Major Medical Health Insurance
Your Health, Your Choice
Whether you’re looking for private plans or exploring the public insurance exchange, we’ve got you covered with options that fit your lifestyle and budget. Headquartered in Greenwood, South Carolina, Fika Insurance Group is here to help you make informed decisions every step of the way, serving clients all across the country, including those in South Carolina, Georgia, Florida, and beyond.
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Who Needs Major Medical Insurance?
Major Medical Insurance is essential for anyone seeking comprehensive protection against the high costs of healthcare. Whether you're managing a chronic condition, planning for a family, or simply want to safeguard your financial well-being, this type of insurance provides the security you need. It’s an effective way to cover the costs of everyday medical care and offers peace of mind in case of a major health event.
Health Insurance Plan Types
There are several types of health insurance plans, each designed to meet different healthcare needs and preferences:
Exclusive Provider Organization (EPO):
An EPO is a managed care plan that covers services only if you use doctors, specialists, or hospitals within the plan’s network, except in emergencies. It’s ideal for those who prefer lower premiums and do not need the flexibility of out-of-network care.
Health Maintenance Organization (HMO):
An HMO typically limits coverage to care from doctors and healthcare providers who work for or are contracted with the HMO. It generally does not cover out-of-network care except in emergencies. An HMO may require you to live or work within its service area to qualify for coverage. These plans often emphasize integrated care, focusing on prevention and wellness.
Point of Service (POS):
POS plans offer lower costs if you use healthcare providers within the plan's network. You’ll need a referral from your primary care doctor to see a specialist, giving you a balance between cost savings and flexibility.
Preferred Provider Organization (PPO):
PPO plans provide more flexibility by allowing you to see any healthcare provider you choose, both inside and outside of the plan’s network, often without a referral. You’ll typically pay less if you use in-network providers.
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What Programs Offer Major Medical Insurance?
In 2024, there are three primary ways to obtain health insurance: through an employer, the government, or privately on your own. Here’s a breakdown of the options:
Public:
- Medicaid: A federal and state program that provides health coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities.
- Children’s Health Insurance Program (CHIP): Provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid but not enough to afford private insurance.
- Medicare: A federal program that provides health coverage if you are 65 or older or have a severe disability, no matter your income.
Private:
- Individual (Marketplace or Exchange): Health insurance plans purchased by individuals through the federal or state health insurance marketplaces. These plans offer coverage for essential health benefits and may be eligible for subsidies based on income.
- Group Insurance (Employer-Sponsored): Health insurance provided by your employer. These plans are typically more affordable because employers often share the cost of premiums with employees.
G-2 Certified
Your Assurance of Quality and Trust
Fika Insurance Group is proud to be G-2 Certified, a mark of our commitment to excellence and integrity in the insurance industry. This certification is your assurance that we adhere to the highest standards of quality and trust, providing you with reliable and trustworthy insurance solutions.
Frequently Asked Questions!
One of the main goals of the Affordable Care Act (ACA) is to make health insurance more affordable for Americans. To achieve this, the ACA established several methods to help lower the cost of health insurance. When you apply for health insurance through the Marketplace, you may find out if you qualify for:
- Premium Tax Credits: If your income falls within 100% to 400% of the Federal Poverty Level (FPL), you may be eligible for subsidies to help pay your monthly premium. These credits can significantly reduce the cost of your insurance.
- Cost-Sharing Reductions (CSR): If your income is within 250% of the FPL, you may also qualify for CSRs, sometimes referred to as “extra savings.” These reductions lower your out-of-pocket costs, such as deductibles, copayments, and coinsurance, making your healthcare more affordable.
Most people join a new health plan during the Open Enrollment Period (OEP). For 2024, the Open Enrollment Period begins on November 1, 2023 and ends on December 15, 2023. If you enroll during this time, your coverage will start on January 1, 2024.
However, if you miss the Open Enrollment Period, certain life events may qualify you for a Special Enrollment Period (SEP), allowing you to obtain health coverage outside of the OEP. Typically, you have 60 days to enroll in a health plan from the date of the Qualified Life Event (QLE).
Clients Nationwide
Serving Multiple States
At Fika Insurance Group, headquartered in Greenwood, South Carolina, and serving South Carolina, Georgia, and other states, we’re here to help you navigate the complexities of Medicaid and Medicare. Contact us for expert guidance and support.
South Carolina (SC)
Our home state, where we provide comprehensive Medicare, Life, and Health insurance solutions tailored to meet the unique needs of South Carolinians.
North Carolina (NC)
Serving North Carolina with personalized insurance plans that ensure peace of mind for individuals and families.
Georgia (GA)
Offering Georgia residents access to a wide range of insurance products designed to protect and secure their future.
Tennessee (TN)
In Tennessee, we are dedicated to providing exceptional insurance coverage to safeguard your health and financial well-being.
Florida (FL)
Serving North Carolina with personalized insurance plans that ensure peace of mind for individuals and families.
Texas (TX)
Serving the vast and diverse population of Texas with tailored insurance solutions that fit their specific needs.
Colorado (CO)
Providing Colorado residents with reliable insurance options to protect their health and assets.
Indiana (IN)
Offering comprehensive insurance services to ensure the well-being and security of Indiana residents.
Ohio (OH)
Helping Ohioans find the right insurance coverage to meet their health and financial goals.
Pennsylvania (PA)
Providing personalized insurance solutions to the residents of Pennsylvania, ensuring their peace of mind.
Maryland (MD)
Serving Maryland with expert insurance advice and comprehensive coverage options.
Maine (ME)
Offering Maine residents access to top-notch insurance products to protect their health and future.
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Medicare Guide
The team at Fika Insurance Group simplifies the complex world of insurance for you. Whether you need clarity on Medicare, Life, or Health Insurance, we are here to help. By signing up for our monthly newsletter, you'll receive our free audiobook, "Understanding Medicare: Your Complete Guide." Stay informed with expert insights and tips, and make confident decisions about your coverage.