Answers That Make Insurance Feel Simple
Got questions? You’re not alone. We believe smart coverage starts with clear answers - and that’s why we’ve gathered our most common insurance questions in one place. Whether you're exploring plan types, understanding coverage, or just wondering where to start, we’ve got you.
Frequently Asked Questions
General Insurance FAQs
How can I choose the right insurance plan?
Start by identifying what matters most: routine checkups, vision correction, or income support. Pillars of Health makes it easy to compare plans based on your needs and budget—plus, our team is here to guide you every step of the way.
Can I stay with my current dentist or doctor?
Yes, in most cases. Pillars of Health partners with a wide network of providers, so you can likely keep your preferred professionals. We’ll help you verify before you enroll.
What does disability insurance cover?
Our plans help replace lost income if you're unable to work due to illness or injury. Options range from short-term to long-term support—and many include rehab and return-to-work resources.
Are family or bundled plans available?
Absolutely. We offer plans for individuals, couples, and families—with bundled options across dental, vision, and disability that can save you money and simplify your benefits.
How long do claims usually take?
Claims are processed quickly—some within 48 hours of submission. We use a streamlined system designed for clarity and speed.
Can I enroll at any time during the year?
Enrollment periods may vary by plan type and eligibility. Some plans offer open enrollment annually, while others allow special enrollment after qualifying life events like a job change or marriage.
Do your plans cover pre-existing conditions?
Many of our plans do offer coverage for pre-existing conditions, though specifics depend on the provider and plan. We’ll help you review the details before you enroll to ensure it fits your health history.
Is there a waiting period before coverage begins?
Some benefits may have waiting periods—especially for major dental services or disability coverage. We’ll walk you through when coverage kicks in so there are no surprises.
How much do your insurance plans cost?
It depends on your selected coverage, location, and number of people on the plan. We’ll provide a personalized quote with no obligation so you can make an informed decision.
What makes Pillars of Health different from other providers?
We combine trusted care, transparent pricing, and a human-first experience. Whether it’s picking a plan or filing a claim, Pillars of Health supports you with real people—not just paperwork.
Why do I need dental, vision, or disability insurance?
These plans provide financial protection and access to preventive care that’s often overlooked until it’s urgent. Coverage helps reduce out-of-pocket costs and ensures you get the support you need when it matters most.
Is insurance legally required?
While dental, vision, and disability insurance aren’t mandated by federal law like health insurance under certain conditions, they are highly recommended to avoid surprise expenses and gaps in care.
What’s the difference between health insurance and supplemental insurance?
Health insurance typically covers major medical needs—hospital visits, surgeries, prescriptions. Supplemental plans like dental, vision, and disability fill the gaps by covering targeted services and offering income protection.
Can I get these plans without going through an employer?
Yes. Pillars of Health offers individual and family plans that don’t require employer sponsorship. You can apply directly and manage coverage independently.
How much does insurance typically cost?
Costs vary based on the type of coverage, location, and household size. Some plans start as low as a few dollars per week. We’ll help you compare options and provide custom quotes with no obligation.
Is it worth getting insurance if I’m healthy?
Definitely. Preventive care is most effective when you’re already healthy—and disability coverage protects you against income loss in case of illness or injury. Insurance is peace of mind, not just treatment access.
Do I need separate plans for dental, vision, and disability?
Not necessarily. Bundled coverage options can simplify billing and save money. We’ll help you find a package that fits your needs and budget.
How do I know which provider to choose?
We work with vetted, licensed insurance carriers across the country. Based on your location and needs, we’ll match you with the most appropriate provider and plan.
What happens if I don’t have any coverage at all?
Without coverage, even routine care like cleanings or eye exams can be expensive. More serious issues—like dental emergencies or loss of income due to disability—can become financially overwhelming without protection.
Can I cancel or change my plan later?
Yes—plans can be modified, upgraded, or canceled depending on your situation. We’re here to help you adjust coverage as your needs evolve, without the hassle.
Dental Insurance FAQs
What does a typical dental insurance plan cover?
Most plans include preventive care like exams, cleanings, and X-rays. Many also cover fillings, extractions, and a portion of restorative services such as crowns or root canals—depending on your level of coverage.
Are cleanings and X-rays fully covered?
Yes—most dental plans cover two cleanings and exams per year at 100%, along with annual bitewing X-rays. Preventive care helps catch issues early and often comes with no out-of-pocket cost.
Can I choose my own dentist?
In most cases, yes. Pillars of Health dental plans offer access to broad provider networks, so you can typically keep your preferred dentist. We’ll help verify they’re in-network before you enroll.
What if I need major dental work like crowns or root canals?
Major procedures are often partially covered depending on your plan. There may be waiting periods or annual maximums, so we’ll help you choose the right plan for your situation.
Do dental plans cover children or orthodontics?
Yes. Some plans include pediatric care and orthodontic options like braces or aligners. Coverage varies, so we’ll help you compare benefits if you need family or child-specific plans.
Is there a waiting period for dental coverage?
Many plans begin preventive coverage right away, but major services might have waiting periods of 6–12 months. We’ll walk you through the timelines so there are no surprises.
How much will I pay for dental insurance?
Costs vary based on your location, coverage level, and whether you’re enrolling as an individual or family. We offer personalized quotes so you only pay for the coverage you need.
Does dental insurance cover cosmetic procedures?
Usually not. Most plans exclude purely cosmetic procedures like teeth whitening or veneers—but some may offer discounts. We can review those options if aesthetics are a priority.
Are emergency dental visits covered?
Yes, most plans cover emergency visits for things like pain, broken teeth, or infection. Coverage for follow-up procedures may vary depending on your plan level.
How do I find an in-network dentist near me?
Use our provider search tool or contact us for help locating an in-network dentist based on your zip code. Staying in-network keeps your costs lower.
Vision Insurance FAQs
What does vision insurance usually cover?
Most plans cover annual eye exams, basic lenses, and frames or contact lenses. Some also include discounts on LASIK or enhanced lens coatings depending on the plan.
How often can I get an eye exam with vision insurance?
Typically, once every 12 months. Preventive eye care helps catch vision changes and eye health issues early—which is why it’s included in most standard plans.
Does vision insurance cover both glasses and contacts?
Yes—but usually one or the other per coverage period. You can choose to apply your benefit to either prescription glasses (frames and lenses) or a supply of contact lenses.
Is LASIK or corrective eye surgery covered?
Most plans don’t fully cover LASIK, but many offer negotiated discounts with partner surgeons. We’ll help you review your options if you’re considering vision correction procedures.
Can I keep my current eye doctor?
In most cases, yes. Pillars of Health works with large provider networks, so your current optometrist may already be included. We’ll help you check network status during enrollment.
Are designer frames or specialty lenses included?
Many plans cover a portion of designer or specialty upgrades. You’ll usually receive an allowance amount toward frames, with the option to pay the difference for premium brands or features.
What’s the difference between vision insurance and medical eye care?
Vision insurance covers routine exams, glasses, and lenses. Medical eye care—like treatment for glaucoma or eye injuries—is usually billed through your regular health insurance.
Can children be added to a vision plan?
Yes, most plans support dependent enrollment for children. Pediatric exams and glasses are often included at no extra cost with family vision plans.
Is there a waiting period for vision benefits?
Not usually. Most vision plans activate quickly—often on your plan’s effective date—so you can schedule exams and shop for glasses right away.
How do I use my vision benefits?
Book an eye exam with an in-network provider, then apply your benefits toward glasses, lenses, or contacts at participating retailers. We’ll guide you through each step so nothing’s left unclear.
Disability Insurance FAQs
What’s the difference between short-term and long-term disability insurance?
Short-term disability typically covers temporary conditions like surgery recovery or illness, providing income for a few weeks to several months. Long-term disability offers extended benefits if you're unable to work for a longer period—often years or until retirement, depending on the plan.
How soon do benefits start after a disability occurs?
It depends on the waiting or elimination period in your plan. Short-term disability may begin after 7–14 days, while long-term disability usually starts after 90–180 days. We’ll help you choose a plan that fits your risk and income needs.
Does vision insurance cover both glasses and contacts?
Most working adults can qualify, including full-time employees, self-employed professionals, and business owners. You may need to provide medical and income documentation during enrollment or when filing a claim.
Can I still work part-time and receive disability benefits?
In many cases, yes. Some plans offer partial disability benefits, which supplement reduced income if you're able to return to work in a limited capacity. We’ll help assess which plans support flexible return-to-work options.
What percentage of my income is covered?
Disability insurance typically replaces 50–70% of your gross monthly income, up to a capped amount. Your benefit depends on your earnings and plan terms—let us help you estimate it accurately before enrolling.
Is disability coverage only for workplace injuries?
No—it also covers off-the-job conditions like illness, surgeries, mental health concerns, or pregnancy complications. This makes it a valuable safety net beyond workers’ comp.
Are disability benefits taxable?
It depends on who pays the premium. If you pay with after-tax dollars, benefits are usually tax-free. If your employer pays or you use pre-tax dollars, your benefits may be taxable.
Do I need a medical exam to enroll?
Some plans require medical underwriting or questionnaires, while others offer simplified issue coverage with no exam. We’ll guide you through the easiest path based on your health status.
Can I customize the coverage to fit my lifestyle?
Yes—many plans let you adjust benefit period, waiting time, and monthly payout levels. Whether you’re a gig worker or executive, we can tailor coverage that meets your income protection goals.
How do I file a disability claim?
Once your condition meets your plan’s definition of disability, you’ll submit a claim form with supporting medical and income documentation. Our team can help you prepare a complete file to speed up approval.
Enrollment & Eligibility FAQs
When can I enroll in a new insurance plan?
Most plans have open enrollment once a year, but you may qualify for special enrollment at any time if you’ve experienced a major life event like job loss, marriage, or relocation.
What counts as a qualifying life event?
Life events that may qualify you for special enrollment include losing employer coverage, getting married or divorced, having a child, moving to a new state, or turning 26 and aging off a parent’s plan.
Can I switch plans if my needs change mid-year?
You typically can’t switch plans outside of open enrollment unless you qualify for a special enrollment period. However, some supplemental plans allow changes year-round—check your plan details or contact us for guidance.
Who is eligible for dental, vision, or disability insurance?
Eligibility varies slightly by plan, but most adults qualify—including self-employed professionals, freelancers, and part-time workers. You don’t need a full-time employer to get covered.
Can I add my spouse or children to my plan?
Yes. Most plans allow you to enroll dependents such as your spouse, children, or domestic partner. Family plans often offer bundled savings and coordinated benefits.
What documents do I need to enroll?
You’ll typically need a government-issued ID, proof of address, and documents verifying qualifying events if enrolling outside the standard window. We’ll guide you through what’s required step by step.
Is there an age limit for enrollment?
There’s no upper age limit for most plans. However, some pediatric or student-specific plans have age caps. We’ll help find the best fit based on your age and coverage needs.
Can I get coverage if I’m self-employed or between jobs?
Absolutely. Many of our clients are self-employed, freelancing, or in career transition. We offer flexible plans that don’t require employer sponsorship.
How soon does coverage start after I enroll?
It depends on the plan and enrollment period. Some benefits begin the first of the following month, while others may have waiting periods. We’ll clarify the effective date before you complete enrollment.
Can I enroll if I missed the open enrollment deadline?
Yes, if you qualify for a special enrollment period or if the plan allows rolling enrollment. Certain coverage types—like dental or vision—may be available year-round.
Billing & Payments FAQs
How can I pay for my insurance plan?
You can pay by debit card, credit card, or ACH bank transfer through our secure online portal. Some plans also allow mailed checks or autopay setup during enrollment.
Can I set up automatic payments?
Absolutely. Enabling autopay ensures you never miss a due date. You can activate recurring payments through your online account or during the signup process.
What happens if I miss a payment?
Most plans offer a short grace period—typically 15 to 30 days—before cancellation. We’ll send reminders by email or SMS so you can stay ahead of any gaps in coverage.
Do premiums vary month to month?
No—your premium usually remains the same throughout your plan year, unless you make changes to coverage or household size. Renewal pricing is discussed before your policy refreshes.
Are there discounts for paying annually instead of monthly?
Some plans offer small discounts or processing fee waivers for annual payments. We’ll show your billing options during quote review so you can choose what fits best.
Can I pay for more than one plan at once?
Yes, especially if you're bundling dental, vision, and disability plans through Pillars of Health. You’ll receive a unified invoice and can manage everything through one account.
Are insurance premiums tax-deductible?
Sometimes. If you're self-employed or using post-tax income, your premiums may qualify for deductions—especially for disability coverage. It’s best to consult your tax advisor.
What billing frequency options are available?
Most plans offer monthly billing by default, but quarterly, semi-annual, and annual cycles may be available on request. Let us know what works best for your cash flow.
Can I split payments between cards or accounts?
In most cases, no—but we can help you designate the right primary payment method and update it at any time. Contact us if you're managing family member contributions.
How do I update my billing info or fix a failed payment?
Log in to your account to securely update your card, bank details, or billing address. If a payment fails, you’ll be notified with options to retry or resolve the issue.
Claims & Benefits FAQs
How do I file an insurance claim?
You can file a claim online through your member portal or by downloading and submitting a claim form via email or mail. We’ll walk you through each step to ensure it’s done right the first time.
What documents do I need to submit a claim?
You’ll typically need a completed claim form, proof of service or care (like an itemized invoice), and your provider’s information. Additional medical documentation may be required for disability or major procedures.
How long does it take to process a claim?
Most claims are processed within 5 to 10 business days. You’ll receive confirmation once your claim is received and another update when it’s approved or if more info is needed.
Can I track the status of my claim?
Yes—log into your secure member portal to check the status of claims, see what’s been reimbursed, or upload supporting documents. Email or SMS updates are also available if you opt in.
What happens if my claim is denied?
If your claim is denied, you’ll receive an explanation of benefits (EOB) outlining the reason. You may be able to correct missing info, appeal the decision, or ask for a secondary review. We’re happy to assist.
Is there a time limit to file a claim?
Yes—most plans require you to file within 90 to 180 days of receiving care. Delayed filing may result in a denied claim, so we recommend submitting as soon as possible.
Do I need to pay upfront or will my provider bill the plan directly?
Some in-network providers bill us directly. Others may require upfront payment, with reimbursement sent to you afterward. We’ll help you check your provider’s billing approach before your appointment.
What’s an Explanation of Benefits (EOB)?
An EOB is a statement that shows what was billed, what your plan covered, and what you may owe. It’s not a bill—it’s a summary of how your benefits were applied.
Can I use benefits immediately after enrolling?
Preventive services like dental cleanings or vision exams are often available right away. More advanced services (like crowns or disability benefits) may have waiting periods. Your plan details will outline specific timing.
How will I receive my reimbursement?
Once your claim is approved, you’ll receive reimbursement via mailed check or direct deposit, depending on your account setup. Direct deposit is the fastest and most secure option.
Provider Network FAQs
How can I find an in-network provider near me?
Use our online provider search tool to locate dental, vision, or medical professionals by zip code, specialty, or plan type. We also offer personalized assistance if you’d like help verifying options.
What happens if I visit an out-of-network provider?
Out-of-network services may result in higher out-of-pocket costs or reduced reimbursement. Some plans offer partial coverage, while others require you to stay in-network for full benefits.
Do I need a referral to see a specialist?
It depends on your plan. PPO plans typically allow direct access to specialists, while HMO or managed plans may require a referral from your primary provider. We’ll explain the referral process during enrollment.
Are telehealth or virtual visits covered by my plan?
Yes—many of our plans include telehealth options for eligible services like consultations, follow-ups, or mental health care. Virtual visits are convenient, covered, and HIPAA-compliant.
Can I keep my current dentist or eye doctor?
Very likely. Pillars of Health partners with wide provider networks, so we’ll help confirm whether your provider is in-network—or offer equivalent options nearby.
How do I confirm if a provider is in-network?
Visit our provider directory online or contact our support team with your provider’s name and zip code. We’ll verify their network status and confirm any coverage details specific to your plan.
Can I switch providers after enrolling?
Yes—you can change providers within your network at any time without affecting your coverage. Just notify your provider and update your records through the member portal.
Do provider networks vary by state?
Yes. While many national networks are available, provider availability can vary depending on your location. That’s why we tailor plan recommendations to where you live.
What if I’m traveling and need care outside my network area?
Some plans offer national coverage or emergency out-of-area benefits. If you travel frequently, we’ll help you select a plan with the flexibility you need while away from home.
Are pediatric or family specialists included in the network?
Yes—our plans include access to pediatric dentists, eye care specialists, and family-focused providers. Let us know your household’s needs and we’ll help match you with the right professionals.
Plan Comparison FAQs
What’s the difference between PPO and HMO insurance plans?
PPO (Preferred Provider Organization) plans offer more flexibility—you can see specialists without referrals and choose out-of-network providers (often at a higher cost). HMO (Health Maintenance Organization) plans typically require you to choose a primary provider and get referrals, but they’re usually more affordable.
Is it better to bundle dental, vision, and disability plans together?
Bundling can offer savings and simplify billing by combining all coverage into one plan or provider. It’s ideal for families or individuals who want streamlined benefits across multiple areas.
How do I know which plan is right for me?
Start by identifying your needs—like preventive dental care, routine eye exams, or income protection. Then consider your budget and preferred level of flexibility. Our team can help tailor a recommendation based on your lifestyle.
Can I upgrade my plan later if I need more coverage?
In most cases, yes. You may be able to upgrade during annual enrollment or after a qualifying event. Some supplemental policies allow changes year-round.
Do more expensive plans always offer better coverage?
Not necessarily. Higher-cost plans may include more providers or broader benefits, but that doesn’t mean they’re better for your situation. The right plan balances cost, convenience, and what you actually use.
What are the pros and cons of employer vs. private insurance?
Employer plans often cost less per month but may limit provider choice or coverage depth. Private plans give you more control and portability—especially useful for freelancers or self-employed professionals.
How does coverage differ between individual and family plans?
Family plans include multiple people under one policy and may offer bundled discounts. Individual plans cover one person and often have lower premiums but no shared benefits.
Are short-term plans a good alternative to full coverage?
They can be helpful for temporary gaps in coverage, but short-term plans often exclude pre-existing conditions and certain benefits. For consistent care, we typically recommend a full-term policy.
Do you offer side-by-side plan comparisons?
Yes—we provide comparison tools and personalized summaries to help you understand the differences between plans at a glance. You’ll see coverage limits, deductibles, provider access, and costs clearly outlined.
What’s included in your personalized plan consultation?
We’ll review your goals, location, budget, and preferences—then walk you through plan options in plain language. There’s no pressure to enroll, just a friendly guide to smart coverage.
Plan Comparison FAQs
What’s the difference between PPO and HMO insurance plans?
PPO (Preferred Provider Organization) plans offer more flexibility—you can see specialists without referrals and choose out-of-network providers (often at a higher cost). HMO (Health Maintenance Organization) plans typically require you to choose a primary provider and get referrals, but they’re usually more affordable.
Is it better to bundle dental, vision, and disability plans together?
Bundling can offer savings and simplify billing by combining all coverage into one plan or provider. It’s ideal for families or individuals who want streamlined benefits across multiple areas.
How do I know which plan is right for me?
Start by identifying your needs—like preventive dental care, routine eye exams, or income protection. Then consider your budget and preferred level of flexibility. Our team can help tailor a recommendation based on your lifestyle.
Can I upgrade my plan later if I need more coverage?
In most cases, yes. You may be able to upgrade during annual enrollment or after a qualifying event. Some supplemental policies allow changes year-round.
Do more expensive plans always offer better coverage?
Not necessarily. Higher-cost plans may include more providers or broader benefits, but that doesn’t mean they’re better for your situation. The right plan balances cost, convenience, and what you actually use.
What are the pros and cons of employer vs. private insurance?
Employer plans often cost less per month but may limit provider choice or coverage depth. Private plans give you more control and portability—especially useful for freelancers or self-employed professionals.
How does coverage differ between individual and family plans?
Family plans include multiple people under one policy and may offer bundled discounts. Individual plans cover one person and often have lower premiums but no shared benefits.
Are short-term plans a good alternative to full coverage?
They can be helpful for temporary gaps in coverage, but short-term plans often exclude pre-existing conditions and certain benefits. For consistent care, we typically recommend a full-term policy.
Do you offer side-by-side plan comparisons?
Yes—we provide comparison tools and personalized summaries to help you understand the differences between plans at a glance. You’ll see coverage limits, deductibles, provider access, and costs clearly outlined.
What’s included in your personalized plan consultation?
We’ll review your goals, location, budget, and preferences—then walk you through plan options in plain language. There’s no pressure to enroll, just a friendly guide to smart coverage.
Location-Specific FAQs
Does coverage vary by state?
It can. Factors like provider availability, waiting periods, and eligibility rules often vary due to state insurance regulations. Each state page outlines what makes your region unique.
Can I keep my coverage if I move to a new state?
In many cases, yes. You may need to switch plans or update provider networks, but coverage can often transfer. Contact our team before you relocate to ensure a smooth transition.
How do I find in-network providers near my zip code?
Use our provider search tool to locate dentists, optometrists, and specialists based on your city or zip code. It’s updated regularly and includes location-based filtering.
Are there state-specific enrollment deadlines?
While supplemental plans like dental and vision often have flexible enrollment, some states enforce timelines for disability or combined policies. We’ll flag any important dates during signup.
Do benefits comply with my state’s insurance laws?
Yes—all our coverage options meet local compliance standards. We work with licensed carriers and ensure every plan fits your state’s regulatory framework.
Can I get bundled coverage across multiple states?
If you're a household or business with members in different states, we’ll help coordinate multi-state coverage while keeping billing and support centralized.
Are plan recommendations personalized to my location?
Absolutely. We tailor plan recommendations based on your address, preferred providers, and local regulations—so what you see matches your real-world options.
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