The Requirement to Buy Coverage Under the Affordable Care Act
Along with changes to the health insurance system that guarantee access to coverage to everyone regardless of pre-existing health conditions, the Affordable Care Act includes a requirement that many people be insured or pay a penalty. The employee penalty progresses over a three year period. In 2014, it is the greater of 1% of adjusted household income or $95 per adult plus $47.50 per child; in 2015, it is the greater of 2% of adjusted household income or $325 per adult plus $162.50 per child; thereafter the greater of 2.5% of adjusted household income or $695 per adult plus $347.50 per child. Please contact us for guidance on how the requirement (sometimes known as an "individual mandate") works.
Typically, vision coverage is offered as a discount program. Vision coverage is meant to cover only predictable costs such as comprehensive annual or bi-annual exams, lenses, frames and contact lenses. The American Optometric Association recommends the following for a comprehensive eye exam:
A check of internal and external eye health for signs of possible disorders such as cataracts or problems with your retina
An evaluation of your current prescription (glasses or contact lenses)
A visual acuity test to check your ability to see clearly at all distances
A refraction test to determine your eyes' ability to focus light rays on the retina at all distances
A glaucoma test of your eyes' internal pressure
A visual coordination test for muscle control
A test of your eyes' ability to change focus.
While an eye exam may reveal eye problems, the purpose of vision coverage is not to replace your medical coverage.
We compare vision plans by checking to see whether exams are covered each year or only once every other year. Another way to compare vision coverage is to check how often lenses, frames or contacts are covered and in what amount. Getting a discount on services and corrective lenses you need is an obvious plus.
People with dental insurance commonly have what's described as "100-80-50" coverage, meaning it pays 100 percent of the cost of routine preventive and diagnostic care, such as checkups and cleanings; covers 80 percent for fillings, root canals and other basic procedures; and 50 percent for crowns, bridges and major procedures. Orthodontia is optional.
There are many important plan features to consider.
Most dental benefits are calculated within a "benefit period," which is typically for one year but not always a calendar year. Be aware of this information so you know when you might be approaching your deductible limits or program maximums.
Most dental plans have an annual dollar maximum. This is the maximum dollar amount a dental plan will pay toward the cost of dental care within a specific benefit period. The patient is personally responsible for paying costs above the annual maximum.
Some dental plans have a specific dollar deductible. It works like your car insurance deductible. During a benefit period, you will have to personally pay a portion of your dental bill before your insurance carrier will contribute to your bill. Your handbook will describe how your deductible works. Plans do vary on this point. For instance, some dental plans will apply the deductible to preventive treatments, and others will not.
Many insurance plans have a coinsurance policy. That means the insurance carrier might pay a predetermined percentage of the cost of your treatment, and you are responsible for paying the balance. The amount you pay is called coinsurance. It is paid even after a deductible is reached.
Coordination of Benefits
Coordination of Benefits eliminates duplicate payments for dental or orthodontic services if you have more than one provider.
MD Insurance Guide offers a variety of plans with different features to meet your needs.
Your need for life insurance will vary with your age and responsibilities. The amount of insurance you buy should depend on the standard of living you wish to assure your dependents. Term life is the simplest and (typically) cheapest form of life insurance. Term life is designed to provide coverage for a fixed period of time, such as 5, 10, or 20 years. The premium for the term policy is guaranteed for the duration of the term; if it is a renewable policy, the premium will increase with each renewal. The premiums for renewals are generally guaranteed when the original policy is issued. Because term life policy is for a specific period of time and the payout does not increase, the overall cost of term life insurance is usually very low. We also offer Whole Life, Universal Life and Variable Life policies. Please contact us to assist you.
Individual disability income insurance helps protect a portion of your income and provides financial protection if you become disabled for an extended period of time. Anyone who depends on their income to pay the bills or maintain their lifestyle should consider disability income insurance protection.
Bridge the gaps in health insurance coverage. When a life change leaves you without health insurance, you need coverage to get you through the transition period.
A Short Term Medical Plan can help smooth a life transition by making sure you're never without insurance coverage. You may be between jobs or unemployed, a young adult finished with school, or a student no longer covered under a parent's insurance plan, or an early retiree.
waiting for other coverage to begin. These plans offer a range of deductibles, payment options and lengths of coverage. You can also drop your Short Term Medical coverage at any time without penalty. Most offer optional periods of coverage from 1 to 11 months. Short term plans and other non-compliant plans purchased outside of open enrollment don't comply with ObamaCare's individual mandate! Moving forward into 2015 everyone is allowed a 3 month "short coverage gap" exemption once per year.