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PPO Health Insurance for Pennsylvania

Health Insurance Plan for PennsylvaniaIf you live in Pennsylvania you will be happy to know that New Health Insurance Plans are available for 2019. Many large name carriers are offering Private Health Insurance Policies. Prices on these policies are 40% less than the Obamacare plans, and the plans are PPO coverage so you can choose your doctor and hospital.

Health Insurance Plans for Pennsylvania, Not Obamacare

Here are some key points:

2019 Medicare Part B Changes

Medicare Part B2019 MEDICARE PREMIUMS AND COPAY/DEDUCTIBLES

2019 PART B PREMIUM

The Medicare Part B standard monthly premium will be $135.50 in 2019, compared to $134 in 2018.

Note: The income-related Part B premiums for 2019 will vary depending on the extent to which an individual beneficiary’s income exceeds $85,000 (or a married couple’s income exceeds $170,000).

 

2019

Income level- File Individual

2019

Income Level- File Joint

 

2019 Part B Premium

 
Less than or equal to $85,000 Less than or equal to 170,000 $135.50
Greater than $85,000 and less than or equal to $107,000 Greater than $170,000 and less than or equal to $214,000 $189.60
Greater than $107,000 and less than or equal to $133,500 Greater than $214,000 and less than or equal to $267,000 $270.90
Greater than $133,500 and

less than or equal to $160,000

Greater than $267,000 and

less than or equal to $320,000

$352.20
Greater than $160,000 and less than $500,000 Greater than $320,000 and less than $750,000 $433.40
Greater than or equal to $500,000 Greater than or equal to $750,000 $460.50

 

2019 COPAY/DEDUCTIBLES

As always, 2019 Medicare supplement benefits match the federal program’s deductible and coinsurance increases, a distinct advantage in today’s ever-changing environment.

 

2019 Medicare Supplement Copay/Deductibles
Feature 2018 Benefits 2019 Benefits
Part A Inpatient Hospital Deductible $1,340 $1,364
Hospital Coinsurance

▪      61-90 days

▪      91-150 days (lifetime reserve)

 

$335

$670

 

$341

$682

Skilled Nursing Facility Care Coinsurance

▪      21-100 days

 

$167.50

 

$170.50

Part B Physician’s Services and Supplies Deductible $183 $185

 

Medicare Part A

Medicare Part AMedicare Part A usually begins when turning age 65. Medicare Part A coverage is typically free if you or a spouse paid Medicare taxes during your working career. The majority of Americans are automatically enrolled in Medicare Part A when they are 65 years old. To receive Part A you must be already eligible to receive retirement benefits, either through Social Security or the Railroad Retirement Board. However, you do don’t have to be actively collecting Social Security benefits as many people wait to file. Disabled Americans who are under age 65 and receive Social Security or Railroad Retirement disability benefits are often eligible for Part A after 24 months, and those diagnosed with End-Stage Renal Disease can obtain Medicare Part A.

Key Points of Medicare Part A

  • Americans may receive their Medicare Card three months before their 65th birthday
  • If you receive Social Security checks and turn 65, you are enrolled in Medicare Part A automatically
  • Most Part A beneficiaries will pay zero premium if they contributed 40 or more quarters of work
  • Medicare Part A becomes effective the 1st day of the month of the beneficiaries 65th birthday

What does Medicare Part A Cover?

Medicare Part A is mostly associated with inpatient hospital care. Here is what you pay:

  • $1,364 annual hospital deductible
  • Days 61-90: $341 per a day
  • Days 91 and later (while using 60 lifetime reserve days): $682 per a day

Important: After lifetime reserve days are used Medicare pays nothing, the beneficiary is responsible for all hospital charges.

Keep in mind the above information only lists costs for Medicare Part A. You would also have Medicare Part B costs.

Blood covered under Medicare Part A

Part A annually covers the first three pints of blood at no cost to the beneficiary. The Medicare beneficiary is responsible for paying for all additional pints of blood per calendar year.

What Else does Part A Cover?

Medicare Part A covers expenses that are incurred during a stay in the hospital as well as brief Home Health services for some situations, and sometimes brief Hospice care and Skilled Nursing Facility care, and occasionally Nursing Home care, provided you are not merely in need of assistance with daily living. Mental health care is also a covered service when admitted to a hospital as an in-patient.

Medicare Part A does not cover cosmetic surgery, acupuncture, eye exams for the purpose of prescribing glasses, most dental work, dentures, standard foot care, custodial care or hearing aids and the exams required for fitting them.

Need Help Understanding Medicare Part A?

The easiest way to get help with understanding Medicare Part A is to fill out a request online to speak with us. It only takes ten or fifteen minutes to do a brief overview to Medicare Parts A and B. In the event that more information is needed, we could help direct you to your local Social Security office for an in person appointment.

While Medicare may seem confusing, we strongly urge you to contact us sooner than later. We find many Americans spend a great deal of time looking at the wrong Medicare products or over complicating how Medicare works. Sometimes a nice conversation with a knowledgeable person, can greatly ease the tensions that come with learning something knew and transitioning to Medicare.

What if I want Medicare with No Co-pays or Deductibles?

Medicare with no cost sharing is no problem. About 25% of all Medicare recipients have Part A and Part B. They add a Medicare Supplement to cover their deductibles and co-pays, and Part D, a prescription drug plan. Our office can easily help with this process. As always, our services are no cost to you.

Aetna Dental Insurance with Added Vision and Hearing

Aetna Dental, Vision, and Hearing offers valuable protection by including three types of coverage in one policy. Aetna is trying to help your family smile bigger and brighter, protect healthy vision to see clearer, and hear the world just that much better.

Plan Features

  • Guaranteed Acceptance – No Health Questions
  • Guaranteed Renewable – as long as you pay your premiums on time
  • Issue ages 0-89
  • For individuals or families
  • Choose $1,000 or $1,500 max benefit per policy year that covers dental, vision, and hearing per person
  • Plan deductible is $100 per policy year per a person
  • Freedom to choose any provider or get even better pricing by using Aetna in-network providers
  • Benefits paid directly to insured or to the provider
  • 30-day free look – return your policy for any reason within 30 days for a full refund of all premiums paid

Looking for Medical too? If under age 65, check on Aetna PPO with National General. If you are over 65 and on Medicare, you can shop Aetna Medicare Supplement Plans.

When does my Aetna Coverage Begin?

  • Dental Coverage
    • Day 1 for cleanings, x-rays, exams, filings
    • After 1 year for endodontics, root canals, periodontal surgery, bridges, crowns, and dentures
  • Vision Coverage
    • After 6 months
  • Hearing Coverage
    • After 12 months

See a Comparable Plans through Central United Life or Mutual of Omaha.

The Best Dental Insurance Plans Available

The Best Dental Insurance Policies
Finding a good health insurance plan is essential in keeping up with one’s physical health. It keeps the cost to the patient at a somewhat affordable level and may even help find a better group of doctors who provide amazing care. The same can be said for dental care. Finding good dental insurance is critical to keeping teeth healthy. As such, it is good to know some of the dental insurance policies available.

Golden Rule Insurance Company, a UnitedHealthcare Company

These robust dental policies focus on preventive, major, and emergency dental procedures. Preventive care such as cleanings, x-rays and Exams are covered without a waiting period or a deductible.

The plans cover basic dental services as well as major procedures like a root canal, but this depends on the plans deductible and waiting periods. The PPO offers more than 400,000 dentists, and no claim forms are needed since in-network dentists get direct payment.

There are some age restrictions on dental insurance. Some plans are for age 64 and above, while other plans are for under age 65. Many different plans are offered with many different benefits. Each plan can be customized to best fit the person purchasing it.

Humana

Humana is another insurance company that provides individual and family dental health insurance. Humana has a significant amount of dental insurance plans, all of which are affected by many factors. For example, age, gender, and dental needs can all affect the type of plan that is best for a certain individual.

Humana has plans that differ in benefits. Some plans have a higher premium, monthly payment, than others. Differing plans also have differing co-pays and deductibles, both of which are paid by the patient. Certain plans provide discounts, so the patient would pay the dentist directly at a discounted price. Again, Humana does not have an age limit.

Ameritas

Ameritas is another company that offers dental insurance. Ameritas has no age restrictions for its dental policies, and Ameritas allows next day effective dates to begin coverage.

Ameritas has no co-pays for preventive dental care, and these preventive care benefits are more expansive when using an in-network dentist. The network includes over 382,000 dentists, which reduces the amount of paperwork. Ameritas has a resourceful customer support team that is always available to answer questions and resolve problems.

Ameritas offers plans for individuals beginning as low as $19 a month for the most basic coverage in some states. The most expensive monthly individual plan is $35 a month, and it covers preventive care, restorative care, and orthodontic work. Plan premiums begin to change as more people are added, but Ameritas provides a wide enough variety that everyone should be able to find coverage.

Also see GPM Dental which uses Ameritas PPO Network.

Aetna

Aetna is an insurance company that offers real insurance but like to market its dental discount plans. While not the same as insurance, the discount card will provide a some decrease in the cost of dental procedures for in-network dentists. For an individual, the cheapest discount plan is $7.99 per month, and, for a family, the cheapest discount plan is $10.99. For both, the initial cost is $15. We do not recommend these plans as they are not real insurance….

The discount has a network of dentists achieving more than 200,000 dentists across the United States. Most procedures will see a 15-50% discount through any of the available dental discount plans. Dental specialists accept the discount plans too. Some of the available discount plans offer discounts for vision and hearing care as well as dental care.

The dental discount plans are not as flexible as plans from Ameritas or United Healthcare, but they are still useful. The discounts may be enough for someone who cannot afford full-coverage or for someone who does not want to pay for full-coverage.

The Government

When using the Health Insurance Marketplace, it is possible to purchase dental insurance through the government. To get a dental plan through the Marketplace, a person must be purchasing a health plan as well. Some of the plans in the Marketplace come with dental insurance, which will be shown when comparing the plans. The coverage has low limits and it needs to be purchased with an SEP or during Open Enrollment…..it is not a very good product, certainly not the best dental insurance….

Sometimes, there are dental plans available that are stand-alone. They are not a part of health insurance plans, but they must still be bought at the same time as health insurance is bought. This also means that there will be two monthly premiums that must be paid. Some plans offer high deductibles and low premiums, while others offer low deductibles and high premiums.Dental insurance is considered a necessary benefit for children. Children must be offered dental insurance, whether it is through a stand-alone plan or mixed with a health plan. For adults, dental insurance is not considered necessary. Insurers are not required to provide or even offer a dental insurance plan to adults.

Conclusion

Insurance can seem like a complicated beast, but all it takes is some time to understand it. Finding the right plan for a family or individual can save more money in the end since waiting for a dental disaster can be expensive.

IHC Temporary Health Insurance Plan Overview

IHC Health Insurance has become one of many companies to surface over the last few years. IHC does not partake in any ACA qualified plans and focuses on consumer driven health products, such as Temporary Health Insurance. Many states allow clients to purchase back-to-back temporary policies. Many consumers have chosen this option as their preferred option for coverage. This is mostly due to the affordability of these policies and the flexibility of use.

This site works with a multitude of temporary and short term medical providers. We recommend filling out a quote form so shoppers can see the best selling plans in their area.

Temporary Health Insurance Options

IHC currently has two options for short term medical coverage. First we will discuss the Connect 2.0 plan which is the more affordable of the two options. The goal is to obtain affordable coverage and not worry about gaps in coverage while you’re between health care plans. Here are the most common reasons to buy a temporary policy.

Missed open enrollment: If you have missed the opportunity to Connect coverage during the open enrollment period, you may be ineligible to buy a major medical policy until the next open enrollment period, unless you have a qualifying event. No need to worry, we got you covered!

Waiting for an ACA plan to start: Many plans on the Health Insurance Marketplace are extremely expensive and offer only one effective
date, the first of the month. Depending on when you submit your application, and how long it takes you to prove qualifying for a SEP, Special Enrollment Period, you may have to wait up to 45 days for your coverage to begin. Often that is a best case scenario and sometimes it can take up to several months, or many consumers report having to wait until the next January 1st for coverage to begin.

Newly Hired: Often, an employer-sponsored plan includes a waiting period before health insurance benefits begin. No need to worry, we got you covered!

Filling the Gap: Coverage can begin as early as the day following your online application, if approved, and last up to 90 days. AND many states offer instant re-apply to obtain longer lengths of coverage.

Unique Plan Benefits

$50 Office Visit Copay: The copay applies to the first covered office visit during the policy period. After the copay, the balance of the
doctor office visit charge is covered at 100 percent. Additional covered expenses incurred during the office visit, including expenses for laboratory and diagnostic tests will be subject to plan deductible and coinsurance.

Deductible Options, You Decide: $1,000 | $1,800 | $2,500 | $5,000 | $10,000

The selected deductible must be paid by the covered person before coinsurance benefits begin. Family deductible maximum: Three individual deductible amounts per a policy term.

Coinsurance Percentages: a variety of coinsurance percentages including 20%, 30%, and 50% – You decide.

Out-of-Pocket Limits: $1,000 – $10,000 – You decide

Maximum Benefit per Term: $2,000,000

Check the rates on Short Term Health Insurance.

 

Covered expenses: includes treatments, services and supplies for:

  • Physician services for treatment and diagnosis
  • X-ray exams, laboratory tests and analysis
  • Mammography, Pap smear and prostate antigen test
  • Emergency room, outpatient hospital surgery or ambulatory surgical center
  • Surgeon services in the hospital or ambulatory surgical center
  • Services when a doctor administers anesthetics up to 20 percent of the primary
    surgeon’s covered charges
  • Assistant surgeon services up to 20 percent of the primary surgeon’s covered charges
  • Surgeon’s assistant services up to 15 percent of the primary surgeon’s covered charges
  • Ground ambulance services up to $500 per occurrence
  • Air ambulance services up to $1,000 per occurrence
  • Organ, tissue, or bone marrow transplants up to $150,000 per coverage period
  • Acquired Immune Deficiency Syndrome (AIDS) up to $10,000 per coverage period
  • Blood or blood plasma and their administration, if not replaced
  • Oxygen, casts, non-dental splints, crutches, non-orthodontic braces, radiation and
    chemotherapy services and equipment rental

Inpatient covered expenses:

  • Hospital room and board, doctor visits and general nursing care up to the amount billed for a semi-private room or 90 percent of the private room billed amount
  • Intensive care or specialized care unit up to three times the amount billed for a semiprivate room or three times 90 percent the private room billed amount
  • Prescription drugs administered while hospital confined

Pre-existing Condition: Connect 2.0 will not provide benefits for any loss caused by or resulting from a pre-existing
condition. A pre-existing condition is any medical condition or sickness for which medical advice, care, diagnosis, treatment, consultation or medication was recommended or received from a doctor within five years immediately preceding the covered person’s effective date of
coverage; or symptoms within the five years immediately prior to the coverage that would cause a reasonable person to seek diagnosis, care or treatment. (Notice Plan Option 2, Connect Plus (see below) does have a higher level of coverage for pre-existing).
Usual and reasonable charge: The usual and reasonable charge for medical services or supplies is the lesser of: a) the amount usually charged by the provider for the service or supply given; or b) the average charged for the service or supply in the locality in which it is received.
With respect to the treatment of medical services, usual and reasonable means treatment that is reasonable in relationship to the service or supply given and the severity of the condition. In reaching a determination as to what amount should be considered as usual and reasonable,
we may use and subscribe to a industry reference source that collects data and makes it available to its member companies.

Continuing Coverage: If your need for temporary health insurance continues, most states allow you to apply for another short-term medical plan. Your application is subject to eligibility, underwriting requirements and state availability of the coverage. The next coverage period is not a continuation of the previous period; it is a new plan with a new deductible, coinsurance and pre-existing condition limitation. It is best to fill out a quote and shop all available options and speak with an agent to get the best plan for you.

Connect Plus – Temporary Health Insurance with a limited benefit for pre-existing conditions. Providing peace of mind during times of transition.

Connect Plus is a short-term medical (STM) insurance plan with a limited benefit for pre-existing conditions. STM, sometimes called short-term medical limited duration insurance, is designed to provide coverage during transitions or gaps in major medical coverage. Most STM plans do not cover healthcare expenses for pre-existing medical conditions. Connect Plus provides a benefit up to a maximum of $25,000 for eligible pre-existing healthcare expenses. This policy is a step above the standard Connect 2.0 policy explained above.

Why Short Term Health Insurance?
Short Term Health Insurance plans provide coverage during life transitions. When you are between group insurance or individual major medical policies, these temporary health plans pay for covered medical expenses due to unexpected illnesses or injuries. Covered expenses include diagnostic physician visits, emergency room treatment, hospital stays, surgery, intensive care and more, but do not include maternity care or outpatient prescription drugs. Learn more about Short Term Health Insurance.

An IHC Health Insurance Plan may be right for you if you:

  • Have missed the open enrollment period and aren’t eligible for special enrollment under the Affordable Care Act (ACA)
  • Are waiting for your ACA coverage to start
  • Are waiting for health insurance benefits to begin at a new job
  • Are looking for coverage to bridge you to Medicare
  • Are turning 26 and coming off your parent’s insurance
  • Are losing coverage following a divorce
  • Are needing an alternative to COBRA
  • Are healthy and under age 65

Customize Your Plan: Select from various benefit levels which best meet your coverage and premium needs. You can also include other supplemental coverage such as dental or a discount prescription drug program to obtain additional coverage.

Quick and Convenient: Coverage can begin as early as the day following your online application. The underwriting process is simple and policy fulfillment, including claims and ID cards, are available online.

Cost Effective: Temporary health insurance plans are affordable. While short term medical does contain limitations when compared
to traditional major medical plans, the premium is generally lower.

You may want to keep the following in mind as you plan for your needs and
explore your options:

  • IHC plans do not meet the Minimum Essential Coverage requirements under the ACA and may result in a tax penalty. Temporary plans are designed to provide temporary healthcare insurance during unexpected coverage gaps.
  • The ACA-compliant medical plans are guaranteed issue, meaning you cannot be denied coverage based on your health history. These plans are underwritten, which means you must answer a series of medical questions when applying for
    coverage. Based on your answers, you may be declined for coverage.
  • Unlike the ACA plans, which are required to cover the 10 Essential Health Benefits (EHB), These IHC plans cover some EHBs but not necessarily all. Plans will vary in what they cover, so you should check your plan details carefully.

IHC Plans are not Affordable Care Act (Obamacare) Plans
IHC plans do not meet ACA standards. The ACA is a Federal law that requires all major medical plans to provide specific benefits and mandates that most Americans have health plans that qualify as Minimum Essential Coverage (MEC). These rules do not apply to IHC plans.

Pre-existing Condition – How it works

Unlike most temporary health plans, Connect Plus provides a benefit for eligible preexisting conditions. The plan provides up to a maximum of $25,000 for eligible medical expenses for a pre-existing condition, per person, per policy. After the $25,000 maximum has been reached, expenses due to pre-existing conditions are not covered. The definition of a preexisting condition is listed below:

Pre-existing Condition:
A pre-existing condition is any medical condition or sickness for which medical advice, care, diagnosis, treatment, consultation or medication was recommended or received from a doctor within five years immediately preceding the covered person’s effective date of coverage; or symptoms within the five years immediately prior to the coverage that would cause a reasonable person to seek diagnosis, care or treatment. This period of time may vary by state.

Utilize a network provider and save
With your plan, you have the freedom to choose any provider. In certain markets, you also have access to discounted medical services through national preferred provider organizations (PPOs). These network providers have agreed to negotiated prices for their services and supplies. While you have the flexibility to choose any healthcare provider, the discounts available through network providers for covered services may help to lower your out-of-pocket costs. At the time of service, simply present your identification card which will include
the network information needed for the provider to correctly process covered billed charges.

Continuation of Coverage: If your need for temporary health insurance continues, most states allow you to
apply for another IHC plan. Your application is subject to eligibility, underwriting requirements and state availability of the coverage. The next coverage period is not a continuation of the previous period; it is a new plan with a new deductible, coinsurance and pre-existing condition limitation. Note that based on your state, you may be limited to two or three consecutive terms only.

Is Temporary Health Insurance the Right Choice for Me?

It is recommended to get a short term medical insurance quote on this site, so you can see a multitude of options. Then it is advised to speak with one of our licensed agents so you may ask questions and review products. Products vary greatly from state to state and an agent can help explain what is unique about your state. Since the start of the ACA, temporary health insurance plans have become more and more popular.

Protected: Golden Rule Health Insurance Plans

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Get Humana Dental Insurance Online

Humana Dental InsuranceHumana dental insurance is an affordable way to obtain dental coverage in many states. Humana offers a rang of plans including PPO and HMO options. The Dental Preventive Plus is the most affordable plan, while the Dental Loyalty is the most comprehensive. If you are normally in need of major dental work the Dental Loyalty would be the best way to go. Get a Quick Quote.

Which Humana Dental Insurance Policy is Correct for Me?

Humana offers different levels of coverage to meet different needs. Humana dental insurance can also be combined with a vision plan. All coverage is easy to understand and easy to purchase through this site. Humana’s PPO network includes hundreds of thousands of dentists and optometrist. No matter which policy you choose, you’ll have access to a large number of providers.

Learn more about dental insurance in the US, or see dental insurance quotes.

Dental Loyalty Plus Plan by Humana

Dentist Options: Choose any dentist, in-network or out-of-network. Get enhanced saving by using an in-network dentist.
Annual deductible: One-time deductible for the life of the policy: $150 per person up to $450 for a family.

Preventive / Routine cleaning / X-rays: Plan covers 100% for two cleanings a year and 40-70% for X-rays.

Office Visits: No copay. Coverage or possible discount is based on unique services provided.

Annual Maximum Benefits: $1,000 1st year, $1,250 2nd year, and $1,500 3rd year and onward.

Waiting Periods: None. You can start saving right away. The longer you have the plan the more you save!

More about Humana Dental Loyalty Plus

The Humana Loyalty Plus plan REWARDS YOU with increasing benefits from years one to three. This plan has no waiting period for covered services. Members can choose to visit any dentist that you prefer. However, you can save even more by accessing Humana’s dental PPO network and picking one of the more than 130,000 dentists who are contracted with Humana  to offer you lower rates.

See Humana Loyalty Plus Brochure or Get a Dental Quote now.

Humana Dental Preventive Plus

Dentist: Choose any dentist, in-network or out-of-network. Stay in-network and access enhanced savings.

Annual Deductible: $50 for one person or up to $150 for a family ( deductible does not apply to discounted services).

Annual Maximum Benefits: $1,000.

Preventive / Routine cleaning / X-rays: Plan covers 100%.

Office Visits: No copay. All coverage or possible discount is based on services provided.

Waiting Periods: No waiting period for preventive care services; 6 months for basic dental services like fillings and oral surgery.

See Preventive Plus Brochure or Get a Dental Quote now.

More on the Dental Preventive Plus by Humana

While the Humana Dental Preventive Plus focuses on coverage for preventive and basic services, discounts may be available on major services like crowns, bridgework, as well as orthodontics for people of all ages. These special Humana dental insurance discounts are only available with in-network dentists. After you get a dental quote, you can see more details about benefits and discounts.