Health Insurance
Are You Covered?
Navigating insurance plans can be a complex task, and understanding which plan effectively covers all your assets can often seem daunting. We recognize the challenges you may face. That’s why our dedicated associates are here by your side every step of the way, offering personalized guidance and expertise.
We go beyond simply selecting a plan; we take the time to thoroughly review your coverage needs and work closely with you to create customized insurance solutions tailored specifically to protect your valuable assets.
Would you like a health insurance plan tailored just for you?
Our Insurance plans
Major Medical
Medicare
Short-Term
Group
Major Medical:
Major medical health insurance is a type of health insurance that covers the expenses associated with serious illness or hospitalization.
Creating what is right for you
Major medical insurance is a specific type of health insurance plan that will help cover your medical expenses. It often covers preventive care services, urgent care visits, emergency room visits, prescription medications, and other routine medical expenses. However, this type of plan will not cover cosmetic procedures. It also has a longer duration than a short-term insurance plan. The goal of this plan is to minimize out-of-pocket costs for the policyholder.
Major medical plans usually have a set amount, or deductible, which the patient is responsible for paying. Once that deductible is paid, the plan typically covers most of the remaining cost of care. There is usually coinsurance after the deductible is met, which involves the patient paying a percentage of the bill (20% is a common amount) and the insurance company paying the rest.
Major medical health insurance covers all the minimum essential benefits and meets the standards of the Affordable Care Act (ACA) for individual and family coverage. Many individuals and families select major medical coverage to ensure all their medical expenses are covered no matter what health concerns might occur throughout the year.
Essential benefits:
- Hospitalization
- Outpatient procedures (also called ambulatory care)
- Preventive care like check-ups and immunizations
- Prescription medication
- Mental health and addiction counseling
- Laboratory services
- Emergency services
- Pediatric care
- Maternity and newborn care
Key features and benefits
Major medical health insurance is designed to provide extensive coverage for significant healthcare needs, particularly in cases of serious illness and hospitalization. This type of insurance offers several key benefits:
Coverage for preventative care
These plans typically cover essential preventive services, such as vaccinations, screenings, and annual check-ups, often at no additional cost to the policyholder. This can encourage early detection and prevention of serious health issues.
Solutions
Easier to obtain than other health insurance policies, specifically for those with pre-existing medical conditions
ACA Compliance
By qualifying for the ACA, these plans enable policyholders to avoid tax penalties in states that enforce them for not having health insurance.
Qualifies for the ACA
So fines can be avoided in states with tax penalties
Accessibility
Major medical plans are generally more accessible, even for individuals with pre-existing medical conditions. This inclusivity is especially important under the Affordable Care Act (ACA), which prohibits denial of coverage based on pre-existing conditions.
Potential for Subsidies
During Open Enrollment, these plans may qualify for subsidies, making them more affordable by significantly reducing the cost of premiums.
Assessment
We begin by thoroughly understanding your unique insurance needs and financial goals.
Comprehensive Coverage
These plans often include a broad range of medical services and treatments, from routine care to specialized procedures, providing a safety net for various health care needs.
medicare
The federal health insurance program for
- People who are 65 or older
- Certain younger people with disabilities
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
What are the parts of Medicare?
The different parts of Medicare help cover specific services:
- Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. - Medicare Part B (Medical Insurance)
Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. - Medicare Part D (prescription drug coverage)
Helps cover the cost of prescription drugs (including many recommended shots or vaccines).
short Term health insurance
Short-term health insurance is a type of health plan that can provide you with temporary medical coverage when you are between health plans, outside enrollment periods, and need some coverage in case of an emergency.
Benifits of short-term insurance
- Designed to fill short-term gaps in coverage should you need it
- You can cancel coverage whenever you’d like without penalties
- You can typically choose a plan that covers you up to 3 months, if needed
- Many different plan designs are available, depending on insurance carrier
Questions?
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What is short-term health insurance?
Short-term health insurance is a type of health plan that can provide you with temporary medical coverage when you are between health plans, outside enrollment periods, and need some coverage in case of an emergency. However, to get the most out of a short term health plan, you need to understand how they work, what they cost, and what they cover.
What is covered?
Short-term health insurance coverage varies greatly depending on the plan and the insurance company you buy from. These types of plans are not required to comply with Affordable Care Act (ACA) guidelines. ACA plans are required to provide certain levels of coverage—called minimum essential coverage. Short-term health plans are not required to meet the same standards.
Short-term medical insurance typically provides some level of coverage for preventive care, doctor visits, urgent care, and emergency care. There may also be coverage for prescriptions. Some plans also offer cost savings for seeing in-network providers. Make sure to read the “exclusions and limitations” information before buying any plan. This will tell you what’s covered and not covered by a certain plan
How much does short-term health insurance cost?
If you’re considering temporary health insurance, typical upfront costs include:
- Premium: This is the monthly fee you pay for having coverage. The premium will vary depending on the level of coverage you choose, including deductible and coinsurance, as well as the types of services covered.
- Deductible: The deductibles on short-term health plans can be significantly higher than other more traditional health plans. You pay out of pocket for services until you meet your deductible. Then your plan starts sharing costs.
- Coinsurance: This is the percentage of costs you share with your plan after you meet your deductible. It’s often shown as a percentage. Most short-term plans have a deductible and coinsurance.
- Copay: This is a fee you may have to pay when you visit a doctor; usually payable at the time of the visit. Some short-term plans require you to pay a copay for certain doctor visits.
- Other out-of-pocket costs: If there are health care services not covered by your short-term plan, you could end up paying all costs. For example, some short-term plans may not cover or may limit your coverage for maternity care, mental health or substance use services, vision care, or dental care—these are costs you’d have to pay yourself for any services you receive.
group insurance
What is Group lnsurance?
Group insurance is coverage issued to a group of members as part of an employee benefits package, rather than insurance you purchase on your own.
Group health insurance plans are selected and purchased by companies or organizations and then offered to employees.
We offer a variety of healthcare benefit options to help your employees make the best choices for their continued health and wellness. Whatever the size of your business, our health plans can help you create a healthier and more productive workforce that attracts and retains top talent.
Who Can Sign Up for Group Health Insurance?
To be eligible for group health insurance, an employee must be on payroll and the employer must pay payroll taxes. Individuals usually not eligible for group coverage include independent contractors, retirees and seasonal or temporary employees. Employees who are on unpaid leave are often ineligible for group coverage until they return to work.
Generally, group health insurance coverage must also be offered to an employee’s spouse and dependent children until age 26, though employers may choose to expand the age definition for child dependents. Employers may also opt to extend health benefits to unmarried partners of the same or opposite sex, and that coverage must mirror the coverage extended to spouses on the same plan.
Benefits of group insurance
Group insurance coverage can be an excellent option.
- Lower cost: Because you typically split the price of insurance premiums with your employer, you’ll likely save money by enrolling in group insurance.
- No exams: Unlike individual insurances, group coverage typically won’t require you to disclose any pre-existing conditions or circumstances that might otherwise make it difficult to enroll.
- Ease of enrollment: Typically, group insurance coverage is managed by your HR representatives and requires little, if any, communication between yourself and the insurer to enroll.
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CONTACT US HERE WITH ANY QUESTIONS
Address
5379 Lyons Road #1684
Coconut Creek, Florida 33073
info@lotusfingrp.com
Legal Disclaimer:
Neither Lotus Financial Group, LLC., nor its representatives or employees provide legal or tax advice. If legal or tax advice or other expert assistance is required, the service of a currently practicing professional should be sought.
Insurance Services are offered through Lotus Financial Group, LLC., and is not registered to offer securities and advisory services in all states. *Third-party rankings and recognitions are no guarantee of future investment success and do not ensure that a client or prospective client will experience a higher level of performance or results. These ratings should not be construed as an endorsement of the advisor by any client nor are they representative of any one client's evaluation. Not affiliated with the U. S. government or federal Medicare program. 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.