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Affordable Health Care Law / ObamaCare

The Affordable Care Act of the United States government ("Obamacare") now requires almost everyone to have health insurance. Click here for more information.

What types of health insurance are there?

There are essentially two types of health insurance: payment for service and managed care. Although these plans differ, both cover a variety of medical, surgical and hospital expenses. Most cover prescription drugs and some also offer dental coverage.

1. Charge for service
These plans generally assume that the medical professional will receive a fee for each service provided to the patient. Patients are attended by a doctor of their choice and the claim is presented by the medical provider or the patient.

2. Managed care
More than half of all Americans have some type of managed care plan. Several plans work differently and may include: health maintenance organizations (HM0), preferred provider organizations (PPO) and service point plans (POS). These plans provide comprehensive health services to their members and offer financial incentives to patients who use the providers in the plan.


What is long-term care?

Due to old age, mental or physical illness, or injuries, some people need help with eating, bathing, dressing, going to the bathroom, or continuing and / or moving (for example, getting up from a chair or getting out of bed). These six actions are called Daily Living Activities, sometimes called ADL. In general, if you cannot do two or more of these activities, or if you have cognitive impairment, it is said that you need "long-term care."

Long-term care is not a very useful name for this type of situation because, on the one hand, it may not last long. Some people who need ADL services may need them only for a few months or less.

Many people think that long-term care is provided exclusively in a nursing home. It can be, but it can also be provided in an adult day care center, in an assisted living center or at home.


ADL assistance, called "custodial care," can be provided at the same place of residence (and, therefore, sometimes confused with "specialized care"). Qualified care means medical, nursing or rehabilitation services, which include help taking medication, testing (for example, blood pressure) or other similar services. This distinction is important because, in general, Medicare and most private health insurance pay only for specialized care, not custodial care.

What are the types of disability insurance?

There are two types of disability policies: short-term disability (STD) and long-term disability (LTD):

  • Short-term disability (STD) policies have a disability period of 0 to 14 days with a maximum benefit period of no more than two years.
  • Long Term Disability (LTD) policies have a period of disability of several weeks to several months, with a maximum benefit period ranging from a few years to the rest of your life.

Disability policies have two different protection characteristics that are important to understand:

  • Non-cancelable: means that the policy cannot be canceled by the insurance company, except for the lack of payment of premiums. This entitles you to renew the policy every year without an increase in the premium or a reduction in benefits.
  • The renewal guarantee gives you the right to renew the policy with the same benefits and the policy cannot be canceled by the company. However, your insurer has the right to increase your premiums as long as you do so for all other insured in the same rating class you have.

In addition to traditional disability policies, there are several options you should consider when buying a policy:

  • Additional purchase options: Your insurance company grants you the right to purchase additional insurance at a later time for an additional cost.
  • Coordination of benefits: The amount of benefits you receive from your insurance company depends on other benefits you receive due to your disability. Your policy specifies a target amount that you will receive from all the combined policies, so this policy will compensate for the difference not paid by other policies.
  • Cost of living adjustment (COLA): COLA increases its disability benefits over time as the cost of living increases as measured by the Consumer Price Index. You will pay a higher premium if you select COLA.
  • Insured with partial or residual disability: This provision allows you to return to part-time work, collect part of your salary and receive a partial disability payment if you are still partially disabled.
  • Premium refund: This provision requires the insurance company to reimburse part of your premium if no claims are made for a specific period of time stated in the policy.
  • Waiver of premium provision: This clause means that you do not have to pay premiums in the policy after it has been disabled for 90 days.

What types of life insurance are available?

There are many types of life insurance, but they generally fall into two categories: term insurance and permanent insurance.

Temporary insurance is designed to meet temporary needs. It provides protection for a specific period of time (the "term") and generally pays a benefit only if you die during the term. This type of insurance often makes sense when you have a need for coverage that will disappear at a specific time. For example, you can decide that you only need coverage until your children graduate from college or a particular debt is paid, such as your mortgage.

In contrast, permanent insurance provides lifetime protection. As long as you pay the premiums and no loans, withdrawals or deliveries are taken, the total amount will be paid.

Because it is designed to last a lifetime, permanent life insurance accumulates cash value and has a price for you to keep it for a long period of time.

It is impossible to say what type of life insurance is best because the type of coverage that is right for you depends on your specific financial circumstances and goals.


But remember, the best way to determine the amount and type of life insurance that makes sense for your particular situation is to meet with a qualified life insurance professional.

Life and Health Insurances

Life and Health Insurance - Miami and Orlando, FL

Also at the service of Kendall, Doral, Coral Gables, Adventure and other areas in Florida

Your health and the financial future of your family are among your most important concerns. Fortunately, there are many options that offer financial protection for both. Health insurance and life insurance can provide many benefits for you and your loved ones, but how can you get coverage or determine which plan is right for your needs?

We can help you! Prestige Insurance Group, Inc. has multiple health and life insurance options, along with experience to help you choose the right coverage for your specific needs and budget. Call us at (305) 969-8776 or request a health insurance quote or a life insurance quote online today to get started!

We can offer you:

  • Medicare Enrollment
  • Health Plans - Obamacare
  • Temporary Health Plans
  • Dental
  • Vision
  • Long term life
  • Universal life

We also offer:

  • Supplemental insurance plans
  • Hospital compensation
  • Accident
  • Disability
  • Cancer
  • Critical illness
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