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Individual & Family Plans

Without health insurance, a single illness can cause serious, and often irrevocable, financial hardship. Having health insurance should be one of your most important coverage.

Acceptability is based on a persons' overall general health. A medical preexisting condition may cause your plan to be ser-charged when you are initially underwritten. Underwriting acceptability changes may occur due to change in utilization of medical services, prescription drugs, cures, and new methods of treatment. When conditions improve, quite often the ser-charge can be removed. Gough Insurance & Financial Services offer the best solutions that meet your changing needs and keep you advised on changes in the marketplace. Whether you decide to work with a broker or not the cost of your plan is the same. The plan your purchase today may not be the right plan in your future situation.

HMOs: Subscribers under the HMO plan receive medical services from participating Physicians,clinics, and hospitals. The insurance companies setup an HMO and gets a group of participating doctors to participate. Everyone agrees on certain costs and charges, which in turn allows the insurance companies control expenses and give you lower prices. If you currently have a doctor and he is not member of the HMO, you can't bring him or her with you.

PPOs: Offers choices and access, but there is typically a cost associated with that freedom that is higher than the HMO costs. Like an HMO, it is a network, but rather than choosing a primary care physician, you can see any health care professional in the network any time you choose to make an appointment. You do not need referrals for specialists or other services. If you decide to choice a PPO plan you will only have the option to change once a year on "Open Enrollment" that is if you want to change your plan.

These combine characteristics of HMOs and PPOs. You choose a primary care physician who controls all aspects of care, including referrals to specialists. All care received under the physician's guidance (including referrals) is fully covered. Care received by out-of-plan providers is reimbursed, but you have to pay a significant CO-payment or deductible. So basically you decide each time you need medical care whether you want to use your plan as an HMO or PPO.

Health Savings Accounts (HAS'S)

As of January 1, 2004 new law provides broad access to Health Savings Accounts, which allow consumers to pay for qualified medical expenses with pre-taxed dollars (Income-Taxed Free!) and save for your retirement on a tax-deferred basis. (HAS'S) plans are an excellent choice for individuals and families who want to take control of their health insurance costs by combining a lower cost high deductible insurance plan with a tax advantage savings account. In order to be eligible for (HAS'S) you must not be on Medicare and have an annual deductible of at least $1,000 for an individual health plan and for family health plans at least a $2,000 deductible. The annual deductible and the other annual out-of-pocket expenses have to be paid, under the health plan (other than the premiums) do not exceed $5,100 for individuals and $10, 200 for families.

Purchasing the right insurance that meets your needs can be challenging. Insurance can be one of the most important ongoing purchases you make to protect yourself and your family from financial hardship. Since your needs and financial situation change over time, it is important to understand and review your insurance policies annually to decide if the same policies are still right for you.

Contact us today so that we may help you. We are here to serve you!