"Our mission is providing the right products for our customers in helping them take care of their insurance, as well as financial investment needs, both short term and long term." ~ Tim Joslen
Portland / Vancouver Metro - 360-256-7536
The Ever Changing World
of Health Insurance
Health insurance continues to hold confusion in terms of what the new laws may require.
Health insurance typically covers the cost of medical or hospitalization care as a result of an illness or injury that occurs or is manifested while the policy is in force. Like other kinds of insurance, the benefits are payable in return for the insured paying the premium. The premium is the amount of money charged by the insurer for the coverage.
A Quick Video On Short Term
Check out this video that helps explain a bit more about short term affordable medical policies and see if it may be right for you.
Contact us today to review this and any other questions you may have.
We Do The Shopping For You!
One of the main advantages in working with Pacific Prosperity Group, LLC is the large number of companies we work with that help us to the best job for our clients. It is important to know that not all health insurance Carriers’ products can be purchased through a State or Federal Exchange. A health plan can be compliant and ACA approved with the 10 essential benefits but still choose to not be involved in selling through the exchanges which allow some Americans a Federal tax credit.
In 2014, all ACA Metallic plans have a maximum out-of-pocket maximum of $6,350 per individual and $12,700 per family. All plans must have the 10 Essential Benefits required under the ACA. If a customer qualifies for a Federal tax credit (see health reform calculator) the credit is based off of a “Silver” plan premium.
Platinum plans will pay on average 90% of covered costs, while the enrollee pays 10% up to the yearly maximum.
Gold plans will pay on average 80% of covered costs, while the enrollee pays 20% up to the yearly maximum.
Silver plans will pay on average 30% of covered costs, while the enrollee pays 30% up to the yearly maximum.
Bronze plans will pay on average 60% of covered costs, while the enrollee pays 40% up to the yearly maximum.
10 Essential Benefits
These essential health benefits are included in ALL ACA medal plans
1. Outpatient care—the kind you get without being admitted to a hospital
2. Trips to the emergency room
3. Treatment in the hospital for inpatient care
4. Care before and after your baby is born
5. Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
6. Your prescription drugs
7. Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
8. Your lab tests
9. Preventive services including counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease.
10. Pediatric services: This includes dental care and vision care for kids