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Keembely Díaz — Insurance Agent
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Answers

Your insurance questions, answered clearly and simply.

What I explain to each person on the phone — deductibles, ACA vs. private, when to change, and dental — no jargon.

What is a deductible?

It is the amount you have to pay for certain covered medical services before your health plan starts sharing the costs.

Example: if your deductible is $1,000, you have to reach that amount in services subject to the deductible before the plan starts paying according to the benefits of your coverage.

Important: not every medical service is subject to the deductible.

ACA vs. private insurance

ACA / Obamacare: a health insurance option that can help you get coverage at a more affordable cost depending on your income and eligibility. It includes coverage for pre-existing conditions and a range of medical benefits.

Private insurance: an alternative outside the Marketplace, offering different coverage options depending on your needs and your budget. Depending on the plan, you can apply at different times of year and choose between different levels of benefits.

Her private plans are PPO, with a wide network, and you can use them in any state.

When can I change my insurance?

ACA (Obamacare) plans have specific periods for enrolling or making changes, although certain life situations can let you do it during the year.

Private insurance can offer more flexibility and, depending on the plan, be available at different times of year.

Dental: waiting periods

The waiting period is the time you have to wait after activating your dental insurance before certain treatments are covered.

If the insurance is interrupted — non-payment, a temporary cancellation, anything else — the waiting period stops counting.
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