Health Insurance

Health Insurance Quote Forms

Looking for coverage? Click any of the following links to submit a quote for quick, accurate and affordable rates.

Health Insurance Information

Health Insurance for Individual/Families

2019 Open Enrollment Period is November 1, 2018 through December 15, 2018. This is the only time you can apply for coverage or change plans for 2019 unless you have a Qualifying Special Event.

Shopping for health insurance for individual and families can be as easy as 1 – 2 – 3 !

Step 1:

Is it possible that I may qualify for a government advanced tax credit/subsidy to offset the cost of my monthly health insurance premium?

Two questions must be answered:

1. Does my employer offer a health insurance plan to me and is it deemed affordable (employee doesn’t pay more than 9.5% of their income towards coverage for a single person rate)?

  1. No – Then I may qualify for the tax credit Proceed to step 2
  2. Yes – Then I am not eligible for a tax credit. But I can still purchase individual/family coverage without a subsidy. Proceed to step 3

Step 2:

2. Is my Household income below the threshold for a tax credit?

Number of People in Family Annual Household Income
1 $48,560
2 $65,840
3 $83,120
4 $100,400

Or you can utilize this tool to determine if you may qualify:

Subsidy Calculator

If you were able to answer yes you must proceed to the Federally Facilitated Marketplace to apply for the tax credit and chose from over 52 plans that are available.

Keep in mind Open Enrollment is available through 12/15/18. After that deadline, you have to qualify for a special enrollment period due to your individual circumstances such as ( change in dependents, loss of employer coverage, etc.)

Proceed to and apply

When prompted by the question/screen “Is anyone assisting you with this application” Enter:

Name:    Sherry Diederich
FFM ID:Sdiederich
NPN#:   3414969

By entering this information I will be able to assist you with the plan selection and ultimately be your agent on the plan you purchase.

Step 3:

If you are not eligible of a tax credit, you may purchase individual/family coverage from any carrier at any time.

When comparing and reviewing plans be aware that the government has standardized plan value, but not plan deductibles, copays, and out of pocket maximums. The following table shows the government criteria for plans based on actuarial value:

Government Criteria For Plans Based on Actuarial Value
Platinum– Insurer pays 90% of medical expense, Insured pays 10% of medical expense
Gold– Insurer pays 80% of medical expense, Insured pays 20% of medical expense
Silver– Insurer pays 70% of medical expense, Insured pays 30% of medical expense
Bronze– Insurer pays 60% of medical expense, Insured pays 40% of medical expense
Catastrophic Plans– Available to those under 30 years of age only.

Shopping Tips

When shopping for plans pay particular attention to the following plan options:

Plan Type – PPO / HMO / POS – this option dictates what flexibility you have in selecting doctors and hospital

Network – This tells you what doctors and hospitals will be considered “In-Network” and eligible for lower copays and deductibles.

Plan Description – H.S.A./ H.R.A./ Traditional Plan – this option dictates how deductibles and copays will be facilitated

Deductibles – this typically is the dollars you will pay out of pocket first before coverage kicks in.

Copays – some expenses like prescriptions, doctors visits, urgent care, etc will have separate copays that are paid either before or after deductibles.

Out of Pocket Maximum – this is the most you can expect to pay out of your pocket for expenses during the course of the plan year.

Review your plan options and determine a budget and feel free to call our office at any time and our team of agents will help you compare plans and make a choice that fits your needs.

Contact TDA Insurance & Financial at 877-832-6690, to speak with an agent right now to discover your options for comprehensive, dependable Walled Lake health insurance.

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