The cost of basic care can add up quickly, but the cost of care for a major illness or injury can be financially crippling. Medical insurance from Bothun can help you be prepared for the worst with piece of mind.
Contact us: we can help you explore why having health insurance is necessary, how affordable it can be and the many ways to get the most from your health insurance.
Individual Health (Under 65)
With a PPO (Preferred Provider Organization) plan, you are encouraged to use a network of preferred doctors and hospitals. These providers are contracted to provide service to plan members at a negotiated or discounted rate. You generally are not required to designate a Primary Care physician but will have the choice to see any doctors or specialists within the plans network.
You generally have an annual deductible that you would be required to pay before the insurance company begins covering your medical bills. You may also have a co-payment for certain services or a co-insurance where you are responsible for a percentage of the total charges of your medical expenses.
With a PPO, services rendered outside of the network may result in a higher out-of-pocket cost.
A PPO may be a good option for you and your family if you:
- Need flexibility when choosing physicians and other providers
- Do not want the burden of obtaining a referral to see a specialist
- Like the balance of greater provider choice versus lower premiums
Medicare Supplement (Over 65)
Original Medicare pays for many, but not all, health care services and supplies. A Medigap policy, sold by private insurance companies, can help pay some of the health care costs (“gaps”) that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share. Medicare doesn’t pay any of the premiums for a Medigap policy.
Every Medigap policy must follow Federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Medigap insurance companies can sell you only a “standardized” Medigap policy identified in most states by letters. All plans offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs.
Medicare Blue RX (PDP)
A prescription drug plan (PDP) is one option for individuals who want to enroll in the Medicare Part D prescription drugs for enrollees. A prescription drug plan (PDP) is a stand-alone plan, covering only prescription drugs. Enrollees who choose the option of prescription drug coverage through a Medicare Advantage plan would also have coverage for other medical expenses as part of that plan.
Enrollees pay a co-pay for each prescription, a monthly premium and a deductible.