Individual Health Insurance: What’s Right for You?

You’re probably aware that there have been some big changes in health insurance. Perhaps the biggest change is that federal law requires you to have it. But what does that really mean for you?  

If you’re without group health insurance or soon will be, M3’s first step will be to educate you on your options. Once you have a solid understanding of your choices, rights, and responsibilities, we can provide you helpful guidance to help you make smart insurance decisions that fit your needs and fall within your budget.

You may be able to customize your individual plan by choosing deductibles, copays, out-of-pocket limits, and provider network physicians. The plan may also be portable, moving with you as you change jobs, cities, etc.

All private health insurance plans offer the same set of essential health benefits, including:
  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity and newborn care
  • Mental health and substance use disorder services (including prescription drugs)
  • Rehabilitative and habilitative services
  • Laboratory services
  • Preventative and wellness services
  • Chronic disease management
  • Pediatric services (including oral and vision care)

Short-Term Medical: Don’t Leave Yourself Vulnerable

You or a family member may simply be in need of a short-term health insurance solution. These types of products, which provide temporary coverage for 30 to 365 days, include comprehensive medical and hospital benefits and are offered with a choice of several deductibles. Many people qualify for this type of coverage:

  • Recent college graduates
  • Part-time and temporary employees
  • People between jobs who are looking for an affordable
    alternative to COBRA
  • New employees waiting for health benefits to begin
  • Recent retirees waiting for Medicare eligibility

Medicare Shouldn’t Be A Mystery to You

First, the basics: “Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)” (from Medicare.gov).  Unfortunately, from here things can get confusing. So maybe you know you’re Medicare eligible – but that’s about all you know? Not a problem! If you’re getting tangled up in the terminology of Medicare or overwhelmed with its various options, you’ve come to the right place.

Medicare’s four main parts include the following:

  • Hospitalization (Part A) – automatically included in all Medicare plans
  • Physicians Services (Part B) – optional
  • Advantage Plans (Part C) – optional
  • Prescription Drugs (Part D) – optional at an additional cost

Numerous plans are available for you and all include preventative care, cancer screenings, and hospice care at 100% coverage. In most cases, guarantee issue is also available, as is claims assistance. When your coverage through Medicare needs a boost, supplemental products are available that can help offset out-of-pocket expenses. These include coverage for foreign travel, additional home health care, excess charges, vision, hearing, and dental. You can also consult with M3 on the numerous Part D prescription plans available to decide which one is right for you.