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Individual Health Insurance 2017-09-14T12:40:44+00:00

At the djb group, we provide individual health insurance and other supplemental benefits to individuals, families, self-employed individuals, seniors and any other person who may need an individual policy.

Click below to learn more about our individual health insurance plans or request a quote to the right.

Individual Health Insurance

photo to doctors to represent individual health insuranceHMOs

An HMO individual health insurance plan requires you to appoint a primary care physician and to use doctors and facilities that are affiliated with the HMO. If you use healthcare service providers outside of the HMO, there is a good chance those charges won’t be covered by your policy. Therefore, the great thing about an HMO is that the only charges you incur, outside of your premiums, are co-pays for doctor’s visits and other services such as procedures and prescriptions.

PPOs

Preferred Provider Organization or PPO individual health insurance plan will save you money on services if you use the preferred providers within the network. However, keep in mind that deductibles must be met on this plan before some services will be covered.  Thus, a PPO will generally allow a certain amount of services annually outside of the deductible with a small co-pay, and, in addition the PPO has a large network with quality care providers and excellent prescription drug coverage.

Catastrophic Plans

Catastrophic Health Insurance Plans are great for those healthy individuals who do not expect to need medical care throughout the year other than routine preventative care.  Accordingly, these plans are generally available for those people under age 30. However, you should be aware that catastrophic plans may or may not contain the essential benefits required by the ACA to avoid a tax penalty.

Federal Marketplace Health Plans

When we help you purchase your individual health insurance through the Federal Health Insurance Marketplace, you may be eligible for a tax credit which is discounted from your monthly. Families earning up to $94,000 per household can qualify. This equals about about  400% of the poverty level. We suggest you the Marketplace Subsidy Calculator to see if you qualify.

Wellness Tools and Health Savings Accounts (HSAs) are cost saving strategies implemented into individual health insurance plans to help save consumers money on their healthcare costs.  Accordingly, an HSA allows you to open a tax free savings account to help pay for health-related expenses.  Wellness tools help you to live a more healthy lifestyle.

photo of hospital bed to represent individual health insurance

Short Term Health

Temporary or Short Term Individual Health Insurance Plans are medical plans designed for times of transition and help to bridge gaps in coverage for individuals and families.  Short term plans are generally less expensive than traditional health insurance, but they do not provide full coverage and they typically do not cover pre-existing conditions. Based on your needs, you can select the length of time (1 to 11 months in many states) and from a range of available deductible amounts.

Additionally, short-term health insurance plans do not contain the essential benefits required by the Affordable Care Act (ACA) to avoid penalty.

photo of passport, map, concept of traveling representing individual health insurance

Travel Health Insurance

Whatever the reason for your travels and stay, you don’t have to be without health insurance coverage. We offer both national and international health insurance and trip protection plans for Students, Educational Institutions, Individuals and Families, Employers and Employees, as well as Missionary Organizations and more.  You’ll have access to doctors and hospitals in 180 countries in case of an unforeseen illness or medical emergency while traveling.

Dental & Vision Insurance

photo of young boy at dentist with individual health insurance dental plan

Individual Dental Plans

Individual health insurance dental plans are inexpensive and can contribute greatly in promoting overall good health. Studies have shown that regular dental exams can optimize oral health to prevent cavities and bad breath.  In addition, they help to detect serious medical conditions such as heart disease and diabetes. Some studies have even shown that people who have dental insurance suffer less from depression.

Dental plans can range from a PPO or HMO to Pre-Paid, Fee-for-Service, and Discount on a variety of diagnostic and preventative care services including cleanings, exams, x-rays, fillings, orthodontia for children, and emergency care while traveling.

young woman at eye doctor with individual health insurance vision plan

Individual Vision Plans

Take care of your eyes with an individual health insurance vision plan that can be purchased separately or combined with your major medical insurance. Individual vision plans are similar to individual dental policies, as they are inexpensive and save you money on routine exams, eyeglass frames and lenses, contacts, and even offer big discounts on procedures like LASIK. Additionally, monitoring your eye health with regular exams helps to prevent serious eye diseases like glaucoma and cataracts, and also helps to detect early stages of diabetes, high blood pressure, and high cholesterol.

Life Insurance

photo of happy family with peace of mind with term life insurance through individual health insurance planTerm Life Insurance

Even though Term Life does not build a cash value, it will help pay for your final expenses, your mortgage, your taxes, and the living expenses of your loved ones when they no longer have your income.

This type of coverage covers you for a set period of time provided you pay the monthly premium, or in some instances, a lump sum in advance. The policy will pay to the named beneficiary the face amount of the policy (set benefit and/or lump sum) upon death of the insured within the stated term. Depending on the policy, it may also make payments upon terminal or critical illness.

Happy senior couple on beach representing life insurance with individual health insurance plan

Permanent Life Insurance

This type of life insurance policy helps you save for the future by building a cash value that has many benefits to the insured, such as borrowing against the policy or building a tax deferred investment income, in addition to paying a death benefit. Whole life, variable life and universal life are all types of cash value life insurance. Cash value insurance is also known as permanent life insurance because it provides coverage for the policyholder’s entire life.

Disability Insurance

young woman on crutches to indicate short term disability through individual health insurance

Overview of  Disability Insurance

Disability Insurance protects your ability to earn a living during your working years.  In other words, it protects one of your most valuable assets. And, this is pretty important considering that statistics show our chances are greater of becoming disabled than dying between the ages of 25 & 45.  During the time you are unable to work due to a qualifying disability (illness or injury), the replacement of your regular income through a monthly benefit provided by disability insurance helps to maintain your pre-disability lifestyle.

Employers often provide standard short-term disability (STD) and long-term disability (LTD) insurance to meet federal guidelines. Individual disability income insurance can be customized to meet your needs and considers your occupation, age, income and other factors in determining your cost and monthly benefit payment amount.

Who needs coverage?

Individuals who do not have disability through their employer can purchase an individual disability policy.  Additionally, self-employed individuals who desire disability coverage can also purchase an individual policy.  Even those who already have disability insurance through their employer, may wish to consider a “wrap around” disability policy to supplement their employer provided coverage.

What type of coverage is available?

A standard Short Term Disability (STD) policy allows for income payments to begin after a two-week waiting period.  Payments will continue to the insured until he/she recovers or maxes out the benefits.  Thus, total benefits for a STD  could last for anywhere from one month to two years, depending on the policy.

A Long Term Disability (LTD) policy allows for income payments to begin after a ninety-day waiting period, although it could be much longer depending on the policy.  Once payments begin, they will continue far longer than STD.  Thus, the total benefits for a LTD could last for a few years, up to age 65, or even for life.

Annuities

photo of peaceful couple on dock representing individual health insurance

Want to provide an income you can’t outlive?

In today’s employment landscape where pensions are becoming a thing of the past, annuities are becoming more popular with the younger generation.  However, they can be a good solution for anyone who wants to build a nest egg.

How do Annuities work?  

Simply defined, an annuity is an insurance product designed to pay you an income over a period of time.  In that sense, they are also considered investment contracts.  Accordingly, they can help you grow your savings, inheritance, and retirement portfolio.  In fact, they often provide you with retirement income that you cannot outlive. Thus, payments may begin immediately, or at some future date in exchange for a lump sum payment, or a series of payments made prior to start of the annuity. Thus, it really depends on your needs on how you structure the annuity.

Annuities may arise as a result of a structured liability settlement. They can provide either an immediate income stream, or an income stream at retirement (or other future date) that transfers some of the risk of you outliving your money (“lifespan uncertainty”), to the insurer.

Accordingly, we offer Annuities from carriers with the highest ratings available.  Thus, we strive to achieve the highest current interest rates and shortest surrender charges.

*Note.  Annuities are complex with an array of product choices.  Accordingly, these could be fixed, variable or indexed.  Additionally, they can be deferred, or immediate.  And, they can be for both the qualified and non-qualified marketplaces.  In fact, many people are sold annuity products, but don’t really understand them.  Because of the complex nature of annuity products, we recommend you contact an experienced agent to discuss possible benefits, risks, and costs.  Additionally, you may also discuss potential tax deferral advantages to see if annuities are a good fit for your financial plans.  If you would like more information, please fill out the quote request to the right.  Then, we will contact you.

Long Term Care Insurance

senior in hospital bed to represent long term care through individual health insuranceLTC or Long Term Care Insurance

Recipients of LTC are not “sick” in the traditional sense. Instead, they unable to perform some of the activities of daily living such as dressing, bathing, eating, getting in/out of bed, toileting, walking or other basic activities. Overall, Long Term Care covers services that fall under two general categories which are skilled care and personal care.

  • Skilled care is provided when recovering from an illness or an injury.
  • Personal care helps maintain the daily activities and functions of life.

As stated, long-term care is usually not medical care and most often does not require a doctor or a nurse.  In addition, the need for LTC is not always age related.  In fact, statistics tell us that more than half of all individuals age 65 & over will need LTC at some point.  Even so, it is important to note that roughly 40% of those receiving LTC today are between the ages of 18 and 64.

Why LTC Insurance?

Regular health insurance, Medicare or Medicaid typically will not pay for Long-Term Care services.  The cost of LTC can quickly add up and burden those closest to you, both financially and emotionally. Purchasing a LTC plan can help you avoid those difficult situations, as well as give you the power you need to maintain control of your care, choosing the facilities that best suit your needs.  Thus, instead of allowing welfare or the government to make your LTC decisions for you, you are in charge.  Additionally, you should be aware that Disability Income Insurance is not designed to cover LTC expenses, but simply replaces part or all of your income during your working years should you become disabled. You need specific coverage to pay for long-term care needs.

Here are examples of what LTC policies may cover:
  • Institutional Care: Nursing home, assisted living services, residential care facility, hospice care, adult foster home, respite care and more.
  • Home Care: Home health care, adult day care, personal care, homemaker services, hospice care, respite care and more.

Medicare Insurance

senior woman reading about Medicare on her computer representing individual health insurance

Medicare Overview

Medicare is individual health insurance for people over 65 and is the federal health insurance program.  By and large, it is for people who are 65 or older.  For the most part, the different parts of Medicare help cover specific services:

Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays.  In addition, it also covers care in a skilled nursing facility, as well as hospice care, and some home health care.

Medicare Part B (Medical Insurance)
Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.  Most people will pay a standard Part B premium which varies depending on income.

When are you eligible for Medicare?

To sign up for Medicare Parts A & B (known as original Medicare) most people will have an Initial Enrollment Period.  Thus, this period begins 3 months prior to the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.

During your Initial Enrollment Period, you may enroll in a Medicare Supplement Plan, also known as a Medigap Plan.  Accordingly, since Medicare won’t cover all your health costs, a Medigap plan will help cover the difference. Additionally, you may also consider a Medicare Advantage Plan (Part C) and also enroll in a prescription drug plan (Part D) during your Initial Enrollment Period.

When you can change plans.

If you have enrolled in a Medicare Advantage Plan or a prescription drug plan, you may change plans each year during the Open Enrollment Period. Thus, open enrollments run from October 15 to December 7 each year.  Then if you decide to change your plan, your new plan will become effective January 1 of the following year.  In any case, you may change your Medicare Supplement Plan at any time. However, you may be subject to Medical Underwriting to qualify for your new Medigap Plan.

Did you miss your Initial Election Period deadline?  Then, you may qualify for a Special Election Period (SEP).  Accordingly the SEP allows you to enroll in original Medicare, a Medicare Advantage Plan or a prescription drug plan through a qualifying event.

  • You are turning 65
  • You move to a new area that is not in your current plan’s service area
  • Recently moved back to the US
  • You lose your current coverage (either Group or Medicaid)
  • You now need a SNP (Special Needs Plan) or you no longer need a SNP
 

senior with her doctor using Medicare Advantage insurance to represent Individual Health Insurance

Medicare Advantage Insurance

A Medicare Advantage Plan (known as Medicare Part C) is a health plan through a private insurance company that contracts with Medicare to provide you with all of your Part A and Part B benefits.

Medicare Advantage plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.

If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare.  However, most often a Medicare Advantage plan with save you money with better benefits than your original Medicare Part A & B coverage.

Most Medicare Advantage Plans offer prescription drug coverage.  If not, you can purchase an additional Part D plan.

When can you enroll in a Medicare Advantage Plan?

You can purchase or change your Medicare Advantage plan during annual open enrollment or during your initial enrollment period when you turn 65.  You may also qualify for a special enrollment under certain qualifying events.  See our tab “About Medicare” above for more information on enrollment.

photo of pill bottle with dollar bills to indicate cost of prescription drugh with Medicare Part and Individual health insurance planPrescription Drug Coverage Medicare Part D

Medicare Part D is prescription drug coverage and offered by private insurance carriers.  These insurance carriers are contracted and approved by CMS (The Centers for Medicare & Medicaid Services).  Thus, the premiums vary between insurance carriers.

Selecting the right Medicare Part D Plan for your needs can be tricky, but can save you potentially thousands in your prescription drug costs when done properly.

The DJB Group will help you find the best plan that saves you the most on your unique prescription needs.

When can you purchase a Medicare Part D Plan?

 You can purchase or change your Medicare Part D plan during annual open enrollment, or during your initial enrollment period when you turn 65.  You may also qualify for a special enrollment under certain qualifying events.  See our tab “About Medicare” above for more information on enrollment.

Important:  To avoid an additional penalty each month, it’s important to enroll in a Medicare Part D plan with your initial transition into Medicare.

senior saving money on healthcare with individual health insurance Medicare supplements

Medigap or Medicare Supplements

Medicare Supplement Insurance policies are offered through private carriers.  They can help you save a signficant amount of money on your healthcare costs by complementing your original Medicare. Accordingly, a Medicare Supplement policy will pay for some, if not all, of the expenses that your original Part A and B do not cover.

Because CMS has standardized Medicare Supplements, the plans typically do not vary between carriers.  However, premiums do vary from one insurance carrier to another.

Ultimately, the best Medicare Supplement Plan is the one that fits your needs and is affordable.

When can you purchase a Medicare Supplement Plan?

 You can purchase a Medicare Supplement at any time during the year; however, you can typically purchase a plan without medical underwriting when purchased through annual open enrollment.  See our tab “About Medicare” for more information on Medicare enrollment.

Important Disclaimers:

Benefits. Any benefit information provided on our website is a brief summary, not a comprehensive description of benefits, and may contain inaccuracies. For more information on individual health insurance contact the plan administrator or carrier directly. Limitations, copayments, and restrictions may apply, depending on the plan.

Contact Forms. By submitting our contact forms, you agree that a licensed authorized representative of the DJB Group Insurance Agency may contact you to discuss individual health insurance. We will answer your questions or provide additional information about health, life, Medicare and supplemental health insurance.

Agents.  The DJB Group Insurance Agency is a fully licensed insurance agent/agency.  We are authorized to market individual health insurance, life and Medicare supplemental health insurance plans.  Therefore, this is a solicitation for insurance.  However, you have no guaranteed issue or other benefits. Accordingly, only an insurance carrier will make an offering of insurance, once you have submitted applications.  The DJB Group Insurance Agency is sn independent insurance brokerage and, therefore, is not an insurance carrier.

Neither the DJB Group Insurance Agency nor its agents are connected with the Federal Medicare program.

LICENSED IN PA, OH, & WV.