Frequently Asked Question

This is an initial out of pocket expense. It’s the amount you have to pay each year for covered health services before the insurer starts to chip in. Some plans may have separate individual & family deductibles and/or deductibles for separate services, such as hospitalization.
This is another amount paid by the insured. A copayment is a fixed amount you pay toward each medical service you access. For an example, $25 for a checkup. 
It’s a fixed percentage that the insured must pay toward each service. This is NOT a flat rate amount.
When a doctor, hospital, or other health provider accepts your health insurance plan. Also known as participating providers.
When a doctor, hospital, or other health provider does NOT accept your health insurance plan. 
Stands for Health Maintenance Organization. Plans offered by HMOs do NOT include out-of-network benefits. Simply put, if the insured goes to a provider for non-emergency care who doesn’t accept his/her plan, the insured pays ALL the costs.
Stands for Preferred Provider Organization. PPO plans include out-of-network benefits. The PPO will assist in paying for the care you have received from providers that don’t accept your plan. For example, your plan may pay 80%, with you paying the remaining 20%, if you obtain health services from an in-network health care provider. If you receive health care services from an out-of-network provider, your plan may cover 60% and you’d be responsible for the remaining 40%.
Go directly to the closest hospital when you need emergency services. HMO and PPO plans will help paying for medically necessary services.

Employer-sponsored Health Plans:
Typically, these plans can only be modified or changed during the employer’s open enrollment period.
Individual ACA Plans:
These can only be changed during open enrollment (November 1 – December 15) unless the individual qualifies for Special Enrollment. Typically, the individual needs to have a Qualifying Life Event (QLE) within 60 days to qualify for Special Enrollment.
Non-ACA Plans:
Year-round enrollment.

Health insurance is tax deductible if the individual is self-employed OR has a health savings account. If you are self-employed, the premiums you pay for health insurance for yourself and your dependent(s) can be deducted from your taxes. That said, if your dependents are covered under another insurance plan, you cannot deduct those premiums. A health savings plan (HSA) is used in conjunction with a high deductible health plan. The individual must typically purchase these plans from an employer, although they’re also offered through private insurance companies. The funds you contribute to your HSA account —up to a specific amount— are tax deductible. 
The Affordable Care act requires all employers who have at least 50 full-time employees to provide them with subsidized health care coverage. If you are receiving health coverage benefits through your employer, the employer is likely paying about 3X as much as you are toward your premiums. Some individuals feel that the policies offered are lacking in coverage and may want to research other options on the private market to compare costs and coverage. In some circumstances, this may be beneficial. However, without an employer subsidy it may be harder to find a more comprehensive plan that has a comparable or better cost.
This means there’s NO deductible to pay. The insurance kicks in immediately with the first covered expense.

Obtaining your own health plan with Decision 1 Health’s assistance frees you from corporate handcuffs. When you have your own health coverage, it’s no longer necessary to stay in a dead-end job simply to keep your health insurance. You keep your health coverage even if you switch jobs or become self-employed.

If you’re currently between jobs, self-employed, on an ACA plan or paying massive COBRA premiums, you owe it to yourself to check out other options. In most cases across the U.S., we can assist you in finding a better plan with better coverage, one that could possibly also save you money.

Yes. We are licensed to sell life and health products in the U.S.

Each state program has its own rules about who qualifies for CHIP.
Apply now by filling out an application through the Health Insurance Marketplace.

There are 2 ways to apply for CHIP:

Call 1-800-318-2596 (TTY: 1-855-889-4325)

Or get all the information you need at:

Here at Dave Knows Health®, Dave understands health coverage isn’t the easiest to understand. Dave strives to make it as easy as possible for Americans to comprehend & obtain.

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