Health Plans in Sarasota

You may be wondering what will happen to health plans in Sarasota with Obamacare going away. What does that exactly mean…Obamacare going away. It actually remains to be seen. According to the government, you are no  longer required to have a plan that qualifies as “minimum essential coverage”. It also means, according to the government and what President Trump has voted on…no longer are subsidies available however, my conversations with carriers in this area tell me they will still be granting them.

Since we are pre-open enrollment, the only for thing for certain, is that nothing is for certain going into the open enrollment period which is November 1- December 15 each year. This is your chance to choose a standard plan. Good news for consumers is there are numerous options outside of the enrollment period.

Health Plans Sarasota Overview

When purchasing health plans in Sarasota, FL it’s important to remember that it’s difficult to know what will happen in the future. Do not try to and guess what health care requirements might happen over the next year. Instead, to make a more educated guesstimate as to the best health insurance plan to choose, consider looking at your past health care needs. This helps in the identification of the best plan to suit your needs for the next year. If you have been generally healthy over the past few years and are in good health, you will likely only need to purchase a low-cost, high deductible plan that offers only essential benefits. This gives you peace of mind that you will be covering a catastrophic event without going bankrupt while saving premium dollars every month in the event that nothing happens. Individuals with chronic or severe conditions may want to consider plans that more extensive coverage to account for potential high dollar medications or surgical care.

Another option for generally health individuals is catastrophic insurance plans. They are designed primarily to cover emergency healthcare costs and provide maximum amounts, usually a million dollars in a lifetime. They generally do not cover Dr. Visits, surgeries or medications but may be a good fit for healthy individuals in their 20’s and early 30’s. If you play sports on a competitive level, you should choose a plan that provides coverage for both doctor visits and trips to the ER. These are a couple examples that could help determine which plan to purchase.

An additional option is called Indemnity insurance plans. These typically have a number of options available. Indemnity plans work as reimbursement plans and typically cap out at maximum amounts. For example, if you visit a primary care Doctor, the plan may cover $80 for that visit. You submit your cash recent and receive a check for $80. Indemnity plans are popular among young adults who have a limited income.

Shop Health Plans and Enroll Here

If you are looking for comprehensive coverage, in the Sarasota, FL area, there are standard health insurance plans available which you will pay dearly for in most cases. It remains to be seen if individuals will get a subsidy based on income. In the past few years, insureds who wanted standard plans would pay a family high rate. I had a healthy family that was paying $3300 for a Platinum plan, based solely on the fact that they were “doing well” Higher premiums mean better coverage, the insurance company will readily pay more for any healthcare needs the individual has in the future. The most important thing to keep in mind when choosing between insurance plans is to always have the basics covered and don’t overpay. In many cases, individuals and families are overpaying for health plans in Sarasota because they think they need the “best coverage”. As long as the basic needs are covered, further coverage can be purchased depending on health history and general lifestyle.

Types of Health Plans Options in Sarasota, FL

Did you know that there are several types of health insurance plans are available in Sarasota, FL? Depending on the type of health plan you are looking for, you will have some basic and more comprehensive plan types.

For standard full blown coverage you choices are:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Point of Service Plan (POS),
  • Health Savings Account (HSA),
  • Health Reimbursement Agreement (HRA),
  • Flexible Spending Account (FSA), and

Medical Savings Account (MSA).

In order to compare the many options, it is best to speak to a knowledgeable, local agent. Before selecting a health insurance plan, however, it is important to recognize the basic differences between them.

An HMO, or Health Maintenance Organization in Sarasota, FL, is a network that requires the insured to select a primary care physician (PCP) to act as the gatekeeper for your health care and related needs. If you need to visit a specialist, the primary care doctor must refer you to the specialist. He or she decides if it is necessary for you to see a specialist. HMOs typically have lower premiums than other plans, but the network of doctors available to the insured may be limited. If the insured wants to see a doctor outside of the HMO network, these doctors might not accept the HMO insurance plan. On the plus side, many HMO plans have no deductibles and out-of-pocket costs are usually reasonable.

A PPO plan, or Preferred Provider Organization, usually offers a large network of health care providers to the insured. He or she may choose any primary care doctor within the PPO network and see specialists without a referral from the primary care physician. Although the insured receives the best financial deal from in-network doctors and hospitals, he or she receives partial financial assistance for out-of-network doctors, specialists, and hospitals as well. PPO participants usually pay deductibles and copayments. Limits may apply concerning annual out-of-pocket costs.

A variety of non-traditional health insurance plans are available in Sarasota, FL, such as a Health Savings Account (HSA), a Health Reimbursement Account (HRA), a Flexible Spending Arrangement (FSA), and a Medical Savings Account (MSA). These approaches operate on the idea that you and/or your employer set money aside in a tax-free savings account for any medical-related expenses. Money in the plan may be used to pay for doctor visits, surgeries, prescriptions, and some over-the-counter medicines. These health care plans offer a great deal of flexibility concerning how the money is used. Some plans allow users to rollover money from year-to-year.


Health Insurance Costs in Sarasota, FL

To have health insurance coverage in Sarasota, Manatee or Charlotte Counties in FL, people will pay premiums each month. If you do not go to the doctor, you will not get the money back. Depending on the insurance plan, a deductible might be required. A deductible is the amount you will be required to pay at the doctor’s visit. Many doctors require the deductible to be paid up front.

Deductibles and out-of-pocket expenses are different. A deductible means the amount a person will pay yearly before the insurance begins, and out-of-pocket expenses is what individuals will pay before the insurance company will pay the full bill.

When a new year begins, both deductibles and out-of-pocket expenses will reset. Going forward, the previous year’s expenses will affect what happens. For example, if a person in Venice, FL has a deductible of $4000 and they spend $3000 out-of-pocket, the insurance plan will remain the same for the next year. The $3000 does not carry over, so they out-of-pocket expenses will be $0. Some plans allow rollovers to occur. Therefore, the deductible amount a person paid can be used for the first quarter of the next year.

When a person visits the doctor, he might be required to pay a copayment or coinsurance. If the co-payment is $50 each time a doctor’s visit occurs, the insured will be required to pay $50. The insurance will pay the remaining portion of the bill. Co-payments will not be put toward the deductible.

In some cases, an insurance company will offer a maximum lifetime benefit. This is the most amount of money that the insurance company will completely pay for the healthcare. After a person has used all of the money, the company will no longer pay for any medical services.

Where a person works has a huge impact on health insurance coverage. Larger companies will provide a group health insurance plan. These are usually less expensive than if a person chooses a private plan. However, by law individuals are not required to participate in an employer’s plan.

Self-employed or unemployed individuals have the choice to buy private individual health insurance. Government programs, such as Medicare will assist seniors in receiving health care. Medicaid will assist people who make lower income.

Individuals need to ask their physician in Sarasota, FL which insurance plans they take if they want to continue seeing a certain doctor. If a person’s insurance plan changes he needs to make sure he informs his doctor of the change. If the insured has any questions about coverage, he should contact the insurance company with any questions.