Individual and Family Health Insurance Roseville CA

Are you looking for Health Insurance for you or your family? Ankley Insurance Services can help you understand the confusing world of individual and family health insurance Roseville CA, and help you find a plan that is right for you and your budget.

What is Health Insurance?

Health Insurance is a type of insurance offered by private health insurance companies that helps cover the cost of medical expenses. Even minor medical issues can become quite costly and can quickly be a burden on most families. Major medical issues can be financially devastating.

With the increasing costs of medical care and a large number of uninsured Americans, Congress passed the Health Care Reform law; the Affordable Care Act, more commonly known as ObamaCare. Major provisions of this are intended to:

  • 1) cover many of the uninsured 
  • 2) decrease the premium costs of health insurance.

The mandate that all Americans purchase health insurance is intended to decrease the premium we all pay for health insurance. This idea is that the more people who buy health insurance the cheaper the premium will be for everyone. Why? When the economy is down, like it has been for the last several years, healthier people and younger people who do not use health insurance very much drop their health insurance and take a risk that they will not get sick or hurt, thus, leaving a higher percentage of sick people actually buying health insurance. If the pool of people left in the insurance market use the insurance more, then the premiums (costs) for health insurance increases. This is where we have found ourselves the last few years. Forcing the healthier, low claim people to purchase insurance will cause the rates to lower for everyone. To cover many of the uninsured Americans, the law increases Medicaid services to millions of people. The law also offers financial premium subsidies to millions more Americans who make up to 400% of the Federal Poverty Level, around $92,000 per year for a family of four. The premium subsidy pays a portion of the insured’s monthly premium, thus making it more attractive and affordable for people to purchase health insurance.

How does Individual and Family Health Insurance Roseville CA Work?

For a certain amount of money per month, premium; determined by age, zip code and family size, an insurance company agrees to pay for covered health insurance expenses up to an unlimited dollar amount. To help keep costs down and prevent fraud, there is a cost-sharing component to health insurance. Here are the main categories of cost-sharing:

  • Deductible – This is a set dollar amount that the insured is responsible for paying before the insurance company pays for most medical expenses.
  • Copay – This is a set dollar amount that the insured pays for some specific covered benefits. The insurance company pays the difference. Doctor office visit and Prescription drug are the two most common benefits with copays.
  • Coinsurance – This is a percentage that the insured pays for medical expenses after the deductible is met and up to the policy’s stop loss. Once the policy’s stop loss is met, then the insurer will cover 100% of additional costs. 70/30, 80/20 and 90/10 are the most common Coinsurance splits, with the insurer paying the higher percentage. Stop loss limits range from $1000 to $5000 on average.
  • Max-Out-Of-Pocket – This is the maximum amount of money an insured would expect to pay toward cost sharing in a given year. It is the accumulation of deductibles, copays, and coinsurance.

Individual and Family Health Insurance Roseville CA

Give Ankley Insurance Services a call today to help answer any questions you might have understanding individual and family health insurance Roseville CA and to find a plan that is right for you and your budget.