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HEALTH INSURANCE Facts


What is Health Insurance?
Since the inception of the Affordable Care Act, every health insurance company must cover specific essential healthcare services. More than this, health insurance companies are your biggest wellness advocate dedicated to improving members’ overall health and peace of mind by facilitating access to affordable, high-quality health insurance. Accessing health insurance doesn’t stop here. Health insurance companies are committed to offering high-quality, value-added services, tools and information as part of your health insurance plan. There’s no reason to break the bank in finding your best coverage. Quality health insurance gives you the road map to living your best life at a price you can afford.

What is the Exchange?
The exchange is your connection to health insurance. The goal is to increase affordable health insurance coverage for all residents through a transparent, customer-friendly experience. Individuals or families can compare health insurance options, purchase health insurance, and determine if you are eligible for financial assistance when paying for health insurance coverage. Individuals who do not receive health insurance coverage through their jobs qualify to use the exchange. When you’re ready to determine your tax credit eligibility, our qualified health insurance agents will help you compare plan costs and tax credits. Health insurance is only a click away!

Health Insurance Rates in 2018
In 2018, premiums are likely to increase but you will still have access to health insurance. The good news is that the percentage of people able to find health insurance plans will increase due to increased subsidies with more generous plans to choose from. What does this mean for you? You will more than likely see an increase in your monthly premium, which is the amount you pay your health insurance company every month to maintain your health insurance coverage. There are unavoidable costs the ACA recognizes and governs to cover to stay on the forefront of healthcare innovation. This premium increase covers increased costs of care, particularly prescription drug costs and care provided by specialists, as well as taxes mandated by the Affordable Care Act. While obtaining health insurance is a great start, there are things you can do to lower your own healthcare costs. You can use generic drugs, go to in-network doctors, seek the right level of care, and stay healthy. Still have questions? Call one of our qualified health insurance agents.

Is there a “fine” for having a gap in health coverage?
Under ACA regulations, if you can afford health insurance but choose not to buy it, you may pay the “individual shared responsibility payment” (also known as the “penalty”, “fine”, or “mandate”). You may owe the fee for each month you, your spouse, or tax dependents don’t have qualifying coverage, also known as minimal essential coverage. You will be asked about your health care coverage when you file your taxes. Good news! Anyone with a gap in health coverage of TWO MONTHS or LESS can claim an exemption and not be charged the “fine”. However, if you have extended coverage gaps, you would pay the “fine” in one of two ways. You pay as a percentage of your household income or per person. You pay whichever is HIGHER. Calculating your “fine” can be confusing but our experienced health insurance agents can walk you through the process and answer your questions.

Tips For Finding Health Insurance Plans


Purchasing the Right Insurance
Finding the right health insurance plan that covers everything you need can be overwhelming. Whether you’re a first-time health insurance buyer or this is your fourth time switching plans, it’s important that you understand the differences in coverage and how specific benefits might impact your wallet. Being smart about choosing your health insurance plan can save you thousands of dollars and unnecessary pain and suffering. You have a lot of choices to make and to better help you with choosing your best health plan, consider the following tips.

Browsing and Comparing Prices
Chances are you wouldn’t commit to buying a home or vehicle without shopping around, comparing prices and asking a lot of questions prior to locking-in your best deal. Purchasing the right health insurance plan is no different. You will benefit from comparing at least 2-3 other plans before making your decision. Not all coverage is created equal. Some plans have higher monthly premiums, deductibles, and co-pays which will affect your spending plan. As you browse and compare different health plans, make sure you understand these terms and how much each plan will cost you for your actual medical needs.

Understanding Network Options
A provider network is a list of doctors, other health care providers, and hospitals that an insurance plan has contracted with to provide medical care to its members. Using a doctor that’s within your health plan network will save you money because the doctor has already contracted with your health plan to save you money. On the other hand, if you choose a doctor outside your network of doctors, be prepared to pay out-of-pocket for your medical services. If you want the option of keeping your own doctor or selecting a new one, then you would want a plan that offers a broader network of doctors to choose from. If your health care demands minimal medical supervision, you might choose a plan with a narrow network of doctors.

Coverage vs. Cost
When shopping for individual health insurance plans, most buyers base their decision on price alone. Even though affordability is a key factor, choosing a plan that optimally covers your actual medical needs should take precedence. Ask yourself “How many times do I plan to see the doctor this year?” or "Does this plan cover the cost of my medication(s)?”. You will save yourself money in the long run if you choose a plan that ensures your medical services are covered. Be sure to fully understand all available options and consider as many questions as possible when speaking to a licensed health insurance agent.

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