Individual Health Insurance & Medicare Supplement (Medigap)

When you purchase insurance, you commit a defined amount of money now to guard against an unpredictable, potentially enormous financial loss later.  Health insurance plans

• promote your good health through preventive programs and services,
• provide affordable access to emergency care and routine health services over an extended period, and
• reduce the risk of extreme financial loss in the event of severe illness or injury.

Which Plan is best for you?

For many individuals and families the premium determines the plan they purchase, so with our versatile portfolio of companies we provides you with a broad selection of options and prices.  Although premium is just one part of a plan's overall cost, there are other elements that may influence your overall costs, such as the annual plan deductible, copayments and coinsurance.  These are your share of costs-up to the annual maximum.  Raising or lowering your share of health cost affects the premium you will be charged for the plan.

Preexisting conditions

An important fact about individual health coverage is that preexisting conditions will not be covered for a waiting period following the effective date of the plan for medical conditions that existed in the 12 months prior to the effective date.  As a stipulation of the federal HIPPA guidelines, individual carriers must give you credit for the time an insured person was covered by any other creditable coverage that was in effect during the 18 months preceding either the Effective Date of Coverage or the date SBCIA received a substantially completed application, if the most recent creditable coverage was under a group health plan, governmental plan, or church plan.

Eligibility for coverage

To be eligible for enrollment, you must be<

• age 64½ or younger
• the applicant's spouse, age 64½ or younger
• the applicant's unmarried child up to age 19
• the applicant's unmarried child who is a full-time student (12 units), age 19 through 22 to 24 (depending on underwriting company)
• a resident of the United States for at least six months
• able to meet the underwriting requirements
• not eligible for Medicare
• not enrolled under any other individual or group or health plan or insurance policy
• unmarried stepchildren who reside with the applicant up to age 19 or if a full-time student (12 units), age 19 through 22 to 24 (depending on underwriting company)
• unmarried grandchildren if they are dependents for federal income tax purposes up to age 19, or if a full-time student (12 units), age 19 through 22 to 24 (depending on underwriting company)

How to enroll

Each individual and family member who applies for coverage in any of the SBCIA plans must submit an individual application for underwriting review.  If any applicant does not qualify based on underwriting standards, the application will not be approved.  Certain conditions, subject to underwriting guidelines may qualify the applicant for the plan at a premium that is higher than the preferred premium and/or coverage for a particular medical condition may be excluded from coverage by a waiver. 

Some plans include optional or pre-integrated dental and vision (copay or discount programs & networks)

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SBCIA - www.sbcia.com - specializes in general liability insurance, tax and financial planning in Texas.