Health insurance can be a complex topic, and while many people recognize its importance, few truly understand how it works. At Health Plans of America, we aim to simplify the process and help you better grasp the basics of health insurance.

First, it’s essential to know that depending on the type of health insurance you have, costs are handled in different ways. The insured may pay out-of-pocket, receive reimbursement, or the insurer may directly pay the healthcare provider.

There are two primary categories of health insurance: private and public (government-funded).

• Private Insurance: This is the most common form of health insurance, typically offered through employers or purchased individually.
• Public (Government) Insurance: These plans are funded by federal, state, or local governments to provide coverage for those who qualify.

Within these categories, there are various organizations that manage medical care for the insured. Two common types are:

• Health Maintenance Organization (HMO): This plan often offers the most affordable coverage. It requires you to visit a primary care physician for referrals and utilizes negotiated fees with providers to keep costs low.
• Preferred Provider Organization (PPO): This plan offers greater flexibility, allowing you to visit any doctor you choose without needing a referral. It still uses negotiated rates with providers but offers more freedom in choosing healthcare professionals.

If your employer or union offers health insurance, that can be an excellent option. However, many individuals remain uninsured.

Whether you’re purchasing health insurance for the first time or switching plans, Health Plans of America is here to help. We provide the tools and resources to make the insurance process easy and stress-free.

Are you among the many individuals looking to change your Medicare coverage? Many people make this decision to improve access to their healthcare providers or gain coverage for specific medications. Whatever your reason for making the switch, there are a few key things to know before you proceed:

• The general open enrollment period runs from October 15 to December 7, though some states may extend it until January 31.
• If you’re new to a Medicare Advantage plan, you can switch to Original Medicare during the first year through the trial period.
• During the annual Medicare Advantage open enrollment period, you also have the option to return to Original Medicare.
• Depending on your situation, such as a move or loss of coverage, you may be eligible for a special enrollment period, allowing you to switch plans.

If you have more questions or need guidance, Health Plans of America is here to help. Our site connects you to licensed insurance professionals who offer valuable information and resources to help you make informed decisions. Connect today!

Many people your age are wondering when they should enroll in Medicare. Here at Health Plans of America, we are here to provide you with the information you need to make the best choices. 

The first thing to note, the best time to enroll is around your 65th birthday, but give yourself plenty of time before then to enroll so your Medicare coverage kicks in by the time you turn 65. We suggest enrolling approximately three months before your birthday, so if you enroll between January through March, April is when your coverage will be effective.

It may seem like a nuisance to be particular about these dates, but it’s more important to stay on top of these things than to delay your coverage altogether. If you skip your initial enrollment period, you may find yourself waiting months longer to get coverage. For example, if you decide in April to enroll in Medicare, you could potentially be waiting up to 14 months for your coverage to take effect. Sometimes you even have to pay a penalty if you delay your enrollment.

If, on the other hand, you are still working after age 65 and receiving coverage from your employer’s plan, delaying enrollment in Medicare might be the right choice for you.

Have more questions and want to talk to a licensed insurance professional? That’s where Health Plans of America comes in. They do all the hard work for you by offering information and resources to help you make informed decisions. Connect with a licensed Medicare specialist in your area today.