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Health

  • Individual/Family Health Insurance

    Individual health insurance programs are designed for individuals and families who cannot obtain health insurance through an employer. Due to the continually rising cost of medical care, it has become more important to provide health insurance for you and your family. As an independent agency, Koram Insurance can provide insurance plans from numerous health insurance companies. With the health insurance market changing frequently, we are always on the lookout for quality, service-oriented insurance companies for our clients



    Group Health Plan

    In today’s environment, offering the right health insurance benefits can be a challenge. You want to provide the best possible plan for your employees yet it must be cost efficient for your business.

    Koram Insurance is committed to health insurance for both our commercial customers, who need group coverage for their employees, as well as the individual or family that needs coverage. With the changing face of health insurance in today's market, we are staying abreast of the latest developments that will affect the coverage you expect as well as the cost impact upon you.



    Dental & Vision Insurance

    For the people without dental insurance, cost often stands in the way of getting the care they need to maintain the health of their teeth and gums. Even for routine preventive care, a trip to the dentist's office could mean a substantial amount of money out of your pocket.

    Vision Insurance is a separate plan that provides coverage for eye exams and/or for frames, lenses and contact lenses. Many times the basic health insurance plan may provide for routine eye examinations; however, it will usually not provide any benefit for frames, lenses or contact lenses.



    Affordable Care Act

    The Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. The law establishes minimum standards for health insurance policies and mandates that everyone purchase some form of health insurance. One of the primary goals of Obamacare is the expansion of coverage to individuals who were previously unable to purchase insurance due to pre-existing conditions.



    Medicare Supplemental Plan (Medigap)

    A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will pay both their shares of covered health care costs.



    Medicare Advantage Plan (Part C)

    Medicare Advantage Plans (also known as Medicare Part C) are health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Medicare-covered health care through that plan. This coverage can include Medicare Part D prescription drug coverage or you can enroll in a separate Medicare Part D prescription drug coverage plan. Medicare Advantage Plans include:

    • Medicare Health Maintenance Organization (HMOs)
    • referred Provider Organizations (PPO)
    • Private Fee-for-Service (PFFS) Plans
    • Medicare Special Needs Plans (SNP)
    • Medicare Medical Savings Accounts (MSA)



    Prescription Plans (Part D)

    Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are able to choose not to cover some drugs at all.



    Medicare

    In general, individuals are eligible for Medicare if they (or their spouse) worked for at least 10 years in Medicare-covered employment and are at least 65 years old and are a citizen or permanent resident of the United States of America.

    Individuals who are under 65 years old can also be eligible if they are disabled or have end stage renal disease. People under 65 and disabled must be receiving disability benefits from either Social Security or the Railroad Retirement Board for at least 24 months before Medicare automatic enrollment occurs.

    Part A: Hospital Insurance:
    Part A covers hospital stays (including stays in a skilled nursing facility) if certain criteria are met.

    Part B: Medical Insurance:
    Part B medical insurance helps pay for some services and products not covered by Part A, generally on an outpatient basis. Part B is optional and may be deferred if the beneficiary or their spouse is still actively working. There is a lifetime penalty (10% per year) imposed for not taking Part B if not actively working.

    Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation,