments or coinsurance the plan requires; read more about those below!

Some insurance plans may include coinsurance, which means you’ll pay a percentage of the bill even after you’ve met your full deductible.

It’s a way to share the cost of your healthcare service. Let’s say you’ve met your deductible for the year. The next time you go to the doctor, instead of paying all costs, you and your plan will share the cost. So, if your coinsurance rate is 20% and the cost of a doctor’s visit is $100, you’ll pay $20, and your insurance will handle the remaining 80% of the bill.

A copayment is a set fee you pay for a particular healthcare service.

You might have different copayments for doctors, hospital stays, prescription medication, and other types of care. Your plan determines what your copay is for each service. Your copay can be independent of your deductible and coinsurance.

It is essential to consider out-of-pocket expenses. Even if you have health insurance, you will likely pay for some of your care.

Out-of-pocket costs represent your share of the medical expenses, what health insurance doesn’t cover.

CAN INCLUDE: Deductibles, Coinsurance, Copays, and Services that aren’t covered by your plan.

Be aware of which services are covered, as well as which providers are in-network. Out-of-network care can increase your out-of-pocket costs substantially since these are services not generally covered by your plan. 

Yes, there is a maximum out-of-pocket (MOOP) cost for most plans.

Under the Affordable Care Act (ACA), out-of-pocket maximums are established for plans sold on state marketplaces. There are exceptions though! Even with an out-of-pocket limit, you could still be on the hook for additional expenses.

What doesn't count towards the "MOOP"?

Monthly Premiums, Out-of-network care, Services not covered by your plan, and provider charges beyond the amount allowed for a service.

ACA plans are categorized into 4 Metal tiers based on cost-sharing between you and the insurance provider:

Bronze: Lowest monthly premiums but highest out-of-pocket costs. The plan pays approximately 60% of covered healthcare expenses, while you pay about 40%. Suitable if you want low premiums and don’t expect frequent medical care.

Silver: Moderate premiums and out-of-pocket costs. The plan covers about 70% of healthcare expenses, leaving you with 30%. If you qualify for cost-sharing reductions, you must choose a silver plan to receive those extra savings.

Gold: Higher premiums with lower out-of-pocket costs. The plan pays around 80% of covered expenses, and you pay 20%. Ideal if you anticipate needing regular medical care and can afford higher monthly premiums.

Platinum: Highest premiums but the lowest out-of-pocket costs. The plan covers about 90% of healthcare expenses, with you paying 10%. Best if you require frequent medical services and prefer higher premiums for more comprehensive coverage.

 Book an appointment today to get unbiased and personalized guidance!