Choosing the Right Plan

Although the Affordable Healthcare Act reformed the healthcare industry with the intention to help uninsured and under-insured Americans find affordable healthcare. Facilitated through the website Healthcare.gov, health insurance policies are offered through health insurance companies with some regulated oversight from the federal government.

If you choose to enroll in health coverage outside of the Affordable Care Act marketplace, we can help with that as well. Keep in mind that these plans still follow basic regulations set forth by the ACA, including an open enrollment period. Unless you meet certain exceptions, you will need to enroll during this period, which takes place in the months before and after each New Year.

Types of Health Insurance Coverage

There are a number of general health insurance and health coverage options available to you, including:

• Preferred Provider Organizations – This type of plan encourages you to visit providers within a certain network with a lower fee. It also allows you the freedom to visit other providers at a higher cost if you choose.
• Exclusive Provider Organizations – An EPO only covers providers within your specific network – except sometimes in the case of an emergency. Visits to providers outside of this network are fully out of pocket.
• Health Maintenance Organizations – Another common plan, an HMO usually limits your coverage to certain providers in contract with your HMO. This type of plan greatly emphasizes prevention.
• Point of Service Plans – A POS plan also costs less when you use providers in your network and may require that you see your primary care doctor before it will pay claims for visits to any specialists or other providers.

Medicare Options

If you are nearly 65 or older, have a disability or have been diagnosed with End Stage Renal Disease (ESRD), we can also help you enroll in Medicare. In addition to Original Medicare (Medicare Types A and B), you may also want to explore Medicare Advantage Plans or adding a Medicare Supplement plan to your current coverage. Choosing the right type of Medicare up front is important, as you may not be able to change your plan once it is selected.

Levels of Health Insurance

Once you have selected what type of health insurance works best for your budget and for your preferences in healthcare providers, you will need to select a level. Plans come in bronze, silver, gold and platinum packages. You pay more out-of-pocket for care with a bronze plan, but have a lower premium. Conversely, a platinum plan has a higher premium, but with it your insurance company will pay 90% of your healthcare costs.

Choosing Your Health Insurance Wisely

Your health is essential to your family’s success and happiness. When you choose to work with the agents at Health Insurance Demo, we can design a plan that keeps you thriving. Contact our office in San Diego, California to begin exploring your policy options today.

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Diet is Key

Eat Plenty of Fruits and Vegetables – Fruits and vegetables are packed full of vitamins, minerals, fiber, and antioxidants, yet are very low in calories. Eating plenty of fruits and vegetables will help you feel full, decreasing hunger and the urge to reach for less healthy snacks throughout the day. Try to stick to a mix of various fruits and vegetables of all colors to ensure you are getting a variety of different nutrients.

Eat Plenty of Lean Protein – Adults need plenty of protein for to support a number of bodily processes. Aim for at least .8g of protein per kilogram of body weight each day. Stick to lean sources of protein such as chicken, turkey, seafood, and lean ground beef as well as other high-quality protein sources such as nuts, beans, eggs, and seeds.

Eat Whole Grains and “Good Carbs” – Try to limit refined carbohydrates and stick to whole-grain foods such as whole wheat, brown and wild rice, and oats as well as other “good carbs” such as beans, fruits, and vegetables. These sources of carbohydrates are higher in fiber and important nutrients compared to refined alternatives.

Eat Plenty of Healthy Fats – Healthy fats are important and essential for overall health. Many bodily processes rely on fats for proper function and omega-3 fats can reduce your risk of cardiovascular diseases. Nuts, avocados, and healthy oils are great sources of fat. Fatty fish such as salmon and sardines are excellent sources of omega-3 fatty acids. Try to avoid trans fats found in processed foods such as margarine and snack foods.

Don’t Neglect Exercise and Physical Activity

In addition to a healthy diet, physical activity is very important for good health as well. Whether you choose to go for a bike ride, lift weights, or take care of some yard work a few times a week, any exercise or increase in physical activity can be beneficial to your health. Physical activity not only helps you to lose weight by burning more calories, but it can also decrease blood pressure, reduce the risk for cardiovascular disease, and improve mood.

At Health Insurance Demo, we strongly believe that moderation is one of the biggest keys to successfully changing your eating habits and lifestyle. Remember, do not try and change everything about your diet or activity levels overnight. Make small steps and changes to slowly improve. It is ok to still have some of the foods you love and enjoy. Do not think of these foods as completely off-limits because they may not be considered the healthiest foods. Reduce portion sizes and cut back on how often you have these foods, and balance the remaining meals of the day with healthier options.

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Choosing a Carrier and Plan

Our team will help you analyze your business and the carriers and policies that may be a good fit for your needs. We can compare plans from top insurance companies to find the ones that work best for you. Once you have chosen a plan or group of plans, we’ll implement your it in coordination with the selected carrier and prepare to introduce the policy to your employees.

Employee Open Enrollment

Each year, our agents will come to your workplace to present the group health insurance options to your employees. If you’ve chosen a policy with different employee options, such as a PPO and HMO, we’ll explain the differences in cost and coverage. After the presentation, our team will be available in person and by phone to answer any policy questions that arise while employees are selecting their plans. Each employee will have to go online to make his or her elections for coverage or waive coverage.

New Employee Enrollment

For new employees who sign on to insurance at times of the year other than open enrollment, we will provide a packet with an explanation of benefits and are available to answer any questions.

Yearly Renewals

Each year, we’ll review any changes and rate increases that affect your group policy and help explain them to your employees. You’ll have to renew your group policy each year in order to continue protecting your employees. If you’d like to consider switching insurance carriers, we can explore other group health insurance option and compare contributions and coverage.

Affordable Care Act

When it was first released, the ACA made some big changes in terms of coverage requirements and out-of-pocket expenses for many. We will educate you and your employees on which annual visits are covered free of charge, which prescriptions may also be free – such as birth control – and other requirements that must be included in all new insurance offerings.

Keep Your Employees Protected

At Health Insurance Demo, we’re constantly learning about group health insurance and looking for ways to best serve you. We research changes in healthcare insurance trends and stay up-to-date with health insurance laws as they relate to California. We would love to use this knowledge to help you find a great policy for your employees. If you own a business, large or small, in San Diego or nearby California, and want to explore group health insurance, contact us today.

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Are You Eligible for Medicare Supplement Insurance?

To be eligible for Medicare Supplement Insurance, you must first have Original Medicare. Original Medicare is Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). To qualify for Original Medicare, you must be:

• Age 65 or older
• Disabled
• Have end-stage renal disease (ESRD)

If you are already enrolled in Medicare Part A and Medicare Part B, you can elect to add Medicare Supplement Insurance to your current plan at an additional cost. You cannot enroll in Medigap, however, if you are already enrolled in a Medicare Advantage plan. You may choose to switch to a combination of Original Medicare and Medicare Supplement Insurance as long as you end your Medicare Advantage plan first.

Medicare Supplement Standardized Options

At Health Insurance Demo, we can help you understand all 10 standardized Medigap plans available to you as a California resident in San Diego. While Medigap insurance is offered through private insurance companies, all types of Medigap are standardized by the government.

To understand what type of Medicare Supplement Insurance will work for you, you should first evaluate how much you are paying out-of-pocket on Original Medicare alone. Usually, these costs include out-of-pocket deductibles, coinsurance and copayments. Many Medigap plans also cover emergency healthcare outside of the United States for patients when they require it. Medigap insurance is designed to partially or fully cover these costs in exchange for your regular premium payments.

When to Purchase Medicare Supplement Insurance

You are eligible to enroll in Medicare Supplement Insurance once you have been enrolled in Original Medicare and are 65 or older, have a disability or have been diagnosed with End Stage Renal Disease (ESRD). If at all possible, you should consider purchasing Medigap during your initial six-month Medigap open enrollment period (once you turn 65 and have enrolled in Medicare Part B).

During this time, you can purchase any of the 10 types of Medigap insurance, no matter the state of your health. While you may apply for Medicare Supplement Insurance at a later date, you may be denied coverage due to pre-existing conditions or have to pay a much higher premium for coverage.

Paying for Medigap

A Medicare Supplement policy may be right for you if you anticipate paying regular copays, deductibles, or coinsurance. Our licensed agents can discuss your unique situation to determine whether this add-on service will save you money long term. We can also help you understand other options, such as Medicare Advantage Plans, or adding on Medicare Part D (for prescriptions) to help ease the burden of expensive monthly prescriptions.

Consider Medigap Before Your Enrollment Period

At Health Insurance Demo, we are here to serve you. Our passionate agents will help you understand what type of insurance plan works best for you and your family. Contact us today to schedule a confidential consultation today.

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Term Life Insurance

The two main divisions of life insurance are term and permanent. Term life insurance is life insurance with a time limit. Term policies promise a payout to beneficiaries if the insured dies during a set period of time, usually 10-30 years. The insured makes regular premium payments during the coverage period. If he or she dies during the term, the policy pays out a predetermined lump sum to the beneficiaries. If the insured does not die before the term ends, he or she may be able to purchase continued coverage, but usually at a much higher rate. Term life insurance policies are more affordable than permanent solutions, but it’s important to carefully look at how long of a term you think you will need before choosing this type of policy.

Permanent Life Insurance

Permanent life insurance policies are – as their name implies – permanent. These policies pay out a death benefit regardless of when the policyholder dies. They are costlier than term life insurance policies but offer greater security.

There some common types of permanent life insurance: universal, whole, and variable life insurance.

• Universal life insurance policies require that the insured must maintain a minimum level of premium payment throughout the year, but those payments can vary month over month as needed.
• Variable life insurance policies are invested by the insurance company, which can be profitable for the insured, but is risky in case the investments do not do well.
• Whole life insurance policies have fixed premium and cash value that slowly accumulates over time. They have less earning potential than variable policies, but they are more predictable.

We’re Here to Help at Every Step

The team at  Health Insurance Demo helps clients in San Diego, California find the right insurance policies for you and your family. Our agents offer the one-on-one attention you deserve. We’re here to help you find and choose a policy and to support you throughout the life of the policy and support your family when you’re gone. We offer a full spectrum of term and permanent life insurance policies to suit your needs. Contact us to get started.

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