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Dental: |
| Many people do not realize how important receiving proper dental care is, until it is too late. It is recommended by the Surgeon General to visit your dentist at least once per year for a complete dental examination and routine cleaning. Following this advice could prevent you from having dental problems in the future, since the earlier decay is detected, the easier it is to combat. Since dental expenses (especially orthodontic), can be some of the most expensive outpatient treatments around, having dental insurance can be a valuable financial investment.
People buy dental insurance for a variety of reasons. Here are three of the most common reasons. |
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To Pay For Costly Care:
Dental care can be a simple cleaning and x-rays. Or, it can involve costly care from orthodontics (braces) to crowns and oral surgery. Dental insurance generally pays all or a percentage of the charges related to your dental care
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To Maintain A Healthy Mouth:
Studies show that regular dental check-ups and cleanings help maintain a healthy mouth. That's why most insurance plans pay 100% for check-ups every six (6) months. Some will even cover (pay for) a check-up immediately after you are approved for coverage.
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To Protect Their Children:
From cavities to braces, younger family members will benefit from regular professional dental care. Dental insurance can be a very affordable way to protect against the cost of regular check-ups. You plan may even pay for more costly care -- even braces.
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Dental insurance is rather unique. First, its low cost makes it highly affordable for individuals and families. Second, because dental insurance encourages and generally pays for regular check-ups, many people who purchase protection start to benefit immediately. Finally, the price of maintaining a healthy mouth can cost hundreds ... even thousands of dollars. Should you ever need costly care, from filings and crowns to periodontics and orthodontics, your dental insurance will be there to provide benefits when needed. |
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| Health: |
Health Insurance is one of your most important needs. Without it, one serious illness or accident could wipe you out financially. We offer information that will help you decide which is the best plan for you and your budget. Most Americans get health insurance through their jobs or are covered because a family member has insurance at work. This is called group health insurance and is generally the least expensive kind. Some employers offer only one health insurance plan. Some offer a choice of plans: a fee-for-service plan, a health maintenance organization (HMO), or a preferred provider organization (PPO). These plans differ in significant ways and can be explained in detail by our agent. |
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Health Maintenance Organization (HMO) Plan Policy Overview:
Subscribers to an HMO receive medical services from participating physicians, clinics and hospitals. You choose a primary care physician (PCP) from a list of participating doctors. That doctor is used for typical circumstances such as annual exams and usual health issues. If you need to see a specialist, be hospitalized, or have lab or X-ray work, your doctor will refer you to a provider or facility within the HMO system. Your doctor must give authorization for those services to be covered by your HMO. In other words, you must see HMO approved physicians and use HMO approved facilities or pay the entire cost of the visit yourself.
Similar to Point-of Service
(POS) and PPO's, HMO's have made arrangements
for lower fees with a network of health care
providers and give their policyholders a financial
incentive to stay within that network.
You
may have to pay some portion of the cost (co-payment)
for each office or hospital visit, such as
$20 -$30 per doctor visit, regardless of what the
services cost. Also, some services such as
emergency room, mental health and chemical dependency
services may carry additional costs in HMO health
maintenance.
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Preferred Provider Organization (PPO) Plan Policy Overview:
You can see any health
care professional in the network any time you
choose to make an appointment. You don't need
referrals for specialists or other services
as you do in an HMO.
You can see doctors or
specialists outside your PPO network; however,
your portion of the costs will be higher.
You may have to pay some portion of the cost (co-payment) for each office or
hospital visit, such as $20 - $30 per doctor
visit, regardless of what the services cost.
Also, some services such as emergency room,
mental health and chemical dependency services
may carry additional costs in a PPO health
insurance plan.
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Point of Service (POS) Plan Policy Overview:
Less restrictive than
an HMO or PPO, a (POS) or Point of Service
plan lets you see any licensed health care
professional for anything covered by the insurance.
Care you receive from
out-of-plan health care professionals is reimbursed,
but you must pay an often times much higher
co-payment or deductible amount. While you
may choose to see a physician outside the network,
if you don't receive
permission from your (PCP) primary care physician,
you're likely to end up submitting the bills
yourself and receiving only a small reimbursement
- if any.
Costs that exceed your deductible are covered
by a co-insurance plan in which you and the
insurance company share the cost for services
covered by the policy. Also, some services
such as emergency room, mental health
and chemical dependency services may carry
additional costs in a POS health insurance
plan.
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Fee-for-Service or Major Medical Policy:
Major
medical health insurance provides benefits up to a high limit for
most types of medical expenses incurred, subject
to a deductible. Once you meet the deductible,
our New Jersey Major Medical Insurance plans
pay a percentage of what is considered the "Usual
and Customary" charge
for covered services. The insurance company
generally pays 80% of the Usual and Customary
costs and you pay the other 20%, which is known
as co-insurance.
If the insurance company charges more than
the Usual and Customary rates, you will need
to pay both the co-insurance and the difference.
With Major Medical Insurance plans you can choose
your doctor and any hospital for your medical
services.
You or your doctor sends the bill to the insurance
company, which pays part of it. Usually, you
have a deductible such as $250 or more to pay
each year before the insurer starts paying.
The plan will pay for
charges such as medical tests and prescriptions
as well as from doctors and hospitals. Major
medical insurance coverage offer more choice
of doctors (including specialists, such as
cardiologists and
surgeons), hospitals, and other health care
providers than managed care plans, such as
HMO, PPO, and POS. Major Medical Insurance
may not pay for some preventive care, such
as check-ups, and is usually a more
expensive health insurance coverage than utilizing
an HMO, PPO, or POS plan.
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Not all employers offer dental or health insurance. You might find this to be the case with your job, especially if you work for a small business or work part-time. If your employer does not offer dental or health insurance, you can buy an individual policy. |
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Let
the qualified agents of Horizon Coast Insurance and Financial
Services, LLC help you utilize to compare your options
and choose the best coverage with highly rated insurance
companies. We are committed to deliver the high caliber
products and service you expect when doing business with
Horizon Coast Insurance and Financial Services, LLC. |
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Please ensure you complete the quotation form as accurately as possible in order to ensure the best possible estimate. If you would rather speak to one of our representatives,
please Call (973) 836-0310 or e-mail: health@horizoncoast.com to setup a confidential consultation. |
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| Completion of this form is for informational purposes only, and is just an estimate and is not a statement of contract. Coverage may not apply in all states. This WILL NOT result in a new policy, or change to an existing policy. For complete details of coverage, conditions, limits and losses not covered, be sure to read the policy, including all endorsements |
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