Frequently Asked Questions
How do I know for what plans I'm eligible?
Generally, all AvantGuild members are eligible for their choice of these plans,
unless you live in the following states: New York, Massachusetts, Maine, Rhode
Island, Hawaii, Vermont, Washington, and New Jersey.
Why are residents of certain states ineligible?
Certain states have what are known as "community rating" laws, which
means that rates are determined by a "pool" of insured and not by
your individual risk factors. This often prevents an insurer from being able
to underwrite the risk and thus they do not want to participate in those states.
What can I do if I live in a state whose residents are not eligible for
this plan?
New York residents can learn more about their insurance options here.
Residents of Massachusetts, Maine, Rhode Island, and New Jersey can search
our affiliate, ExtendOne, risk free.
How do I know which is the best plan for me?
Once you sign up for AvantGuild, you will receive access to a website and a
toll-free number that will allow you to speak to one of Affinity's health insurance
experts. These representatives can walk you through your options and help you
decide which general type or specific plan is right for you.
What are the differences between the different plans?
PPO (Preferred Provider Organization) co-pay plans are what people are usually
thinking about when referring to "health insurance". They offer a
certain amount of financial protection in exchange for payment of regular premiums.
HSA (Health Savings Accounts) generally require higher maximum out-of-pocket
expenses and lower premiums, and involve investing a portion of the money that
would otherwise go toward premiums. There are many different options available
within these two types of plans.
What is an HSA?
A Health Savings Account is an investment account dedicated to healthcare costs.
You do not pay tax on money invested into the HSA, and several investment options
are available to grow those funds. With a HSA, the insurance company offers
you lower premiums and administrates the actual account. HSA plans usually offer
a higher deductible and higher out-of-pocket maximum, which offsets their risk
in exchange for those lower premiums, but all expenses below the annual deductible
are paid out of the HSA, not out of your pocket. For a more in-depth description
and comparison with a standard PPO plan, click here.
How much will this insurance cost me a month?
We'd love to be able to give you a concrete number but various plans offer diverse
premium options to fit all financial needs, and vary based on a range of factors
including age, gender, smoking status, type of plan (HSA, PPO Coverage, etc),
effective date, and state of residence. Here are examples of possible costs
and plans for Chicago, Philadelphia, and Los Angeles.
If I sign up for one plan, how hard is it to switch?
You can switch at anytime although it may be subject to new underwriting requirements.
Most plan amendments are made at the anniversary of coverage.
Are prescription drugs covered?
Most plans offer a prescription option (example: $15 for generic prescriptions).
Brand name drugs can also be covered, but they may be subject to a high co-pay
or a deductible or coinsurance provision. There are many options that AHP can
help with. In addition, AvantGuild members can apply for a free prescription
drug discount card that entitles them to discounts on certain medications. Click
here to learn more.
Are pre-existing conditions covered?
Pre-existing conditions are underwritten on a case-by-case basis. Some conditions
may be excluded permanently, others for a specific time period.
Are children, spouses, and domestic partners covered?
Plans are available offering both family and individual coverage. Domestic coverage
varies by state.
Can I choose my doctor?
With more than 750,000 participating providers and 8,500 medical facilities
nationwide, you have a huge array of doctors available from which to choose.
Cost for non-network doctors varies on the options selected. In most instances
it is subject to the plan's deductible and coinsurance provisions.
Do I need to get a referral from my doctor in order to see a specialist?
Referrals are not required to see specialists.
How to apply for your insurance
You are not AvantGuild. Please login or join AvantGuild in order to take advantage of this special discount.
Still have questions? Click here to contact us.
