Alderette Insurance Agency, Inc.
Call Us Today! (866) 639-1662
Alderette Insurance Agency, Inc.
Call Us Today! (866) 639-1662
Need Help Finding The Right Health Plan? You've come to the right place!
Set a phone appointment to speak with one of our licensed health Insurance experts at no cost to you!
Individual & Family Plan Coverage Basics
There are two ways that individuals and families can purchase health plans: directly with a health insurance company or through your states’ health insurance exchange.
Those who qualify based on income guidelines may be eligible to receive subsidies to help pay plan premiums if they enroll through their state health insurance exchange. In some cases, they may also qualify for reduced deductibles, copays and other costs related to medical expenses. Those who do not qualify for subsidies may find that health insurance premiums are lower when enrolling directly with an insurance company (this is also called “off-exchange”).
Health insurance plans are offered in five levels of coverage: Minimum Coverage, Bronze, Silver, Gold and Platinum. Minimum Coverage and Bronze plans have the lowest monthly premiums, but you will pay more when you need medical care. Silver, Gold and Platinum plans have higher monthly premiums, but you will pay less when you need medical care. You can choose the level of coverage that best meets your needs and budget.
Need Help Finding The Right Health Plan? You've come to the right place!
Set a phone appointment to speak with one of our licensed health Insurance experts at no cost to you!
Individual & Family Plan Coverage Basics
There are two ways that individuals and families can purchase health plans: directly with a health insurance company or through your states’ health insurance exchange.
Those who qualify based on income guidelines may be eligible to receive subsidies to help pay plan premiums if they enroll through their state health insurance exchange. In some cases, they may also qualify for reduced deductibles, copays and other costs related to medical expenses. Those who do not qualify for subsidies may find that health insurance premiums are lower when enrolling directly with an insurance company (this is also called “off-exchange”).
Health insurance plans are offered in five levels of coverage: Minimum Coverage, Bronze, Silver, Gold and Platinum. Minimum Coverage and Bronze plans have the lowest monthly premiums, but you will pay more when you need medical care. Silver, Gold and Platinum plans have higher monthly premiums, but you will pay less when you need medical care. You can choose the level of coverage that best meets your needs and budget.
Need Help Finding The Right Health Plan? You've come to the right place!
Set a phone appointment to speak with one of our licensed health Insurance experts at no cost to you!
Individual & Family Plan Coverage Basics
There are two ways that individuals and families can purchase health plans: directly with a health insurance company or through your states’ health insurance exchange.
Those who qualify based on income guidelines may be eligible to receive subsidies to help pay plan premiums if they enroll through their state health insurance exchange. In some cases, they may also qualify for reduced deductibles, copays and other costs related to medical expenses. Those who do not qualify for subsidies may find that health insurance premiums are lower when enrolling directly with an insurance company (this is also called “off-exchange”).
Health insurance plans are offered in five levels of coverage: Minimum Coverage, Bronze, Silver, Gold and Platinum. Minimum Coverage and Bronze plans have the lowest monthly premiums, but you will pay more when you need medical care. Silver, Gold and Platinum plans have higher monthly premiums, but you will pay less when you need medical care. You can choose the level of coverage that best meets your needs and budget.
Common Types of Individual & Family Plans
Minimum Coverage plan:
If you are under 30, you may be able to buy a health insurance plan option called a “Minimum Coverage” plan. These plans usually have lower premiums and mostly protect you from catastrophic medical costs. Minimum Coverage plans typically cover three doctor visits or urgent care visits, (including outpatient mental health visits) without having to meet the deductible. Preventive care benefits are covered at no charge. For all other services, you will have to pay the negotiated in-network price until you’ve reached your plans’ out of pocket limit. The out of pocket limit is the most you could be responsible for within a calendar year. Once you have reached your plans’ out of pocket limit, all in-network services are covered at 100%.
Bronze:
On average, a Bronze health plan pays 60% of your medical expenses and you pay 40% once your plans’ deductible has been met. Once you have reached your plans’ out of pocket limit, all in-network services are covered at 100%.
Silver:
Typically, a Silver level health plan pays 70% of medical expenses and you pay 30% after the deductible has been met. Once you have reached your plans’ out of pocket limit (the most you are responsible for in a calendar year), all in-network services are covered at 100%. Those who enroll in a health plan through a public health insurance exchange may qualify for Enhanced Silver benefits based on low income guidelines. This means that when an individual or family qualifies based on lower income and they choose a Silver level plan, copays, coinsurance and deductibles will be lower compared to a standard Silver plan. People in these savings categories get the benefits of a Gold or Platinum plan for the price of a Silver plan. In the three categories of Enhanced Silver, the plan pays either 94%, 87% or 73% of expenses, with the enrollee responsible for the rest up until the out of pocket limit is reached. It is important to note that only Silver level plans purchased through a state or federal health insurance exchange offer these Enhanced benefits.
Gold:
On average, Gold level health plans pay 80% of medical expenses and you pay 20% up until the out of pocket limit is met. Most Gold level plans do not have deductibles.
Platinum:
On average, Platinum level health plans pay 90% of your medical expenses and you pay 10% up until the out of pocket limit is met. Platinum level plans do not have deductibles.
HMO, EPO, POS, PPO and HDHP with HSA – What does that mean?
The health insurance industry uses a lot of acronyms like “HMO”, “PPO, “POS“ and “HSA”. So it’s easy to see why many people get confused when trying to find the right health plan.
Below is an overview of each of the plan types.
HMO (Health Maintenance Organization):
A Health Maintenance Organization (HMO) plan is one of the least expensive types of health insurance. It has low premiums and deductibles as well as fixed copays for doctor visits. HMOs require you to choose doctors within their network. When you sign up for the plan, you’ll select a primary care physician (PCP), whom you’ll see for regular checkups. Your PCP will need to give you a referral before you can see a specialist (for example: a dermatologist or an orthopedic doctor). Because all your health services are funneled through your PCP, it’s important to find one you trust. HMOs can be a very good value as long as the doctors and medical centers you would like to see are in-network.
EPO (Exclusive Provider Organization):
An Exclusive Provider Organization (EPO) is a lesser-known plan type. Like HMOs, EPOs cover only in-network care, but networks are generally larger than HMOs. They may or may not require referrals from a primary care physician. Premiums are higher than HMOs, but lower than PPOs.
POS (Point of Service):
As with an HMO, a Point of Service (POS) plan requires that you get a referral from your primary care physician (PCP) before seeing a specialist. However, this plan type does allow you to see some out-of-network providers. This is an important difference if you are managing a condition and one or more of your doctors are not in network.
PPO (Preferred Provider Organization):
Preferred Provider Organization (PPO) plans tend to have higher premiums than HMO, EPO or POS plans. The main difference, however, is that PPO plans allow you to see specialists and out-of-network doctors without a referral. Copays and coinsurance for in-network services are typically higher than other plan types. Out of network coinsurance can cost up to 50% of medical expenses up until the plans’ out of pocket limit is met. PPO plans are a good option for those who want more flexibility with their provider choices and don’t mind paying higher premiums and cost share.
HDHP with HSA (High Deductible Health Plan with a Health Savings Account):
High Deductible Health Plans (HDHP) have low premiums but higher immediate out-of-pocket costs. HDHPs are often paired with a Health Savings Account (HSA) funded to cover some or all of your deductible. You may also deposit pre-tax dollars in your account to cover medical expenses, saving you about 30%. And remember, depending on your age, services such as mammograms, colonoscopies, annual well visits and vaccinations may be covered free of charge, even if you haven’t met your deductible. An HDHP can be an HMO, POS, PPO or EPO.
We’re here to serve you
At Alderette Insurance, we’re dedicated to helping consumers navigate the health insurance market place. We’ll work with you to indentify your needs and present clear and transparent options that enable you to find the right coverage. We can assist you with enrollment either directly with health insurance companies or through public health insurance exchanges.
Our Services are FREE!
Our services are provided at no cost to you. That's right - zero, zip, nada! Our agency gets paid by the insurance carriers we represent. You will pay the exact same amount no matter if you choose to use us or if you decide to enroll on your own. The difference that makes the difference is the level of customer care we offer. Get in touch with us today and find out why our clients love us!
Click here to set a phone appointment to speak with one of our Covered CA licensed experts.
Common Types of Individual & Family Plans
Minimum Coverage plan:
If you are under 30, you may be able to buy a health insurance plan option called a “Minimum Coverage” plan. These plans usually have lower premiums and mostly protect you from catastrophic medical costs. Minimum Coverage plans typically cover three doctor visits or urgent care visits, (including outpatient mental health visits) without having to meet the deductible. Preventive care benefits are covered at no charge. For all other services, you will have to pay the negotiated in-network price until you’ve reached your plans’ out of pocket limit. The out of pocket limit is the most you could be responsible for within a calendar year. Once you have reached your plans’ out of pocket limit, all in-network services are covered at 100%.
Bronze:
On average, a Bronze health plan pays 60% of your medical expenses and you pay 40% once your plans’ deductible has been met. Once you have reached your plans’ out of pocket limit, all in-network services are covered at 100%.
Silver:
Typically, a Silver level health plan pays 70% of medical expenses and you pay 30% after the deductible has been met. Once you have reached your plans’ out of pocket limit (the most you are responsible for in a calendar year), all in-network services are covered at 100%. Those who enroll in a health plan through a public health insurance exchange may qualify for Enhanced Silver benefits based on low income guidelines. This means that when an individual or family qualifies based on lower income and they choose a Silver level plan, copays, coinsurance and deductibles will be lower compared to a standard Silver plan. People in these savings categories get the benefits of a Gold or Platinum plan for the price of a Silver plan. In the three categories of Enhanced Silver, the plan pays either 94%, 87% or 73% of expenses, with the enrollee responsible for the rest up until the out of pocket limit is reached. It is important to note that only Silver level plans purchased through a state or federal health insurance exchange offer these Enhanced benefits.
Gold:
On average, Gold level health plans pay 80% of medical expenses and you pay 20% up until the out of pocket limit is met. Most Gold level plans do not have deductibles.
Platinum:
On average, Platinum level health plans pay 90% of your medical expenses and you pay 10% up until the out of pocket limit is met. Platinum level plans do not have deductibles.
HMO, EPO, POS, PPO and HDHP with HSA – What does that mean?
The health insurance industry uses a lot of acronyms like “HMO”, “PPO, “POS“ and “HSA”. So it’s easy to see why many people get confused when trying to find the right health plan.
Below is an overview of each of the plan types.
HMO (Health Maintenance Organization):
A Health Maintenance Organization (HMO) plan is one of the least expensive types of health insurance. It has low premiums and deductibles as well as fixed copays for doctor visits. HMOs require you to choose doctors within their network. When you sign up for the plan, you’ll select a primary care physician (PCP), whom you’ll see for regular checkups. Your PCP will need to give you a referral before you can see a specialist (for example: a dermatologist or an orthopedic doctor). Because all your health services are funneled through your PCP, it’s important to find one you trust. HMOs can be a very good value as long as the doctors and medical centers you would like to see are in-network.
EPO (Exclusive Provider Organization):
An Exclusive Provider Organization (EPO) is a lesser-known plan type. Like HMOs, EPOs cover only in-network care, but networks are generally larger than HMOs. They may or may not require referrals from a primary care physician. Premiums are higher than HMOs, but lower than PPOs.
POS (Point of Service):
As with an HMO, a Point of Service (POS) plan requires that you get a referral from your primary care physician (PCP) before seeing a specialist. However, this plan type does allow you to see some out-of-network providers. This is an important difference if you are managing a condition and one or more of your doctors are not in network.
PPO (Preferred Provider Organization):
Preferred Provider Organization (PPO) plans tend to have higher premiums than HMO, EPO or POS plans. The main difference, however, is that PPO plans allow you to see specialists and out-of-network doctors without a referral. Copays and coinsurance for in-network services are typically higher than other plan types. Out of network coinsurance can cost up to 50% of medical expenses up until the plans’ out of pocket limit is met. PPO plans are a good option for those who want more flexibility with their provider choices and don’t mind paying higher premiums and cost share.
HDHP with HSA (High Deductible Health Plan with a Health Savings Account):
High Deductible Health Plans (HDHP) have low premiums but higher immediate out-of-pocket costs. HDHPs are often paired with a Health Savings Account (HSA) funded to cover some or all of your deductible. You may also deposit pre-tax dollars in your account to cover medical expenses, saving you about 30%. And remember, depending on your age, services such as mammograms, colonoscopies, annual well visits and vaccinations may be covered free of charge, even if you haven’t met your deductible. An HDHP can be an HMO, POS, PPO or EPO.
We’re here to serve you
At Alderette Insurance, we’re dedicated to helping consumers navigate the health insurance market place. We’ll work with you to indentify your needs and present clear and transparent options that enable you to find the right coverage. We can assist you with enrollment either directly with health insurance companies or through public health insurance exchanges.
Our Services are FREE!
Our services are provided at no cost to you. That's right - zero, zip, nada! Our agency gets paid by the insurance carriers we represent. You will pay the exact same amount no matter if you choose to use us or if you decide to enroll on your own. The difference that makes the difference is the level of customer care we offer. Get in touch with us today and find out why our clients love us!
Tap here to set a phone appointment to speak with one of our Covered CA licensed experts.
Common Types of Individual & Family Plans
Minimum Coverage plan:
If you are under 30, you may be able to buy a health insurance plan option called a “Minimum Coverage” plan. These plans usually have lower premiums and mostly protect you from catastrophic medical costs. Minimum Coverage plans typically cover three doctor visits or urgent care visits, (including outpatient mental health visits) without having to meet the deductible. Preventive care benefits are covered at no charge. For all other services, you will have to pay the negotiated in-network price until you’ve reached your plans’ out of pocket limit. The out of pocket limit is the most you could be responsible for within a calendar year. Once you have reached your plans’ out of pocket limit, all in-network services are covered at 100%.
Bronze:
On average, a Bronze health plan pays 60% of your medical expenses and you pay 40% once your plans’ deductible has been met. Once you have reached your plans’ out of pocket limit, all in-network services are covered at 100%.
Silver:
Typically, a Silver level health plan pays 70% of medical expenses and you pay 30% after the deductible has been met. Once you have reached your plans’ out of pocket limit (the most you are responsible for in a calendar year), all in-network services are covered at 100%. Those who enroll in a health plan through a public health insurance exchange may qualify for Enhanced Silver benefits based on low income guidelines. This means that when an individual or family qualifies based on lower income and they choose a Silver level plan, copays, coinsurance and deductibles will be lower compared to a standard Silver plan. People in these savings categories get the benefits of a Gold or Platinum plan for the price of a Silver plan. In the three categories of Enhanced Silver, the plan pays either 94%, 87% or 73% of expenses, with the enrollee responsible for the rest up until the out of pocket limit is reached. It is important to note that only Silver level plans purchased through a state or federal health insurance exchange offer these Enhanced benefits.
Gold:
On average, Gold level health plans pay 80% of medical expenses and you pay 20% up until the out of pocket limit is met. Most Gold level plans do not have deductibles.
Platinum:
On average, Platinum level health plans pay 90% of your medical expenses and you pay 10% up until the out of pocket limit is met. Platinum level plans do not have deductibles.
HMO, EPO, POS, PPO and HDHP with HSA – What does that mean?
The health insurance industry uses a lot of acronyms like “HMO”, “PPO, “POS“ and “HSA”. So it’s easy to see why many people get confused when trying to find the right health plan.
Below is an overview of each of the plan types.
HMO (Health Maintenance Organization):
A Health Maintenance Organization (HMO) plan is one of the least expensive types of health insurance. It has low premiums and deductibles as well as fixed copays for doctor visits. HMOs require you to choose doctors within their network. When you sign up for the plan, you’ll select a primary care physician (PCP), whom you’ll see for regular checkups. Your PCP will need to give you a referral before you can see a specialist (for example: a dermatologist or an orthopedic doctor). Because all your health services are funneled through your PCP, it’s important to find one you trust. HMOs can be a very good value as long as the doctors and medical centers you would like to see are in-network.
EPO (Exclusive Provider Organization):
An Exclusive Provider Organization (EPO) is a lesser-known plan type. Like HMOs, EPOs cover only in-network care, but networks are generally larger than HMOs. They may or may not require referrals from a primary care physician. Premiums are higher than HMOs, but lower than PPOs.
POS (Point of Service):
As with an HMO, a Point of Service (POS) plan requires that you get a referral from your primary care physician (PCP) before seeing a specialist. However, this plan type does allow you to see some out-of-network providers. This is an important difference if you are managing a condition and one or more of your doctors are not in network.
PPO (Preferred Provider Organization):
Preferred Provider Organization (PPO) plans tend to have higher premiums than HMO, EPO or POS plans. The main difference, however, is that PPO plans allow you to see specialists and out-of-network doctors without a referral. Copays and coinsurance for in-network services are typically higher than other plan types. Out of network coinsurance can cost up to 50% of medical expenses up until the plans’ out of pocket limit is met. PPO plans are a good option for those who want more flexibility with their provider choices and don’t mind paying higher premiums and cost share.
HDHP with HSA (High Deductible Health Plan with a Health Savings Account):
High Deductible Health Plans (HDHP) have low premiums but higher immediate out-of-pocket costs. HDHPs are often paired with a Health Savings Account (HSA) funded to cover some or all of your deductible. You may also deposit pre-tax dollars in your account to cover medical expenses, saving you about 30%. And remember, depending on your age, services such as mammograms, colonoscopies, annual well visits and vaccinations may be covered free of charge, even if you haven’t met your deductible. An HDHP can be an HMO, POS, PPO or EPO.
We’re here to serve you
At Alderette Insurance, we’re dedicated to helping consumers navigate the health insurance market place. We’ll work with you to identify your needs and present clear and transparent options that enable you to find the right coverage. We can assist you with enrollment either directly with health insurance companies or through public health insurance exchanges.
Our Services are FREE!
Our services are provided at no cost to you. That's right - zero, zip, nada! Our agency gets paid by the insurance carriers we represent. You will pay the exact same amount no matter if you choose to use us or if you decide to enroll on your own. The difference that makes the difference is the level of customer care we offer. Get in touch with us today and find out why our clients love us!
Tap here to set a phone appointment to speak with one of our Covered CA licensed experts.
© Alderette Insurance Agency, Inc. CA Insurance License #: 0F82790, NV Insurance License #: 524416, AZ & OR Insurance License #: 8583235, WA Insurance License #: 1053162
By using this site, you acknowledge that you have read and agree to the Terms of Service and Privacy Policy. Please read our privacy policy carefully to get a clear understanding of how we collect, use, protect or otherwise handle your Personally Identifiable Information in accordance with our website. Alderetteinsurance.com is privately owned and operated by Alderette Insurance Agency, Inc. Submission of your information constitutes permission for an agent to contact you with additional information about the cost and coverage details of health plans. Possible options include, but are not limited to Major Medical Plans, Short Term Plans, Dental Plans, Vision Plans, and more. Descriptions are for informational purposes only and subject to change. Insurance plans may not be available in all states. For a complete description, please call 1-866-639-1662 to determine eligibility and to request a copy of the applicable policy. Alderetteinsurance.com is not affiliated with or endorsed by the United States government or the federal Medicare program. We do not offer every Medicare plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Our company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability.
© Alderette Insurance Agency, Inc. CA Insurance License #: 0F82790, NV Insurance License #: 524416, AZ & OR Insurance License #: 8583235, WA Insurance License #: 1053162
By using this site, you acknowledge that you have read and agree to the Terms of Service and Privacy Policy. Please read our privacy policy carefully to get a clear understanding of how we collect, use, protect or otherwise handle your Personally Identifiable Information in accordance with our website. Alderetteinsurance.com is privately owned and operated by Alderette Insurance Agency, Inc. Submission of your information constitutes permission for an agent to contact you with additional information about the cost and coverage details of health plans. Possible options include, but are not limited to Major Medical Plans, Short Term Plans, Dental Plans, Vision Plans, and more. Descriptions are for informational purposes only and subject to change. Insurance plans may not be available in all states. For a complete description, please call 1-866-639-1662 to determine eligibility and to request a copy of the applicable policy. Alderetteinsurance.com is not affiliated with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Our company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability.
© Alderette Insurance Agency, Inc.
CA Insurance License #: 0F82790, NV Insurance License #: 524416, AZ & OR Insurance License #: 8583235, WA Insurance License #: 1053162
By using this site, you acknowledge that you have read and agree to the Terms of Service and Privacy Policy. Please read our privacy policy carefully to get a clear understanding of how we collect, use, protect or otherwise handle your Personally Identifiable Information in accordance with our website. Alderetteinsurance.com is privately owned and operated by Alderette Insurance Agency, Inc. Submission of your information constitutes permission for an agent to contact you with additional information about the cost and coverage details of health plans. Possible options include, but are not limited to Major Medical Plans, Short Term Plans, Dental Plans, Vision Plans, and more. Descriptions are for informational purposes only and subject to change. Insurance plans may not be available in all states. For a complete description, please call 1-866-639-1662 to determine eligibility and to request a copy of the applicable policy. Alderetteinsurance.com is not affiliated with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Our company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability.