- Posted by Canopy KC
- On December 20, 2016
- 0 Comments
- ACA Special enrollment period, avoid costly health insurance, buy a health insurance plan, choose the right plan, kansas city, premiums
There are many questions associated with buying health insurance and it seems that the answers as well as laws are continually changing. However, the most FAQ about buying individual health insurance seem to remain the same, Who, What/How, When and Where. Questions are fantastic because it means you are doing your research, and knowledge is power when it comes to deciding on health insurance. Keep reading to find the answers to the FAQ about buying individual health insurance.
Yes! It is no secret that healthcare is expensive and medical surprises don’t tell you when they are going to drain your savings account. By purchasing health insurance, even at a minimum, you are securing a contract with an insurance company stating that some or all of your medical bills will be covered. Also, this fact is old news but worth mentioning again, every person is required by law to have health insurance or face a standardized tax penalty of 2.5% of your annual income per adult or $695 and $347.50 per child (healthcare.gov) as of 2016. If you are over the age or 26, regardless of school or employment status, you can no longer be on your parent’s health insurance plan.
What/How: What does health insurance cover and how does it work?
This will depend largely on the type of policy that you purchase either through your employer, private coverage, Affordable Care Act, Medicare or Medicaid. Generally speaking, the majority of policies require a monthly premium to be paid to purchase the policy. Each policy is associated with out of pocket expenses including your deductible, copay, and coinsurance.
- Copay: Fixed dollar amount that you must pay for direct services and doctor visits.
- Deductible: Dollar amount that you must pay out of pocket for both individual and family medical care prior to sharing the cost with your insurance company. This sharing is called, coinsurance.
- Coinsurance: Percentage you are still responsible for after your deductible has been met. For example, 20% coinsurance means that your insurance company will pay 80% of covered medical services after your deductible has been met and you are responsible for the remaining 20%.
- Financial assistance or tax credits may be available if you qualify through the Affordable Care Act. Subsidy eligibility is based on income and eligible dependents and can only be accessed through The Federal Marketplace.
When: When can I purchase or change my health insurance?
Now! The open enrollment period for 2017 began November 1, 2016, and ends January 31, 2017, and when you enroll or change your plan in the month will affect your coverage start date.
- Medicare’s Open Enrollment period for 2017 began October 15, 2016, and ends December 7, 2016.
- Medicaid or other federally funded state insurance programs do not apply and have a specific open enrollment period unique to those programs.
- Special Open Enrollment Period: The exception to the open enrollment period rule is if you experience a life changing qualifying event. Some examples include a change in marital status including marriage or divorce, a change in dependents including birth, death or adoption, a change in employment, or a move to another state. Qualifying events open a special enrollment period where you can purchase a new health insurance plan or make changes to an existing plan.
Where: Where do I purchase an insurance plan?
- Direct from insurance company: You can call direct to the insurance company and speak to a representative (not licensed broker or agent) or compare and contrast plans on the company website. In this situation, your options are limited to that company only.
- The Marketplace: Every State has an online Marketplace or website with subsidized health insurance plans, but the official Federal Marketplace website is www.healthcare.gov. There are tools available online to assist you in this process but it can be confusing.
- Licensed Insurance Brokers or Agents like those at Canopy have access to compare multiple plans from different carriers in this region and will assist you in determining the best option for individual or family health care coverage. An added benefit to the customer service you receive is that there is no out of pocket cost paid to the broker from you when deciding on health insurance.
At Canopy, we are here to help you make informed decisions about your health insurance coverage, stay on top of deadlines, and even navigate healthcare.gov if that’s what you need. There isn’t a FAQ about buying individual health insurance that we can’t help find an answer to. We mean it when we say that at Canopy, “You’re Covered.”