Health Insurance Types and Requirements

Since the passage of the Health Insurance Portability Act, an increased number of individuals have obtained health insurance. Those who are self-employed typically obtain their own insurance.

Health Insurance Coverage Types

Redden Insurance Agency of Bradley WV wants to help you understand the options available to you for health insurance coverage. Not all insurance policies cover the same providers or treatments. You need to consider your family’s health history as well as your own when choosing your level of coverage. Four main types of insurance coverage exist.

  • Exclusive Provider Organization (EPO): This type of plan, referred to as managed care, covers all medical services provided by in-plan doctors and hospitals. The only exception is for emergency treatment.
  • Health Maintenance Organization (HMO): This type of plan provides what people typically think of as traditional health insurance. It pays for medical services provided by HMO physicians within its eligible service area. These may include a prevention and wellness program.
  • Point of Service (POS): This plan type reduces cost of treatment when you use in-plan network doctors and hospitals. To see a specialist, you must obtain a referral.
  • Preferred Provider Organization (PPO): This plan type also reduces the cost of treatment when you use in-plan network doctors and hospitals. You can choose to use outside of network doctors and hospitals, but it will cost more. You can see a specialist without a referral.

Call Redden Today

Learn more about your health insurance options, by talking to Redden Insurance Agency of Bradley WV. Let our insurance representatives help you choose the type of health insurance plan that best fits your budget and health concerns if any.

Can I cancel my private policy if I get married and get added to my spouse’s health insurance?

Just when people were getting used to the new healthcare system, new rules were added this year. It can seem overwhelming, especially for people who get their health insurance through the market. At least if insurance is offered through an employer, the choices are more limited, which isn’t necessarily good.

If you live in Bradley WV and purchase your own health insurance policy, you will find that you have a lot of choices. Redden Insurance Agency can help you find a policy through different companies with different features, like different co-pays, deductibles and overall coverage.

The one thing that doesn’t usually change is the enrollment period. Normally there is a time period at the end of the year, usually around November, where anyone responsible for a health insurance plan can add people, take them off, adjust the coverage and deductible, and make other changes. Once those changes are made, they can be difficult if not impossible to change.

However, there are exceptions for certain qualifying events. A qualifying event may include

  • the birth of a child,
  • the adoption of a child, 
  • marriage, 
  • divorce,
  • a change in hours meaning the holder of an employer-sponsored plan is no longer eligible for benefits, and
  • an end of employment where the individual or family received benefits from the job

If you have health insurance in Bradley WV, marriage is considered a qualifying event as far as making changes in a health plan. Depending on the situation, newly married people might add a new spouse or also add the children of the new spouse.

If you want to learn more about your options regarding your health insurance plan, or if you have questions about an existing plan, please feel free to call Redden Insurance Agency today.

Purchasing Family Health Insurance May Be Simpler Than You Think.

Redden Insurance Agency is here for the people who need health insurance in West Virginia at any time of the year. If you have been putting off purchasing a family plan because you think the process will be too complex and time-consuming, we want you to know it may be simpler than you expect. We serve Bradley WV and the surrounding areas with quality insurance services. 

During open enrollment buying health insurance for the whole family is as simple as calling us or sitting down at your computer with your family’s personal information and the first payment. You can shop within your budget and needs with a simple click of a button and if you have any concerns our qualified agent will be happy to guide you or to help you with the process over the phone. Buying health insurance for the whole family has never been so easy, in fact, you can purchase health insurance, life insurance, and car insurance from the same company. Our agents are trained and qualified in all of these facets of insurance to keep you and your family fully protected. 

If you are concerned about purchasing health insurance because of the pandemic or after open enrollment you may not have that as a worry. So far, nine states have re-opened the health insurance options due to the pandemic. West Virginia is not among these yet but if needed all states will allow people to buy insurance in times of need. 

Contact us at Redden Insurance Agency if you have any questions about family health insurance. We serve the people of Bradly WV and the surrounding communities. 

What are the differences between HMO and PPO health insurance?

Choosing the right health insurance can be a daunting task when you are not familiar with the common acronyms denoting different plan types. HMO and PPO are only two of the myriad terms you will encounter when browsing insurance offerings. Knowing the difference between plans makes it possible to choose the insurance that best fits your monthly budget and health insurance needs. Consulting with an insurance agent at Redden Insurance Agency serving Bradley WV can also help inform your decision. 

Health maintenance organizations

Health maintenance organizations, or HMOs, are one of the most common types of health insurance plans but can also be the most restrictive. These plans are somewhat lower in cost and feature a network of doctors, hospitals and care providers. You are typically required to use plan enrolled physicians, and referrals are needed for many types of specialty care. This includes seeing a specialist or visiting a care provider outside the network. 

An HMO typically provides streamlined payments in the form of co-pays or co-insurance and claims are easily filed by the healthcare provider, eliminating the burden of filing a personal claim. 

Preferred Provider Organizations

A preferred provider organization health plan, or PPO, also features a network of doctors, but the use of the network is more flexible. A primary care physician is not needed to refer visits to specialists, and it’s typically easier to visit an out-of-network provider when compared to an HMO. However, additional costs may apply when out-of-network services are used.

Standard co-pays apply based on the deductible in your health plan documents, and monthly premiums may be slightly higher versus a HMO due to the plan’s added flexibility.

Unsure which plan is right for you? Visit the Redden Insurance agency serving Bradley, WV or call today to schedule a consultation with an experienced agent. An agent will review your budget and health insurance requirements before presenting a variety of insurance options.

How Does Health Insurance Work?

Health care is one of the most expensive industries in Bradley WV and all over America, and most people have trouble paying for this care out-of-pocket. Health insurance is a way to reduce these costs to a more attainable amount. When you sign up for a health insurance policy, you and the health insurance agency come to an agreement on what care they will cover, the amount you will pay monthly (your premiums), the amount you will need to pay prior to your insurance paying (your deductible), and your copay (the amount you will need to pay at the time of care).

Each month, you will pay your premiums toward the total cost of care you agreed upon. This is your “bill”. When you need health care, your insurance policy will help cover the costs if the care is part of your health insurance plan. Before your insurance will begin to pay, though, you will have to meet your deductible. If you have not yet met your deductible, you will be responsible for your care.

One important part of your insurance plan is that you will be given the option of health care providers that are “in-network”. This network is a group of doctors, pharmacies, hospitals, and more that have agreed to charge less for patients in with that plan. If you choose to go to a different provider, you can still use your insurance, but you will usually pay additional costs. It is usually best to use the in-network providers if possible.

Here are Redden Insurance Agency, we know that health insurance can be a confusing topic. Let us help you understand it better and get the coverage you need. If you are in Bradley WV, stop by Redden Insurance Agency or give us a call today!

How To Choose The Right Health Insurance For Your Family

At Redden Insurance Agency in Bradley WV, we offer all kinds of health insurance. We will admit that health insurance is one of the most complex types of insurance because the coverage depends on different factors. 

It may sound simple, but making the choice is not always as simple as it sounds. That’s why we will advise you to find out the following things before you make a choice.

1.    Consider the 4 metal categories

There are 4 metal categories of health insurance plans. They are Platinum, Gold, Silver, and Bronze. These categories indicate how the cost of healthcare services for you and your family will be shared between you and your health insurance provider. 

Many people erroneously believe that it has to do with healthcare quality. No, it has nothing to do with the quality of healthcare services. So, take the time and choose wisely.

2.    Plan Vs. Network type

Some of the common network types are EPO, POS, PPO, and HMO. While some plans will restrict you to the use of medical services within your insurer’s network, others do not restrict you but may cost you more. It is because using on-net services will cost your insurer much less. 

So, it is left for you to choose what is suitable for you and your family. Check all the medical facilities that are within your insurer’s network. Consider their geographical spread. This is necessary in case you have a kid that is studying in another city or state. 

3.    Your total cost of healthcare

Do you want higher premiums and lower deductibles or the reverse? Premium is the amount you pay to your insurance company every month whether you use any medical services or not. On the other hand, a deductible is an amount you will pay out-of-pocket for a certain medical service before your insurer adds theirs. You only pay a deductible when you enjoy medical services. So, you need to weigh both options before making a choice.

If you are still confused, you can schedule an appointment with us at Redden Insurance, and we will help you make the best choice for you and your family. 

Understanding Your Health Insurance: What Is Covered?

Over the years, we have found out at Redden Insurance, Bradley WV, that health insurance is riddled with a lot of confusion. There are cases when a patient pays for a particular healthcare service with the hope of getting a refund from her insurance company, only to be told that her policy does not cover the treatment.

Sometimes, policyholders contact their insurance company to find out how much of a particular treatment is covered by their policy and they are told that it depends on certain factors. Really, from the other end, it may appear that health insurance providers lack integrity. On the contrary, the real problem is that healthcare insurance is complex.

That’s why we usually take the time to educate and guide our clients regularly. Also, in terms of health issues, every patient is unique. No two people have ever been in a similar health/insurance situation. However, here are what health insurance generally covers and what it does not cover.

What health insurance generally covers

  • The use of medical devices
  • Wellness care
  • Prescription drugs
  • Hospital visits
  • Medical consultations
  • Some health insurance policies also cover medical checkups

What it does not cover

  • Use of off-label drug
  • Beauty treatments
  • Elective procedures
  • Cosmetic procedures

However, some procedures are for medical reasons. So, the insurance company may decide to pay for such. If you specific questions about what individual procedures, please talk to one of our experienced insurance agents at Redden Insurance Agency.

Before you purchase any health insurance policy, it is necessary to understand what it covers and what it does not cover. Don’t assume. If you want professional guidance on health insurance as it applies to West Virginia, don’t hesitate to contact us. Our doors are always open to you because you are either our client or you are our potential client.

What to Know Before Purchasing Health Insurance

Health insurance is considered a necessity with the high cost of medical care today. In fact, medical bills are the number one reason people consider bankruptcy. 137 million Americans struggled financially due to medical debt in 2019. At Redden Insurance Agency in Bradley WV, we know how important the right insurance plan is, for your health and your financial future. 

Types of Plans

The basic types of plans are senior, family, individual, and group. Senior plans are for those 55 and over. Family plans are for families who want to ensure everyone under the same policy. Individual plans only cover yourself. Group plans are often offered through workplaces and allow you to purchase insurance at a group rate.

Employer Coverage May Not be Right for You

Employer coverage was once considered the gold standard. Any option outside of insurance provided by your employer would likely be less coverage and more expensive. However, things have changed in recent years, and your employer may not offer the best policy for your needs.

Employers get insurance at a group rate. This means the average health of the group is considered, instead of your individual health. If you are very healthy, you may find insurance cheaper on your own. 

Group policies, by their nature, don’t allow for a lot of customization. You will be limited to doctors in-network, and supplemental types of coverage may not be available through your employer plan.

Learn More at Redden Insurance

Health insurance can be extremely confusing. After you choose the type of insurance you want to buy, you have to look at premiums, coverage limits,  deductibles, and exclusions. If you need health insurance in Bradley WV, our agents at Redden Insurance Agency can help you understand your options. Stop by our office today and get the plan that you need.