Affordable Care Act / ACA PLANS / Obamacare

Under the Obama care or the ACA plan is a landmark healthcare reform which was passed in March 2010. Under this act every citizen is liable to receive health benefits regardless of age or gender. This further includes the prohibition of not giving insurance to employees or individuals or family members based on per-existing conditions (tobacco usage not included). The benefits come under four tiers; bronze, silver, gold and platinum.

On Exchange ACA Plans

On-exchange plans are those that are available on public exchange only. If a customer qualifies for the subsidy and chooses to use it on their health plan, then shopping on-exchange is a great option. About 3.5% of the US population qualify for this financial assistance. At Rise we wish to provide you the best of the best as per your needs and if on-exchange plan is the one for you, then we are here to get you to it.

Off Exchange ACA Plans

Off-exchange plans are those which are available outside of public exchange or open market. Shopping off-exchange is highly beneficial and a great plan choice! The advantage of shopping off-exchange is beneficial if you don’t qualify for a subsidy. With Rise, anyone can get access to off-exchange plans, and we work with you to determine where you should shop for coverage.

Our Major Medical and Minimum Value Plans are offered under the RiseMed Health by The Medical Access Network. We offer plans at an affordable price point (20% to 30% lower than traditional health plans) with year-round enrollment options.


RISEMED HEALTH/ THE MEDACCESS NETWORK COVERED SERVICES:

  • Physician Services
  • Surgical Services
  • Outpatient Services
  • Lab testing
  • Radiology
  • Hospital Services
  • Emergency Services
  • Urgent Care Services
  • Ambulance Service
  • Prescription Drugs
  • Durable Medical Equipment
  • Mental Health & Substance Abuse
  • Maternity Care
  • Prenatal and Postnatal Care
  • Preventive Care Services
  • Immunizations
  • Birth Control
  • Cancer Screening Tests
  • Eye Care Services
  • Telemedicine

PLAN DIFFERENTIATION:

  1. RISEMED MINIMUM VALUE PLAN – ACA Compliant Erisa based plan which is similar to a Bronze. $5000/$10,000 (individual/family max out of pocket deductible/yr) plus 30% co-insurance after the deductible is met
  2. RISEMED METAL MAJOR MEDICAL BRONZE – $6350/$12,700 (individual/family max out of pocket deductible/yr) and no co-insurance after the deductible is met.
  3. RISEMED METAL MAJOR MEDICAL SILVER – $3,500/$12,000 (individual/family max out of pocket deductible/yr) and no co-insurance after the deductible is met.
  4. RISEMED METAL MAJOR MEDICAL GOLD – $2,500/$5,000 (individual/family max out of pocket deductible/yr) and no co-insurance after the deductible is met.
  5. RISEMED METAL MAJOR MEDICAL PLATINUM – $1,500/$3,500 (individual/family max out of pocket deductible/yr) and no co-insurance after the deductible is met.

Our  Minimum Value Plan (MVP)  to Metal  Major Medical Plans – these plans have no annual limits, however, just like a traditional health insurance plans, they are subject to deductibles and co-insurance and maximum out of pocket expenses per year. They have no annual limits and no lifetime maximum to what the plan pays and plans have unlimited preventive and sick visits.

TELEMEDICINE  is inclusive of all plans. It includes access to a mobile app where the insured creates a mobile profile and will have access to mental and behavioral health management like anxiety, depression, addiction, access to physicians for chronic and minor issues, dermatology, pediatrics, senior care etc.

*Our MAJOR MEDICAL PLANS ARE INSURANCE BASED PLANS.

 UNDERSTANDING TERMINOLOGIES:

Co-Pay

This is the set amount you pay for covered services whether or not you have met your annual deductible. Normally you’re responsible to pay $35 per doctor visit. Restrictions apply.

Responsibility Share

This is the fixed percentage of the cost you will be responsible to pay after you reach your annual deductible for the calendar year.

​Restrictions apply.

Deductible

This is the amount you pay annually before the health plan begins paying for most covered services.

Annual Out-of-Pocket Max

This is the most you will pay for the calendar year before your plan starts paying 100% for most covered services.

RiseMed Health  is a brand used for the Association-based health benefits plan and insurance based plans administered by The Med Access Network and its affiliates and partners.

“I’m so happy I can get my medical treatments and be admitted in the hospital without having to worry about my medical expenses for a few days. Plus I can also pay my house bills. Rise Benefits alternative health insurance plan really made my life easier now. I am surely happy to connect with Rise”

MaryAnn Lorenz